1. Field of the Invention
The present invention generally relates to medical devices used for ablation of biological tissues, and more particularly to an ablation catheter apparatus incorporating one or more electrodes such as electrocardiogram (ECG) electrodes.
2. Related Art
Ablation catheters apply energy to a biological tissue site which requires ablation. Such catheters may use various energy modes, such as radiofrequency, ultrasound, laser, cryogenic, and the like. Radio frequency (“RF”) ablation catheters generally operate in the microwave frequency range and are used to destroy or ablate biological tissues for therapeutic purposes. In one application, microwave ablation catheters are used to ablate cardiac tissues that cause irregular heartbeats or arrhythmia, avoiding the need for more risky and invasive open heart surgery. In a microwave ablation procedure, the catheter-antenna is passed through the vein for access to the atrium. Within the atrium, the antenna is positioned at the desired location where ablation is required. An intracardiac electrogram is used to identify conductive pathways at the cardiac tissue site that needs to be ablated.
Prior art ablation catheters have been equipped with two or more electrocardiogram (“ECG”) electrode rings or buttons made of electrically conductive material to provide the necessary output signal for identification of the desired ablation site. Traditionally, all catheters used for this purpose are installed with metallic electrodes, regardless of energy mode (RF, ultrasound, laser, cryogenic, or the like). Installing metallic electrodes over a microwave antenna has special challenges. Naked metallic electrodes installed wrongly can absorb ablation energy and become hot. Hot electrodes can have adverse effects on the heart or other biological tissues or organs, such as blood clot formation, adherence to tissue, and tissue charring. Naked metallic electrodes can also impede efficient delivery of energy and hinder ablation efficiency. Additionally, metallic electrodes can separate from the catheter when it is bent, resulting in inaccurate or lost signals.
Accordingly, what is needed is an efficient system and method for providing an ECG output signal from an ablation catheter device.
The ablation catheter system of this invention comprises an elongate catheter adapted for insertion into a body vessel of a patient, the catheter having a distal end portion adapted for positioning adjacent a biological tissue site requiring treatment and a proximal end portion having a connector for connection to a control unit for controlling the ablation procedure, an antenna disposed at the distal end portion of the catheter for providing output energy for tissue ablation purposes, a pair of conductors extending through the catheter from the proximal end portion and connected to the antenna for providing power to the antenna from a power supply in the control unit, and at least one electrode formed of a flexible conductive material disposed at the distal end portion of the antenna and connected to the connector at the proximal end portion of the catheter for providing an output signal to the control unit. The flexible conductive material is at least substantially non-metallic.
One or more electrodes may be disposed at the distal end portion of the catheter. In one embodiment, the electrode or electrodes are of conductive polymer material with hydrophilic characteristics for improved wetability. Two spaced electrode rings are mounted on or embedded in the outer surface of the cathode. Alternatively, one electrode ring may be provided and the other electrode may be a tip of conductive polymer material at the distal end of the catheter. In alternative embodiments, layers of conductive and nonconductive polymer material may be provided at specific positions at the distal end portion of the catheter to produce multiple working electrodes. In each case, the electrode output signal can be connected to a suitable electrode recording system inputs in the control unit or a separate electrocardiogram unit to provide intracardiac signal mapping.
This arrangement avoids the problems of metallic electrodes and also provides electrodes which are of a flexible polymer material which can bend readily with the distal end portion of the catheter as it is shaped or bent to negotiate a path through a body vessel.
Other features and advantages of the present invention will become more readily apparent to those of ordinary skill in the art after reviewing the following detailed description and accompanying drawings.
The details of the present invention, both as to its structure and operation, may be gleaned in part by study of the accompanying drawings, in which like reference numerals refer to like parts, and in which:
Certain embodiments as disclosed herein provide for systems and methods for ablation of biological tissues in body areas such as the heart, liver, and the like using a bendable radio-frequency (RF) catheter. The catheter is provided with electrodes of a flexible conductive material such as a conductive polymer at its distal end for providing an output signal such as an intracardiac electrocardiogram (“ECG”) signal to a control unit to allow physicians to obtain tissue proximity and electrical conductivity information both before and after tissue ablation, as well as to provide other feedback during the ablation procedure.
