US20120059370A1 - Surgical ablation and pacing device - Google Patents

Surgical ablation and pacing device Download PDF

Info

Publication number
US20120059370A1
US20120059370A1 US13292795 US201113292795A US2012059370A1 US 20120059370 A1 US20120059370 A1 US 20120059370A1 US 13292795 US13292795 US 13292795 US 201113292795 A US201113292795 A US 201113292795A US 2012059370 A1 US2012059370 A1 US 2012059370A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
tip
electrodes
device
tissue
pacing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US13292795
Inventor
Salvatore Privitera
Keith Edward Martin
Michael Dawson Hooven
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
AtriCure Inc
Original Assignee
AtriCure Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1402Probes for open surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00026Conductivity or impedance, e.g. of tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00039Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A61B2017/00044Sensing electrocardiography, i.e. ECG
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00375Ostium, e.g. ostium of pulmonary vein or artery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1495Electrodes being detachable from a support structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/04Detecting, measuring or recording bioelectric signals of the body or parts thereof
    • A61B5/0402Electrocardiography, i.e. ECG
    • A61B5/0408Electrodes specially adapted therefor
    • A61B5/042Electrodes specially adapted therefor for introducing into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode

Abstract

A surgical device has an integral first tip having pair of electrodes configured to ablate tissue using electric energy. A second tip has a pair of electrodes configured to provide pacing signals to a heart and/or to sense electrical signals passing through heart tissue. The second tip is configured to snap onto the first tip, such that the same device may be used for ablation, pacing, and sensing. Alternatively, the second tip may be integral with the device and the first tip configured to snap onto the second tip. Alternatively, a single integral tip of the surgical device may be used for ablation, pacing, and sensing. Such a multipurpose tip may comprise a plurality of electrode pairs or an array of electrodes. A user interface on the device or elsewhere may be operable to provide selectable modes for selectively varying properties of signals communicated to the electrodes.

