The instant disclosure relates to various types of medical catheters, in particular catheters for diagnostics within, and/or treatment of, a patient's cardiovascular system. In one embodiment, the instant disclosure relates to an ablation catheter for treating cardiac arrhythmias within a cardiac muscle. Various aspects of the instant disclosure relate to force sensing systems capable of determining a force applied at a distal tip of the ablation catheter.
The present disclosure further relates to low thermal mass ablation catheter tips (also known as high-thermal-sensitivity catheter tips) and to systems for controlling the delivery of RF energy to such catheters during ablation procedures.
Exploration and treatment of various organs or vessels has been made possible using catheter-based diagnostic and treatment systems. These catheters may be introduced through a vessel leading to the cavity of the organ to be explored, and/or treated. Alternatively, the catheter may be introduced directly through an incision made in the wall of the organ. In this manner, the patient avoids the trauma and extended recuperation times typically associated with open surgical procedures.
The human heart routinely experiences electrical currents traversing its many layers of tissue. Just prior to each heart contraction, the heart depolarizes and repolarizes as electrical currents spread across the heart. In healthy hearts, the heart will experience an orderly progression of depolarization waves. In unhealthy hearts, such as those experiencing atrial arrhythmia, including for example, ectopic atrial tachycardia, atrial fibrillation, and atrial flutter, the progression of the depolarization wave becomes chaotic.
Catheters are used in a variety of diagnostic and/or therapeutic medical procedures to diagnose and correct conditions such as atrial arrhythmia. Typically, in such a procedure, a catheter is manipulated through a patient's vasculature to the patient's heart carrying one or more end effectors which may be used for mapping, ablation, diagnosis, or other treatment. Where an ablation therapy is desired to alleviate symptoms including atrial arrhythmia, an ablation catheter imparts ablative energy to cardiac tissue to create a lesion in the cardiac tissue. The lesioned tissue is less capable of conducting electrical signals, thereby disrupting undesirable electrical pathways and limiting or preventing stray electrical signals that lead to arrhythmias. The ablation catheter may utilize ablative energy including, for example, radio frequency (RF), cryoablation, laser, chemical, and high-intensity focused ultrasound. Ablation therapies often require precise positioning of the ablation catheter, as well as precise pressure exertion for optimal ablative-energy transfer into the targeted myocardial tissue. Excess pressure between the ablation catheter tip and the targeted myocardial tissue may result in excessive ablation which may permanently damage the cardiac muscle and/or surrounding nerves. When the contact pressure between the ablation catheter tip and the targeted myocardial tissue is below a target pressure, the efficacy of the ablation therapy may be reduced.
Ablation therapies are often delivered by making a number of individual ablations in a controlled fashion in order to form a lesion line. To improve conformity of the individual ablations along the lesion line, it is desirable to precisely control the position at which the individual ablations are conducted, the ablation period, and the contact pressure between the ablation catheter tip and the targeted tissue. All of these factors affect the conformity of the resulting lesion line.
The foregoing discussion is intended only to illustrate the present field and should not be taken as a disavowal of claim scope.
It is desirable to control the delivery of RF energy to a catheter to enable the creation of lesions in tissue, by keeping the generator power setting sufficiently high to form adequate lesions, while mitigating against overheating of tissue. Accordingly, aspects of the present disclosure are directed toward an ablation catheter tip including high thermal sensitivity materials which facilitate near real-time temperature sensing at the ablation catheter tip. Further aspects of the present disclosure are directed to improved ablation catheter force measurements in response to tissue contact on the ablation catheter tip.
