US20040006333A1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Coaxial catheter instruments for ablation with radiant energy
Assignee: Cardiofocus Inc
•
Filing: 2003-02-03
•
Granted: —
•
Expires: 2023-02-03
Abstract
Abstract Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein. A projection balloon structure is also disclosed that can be slid over the first (anchor balloon) catheter body and inflated within the heart, to define a staging from which to project radiant energy. An ablative fluid can also be employed outside of the instrument (e.g., between the balloon and the target region) to ensure efficient transmission of the radiant energy when the instrument is deployed. In another aspect of the invention, generally applicable to a wide range of cardiac ablation instruments, mechanisms are disclosed for determining whether the instrument has been properly seated within the heart, e.g., whether the device is in contact with a pulmonary vein and/or the atrial surface, in order to form a lesion by heating, cooling or projecting energy. This contact-sensing feature can be implemented by an illumination source situated within the instrument and an optical detector that monitors the level of reflected light. Measurements of the reflected light (or wavelengths of the reflected light) can thus be used to determine whether contact has been achieved and whether such contact is continuous over a desired ablation path.
Inventors
- 👤 Jeffrey Arnold
- 👤 Edward Sinofsky
- 👤 Lincoln Baxter
- 👤 Norman Farr
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 06:29
CPC Classifications
A; A61; A61B; A61B18/00; A61B18/18; A61B18/20; A61B18/22; A61B18/24; A61B18/245; A61L; A61L2/00; A61L2/02; A61L2/08; A61L2/10; A61L29/00; A61L29/08; A61L29/085; A61B17/00; A61B2017/00017; A61B2017/00022; A61B2017/00057; A61B2017/00061; A61B2018/00964; A61B2018/0097; A61B2018/2255; A61B2018/2261; A61B2018/2266; A61B2018/2272; A61B90/00; A61B90/06; A61B2090/064; A61B2090/065; A61N; A61N7/00; A61N7/02
Claims Analysis
Total Claims: 83
Claim 1
Independent Claim
65 words
1 . A cardiac ablation instrument comprising: a catheter body adapted for disposition within a heart having at least one lumen therein, which body can be deployed at a desired location within the heart; and an energy emitter movable within a lumen of the catheter body such that it can be disposed at the desired location and deliver ablative energy to a target tissue site.
Claim 2
Dependent Claim
65 words
1 . A cardiac ablation instrument comprising: a catheter body adapted for disposition within a heart having at least one lumen therein, which body can be deployed at a desired location within the heart; and an energy emitter movable within a lumen of the catheter body such that it can be disposed at the desired location and deliver ablative energy to a target tissue site.
Claim 3
Dependent Claim
42 words
2 . The instrument of claim 1 , wherein the energy emitter is slidably disposed within a lumen of the catheter body and the instrument further comprises a translatory mechanism for positioning the emitter at a selected location within the catheter body.
Claim 4
Dependent Claim
17 words
3 . The instrument of claim 1 , wherein the energy emitter is a radiant energy emitter.
Claim 5
Dependent Claim
31 words
4 . The instrument of claim 1 , wherein the energy emitter projects a ring of radiant ablative energy of variable diameter based on its axial position within the catheter body.
Claim 6
Dependent Claim
16 words
5 . The instrument of claim 3 wherein the catheter body further comprises a projection balloon.
Claim 7
Dependent Claim
34 words
6 . The instrument of claim 5 wherein the catheter body further comprises a projection balloon adapted for inflation in proximity to a pulmonary vein ostium to provide a transmission pathway for radiant energy.
Claim 8
Dependent Claim
44 words
7 . The instrument of claim 3 , wherein the radiant energy emitter further comprises a light transmitting optical fiber adapted to receive radiant energy from a light source and a light emitting tip at a distal end of the fiber for emitting light.
Claim 9
Dependent Claim
51 words
8 . The instrument of claim 7 , wherein the light emitting tip further comprises a beam forming optical waveguide for projecting an annular beam of light, such that the radiant energy emitter projects a ring of ablative energy of variable diameter based on its axial position within the catheter body.
Claim 10
Dependent Claim
32 words
9 . The instrument of claim 3 wherein the instrument further comprises a light source for generating photoablative radiation at desired wavelengths ranging from between about 800 nm and about 1000 nm.
