Atrial ablation catheter adapted for treatment of septal wall arrhythmogenic foci and method of use

Information

  • Patent Grant
  • 9005194
  • Patent Number
    9,005,194
  • Date Filed
    Friday, July 18, 2008
    15 years ago
  • Date Issued
    Tuesday, April 14, 2015
    9 years ago
Abstract
An atrial ablation catheter with an electrode array particularly adapted to locate and ablate foci of arrhythmia which are required for sustained atrial fibrillation is provided. The array is easily deployed and retracted from the catheter, and presents a proximally oriented electrode array that can be pulled against the septal wall of the left atrium to engage the septal wall.
Description
FIELD OF THE INVENTION

The inventions described below relate the field of atrial ablation.


BACKGROUND OF THE INVENTION

Atrial fibrillation is a form of arrhythmia, or irregular heartbeat, in which the atria (the two small upper chambers of the heart) quiver instead of beating effectively. While there are a number of variations of atrial fibrillation with different causes, they all involve irregularities in the transmission of electrical impulses through the heart. As a result of abnormalities in the heart's electrical impulses, the heart is not able to pump the blood out properly, and it may pool and clot. If a blood clot moves to an artery in the brain, AF can lead to stroke. AF is also associated with increased risks of congestive heart failure and cardiomyopathy. These risks warrant medical attention for patients with AF even if the symptoms are mild. Atrial fibrillation is the most common sustained heart rhythm disorder and increases the risk for heart disease and stroke, both leading causes of death in the United States. Over 2 million adults in the United States have been diagnosed with atrial fibrillation.


Various ablation techniques have been proposed to treat atrial fibrillation, including the Cox-Maze procedure, linear ablation of various regions of the atrium, and circumferential pulmonary vein ablation. Each of these techniques has its various drawbacks. The Cox-Maze procedure and linear ablation procedures are tedious and time-consuming, taking up to several hours to accomplish endocardially. Circumferential ablation is proving to lead to rapid stenosis and occlusion of the pulmonary veins, and of course is not applicable to treatment of the septal wall of the left atrium. The catheter mounted electrode arrays described in our co-pending patent application Kunis, et al., Atrial Ablation Catheter and Method of Use, U.S. application Ser. No. 10/997,172 filed Nov. 22, 2004 provide for more efficient and effective treatment of atrial fibrillation. The treatment of the septal wall is facilitated with the devices and methods described below, which permit septal wall treatment from a percutaneous venous access route without the need to maneuver a distally facing electrode array in apposition to the septal wall.


SUMMARY OF THE INVENTION

The devices and methods described below provide for a simplified approach to the treatment of atrial fibrillation with substantially improved efficacy and outcomes in patients with paroxysmal or persistent atrial fibrillation, especially for those arrhythmia originating from, or sustained by, arrhythmogenic foci located on the septal wall of the left atrium. An endocardial catheter with an electrode array particularly adapted to locate and ablate foci of arrhythmia which are required for sustained atrial fibrillation is provided. The array is easily deployed and retracted from the catheter, and presents a proximally oriented electrode array that can be pulled against the septal wall of the left atrium to engage the septal wall. A control system comprising an ECG analyzer and a RF power supply operates to analyze electrical signals obtained from the electrode array, determine if an arrhythmogenic focus is present in the area covered by the array, and supply RF power to appropriate electrodes to ablate the focus.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 illustrates the treatment to be accomplished with the devices and methods described below.



FIG. 2 illustrates an atrial sensing and ablation catheter with an expandable electrode array constrained within an outer catheter tube.



FIG. 3 is an enlarged view of the distal portion of the catheter of FIG. 2.



FIG. 4 is a cross-section of the distal portion of the catheter of FIG. 2.



FIG. 5 illustrates the atrial sensing and ablation catheter of FIG. 2 with the electrode array in its expanded configuration.



FIGS. 6 and 6
a is an enlarged view of the electrode array in its expanded configuration.



FIG. 6
b illustrates the meaning of the terminology which precisely defines the electrode array of FIGS. 5 and 6



FIG. 7 is an end view of the electrode array in its expanded configuration.



FIG. 7
a is an end view of the electrode array, with an asymmetric arrangement of electrodes, in its expanded configuration.



FIGS. 8 and 9 illustrate the mechanism of recapture of the electrode array of the atrial ablation catheter.



FIGS. 10 and 10
a illustrates an alternate geometry of the septal wall array.



FIG. 10
b illustrates the meaning of the terminology which precisely defines the electrode array of FIGS. 10 and 10a.



FIGS. 11, 12 and 13 illustrate additional alternative geometries of the array.



FIGS. 14 and 15 illustrate the method of using the device of to treat the septal wall of the left atrium.





DETAILED DESCRIPTION OF THE INVENTION


FIG. 1 illustrates the treatment to be accomplished with the devices and methods described below. FIG. 1 shows a cutaway view of the human heart 1, showing the major structures of the heart including the right atrium 2, the left atrium 3, the right ventricle 4, and the left ventricle 5. The atrial septum 6 separates the left and right atria. The fossa ovalis 7 is a small depression in the atrial septum which is easily punctured and easily heals. The percutaneous venous approach through the right atrium and the fossa ovalis is the preferred access pathway to the left atrium. In a patient suffering from atrial fibrillation, aberrant electrically conductive tissue may be found in the atrial walls 8 and 9, including the septal wall surrounding the fossa ovalis, as well as in the pulmonary veins 10 and pulmonary arteries 11. These areas of aberrant electrically conductive tissue, referred to as arrhythmogenic foci, drivers or rotors, cause or sustain atrial fibrillation. Ablation of these areas is an effective treatment for atrial fibrillation. Though circumferential ablation of the pulmonary veins cures the arrhythmia which originates in the pulmonary veins, it often results in rapid stenosis of the pulmonary veins. Ablation of foci, rotors or drivers on atrial walls, however, may prevent the propagation of any aberrant electrical activity that originates in the pulmonary veins, originates in other regions of the atrial wall, or originates on the septal wall itself.


To accomplish ablation of the septal wall of the left atrium, a catheter is inserted into the atrium, preferably through the inferior vena cava 20, as shown in the illustration, or through the superior vena cava 21, into the right atrium and then into left atrium. When passing into the left atrium, as illustrated, the catheter penetrates the fossa ovalis (a trans-septal puncture will facilitate the crossing). The catheter 22 carries a distal electrode array 23 into the atrium, and this electrode array is adapted to be pulled into contact with the section of the atrial wall surrounding the fossa ovalis. The electrode array is electrically connected to circuitry in a control system 24 which is operable to analyze electrical signals detected by the electrodes and pass RF current through the electrodes and heart tissue to ablate the tissue. A surface electrode 25 is mounted on the patient's body (typically on the back) to permit use of the electrodes in monopolar modes. A return electrode 26 may also be provided on the catheter 22, proximal to the electrode array. Using the catheter, an electrophysiologist will map regions of the septal wall of the left atrium and apply energy through the catheter to ablate any arrhythmogenic foci which are identified in the mapping procedure. The procedure may be repeated as necessary on the septal wall, rotating the array if necessary, to ablate all detected foci.