One embodiment of the present disclosure is directed to a high thermal-sensitivity ablation catheter tip. The high-thermal-sensitivity ablation catheter tip includes a conductive shell, a structural member, a manifold, and a flexible electronic circuit. The conductive shell includes a dispersion chamber for irrigant distribution. The structural member is coupled to a proximal end of the conductive shell, and deflects in response to a force exerted on the conductive shell. The manifold includes an irrigation lumen extending through a longitudinal axis of the manifold, and the irrigation lumen delivers irrigant into the dispersion chamber. The flexible electronic circuit extends through the irrigation lumen of the manifold. In more specific embodiments, the flexible electronic circuit includes one or more bends positioned on a portion of the flexible circuit within the irrigant lumen. The one or more bends deflect in response to an axial force exerted on the conductive shell while minimally absorbing the axial force.
Some embodiments of the present disclosure are directed to a method of assembling an ablation catheter tip. One example of such a method includes the following steps: providing a manifold with an irrigant lumen extending there through; providing a flexible electronic circuit including one or more thermocouples; and directing a distal portion of the flexible circuit through the irrigant lumen. In more specific embodiments, the method further includes forming a bend in the flexible electronic circuit, and positioning the bend within the irrigant lumen of the manifold.
The foregoing and other aspects, features, details, utilities, and advantages of the present disclosure will be apparent from reading the following description and claims, and from reviewing the accompanying drawings.
Various example embodiments may be more completely understood in consideration of the following detailed description in connection with the accompanying drawings.
While various embodiments discussed herein are amenable to modifications and alternative forms, aspects thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the invention to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure including aspects defined in the claims. In addition, the term “example” as used throughout this application is only by way of illustration, and not limitation.
Referring now to the drawings wherein like reference numerals are used to identify identical components in the various views,
In the illustrative embodiment of
The handle 21 provides a portion for a user to grasp or hold the elongated medical device 19 and may further provide a mechanism for steering or guiding the shaft 22 within the patient's body 14. For example, the handle 21 may include a mechanism configured to change the tension on a pull-wire extending through the elongated medical device 19 to the distal end 24 of the shaft 22 or some other mechanism to steer the shaft 22. The handle 21 may be conventional in the art, and it will be understood that the configuration of the handle 21 may vary. In an embodiment, the handle 21 may be configured to provide visual, auditory, tactile and/or other feedback to a user based on information received from the sensor assembly 11. For example, if contact to tissue 13 is made by distal end 24, the sensor assembly 11 may transmit data to the computer system 15 indicative of contact. In response to the computer system 15 determining that the data received from the sensor assembly 11 is indicative of contact between the distal end 24 and a patient's body 14, the computer system 15 may operate a light-emitting-diode on the handle 21, a tone generator, a vibrating mechanical transducer, and/or other indicator(s), the outputs of which could vary in proportion to the calculated contact force.
The computer system 15 may utilize software, hardware, firmware, and/or logic to perform a number of functions described herein. The computer system 15 may be a combination of hardware and instructions to share information. The hardware, for example may include processing resource 16 and/or a memory 17 (e.g., non-transitory computer-readable medium (CRM) database, etc.). A processing resource 16, as used herein, may include a number of processors capable of executing instructions stored by the memory resource 17. Processing resource 16 may be integrated in a single device or distributed across multiple devices. The instructions (e.g., computer-readable instructions (CRI)) may include instructions stored on the memory 17 and executable by the processing resource 16 for force detection.
The memory resource 17 is communicatively coupled with the processing resource 16. A memory 17, as used herein, may include a number of memory components capable of storing instructions that are executed by processing resource 16. Such a memory 17 may be a non-transitory computer readable storage medium, for example. The memory 17 may be integrated in a single device or distributed across multiple devices. Further, the memory 17 may be fully or partially integrated in the same device as the processing resource 16 or it may be separate but accessible to that device and the processing resource 16. Thus, it is noted that the computer system 15 may be implemented on a user device and/or a collection of user devices, on a mobile device and/or a collection of mobile devices, and/or on a combination of the user devices and the mobile devices.