Claim 11
Dependent Claim
33 words
10 . The instrument of claim 3 , wherein the instrument further comprises a light source for generating photoablative radiation at a desired wavelength ranging from about 915 nm to about 980 nm.
Claim 12
Dependent Claim
16 words
11 . The instrument of claim 3 , wherein the energy emitter comprises an ultrasound generator.
Claim 13
Dependent Claim
30 words
12 . The instrument of claim 11 , wherein the ultrasound generator generates ultrasound energy at at least one wavelength in the range of about 5 to about 20 MHz.
Claim 14
Dependent Claim
30 words
13 . The instrument of claim 11 , wherein the ultrasound generator generates ultrasound energy at at least one wavelength in the range of about 7 to about 10 MHz.
Claim 15
Dependent Claim
16 words
14 . The instrument of claim 3 , wherein the energy emitter comprises a microwave generator.
Claim 16
Dependent Claim
26 words
15 . The instrument of claim 5 , wherein the instrument further comprises a contact sensor for sensing contact between the projection balloon and target tissue.
Claim 17
Dependent Claim
54 words
16 . The instrument of claim 15 , wherein the contact sensor further comprises a contact sensing element movable within a lumen of the catheter body such that it can be disposed at various locations to detect reflected radiant energy and, based on the reflected energy, select a desired location for forming a lesion.
Claim 18
Dependent Claim
22 words
17 . The instrument of claim 15 , wherein the reflectance sensor further comprises a light detector for detecting reflected light energy.
Claim 19
Dependent Claim
22 words
18 . The instrument of claim 15 , wherein the reflectance sensor further comprises an ultrasound detector for detecting reflected ultrasound energy.
Claim 20
Dependent Claim
63 words
19 . A cardiac ablation instrument comprising: a catheter body adapted for disposition within a heart having at least one lumen therein; and a contact sensing element movable within a lumen of the catheter body such that it can be disposed at various locations to detect reflected radiant energy and, based on the reflected energy, select a desired location for forming a lesion.
Claim 21
Dependent Claim
63 words
19 . A cardiac ablation instrument comprising: a catheter body adapted for disposition within a heart having at least one lumen therein; and a contact sensing element movable within a lumen of the catheter body such that it can be disposed at various locations to detect reflected radiant energy and, based on the reflected energy, select a desired location for forming a lesion.
Claim 22
Dependent Claim
23 words
20 . The instrument of claim 19 , wherein the contact sensing element further comprises a light detector for detecting reflected light energy.
Claim 23
Dependent Claim
23 words
21 . The instrument of claim 19 , wherein the contact sensing element further comprises an ultrasound detector for detecting reflected ultrasound energy.
Claim 24
Dependent Claim
32 words
22 . The instrument of claim 19 wherein the instrument further comprises a projection balloon for clearing a transmission pathway for radiant energy from an energy emitter to a target treatment site.
Claim 25
Dependent Claim
24 words
23 . The instrument of claim 19 wherein the instrument further comprises at least one optical sensor within the instrument for receiving reflected light.
Claim 26
Dependent Claim
35 words
24 . The instrument of claim 23 wherein the instrument further comprises a source of illumination for illuminating a region surrounding the instrument and inducing reflected light that can be collected by the optical sensor.
Claim 27
Dependent Claim
24 words
25 . The instrument of claim 23 wherein the instrument further comprises a detector capable of distinguishing at least two wavelengths of reflected light.
Claim 28
Dependent Claim
48 words
26 . The instrument of claim 19 , wherein the instrument further comprises a radiant energy emitter that is slidably disposed within a lumen of the catheter body and the instrument further comprises a translatory mechanism for positioning the emitter at a selected location within the catheter body.
Claim 29
Dependent Claim
47 words
27 . The instrument of claim 26 , wherein the radiant energy emitter further comprises a light transmitting optical fiber adapted to receive radiant energy from a light source and beam forming optics at a distal end of the fiber for projecting an annular beam of light.
