This application is in the general field of therapeutic electrical energy delivery, and it pertains more specifically to electrical energy delivery in the context of ablation of nerves in the vascular or vessel walls of renal arteries or renal denervation, a therapeutic procedure that can lead to reduced hypertension in patients with high blood pressure. The ablation energy can be in the form of high voltage DC pulses that generate irreversible electroporation of cell membranes and destroy tissue locally for therapeutic purposes, or it can be applied as RF energy that generates thermal energy.
The past two decades have seen advances in the technique of electroporation as it has progressed from the laboratory to clinical applications. Known methods include applying brief, high voltage DC pulses to tissue, thereby generating locally high electric fields, typically in the range of hundreds of Volts/centimeter. The electric fields disrupt cell membranes by generating pores in the cell membrane, which subsequently destroys the cell membrane and the cell. While the precise mechanism of this electrically-driven pore generation (or electroporation) awaits a detailed understanding, it is thought that the application of relatively large electric fields generates instabilities in the phospholipid bilayers in cell membranes, as well as mitochondria, causing the occurrence of a distribution of local gaps or pores in the membrane. If the applied electric field at the membrane exceeds a threshold value, typically dependent on cell size, the electroporation is irreversible and the pores remain open, permitting exchange of material across the membrane and leading to apoptosis or cell death. Subsequently, the surrounding tissue heals in a natural process.
While pulsed DC voltages are known to drive electroporation under the right circumstances, the examples of irreversible electroporation applications in medicine and delivery methods described in the prior art do not provide specific means of limiting possible damage to nearby tissue while it is desired to ablate tissue relatively farther away. There is a need for selective energy delivery methods and devices that generate tissue ablation where it is desired, while leaving tissue elsewhere relatively intact and unchanged. In the specific context of minimally invasive renal denervation for the treatment of hypertension, known ablation devices are generally positioned in the renal arteries for electrical energy delivery to the renal artery walls. The outer layers of the renal arteries, or adventitia, have a distribution of renal nerve endings. When these nerve endings are destroyed by application of a high electric field, the consequent reduction in renal sympathetic activity can result in decreased hypertension. During this process, the vessel wall must be maintained intact; the local electric field in the vessel wall must not be too large, in order to avoid generating locally large current densities in the vessel wall which can lead to local thermal “hot spots” that can unintentionally damage or perforate the renal vessel. Thus it is desired to maintain vessel integrity and reduce and/or avoid local thermal hot spots driven by locally large current densities while still maintaining an electric field magnitude that is still above the threshold of irreversible electroporation.
There is a need for selective energy delivery for electroporation in such a manner as to preserve overall vascular integrity while destroying the nerve endings in the adventitia of the renal artery where ablation is to be performed.
The present disclosure addresses the need for tools and methods for rapid and selective application of electroporation therapy in the treatment of hypertension by minimally invasive ablation of the renal arteries. The embodiments described herein can result in well-controlled and specific delivery of electroporation in an efficacious manner while preserving vascular tissue where the local damage is to be preferentially minimized by reducing and/or eliminating thermal hot spots (or localized areas of high temperature and/or spatial temperature gradients), in order to maintain overall vascular integrity. In some embodiments, an apparatus includes a flexible catheter shaft and at least one electrode pair. The flexible catheter shaft has an electrically insulating expandable member coupled thereto such that the expandable member surrounds a portion of the catheter shaft. The portion of the catheter shaft defines a lumen, and a surface of the catheter shaft defines a first opening and a second opening. The first opening and the second opening are each in fluid communication with the lumen. The expandable member is disposed between the first opening and the second opening to establish a pathway through the expandable member via the lumen. The electrode pair includes a first electrode and a second electrode. The first electrode is coupled to the catheter shaft between the first opening and the expandable member. The second electrode is coupled to the catheter shaft between the second opening and the expandable member.
In some embodiments, a method includes using the catheter device and systems for the selective and rapid application of DC voltage to produce electroporation ablation for renal denervation. For example, in some embodiments, an irreversible electroporation system includes a DC voltage/signal generator and a controller for triggering voltage pulses to be applied to a selected multiplicity or a subset of electrodes. The catheter device has a set of electrodes for ablation or delivery of voltage pulses, and an expandable member (e.g., an inflatable balloon) disposed between a pair of electrodes. When the expandable member is moved to an expanded configuration (e.g., the balloon is inflated), the electrodes are positioned in the central region of the vessel lumen, away from the vessel wall. Furthermore, the catheter has openings from the exterior surface into an internal lumen that runs along a path approximately parallel to the longitudinal axis of the balloon, and with a lumen length that extends beyond either electrode of the electrode pair. Thus, the internal lumen provides an internal path in the device for blood flow through the renal vessel. When the balloon is inflated and blocks most of the vessel lumen, blood can still flow from one end of the balloon to the other through the internal blood path in the catheter. Thus, vessel occlusion of blood flow does not occur. The internal blood path also provides a shunt path for electric current to flow through when the electrodes on either end of the balloon are polarized. This shunt path for electric current also serves to reduce electric field intensities in corner regions between the balloon and the vessel wall, suppressing or eliminating local or regional hot spots where large current density values can drive local thermal heating of vascular tissue, resulting in a safer and more effective ablation device. Thus, the intense electric field near or in the internal vessel wall is reduced and/or eliminated, reducing the likelihood of vessel wall perforation. The electric field magnitude in the vessel wall can remain large enough to generate irreversible electroporation of the renal nerve endings therein.
In some embodiments, the catheter device has a set of electrodes for ablation or delivery of voltage pulses, at least one member of which is recessed from the outer surface such that when inserted in a vascular structure, it cannot directly contact the inner vascular wall. The recessed electrode contacts blood in the vessel, with blood forming a portion of the electrical path between anode and cathode electrodes, and with the vascular wall also forming a portion of the electrical path between anode and cathode electrodes. In some embodiments, all of the electrodes on the catheter are recessed so that there is no direct physical contact between any of the electrodes and the vascular wall. Thus, the intense electric field near the electrode surface is removed from the wall, reducing or eliminating the likelihood of vessel wall perforation. The electric field magnitude in the vessel wall, however, is large enough to generate irreversible electroporation of the renal nerve endings therein. In some embodiments, at least one pair of anode and cathode electrodes are set in a recessed void in the catheter, and separated from each other by an insulator. In general, the catheter can have a multiplicity of such pairs of anode and cathode electrodes recessed in the catheter, so as to be able to ablate a longer region or length of arterial wall more conveniently.
In some embodiments, for example, the voltage pulses can have pulse widths in the range of nanoseconds to hundreds of microseconds. In some embodiments, there could be a multiplicity of such voltage pulses applied through the electrodes, with an interval between pulses that can for illustrative purposes be in the range of nanoseconds to hundreds of microseconds. The generator can output waveforms that can be selected to generate a sequence of voltage pulses in either monophasic or multiphasic forms and with either constant or progressively changing amplitudes.
This embodiments described herein include a catheter device and systems for renal denervation ablation with rapid application of DC high voltage pulses to drive irreversible electroporation. In some embodiments, the irreversible electroporation system described herein includes a DC voltage pulse/signal generator and a controller capable of being configured to apply voltages to a selected multiplicity of electrodes.
In some embodiments, the catheter has an inflatable balloon or similar expandable member disposed in its distal portion such that the catheter shaft passes through the balloon. The catheter has at least one anode-cathode pair of electrodes that are disposed on either end of the expandable member or inflatable balloon in the distal region of the catheter. With the balloon inflated, the electrodes are positioned in the central region of the vessel lumen and away from the vessel wall. Furthermore, the catheter has openings from the exterior surface into an internal lumen that runs along a path approximately parallel to the longitudinal axis of the catheter/balloon, and with a lumen length that extends beyond either electrode of the electrode pair. Thus, the internal lumen provides an internal path for blood flow in the device starting from a location proximal to the proximal electrode and ending at a location distal to the distal electrode, thus shunting blood flowing through the renal vessel. In this manner, when the balloon is inflated and blocks most of the vessel lumen, blood can still flow from one end of the balloon to the other through the internal blood path in the catheter. Thus, vessel occlusion of blood flow does not occur.
Moreover, in some embodiments, the internal blood path also provides a shunt path for electric current to flow through when the electrodes on either end of the balloon are polarized by an applied potential difference. This shunt path for electric current also serves to reduce electric field intensities in corner regions between the balloon and the vessel wall, suppressing or eliminating local or regional hot spots where large current density values can drive local thermal heating of vascular tissue, thereby resulting in an overall safer and more effective ablation device. Thus, the intense electric field and associated large current density near or in the internal vascular wall is eliminated, reducing the likelihood of vessel wall perforation.