The memory 17 may be communicatively coupled with the processing resource 16 via a communication link (e.g., path). The communication link may be local or remote to a computing device associated with the processing resource 16. Examples of a local communication link may include an electronic bus internal to a computing device where the memory 17 is one of a volatile, non-volatile, fixed, and/or removable storage medium in communication with the processing resource 16 via the electronic bus.
In various embodiments of the present disclosure, the computer system 15 may receive optical signals from a sensor assembly 11 via one or more optical fibers extending a length of the catheter shaft 22. A processing resource 16 of the computer system 15 may execute an algorithm stored in memory 17 to compute a force exerted on distal end 24, based on the received optical signals.
U.S. Pat. No. 8,567,265 discloses various optical force sensors for use in medical catheter applications, such optical force sensors are hereby incorporated by reference as though fully disclosed herein.
In an alternative operation of the system 10 of
In the embodiment depicted in
Flexible circuit 290 may include one or more connectors 292 located at the distal end of a strand of the flexible circuit to facilitate manufacturability within a catheter tip sub-assembly. For example, where the catheter tip is completed in sub-assembly form prior to installation in a catheter shaft sub-assembly, the connectors 292 may extend from the catheter tip sub-assembly to facilitate coupling to another flexible circuit, or lead wires extending from the catheter shaft sub-assembly. To further facilitate assembly, the connectors 292 may be electrically coupled to the flexible circuit(s) of the catheter shaft sub-assembly via an electrical connector. Alternatively, solder pads of the two flexible circuits may be soldered to one another. The use of flexible circuits may also further facilitate automation of the catheter assembly process.
In
In various embodiments, flexible circuit 290 may further include one or more electrical contacts 2941-3 (for electrically coupling to spot electrodes). These electrodes, when capacitively coupled to a conductive shell, or extending through the conductive shell, may collect electrophysiology data related to tissue (e.g., myocardial tissue) in contact with (or in close proximity to) the conductive shell/electrodes. This electrophysiology data is then communicated via traces 296 to one or more solder pads 291 and 293 on the connectors 292 of the flexible circuit.
To facilitate coupling of flexible circuit 290 to a tip insert or other structure, vias 295 may extend through the flexible circuit board 291. In such embodiments, a protrusion may extend out from an external surface of a tip insert, and extend through the mating vias 295 in the flexible circuit board 291. Once properly located, the protrusions may be heat staked to create an interference fit between the via and the protrusion to permanently couple them. In the alternative, the flexible circuit board 291 may include bonding locations that facilitate such coupling. It is to be understood that various coupling means may be utilized, including: ultrasonic welding, fasteners, adhesives, friction and compression fits, etc. to achieve coupling of the flexible circuit board 291 to the tip insert. To facilitate electrical and thermal coupling between thermocouples 68 and 68′, and an inner surface of a conductive shell, the thermocouples may be directly coupled to the conductive shell. Thereby obviating any precise fitting required between the thermocouples and the conductive shell. In various embodiments consistent with the present disclosure, a quick thermal response of the thermocouples is desirable to provide an ablation control system with control inputs with as little lag as possible. Slow thermal response of the thermocouples may cause over ablation of tissue.
As discussed in more detail in relation to
It is to be understood that various circuit board layouts may be utilized to facilitate application specific design constraints in various flexible circuit 290 designs, consistent with the present disclosure. For example, to limit circuit board area, additional PCB layers may be added where the Z-dimension of a given application allows. Similarly, more or less connectors 292 may be implemented.
In various embodiments, the flexible circuit board 291 may include three layers: a copper layer at a top surface, an intermediate polyimide layer, and a constantan layer opposite the copper layer. Each of the thermocouples 68 and 68′ may be formed by drilling a via through the copper, polyimide, and constantan layers, and through plating the via with copper. Various thermocouple designs and manufacturing methods are well known in the art and may be applied hereto. Either side of the thermocouple is then electrically coupled to a trace on its respective layer. The voltage across the two traces may be compared, and the resulting voltage change is indicative of a temperature of a conductive shell thermally coupled to the thermocouple. In various applications, including ablation therapies, as the conductive shell is in direct contact with tissue being ablated, efficacy of an ablation therapy may be surmised.