Claim 30
Dependent Claim
33 words
28 . The instrument of claim 27 , wherein the instrument further comprises a light source for generating photoablative radiation at desired wavelengths ranging from between about 800 nm and about 1000 nm
Claim 31
Dependent Claim
17 words
29 . The instrument of claim 26 , wherein the radiant energy emitter comprises an ultrasound generator.
Claim 32
Dependent Claim
17 words
30 . The instrument of claim 26 , wherein the radiant energy emitter comprises a microwave generator.
Claim 33
Dependent Claim
23 words
31 . The instrument of claim 19 wherein the instrument further comprises an ablation element at the distal end of the catheter body.
Claim 34
Dependent Claim
16 words
32 . The instrument of claim 31 wherein the ablation element is a contact heating element.
Claim 35
Dependent Claim
30 words
33 . The instrument of claim 31 wherein the instrument further comprises an expandable element and the ablation element is coupled to at least a portion of the expandable element.
Claim 36
Dependent Claim
24 words
34 . The instrument of claim 31 wherein the ablation element comprises at least one electrode adapted to couple to an electric current source.
Claim 37
Dependent Claim
19 words
35 . The instrument of claim 34 wherein the electrode is coupled to a radio frequency electric current source.
Claim 38
Dependent Claim
16 words
36 . The instrument of claim 31 wherein the ablation element is a cryogenic ablation element.
Claim 39
Dependent Claim
16 words
37 . The instrument of claim 31 wherein the ablation element is an ultrasound ablation element.
Claim 40
Dependent Claim
27 words
38 . The instrument of claim 31 wherein the ablation element is adapted to be positioned at a location where a pulmonary vein extends from an atrium.
Claim 41
Dependent Claim
21 words
39 . The instrument of claim 19 wherein the contact sensor comprises at least one optic fiber for collecting reflected light.
Claim 42
Dependent Claim
23 words
40 . The instrument of claim 19 wherein the contact sensor comprises a plurality of optic fibers for illuminating light to different directions.
Claim 43
Dependent Claim
89 words
41 . A cardiac ablation instrument comprising: a first catheter body adapted for disposition within a heart having at least one lumen therein and comprising at least one anchorage element which can be deployed at the desired location to contact a cardiac structure and secure the device in place; and a radiant energy emitter movable within a lumen of the first catheter body such that it can be disposed at the desired location and deliver radiant energy through a transmissive region of the instrument to a target tissue site.
Claim 44
Dependent Claim
89 words
41 . A cardiac ablation instrument comprising: a first catheter body adapted for disposition within a heart having at least one lumen therein and comprising at least one anchorage element which can be deployed at the desired location to contact a cardiac structure and secure the device in place; and a radiant energy emitter movable within a lumen of the first catheter body such that it can be disposed at the desired location and deliver radiant energy through a transmissive region of the instrument to a target tissue site.
Claim 45
Dependent Claim
30 words
42 . The instrument of claim 41 wherein the anchorage element is an anchor balloon adapted for inflation within a pulmonary vein to secure the instrument at a desired location.
Claim 46
Dependent Claim
45 words
43 . The instrument of claim 41 , wherein the radiant energy emitter is slidably disposed within a lumen of the first catheter body and the instrument further comprises a translatory mechanism for positioning the emitter at a selected location within the first catheter body.
Claim 47
Dependent Claim
44 words
44 . The instrument of claim 41 , wherein the radiant energy emitter further comprises a light transmitting optical fiber adapted to receive radiant energy from a light source and a light emitting tip at a distal end of the fiber for emitting light.
Claim 48
Dependent Claim
27 words
45 . The instrument of claim 44 , wherein the light emitting tip further comprises a beam forming optical waveguide for projecting an annular beam of light.
Claim 49
Dependent Claim
19 words
46 . The instrument of claim 44 , wherein the light emitting tip further comprises a light diffusing element.
Claim 50
Dependent Claim
33 words
47 . The instrument of claim 44 , wherein the instrument further comprises a light source for generating photoablative radiation at desired wavelengths ranging from between about 800 nm and about 1000 nm
Claim 51
Dependent Claim
33 words
48 . The instrument of claim 44 , wherein the instrument further comprises a light source for generating photoablative radiation at a desired wavelength ranging from about 915 nm to about 980 nm.