The electric field magnitude in the vessel wall, however, can remain large enough to generate irreversible electroporation of the renal nerve endings therein and successful ablation results. In some embodiments, the voltage pulses can have pulse widths in the range of nanoseconds to hundreds of microseconds. In some embodiments, there could be a multiplicity of such voltage pulses applied through the electrodes, with an interval between pulses that can for illustrative purposes be in the range of nanoseconds to hundreds of microseconds. The generator can output waveforms that can be selected to generate a sequence of voltage pulses in either monophasic or multiphasic forms and with either constant or progressively changing amplitudes.
The balloons and/or expandable members described herein can be constructed from any suitable material. For example, in some embodiments, the balloon is made of a material that is electrically an insulator such as for example polyurethane.
In some embodiments, an apparatus includes a flexible catheter shaft and at least one electrode pair. The flexible catheter shaft has an electrically insulating expandable member coupled thereto such that the expandable member surrounds a portion of the catheter shaft. The portion of the catheter shaft defines a lumen, and a surface of the catheter shaft defines a first opening and a second opening. The first opening and the second opening are each in fluid communication with the lumen. The expandable member is disposed between the first opening and the second opening to establish a pathway through the expandable member via the lumen. The electrode pair includes a first electrode and a second electrode. The first electrode is coupled to the catheter shaft between the first opening and the expandable member. The second electrode is coupled to the catheter shaft between the second opening and the expandable member.
In some embodiments, a method includes inserting a catheter device comprising a flexible catheter shaft and at least one electrode pair into a renal artery. The flexible catheter shaft has an electrically insulating expandable member coupled thereto such that the expandable member surrounds a portion of the catheter shaft. The expandable member is expanded until in expanded form it abuts the arterial vessel wall around its circumference, thereby positioning the catheter device so that it becomes well-centered within the vessel lumen. The portion of the catheter shaft surrounded by the expandable member defines a lumen, and a surface of the catheter shaft defines a first opening and a second opening each in fluid communication with the lumen. With the expandable member in expanded form, the first and second openings in the catheter shaft surface and the lumen together provide a path for blood flow to continue in the arterial vessel, even when the expanded member occludes longitudinal blood flow in the circumferential portions of the vessel cross section. With the device thus deployed, a voltage pulse for tissue ablation is applied between the electrodes of the electrode pair, ablating the nerve endings in the renal arterial wall. Subsequently, the expandable member is relaxed or returned to unexpanded form, and the catheter device is inserted further into the renal arterial vessel for ablation at a subsequent location, and so on. The iterative steps of inserting and positioning the catheter device and applying ablation are continued as needed until the user decides that a sufficient degree of ablation has been applied.
An anatomical pathway and context for use of the catheter device according to an embodiment in a renal denervation ablation procedure is illustrated in
A catheter assembly according to an embodiment is illustrated in
A catheter device 400 according to an embodiment is shown in a more detailed illustration (not to scale) in
As shown, electrodes in the form of rings 350 and 351 are indicated as mounted on the catheter shaft near proximal and distal ends respectively of the balloon 348. The electrodes 350, 351 can have any suitable size and/or shape. For example in some embodiments, the electrodes 450, 451 can be a ring-shaped electrode having a width in the range 1 mm-6 mm, and a diameter in the range of about 1 mm to about 6 mm. The nearest edge-to-edge separation between electrodes can be in the range from about 3 mm to about 25 mm.
In one method of assembly, segmental pieces A1-B1, B1-C1, C1-D1, and D1-E1 with distinct and suitably mating lumen structures can comprise polymeric material, be extruded separately and joined by processes such as heat bonding that are well known to those skilled in the art. Various polymeric materials can be used in the construction; for example, the balloon can be made of thin polyurethane with suitable stretchability (or compliance) for inflation. The catheter shaft can comprise polymers such as Teflon, polyurethane, Nylon, PEEK (Poly Ester Ester Ketone) or polyethylene that are utilized frequently in the medical device industry and known to one skilled in the art. The balloon 348 (and any of the balloons or expanded members described herein) can have a length in the range 3 mm-25 mm and an inflated diameter in the range 2 mm-6 mm. It is to be noted that in alternate embodiments, the inflatable balloon 348 (and any of the balloons or expanded members described herein) can instead be in the form of an expandable member, whether in the form of an expanded structure with a mesh-based unfolding structure, or a variety of other forms known to those skilled in the art. In the latter case the expandable member can have an expanded diameter in the range of about 2 mm to about 6 mm and a length in the range 3 mm-25 mm.
The catheter shaft can also include metallic mesh or braid constructions in the wall for torque transmission and suitable rigidity. The electrodes can include metals such as Platinum Iridium alloy, stainless steel, silver or other biocompatible metals that are known in the medical device industry as suitable electrode materials, and may be affixed to the catheter by an etching and gluing process, swaging, crimping or other processes known to one skilled in the art. The electrodes have leads attached to the inner or non-exposed side that run back to the catheter handle for connection to an appropriate electrical connector (not shown in
A schematic cutaway view of a catheter 13 according to an embodiment is shown in
Such a simulation result is shown in
A finite element analysis-derived spatial quiver plot of current density within a finite element geometry similar to that of
In like manner,
The sharp drop-off of electric field intensity from a localized peak along a longitudinal direction can be illustrated with line plots as for example shown in
In one embodiment, the catheter has at least one anode-cathode pair of electrodes that are recessed from the exterior surface of the distal region of the catheter. With the electrodes positioned away in a radially inward manner from the diameter profile of the cross section of the catheter, the electric field generated due to an applied potential difference between the electrodes is not excessively large at the arterial wall, thus preserving the wall itself. At the same time, the nerve cells in the nerves present in the vascular wall are in the presence of an electric field large enough to generate irreversible electroporation and subsequent cell necrosis.
The recessed electrodes contact blood in the vessel, with blood thus forming a portion of the electrical path between anode and cathode electrodes. The vascular wall also forms a portion of the electrical path between anode and cathode electrodes. In some embodiments, all the electrodes on the catheter are recessed so that there is no direct physical contact between any of the electrodes and the vascular wall. Thus, the intense electric field near the electrode surface is removed from the wall, reducing or eliminating the likelihood of vessel wall perforation while the electric field is still large enough to generate irreversible electroporation of the renal nerve endings therein. In some embodiments, a pair of anode and cathode electrodes are set in a recessed void in the catheter, and separated from each other by an insulator. The voltage pulses can for exemplary purposes have pulse widths in the range of tens to hundreds of microseconds. In some embodiments there could be a multiplicity of such voltage pulses applied through the electrodes, with an interval between pulses that can for illustrative purposes be in the range of tens to hundreds of microseconds. The generator can output waveforms that can be selected to generate a sequence of voltage pulses in either monophasic or multiphasic forms and with either constant or progressively changing amplitudes.
A catheter according to an embodiment having a recessed void in the exterior surface of the catheter, wherein recessed electrodes are disposed therein for applying electrical voltages for ablation purposes, is shown in
The internal arrangement of the electrodes within the recess is displayed more clearly in
It is to be noted that while
The three dimensional geometry of the catheter with the recessed electrodes within a blood vessel filled with blood is further illustrated in
Such a simulation result is shown in
An embodiment of the catheter device according to an embodiment with two pairs of anode-cathode ablation electrodes in the distal portion of the device is illustrated in
A schematic representation of an irreversible electroporation system is depicted in
A DC voltage for electroporation can be applied to the catheter electrodes. The DC voltage is applied in brief pulses sufficient to cause irreversible electroporation can be in the range of 0.5 kV to 10 kV and more preferably in the range 1 kV to 4 kV, so that an appropriate threshold electric field is effectively achieved in the renal nerve tissue to be ablated. In one embodiment of the invention, the electrodes marked for ablation can be automatically identified, or manually identified by suitable marking, on an X-ray or fluoroscopic image obtained at an appropriate angulation that permits identification of the geometric distance between anode and cathode electrodes, or their respective centroids. In one embodiment, the DC voltage generator setting for irreversible electroporation is then automatically identified by the electroporation system based on this distance measure. In an alternate embodiment, the DC voltage value is selected directly by a user from a suitable dial, slider, touch screen, or any other user interface. The DC voltage pulse results in a current flowing between the anode and cathode electrodes, with said current flowing through the blood in the renal artery, the blood path through the catheter lumen, and the vessel wall tissue, with the current flowing from the anode and returning back through the cathode electrode. The forward and return current paths (leads) are both inside the catheter.
The controller and generator can output waveforms that can be selected to generate a sequence of voltage pulses in either monophasic or biphasic or more generally, multiphasic forms and with either constant or progressively changing amplitudes.