Description

    PRIORITY
  • This application is a continuation-in-part of U.S. Non-Provisional patent application Ser. No. 11/037,543, filed Jan. 18, 2005, entitled “Surgical Ablation Device,” the disclosure of which is incorporated by reference herein. This application also claims priority to U.S. Provisional Patent Application Ser. No. 60/699,679, filed Jul. 15, 2005, entitled “Ablation Device with Sensor,” the disclosure of which is incorporated by reference herein.
  • BACKGROUND
  • The present invention relates to surgical instruments, with examples relating to cardiovascular pacing devices, systems for controlling such devices, and methods for using such devices. “Surgery” generally refers to the diagnosis or treatment of injury, deformity, disease, or other conditions. In a variety of surgical procedures, it may be desirable to stimulate the heart using a pulsed current via a bi-polar probe or other device. Such pacing may be desirable, for instance, after an ablation procedure has been performed on a heart in order to determine how successful the ablation was. Accordingly, it may be desirable to provide a device operable for use in both ablation and pacing procedures. The foregoing examples are merely illustrative and not exhaustive. While a variety of techniques and devices have been used to pace the heart of a patient or perform other procedures, it is believed that no one prior to the inventors has previously made or used an invention as described in the appended claims.
  • BRIEF DESCRIPTION OF DRAWINGS
  • While the specification concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
  • FIG. 1 illustrates a perspective view of an example of an ablation device;
  • FIG. 2 illustrates a perspective detailed view of the head of the ablation device of FIG. 1;
  • FIG. 3 illustrates an exploded view of the head of the ablation device of FIG. 1;
  • FIG. 4 illustrates a cross-sectional view of the head of the ablation device of FIG. 1;
  • FIG. 5 illustrates a perspective view of an example of a pacing tip configured to engage the head of the ablation device of FIG. 1;
  • FIG. 6 illustrates a partial cross-sectional view of the pacing tip of FIG. 5 prior to engagement with the head of the ablation device of FIG. 1;
  • FIG. 7 illustrates a partial cross-sectional view of the pacing tip of FIG. 5 engaged with the head of the ablation device of FIG. 1;
  • FIG. 8 illustrates a partial left lateral view of a patient's heart;
  • FIG. 9 illustrates a partial right lateral view of the heart of FIG. 8;
  • FIG. 10 illustrates a perspective view of an alternative head tip configured to engage the head of the ablation device of FIG. 1;
  • FIG. 11 illustrates a frontal view of an alternative head tip that may be used in addition to or in lieu of the head tips of FIGS. 1-7 or 10;
  • FIG. 12 illustrates a frontal view of an alternative head tip that may be used in addition to or in lieu of the head tips of FIGS. 1-7 or 10-11; and
  • FIG. 13 illustrates a frontal view of an alternative head tip that may be used in addition to or in lieu of the head tips of FIGS. 1-7 or 10-12.
  • DETAILED DESCRIPTION
  • The following description of certain examples of the invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the invention. As will be realized, the invention is capable of other different and obvious aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
  • FIG. 1 illustrates an example of an ablation device (10). The ablation device (10) in this embodiment comprises a handheld wand. The ablation device (10) includes a head (12) connected to the distal end of a shaft (14), and a handle (16) connected to the proximal end of the shaft (14). As shown here, the shaft (14) is straight and substantially rigid; however, flexible, curved, malleable, articulated, or other shafts could also be used depending on a variety of considerations. A power source (not shown) is connected to the cord (18) in the present example.
  • FIG. 2 illustrates an more detailed view of the head (12) of the ablation device (10). The head (12) includes a tip portion (19) having two electrodes (22), which are capable of being energized with bi-polar energy. In the present example, each electrode (22) includes a smooth surface area for contacting tissue. Each electrode (22) is slender in the sense that the length of the tissue contacting surface is at least 4 times its width. As shown in the present example, the length is between about 5 to 7 times the width. Of course, any other suitable configuration for electrodes (22) may be used.
  • The electrodes (22) in this example are substantially parallel to one another, and as shown here the electrodes (22) are spaced between about 2 to 4 mm from one another. It will be appreciated, however, that these dimensions are merely exemplary. An electrically insulative surface (32) is interposed between the electrodes (22). In this example, the surface (32) is convex between the electrodes (22), distally extending about 0.01 inches from the lateral plane between the electrodes (22). Again, though, any other suitable dimensions may be used. As shown in the figures, a portion of the tip portion (19) of the head (12) is curved along the transverse axis. In the present example, the curved end is an arc with a radius between 0.19 and 0.21 inches. The electrodes (22) and surface (32) have similar curves. An electrically insulative sheath (40) covers other portions of the head (12). Other suitable configurations will be apparent to those of ordinary skill in the art.
  • FIGS. 3 and 4 illustrate some component parts of the head (12) and some related structures. A rib (33) extends distally from the shaft (14). Electrical wires in communication with the cord (18) pass through the shaft (14) and end with electrical terminals (37). A pair of electrical insulators (30) laterally connect to either side of the rib (33). The distal tips of the insulators (30) define the insulative surface (32). A post (hidden in this view) on the right insulator (30) mates with the holes (35, 34). A receiving structure (38) is dimensioned to hold the terminals (37) in their desired positions.
  • Two conductors (20) laterally connect with the insulators (30). In the present example, each conductor (20) is a contiguous and unitary part; however, two or more components could form the conductor (20). Also in this example, each conductor (20) is a homogeneous material. Each conductor (20) includes an electrode (22) and heat sink (24). Each conductor has a recess (28) dimensioned to snugly receive the corresponding terminal (37), thus facilitating electrical contact with the terminal (37). The sheath (40) covers the assembled head (12). Posts (42, 36) mate with the holes (26) in the conductor (20) to facilitate and maintain alignment of the assembly. The distal ends of the conductors (20), bounded by the surface (32) and the sheath (40), define the surface areas of the electrodes (22).
  • The conductor (20) in this example is electrically conductive, thus facilitating the flow of current from the terminal (37) to the electrode (22). The conductor (20) in this example is also thermally conductive, thus facilitating the flow of heat from the electrode (22) to the heat sink (24). Some suitable materials for the conductor (22) include, without limitation, copper, silver, gold, platinum, titanium, aluminum, beryllium, nickel, and the like. In one variation, the heat sink (24) is copper while the electrode (22) is gold plated. The heat sink (24) has a volume, which in this example is the volume of the conductor (20). Preferably, the ratio of tissue contacting surface area of the electrode (22) to volume of the heat sink (24) is less than about 3 in2/in3. In the present example, the ratio is less than about 1 in2/in3. Any other suitable ratio may be used.
  • One illustrative use of the device (10) is during surgery to ablate tissue. The surface area of the electrodes (22) are placed in contact with the tissue surface. The electrodes (22) are energized with bi-polar energy by connecting the device (10) to an electric power source. As one with ordinary skill in the art will readily appreciate, RF energy is transmitted to the tissue through the electrodes (22), thus heating the tissue until ablated and a desired lesion is formed in the tissue. Optionally, the head (12) may be swiped over the tissue surface, either laterally or transversely, while maintaining the electrodes (22) in contact with the tissue to ablate larger areas or to ablate the tissue in a desired pattern. Other methods of using the device (10) will be apparent to those of ordinary skill in the art. The heat sink (24) draws heat away from the tissue during the ablation process, thus reducing the temperature elevation of the tissue surface. The temperature reduction may provide the benefit (among other benefits) of facilitating deeper and more controlled lesions, including, when desired, transmural lesions through a tissue wall.
  • It will be appreciated that creating an ablation in tissue with the device (10) may provide a barrier to electrical signals that may otherwise be communicated across the ablated tissue. By way of example only, such a barrier may provide a form of treating atrial fibrillation or other conditions. For instance, where atrial fibrillation is caused by aberrant or erratic electrical signals coming from one or more pulmonary veins to one or both atria of the heart, an ablation may be provided as a barrier between such veins and atria. In other words, one or more ablations may serve to electrically isolate one or more pulmonary veins from the atria. By preventing or substantially preventing aberrant or erratic electrical signals coming from one or more pulmonary veins from reaching the atria, a more desirable sinus rhythm may be maintained. Of course, any other tissues or anatomical structures may be ablated for any reason.