FIG. 2 illustrates an atrial sensing and ablation catheter 22 with an expandable electrode array. The catheter comprises a handle 30 with a steering control knob 31, electrical connector 32 and side-arm connector 33. The electrical connector is used to connect the catheter to the control box. An outer catheter tube 34 is slidably mounted on the inner catheter tube 35, and they may be releasably secured to each other by sliding the proximal portion of the outer catheter sheath strain relief 36 over the cylindrical detent 37 which is fixed to the handle. The side arm connector is used as a flushing port, to allow the flushing of debris and blood from the space between the inner and outer catheter tubes. The electrode array 23 is fixed to the inner catheter tube 35, and is restrained within the distal portion of the outer catheter tube 34.



FIG. 3 is an enlarged view of the distal portion of the catheter of FIG. 2. The electrode array 23 comprises a number of resiliently biased arms 39 which each carry a number of electrodes 40. An array of three arms, each of which carry four electrodes, is suitable for use in the atria. The arms each comprise a wire (preferably a flat wire) with a distal section 41, a proximal section 42 and an intervening bend section 43. The electrodes are placed on the proximal sections. The proximal end of each arm is fixed to the inner catheter tube 35. The distal end of each arm is fixed to the floating tube (or pin) 44. This floating tube is retained within the inner catheter tube, but is free to slide longitudinally within the inner catheter tube. The necessary electrical wires 45 and 46 which connect the electrodes to the control system run from each electrode proximally along the arm (and through any intervening electrodes), and enter the lumen of the floating tube 44 and then run proximally through the inner catheter tube and into the catheter handle. (Additional wires for temperature sensing thermistor or thermocouples may be included.) The wires are looped within the handle to provide the distension necessary for the resilient deployment of the electrode array as illustrated in FIG. 5. A steering pull wire 47 is secured to the distal end of the inner catheter tube. The pull wire runs proximally to the steering control knob in the proximal handle, and is operably connected to the control knob so that rotation of the control knob pulls the pull wire to effectuate steering of the distal end of the device. The outer catheter tube is sufficiently flexible so that it is steered by deflection of the inner catheter tube. The materials used for each component are selected to provide the suitable flexibility, column strength and steerability. The outer catheter tube 34 may comprises nylon, polyester or other suitable polymer, and the inner catheter tube 35 comprises a stainless steel coil covered in shrink tubing to provide tensile strength. The electrode arms 39 comprise flat nitinol wires. The floating tube 44 comprises a stainless steel coil. The floating tube may be disposed over the inner catheter if accommodations are made for proximal fixation of the proximal arm segments to the inner catheter, such as placing the fixation points proximally on the inner catheter or providing slots on the proximal portion of the floating tube. The electrode wires may be disposed on or in the wall of the inner catheter, rather than passing through the lumen of the inner catheter as shown in the Figures.



FIG. 4 is a cross-section of the proximal portion of the catheter of FIG. 2. At this cross section, an electrode 40 is mounted on each arm 39. These electrodes will be located on the proximally facing portion of the deployed array as shown in FIGS. 5 and 6. The electrodes are tubes of triangular cross section, with tissue contacting faces directed radially outwardly from the catheter. The electrode wires 45, which are connected to the inside electrodes, run through the outer electrodes on their route to the floating tube. The electrode wires 46 are fixed to the inner wall of the outer electrode. As shown in this view, the electrodes are collapsed upon the floating tube 44, and due to the triangular shape they are securely packed within the outer catheter tube 34. The floating tube 44 also houses the various electrode wires 45 and 46.



FIGS. 5 and 6 illustrate the atrial sensing and ablation catheter of FIG. 2 with the electrode array in its expanded configuration. The outer catheter tube 34 has been withdrawn proximally over the catheter inner tube, allowing the array arms 39 to expand to create array elements defining a substantially cordate or hastate proximal outline. The term cordate is used as it is in botany to describe a leaf with a base (where the leaf attaches to the stem) which is heart-shaped, having rounded lobes at the base which arch proximally away from the tip and then curve distally toward the tip of the leaf, as shown in FIG. 6b. The term hastate is also adopted from botany, and refers to proximally tending lobes with slightly curved proximal outlines and sharply bending tips, also as shown in FIG. 6b. In the array shown in FIGS. 5 and 6, the base of the array (the proximal portion analogous to the base of a leaf) is heart-shaped, having rounded lobes at the base which arch proximally away from the base and then curve outward and distally toward the tip of the array. Each proximal arm segment resiliently bends radially outwardly from the proximal connection with the inner catheter tube, bending sharply in the proximal direction before arching outwardly and distally, while each distal arm segment bends radially inwardly from the bend portion toward the longitudinally axis of the catheter.


The electrode array includes a number electrodes 40 mounted on the proximal section 42 of each array arm, and the distal section 41 need not have any electrodes disposed on it, as is shown. The overall shape of each arm is elongate on an axis perpendicular to the long axis of the catheter, having a radial length R which is several times the axial length A.


The resilient expansion of the electrode array pushes the floating tube 44 proximally into the inner catheter tube. When the outer catheter tube is pushed distally over the electrode array, the distal electrode arms will be forced distally, as the proximal segments are compressed inwardly starting from the proximal end, to first splay the distal segments toward and through a perpendicular relationship with the floating tube such that the joint between the arms and the floating tube is distal to the bend point, while drawing the floating tube distally within the inner catheter tube.