In the present embodiment, flexible circuit 290 is designed to facilitate individual addressability of each of the thermocouples 68 and 68′, and electrical contacts 294. In more simplified embodiments, the thermocouples 68 in a distal circumferential ring may be electrically coupled in parallel to effectively facilitate temperature averaging of the distal thermocouples, and to minimize printed circuit board size. A similar configuration may also be utilized with thermocouples 68′. Such an embodiment may be particularly useful in applications where determining a tissue contact point along a circumference of the ablation catheter is not necessary. The present embodiment may also limit the effect of minute hot zones on an ablation control system.
As further shown in
In some embodiments of flexible circuit 290, a top copper layer is placed above the two other layers of the flexible circuit board 291—polyimide, and constantan layers. Signal traces 296A, printed on the top copper layer, which are electrically coupled to a hot junction for each of the thermocouples. As is well known in the arts, thermocouples typically comprise two dissimilar metals joined together at respective ends of the dissimilar metals. The end of the thermocouple placed into thermal contact with a hot object is called the hot junction, while the opposite end, which is disposed to a base-line temperature within the tip insert, is a cold junction. The hot junction in the top copper layer and the cold junction in the constantan layer are electrically coupled to one another through the polyimide layer. When a catheter tip, consistent with the present embodiment, is placed against a warm object, such as myocardial tissue being ablated by radio frequencies, a voltage difference across the hot and cold junctions develops. The voltage difference is correlated with a temperature of the hot junction. The materials of the hot and cold junctions may include one or more of the following materials: iron, nickel, copper, chromium, aluminum, platinum, rhodium, alloys of any of the above, and other metals with high conductivity.
As each spot electrode (which is electrically coupled to one of electrical contacts 2941-3) forms only one half of a circuit, each electrode need only one trace 296 extending to a connector 292 of the flexible circuit. The electrical signal from each spot electrode is compared and analyzed to detect electrophysiological characteristics indicative of medical conditions, such as, atrial fibrillation. Similarly, during and after treatment, the electrodes may be used to conduct diagnostics and determine a treatment efficacy.
In the embodiment of
As further shown in
The tip insert 58 includes six laterally-extending irrigation channels 70, each of the irrigation channels 70 have a longitudinal axis arranged substantially perpendicular to the longitudinal axis of the catheter. The laterally-extending irrigation channels 70 deliver irrigant circumferentially about the catheter distal tip. It should be noted that the laterally-extending irrigation channels could be arranged at a different angle (i.e., different from 90°) relative to the catheter longitudinal axis. Also, more or fewer than six laterally-extending irrigation channels may be present in the tip insert.
In various embodiments, to assist longitudinal and radial placement of the flexible circuit relative to the tip insert, the tip insert may include longitudinally extending and radially offset channels 761-N and 76′1-N on both proximal and distal ends (or just one end) of the tip insert.
The isometric orientation of the tip insert 58 in
The tip insert 58 can be constructed from, for example, plastic (such as PEEK, which is polyether ether ketone) thermally-insulative ceramic (or other material with similar insulative properties), or ULTEM. All of the ablation tip inserts described herein are preferably constructed from thermally-insulative material.
