The present invention relates generally to irrigated ablation catheters, and more particularly, to electrode assemblies having one or more distal irrigation passageways that are off-center.
Electrophysiology (EP) catheters have been used for an ever-growing number of procedures. For example, catheters have been used for diagnostic, therapeutic, mapping and ablative procedures, to name just a few examples. Typically, a catheter is manipulated through the patient's vasculature and to the intended site, for example, a site within the patient's heart, and carries one or more electrodes, which may be used for mapping, ablation, diagnosis, or other treatments.
There are a number of methods used for ablation of desired areas, including, for example, radio frequency (RF) ablation. RF ablation is accomplished by transmission of radio frequency energy to a desired target area through an electrode assembly to ablate tissue at the target site. Because RF ablation may generate significant heat, which if not controlled can result in undesired or excessive tissue damage, such as steam pop, tissue charring, and the like, it is commonly desirable to include a mechanism to irrigate the target area and the device with biocompatible fluids, such as a saline solution. The use of irrigated ablation catheters can also prevent the formation of soft thrombus and/or blood coagulation.
Typically, there are two general classes of irrigated electrode catheters, i.e., open irrigation catheters and closed irrigation catheters. Closed ablation catheters usually circulate a cooling fluid within the inner cavity of the electrode. Open ablation catheters typically deliver the cooling fluid through open outlets or openings on or about an outer surface of the electrode. Open ablation catheters often use the inner cavity of the electrode, or distal member, as a manifold to distribute saline solution, or other irrigation fluids, to one or more passageways that lead to openings/outlets provided on the surface of the electrode. The saline thus flows directly through the outlets of the passageways onto or about the distal electrode member. This direct flow of fluid through the electrode tip lowers the temperature of the tip during operation, rendering accurate monitoring and control of the ablative process more difficult.
Another known mechanism to control heat is to provide an ablation generator with certain feedback features, such as a temperature readout of the electrode temperature. To provide for such feedback to the physician/clinician during the procedure, conventional RF ablation generators are typically configured for connection to a temperature sensor, such as a thermocouple, located within the electrode.
A common conventional irrigated ablation catheter design involves the use of a distal irrigation passageway in combination with an electrode-disposed thermal sensor. The distal irrigation passageway is thermally insulated and is typically located on the center axis of the electrode assembly. Because the distal irrigation passageway is located on the center axis, the thermal sensor must be moved away from the center axial position. This off-center positioning of the thermal sensor is less than ideal since it could affect the temperature measurement. For example, consider the situation where the catheter electrode is in a parallel contact orientation. The temperature reading will depend on which side of the electrode is contacting the tissue, since it is on the contact side of the electrode where the significant heat will be generated. The preferred location for the thermal sensor would be on or near the center axis of the electrode.
There is therefore a need to minimize or eliminate one or more of the problems set forth above.
One advantage of the present invention is that is provides an irrigated ablation electrode assembly with an improved and more consistent temperature monitoring capability over a broad range of expected operating orientations. Another advantage of the present invention is that it provides such improved temperature monitoring with no significant impairment to the distal tip irrigation capability.
The present invention is directed to a distal electrode assembly of an irrigated ablation catheter, where the assembly includes a manifold and an ablation electrode, which together extend along a main or center axis. The manifold is configured for connection to a distal end of a shaft portion of the catheter. The ablation electrode has a first irrigation passageway having a first opening at a distal tip thereof. The first opening is offset in distance from the center axis. Moving the distal irrigation passageway vacates space in the center of the electrode, on or near the center axis. Through the foregoing, a thermal or temperature sensor, such as a thermocouple, thermistor or the like, may be disposed within a sensor cavity in the electrode at or near the center axis which overcomes the problems described above.
In one embodiment, the irrigation passageway is thermally insulated, such as through insertion of a thermally insulated tubular element. In another embodiment, the distal assembly includes first and second irrigation passageways with respective first and second openings at the distal tip of the electrode to define a dual distal irrigation passageway ablation electrode assembly. These dual irrigation passageways have respective openings that are both offset in distance from the center axis so as to allow the temperature sensor to be placed at or near the center axis, thereby improving temperature monitoring performance.