FIG. 7 is a proximal end view of the electrode array in its expanded configuration. In this view, the three-arm array is fully expanded resiliently. The array provides four electrodes on each of three arms evenly distributed about the floating tube 44. The electrode wires 45 and 46 (shown in FIG. 3) extend inwardly from the electrodes and run proximally down the floating tube. The arms are each separated from the adjacent arms by about 120°. The array, when deployed and flattened as shown, is preferably about 15 to 30 mm in diameter (to the outer extent of the arm), with each distal arm segment 41 being about 7.5 to 15 mm long. The diameter of the electrode group (from the center to the outer extent of the electrodes) is preferably about 2 to 30 mm. The wire width is preferable about 0.26 mm, and the distal face of the electrodes is preferably about 1 to 2 mm wide and 2 to 3 mm long (the illustrated electrodes are 2 mm wide and 1.6 mm wide). The electrode array can comprise any number of arms, and each arm can carry any number of electrodes, though the three arm array, with dimensions described above, is well suited for the septal wall ablation therapy. FIG. 7a is an end view of the electrode array, with an asymmetric arrangement of electrodes, in its expanded configuration. In this embodiment, each electrode is 2 mm long, and is fixed to the array arm with a 2 mm gap between adjacent electrodes. The inner electrode of the first set of electrodes 40a is placed at a distance of 2 mm (indicated by item d1) from the inner catheter tube 35 and each of the additional electrodes are placed with 2 mm gaps between each electrode, while the inner electrode of the second set of electrodes 40b is placed at a distance of 4 mm (indicated by item d2) from the inner catheter tube 35 and each of the additional electrodes are placed with 2 mm gaps between each electrode, and the inner electrode of the third set of electrodes 40c is placed at a distance of 6 mm (indicated by item d3) from the inner catheter tube 35 and each of the additional electrodes are placed with 2 mm gaps between each electrode. With the electrodes arranged in this asymmetric pattern on each of the otherwise symmetrical array arms, rotation of the array after ablation in one position will be less likely to result in seating the electrodes directly on a previously ablated section of the septal wall.



FIGS. 8 and 9 illustrate the mechanism of recapture of the electrode array. When the outer catheter tube 34 is pushed distally over the inner catheter tube 35 and the electrode array, the distal electrode arms 41 will be forced distally, as the proximal segments 42 are compressed inwardly starting from the proximal end, as shown in FIG. 8. This initially splays the distal segments toward a perpendicular relationship with the floating tube as shown in FIG. 8. As the outer catheter tube is translated further distally, such that the joint between the arms and the floating tube is distal to the bend point, the distal arm segments become further splayed, such that they are distal to the proximal arms segments. Because the distal arm segments are fixed to the floating tube, their movement distally draws the floating tube distally within the inner catheter tube. The array is completely captured when the outer catheter tube is translated fully forward to resume the position shown in FIGS. 2 and 3. As can be seen from the illustration, the bend sections provide a means for rotatably joining the distal arm segment to the proximal arm segment, and other suitable mechanisms, such as hinges, may be used instead.



FIGS. 10 and 10
a illustrate an alternate geometry of the septal wall array. The outer catheter tube 34 has been withdrawn proximally over the catheter inner tube, allowing the array arms 39 to expand to create array elements defining a substantially sagittate proximal outline. We use the term sagittate as that term is used in botany, where it describes a leaf with a base (where the leaf attaches to the stem) which is arrow-shaped (the back end of the arrow), having sharply triangular lobes with generally straight sides at the base which bend proximally away from the tip and then sharply turn distally toward the tip of the leaf, as shown in FIG. 10b. Here, the array arms have sharply triangular lobes at the base which bend proximally away from the catheter and then sharply turn distally toward the tip of the array. Each proximal arm segment resiliently bends radially outwardly from the proximal connection with the inner catheter tube, bending sharply in the proximal direction, while each distal arm segment bends radially inwardly from the bend portion toward the longitudinally axis of the catheter. The floating tube 44 of FIG. 6 need not be used, as in this example the array distal arm segments are joined at their extreme distal ends to floating pins 51 which comprise proximally running segments that enter the inner catheter tube to provide the floating attachment of the distal arm segments to the catheter body. (Thus both floating pin or arm extensions, or the floating tube, and other suitable means, may be used to fix the distal end of the electrode arms in a radially central area while leaving the distal ends of the electrode arms freely translatable along the catheter longitudinal axis.) The electrode array can be restrained within the outer catheter tube, released and recaptured by sliding the outer catheter proximally or distally.



FIGS. 11, 12 and 13 illustrate additional alternative geometries of the array. In each device, the overall shape of the array arms may be as shown in any of the previous figures, but the array is asymmetrical or oblique. In FIG. 11, the array consists of a single arm 39, while in FIG. 12 the array comprises two arms disposed at a slight angle to each other, so that the array is radially asymmetrical. In FIG. 13, the array comprises an array arms 39 and 39a which are of substantial different sized, resulting in an oblique arrangement. Again, the term oblique is borrowed from botany, where it refers to leaves with lopsided proximal lobes, very similar to the lopsided proximal outlines of the array arms in FIG. 13. These arrays may be used where the anatomy of a particular patient's atrium demands, as where the fossa ovalis is positioned very near an upper or lower wall which would prevent full deployment of a symmetrical array.



FIGS. 14 and 15 illustrate the method of using the device of FIG. 6 or 10. FIG. 14 shows the heart 1 from the left side, showing the left atrium 3, the left ventricle 5, pulmonary veins 10, pulmonary artery 11. The left atrium is shown in a cutaway view, in which the atrial septum 6 and its left atrial surface 53 and the fossa ovalis 7 are shown. To treat arrhythmogenic foci, drivers or rotors on the septal wall near the fossa ovalis, the distal end of the catheter of FIG. 6 or 10 is inserted through the fossa ovalis (via the transeptal approach from the right atrium). Thereafter, the outer catheter is withdrawn, so that the electrode array arms 39 resiliently expand to the configuration in which the proximal arm segments are substantially parallel or slightly reflexed relative to the long axis of the catheter. As shown in FIG. 15, to engage the septal wall, the electrode array is pulled proximally into contact with the septal wall, by pulling proximally on the catheter inner tube 35. As shown, the array will deform, forcing the distal arm segments 41 to splay distally, drawing the floating posts or pins 51 distally in response to the deformation of the array, while at the same time resiliently biasing the proximal arm segments 42 and the electrodes 40 against the septal wall 53 of the left atrium.


After contact has been established between the atrium wall and the electrode array, the operator will analyze electrical signals detected by the electrodes to determine if the array has been placed over an arrhythmogenic focus. If it has, the operator may energize any of the electrodes, as appropriate, to ablate the focus. Bipolar RF energy may be applied between pairs of the electrodes, or monopolar energy may be applied to any of the electrodes (grounded to the surface electrode or a return electrode located proximally on the catheter body). The array may moved off the septal wall, rotated slightly, and reseated against the septal wall to test and treat the entire area surrounding the fossa ovalis with just a few array arms (alternatively, the array may be provided with many arms, such that the electrode density it sufficient to find an ablate all significant foci within its footprint). Linear lesions may be created using the electrodes along a single proximal arm, operating the electrodes in bipolar mode, and other therapeutic lesions may be created using electrodes pairs established between the electrodes of one arm and the electrodes of another arm, operating such pairs in bipolar mode, or operating electrodes in conjunction with return electrodes in a monopolar mode.