Further, it should be understood that, in other embodiments of the thermally-insulative ablation tip insert (both irrigated and non-irrigated embodiments), there may be more or fewer channels 76. In fact, although the channels may facilitate placement of the sensors 68 on the insert (e.g., during catheter assembly), the outer surface of the main body of the tip insert may be smooth (or at least channel-less). In such an embodiment, the sensors may be aligned on the smooth outer surface of the tip insert (and, possibly, held in place by, for example, adhesive). Then, when the conductive shell is installed around the tip insert and the sensors 68, the gaps or voids between the inner surface of the conductive shell and the outer surface of the tip insert may be filled with material (e.g., potting material or adhesive). It is worth noting that the sensors may be put in place before or after the conductive shell is placed over the tip insert. For instance, the sensors may be mounted on (e.g., adhered to) the smooth outer surface of the tip insert forming a tip-insert-sensor subassembly. Then, the conductive shell may be placed over that tip-insert-sensor subassembly before the remaining voids between the tip-insert-sensor subassembly and the conductive shell are filled. Alternatively, the conductive shell may be held in place over the tip insert while one or more sensors are slid into the gap between the outer surface of the tip insert and the inner surface of the conductive shell. Subsequently, the voids would again be filled. These alternative manufacturing techniques may apply to all of the disclosed embodiments that comprise sensors mounted between a tip insert and a conductive shell member.
It should also be noted that the outer surface of the temperature sensors are mounted so as to at least be in close proximity to, and preferably to be in physical contact with, the inner surface of the conductive shell 44. As used herein, “in close proximity to” means, for example, within 0.0002 to 0.0010 inches, particularly if a conductive adhesive or other bonding technique is used to bond the temperature sensors to the inner surface of the shell. Depending on the specific properties of the sensors, the construction and materials used for the shell, and the type of conductive adhesive or the other bonding technique employed, it is possible that enough temperature sensitivity may be achieved despite even larger gaps between the sensors and the conductive shell, as long as the sensors are able to readily sense the temperature of the tissue that will be touching the outer surface of the conductive shell during use of the catheter tip.
In
Where catheter tip assembly 42 is an RF ablation catheter, to reduce RF-related interference to the signals received by spot electrodes 328, it may be advantageous to electrically isolate the spot electrodes, from the rest of conductive shell 44 and an RF emitter within the catheter tip assembly. Accordingly, the
The various conductive shells 44, disclosed herein, may comprise platinum, a platinum iridium composition, or gold. The conductive shell 44 (which may weigh, for example, 0.027 g) may comprise one or more parts or components. As shown in
Although a single-layer conductive shell 44 constructed from a thin layer of gold, for example, may perform in an magnetic resonance (MR) environment without causing undesirable or unmanageable MR artifacts, a conductive shell comprising an outer layer of a paramagnetic material such as platinum or platinum iridium, for example, may benefit from a multilayer construction as discussed below. A multilayer conductive shell may have just a multilayer cylindrical body portion, just a multilayer domed distal end portion, or both a multilayer domed distal end portion and a multilayer cylindrical body. Again, however, it is not a requirement that the domed distal end portion and the cylindrical body must both be constructed with the same number of layers or with the same thickness of layers. Also, the walls of the conductive shell 44 may, for example, be of a total thickness that is the same as, or nearly the same as, the thickness of the single-layer conductive shell 44 described above. The conductive shell may be formed or manufactured per, for example, the techniques already described herein.
Platinum iridium (a paramagnetic material) is commonly used for constructing catheter tips. Thus, various embodiments disclosed herein utilizing a thin conductive shell constructed entirely from platinum or platinum iridium (or some other paramagnetic material) may induce MR artifacts in an MR environment. Alternatively, for MR applications, the conductive tip shell may comprise a single layer constructed entirely from a diamagnetic material (e.g., a thin gold conductive shell) or a multilayer conductive shell including, for example, a platinum iridium outer layer and a diamagnetic material (e.g., gold or copper) inner layer. In such an embodiment, the paramagnetic outer layer and the diamagnetic inner layer minimize or entirely mitigate undesirable MR artifacts. Alternatively, the multilayer conductive shell may have an outer layer constructed from a diamagnetic material (such as bismuth or gold) and an inner layer constructed from a paramagnetic material (such as platinum or platinum iridium).