Yet another example of a waveform or pulse shape that can be generated by the system is illustrated in
The time duration of each irreversible electroporation rectangular voltage pulse could lie in the range from 1 nanosecond to 10 milliseconds, with the range 10 microseconds to 1 millisecond being more preferable and the range 50 microseconds to 300 microseconds being still more preferable. The time interval between successive pulses of a pulse train could be in the range of 1 nanosecond to 1 millisecond, with the range 50 microseconds to 300 microseconds being more preferable. The number of pulses applied in a single pulse train (with delays between individual pulses lying in the ranges just mentioned) can range from 1 to 100, with the range 1 to 10 being more preferable. In one embodiment, a pulse train can be driven by a user-controlled switch or button, in one embodiment mounted on a hand-held joystick-like device while in an alternate embodiment it could be in the form of a foot pedal and in still another embodiment it could be implemented with a computer mouse. Indeed a variety of such triggering schemes can be implemented by those skilled in the art, as convenient for the application and without departing from the scope of the present invention. In one mode of operation a pulse train can be generated for every push of such a control button, while in an alternate mode of operation pulse trains can be generated repeatedly for as long as the user-controlled switch or button is engaged by the user.
While several specific examples and embodiments of systems and tools for tissue ablation with irreversible electroporation were described in the foregoing for illustrative and purposes, it should be clear that a wide variety of variations and alternate embodiments could be conceived or constructed by those skilled in the art based on the teachings of the present invention. Persons skilled in the art would recognize that any of a wide variety of other control or user input methods and device variations can be implemented without departing from the scope of the embodiments described herein. Likewise, while the foregoing described specific tools or devices for more effective and selective DC voltage application for irreversible electroporation, other device constructions and variations could be implemented by one skilled in the art by employing the principles and teachings disclosed herein without departing from the scope of the present invention. For example, while the description above discussed one electrode located proximal to the balloon and another electrode located distal to the balloon, in one variation a multiplicity of electrodes could be located proximal to the balloon and a multiplicity of electrodes could be located distal to the balloon.
Although various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having a combination of any features and/or components from any of embodiments as discussed above. For example, in some embodiments, a device can include an expandable member similar to the expanded member shown and described with reference to
This application is a division of U.S. patent application Ser. No. 15/201,997 filed Jul. 5, 2016, entitled “APPARATUS AND METHODS FOR RENAL DENERVATION ABLATION,” now issued as U.S. Pat. No. 10,517,672, which is a continuation of PCT/US2015/010223 filed Jan. 6, 2015, entitled “APPARATUS AND METHODS FOR RENAL DENERVATION ABLATION,” which claims priority to and the benefit of U.S. Provisional Application No. 61/923,969 filed Jan. 6, 2014, entitled “BALLOON CATHETER WITH BLOOD PATH,” and U.S. Provisional Application No. 61/923,966 filed Jan. 6, 2014, entitled “OFFSET RENAL DENERVATION ELECTRODE,” each of which are incorporated by reference herein in their entirety.
Number | Name | Date | Kind |
---|---|---|---|
4200104 | Harris | Apr 1980 | A |
4470407 | Hussein | Sep 1984 | A |
5242441 | Avitall | Sep 1993 | A |
5257635 | Langberg | Nov 1993 | A |
5281213 | Milder et al. | Jan 1994 | A |
5334193 | Nardella | Aug 1994 | A |
5341807 | Nardella | Aug 1994 | A |
5342301 | Saab | Aug 1994 | A |
5398683 | Edwards et al. | Mar 1995 | A |
5443463 | Stern et al. | Aug 1995 | A |
5454370 | Avitall | Oct 1995 | A |
5515848 | Corbett, III et al. | May 1996 | A |
5531685 | Hemmer et al. | Jul 1996 | A |
5545161 | Imran | Aug 1996 | A |
5578040 | Smith | Nov 1996 | A |
5617854 | Munsif | Apr 1997 | A |
5624430 | Eton et al. | Apr 1997 | A |
5667491 | Pliquett et al. | Sep 1997 | A |
5672170 | Cho | Sep 1997 | A |
5700243 | Narciso, Jr. | Dec 1997 | A |
5702438 | Avitall | Dec 1997 | A |
5706823 | Wodlinger | Jan 1998 | A |
5722400 | Ockuly et al. | Mar 1998 | A |
5722402 | Swanson et al. | Mar 1998 | A |
5749914 | Janssen | May 1998 | A |
5779699 | Lipson | Jul 1998 | A |
5788692 | Campbell et al. | Aug 1998 | A |
5810762 | Hofmann | Sep 1998 | A |
5833710 | Jacobson | Nov 1998 | A |
5836874 | Swanson et al. | Nov 1998 | A |
5836942 | Netherly et al. | Nov 1998 | A |
5836947 | Fleischman et al. | Nov 1998 | A |
5843154 | Osypka | Dec 1998 | A |
5849028 | Chen | Dec 1998 | A |
5863291 | Schaer | Jan 1999 | A |
5868736 | Swanson et al. | Feb 1999 | A |
5871523 | Fleischman et al. | Feb 1999 | A |
5876336 | Swanson et al. | Mar 1999 | A |
5895404 | Ruiz | Apr 1999 | A |
5899917 | Edwards et al. | May 1999 | A |
5904709 | Arndt et al. | May 1999 | A |
5916158 | Webster, Jr. | Jun 1999 | A |
5916213 | Haissaguerre et al. | Jun 1999 | A |
5921924 | Avitall | Jul 1999 | A |
5928269 | Alt | Jul 1999 | A |
5928270 | Ramsey, III | Jul 1999 | A |
6002955 | Willems et al. | Dec 1999 | A |
6006131 | Cooper et al. | Dec 1999 | A |
6009351 | Flachman | Dec 1999 | A |
6014579 | Pomeranz et al. | Jan 2000 | A |
6029671 | Stevens et al. | Feb 2000 | A |
6033403 | Tu et al. | Mar 2000 | A |
6045550 | Simpson et al. | Apr 2000 | A |
6068653 | LaFontaine | May 2000 | A |
6071274 | Thompson et al. | Jun 2000 | A |
6071281 | Burnside et al. | Jun 2000 | A |
6090104 | Webster, Jr. | Jul 2000 | A |
6096036 | Bowe et al. | Aug 2000 | A |
6113595 | Muntermann | Sep 2000 | A |
6119041 | Pomeranz et al. | Sep 2000 | A |
6120500 | Bednarek et al. | Sep 2000 | A |
6146381 | Bowe et al. | Nov 2000 | A |
6164283 | Lesh | Dec 2000 | A |
6167291 | Barajas et al. | Dec 2000 | A |
6216034 | Hofmann et al. | Apr 2001 | B1 |
6219582 | Hofstad et al. | Apr 2001 | B1 |
6223085 | Dann et al. | Apr 2001 | B1 |
6231518 | Grabek et al. | May 2001 | B1 |
6245064 | Lesh et al. | Jun 2001 | B1 |
6251107 | Schaer | Jun 2001 | B1 |
6251128 | Knopp et al. | Jun 2001 | B1 |
6270476 | Santoianni et al. | Aug 2001 | B1 |
6272384 | Simon et al. | Aug 2001 | B1 |