  • FIGS. 5 through 7 illustrate a pacing tip (100) configured to engage the head (12) of the device (10). The pacing tip (100) comprises a pair of electrodes (122), an insulative face (132), an upper clipping portion (140), a lower clipping portion (142), and a pair of sidewalls (144) extending between the upper and lower clipping portions (140, 142). The upper clipping portion (140) comprises a pair of gaps (146), which are configured to permit some motion of upper clipping portion (140) relative to sidewalls (144). Such gaps (146) may facilitate engagement and disengagement of pacing tip (100) with the head (12) of the device (10). Each of the electrodes (122) comprises a respective leaf spring portion (124). As shown in FIGS. 6 and 7, the upper and lower clipping portions (140, 142) are configured to “snap on” to the head (12) of the device (10). Each of the leaf spring portions (124) is configured to engage a respective electrode (22) on the head (12) when the pacing tip (100) is snapped onto the head (12). The leaf spring portions (124) are further configured to provide electrical continuity between the electrodes (22) of the head (12) and the electrodes (122) of the pacing tip (100). It will be appreciated that, to the extent that the electrodes (122) of the pacing tip (100) are not aligned with the electrodes (22) of the head (12), the leaf spring portions (124) may still be configured to provide electrical continuity between the electrodes (122, 22). It will also be appreciated that leaf spring portions (124) are not necessarily required, and that any other suitable structures or features configured to provide electrical continuity between the electrodes (122, 22) may be used.
  • As shown, the electrodes (122) of the pacing tip (100) are spaced apart further than the electrodes (22) of the head (12). For instance, the electrodes (122) may be spaced anywhere from approximately 2 mm apart to approximately 5 mm apart. In the present example, the electrodes are spaced apart approximately 3 mm. Of course, any other suitable electrode (122) spacing may be used. In addition, the electrodes (122) of the pacing tip (100) of the present example are each relatively narrower and shorter than the corresponding electrodes (22) on the head (12). It is contemplated that a variety of pacing tips (100) may be made and used having a variety of electrode (122) spacings, dimensions, and configurations. A few of such alternative electrode (122) configurations will be described in greater detail below. It is further contemplated that such a variety of pacing tips (100) may all be similarly engageable with the head (12), providing a modular selection of pacing tips (100) available for user selection based on ideal electrode (122) configurations for a particular use or based on other considerations.
  • In one exemplary use, the pacing tip (100) is secured to the head (12) of the device (10), and the electrodes (122) are positioned on tissue adjacent the pulmonary veins of a patient's heart. As will be described in greater detail below, a pacing signal is then sent to the tissue via the electrodes (122) until an effect on the heart of the patient (e.g., an increase in the heartbeat rate) is observed. The pacing tip (100) us then removed from the head (12), and the pacing tip (100) and head (12) are both cleaned. Next, the device (10) is used to ablate tissue between the pulmonary veins and heart atria (e.g., using electrodes (22) as described above), providing an ablation line in the tissue. Of course, such a “line” need not be straight, and may comprise a curve or pattern, etc. The head (12) is then cleaned again, and the pacing tip (100) is snapped back onto the head (12) of the device (10). With the pacing tip (100) secured to the head (12), the electrodes (122) are again positioned on tissue adjacent the pulmonary veins of the patient's heart. For instance, the electrodes (122) may be positioned in approximately the same location at which they were positioned previously during the prior act of pacing. The pacing signal that had previously produced an observed effect on the heartbeat rate of the patient is again sent to the tissue via the electrodes (122). To the extent that the same signal no longer produces the same effect, the success of the ablation may be confirmed. In other words, this subsequent act of pacing may be used to verify whether the ablated tissue provides sufficient electrical resistance. Conversely, if the same pacing signal produces the same effect that it had before (or some other unsatisfactory effect), the ablation steps may be performed again, then checked again with the pacing steps until satisfactory results are achieved.
  • It will be appreciated that any of the foregoing steps may be varied, substituted, supplemented, or omitted. For instance, the initial step of pacing may be omitted. In addition, the second act of pacing may comprise the use of a pacing signal having properties that differ from the prior pacing signal (e.g., higher voltage, higher frequency, etc.). The success of an ablation may also be checked or verified using any suitable techniques other than pacing. Still other ways in which the exemplary method may be modified will be apparent to those of ordinary skill in the art.
  • As noted above, the device (10) may be used in a pacing mode to deliver a low frequency signal via the electrodes (122) to verify that the ablation has provided a satisfactory conduction block or other sufficient amount of electrical resistance in the tissue. By way of example only, such pacing may include the stimulation of the tissue with a pulsed current via the electrodes (122) of the pacing tip (100). In the context of use on heart tissue, if the heart does not respond to an initial pulsed current, the current may be increased until the heart responds to the stimulation. A response to stimulation may be detected using, by way of example only, an ECG, visual observation to detect an increase in heart rate, and/or by using any other suitable technique. Accordingly, it will be appreciated that, after placing an ablation line on the tissue, the user may verify sufficient conduction block by showing that the heart does not respond to the stimulus when placed on the other side of the electrically isolated line. By way of example only, the pacing signal may be anywhere from between approximately 1.0 to 2.5 Hz, at approximately 0.5 to 10.0 volts, with a current ranging from approximately 0.1 mA to 20.0 mA, at a 500 ohm load. In one embodiment, a signal is varied between approximately 1 to 2 Hz and approximately 0.5 to 2.0 volts. Other signal parameters suitable for pacing may be used, as will be apparent to those of ordinary skill in the art.
  • While the present example discusses the use of the device (10) to perform pacing, it will be appreciated that a variety of other devices may be used to perform pacing. In particular, like device (10), these other devices may be capable of performing both ablation and pacing, with or without modification of the structure of such devices. For instance, a bi-polar clamp used for ablation may also be used for pacing. By way of example only, any of the bi-polar clamps disclosed in U.S. Non-Provisional patent application Ser. No. 11/254,075, entitled “Articulated Bi-Polar Clamp,” filed Oct. 19, 2005, the disclosure of which is incorporated by reference herein, may be used to perform pacing in a manner similar to that described above.
  • In a high frequency stimulation mode, the device (10) may be used to identify specific anatomical structures, including but not limited to terminations of the sympathetic and parasympathetic nervous systems located in the fat pads on and around the heart. Examples of such structures are shown in FIGS. 8 and 9, which depict portions of a heart (600). In particular, FIG. 8 shows the right atrium (602) with superior vena cava (610) and inferior vena cava (612); the left atrium (604) with right superior pulmonary vein (608) and right inferior pulmonary vein (606); and Waterston's groove (622). FIG. 9 shows the left ventricle (603), the left atrium (604) with left atrial appendage (605), left superior pulmonary vein (616), left inferior pulmonary vein (618), and Ligament of Marshall (620); and pulmonary artery (614). FIGS. 8 and 9 also depict autonomic ganglia, which are present on the epicardial surface of the right atrium (602) and left atrium (604), and comprise the anterior right ganglionated plexus (626), the superior left ganglionated plexus (634), the inferior right ganglionated plexus (628), the inferior left ganglionated plexus (636), the SVC-RA ganglionated plexus (630), and the crux ganglionated plexus (624). As shown, the anterior right ganglionated plexus (626) is located anterior to the right pulmonary veins (606, 608). The superior left ganglionated plexus (634) is located between the superior surface of the left atrium (604) (near the base of the left superior pulmonary vein (616)) and the pulmonary artery (614), in close proximity to the site of insertion of the Ligament of Marshall (620) into the pericardium. The inferior right ganglionated plexus (628) is located inferior to the right inferior pulmonary vein (606), at the bottom of the antrum of the right pulmonary veins (606, 608). The inferior left ganglionated plexus (636) is located inferior to the left inferior pulmonary vein (618), at the bottom of the antrum of the left pulmonary veins (616, 618). The SVC-RA ganglionated plexus (630) is located at the medial aspect of the junction of the superior vena cava (610) and right atrium (602). The crux ganglionated plexus (624) is located at the crux of the heart (600) between the right atrium (602) and left atrium (604), close to the coronary sinus ostium (not shown) and inferior vena cava (612). Those of ordinary skill in the art will appreciate that the locations of the ganglionated plexi (626, 628, 630, 632, 634, 636) may vary somewhat relative to FIGS. 8 and 9 for a given patient. Furthermore, it will be appreciated that, using high frequency stimulation, the device (10) may be used to identify or localize these ganglionated plexi (626, 628, 630, 632, 634, 636).