A catheter including the inventive electrode assembly and a method of manufacturing an irrigated ablation catheter are also presented.
Referring now to the drawings wherein like reference numerals are used to identify identical components in the various views,
The catheter 12 may include a cable connector portion or interface 18, a handle 20 and a shaft 22 having a proximal end 24 and a distal end 26. Disposed on the shaft 22 near the distal end is an ablation tip electrode 28T. The system 10 may further include an electrical return which is used in cooperation with the ablation electrode 28T, such as a skin patch 30 (i.e., an RF dispersive indifferent electrode/patch).
The shaft 22 may further include one or more other electrodes, configured for intra-cardiac use, such as various ring electrodes 28R. It should be re-iterated that the catheter 12 may include still other electrodes, and that in any event, in other embodiments, one or more such other electrodes may be used for any number of diagnostic and/or therapeutic purposes. For instance, such electrodes and therefore such catheters may be used for performing ablation procedures as noted, but also for cardiac mapping, electrophysiological (EP) studies and other like procedures.
The general structural and functional features of catheter systems such as those generally comprising the catheter 12, the fluid source 14 and the RF ablation generator 16 are generally well known to those of skill in the art. For example, the fluid source 14 can comprise various known assembly, including fixed volume rolling pumps, variable volume syringe pumps and other pump assembly known to those skill in the art, including a gravity fed supply as shown. The fluid provided by fluid source 14 may comprise a suitable biocompatible fluid, such as saline. The RF ablation generator 16 may comprise conventional apparatus, such as a commercially available unit sold under the model number IBI-1500T RF Cardiac Ablation Generator, available from Irvine Biomedical, Inc. Of course, the RF ablation generator 16 can also comprise other known energy sources.
It is desirable to position the thermal sensor on the center axis, at or near the center axial location in the electrode. In order to do so, the distal irrigation passageway, in accordance with the invention, is moved away from its conventional on-axis position to an off-center position.
Referring now to
The manifold 54 further includes a centrally-disposed distribution cavity 80, configured for transporting and/or distributing fluid throughout various portions of the electrode assembly 32. The cavity 80 has an inlet 82, which is configured to cooperate with a fluid delivery tube 84. In particular, the fluid delivery tube 84 may be securely provided in fluid communications with the distribution cavity 80 through the insertion of the tube 84 in the inlet 82. An optional seal (not shown) may be provided about (around) the tube 84 after insertion thereof into the inlet 82. The fluid delivery tube 84 may be disposed in a central lumen 86 of the shaft 22, as shown.
The manifold 54 may further include one or more proximal irrigation passageways or ports 88 (hereinafter “ports” 88) extending (e.g., at an acute angle) between the distribution cavity 80 to an outer surface of the manifold 54. The distribution cavity 80 may serve to distribute irrigation fluid to the proximal ports 88. In one embodiment, the manifold 54 may be formed so that a plurality of proximal ports 88 are substantially equally distributed around the circumference of the manifold to provide substantially equal distribution of fluid. It should be understood that the art is replete with various configurations and design approaches for proximal irrigation passageways, and will therefore not be further elaborated upon.
The manifold 54 also includes a tapered lumen portion 94, located intermediate the main, irrigation distribution cavity 80 and the distal irrigation passageway 60, configured to transition the fluid paths from an on-center path (i.e., the cavity 80) to an off-center path (i.e., the distal irrigation passageway 60).