6287306 | Kroll et al. | Sep 2001 | B1 |
6314963 | Vaska et al. | Nov 2001 | B1 |
6322559 | Daulton et al. | Nov 2001 | B1 |
6350263 | Wetzig et al. | Feb 2002 | B1 |
6370412 | Armoundas et al. | Apr 2002 | B1 |
6391024 | Sun et al. | May 2002 | B1 |
6447505 | McGovern et al. | Sep 2002 | B2 |
6464699 | Swanson | Oct 2002 | B1 |
6470211 | Ideker et al. | Oct 2002 | B1 |
6502576 | Lesh | Jan 2003 | B1 |
6503247 | Swartz et al. | Jan 2003 | B2 |
6517534 | McGovern et al. | Feb 2003 | B1 |
6527724 | Fenici | Mar 2003 | B1 |
6527767 | Wang et al. | Mar 2003 | B2 |
6592581 | Bowe | Jul 2003 | B2 |
6595991 | Tollner et al. | Jul 2003 | B2 |
6607520 | Keane | Aug 2003 | B2 |
6623480 | Kuo et al. | Sep 2003 | B1 |
6638278 | Falwell et al. | Oct 2003 | B2 |
6666863 | Wentzel et al. | Dec 2003 | B2 |
6669693 | Friedman | Dec 2003 | B2 |
6702811 | Stewart et al. | Mar 2004 | B2 |
6719756 | Muntermann | Apr 2004 | B1 |
6723092 | Brown et al. | Apr 2004 | B2 |
6728563 | Rashidi | Apr 2004 | B2 |
6743225 | Sanchez et al. | Jun 2004 | B2 |
6743239 | Kuehn et al. | Jun 2004 | B1 |
6764486 | Natale | Jul 2004 | B2 |
6780181 | Kroll et al. | Aug 2004 | B2 |
6805128 | Pless | Oct 2004 | B1 |
6807447 | Griffin, III | Oct 2004 | B2 |
6892091 | Ben-Haim et al. | May 2005 | B1 |
6893438 | Hall et al. | May 2005 | B2 |
6926714 | Sra | Aug 2005 | B1 |
6955173 | Lesh | Oct 2005 | B2 |
6960206 | Keane | Nov 2005 | B2 |
6960207 | Vanney et al. | Nov 2005 | B2 |
6972016 | Hill, III et al. | Dec 2005 | B2 |
6973339 | Govari | Dec 2005 | B2 |
6979331 | Hintringer et al. | Dec 2005 | B2 |
6984232 | Vanney et al. | Jan 2006 | B2 |
6985776 | Kane et al. | Jan 2006 | B2 |
7001383 | Keidar | Feb 2006 | B2 |
7041095 | Wang et al. | May 2006 | B2 |
7171263 | Darvish et al. | Jan 2007 | B2 |
7182725 | Bonan et al. | Feb 2007 | B2 |
7195628 | Falkenberg | Mar 2007 | B2 |
7207988 | Leckrone et al. | Apr 2007 | B2 |
7207989 | Pike, Jr. et al. | Apr 2007 | B2 |
7229402 | Diaz et al. | Jun 2007 | B2 |
7229437 | Johnson et al. | Jun 2007 | B2 |
7250049 | Roop et al. | Jul 2007 | B2 |
7285116 | de la Rama et al. | Oct 2007 | B2 |
7285119 | Stewart et al. | Oct 2007 | B2 |
7326208 | Vanney et al. | Feb 2008 | B2 |
7346379 | Eng et al. | Mar 2008 | B2 |
7367974 | Haemmerich et al. | May 2008 | B2 |
7374567 | Heuser | May 2008 | B2 |
7387629 | Vanney et al. | Jun 2008 | B2 |
7387630 | Mest | Jun 2008 | B2 |
7387636 | Cohn et al. | Jun 2008 | B2 |
7416552 | Paul et al. | Aug 2008 | B2 |
7419477 | Simpson et al. | Sep 2008 | B2 |
7419489 | Vanney et al. | Sep 2008 | B2 |
7429261 | Kunis et al. | Sep 2008 | B2 |
7435248 | Taimisto et al. | Oct 2008 | B2 |
7513896 | Orszulak | Apr 2009 | B2 |
7527625 | Knight et al. | May 2009 | B2 |
7578816 | Boveja et al. | Aug 2009 | B2 |
7588567 | Boveja et al. | Sep 2009 | B2 |
7623899 | Worley et al. | Nov 2009 | B2 |
7678108 | Chrisitian et al. | Mar 2010 | B2 |
7681579 | Schwartz | Mar 2010 | B2 |
7771421 | Stewart et al. | Aug 2010 | B2 |
7805182 | Weese et al. | Sep 2010 | B2 |
7850642 | Moll et al. | Dec 2010 | B2 |
7850685 | Kunis et al. | Dec 2010 | B2 |
7857808 | Oral et al. | Dec 2010 | B2 |
7857809 | Drysen | Dec 2010 | B2 |
7869865 | Govari et al. | Jan 2011 | B2 |
7896873 | Hiller et al. | Mar 2011 | B2 |
7917211 | Zacouto | Mar 2011 | B2 |
7918819 | Karmarkar et al. | Apr 2011 | B2 |
7918850 | Govari et al. | Apr 2011 | B2 |
7922714 | Stevens-Wright | Apr 2011 | B2 |
7955827 | Rubinsky et al. | Jun 2011 | B2 |
8048067 | Davalos et al. | Nov 2011 | B2 |
8048072 | Verin et al. | Nov 2011 | B2 |
8100895 | Panos et al. | Jan 2012 | B2 |
8100900 | Prinz et al. | Jan 2012 | B2 |
8108069 | Stahler et al. | Jan 2012 | B2 |
8133220 | Lee et al. | Mar 2012 | B2 |
8137342 | Crossman | Mar 2012 | B2 |
8145289 | Calabro′ et al. | Mar 2012 | B2 |
8147486 | Honour et al. | Apr 2012 | B2 |
8160690 | Wilfley et al. | Apr 2012 | B2 |
8175680 | Panescu | May 2012 | B2 |
8182477 | Orszulak et al. | May 2012 | B2 |
8206384 | Falwell et al. | Jun 2012 | B2 |
8206385 | Stangenes et al. | Jun 2012 | B2 |
8216221 | Ibrahim et al. | Jul 2012 | B2 |
8221411 | Francischelli et al. | Jul 2012 | B2 |
8226648 | Paul et al. | Jul 2012 | B2 |
8228065 | Wirtz et al. | Jul 2012 | B2 |
8235986 | Kulesa et al. | Aug 2012 | B2 |
8235988 | Davis et al. | Aug 2012 | B2 |
8251986 | Chornenky et al. | Aug 2012 | B2 |
8282631 | Davalos et al. | Oct 2012 | B2 |
8287532 | Carroll et al. | Oct 2012 | B2 |
8414508 | Thapliyal et al. | Apr 2013 | B2 |
8430875 | Ibrahim et al. | Apr 2013 | B2 |
8433394 | Harlev et al. | Apr 2013 | B2 |
8449535 | Deno et al. | May 2013 | B2 |
8454594 | Demarais et al. | Jun 2013 | B2 |
8463368 | Harlev et al. | Jun 2013 | B2 |
8475450 | Govari et al. | Jul 2013 | B2 |
8486063 | Werneth et al. | Jul 2013 | B2 |
8500733 | Watson | Aug 2013 | B2 |
8535304 | Sklar et al. | Sep 2013 | B2 |
8538501 | Venkatachalam et al. | Sep 2013 | B2 |
8562588 | Hobbs et al. | Oct 2013 | B2 |
8568406 | Harlev et al. | Oct 2013 | B2 |
8571635 | McGee | Oct 2013 | B2 |
8571647 | Harlev et al. | Oct 2013 | B2 |
8585695 | Shih | Nov 2013 | B2 |
8588885 | Hall et al. | Nov 2013 | B2 |
8597288 | Christian | Dec 2013 | B2 |
8608735 | Govari et al. | Dec 2013 | B2 |
8628522 | Ibrahim et al. | Jan 2014 | B2 |
8632534 | Pearson et al. | Jan 2014 | B2 |
8647338 | Chornenky et al. | Feb 2014 | B2 |
8708952 | Cohen et al. | Apr 2014 | B2 |
8734442 | Cao et al. | May 2014 | B2 |
8771267 | Kunis et al. | Jul 2014 | B2 |
8795310 | Fung et al. | Aug 2014 | B2 |
8808273 | Caples et al. | Aug 2014 | B2 |
8834461 | Werneth et al. | Sep 2014 | B2 |
8834464 | Stewart et al. | Sep 2014 | B2 |
8868169 | Narayan et al. | Oct 2014 | B2 |
8876817 | Avitall et al. | Nov 2014 | B2 |
8886309 | Luther et al. | Nov 2014 | B2 |
8903488 | Callas et al. | Dec 2014 | B2 |
8920411 | Gelbart et al. | Dec 2014 | B2 |
8926589 | Govari | Jan 2015 | B2 |
8932287 | Gelbart et al. | Jan 2015 | B2 |
8945117 | Bencini | Feb 2015 | B2 |
8979841 | Kunis et al. | Mar 2015 | B2 |
8986278 | Fung et al. | Mar 2015 | B2 |
9002442 | Harley et al. | Apr 2015 | B2 |
9005189 | Davalos et al. | Apr 2015 | B2 |
9005194 | Oral et al. | Apr 2015 | B2 |
9011425 | Fischer et al. | Apr 2015 | B2 |
9044245 | Condie et al. | Jun 2015 | B2 |
9055959 | Vaska et al. | Jun 2015 | B2 |
9072518 | Swanson | Jul 2015 | B2 |
9078667 | Besser et al. | Jul 2015 | B2 |
9101374 | Hoch et al. | Aug 2015 | B1 |
9119533 | Ghaffari | Sep 2015 | B2 |
9119634 | Gelbart et al. | Sep 2015 | B2 |
9131897 | Harada et al. | Sep 2015 | B2 |
9155590 | Mathur | Oct 2015 | B2 |
9162037 | Belson et al. | Oct 2015 | B2 |
9179972 | Olson | Nov 2015 | B2 |
9186481 | Avitall et al. | Nov 2015 | B2 |