  • By way of example only, the stimulation signal used to identify the ganglionated plexi (626, 628, 630, 632, 634, 636) may be anywhere from between approximately 13 to 25 Hz, at approximately 1 to 12 volts, with a current ranging from 2 to 24 mA, at a 500 ohm load, with a pulse width between approximately 0.02 and 9 ms. In one embodiment, a signal is varied between approximately 15 to 20 Hz at approximately 10 volts. Other signal parameters suitable for stimulation may be used, as will be apparent to those of ordinary skill in the art. When administered close to or adjacent to a ganglionated plexus (626, 628, 630, 632, 634, or 636), a stimulation signal may produce a vagal response identified by a marked lengthening of the R-R interval during atrial fibrillation.
  • Having identified any of the ganglionated plexi (626, 628, 630, 632, 634, 636) using stimulation with the device (10), the device (10) may then be used to ablate any or all of the identified ganglionated plexi (626, 628, 630, 632, 634, 636). Endocardial ablation at or near such sites may eliminate the vagal response to stimulation and high frequency fractionated potentials in such areas during stimulation. Ablation of the Ligament of Marshall (620) may also reduce the likelihood of atrial fibrillation. Other suitable ablations sites will be apparent to those of ordinary skill in the art. Similarly, other anatomical structures that may be identified by stimulation with device (10) will be apparent to those of ordinary skill in the art.
  • In a sensing mode, rather than being used to deliver a signal to the heart, the device (10) is used to measure small signal electrograms at various points on the heart. These may be low frequency, low amplitude signals. To the extent that these signals may vary by location on the heart, it will be appreciated that a point contact may offer sufficient spatial resolution to discriminate between various signals. A sensing mode may therefore permit a user to identify the approximate location of particular anatomical structures or features based on sensed signals received through the device (10). Sensing (e.g., with device (10)) may also be useful in assessing the performance of a conduction block (e.g., one created through ablation with device (10)). For instance, prior to ablation, electrodes (122) may be placed on an area to be isolated through ablation, and the signal sensed at the area may be noted or recorded. After the area is isolated through ablation, the electrodes (122) may again be placed on the same area and compare the sensed signal reading to the one noted or recorded prior to ablation. By way of example only, where pulmonary veins (606, 608, 616, or 618) are conductively isolated through ablation, electrodes (122) may be placed on such pulmonary veins (606, 608, 616, or 618) after the ablation to see of electrical activity of the corresponding atrium (604 or 604) can be sensed. The success of the ablation may be judged by the degree to which the electrical activity of the atrium (604 or 604) can be sensed in the corresponding pulmonary veins (606, 608, 616, or 618). Other suitable targets for sensing, and ways in which sensing may be used, will be apparent to those of ordinary skill in the art.
  • In one example, the spacing between electrodes (122) on pacing tip (100) for use during sensing is approximately 2 mm. Of course, and other suitable spacing for electrodes (122) may be used. Similarly, any other suitable method for identifying the approximate location of particular anatomical structures or features may be used.
  • Where the device (10) is in communication with a power source (not shown) via the cord (18), the power source may comprise a user interface operable to receive user input indicating a particular task that the user intends to perform with the device (10). The power source may then communicate an appropriate signal to the electrodes (22, 122) in accordance therewith. Alternatively, the device (10) and/or power source may comprise a logic that is configured to detect the presence of a particular tip (e.g., the pacing tip (100)) secured to the head (12) of the device (10), and may automatically vary the signal based on the detected tip. One exemplary power source that may be used with the device (10) is described in U.S. Provisional Patent Application Ser. No. 60/699,664, entitled “Matrix Router,” filed Jul. 15, 2005, the disclosure of which is incorporated by reference herein. In yet another version, a user interface is provided on the device (10) for a user to select a particular mode of use. To the extent that a user interface is used, regardless of its location, the user interface may be operable to provide to the electrodes (22, 122) a signal having suitable parameters for a particular mode of use indicated by the user through the user input.
  • In another embodiment, the device (10) is configured such that the electrodes (22) may be used for both ablation and pacing, such as by merely changing the power output to the electrodes (22). It will therefore be appreciated that pacing and ablation may both be provided without the need to remove or secure a separate tip (e.g., the pacing tip (100) of FIGS. 5-7) from or to the head (12) of the device (10). Similarly, the electrodes (22) may be configured to permit use for all of ablation, pacing, stimulation, sensing, and any other tasks.
  • In yet another embodiment, the device (10) is varied such that the electrodes (122) of the pacing tip (100) are integral with the head (12). In one version of this embodiment, a separate ablation tip (not shown) is configured to selectively engage the pacing tip (100), such as by snapping onto the pacing tip (100) portion of the head (12). Such a separate ablation tip may also comprise a functional equivalent to the leaf spring portions (124) to provide electrical continuity between the pacing electrodes (122) and the ablation electrodes (22). In another version of this embodiment, the head (12) comprises two or more pairs of electrodes, each pair being dedicated to a particular task. For instance, a first pair of electrodes (22) may be dedicated to ablation, with a second pair of electrodes (122) being dedicated to pacing. In this version, the device (10) may be operable to electrically address a particular pair or set of electrodes (e.g., 22 or 122) in accordance with selections made by a user. By way of example only, such electrode selections may be made by a user via a user interface on the device (10) or a user interface on a separate control unit. Electrode selections may also be provided automatically based on a user's selection of a task to be performed via a user interface.
  • A few non-exhaustive examples of alternative tip designs are shown in FIGS. 10-13. Any of these alternative tip designs may be implemented integrally with the head (12), or may be provided in a removable tip (e.g., similar to pacing tip (100)).
  • FIG. 10 shows a tip (500) having a pair of electrode prongs (502). In this embodiment, electrode prongs (502) are operable in a manner similar to electrodes (22 or 122) described above, with the difference being that electrode prongs (502) extend substantially from face (132) of tip (500). Thus, it will be appreciated that electrode prongs (502), or any suitable variation thereof, may be used to ablate, pace, sense, stimulate, or perform any other task. It will also be appreciated, particularly where electrode prongs (502) are substantially integral with head (12), that extension of electrode prongs (502) may be adjustable (e.g., via a lever, slider, or other input in handle 16). A user may therefore selectively adjust the amount of is extension of electrode prongs (502) as desired.
  • FIG. 11 shows a tip (200) having a plurality of electrodes (222) disposed about a non-conductive face (232). FIG. 12 shows another tip (300) having a plurality of electrodes (322) disposed about a non-conductive face (332). FIG. 13 shows yet another tip (400) having a matrix or array of electrodes (422) disposed about a non-conductive face (432). It will be appreciated that each electrode (222, 322, 422) may extend from their respective face (232, 332, 432) to a degree similar to the extension of electrodes (122) from face (132) (e.g., generally co-planar with face (132) or a few millimeters from face (132)). Alternatively, each electrode (222, 322, 422) may extend substantially from their respective face (232, 332, 432) in a manner similar to the extension of electrode prongs (502) from face (132) of tip (500). Other suitable degrees of extension will be apparent to those of ordinary skill in the art.
  • It will also be appreciated that, in the versions shown in FIGS. 11-13, each electrode (222, 322, 422) of a plurality may be individually electrically addressable (e.g., in accordance with user selections or automatic selections). It will also be appreciated that electrodes (222, 322, 422) may be addressable in pairs or sets. Suitable structures and techniques for addressing electrodes (222, 322, 422), as well as selections of electrodes (222, 322, 422) for being addressed in particular circumstances, will be apparent to those of ordinary skill in the art. In addition, it will be appreciated that any other suitable number or configuration of electrodes may be used.
  • Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.