The manifold 54 may also include guideways (not shown) configured to allow one or more electrical connection wires to pass therethrough. For example, a main ablation power wire 90 is shown in
The manifold 54 may also comprise thermally nonconductive or reduced (i.e. poor) thermally conductive material that serves to insulate the fluid from the remaining portions of electrode assembly 52, for example, the electrode 56. Moreover, such selected material(s) for the manifold 54 may also exhibit electrically nonconductive properties. Comparatively, the manifold 54 may have lower thermal conductivity than the electrode 56. In one embodiment, the manifold 54 may comprise a reduced thermally conductive polymer material. A reduced thermally conductive material is one with physical attributes that decrease heat transfer by about 10% or more, provided that the remaining structural components are selected with the appropriate characteristics and sensitivities to maintain adequate monitoring and control of the process. Moreover, a reduced thermally conductive material may include polyether ether ketone (“PEEK”). Further examples of reduced thermally conductive materials that may be useful in conjunction with the present invention include, but are not limited to, high-density polytheylene, polyimides, polyaryletherketones, polyetheretherketones, polyurethane, polypropylene, oriented polypropylene, polyethylene, crystallized polyethylene terephthalate, polyethylene terephthalate, polyester, polyetherimide, acetyl, ceramics, and various combinations thereof. Moreover, for some embodiments, the manifold 54 may be substantially less thermally conductive than the electrode 56. As a result, the irrigation fluid flowing through manifold 54 may have very little thermal effect on the electrode 56 due to the poor thermal conductivity of manifold 54 (e.g. less than 5% effect), and preferably may have nearly 0% effect.
The ablation electrode 56 is configured to have an ablation surface, including distal tip 64. The electrode 56 may generally comprise electrically and potentially thermally, conductive materials, as known to those of ordinary skill in the art. Examples of suitable electrically conductive materials include (but are not limited to) gold, platinum, iridium, palladium, stainless steel, and various mixtures, alloys and combinations thereof. In one embodiment, the distal tip 64 may be rounded (e.g., partially spherical or hemispherical), although other configurations may be used.
The electrode 56 is further configured with a sensor cavity 96 that is configured in size and shape to receive the temperature sensor 68. In the illustrated embodiment, the sensor 68 may be disposed near the central longitudinal axis 58. In alternate embodiments described in connection with
The electrode 56 further includes the off-center distal irrigation passageway 60 having the opening 62 that is offset in distance from the center axis, described above. The interior of the passageway 60 may be, and preferably is, thermally insulated from the electrode body, for example, through the use of thermally insulated tubular element 98. This insulation is to minimize temperature disturbances to the sensed electrode temperature that may be introduced by the irrigation fluid lowering the temperature of the electrode body.
Thermally insulated tubular element 98 may comprise thermally non-conductive and/or poor conductive material. Such material may include, but is not limited to, high-density polyethylene, polyimides, polyaryletherketones, polyetheretherketones, polyurethane, polypropylene, oriented polypropylene, polyethylene, crystallized polyethylene terephthalate, polyethylene terephthalate, polyester, polyetherimide, acetyl, ceramics, and various combinations thereof.
As shown in
Referring to
The electrode 56′ includes a sensor cavity 96′ located substantially on the center axis 58, which in turn allows for the temperature sensor 68 to be disposed substantially on the center axis 58 as well, providing improved temperature monitoring as described above.
As shown in
Referring to
The electrode 56″ also includes a sensor cavity 96″ located substantially on the center axis 58, which in turn allows for the temperature sensor 68 to also be disposed substantially on the center axis 56, providing the improved temperature monitoring as described above.
A method of manufacturing an electrode assembly, in any of the embodiments as described above, is provided and involves a number of steps. First, providing an electrode portion of a distal electrode assembly with a first irrigation passageway having a first opening at a distal tip surface thereof, where the first opening is offset in distance from the center axis of the electrode assembly. The step of providing the electrode may further include the substep of providing a temperature sensor on or near the center axis of the electrode assembly, in the space vacated by moving the irrigation passageway(s) to off-center locations. The next step involves coupling the electrode to a manifold portion of the electrode assembly. Finally, the last step involves coupling the free end of the manifold (i.e. proximal coupling portion of the manifold) to a catheter shaft.
Although numerous embodiments of this invention have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the spirit or scope of this invention. All directional references (e.g., plus, minus, upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present invention, and do not create limitations, particularly as to the position, orientation, or use of the invention. Joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the spirit of the invention as defined in the appended claims.
This application is a continuation of U.S. application Ser. No. 12/347,270, filed 31 Dec. 2008 (the '270 application). The '270 application is hereby incorporated by reference as though fully set forth herein.
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Number | Date | Country | |
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20190083173 A1 | Mar 2019 | US |
Number | Date | Country | |
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Parent | 12347270 | Dec 2008 | US |
Child | 16134503 | US |