While the preferred embodiments of the devices and methods have been described in reference to the environment in which they were developed, they are merely illustrative of the principles of the inventions. Other embodiments and configurations may be devised without departing from the spirit of the inventions and the scope of the appended claims.

Claims
  • 1. An ablation catheter configured to ablate septal wall tissue, comprising: an elongate delivery tube defining a major axis and having a distal end adapted for insertion into the heart of a patient;at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section, a proximal arm section, and a bend section disposed between the distal arm section and the proximal arm section, the proximal arm section of the at least one resilient arm defining a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; anda plurality of electrodes disposed on the proximal arm section of the at least one resilient arm, wherein the distal arm section defines a substantially linear configuration substantially orthogonal to the major axis when the at least one resilient arm is in the expanded configuration.
  • 2. The ablation catheter of claim 1 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.
  • 3. The ablation catheter of claim 1 wherein the proximal arm section forms an acute angle with the distal arm section at the bend section when the at least one resilient arm is in the expanded configuration.
  • 4. The ablation catheter of claim 1 further comprising a pin extending into the elongate delivery tube, the pin being longitudinally slidable relative to the elongate delivery tube.
  • 5. The ablation catheter of claim 4 wherein the proximal arm section is attached to the elongate delivery tube and the distal arm section is attached to the pin.
  • 6. The ablation catheter of claim 1 further adapted to map septal wall tissue.
  • 7. The ablation catheter of claim 1 wherein the proximal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.
  • 8. The ablation catheter of claim 1 wherein the distal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.
  • 9. The ablation catheter of claim 1 wherein the proximal arm section is arcuate when the at least one resilient arm is in the expanded configuration.
  • 10. An ablation catheter configured to ablate septal wall tissue, comprising: an elongate delivery tube having a distal end adapted for insertion into the heart of a patient;at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section, a proximal arm section, and a bend section disposed between the distal arm section and the proximal arm section, the proximal arm section of the at least one resilient arm defining a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; anda plurality of electrodes disposed on the proximal arm section of the at least one resilient arm, wherein the bend section is pre-formed in the at least one resilient arm and forms an acute angle with the distal arm section.
  • 11. The ablation catheter of claim 10 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.
  • 12. The ablation catheter of claim 10 further comprising a pin extending into the elongate delivery tube, the pin being longitudinally slidable relative to the elongate delivery tube.
  • 13. The ablation catheter of claim 12 wherein the proximal arm section is attached to the elongate delivery tube and the distal arm section is attached to the pin.
  • 14. The ablation catheter of claim 10 further adapted to map septal wall tissue.
  • 15. The ablation catheter of claim 10 wherein the proximal arm section extends generally along a lateral axis of the elongate delivery tube when the at least one resilient arm is in the expanded configuration.
  • 16. The ablation catheter of claim 10 wherein the distal arm section extends generally along a lateral axis of the elongate delivery tube when the at least one resilient arm is in the expanded configuration.
  • 17. The ablation catheter of claim 10 wherein the proximal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.
  • 18. The ablation catheter of claim 10 wherein the distal arm section extends generally along a longitudinal axis of the elongate delivery tube when the at least one resilient arm is in the delivery configuration.
  • 19. The ablation catheter of claim 10 wherein the proximal arm section is arcuate when the at least one resilient arm is in the expanded configuration.
  • 20. An ablation catheter configured to ablate septal wall tissue, comprising: an outer catheter tube defining a major axis and having a distal end adapted for insertion into the heart of a patient;an inner catheter tube slidably disposed within the outer catheter tube;a pin slidably disposed within the inner catheter tube;at least one resilient arm with a delivery configuration and an expanded configuration, wherein the at least one resilient arm comprises a distal arm section attached to the pin, a proximal arm section attached to the inner catheter tube, and a bend section disposed between the distal arm section and the proximal arm section,wherein the distal arm section defines a substantially linear configuration substantially orthogonal to the major axis when the at least one resilient arm is in the expanded configuration, and proximal arm section of the at least one resilient arm defines a shape selected from the group consisting of cordate, hastate, and sagittate when the at least one resilient arm is in the expanded configuration; anda plurality of electrodes disposed on the proximal arm section of the at least one resilient arm.
  • 21. The ablation catheter of claim 20 wherein the at least one resilient arm is adapted to bend at the bend section when it is expanded from the delivery configuration to the expanded configuration.
  • 22. The ablation catheter of claim 20 further adapted to map the septal wall.
  • 23. The ablation catheter of claim 20 wherein the proximal arm section is positioned outside of the outer catheter tube when the at least one resilient arm is in the expanded configuration.
  • 24. The ablation catheter of claim 20 wherein the distal arm section is positioned outside of the outer catheter tube when the at least one resilient arm is in the expanded configuration.
  • 25. The ablation catheter of claim 20 wherein the proximal arm section is positioned inside of the outer catheter tube when the at least one resilient arm is in the delivery configuration.
  • 26. The ablation catheter of claim 20 wherein the distal arm section is positioned inside of the outer catheter tube when the at least one resilient arm is in the delivery configuration.
  • 27. A method of treating atrial fibrillation comprising: inserting an ablation catheter defining a major axis into the left atrium of the heart of a patient;expanding a resilient arm of the ablation catheter by bending the resilient arm at a bend section in the resilient arm, wherein the resilient arm comprises proximal and distal arm sections extending from the bend section, the distal arm section defining a substantially linear configuration substantially orthogonal to the major axis when the resilient arm is substantially expanded, and the proximal arm section of the at least one resilient arm defining shape selected from the group consisting of cordate, hastate, and sagittate when the resilient arm is substantially expanded;pulling the proximal arm section of the resilient arm into contact with septal wall tissue; andpassing energy through at least one electrode disposed on the proximal arm section to ablate the septal wall tissue.
  • 28. The method of claim 27 further comprising sensing electrical signals of the septal wall tissue through the at least one electrode disposed on the proximal arm section.
  • 29. The method of claim 28 further comprising repeating the passing energy and sensing steps on another area of septal wall tissue.
  • 30. The method of claim 28 further comprising determining if the proximal arm section is disposed over an arrhythmogenic focus in the left atrium.
  • 31. The method of claim 27 wherein the step of expanding the resilient arm further comprises bending the resilient arm until the proximal arm section extends generally along a lateral axis of the ablation catheter.
  • 32. The method of claim 27 wherein the step of expanding the resilient arm further comprises bending the resilient arm until the distal arm section extends generally along a lateral axis of the ablation catheter.
  • 33. The method of claim 27 further comprising removing an outer catheter tube from the resilient arm before expanding the resilient arm.
  • 34. The method of claim 27 wherein the expanding step further comprises sliding a pin relative to a longitudinal axis of the ablation catheter.
CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 10/997,713, filed Nov. 24, 2004, and entitled “Atrial Ablation Catheter Adapted for Treatment of Septal Wall Arrhythmogenic Foci and Method of Use”, now U.S. Pat. No. 7,468,062, issued Dec. 23, 2008. All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.