Claims (5)

  1. 1-18. (canceled)
  2. 19. A method of treating atrial fibrillation with,
    a surgical device having a head, wherein the head of the device comprises a first tip having electrodes operable to communicate electrical signals the method comprising:
    a) using the device to ablate tissue between one or more pulmonary veins of a patient's heart and one or both atria of the patient's heart, wherein the tissue ablated as a result of the act of using the device to ablate tissue substantially electrically insulates the one or more pulmonary veins from the one or more atria; and
    b) verifying whether the ablated tissue provides sufficient electrical resistance, wherein the act of verifying comprises:
    i) using the device to provide a pacing signal to a first tissue region proximate to a side of the ablated tissue, wherein the first tissue region is adjacent to the one or more pulmonary veins, and
    ii) observing the heart of the patient for heartbeat rate increase in response to the pacing signal; and
    c) securing a second tip onto the head of the surgical device adjacent to the first tip, wherein the second tip has electrodes operable to communicate electrical signals, wherein the act of securing on a second tip is performed either:
    i) before the act of using the device to ablate tissue, wherein the electrodes of the second tip are configured to ablate tissue, or
    ii) between the act of using the device to ablate tissue and the act of using the device to provide a pacing signal, wherein the electrodes of the second tip are configured to pace a heart.
  3. 20. (canceled)
  4. 21. The method of claim 19 further comprising applying the electrodes to the patient's heart and applying high frequency stimulation signals to identify specific anatomical structures.
  5. 22. The method of claim 19 further comprising contacting the electrodes to the pulmonary veins after ablation to sense the electrical activity of the corresponding atrium.
US13292795 2005-01-18 2011-11-09 Surgical ablation and pacing device Abandoned US20120059370A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
US11037543 US20060161149A1 (en) 2005-01-18 2005-01-18 Surgical ablation device
US69967905 true 2005-07-15 2005-07-15
US11363707 US7828795B2 (en) 2005-01-18 2006-02-28 Surgical ablation and pacing device
US12902851 US8057471B2 (en) 2005-01-18 2010-10-12 Surgical ablation and pacing device
US13292795 US20120059370A1 (en) 2005-01-18 2011-11-09 Surgical ablation and pacing device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US13292795 US20120059370A1 (en) 2005-01-18 2011-11-09 Surgical ablation and pacing device