9192769 | Donofrio et al. | Nov 2015 | B2 |
9211405 | Mahapatra et al. | Dec 2015 | B2 |
9216055 | Spence et al. | Dec 2015 | B2 |
9233248 | Luther et al. | Jan 2016 | B2 |
9237926 | Nollert et al. | Jan 2016 | B2 |
9262252 | Kirkpatrick et al. | Feb 2016 | B2 |
9277957 | Long et al. | Mar 2016 | B2 |
9282910 | Narayan et al. | Mar 2016 | B2 |
9289258 | Cohen | Mar 2016 | B2 |
9289606 | Paul et al. | Mar 2016 | B2 |
9295516 | Pearson et al. | Mar 2016 | B2 |
9301801 | Scheib | Apr 2016 | B2 |
9375268 | Long | Jun 2016 | B2 |
9414881 | Callas et al. | Aug 2016 | B2 |
9468495 | Kunis et al. | Oct 2016 | B2 |
9474486 | Eliason et al. | Oct 2016 | B2 |
9474574 | Ibrahim et al. | Oct 2016 | B2 |
9480525 | Lopes et al. | Nov 2016 | B2 |
9486272 | Bonyak et al. | Nov 2016 | B2 |
9486273 | Lopes et al. | Nov 2016 | B2 |
9492227 | Lopes et al. | Nov 2016 | B2 |
9492228 | Lopes et al. | Nov 2016 | B2 |
9517103 | Panescu et al. | Dec 2016 | B2 |
9526573 | Lopes et al. | Dec 2016 | B2 |
9532831 | Reinders et al. | Jan 2017 | B2 |
9539010 | Gagner et al. | Jan 2017 | B2 |
9554848 | Stewart et al. | Jan 2017 | B2 |
9554851 | Sklar et al. | Jan 2017 | B2 |
9700368 | Callas et al. | Jul 2017 | B2 |
9724170 | Mickelsen | Aug 2017 | B2 |
9757193 | Zarins et al. | Sep 2017 | B2 |
9782099 | Williams et al. | Oct 2017 | B2 |
9795442 | Salahieh et al. | Oct 2017 | B2 |
9861802 | Mickelsen | Jan 2018 | B2 |
9913685 | Clark et al. | Mar 2018 | B2 |
9931487 | Quinn et al. | Apr 2018 | B2 |
9987081 | Bowers et al. | Jun 2018 | B1 |
9999465 | Long et al. | Jun 2018 | B2 |
10016232 | Bowers et al. | Jul 2018 | B1 |
10130423 | Viswanathan et al. | Nov 2018 | B1 |
10172673 | Viswanathan et al. | Jan 2019 | B2 |
10507302 | Leeflang et al. | Dec 2019 | B2 |
10512505 | Viswanathan | Dec 2019 | B2 |
10512779 | Viswanathan et al. | Dec 2019 | B2 |
10517672 | Long | Dec 2019 | B2 |
20010000791 | Suorsa et al. | May 2001 | A1 |
20010007070 | Stewart et al. | Jul 2001 | A1 |
20010044624 | Seraj et al. | Nov 2001 | A1 |
20020052602 | Wang et al. | May 2002 | A1 |
20020077627 | Johnson et al. | Jun 2002 | A1 |
20020091384 | Hooven et al. | Jul 2002 | A1 |
20020111618 | Stewart et al. | Aug 2002 | A1 |
20020161323 | Miller et al. | Oct 2002 | A1 |
20020169445 | Jain et al. | Nov 2002 | A1 |
20020177765 | Bowe et al. | Nov 2002 | A1 |
20020183638 | Swanson | Dec 2002 | A1 |
20030014098 | Quijano et al. | Jan 2003 | A1 |
20030018374 | Paulos | Jan 2003 | A1 |
20030028189 | Woloszko et al. | Feb 2003 | A1 |
20030050637 | Maguire et al. | Mar 2003 | A1 |
20030114849 | Ryan | Jun 2003 | A1 |
20030125729 | Hooven et al. | Jul 2003 | A1 |
20030130598 | Manning et al. | Jul 2003 | A1 |
20030130711 | Pearson et al. | Jul 2003 | A1 |
20030204161 | Ferek Petric | Oct 2003 | A1 |
20030229379 | Ramsey | Dec 2003 | A1 |
20040039382 | Kroll et al. | Feb 2004 | A1 |
20040049181 | Stewart et al. | Mar 2004 | A1 |
20040049182 | Koblish et al. | Mar 2004 | A1 |
20040082859 | Schaer | Apr 2004 | A1 |
20040082948 | Stewart et al. | Apr 2004 | A1 |
20040087939 | Eggers et al. | May 2004 | A1 |
20040111087 | Stern et al. | Jun 2004 | A1 |
20040193152 | Sutton | Sep 2004 | A1 |
20040199157 | Palanker et al. | Oct 2004 | A1 |
20040231683 | Eng et al. | Nov 2004 | A1 |
20040236360 | Cohn et al. | Nov 2004 | A1 |
20040254607 | Wittenberger et al. | Dec 2004 | A1 |
20040267337 | Hayzelden | Dec 2004 | A1 |
20050033282 | Hooven | Feb 2005 | A1 |
20050222632 | Obino | Oct 2005 | A1 |
20050251130 | Boveja et al. | Nov 2005 | A1 |
20050261672 | Deem et al. | Nov 2005 | A1 |
20060009755 | Sra | Jan 2006 | A1 |
20060009759 | Chrisitian et al. | Jan 2006 | A1 |
20060015095 | Desinger et al. | Jan 2006 | A1 |
20060015165 | Bertolero et al. | Jan 2006 | A1 |
20060024359 | Walker et al. | Feb 2006 | A1 |
20060058781 | Long | Mar 2006 | A1 |
20060111702 | Oral et al. | May 2006 | A1 |
20060142801 | Demarais et al. | Jun 2006 | A1 |
20060167448 | Kozel | Jul 2006 | A1 |
20060217703 | Chornenky et al. | Sep 2006 | A1 |
20060241734 | Marshall et al. | Oct 2006 | A1 |
20060264752 | Rubinsky et al. | Nov 2006 | A1 |
20060270900 | Chin et al. | Nov 2006 | A1 |
20060287648 | Schwartz | Dec 2006 | A1 |
20060293730 | Rubinsky et al. | Dec 2006 | A1 |
20060293731 | Rubinsky et al. | Dec 2006 | A1 |
20070005053 | Dando | Jan 2007 | A1 |
20070021744 | Creighton | Jan 2007 | A1 |
20070066972 | Ormsby et al. | Mar 2007 | A1 |
20070129721 | Phan et al. | Jun 2007 | A1 |
20070129760 | Demarais et al. | Jun 2007 | A1 |
20070156135 | Rubinsky et al. | Jul 2007 | A1 |
20070167740 | Grunewald et al. | Jul 2007 | A1 |
20070167940 | Stevens-Wright | Jul 2007 | A1 |
20070173878 | Heuser | Jul 2007 | A1 |
20070208329 | Ward et al. | Sep 2007 | A1 |
20070225589 | Viswanathan | Sep 2007 | A1 |
20070249923 | Keenan | Oct 2007 | A1 |
20070260223 | Scheibe et al. | Nov 2007 | A1 |
20070270792 | Hennemann et al. | Nov 2007 | A1 |
20080009855 | Hamou | Jan 2008 | A1 |
20080033426 | Machell | Feb 2008 | A1 |
20080065061 | Viswanathan | Mar 2008 | A1 |
20080086120 | Mirza et al. | Apr 2008 | A1 |
20080091195 | Silwa et al. | Apr 2008 | A1 |
20080103545 | Bolea et al. | May 2008 | A1 |
20080132885 | Rubinsky et al. | Jun 2008 | A1 |
20080161789 | Thao et al. | Jul 2008 | A1 |
20080172048 | Martin et al. | Jul 2008 | A1 |
20080200913 | Viswanathan | Aug 2008 | A1 |
20080208118 | Goldman | Aug 2008 | A1 |
20080243214 | Koblish | Oct 2008 | A1 |
20080281322 | Sherman et al. | Nov 2008 | A1 |
20080300574 | Belson et al. | Dec 2008 | A1 |
20080300588 | Groth et al. | Dec 2008 | A1 |
20090024084 | Khosla et al. | Jan 2009 | A1 |
20090048591 | Ibrahim et al. | Feb 2009 | A1 |
20090062788 | Long et al. | Mar 2009 | A1 |
20090076500 | Azure | Mar 2009 | A1 |
20090105654 | Kurth et al. | Apr 2009 | A1 |
20090149917 | Whitehurst et al. | Jun 2009 | A1 |
20090163905 | Winkler et al. | Jun 2009 | A1 |
20090228003 | Sinelnikov | Sep 2009 | A1 |
20090240248 | Deford et al. | Sep 2009 | A1 |
20090275827 | Aiken et al. | Nov 2009 | A1 |
20090281477 | Mikus et al. | Nov 2009 | A1 |
20090306651 | Schneider | Dec 2009 | A1 |
20100004623 | Hamilton et al. | Jan 2010 | A1 |
20100023004 | Francischelli et al. | Jan 2010 | A1 |
20100137861 | Soroff et al. | Jun 2010 | A1 |
20100185140 | Kassab et al. | Jul 2010 | A1 |
20100185186 | Longoria | Jul 2010 | A1 |
20100191112 | Demarais | Jul 2010 | A1 |
20100191232 | Boveda | Jul 2010 | A1 |
20100241185 | Mahapatra et al. | Sep 2010 | A1 |
20100261994 | Davalos et al. | Oct 2010 | A1 |
20100274238 | Klimovitch | Oct 2010 | A1 |
20100280513 | Juergen et al. | Nov 2010 | A1 |
20100280539 | Miyoshi et al. | Nov 2010 | A1 |