In yet another embodiment (not shown), a multilayer conductive shell may comprise more than two layers. For example, the conductive shell may comprise three layers, including a very thin outer layer of a paramagnetic material, a thicker intermediate layer of a diamagnetic material, and an oversized inner layer of a non-precious metal (or plastic or other material) sized to ensure that the finished geometry of the overall ablation tip is of a desired size for effective tissue ablation.
Materials that could be used for the inner layer include, but are not limited to, the following: silicon (metalloid); germanium (metalloid); bismuth (post transition metal); silver; and gold. Silver and gold are examples of elemental diamagnetic materials that have one-tenth the magnetic permeability of paramagnetic materials like platinum. Thus, one example multilayer shell configuration could comprise a platinum outer layer (or skin) and an inner layer (or liner or core) of gold or silver with a thickness ratio (e.g., platinum-to-gold thickness ratio) of at least 1/10 (i.e., the platinum layer being one-tenth as thick as the gold layer). In another example, a multilayer conductive shell configuration could comprise a platinum outer layer and a bismuth inner layer with a thickness ratio (e.g., platinum-to-bismuth thickness ratio) of at least ½ (i.e., the platinum outer layer being one-half as thick as the bismuth inner layer) since bismuth has a permeability that is about one-half the permeability of platinum. The layers may also be constructed from alloys, which may be used, for example, when a pure element material might otherwise be disqualified from use in the construction of a catheter tip.
In a typical ablation therapy for atrial fibrillation, pulmonary veins may be treated in accordance to their likelihood of having arrhythmic foci. Often, all pulmonary veins are treated. A distal tip of the catheter may include electrophysiology electrodes (also referred to as spot electrodes) which help to expedite diagnosis and treatment of a source of a cardiac arrhythmia, and may also be used to confirm a successful ablation therapy by determining the isolation of the arrhythmic foci from the left atrium, for example, or the destruction of the arrhythmic foci entirely.
During an ablation therapy, a distal end of an ablation catheter tip contacts ablation targeted myocardial tissue in order to conductively transfer energy (e.g., radio-frequency, thermal, etc.) thereto. It has been discovered that consistent force, during a series of tissue ablations, forms a more uniform and transmural lesion line. Such uniform lesion lines have been found to better isolate the electrical impulses produced by arrhythmic foci, thereby improving the overall efficacy of the ablation therapy. To achieve such consistent force, aspects of the present disclosure utilize a deformable body in the ablation catheter tip. The deformable body deforms in response to forces being exerted upon a distal end of the ablation catheter tip. The deformation of the deformable body may then be measured by a measurement device (e.g., ultrasonic, magnetic, optical, interferometry, etc.). Based on the tuning of the deformable body and/or the calibration of the measurement device, the deformation can then be associated with a force exerted on the distal end of the ablation catheter tip (e.g., via a lookup table, formula(s), calibration matrix, etc.).
Referring to
In various embodiments of the present disclosure, to limit the deformation of a structural member 530, partial ablation catheter tip assembly 500 may transmit a portion of a force exerted on flex tip 505 through the manifold 515 (bypassing structural member 530). The manifold 515 transmits the force to a catheter shaft 552 that is coupled to a proximal end of the tip assembly 500 (as shown in
The cross-sectional side views of
In some embodiments, a flexible member 507 of flex tip 505 may comprise a titanium alloy (or other metal alloy with characteristics including a high tensile strength).
Structural member 530 houses a plurality of fiber optic cables 5401-3 that extend through grooves, for example groove 5331. In the present embodiment, the structural member 530 is divided into a plurality of segments along a longitudinal axis. The segments are bridged by flexure portions 5311-2, each flexure portion defining a neutral axes. Each of the neutral axes constitute a location within the respective flexure portions where the stress is zero when subjected to a pure bending moment in any direction.