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US12902851 Continuation US8057471B2 (en) 2005-01-18 2010-10-12 Surgical ablation and pacing device

Publications (1)

Publication Number Publication Date
US20120059370A1 true true US20120059370A1 (en) 2012-03-08

Family

ID=38335769

Family Applications (3)

Application Number Title Priority Date Filing Date
US11363707 Active 2027-09-07 US7828795B2 (en) 2005-01-18 2006-02-28 Surgical ablation and pacing device
US12902851 Active US8057471B2 (en) 2005-01-18 2010-10-12 Surgical ablation and pacing device
US13292795 Abandoned US20120059370A1 (en) 2005-01-18 2011-11-09 Surgical ablation and pacing device

Family Applications Before (2)

Application Number Title Priority Date Filing Date
US11363707 Active 2027-09-07 US7828795B2 (en) 2005-01-18 2006-02-28 Surgical ablation and pacing device
US12902851 Active US8057471B2 (en) 2005-01-18 2010-10-12 Surgical ablation and pacing device

Country Status (2)

Country Link
US (3) US7828795B2 (en)
WO (1) WO2007100754B1 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2853214A1 (en) * 2013-09-29 2015-04-01 Covidien LP Medical treatment devices having adjustable length and/or diameter
CN104510527A (en) * 2013-09-29 2015-04-15 柯惠有限合伙公司 Medical treatment device adjustable in length and/or diameter

Families Citing this family (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5897553A (en) 1995-11-02 1999-04-27 Medtronic, Inc. Ball point fluid-assisted electrocautery device
US7399300B2 (en) 2001-12-04 2008-07-15 Endoscopic Technologies, Inc. Cardiac ablation devices and methods
US7591818B2 (en) * 2001-12-04 2009-09-22 Endoscopic Technologies, Inc. Cardiac ablation devices and methods
US20060161149A1 (en) * 2005-01-18 2006-07-20 Salvatore Privitera Surgical ablation device
US20060161147A1 (en) * 2005-01-18 2006-07-20 Salvatore Privitera Method and apparatus for controlling a surgical ablation device
US8034051B2 (en) * 2005-07-15 2011-10-11 Atricure, Inc. Ablation device with sensor
US7828795B2 (en) * 2005-01-18 2010-11-09 Atricure, Inc. Surgical ablation and pacing device
US20080161705A1 (en) * 2006-12-29 2008-07-03 Podmore Jonathan L Devices and methods for ablating near AV groove
US8641710B2 (en) 2007-11-12 2014-02-04 Intermountain Invention Management, Llc Magnetically coupling devices for mapping and/or ablating
US8100899B2 (en) 2007-11-12 2012-01-24 Ihc Intellectual Asset Management, Llc Combined endocardial and epicardial magnetically coupled ablation device
US8353907B2 (en) 2007-12-21 2013-01-15 Atricure, Inc. Ablation device with internally cooled electrodes
US8998892B2 (en) * 2007-12-21 2015-04-07 Atricure, Inc. Ablation device with cooled electrodes and methods of use
US8118809B2 (en) * 2007-12-21 2012-02-21 St. Jude Medical, Atrial Fibrillation Division, Inc. Flexible conductive polymer electrode and method for ablation
US20100152728A1 (en) * 2008-12-11 2010-06-17 Park Christopher J Method and apparatus for determining the efficacy of a lesion
CN102198013A (en) * 2010-03-25 2011-09-28 北京迈迪顶峰医疗科技有限公司 Ablation, mapping and pacing system, control device and RF ablation executing device
CN104066395B (en) 2011-12-15 2017-09-05 里兰斯坦福初级大学理事会 Apparatus and methods for treating pulmonary hypertension
US9827036B2 (en) 2012-11-13 2017-11-28 Pulnovo Medical (Wuxi) Co., Ltd. Multi-pole synchronous pulmonary artery radiofrequency ablation catheter

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5398683A (en) * 1991-05-24 1995-03-21 Ep Technologies, Inc. Combination monophasic action potential/ablation catheter and high-performance filter system
US6161543A (en) * 1993-02-22 2000-12-19 Epicor, Inc. Methods of epicardial ablation for creating a lesion around the pulmonary veins
US6164283A (en) * 1997-07-08 2000-12-26 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US6311692B1 (en) * 1996-10-22 2001-11-06 Epicor, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US20020107513A1 (en) * 2000-04-27 2002-08-08 Hooven Michael D. Transmural ablation device with thin electrodes
US20030093072A1 (en) * 2001-11-13 2003-05-15 Paul Friedman Tissue ablation device and methods of using
US20050080411A1 (en) * 2003-10-08 2005-04-14 Pentax Corporation Endoscope for high-frequency treatment
US20060293646A1 (en) * 2002-06-14 2006-12-28 Whayne James G Vacuum coagulation & dissection probes