Claim 52
Dependent Claim
17 words
49 . The instrument of claim 41 , wherein the radiant energy emitter comprises an ultrasound generator.
Claim 53
Dependent Claim
17 words
50 . The instrument of claim 41 , wherein the radiant energy emitter comprises a microwave generator.
Claim 54
Dependent Claim
70 words
51 . The instrument of claim 41 wherein the instrument further comprises a second catheter body with an inner channel, configured for coupling to the first catheter body via the channel such that the second catheter body can be passed over the first catheter body into a position within the heart, and having an inflatable projection balloon which be deployed to clear blood from a surrounding region within the heart.
Claim 55
Dependent Claim
15 words
52 . The instrument of claim 41 wherein the instrument further comprises a contact sensor.
Claim 56
Dependent Claim
24 words
53 . The instrument of claim 42 wherein the instrument further comprises at least one optical sensor within the instrument for receiving reflected light.
Claim 57
Dependent Claim
35 words
54 . The instrument of claim 53 wherein the instrument further comprises a source of illumination for illuminating a region surrounding the instrument and inducing reflected light that can be collected by the optical sensor.
Claim 58
Dependent Claim
24 words
55 . The instrument of claim 53 wherein the instrument further comprises a detector capable of distinguishing at least two wavelengths of reflected light.
Claim 59
Dependent Claim
119 words
56 . A method of ablating cardiac tissue, comprising: positioning a guide wire in proximity to a target region of cardiac tissue; coupling a first catheter having at least one lumen to the positioned guide wire via the lumen such that the first catheter can be passed over the guide wire into a position within the heart; removing the guide wire and replacing it with a radiant energy emitter slidable movable within a lumen of the first catheter such that it can be disposed at the desired location; and activating the radiant energy emitter to deliver radiant energy through a transmissive region of the first catheter to the target tissue region to ablate tissue and form a conduction block.
Claim 60
Dependent Claim
119 words
56 . A method of ablating cardiac tissue, comprising: positioning a guide wire in proximity to a target region of cardiac tissue; coupling a first catheter having at least one lumen to the positioned guide wire via the lumen such that the first catheter can be passed over the guide wire into a position within the heart; removing the guide wire and replacing it with a radiant energy emitter slidable movable within a lumen of the first catheter such that it can be disposed at the desired location; and activating the radiant energy emitter to deliver radiant energy through a transmissive region of the first catheter to the target tissue region to ablate tissue and form a conduction block.
Claim 61
Dependent Claim
41 words
57 . The method of claim 56 wherein the step of activating the radiant energy emitter further comprises activating a light emitting element to expose the target region to light energy to induce photocoagulation of cardiac tissue within the target region.
Claim 62
Dependent Claim
40 words
58 . The method of claim 57 wherein the step of activating the radiant energy emitter further comprises activating a light emitting element to expose the target region to light energy to induce a continuous lesion in the cardiac tissue.
Claim 63
Dependent Claim
48 words
59 . The method of claim 57 wherein the step of activating the radiant energy emitter further comprises activating a light emitting element having a beam-forming optical waveguide to expose the target region to an annular beam of light energy to induce a circumferential lesion in cardiac tissue.
Claim 64
Dependent Claim
39 words
60 . The method of claim 57 , the step of activating the radiant energy emitter further comprises activating a light emitting element generating photoablative radiation at a desired wavelength ranging from about 800 nm to about 1000 nm
Claim 65
Dependent Claim
39 words
61 . The method of claim 57 , the step of activating the radiant energy emitter further comprises activating a light emitting element generating photoablative radiation at a desired wavelength ranging from about 915 nm to about 980 nm.
Claim 66
Dependent Claim
41 words
62 . The method of claim 56 , the step of activating the radiant energy emitter further comprises activating an ultrasound emitting element to expose the target region to acoustic energy to induce photocoagulation of cardiac tissue within the target region.
Claim 67
Dependent Claim
58 words
63 . The method of claim 56 , the step of activating the radiant energy emitter further comprises activating a radiation emitting element to expose the target region to at least one form of radiant energy selected from the group consisting of microwave, x-ray, gamma-ray and ionizing radiation to induce photocoagulation of cardiac tissue within the target region.