In a fiber optic distance measurement sensor, fiber optic cables 5401-3 may be disposed in grooves 533, respectively, such that the distal ends of the fiber optic cables terminate at the gaps of either flexure portion 5311-2. As shown in
When a fiber optic sensor consistent with the above is assembled, one or more fiber optic cables 540 are mechanically coupled to structural member 530 via grooves 533. In some embodiments, each of the fiber optics may be communicatively coupled to a Fabry-Perot strain sensor within one of the gaps which form the flexure portions 5311-2. The Fabry-Perot strain sensor includes transmitting and reflecting elements on either side of the slots to define an interferometric gap. The free end of the transmitting element may be faced with a semi-reflecting surface, and the free end of the reflecting element may be faced with a semi-reflecting surface.
In some assemblies of a fiber optic sensor, the fiber optic cables may be positioned along the grooves 5331-3 (as shown in
In some embodiments, structural member 530 may comprise a composition including a stainless steel alloy (or other metal alloy with characteristics including a high tensile strength, e.g., titanium), or platinum iridium (e.g., in a 90/10 ratio).
In partial ablation catheter tip assembly 500 of
Further referring to
In the various catheter tip assemblies disclosed herein, various electronic components in the catheter tip are necessary to facilitate desired functionality. As discussed in more detail above, the catheter tip may include, for example, one or more radio-frequency ablation electrodes, one or more electrophysiology electrodes, and/or a plurality of thermocouples. All of these electronic components must be communicatively coupled to a computer system at a proximal end of the catheter (as discussed above in reference to
In the embodiment disclosed in
Importantly, it has been discovered that the flexible circuits 5901-2 within the ablation catheter tip assembly 500 may function as a structural element of ablation catheter tip assembly 500 in some situations; for example, in response to axial deflections/deformations of the catheter tip. Moreover, in some applications one or more of the flexible circuits, depending on their relative placement to a longitudinal axis of the catheter shaft may also function as a structural element in response to lateral deflections of the catheter tip. This is particularly problematic in ablation catheter systems capable of force sensing (such as discussed herein), and may affect the accuracy of the force measurement system. To address such problems, the present embodiment utilizes a formed bend 5911-2 in one or more of the flexible circuits, which is positioned within the irrigant lumen 516 of manifold 515. As a result, the formed bends in the flexible circuits readily deflect in response to an axial deflection on the catheter tip, absorbing very little of the force, and allowing the force to be almost completely transmitted to the structural member 530, which will deform, the deformation will be measured, and the force exerted on the catheter tip extrapolated therefrom.
Moreover, as each of the flexible circuits have a primarily rectangular cross-section, the flexible circuits are more rigid along a horizontal plane (also referred to as a non-flexible plane, less-flexible plane, less pliable plane), in response to a torque; whereas the flexible circuits are more pliable along vertical planes (also referred to as a flexible plane or more pliable plane). The flexible circuits, along the vertical planes 596 and 596′, are made more pliable due to the formed bends 5911-2. The flexible circuits are far more rigid along horizontal plane 595. Similarly, in many embodiments, structural member 530 may also exhibit varying degrees of flexibility depending on the force vector applied to the conductive shell. The variable flexibility of the structural member may be due, at least in part, to the structural member lacking symmetry across one or more planes extending through a longitudinal axis of the structural member. As a result, a radial vector (or composite radial vector) of the force exerted on the flex tip may greatly impact the resulting deformation of structural member 530. To (at least partially) correct for the resulting lack of repeatability in the deflection of the structural member in response to a constant lateral force exerted with varying radial vectors (and the resulting force measurement calculations), a less pliable plane of the structural member may be aligned with one of the pliable vertical planes 596 and 596′, and if possible a more pliable plane of the structural member may be aligned with a less pliable plane of the flexible circuits (e.g., horizontal plane 595).