US Referenced Citations (444)
Number Name Date Kind
3516412 Ackerman Jun 1970 A
3951136 Wall Apr 1976 A
4017903 Chu Apr 1977 A
4112952 Thomas et al. Sep 1978 A
4411266 Cosman Oct 1983 A
4432377 Dickhudt Feb 1984 A
4660571 Hess et al. Apr 1987 A
4699147 Chilson et al. Oct 1987 A
4785815 Cohen Nov 1988 A
4860769 Fogarty et al. Aug 1989 A
4869248 Narula Sep 1989 A
4882777 Narula Nov 1989 A
4896671 Cunningham et al. Jan 1990 A
4907589 Cosman Mar 1990 A
4920980 Jackowski May 1990 A
4940064 Desai Jul 1990 A
4966597 Cosman Oct 1990 A
5010894 Edhag Apr 1991 A
5016808 Heil, Jr. et al. May 1991 A
5083565 Parins Jan 1992 A
5100423 Fearnot Mar 1992 A
5156151 Imran Oct 1992 A
5184621 Vogel et al. Feb 1993 A
5215103 Desai Jun 1993 A
5228442 Imran Jul 1993 A
5230349 Langberg Jul 1993 A
5231987 Robson Aug 1993 A
5231995 Desai Aug 1993 A
5234004 Hascoet et al. Aug 1993 A
5239999 Imran Aug 1993 A
5255679 Imran Oct 1993 A
5279299 Imran Jan 1994 A
5281213 Milder et al. Jan 1994 A
5281218 Imran Jan 1994 A
5309910 Edwards et al. May 1994 A
5313943 Houser et al. May 1994 A
5318525 West et al. Jun 1994 A
5324284 Imran Jun 1994 A
5327889 Imran Jul 1994 A
5330466 Imran Jul 1994 A
5334193 Nardella Aug 1994 A
5342295 Imran Aug 1994 A
5342357 Nardella Aug 1994 A
5345936 Pomeranz et al. Sep 1994 A
5348554 Imran et al. Sep 1994 A
D351652 Thompson et al. Oct 1994 S
5364352 Cimino et al. Nov 1994 A
5365926 Desai Nov 1994 A
5370644 Langberg Dec 1994 A
5383917 Desai et al. Jan 1995 A
5391147 Imran et al. Feb 1995 A
5397304 Truckai Mar 1995 A
5397339 Desai Mar 1995 A
5400783 Pomeranz et al. Mar 1995 A
5404638 Imran Apr 1995 A
5406946 Imran Apr 1995 A
5411025 Webster, Jr. May 1995 A
5423808 Edwards et al. Jun 1995 A
5423811 Imran et al. Jun 1995 A
5433198 Desai Jul 1995 A
5433739 Sluijter et al. Jul 1995 A
5445148 Jaraczewski et al. Aug 1995 A
5462521 Brucker et al. Oct 1995 A
5462545 Wang et al. Oct 1995 A
5465717 Imran et al. Nov 1995 A
5471982 Edwards et al. Dec 1995 A
5487757 Truckai et al. Jan 1996 A
5492119 Abrams Feb 1996 A
5500011 Desai Mar 1996 A
5507802 Imran Apr 1996 A
5509411 Littmann et al. Apr 1996 A
5527279 Imran Jun 1996 A
5533967 Imran Jul 1996 A
5536267 Edwards et al. Jul 1996 A
5540681 Strul et al. Jul 1996 A
5545161 Imran Aug 1996 A
5545193 Fleischman et al. Aug 1996 A
5545200 West et al. Aug 1996 A
5558073 Pomeranz et al. Sep 1996 A
5573533 Strul Nov 1996 A
5575766 Swartz et al. Nov 1996 A
5575810 Swanson et al. Nov 1996 A
5578007 Imran Nov 1996 A
5582609 Swanson et al. Dec 1996 A
5584830 Ladd et al. Dec 1996 A
5588432 Crowley Dec 1996 A
5588964 Imran et al. Dec 1996 A
5595183 Swanson et al. Jan 1997 A
5596995 Sherman et al. Jan 1997 A
5598848 Swanson et al. Feb 1997 A
5601088 Swanson et al. Feb 1997 A
5606974 Castellano et al. Mar 1997 A
5607462 Imran Mar 1997 A
5620481 Desai et al. Apr 1997 A
5626136 Webster, Jr. May 1997 A
5630425 Panescu et al. May 1997 A
5630837 Crowley May 1997 A
5637090 McGee et al. Jun 1997 A
D381076 Thornton et al. Jul 1997 S
5645064 Littmann et al. Jul 1997 A
5645082 Sung et al. Jul 1997 A
5656029 Imran et al. Aug 1997 A
5657755 Desai Aug 1997 A
5658278 Imran et al. Aug 1997 A
5662606 Cimino et al. Sep 1997 A
5666970 Smith Sep 1997 A
5673695 McGee et al. Oct 1997 A
5680860 Imran Oct 1997 A
5681280 Rusk et al. Oct 1997 A
5682885 Littmann et al. Nov 1997 A
5685322 Sung et al. Nov 1997 A
5687723 Avitall Nov 1997 A
5693078 Desai et al. Dec 1997 A
5697927 Imran et al. Dec 1997 A
5697928 Walcott et al. Dec 1997 A
5699796 Littmann et al. Dec 1997 A
5702438 Avitall Dec 1997 A
5704791 Gillio Jan 1998 A
5706809 Littmann et al. Jan 1998 A
5711298 Littmann et al. Jan 1998 A
5716389 Walinsky et al. Feb 1998 A
5722401 Pietroski et al. Mar 1998 A
5722975 Edwards et al. Mar 1998 A
5724985 Snell et al. Mar 1998 A
5733323 Buck et al. Mar 1998 A
5735280 Sherman et al. Apr 1998 A
5741320 Thornton et al. Apr 1998 A
5766152 Morley et al. Jun 1998 A
5769791 Benaron et al. Jun 1998 A
5769847 Panescu et al. Jun 1998 A
5772590 Webster, Jr. Jun 1998 A
5775327 Randolph et al. Jul 1998 A
5782239 Webster, Jr. Jul 1998 A
5782760 Schaer Jul 1998 A
5782828 Chen et al. Jul 1998 A
5782899 Imran Jul 1998 A
5792140 Tu et al. Aug 1998 A
5800482 Pomeranz et al. Sep 1998 A
5810740 Paisner Sep 1998 A
5820568 Willis Oct 1998 A
5827272 Breining et al. Oct 1998 A
5837001 Mackey Nov 1998 A
5849028 Chen Dec 1998 A
5857464 Desai Jan 1999 A