After reading this description, it will become apparent to one skilled in the art how to implement the invention in various alternative embodiments and alternative applications. However, although various embodiments of the present invention will be described herein, it is understood that these embodiments are presented by way of example only and not limitation. As such, this detailed description of various alternative embodiments should not be construed to limit the scope or breadth of the present invention as set forth in the appended claims.
The catheter device 100 has a flexible, elongated tubular body 120 having a proximal portion 130 and a distal or tip portion 140. Located at the proximal portion of the body is a handle chassis 160 containing steering and positioning controls (not illustrated) for the body, activated by actuator 200. In the embodiment of
A coupling or electrical connector 170 is provided at the proximal end of the catheter device for connecting the catheter to a control unit or the like containing one or more electronic devices such as an RF generator and controller (not shown) for providing power to the antenna during an ablation procedure. Suitable signal control units are known in the ablation catheter field and are therefore not described in detail here.
The dimensions of the catheter body are adapted as required to suit the particular medical procedure, as is well known in the medical art. In one embodiment, the catheter is used to ablate cardiac tissue. However, the catheter may be used to ablate other types of body tissue in different organs, both internal and external to the body. The tubular body 120 of the catheter device may be generally constructed of a polymer material which is bio-compatible with the body vessel environment. Examples of such materials include thermoplastic elastomer material such as Pebaxg available from Autochem Germany, polyethylene, polyurethane, polyester, polyimide, polyamide, and the like, with varying degrees of radiopacity, hardness, and elasticity.
The tubular body of the catheter may be formed with a plurality of segments using one or more of the aforementioned materials or equivalents, such that the catheter body 120 is progressively more flexible towards its distal end. The segments may be joined together by thermal bonding, butt joints, or adhesive bonding. Braiding reinforcement may be provided to the surface of the tubular body to attain a desirable level of stiffness and torsional strength for the catheter to advance and negotiate through the body vessel of the patient, while still allowing the distal end portion to be bent when needed. The distal end portion 140 may be of a softer polymer compound than the remainder of the body, with little or no braiding or reinforcement, to provide the desired flexibility for distal deflection and shaping of the apparatus.
The structure of the catheter in one embodiment will now be described in more detail with reference to
The electrical conductors which connect the RF antenna to the connector 170 may be of a flexible mesh or braided wire construction 260 or of a thin-film electrically conductive material. In the embodiment illustrated in
In the embodiment of
In an alternative embodiment, the electrode ring 314 may be mounted flush in an annular recess or gap in the outer surface of the tubular body, or may be molded integrally with the tubular body, so that it does not project outwardly from the outer surface of the body 318. A conductor or connector 324 extends from electrode ring 314 to the connector 170 at the proximal end of the catheter, for suitable connection to an ECG monitor or the like in a control unit (not illustrated) for the catheter. Conductor 324 is shown spaced from the outer surface of body 318 in
In the embodiment of
Also shown in
The forward contact ring 346 is connected to the proximal end connector 170 via the conductive sleeve 312 and the outer conductor 316 which also provides power to the antenna 250. The rear contact ring 348 is connected to a conductive wire 350 which extends through the tubular body 318 to the proximal end connector 170 of the catheter. The conductors 316, 350 therefore provide the output for the ECG monitor in the control unit in this embodiment.
The embodiment of
A system for monitoring and controlling operation of an RF ablation catheter incorporating a temperature sensor is described in co-pending application Ser. No. 11/479,259 filed on Jun. 30, 2006, the contents of which are incorporated herein by reference. It will be understood that a similar control system may be provided for controlling operation of the microwave antenna in this embodiment or other embodiments described above, with suitable inclusion of a temperature sensor.
