Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical 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
  • A61B18/14—Probes or electrodes therefor
  • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00053—Mechanical features of the instrument of device
  • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00053—Mechanical features of the instrument of device
  • A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
  • A61B2018/00279—Anchoring means for temporary attachment of a device to tissue deployable
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00053—Mechanical features of the instrument of device
  • A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
  • A61B2018/00279—Anchoring means for temporary attachment of a device to tissue deployable
  • A61B2018/00285—Balloons
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
  • A61B2018/00345—Vascular system
  • A61B2018/00351—Heart
  • A61B2018/00375—Ostium, e.g. ostium of pulmonary vein or artery

Definitions

• BACKGROUND Physicians make use of catheters in medical procedures to gain access into interior regions of the body to ablate targeted tissue areas. For example, in electrophysiological therapy, tissue ablation is used to treat cardiac rhythm disturbances. During such procedures, a physician steers a catheter through a main vein or artery into an interior region of the heart. The physician positions an ablating element carried on the catheter near the targeted cardiac tissue, and directs energy from the ablating element to ablate the tissue, forming a lesion. [0003] Such procedure may be used to treat arrhythmia, a condition in which abnormal electrical signals are generated in heart tissue.
• the pump 130 delivers inflation fluid to the anchoring device 110 via the first channel 160 to expand the anchoring device 110.
• delivered fluid exits from the first port 164 and fills the lumen 176 of the expandable-collapsible member 170.
• the delivered fluid inflates the expandable-collapsible member 170 until the expandable-collapsible member 170 can no longer expand, at which point, fluid delivered inside the lumen 176 will flow into a second port 322 and travel to the ablation assembly 108 via the second channel 320 (FIG. 4B).
• the fluid exits from a third port 324 and fills the lumen 186 of the expandable-collapsible member 180 to expand the ablation assembly 108 (FIG. 4C).
• the ablation catheter 300 allows the anchoring device 110 be expanded before the ablation assembly 108.
• check- valves can be secured to any or all of the ports 164, 322, 324 to ensure a flow direction of the fluid.
• FIG. 5 illustrates an ablation catheter 350, which includes a shaft 352 having a proximal end 354, a distal end 356, a channel 358 extending between the proximal and the distal ends 354, 356, and an electrode 368 secured to the shaft 352.
• the electrode 368 has a helical shape, but can have different shapes and configurations in alternative embodiments.
• the shaft 352 has a port 370 at which the channel 358 terminates.
• fluid is pumped into the channel 358 by the pump 130, and exits from the port 370 into a lumen 372 within the expandable-collapsible member 360, thereby expanding the expandable-collapsible member 360.
• the expandable- collapsible member 360 is configured such that the distal portion 362 is expanded before the proximal portion 364.
• the distal portion 362 can be made from a material that is relatively more flexible or elastic than the proximal portion 364.
• the distal portion 362 can have a wall thickness that is relatively thinner than that of the proximal portion 364.
• the sheath 140 When using the system 100 for cardiac ablation therapy, the sheath 140, using a dilator and a guidewire, is inserted through a main vein (typically the femoral vein), and is positioned into a right atrium of a heart using conventional techniques. Once the distal end 144 of the sheath 140 is placed into the atrium, the guidewire is then removed. Next, a needle can be inserted into the lumen 146 of the sheath 140 and exits from the distal end 144 to puncture an atrial septum that separates the right and left atria. Alternatively, the sheath 140 can have a sharp distal end 144 for puncturing the atrial septum, thereby obviating the need to use the needle.
• a main vein typically the femoral vein
• the catheter 102 is then inserted into the lumen 146 of the sheath 140.
• the ablation assembly 108 and the anchoring device 110 are confined within the lumen 146 in their collapsed configurations.
• the catheter 102 is advanced within the lumen 146 until the anchoring device 110 is at the distal end
• the guide wire 408 can be inserted through a separate cannula and into the lumen 602 of the pulmonary vein 600.