5857997 Cimino et al. Jan 1999 A
5860920 McGee et al. Jan 1999 A
5863291 Schaer Jan 1999 A
5871523 Fleischman et al. Feb 1999 A
5873865 Horzewski et al. Feb 1999 A
5876399 Chia et al. Mar 1999 A
5881732 Sung et al. Mar 1999 A
5882333 Schaer et al. Mar 1999 A
5885278 Fleischman Mar 1999 A
5891027 Tu et al. Apr 1999 A
5891135 Jackson et al. Apr 1999 A
5891137 Chia et al. Apr 1999 A
5891138 Tu et al. Apr 1999 A
5893847 Kordis Apr 1999 A
5893884 Tu Apr 1999 A
5893885 Webster, Jr. Apr 1999 A
5895355 Schaer Apr 1999 A
5895417 Pomeranz et al. Apr 1999 A
5897554 Chia et al. Apr 1999 A
5904680 Kordis et al. May 1999 A
5906605 Coxum May 1999 A
5910129 Koblish et al. Jun 1999 A
5911720 Bourne et al. Jun 1999 A
5913854 Maguire et al. Jun 1999 A
5916214 Cosio et al. Jun 1999 A
5928191 Houser et al. Jul 1999 A
5931835 Mackey Aug 1999 A
5935063 Nguyen Aug 1999 A
5938694 Jaraczewski et al. Aug 1999 A
5941845 Tu et al. Aug 1999 A
5951471 de la Rama et al. Sep 1999 A
5954719 Chen et al. Sep 1999 A
5957842 Littmann et al. Sep 1999 A
5960796 Sung et al. Oct 1999 A
5967978 Littmann et al. Oct 1999 A
5968040 Swanson et al. Oct 1999 A
5971980 Sherman Oct 1999 A
5992418 de la Rama et al. Nov 1999 A
5997532 McLaughlin et al. Dec 1999 A
6001093 Swanson et al. Dec 1999 A
6001095 de la Rama et al. Dec 1999 A
6002956 Schaer Dec 1999 A
6004269 Crowley et al. Dec 1999 A
6014581 Whayne et al. Jan 2000 A
6021340 Randolph et al. Feb 2000 A
6023638 Swanson Feb 2000 A
6029091 de la Rama et al. Feb 2000 A
6032674 Eggers et al. Mar 2000 A
6033403 Tu et al. Mar 2000 A
6042580 Simpson Mar 2000 A
6045550 Simpson et al. Apr 2000 A
6048329 Thompson et al. Apr 2000 A
6049737 Simpson et al. Apr 2000 A
6050994 Sherman Apr 2000 A
6052612 Desai Apr 2000 A
6053937 Edwards et al. Apr 2000 A
6056744 Edwards May 2000 A
6059778 Sherman May 2000 A
6063077 Schaer May 2000 A
6063082 DeVore et al. May 2000 A
6064902 Haissaguerre et al. May 2000 A
6068629 Haissaguerre et al. May 2000 A
6070094 Swanson et al. May 2000 A
6071274 Thompson et al. Jun 2000 A
6071279 Whayne et al. Jun 2000 A
6071281 Burnside et al. Jun 2000 A
6071282 Fleischman Jun 2000 A
6074351 Houser Jun 2000 A
6086581 Reynolds et al. Jul 2000 A
6088610 Littmann et al. Jul 2000 A
6096036 Bowe et al. Aug 2000 A
6099524 Lipson et al. Aug 2000 A
6106522 Fleischman et al. Aug 2000 A
6107699 Swanson Aug 2000 A
6115626 Whayne et al. Sep 2000 A
6119041 Pomeranz et al. Sep 2000 A
6120476 Fung et al. Sep 2000 A
6129724 Fleischman et al. Oct 2000 A
6141576 Littmann et al. Oct 2000 A
6146379 Fleischman et al. Nov 2000 A
6146381 Bowe et al. Nov 2000 A
6165169 Panescu et al. Dec 2000 A
6167291 Barajas et al. Dec 2000 A
6171305 Sherman Jan 2001 B1
6171306 Swanson et al. Jan 2001 B1
6179833 Taylor Jan 2001 B1
6200314 Sherman Mar 2001 B1
6212426 Swanson Apr 2001 B1
6214002 Fleischman et al. Apr 2001 B1
6216043 Swanson et al. Apr 2001 B1
6216044 Kordis Apr 2001 B1
6217573 Webster Apr 2001 B1
6217576 Tu et al. Apr 2001 B1
6226542 Reisfeld May 2001 B1
6231570 Tu et al. May 2001 B1
6238390 Tu et al. May 2001 B1
6241666 Pomeranz et al. Jun 2001 B1
6241724 Fleischman et al. Jun 2001 B1
6241725 Cosman Jun 2001 B1
6241726 Raymond et al. Jun 2001 B1
6241727 Tu et al. Jun 2001 B1
6241728 Gaiser et al. Jun 2001 B1
6241754 Swanson et al. Jun 2001 B1
6245067 Tu et al. Jun 2001 B1
6245089 Daniel et al. Jun 2001 B1
6251107 Schaer Jun 2001 B1
6256540 Panescu et al. Jul 2001 B1
6264664 Avellanet Jul 2001 B1
6267746 Bumbalough Jul 2001 B1
6290697 Tu et al. Sep 2001 B1
6293943 Panescu et al. Sep 2001 B1
6302880 Schaer Oct 2001 B1
6309385 Simpson Oct 2001 B1
6312425 Simpson et al. Nov 2001 B1
6319251 Tu et al. Nov 2001 B1
6325797 Stewart et al. Dec 2001 B1
6332880 Yang et al. Dec 2001 B1
6332881 Carner et al. Dec 2001 B1
6346104 Daly et al. Feb 2002 B2
6353751 Swanson Mar 2002 B1
6360128 Kordis et al. Mar 2002 B2
6370435 Panescu et al. Apr 2002 B2
6371955 Fuimaono et al. Apr 2002 B1
6379352 Reynolds et al. Apr 2002 B1
6389311 Whayne et al. May 2002 B1
6391024 Sun et al. May 2002 B1
6425894 Brucker et al. Jul 2002 B1
6428536 Panescu et al. Aug 2002 B2
6428537 Swanson et al. Aug 2002 B1
6440129 Simpson Aug 2002 B1
6447506 Swanson et al. Sep 2002 B1
6451015 Rittman, III et al. Sep 2002 B1
6454758 Thompson et al. Sep 2002 B1
6456864 Swanson et al. Sep 2002 B1
6460545 Kordis Oct 2002 B2
6471693 Carroll et al. Oct 2002 B1
6471699 Fleischman et al. Oct 2002 B1