In various embodiments of the catheter tip assemblies disclosed herein, the catheter tip assemblies may also include a plurality of spot electrodes on a conductive shell thereof which facilitate electrophysiology mapping of tissue, such as myocardial tissue, in (near) contact with the shell. In more specific embodiments, the plurality of spot electrodes may be placed across the shell in such a manner as to facilitate Orientation Independent Algorithms which enhance electrophysiology mapping of the target tissue and is further disclosed in U.S. application Ser. No. 15/152,496, filed 11 May 2016, U.S. application Ser. No. 14/782,134, filed 7 May 2014, U.S. application Ser. No. 15/118,524, filed 25 Feb. 2015, U.S. application Ser. No. 15/118,522, filed 25 Feb. 2015, and U.S. application No. 62/485,875, filed 14 Apr. 2017, all of which are now pending, and are incorporated by reference as though fully disclosed herein.
While various embodiments of the present disclosure, including
It is to be understood that while an irrigated ablation catheter tip is illustrated in various embodiments of the present disclosure, the design of the structural assembly (including structural member, manifold, and end cap) is modular and may facilitate the fitting of various catheter tips (e.g., rigid, flex, and other advanced irrigation tips).
Applicant further envisions utilizing catheters comprising various segmented tip designs with the ablation catheter system described above. Example tip configurations are disclosed in U.S. patent application No. 61/896,304, filed 28 Oct. 2013, and in related international patent application no. PCT/US2014/062562, filed 28 Oct. 2014 and published 7 May 2015 in English as international publication no. WO 2015/065966 A2, both of which are hereby incorporated by reference as though fully set forth herein.
Although several embodiments have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the present disclosure. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the present teachings. The foregoing description and following claims are intended to cover all such modifications and variations.
Various embodiments are described herein of various apparatuses, systems, and methods. Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. It will be understood by those skilled in the art, however, that the embodiments may be practiced without such specific details. In other instances, well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. Those of ordinary skill in the art will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and do not necessarily limit the scope of the embodiments, the scope of which is defined solely by the appended claims.
Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” “an embodiment,” or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment,” “in an embodiment,” or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation.
It will be appreciated that the terms “proximal” and “distal” may be used throughout the specification with reference to a clinician manipulating one end of an instrument used to treat a patient. The term “proximal” refers to the portion of the instrument closest to the clinician and the term “distal” refers to the portion located furthest from the clinician. It will be further appreciated that for conciseness and clarity, spatial terms such as “vertical,” “horizontal,” “up,” and “down” may be used herein with respect to the illustrated embodiments. However, surgical instruments may be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
This application claims the benefit of U.S. provisional application No. 62/832,246, filed 10 Apr. 2019, which is hereby incorporated by reference as though fully set forth herein. This application incorporates by reference as though fully set forth herein: U.S. application Ser. No. 15/088,036, filed 31 Mar. 2016, now pending, which claims the benefit of U.S. provisional application No. 62/141,066, filed 31 Mar. 2015; U.S. application Ser. No. 15/088,052, filed 31 Mar. 2016, now pending, which claims the benefit of U.S. provisional application No. 62/198,114, filed 28 Jul. 2015; U.S. application Ser. No. 15/723,701, filed 3 Oct. 2017, now pending, which claims the benefit of U.S. provisional application No. 62/404,038, filed 4 Oct. 2016; U.S. application Ser. No. 15/724,157, filed 3 Oct. 2017, now pending, which claims the benefit of U.S. provisional application No. 62/404,060, filed 4 Oct. 2016; international application no. PCT/US2017/049264, filed 30 Aug. 2017, now pending, which claims the benefit of U.S. provisional application No. 62/404,013, filed 4 Oct. 2016; U.S. provisional application No. 62/642,178, filed 13 Mar. 2018; U.S. provisional application No. 62/824,840, filed 27 Mar. 2019; U.S. provisional application No. 62/824,844, filed 27 Mar. 2019; and U.S. provisional application No. 62/824,846, filed 27 Mar. 2019.
Number | Date | Country | |
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62832246 | Apr 2019 | US |