• the ablation catheter 102, together with the sheath 140, are then inserted into the cannula and over the guide wire 408, and are advanced into the lumen 602 of the pulmonary vein 600 using the guide wire 408 as a guide.
• the ablation catheter 102 is steerable, such as that shown in FIG.
• the ablation catheter 102 can be steered into the lumen 602 of the pulmonary vein 600 while it is housed within the lumen 146 of the sheath 140.
• inflation fluid is delivered under positive pressure by the pump 130 to urges the anchoring device 110 to expand (FIG. 9C).
• the expanded anchoring device 110 exerts a pressure against an interior surface 604 of the pulmonary vein 600, thereby securing the anchoring device 110 relative to the pulmonary vein 600. Because of the pressure exerted by the anchoring device 110, the pulmonary vein 600 at the location of the anchoring device 110 is slightly enlarged.
• the wire 702 has a helical shape when in its expanded configuration, but can also have other shapes, such as an elliptical shape or a random shape, in alternative embodiments. In its expanded configuration, the wire 702 presses against the interior wall 604 of the pulmonary vein 600 to anchor the ablation assembly 108 relative to the pulmonary vein 600.
• the anchoring device 701 includes a wire 702 that has a helical shape when in its expanded configuration. However, the anchoring device 701 can also have other configurations.
• FIGS. 11 A- 11C show variations of the anchoring device that can be used instead of the wire 702. FIG.
• FIG. 11 A shows an anchoring device 718 having a plurality of splines 720 that form a cage or basket 722.
• the cage 722 is secured to the distal end 106 of the shaft 114 by an elongated member 724.
• the elongated member 724 can be secured to the ablation assembly 108.
• the anchoring device 701 does not include the elongated member 724, and the cage 722 is secured to the ablation assembly 108.
• the splines 720 are made from an elastic material that allows the cage 722 to stretch to a delivery shape having a low profile when inside the sheath 144. When outside the lumen 146 of the sheath 144, the cage 722 expands to a deployed shape for anchoring the ablation assembly 108.
• FIG. 1 IB shows an anchoring device 730 that has a plurality of wires
• the wires 740 are made from an elastic material that allows the assembly 742 to stretch to a delivery shape having a low profile when inside the sheath 144. When outside the lumen 146 of the sheath 144, the assembly 742 expands to a deployed shape for anchoring the ablation assembly 108.
• FIG. 11C shows an anchoring device 750, including a wire 760 that is secured to the distal end 106 of the shaft 114, and a blunt tip 762 at one end of the wire 760 for preventing injury to tissue. Alternatively, the wire 760 can be secured to the ablation assembly 108.
• the wire 760 is made from an elastic material that allows the wire 760 to stretch to a delivery shape having a low profile when inside the sheath 144.
• Such configuration allows a distance 820 between the anchoring device 701 and the ablation assembly 108 be adjusted during use.
• the anchoring device can include a material that swells or expands when in contact with fluid inside a body, thereby allowing the anchoring device to be secured within a pulmonary vein.
• the anchoring device instead of being distal to the ablation assembly, can be located proximal to the ablation assembly for anchoring the ablation assembly to other tissue in other applications.
• the catheter can include other devices for treating tissue or for sensing tissue characteristic(s).
• the catheter can include other devices for treating tissue or for sensing tissue characteristic(s).
• any of the embodiments of the ablation catheter described herein can be used to create lesions at other locations in the body.
• the embodiments of the ablation catheter are not limited to treating atrial fibrillation, and can be used to treat other medical conditions.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Surgery (AREA)
• Engineering & Computer Science (AREA)
• Plasma & Fusion (AREA)
• Medical Informatics (AREA)
• Otolaryngology (AREA)
• Physics & Mathematics (AREA)
• Cardiology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgical Instruments (AREA)
• Electrotherapy Devices (AREA)

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• 2004
  • 2004-06-07 US US10/863,375 patent/US20050273095A1/en not_active Abandoned
• 2005
  • 2005-06-03 WO PCT/US2005/019748 patent/WO2005120378A1/en not_active Ceased
  • 2005-06-03 EP EP05756639A patent/EP1753358A1/en not_active Withdrawn
  • 2005-06-03 CA CA002569578A patent/CA2569578A1/en not_active Abandoned
  • 2005-06-03 JP JP2007515669A patent/JP2008501440A/ja active Pending
• 2006
  • 2006-09-05 US US11/470,187 patent/US20070021746A1/en not_active Abandoned

Patent Citations (5)

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