In
In each of the embodiments of FIGS. 4 to 8, electrodes are mounted at the distal end portion of a shapeable or bendable catheter to allow physicians to locate a tissue region causing problems and to obtain both optimum tissue proximity and electrical conductive activities before and after ablation, as well as to obtain feedback of their actions. Although two electrodes are provided in these embodiments, only one electrode or more than two electrodes may be provided in other embodiments. The electrode or electrodes in these embodiments may be ECG or other types of electrodes. Radio-opaque markers (not illustrated) at the distal end portion of the catheter may also be used to aid in positioning the tip of the catheter, as is known in the field. Where the electrodes are ECG electrodes, it will be understood that the conductor wires connected to the electrodes and to the proximal end connector 170 of the catheter will communicate with an external ECG system and monitor (not illustrated) via a suitable connection cable which will transmit ECG signals between the electrodes and ECG system. The antenna conductors and thermocouple wires (if a temperature sensor is present) will be similarly connected to an appropriate antenna output control system.
In each of the above embodiments, the RF antenna 250 is adapted to receive and radiate electromagnetic energy in order to treat a selected biological tissue site. An example of a suitable spectrum of radio frequency energy for use in the ablation catheter is that of the microwave frequency range above 300 MHz. The RF antenna is capable of applying substantially uniformly distributed electromagnetic field energy along the RF antenna in a direction substantially normal to the longitudinal axis of antenna 250.
The electrodes in the embodiments of FIGS. 4 to 8 are made of a suitable flexible conductive material, so that they can bend with the remainder of the distal end portion during steering. Such electrodes avoid or reduce the problems encountered with metallic electrodes, since they do not absorb microwave energy to any great extent and do not become excessively hot. The electrodes may be of an at least substantially non-metallic material, and in one embodiment they are made from a conductive polymer material such as nylon, polyethylene, polyolefin, polypropylene, polycarbonate, Pebax®, TPE (thermoplastic elastomers) and blends, loaded with a selective conductive material. Other non-conductive parts of the catheter may be of the same polymer material or different polymer materials. The conductive material may be micro-carbon spheres, carbon particles, carbon nanotubes, nickel dust, or the like. The electrodes may be made entirely of conductive polymer material or may be a mixture of conductive and non-conductive polymer material, or a mixture of conductive and non-conductive materials with metal substrates. The composite polymer material is selected to have a relatively low resistance for reduced interference with the microwave radiation pattern, and to be hydrophilic for improved wetability on the outer surface of the catheter.
Communication between the electrodes and the connector 170 at the proximal end of the catheter may be provided in some embodiments by means of conductive ink or adhesive applied over the polymer surface. For example, conductor 324 of
Heat energy, adhesives, and/or mechanical force may be used to laminate the conductive and non-conductive polymer layers in the embodiments of FIGS. 4 to 8. Metallic substrates may also be laminated between the polymer layers, such as the inner and outer tubular conductors which provide power for operating RF antenna 250.
The above description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles described herein can be applied to other embodiments without departing from the spirit or scope of the invention. Thus, it is to be understood that the description and drawings presented herein represent a presently preferred embodiment of the invention and are, therefore, representative of the subject matter which is broadly contemplated by the present invention. It is further understood that the scope of the present invention fully encompasses other embodiments that may become obvious to those skilled in the art and that the scope of the present invention is accordingly limited by nothing other than the appended claims.
The present application is a continuation-in-part of co-pending U.S. patent application Ser. No. 11/359,808 of concurrent ownership, filed on Feb. 22, 2006, which is a divisional of U.S. patent application Ser. No. 10/306,757, filed Nov. 27, 2002, now U.S. Pat. No. 7,004,938, which claims the benefit of Provisional Application No. 60/334,199, filed Nov. 29, 2001 and the contents of each of these documents are incorporated herein by reference in their entirety.
Number | Date | Country | |
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60334199 | Nov 2001 | US |
Number | Date | Country | |
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Parent | 10306757 | Nov 2002 | US |
Child | 11359808 | Feb 2006 | US |
Number | Date | Country | |
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Parent | 11359808 | Feb 2006 | US |
Child | 11551162 | Oct 2006 | US |