6475213 Whayne et al. Nov 2002 B1
6475214 Moaddeb Nov 2002 B1
6477396 Mest et al. Nov 2002 B1
6478793 Cosman et al. Nov 2002 B1
6485487 Sherman Nov 2002 B1
6487441 Swanson et al. Nov 2002 B1
6488678 Sherman Dec 2002 B2
6490468 Panescu et al. Dec 2002 B2
6493586 Stahmann et al. Dec 2002 B1
6500167 Webster, Jr. Dec 2002 B1
6500172 Panescu et al. Dec 2002 B1
6514246 Swanson et al. Feb 2003 B1
6517536 Hooven et al. Feb 2003 B2
6522905 Desai Feb 2003 B2
6529756 Phan et al. Mar 2003 B1
6540744 Hassett et al. Apr 2003 B2
6542773 Dupree et al. Apr 2003 B2
6544262 Fleischman Apr 2003 B2
6551271 Nguyen Apr 2003 B2
6554794 Mueller et al. Apr 2003 B1
6558378 Sherman et al. May 2003 B2
6565511 Panescu et al. May 2003 B2
6569114 Ponzi et al. May 2003 B2
6569162 He May 2003 B2
6569163 Hata et al. May 2003 B2
6572612 Stewart et al. Jun 2003 B2
6574492 Ben-Haim et al. Jun 2003 B1
6575997 Palmer et al. Jun 2003 B1
6583796 Jamar et al. Jun 2003 B2
6597955 Panescu et al. Jul 2003 B2
6602242 Fung et al. Aug 2003 B1
6605087 Swartz et al. Aug 2003 B2
6607505 Thompson et al. Aug 2003 B1
6607520 Keane Aug 2003 B2
6616657 Simpson et al. Sep 2003 B2
6625482 Panescu et al. Sep 2003 B1
6628976 Fuimaono et al. Sep 2003 B1
6632223 Keane Oct 2003 B1
6635056 Kadhiresan et al. Oct 2003 B2
6638223 Lifshitz et al. Oct 2003 B2
6638275 McGaffigan et al. Oct 2003 B1
6640120 Swanson et al. Oct 2003 B1
6652513 Panescu et al. Nov 2003 B2
6652517 Hall et al. Nov 2003 B1
6658279 Swanson et al. Dec 2003 B2
6669692 Nelson et al. Dec 2003 B1
6669693 Friedman Dec 2003 B2
6671533 Chen et al. Dec 2003 B2
6690972 Conley et al. Feb 2004 B2
6701180 Desai Mar 2004 B1
6702811 Stewart et al. Mar 2004 B2
6711428 Fuimaono et al. Mar 2004 B2
6730078 Simpson et al. May 2004 B2
6738673 Desai May 2004 B2
6740080 Jain et al. May 2004 B2
6743225 Sanchez et al. Jun 2004 B2
6746446 Hill, III et al. Jun 2004 B1
6752804 Simpson et al. Jun 2004 B2
6761716 Kadhiresan et al. Jul 2004 B2
6805131 Kordis Oct 2004 B2
6813520 Truckai et al. Nov 2004 B2
6814732 Schaer Nov 2004 B2
6830576 Fleischman et al. Dec 2004 B2
6866662 Fuimaono et al. Mar 2005 B2
6893438 Hall et al. May 2005 B2
6893439 Fleischman May 2005 B2
6893442 Whayne May 2005 B2
6916306 Jenkins et al. Jul 2005 B1
6936047 Nasab et al. Aug 2005 B2
6939349 Fleischman et al. Sep 2005 B2
6952615 Satake Oct 2005 B2
6955173 Lesh Oct 2005 B2
6960206 Keane Nov 2005 B2
6961602 Fuimaono et al. Nov 2005 B2
6964660 Maguire et al. Nov 2005 B2
6966908 Maguire et al. Nov 2005 B2
6972016 Hill, III et al. Dec 2005 B2
6973339 Govari Dec 2005 B2
6987995 Drysen Jan 2006 B2
7001336 Mandrusov et al. Feb 2006 B2
7025766 Whayne et al. Apr 2006 B2
7029470 Francischelli et al. Apr 2006 B2
7029471 Thompson et al. Apr 2006 B2
7044135 Lesh May 2006 B2
7047068 Haissaguerre May 2006 B2
7048734 Fleischman et al. May 2006 B1
7048756 Eggers et al. May 2006 B2
7077823 McDaniel Jul 2006 B2
7094235 Francischelli Aug 2006 B2
7099711 Fuimaono et al. Aug 2006 B2
7099712 Fuimaono et al. Aug 2006 B2
7113831 Hooven Sep 2006 B2
7115122 Swanson et al. Oct 2006 B1
7118568 Hassett et al. Oct 2006 B2
7122031 Edwards et al. Oct 2006 B2
7151964 Desai et al. Dec 2006 B2
7155270 Solis et al. Dec 2006 B2
7156843 Skarda Jan 2007 B2
7163537 Lee et al. Jan 2007 B2
7429261 Kunis et al. Sep 2008 B2
7857808 Oral et al. Dec 2010 B2
20010029366 Swanson et al. Oct 2001 A1
20010039415 Francischelli et al. Nov 2001 A1
20010044625 Hata et al. Nov 2001 A1
20010051803 Desai et al. Dec 2001 A1
20020065465 Panescu et al. May 2002 A1
20020120263 Brown et al. Aug 2002 A1
20020126036 Flaherty et al. Sep 2002 A1
20020161422 Swanson et al. Oct 2002 A1
20030018330 Swanson et al. Jan 2003 A1
20030093069 Panescu et al. May 2003 A1
20030125730 Berube et al. Jul 2003 A1
20030181819 Desai Sep 2003 A1
20030195407 Fuimaono et al. Oct 2003 A1
20030195501 Sherman et al. Oct 2003 A1
20030199746 Fuimaono et al. Oct 2003 A1
20030204185 Sherman et al. Oct 2003 A1
20030204186 Geistert Oct 2003 A1
20040015164 Fuimaono et al. Jan 2004 A1
20040082947 Oral et al. Apr 2004 A1
20040116921 Sherman et al. Jun 2004 A1
20040133154 Flaherty et al. Jul 2004 A1
20040138545 Chen et al. Jul 2004 A1
20040143256 Bednarek Jul 2004 A1
20040152980 Desai Aug 2004 A1
20040158141 Scheib Aug 2004 A1
20040181139 Falwell et al. Sep 2004 A1
20040181249 Torrance et al. Sep 2004 A1
20040182384 Alfery Sep 2004 A1
20040236324 Muller et al. Nov 2004 A1