20100292687 | Kauphusman et al. | Nov 2010 | A1 |
20100312300 | Ryu et al. | Dec 2010 | A1 |
20110028962 | Werneth et al. | Feb 2011 | A1 |
20110028964 | Edwards | Feb 2011 | A1 |
20110040199 | Hopenfeld | Feb 2011 | A1 |
20110098694 | Long | Apr 2011 | A1 |
20110106221 | Neal, II et al. | May 2011 | A1 |
20110130708 | Perry et al. | Jun 2011 | A1 |
20110144524 | Fish et al. | Jun 2011 | A1 |
20110144633 | Govari | Jun 2011 | A1 |
20110160785 | Mori et al. | Jun 2011 | A1 |
20110190659 | Long et al. | Aug 2011 | A1 |
20110190727 | Edmunds et al. | Aug 2011 | A1 |
20110213231 | Hall et al. | Sep 2011 | A1 |
20110276047 | Sklar et al. | Nov 2011 | A1 |
20110276075 | Fung et al. | Nov 2011 | A1 |
20110288544 | Verin et al. | Nov 2011 | A1 |
20110313417 | De La Rama et al. | Dec 2011 | A1 |
20120029512 | Willard et al. | Feb 2012 | A1 |
20120046570 | Villegas et al. | Feb 2012 | A1 |
20120053581 | Wittkampf et al. | Mar 2012 | A1 |
20120059255 | Paul et al. | Mar 2012 | A1 |
20120071872 | Rubinsky et al. | Mar 2012 | A1 |
20120089089 | Swain et al. | Apr 2012 | A1 |
20120095459 | Callas et al. | Apr 2012 | A1 |
20120101413 | Beetel et al. | Apr 2012 | A1 |
20120143177 | Avitall | Jun 2012 | A1 |
20120158021 | Morrill | Jun 2012 | A1 |
20120165667 | Altmann et al. | Jun 2012 | A1 |
20120172859 | Condie et al. | Jul 2012 | A1 |
20120172867 | Ryu et al. | Jul 2012 | A1 |
20120197100 | Razavi et al. | Aug 2012 | A1 |
20120209260 | Lambert et al. | Aug 2012 | A1 |
20120220998 | Long et al. | Aug 2012 | A1 |
20120232409 | Stahmann | Sep 2012 | A1 |
20120265198 | Crow et al. | Oct 2012 | A1 |
20120283582 | Mahapatra et al. | Nov 2012 | A1 |
20120303019 | Zhao et al. | Nov 2012 | A1 |
20120310052 | Mahapatra et al. | Dec 2012 | A1 |
20120310230 | Willis | Dec 2012 | A1 |
20120310237 | Swanson | Dec 2012 | A1 |
20120316557 | Sartor et al. | Dec 2012 | A1 |
20130030425 | Stewart | Jan 2013 | A1 |
20130030430 | Stewart et al. | Jan 2013 | A1 |
20130060247 | Sklar et al. | Mar 2013 | A1 |
20130060248 | Sklar et al. | Mar 2013 | A1 |
20130079768 | De Luca et al. | Mar 2013 | A1 |
20130090651 | Smith | Apr 2013 | A1 |
20130096655 | Moffitt et al. | Apr 2013 | A1 |
20130103027 | Sklar et al. | Apr 2013 | A1 |
20130103064 | Arenson et al. | Apr 2013 | A1 |
20130131662 | Wittkampf | May 2013 | A1 |
20130158538 | Govari | Jun 2013 | A1 |
20130158621 | Ding et al. | Jun 2013 | A1 |
20130165990 | Mathur | Jun 2013 | A1 |
20130172715 | Just et al. | Jul 2013 | A1 |
20130172864 | Ibrahim et al. | Jul 2013 | A1 |
20130172875 | Govari et al. | Jul 2013 | A1 |
20130184702 | Neal, II et al. | Jul 2013 | A1 |
20130218157 | Callas et al. | Aug 2013 | A1 |
20130226174 | Ibrahim et al. | Aug 2013 | A1 |
20130237984 | Sklar | Sep 2013 | A1 |
20130253415 | Sano et al. | Sep 2013 | A1 |
20130296679 | Condie et al. | Nov 2013 | A1 |
20130310829 | Cohen | Nov 2013 | A1 |
20130317385 | Sklar et al. | Nov 2013 | A1 |
20130331831 | Werneth et al. | Dec 2013 | A1 |
20130338467 | Grasse et al. | Dec 2013 | A1 |
20130345620 | Zemel | Dec 2013 | A1 |
20140005664 | Govari et al. | Jan 2014 | A1 |
20140024911 | Harlev et al. | Jan 2014 | A1 |
20140039288 | Shih | Feb 2014 | A1 |
20140051993 | McGee | Feb 2014 | A1 |
20140052118 | Laske et al. | Feb 2014 | A1 |
20140052126 | Long et al. | Feb 2014 | A1 |
20140052216 | Long et al. | Feb 2014 | A1 |
20140081113 | Cohen et al. | Mar 2014 | A1 |
20140100563 | Govari et al. | Apr 2014 | A1 |
20140107644 | Falwell et al. | Apr 2014 | A1 |
20140142408 | De La Rama et al. | May 2014 | A1 |
20140148804 | Ward et al. | May 2014 | A1 |
20140163480 | Govari et al. | Jun 2014 | A1 |
20140163546 | Govari et al. | Jun 2014 | A1 |
20140171942 | Werneth et al. | Jun 2014 | A1 |
20140180035 | Anderson | Jun 2014 | A1 |
20140194716 | Diep et al. | Jul 2014 | A1 |
20140194867 | Fish et al. | Jul 2014 | A1 |
20140200567 | Cox et al. | Jul 2014 | A1 |
20140235986 | Harlev et al. | Aug 2014 | A1 |
20140235988 | Ghosh | Aug 2014 | A1 |
20140235989 | Wodlinger et al. | Aug 2014 | A1 |
20140243851 | Cohen et al. | Aug 2014 | A1 |
20140276760 | Bonyak et al. | Sep 2014 | A1 |
20140276782 | Paskar | Sep 2014 | A1 |
20140276791 | Ku et al. | Sep 2014 | A1 |
20140288556 | Ibrahim et al. | Sep 2014 | A1 |
20140303721 | Fung et al. | Oct 2014 | A1 |
20140343549 | Spear et al. | Nov 2014 | A1 |
20140364845 | Rashidi | Dec 2014 | A1 |
20140371613 | Narayan et al. | Dec 2014 | A1 |
20150005767 | Werneth et al. | Jan 2015 | A1 |
20150011995 | Avitall et al. | Jan 2015 | A1 |
20150066108 | Shi et al. | Mar 2015 | A1 |
20150126840 | Thakur et al. | May 2015 | A1 |
20150133914 | Koblish | May 2015 | A1 |
20150138977 | Dacosta | May 2015 | A1 |
20150141978 | Subramaniam et al. | May 2015 | A1 |
20150142041 | Kendale et al. | May 2015 | A1 |
20150148796 | Bencini | May 2015 | A1 |
20150150472 | Harlev et al. | Jun 2015 | A1 |
20150157402 | Kunis et al. | Jun 2015 | A1 |
20150157412 | Wallace et al. | Jun 2015 | A1 |
20150164584 | Davalos et al. | Jun 2015 | A1 |
20150173824 | Davalos et al. | Jun 2015 | A1 |
20150173828 | Avitall | Jun 2015 | A1 |
20150174404 | Rousso et al. | Jun 2015 | A1 |
20150182740 | Mickelsen | Jul 2015 | A1 |
20150196217 | Harlev et al. | Jul 2015 | A1 |
20150223726 | Harlev et al. | Aug 2015 | A1 |
20150230699 | Berul et al. | Aug 2015 | A1 |
20150258344 | Tandri et al. | Sep 2015 | A1 |
20150265342 | Long et al. | Sep 2015 | A1 |
20150265344 | Aktas et al. | Sep 2015 | A1 |
20150272656 | Chen | Oct 2015 | A1 |
20150272664 | Cohen | Oct 2015 | A9 |
20150272667 | Govari et al. | Oct 2015 | A1 |
20150282729 | Harlev et al. | Oct 2015 | A1 |
20150289923 | Davalos et al. | Oct 2015 | A1 |
20150304879 | Dacosta | Oct 2015 | A1 |
20150320481 | Cosman et al. | Nov 2015 | A1 |
20150321021 | Tandri et al. | Nov 2015 | A1 |
20150342532 | Basu et al. | Dec 2015 | A1 |
20150343212 | Rousso et al. | Dec 2015 | A1 |
20150351836 | Prutchi | Dec 2015 | A1 |
20150359583 | Swanson | Dec 2015 | A1 |
20160000500 | Salahieh et al. | Jan 2016 | A1 |
20160008061 | Fung et al. | Jan 2016 | A1 |
20160008065 | Gliner et al. | Jan 2016 | A1 |
20160029960 | Toth et al. | Feb 2016 | A1 |
20160038772 | Thapliyal et al. | Feb 2016 | A1 |
20160051204 | Harlev et al. | Feb 2016 | A1 |
20160051324 | Stewart et al. | Feb 2016 | A1 |
20160058493 | Neal, II et al. | Mar 2016 | A1 |
20160058506 | Spence et al. | Mar 2016 | A1 |
20160066993 | Avitall et al. | Mar 2016 | A1 |
20160074679 | Thapliyal et al. | Mar 2016 | A1 |
20160095531 | Narayan et al. | Apr 2016 | A1 |
20160095642 | Deno et al. | Apr 2016 | A1 |
20160095653 | Lambert et al. | Apr 2016 | A1 |
20160100797 | Mahapatra et al. | Apr 2016 | A1 |