Family Cites Families (54)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4026303A (en) 1975-11-17 1977-05-31 Vitatron Medical B.V. Endocardial pacing electrode
US4074718A (en) 1976-03-17 1978-02-21 Valleylab, Inc. Electrosurgical instrument
US5230349A (en) 1988-11-25 1993-07-27 Sensor Electronics, Inc. Electrical heating catheter
US5478347A (en) * 1990-10-05 1995-12-26 United States Surgical Corporation Endoscopic surgical instrument having curved blades
US5683366A (en) * 1992-01-07 1997-11-04 Arthrocare Corporation System and method for electrosurgical tissue canalization
US5484435A (en) * 1992-01-15 1996-01-16 Conmed Corporation Bipolar electrosurgical instrument for use in minimally invasive internal surgical procedures
US5558671A (en) 1993-07-22 1996-09-24 Yates; David C. Impedance feedback monitor for electrosurgical instrument
US6099524A (en) 1994-01-28 2000-08-08 Cardiac Pacemakers, Inc. Electrophysiological mapping and ablation catheter and method
US5967976A (en) 1994-08-19 1999-10-19 Novoste Corporation Apparatus and methods for procedures related to the electrophysiology of the heart
US5688267A (en) 1995-05-01 1997-11-18 Ep Technologies, Inc. Systems and methods for sensing multiple temperature conditions during tissue ablation
WO1996034567A1 (en) 1995-05-02 1996-11-07 Heart Rhythm Technologies, Inc. System for controlling the energy delivered to a patient for ablation
US5626578A (en) * 1995-05-08 1997-05-06 Tihon; Claude RF valvulotome
US5634924A (en) 1995-08-28 1997-06-03 Symbiosis Corporation Bipolar roller electrodes and electrocautery probes for use with a resectoscope
US6091995A (en) 1996-11-08 2000-07-18 Surx, Inc. Devices, methods, and systems for shrinking tissues
US7135033B2 (en) 2002-05-23 2006-11-14 Palomar Medical Technologies, Inc. Phototreatment device for use with coolants and topical substances
US5891140A (en) * 1996-12-23 1999-04-06 Cardiothoracic Systems, Inc. Electrosurgical device for harvesting a vessel especially the internal mammary artery for coronary artery bypass grafting
US6033399A (en) 1997-04-09 2000-03-07 Valleylab, Inc. Electrosurgical generator with adaptive power control
US6068627A (en) * 1997-12-10 2000-05-30 Valleylab, Inc. Smart recognition apparatus and method
US6162216A (en) 1998-03-02 2000-12-19 Guziak; Robert Andrew Method for biopsy and ablation of tumor cells
US5951471A (en) * 1998-03-09 1999-09-14 Irvine Biomedical, Inc. Catheter-based coronary sinus mapping and ablation
US6167291A (en) * 1998-03-12 2000-12-26 Cardima, Inc. Protected pin connector for an electrophysiology catheter
US6027500A (en) * 1998-05-05 2000-02-22 Buckles; David S. Cardiac ablation system
US6409722B1 (en) 1998-07-07 2002-06-25 Medtronic, Inc. Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue
US6086586A (en) 1998-09-14 2000-07-11 Enable Medical Corporation Bipolar tissue grasping apparatus and tissue welding method
US6398779B1 (en) 1998-10-23 2002-06-04 Sherwood Services Ag Vessel sealing system
US6436096B1 (en) 1998-11-27 2002-08-20 Olympus Optical Co., Ltd. Electrosurgical apparatus with stable coagulation
US6464696B1 (en) 1999-02-26 2002-10-15 Olympus Optical Co., Ltd. Electrical surgical operating apparatus
US6391024B1 (en) * 1999-06-17 2002-05-21 Cardiac Pacemakers, Inc. RF ablation apparatus and method having electrode/tissue contact assessment scheme and electrocardiogram filtering
US6332881B1 (en) 1999-09-01 2001-12-25 Cardima, Inc. Surgical ablation tool
EP1107703B1 (en) * 1999-09-28 2003-07-02 Karl Storz GmbH & Co. KG Medical bipolar instrument for cutting tissue
US7364577B2 (en) 2002-02-11 2008-04-29 Sherwood Services Ag Vessel sealing system
US6309388B1 (en) * 1999-12-23 2001-10-30 Mayo Foundation For Medical Education And Research Symmetric conization electrocautery device
US6546935B2 (en) 2000-04-27 2003-04-15 Atricure, Inc. Method for transmural ablation
US7047068B2 (en) 2000-12-11 2006-05-16 C.R. Bard, Inc. Microelectrode catheter for mapping and ablation
US6695839B2 (en) 2001-02-08 2004-02-24 Oratec Interventions, Inc. Method and apparatus for treatment of disrupted articular cartilage
US6743225B2 (en) 2001-03-27 2004-06-01 Uab Research Foundation Electrophysiologic measure of endpoints for ablation lesions created in fibrillating substrates
US6730082B2 (en) 2001-07-09 2004-05-04 Scimed Life Systems, Inc. Two-piece distal catheter assembly
US6761716B2 (en) 2001-09-18 2004-07-13 Cardiac Pacemakers, Inc. System and method for assessing electrode-tissue contact and lesion quality during RF ablation by measurement of conduction time
US20030181904A1 (en) 2002-01-23 2003-09-25 Levine Andy H. Electrosurgical cutting, coagulating and suction instrument
US7192427B2 (en) 2002-02-19 2007-03-20 Afx, Inc. Apparatus and method for assessing transmurality of a tissue ablation
US6882885B2 (en) 2002-03-19 2005-04-19 Solarant Medical, Inc. Heating method for tissue contraction
US6953461B2 (en) 2002-05-16 2005-10-11 Tissuelink Medical, Inc. Fluid-assisted medical devices, systems and methods
US7341586B2 (en) 2002-08-21 2008-03-11 Resect Medical, Inc. Thermal coagulation of tissue during tissue resection
US7123954B2 (en) * 2002-09-19 2006-10-17 Sanjiv Mathur Narayan Method for classifying and localizing heart arrhythmias
US7041096B2 (en) 2002-10-24 2006-05-09 Synergetics Usa, Inc. Electrosurgical generator apparatus
US7169146B2 (en) 2003-02-14 2007-01-30 Surgrx, Inc. Electrosurgical probe and method of use
US20040181214A1 (en) 2003-03-13 2004-09-16 Garabedian Robert J. Passively cooled array
JP4389470B2 (en) * 2003-05-01 2009-12-24 セイコーエプソン株式会社 Printing apparatus, a computer program, a printing system, and the determination method
US7753909B2 (en) 2003-05-01 2010-07-13 Covidien Ag Electrosurgical instrument which reduces thermal damage to adjacent tissue
DE10323566B4 (en) 2003-05-26 2006-03-23 Fehling Ag Instrument for unipolar ablation of cardiac tissue
JP4486869B2 (en) * 2004-10-19 2010-06-23 アルプス電気株式会社 Thermal printer
US7828795B2 (en) 2005-01-18 2010-11-09 Atricure, Inc. Surgical ablation and pacing device
US20060161149A1 (en) 2005-01-18 2006-07-20 Salvatore Privitera Surgical ablation device
US7670336B2 (en) 2005-03-25 2010-03-02 Boston Scientific Scimed, Inc. Ablation probe with heat sink