20040247164 Furnish Dec 2004 A1
20050010095 Stewart et al. Jan 2005 A1
20050015084 Hill et al. Jan 2005 A1
20050033137 Oral et al. Feb 2005 A1
20050065512 Schaer Mar 2005 A1
20050096644 Hall et al. May 2005 A1
20050101946 Govari et al. May 2005 A1
20050119651 Fuimaono et al. Jun 2005 A1
20050148892 Desai Jul 2005 A1
20050177146 Sherman Aug 2005 A1
20050187545 Hooven et al. Aug 2005 A1
20050234444 Hooven Oct 2005 A1
20050240176 Oral et al. Oct 2005 A1
20050251132 Oral et al. Nov 2005 A1
20050256521 Kozel Nov 2005 A1
20060030844 Knight et al. Feb 2006 A1
20060084966 Maguire et al. Apr 2006 A1
20060089637 Werneth et al. Apr 2006 A1
20060095030 Avitall et al. May 2006 A1
20060106375 Werneth et al. May 2006 A1
20060111700 Kunis et al. May 2006 A1
20060111701 Oral et al. May 2006 A1
20060111702 Oral et al. May 2006 A1
20060111703 Kunis et al. May 2006 A1
20060111708 Vanney et al. May 2006 A1
20060142753 Francischelli et al. Jun 2006 A1
20060189975 Whayne et al. Aug 2006 A1
20060195082 Francischelli Aug 2006 A1
20060241366 Falwell et al. Oct 2006 A1
20070083193 Werneth et al. Apr 2007 A1
20070083194 Kunis et al. Apr 2007 A1
20070083195 Werneth et al. Apr 2007 A1
20070106293 Oral et al. May 2007 A1
Foreign Referenced Citations (96)
Number Date Country
5200671AA Oct 2005 AU
2327322AA Nov 1999 CA
2327518AA Nov 1999 CA
2328064AA Nov 1999 CA
2328070AA Nov 1999 CA
2371935AA Dec 2000 CA
2222617 Jul 2002 CA
2437140AA Jun 2004 CA
2492283AA Jul 2005 CA
2194061 Apr 2006 CA
2276755 May 2006 CA
2251041 Jun 2006 CA
428812 Mar 1995 EP
779059 Jun 1997 EP
598742 Aug 1999 EP
879016 Oct 2003 EP
1360938 Nov 2003 EP
1364677 Nov 2003 EP
1554986 Jul 2005 EP
823843 Oct 2005 EP
1384445 Feb 2006 EP
1169976 Apr 2006 EP
1415680 Apr 2006 EP
1011437 May 2006 EP
1210021 May 2006 EP
1658818 May 2006 EP
1125549 Jun 2006 EP
1182980 Jun 2006 EP
1207798 Jun 2006 EP
1321166 Jul 2006 EP
1343427 Jul 2006 EP
828451 Sep 2006 EP
1070480 Sep 2006 EP
1014874 Dec 2006 EP
1383437 Dec 2006 EP
1455667 Jan 2007 EP
957794 Jul 2007 EP
2004188179 Jul 2004 JP
1512622 Oct 1989 SU
1544396 Feb 1990 SU
1690786 Nov 1991 SU
WO9006079 Jun 1990 WO
WO9308756 May 1993 WO
WO9325273 Dec 1993 WO
WO9412098 Jun 1994 WO
WO9610961 Apr 1996 WO
WO9632885 Oct 1996 WO
WO9632897 Oct 1996 WO
WO9634558 Nov 1996 WO
WO9634559 Nov 1996 WO
WO9634560 Nov 1996 WO
WO9634567 Nov 1996 WO
WO9634569 Nov 1996 WO
WO9634570 Nov 1996 WO
WO9634650 Nov 1996 WO
WO9634652 Nov 1996 WO
WO9634653 Nov 1996 WO
WO9636860 Nov 1996 WO
WO9639967 Dec 1996 WO
WO9715919 May 1997 WO
WO9717893 May 1997 WO
WO9717904 May 1997 WO
WO9725917 Jul 1997 WO
WO9725919 Jul 1997 WO
WO9732525 Sep 1997 WO
WO9736541 Oct 1997 WO
WO9740760 Nov 1997 WO
WO9742996 Nov 1997 WO
WO9818520 May 1998 WO
WO9819611 May 1998 WO
WO9826724 Jun 1998 WO
WO9828039 Jul 1998 WO
WO9838913 Sep 1998 WO
WO9902096 Jan 1999 WO
WO9956644 Nov 1999 WO
WO9956647 Nov 1999 WO
WO9956648 Nov 1999 WO
WO9956649 Nov 1999 WO
WO0078239 Dec 2000 WO
WO02060523 Aug 2002 WO
WO03041602 May 2003 WO
WO03089997 Oct 2003 WO
WO2005027765 Mar 2005 WO
WO2005027766 Mar 2005 WO
WO2005065562 Jul 2005 WO
WO2005065563 Jul 2005 WO
WO2005104972 Nov 2005 WO
WO2006017517 Feb 2006 WO
WO2006044794 Apr 2006 WO
WO2006049970 May 2006 WO
WO2006052651 May 2006 WO
WO2006052905 May 2006 WO
WO2006055654 May 2006 WO
WO2006055658 May 2006 WO
WO2006055733 May 2006 WO
WO2006055741 May 2006 WO
Non-Patent Literature Citations (7)
Entry
Oral et al.; U.S. Appl. No. 11/932,378 entitled “Ablation catheters and methods for their use,” filed Oct. 31, 2007.
“Werneth et al.; U.S. Appl. No. 12/116,753 entitled”“Ablation therapy system and method for treating continuous atrial fibrillation,”“filed May 7, 2008”.
Sherman et. al. ; U.S. Appl. No. 12/117,596 entitled “RF energy delivery system and method,”filed May 8, 2008.
Kunis et al.; U.S. Appl. No. 12/197,425 entitled “Atrial ablation catheter and method of use,” filed Aug. 25, 2008.
Werneth et al.; U.S. Appl. No. 12/245,625 entitled “Ablation catheter,” filed Oct. 3, 2008.
Nademanee et al., “A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate,” JACC, vol. 43, No. 11, pp. 2044-2053, 2004.
Wittkampf et al., “Radiofrequency ablation with a cooled porous electrode catheter,” (abstract) JACC, vol. 11, No. 2, pp. 17a, Feb. 1988.
Related Publications (1)
Number Date Country
20080275443 A1 Nov 2008 US
Continuations (1)
Number Date Country
Parent 10997713 Nov 2004 US
Child 12176115 US