Claim 68
Dependent Claim
34 words
64 . The method of claim 56 wherein the method further comprises inflating a projection balloon to clear blood from a transmission pathway between the energy emitter and a target region of cardiac tissue.
Claim 69
Dependent Claim
46 words
65 . The method of claim 56 wherein the method further comprises determining whether a clear transmission path has been established between the radiant energy emitter and the target tissue based on reflectance measurements by an optical sensor disposed within the lumen of the first catheter.
Claim 70
Dependent Claim
33 words
66 . The method of claim 65 wherein the method further comprises measuring at least two different wavelengths of reflected light collected by the optical sensor to determine whether a projection path exists.
Claim 71
Dependent Claim
74 words
67 . A method of treating atrial fibrillation, comprising: positioning a distal portion of an ablation instrument in proximity to one or more pulmonary veins, the instrument having a hollow housing and an independently positionable energy emitter within the distal portion, the distal portion being transmissive to radiant energy; and activating the energy emitter to transmit energy through the housing to form an annular lesion in proximity to the one or more pulmonary veins.
Claim 72
Dependent Claim
74 words
67 . A method of treating atrial fibrillation, comprising: positioning a distal portion of an ablation instrument in proximity to one or more pulmonary veins, the instrument having a hollow housing and an independently positionable energy emitter within the distal portion, the distal portion being transmissive to radiant energy; and activating the energy emitter to transmit energy through the housing to form an annular lesion in proximity to the one or more pulmonary veins.
Claim 73
Dependent Claim
60 words
68 . The method of claim 67 , the step of activating the radiant energy emitter further comprises activating a radiation emitting element to expose the target region to at least one form of radiant energy selected from the group consisting of light, ultrasound, microwave, x-ray, gamma-ray and ionizing radiation to induce photocoagulation of cardiac tissue within a target region.
Claim 74
Dependent Claim
34 words
69 . The method of claim 67 wherein the method further comprises inflating a projection balloon to clear blood from a transmission pathway between the energy emitter and a target region of cardiac tissue.
Claim 75
Dependent Claim
40 words
70 . The method of claim 69 wherein the method further comprises determining whether a clear transmission path exists between the energy emitter and the target region based on reflectance measurements by an optical sensor disposed within the ablation instrument.
Claim 76
Dependent Claim
35 words
71 . The method of claim 70 wherein the method further comprises measuring at least two different wavelengths of reflected light collected by the optical sensor to determine whether a projection path has been established.
Claim 77
Dependent Claim
40 words
72 . The method of claim 67 wherein the step of activating the energy emitter further comprises activating a light emitting element to expose the target region to light energy to induce photocoagulation of cardiac tissue within the target region.
Claim 78
Dependent Claim
40 words
73 . The method of claim 67 wherein the step of activating the radiant energy emitter further comprises activating a light emitting element to expose the target region to light energy to induce a continuous lesion in the cardiac tissue.
Claim 79
Dependent Claim
47 words
74 . The method of claim 67 wherein the step of activating the energy emitter further comprises activating a light emitting element having a beam-forming optical waveguide to expose the target region to an annular beam of light energy to induce a circumferential lesion in cardiac tissue.
Claim 80
Dependent Claim
38 words
75 . The method of claim 67 , the step of activating the energy emitter further comprises activating a light emitting element generating photoablative radiation at a desired wavelength ranging from about 800 μm to about 1000 nm
Claim 81
Dependent Claim
38 words
76 . The method of claim 67 , the step of activating the energy emitter further comprises activating a light emitting element generating photoablative radiation at a desired wavelength ranging from about 915 nm to about 980 nm.
Claim 82
Dependent Claim
40 words
77 . The method of claim 67 , the step of activating the energy emitter further comprises activating an ultrasound emitting element to expose the target region to acoustic energy to induce photocoagulation of cardiac tissue within the target region.
Claim 83
Dependent Claim
57 words
78 . The method of claim 67 , the step of activating the energy emitter further comprises activating a radiation emitting element to expose the target region to at least one form of radiant energy selected from the group consisting of microwave, x-ray, gamma-ray and ionizing radiation to induce photocoagulation of cardiac tissue within the target region.
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