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5398683A (en) * 1991-05-24 1995-03-21 Ep Technologies, Inc. Combination monophasic action potential/ablation catheter and high-performance filter system
US6161543A (en) * 1993-02-22 2000-12-19 Epicor, Inc. Methods of epicardial ablation for creating a lesion around the pulmonary veins
US6311692B1 (en) * 1996-10-22 2001-11-06 Epicor, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US6164283A (en) * 1997-07-08 2000-12-26 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US20020107513A1 (en) * 2000-04-27 2002-08-08 Hooven Michael D. Transmural ablation device with thin electrodes
US20030093072A1 (en) * 2001-11-13 2003-05-15 Paul Friedman Tissue ablation device and methods of using
US20060293646A1 (en) * 2002-06-14 2006-12-28 Whayne James G Vacuum coagulation & dissection probes
US20050080411A1 (en) * 2003-10-08 2005-04-14 Pentax Corporation Endoscope for high-frequency treatment

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2853214A1 (en) * 2013-09-29 2015-04-01 Covidien LP Medical treatment devices having adjustable length and/or diameter
US20150094706A1 (en) * 2013-09-29 2015-04-02 Covidien Lp Medical treatment devices having adjustable length and/or diameter
CN104510527A (en) * 2013-09-29 2015-04-15 柯惠有限合伙公司 Medical treatment device adjustable in length and/or diameter
US9351786B2 (en) * 2013-09-29 2016-05-31 Covidien Lp Medical treatment devices having adjustable length and/or diameter

Also Published As

Publication number Publication date Type
US7828795B2 (en) 2010-11-09 grant
WO2007100754A3 (en) 2007-11-01 application
US8057471B2 (en) 2011-11-15 grant
US20060161151A1 (en) 2006-07-20 application
US20110028968A1 (en) 2011-02-03 application
WO2007100754B1 (en) 2008-01-10 application
WO2007100754A2 (en) 2007-09-07 application

Similar Documents

Publication Publication Date Title
US6312425B1 (en) RF ablation catheter tip electrode with multiple thermal sensors
US6745080B2 (en) Helical and pre-oriented loop structures for supporting diagnostic and therapeutic elements in contact with body tissue
US6049737A (en) Catheter having common lead for electrode and sensor
US6488678B2 (en) RF ablation apparatus and method using unipolar and bipolar techniques
US5083565A (en) Electrosurgical instrument for ablating endocardial tissue
US7063698B2 (en) Vacuum coagulation probes
US5893885A (en) Multi-electrode ablation catheter
US6666862B2 (en) Radio frequency ablation system and method linking energy delivery with fluid flow
US6564096B2 (en) Method and system for treatment of tachycardia and fibrillation
US6569162B2 (en) Passively self-cooled electrode design for ablation catheters
US6557559B1 (en) Electrosurgical systems and methods with temperature control
US5954661A (en) Tissue characterization and treatment using pacing
US6477396B1 (en) Mapping and ablation catheter
US6468272B1 (en) Surgical probe for supporting diagnostic and therapeutic elements in contact with tissue in or around body orifices
US6749604B1 (en) Electrosurgical instrument with axially-spaced electrodes
US6582425B2 (en) Electrode having composition-matched, common-lead thermocouple wire for providing multiple temperature-sensitive junctions
US6256540B1 (en) Systems and methods for examining the electrical characteristic of cardiac tissue
US20090005832A1 (en) Circuit-Based Devices and Methods for Pulse Control of Endocardial Pacing in Cardiac Rhythm Management
US7047068B2 (en) Microelectrode catheter for mapping and ablation
US6088614A (en) Tissue characterization to identify an ablation site
US5643338A (en) Single-pass A-V lead for pacing with stimulation of right ventricular outflow tract
US6312408B1 (en) Electrosurgical probe for treating tissue in electrically conductive fluid
US20050010095A1 (en) Multi-purpose catheter apparatus and method of use
US20020151807A1 (en) Bipolar mapping of intracardiac potentials using recessed electrodes
US20030065364A1 (en) Expandable intracardiac return electrode and method of use

Legal Events

Date Code Title Description
AS Assignment

Owner name: SILICON VALLEY BANK, COLORADO

Free format text: SECURITY INTEREST;ASSIGNORS:ATRICURE, INC.;ATRICURE, LLC;ENDOSCOPIC TECHNOLOGIES, LLC;REEL/FRAME:032812/0032

Effective date: 20140424