20160100884 | Fay et al. | Apr 2016 | A1 |
20160106498 | Highsmith et al. | Apr 2016 | A1 |
20160106500 | Olson | Apr 2016 | A1 |
20160113709 | Maor | Apr 2016 | A1 |
20160113712 | Cheung et al. | Apr 2016 | A1 |
20160120564 | Kirkpatrick et al. | May 2016 | A1 |
20160128770 | Afonso et al. | May 2016 | A1 |
20160166167 | Narayan et al. | Jun 2016 | A1 |
20160166310 | Stewart et al. | Jun 2016 | A1 |
20160166311 | Long et al. | Jun 2016 | A1 |
20160174865 | Stewart et al. | Jun 2016 | A1 |
20160183877 | Williams et al. | Jun 2016 | A1 |
20160184003 | Srimathveeravalli et al. | Jun 2016 | A1 |
20160213282 | Leo et al. | Jul 2016 | A1 |
20160220307 | Miller et al. | Aug 2016 | A1 |
20160235470 | Callas et al. | Aug 2016 | A1 |
20160287314 | Arena et al. | Oct 2016 | A1 |
20160310211 | Long | Oct 2016 | A1 |
20160324564 | Gerlach et al. | Nov 2016 | A1 |
20160324573 | Mickelsen et al. | Nov 2016 | A1 |
20160331441 | Konings | Nov 2016 | A1 |
20160331459 | Townley et al. | Nov 2016 | A1 |
20160354142 | Pearson et al. | Dec 2016 | A1 |
20160361109 | Weaver et al. | Dec 2016 | A1 |
20170035499 | Stewart et al. | Feb 2017 | A1 |
20170042449 | Deno et al. | Feb 2017 | A1 |
20170042615 | Salahieh et al. | Feb 2017 | A1 |
20170056648 | Syed et al. | Mar 2017 | A1 |
20170065330 | Mickelsen et al. | Mar 2017 | A1 |
20170065339 | Mickelsen | Mar 2017 | A1 |
20170065340 | Long | Mar 2017 | A1 |
20170065343 | Mickelsen | Mar 2017 | A1 |
20170071543 | Basu et al. | Mar 2017 | A1 |
20170095291 | Harrington et al. | Apr 2017 | A1 |
20170105793 | Cao et al. | Apr 2017 | A1 |
20170151029 | Mickelsen | Jun 2017 | A1 |
20170172654 | Wittkampf et al. | Jun 2017 | A1 |
20170181795 | Debruyne | Jun 2017 | A1 |
20170189097 | Viswanathan et al. | Jul 2017 | A1 |
20170215953 | Long et al. | Aug 2017 | A1 |
20170245928 | Xiao et al. | Aug 2017 | A1 |
20170246455 | Athos et al. | Aug 2017 | A1 |
20170312024 | Harlev et al. | Nov 2017 | A1 |
20170312025 | Harlev et al. | Nov 2017 | A1 |
20170312027 | Harlev et al. | Nov 2017 | A1 |
20180001056 | Leeflang et al. | Jan 2018 | A1 |
20180042674 | Mickelsen | Feb 2018 | A1 |
20180042675 | Long | Feb 2018 | A1 |
20180043153 | Viswanathan et al. | Feb 2018 | A1 |
20180064488 | Long et al. | Mar 2018 | A1 |
20180085160 | Viswanathan et al. | Mar 2018 | A1 |
20180093088 | Mickelsen | Apr 2018 | A1 |
20180133460 | Townley et al. | May 2018 | A1 |
20180184982 | Basu et al. | Jul 2018 | A1 |
20180193090 | de la Rama et al. | Jul 2018 | A1 |
20180200497 | Mickelsen | Jul 2018 | A1 |
20180303488 | Hill | Oct 2018 | A1 |
20180311497 | Viswanathan et al. | Nov 2018 | A1 |
20180344393 | Gruba et al. | Dec 2018 | A1 |
20180360534 | Teplitsky et al. | Dec 2018 | A1 |
20190069950 | Viswanathan et al. | Mar 2019 | A1 |
20190183378 | Mosesov et al. | Jun 2019 | A1 |
20190201089 | Waldstreicher et al. | Jul 2019 | A1 |
20190231425 | Waldstreicher et al. | Aug 2019 | A1 |
20190336198 | Viswanathan et al. | Nov 2019 | A1 |
20190336207 | Viswanathan | Nov 2019 | A1 |
20210015550 | Highsmith et al. | Jan 2021 | A1 |
Number | Date | Country |
---|---|---|
1125549 | Aug 2001 | EP |
0797956 | Jun 2003 | EP |
1127552 | Jun 2006 | EP |
1340469 | Mar 2007 | EP |
1009303 | Jun 2009 | EP |
2213729 | Aug 2010 | EP |
2425871 | Mar 2012 | EP |
1803411 | Aug 2012 | EP |
2532320 | Dec 2012 | EP |
2587275 | May 2013 | EP |
2663227 | Nov 2013 | EP |
1909678 | Jan 2014 | EP |
2217165 | Mar 2014 | EP |
2376193 | Mar 2014 | EP |
2708181 | Mar 2014 | EP |
2777579 | Sep 2014 | EP |
2934307 | Oct 2015 | EP |
2777585 | Jun 2016 | EP |
2382935 | Mar 2018 | EP |
3111871 | Mar 2018 | EP |
3151773 | Apr 2018 | EP |
3056242 | Jul 2018 | EP |
H06-507797 | Sep 1994 | JP |
2000-508196 | Jul 2000 | JP |
2005-516666 | Jun 2005 | JP |
2006-506184 | Feb 2006 | JP |
2008-538997 | Nov 2008 | JP |
2009-500129 | Jan 2009 | JP |
2011-509158 | Mar 2011 | JP |
2012-050538 | Mar 2012 | JP |
WO 9207622 | May 1992 | WO |
WO 9221278 | Dec 1992 | WO |
WO 9221285 | Dec 1992 | WO |
WO 9724073 | Jul 1997 | WO |
WO 9725917 | Jul 1997 | WO |
WO 9737719 | Oct 1997 | WO |
WO 1999004851 | Feb 1999 | WO |
WO 1999022659 | May 1999 | WO |
WO 2002056782 | Jul 2002 | WO |
WO 2003065916 | Aug 2003 | WO |
WO 2004045442 | Jun 2004 | WO |
WO 2004086994 | Oct 2004 | WO |
WO 2005046487 | May 2005 | WO |
WO 2006115902 | Nov 2006 | WO |
WO 2007006055 | Jan 2007 | WO |
WO 2007079438 | Jul 2007 | WO |
WO 2009082710 | Jul 2009 | WO |
WO 2009089343 | Jul 2009 | WO |
WO 2009137800 | Nov 2009 | WO |
WO 2010014480 | Feb 2010 | WO |
WO 2011028310 | Mar 2011 | WO |
WO 2011154805 | Dec 2011 | WO |
WO 2012051433 | Apr 2012 | WO |
WO 2012153928 | Nov 2012 | WO |
WO 2013019385 | Feb 2013 | WO |
WO 2014025394 | Feb 2014 | WO |
WO 2014031800 | Feb 2014 | WO |
WO 2014036439 | Mar 2014 | WO |
WO 2014160832 | Oct 2014 | WO |
WO 2015066322 | May 2015 | WO |
WO 2015099786 | Jul 2015 | WO |
WO 2015103530 | Jul 2015 | WO |
WO 2015103574 | Jul 2015 | WO |
WO 2015130824 | Sep 2015 | WO |
WO 2015140741 | Sep 2015 | WO |
WO 2015143327 | Sep 2015 | WO |
WO 2015171921 | Nov 2015 | WO |
WO 2015175944 | Nov 2015 | WO |
WO 2015192018 | Dec 2015 | WO |
WO 2015192027 | Dec 2015 | WO |
WO 2016059027 | Apr 2016 | WO |
WO 2016060983 | Apr 2016 | WO |
WO 2016081650 | May 2016 | WO |
WO 2016090175 | Jun 2016 | WO |
WO 2017093926 | Jun 2017 | WO |
WO 2017119934 | Jul 2017 | WO |
WO 2017120169 | Jul 2017 | WO |
WO 2017192477 | Nov 2017 | WO |
WO 2017192495 | Nov 2017 | WO |
WO 2017218734 | Dec 2017 | WO |
WO 2018005511 | Jan 2018 | WO |
WO 2018200800 | Nov 2018 | WO |
WO 2019133606 | Jul 2019 | WO |
WO 2020236558 | Nov 2020 | WO |
Entry |
---|
Office Action for Canadian Application No. 2,881,462, dated Mar. 19, 2019, 5 pages. |
Partial Supplementary European Search Report for European Application No. 13827672.0, dated Mar. 23, 2016, 6 pages. |
Supplementary European Search Report for European Application No. 13827672.0, dated Jul. 11, 2016, 12 pages. |
Office Action for European Application No. 13827672.0, dated Feb. 5, 2018, 6 pages. |
Notice of Reasons for Rejection for Japanese Application No. 2015-526522, dated Mar. 6, 2017, 3 pages. |
Office Action for U.S. Appl. No. 14/400,455, dated Mar. 30, 2017, 10 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2013/031252, dated Jul. 19, 2013, 12 pages. |
Office Action for Japanese Application No. 2018-036714, dated Jan. 16, 2019, 8 pages. |
Office Action for U.S. Appl. No. 15/819,726, dated Jun. 4, 2018, 17 pages. |
Office Action for U.S. Appl. No. 15/917,194, dated Jun. 4, 2018, 17 pages. |
Office Action for U.S. Appl. No. 15/917,194, dated Oct. 9, 2018, 13 pages. |
Office Action for U.S. Appl. No. 15/917,194, dated Apr. 29, 2019, 10 pages. |
First Office Action for Chinese Application No. 201580006848.8, dated Jan. 29, 2018, 15 pages. |
Office Action for European Application No. 15701856.5, dated Dec. 11, 2017, 6 pages. |
Notice of Reasons for Rejection for Japanese Application No. 2016-544072, dated Oct. 1, 2018, 11 pages. |
Office Action for U.S. Appl. No. 15/201,983, dated Apr. 3, 2019, 16 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/010138, dated Mar. 26, 2015, 14 pages. |
International Preliminary Report on Patentability for International Application No. PCT/US2015/010138, dated Jul. 12, 2016, 9 pages. |
Supplementary European Search Report for European Application No. 15733297.4, dated Aug. 10, 2017, 7 pages. |
Office Action for U.S. Appl. No. 15/201,997, dated Apr. 3, 2017, 6 pages. |
Office Action for U.S. Appl. No. 15/201,997, dated Aug. 29, 2017, 12 pages. |
Office Action for U.S. Appl. No. 15/201,997, dated Jul. 12, 2018, 12 pages. |
Office Action for U.S. Appl. No. 15/201,997, dated Dec. 17, 2018, 17 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/010223, dated Apr. 10, 2015, 19 pages. |
International Preliminary Report on Patentability for International Application No. PCT/US2015/010223, dated Jul. 12, 2016, 12 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/029734, dated Nov. 24, 2015, 15 pages. |
Extended European Search Report for European Application No. 18189811.5, dated May 14, 2019, 7 pages. |
Office Action for U.S. Appl. No. 15/795,062, dated Dec. 19, 2017, 14 pages. |
Office Action for U.S. Appl. No. 15/795,062, dated Apr. 9, 2018, 20 pages. |
Office Action for U.S. Appl. No. 15/795,062, dated May 3, 2019, 21 pages. |
Office Action for U.S. Appl. No. 15/341,523, dated Jan. 29, 2019, 10 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/031086, dated Oct. 21, 2015, 16 pages. |
Office Action for U.S. Appl. No. 15/795,075, dated Feb. 6, 2018, 9 pages. |
Office Action for U.S. Appl. No. 15/795,075, dated Jun. 15, 2018, 10 pages. |
Office Action for U.S. Appl. No. 15/795,075, dated Apr. 10, 2019, 11 pages. |
Extended European Search Report for European Application No. 15849844.4, dated May 3, 2018, 8 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/055105, dated Mar. 1, 2016, 15 pages. |
Office Action for U.S. Appl. No. 15/796,255, dated Jan. 10, 2018, 12 pages. |
Extended European Search Report for European Application No. 15806855.1, dated Jan. 3, 2018, 8 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/035582, dated Oct. 2, 2015, 17 pages. |
Extended European Search Report for European Application No. 15806278.6, dated Feb. 9, 2018, 5 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2015/035592, dated Oct. 2, 2015, 13 pages. |
Office Action for U.S. Appl. No. 15/334,646, dated Jul. 25, 2017, 19 pages. |
Office Action for U.S. Appl. No. 15/334,646, dated Nov. 16, 2017, 26 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2016/057664, dated Feb. 24, 2017, 11 pages. |
Office Action for U.S. Appl. No. 15/796,375, dated Jan. 24, 2018, 25 pages. |
Office Action for U.S. Appl. No. 15/796,375, dated May 30, 2018, 26 pages. |
Office Action for U.S. Appl. No. 15/796,375, dated Nov. 16, 2018, 27 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2017/012099, dated May 18, 2017, 17 pages. |
Office Action for U.S. Appl. No. 15/711,266, dated Feb. 23, 2018, 14 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2018/029938, dated Aug. 29, 2018, 14 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2019/014226, dated Apr. 29, 2019, 15 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2017/037609, dated Nov. 8, 2017, 13 pages. |
Office Action for U.S. Appl. No. 15/672,916, dated Feb. 13, 2018, 16 pages. |
Office Action for U.S. Appl. No. 15/672,916, dated Jul. 20, 2018, 23 pages. |
Office Action for U.S. Appl. No. 15/672,916, dated Apr. 9, 2019, 31 pages. |
Office Action for U.S. Appl. No. 15/499,804, dated Jan. 3, 2018, 20 pages. |
Office Action for U.S. Appl. No. 15/794,717, dated Feb. 1, 2018, 10 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2018/029552, dated Jun. 29, 2018, 13 pages. |
Partial European Search Report for European Application No. 18170210.1, dated Feb. 14, 2019, 13 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2018/050660, dated Nov. 26, 2018, 13 pages. |
Office Action for U.S. Appl. No. 15/970,404, dated Oct. 9, 2018, 21 pages. |
Office Action for U.S. Appl. No. 15/970,404, dated Apr. 12, 2019, 20 pages. |
International Search Report and Written Opinion for International Application No. PCT/US2019/017322, dated May 10, 2019, 15 pages. |
Du Pre, B.C. et al., “Minimal coronary artery damage by myocardial electroporation ablation,” Europace, 15(1):144-149 (2013). |
Hobbs, E. P., “Investor Relations Update: Tissue Ablation via Irreversible Electroporation (IRE),” Powerpoint (2004), 16 pages. |
Lavee, J. et al., “A Novel Nonthermal Energy Source for Surgical Epicardial Atrial Ablation: Irreversible Electroporation,” The Heart Surgery Forum #2006-1202, 10(2), 2007 [Epub Mar. 2007]. |
Madhavan, M. et al., “Novel Percutaneous Epicardial Autonomic Modulation in the Canine for Atrial Fibrillation: Results of an Efficacy and Safety Study,” Pace, 00:1-11 (2016). |
Neven, K. et al., “Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation,” Circ Arrhythm Electrophysiol., 7:913-919 (2014). |
Neven, K. et al., “Myocardial Lesion Size After Epicardial Electroporation Catheter Ablation After Subxiphoid Puncture,” Circ Arrhythm Electrophysiol., 7(4):728-733 (2014). |
Neven, K. et al., “Epicardial linear electroporation ablation and lesion size,” Heart Rhythm, 11:1465-1470 (2014). |
Van Driel, V.J.H.M. et al., “Pulmonary Vein Stenosis After Catheter Ablation Electroporation Versus Radiofrequency,” Circ Arrhythm Electrophysiol., 7(4):734-738 (2014). |
Van Driel, V.J.H.M. et al., “Low vulnerability of the right phrenic nerve to electroporation ablation,” Heart Rhythm, 12:1838-1844 (2015). |
Wittkampf, F.H. et al., “Myocardial Lesion Depth With Circular Electroporation Ablation,” Circ. Arrhythm Electrophysiol., 5(3):581-586 (2012). |
Wittkampf, F.H. et al., “Feasibility of Electroporation for the Creation of Pulmonary Vein Ostial Lesions,” J Cardiovasc Electrophysiol, 22(3):302-309 (Mar. 2011). |
Number | Date | Country | |
---|---|---|---|
20200297411 A1 | Sep 2020 | US |
Number | Date | Country | |
---|---|---|---|
61923966 | Jan 2014 | US | |
61923969 | Jan 2014 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15201997 | Jul 2016 | US |
Child | 16719708 | US |
Number | Date | Country | |
---|---|---|---|
Parent | PCT/US2015/010223 | Jan 2015 | US |
Child | 15201997 | US |