This invention relates generally to the field of medical systems, devices and methods for use upon a body during surgery. More particularly, the invention relates to electrosurgical systems, devices and methods for use upon tissues of a human body during surgery, particularly open surgery and minimally invasive surgery such as laparoscopic surgery.
Dry-tip electrosurgical devices (e.g. monopolar pencil) have been known to cause tissue desiccation, tissue sticking to the electrodes, tissue perforation, char formation and smoke generation. More recently, fluid-assisted electrosurgical devices have been developed which use saline to inhibit such undesirable effects, as well as cool the tissue being treated and electrically couple the device to the tissue. The present invention provides a further improvement to fluid-assisted electrosurgical devices by providing an improved construction which better promotes the manufacture thereof.
This invention provides a fluid-assisted electrosurgical device to treat tissue in a presence of radio frequency energy and a fluid provided from the device. In one embodiment, the device comprises a handle, a rigid shaft member distal to the handle, and at least one electrode distal to the shaft member. The shaft member comprises a shaft member first body and a shaft member second body joined together along a length of the shaft member. The shaft member further comprises a plurality of longitudinally oriented shaft member passages. The passages may be parallel and positioned along side one another, and have a length defined by the shaft member first body and the shaft member second body. The shaft member first body and the shaft member second body may be made of a plastic material.
In certain embodiments, the plurality of shaft member passages includes an electrical passage containing an electrical conductor, with the electrical conductor electrically coupled to the electrode. The electrical conductor may extend from a proximal end of the shaft member to a distal end of the shaft member where it may be in direct contact with the electrode. The electrical conductor and the electrode may contact one another within a receptacle for the electrode at a distal end of the shaft member. The electrical conductor may be made of sheet metal.
In certain embodiments, the electrical conductor and at least one of the shaft member first body and the shaft member second body may have interconnecting mating features to position the electrical conductor relative to at least one of the shaft member first body and a shaft member second body. The interconnecting mating features may comprise a keyway and a key configured to interconnect with the keyway. In one embodiment, the electrical conductor interconnecting mating feature may comprise the keyway, and the interconnecting mating feature of at least one of the shaft member first body and the shaft member second body may comprise the key configured to interconnect with the keyway. In an alternative embodiment, the keyway may be provided with at least one of the shaft member first body and shaft member second body and the key may be provided with the electrical conductor.
In other embodiments, the plurality of shaft member passages may include a fluid delivery passage, and the fluid delivery passage may be in fluid communication with a fluid outlet configured to provide fluid to the electrode. The fluid outlet may be at least partially defined by the electrode. The shaft member fluid delivery passage may pass through a shaft member connector portion configured to connect the shaft member fluid delivery passage with fluid delivery tubing within the handle. The shaft member connector portion may be defined by at least one of the shaft member first body and the shaft member second body, and may more particularly comprise a barbed connector portion.
In still other embodiments, the device may comprise a first electrode and a second electrode, and the plurality of shaft member passages may include a first electrical passage and a second electrical passage which are isolated from one another. The first electrical passage may contain a first electrical conductor which is electrically coupled to the first electrode, and the second electrical passage may contain a second electrical conductor which is electrically coupled to the second electrode.
In other embodiments, a first fluid outlet may provide fluid to the first electrode and second fluid outlet may provide fluid to the second electrode. The shaft member fluid delivery passage may include a first branch and a second branch. The shaft member fluid delivery passage first branch may be in fluid communication with the first fluid outlet configured to provide fluid to the first electrode, and the shaft member fluid delivery passage second branch may be in fluid communication with the second fluid outlet configured to provide fluid to the second electrode. The first fluid outlet may be at least partially defined by the first electrode, and the second fluid outlet may be at least partially defined by the second electrode.
In other embodiments, the first electrode may include a first electrode fluid delivery passage in fluid communication with the shaft member fluid delivery passage first branch, and the second electrode may include a second electrode fluid delivery passage in fluid communication with the shaft member fluid delivery passage second branch.
In other embodiments, the first electrode fluid delivery passage may pass through a first electrode connector portion configured to connect the first electrode to the shaft member, and the second electrode fluid delivery passage may pass through a second electrode connector portion configured to connect the second electrode to the shaft member. The first electrode connector portion may comprise a barbed connector portion, and the second electrode connector portion may also comprise a barbed connector portion.
In other embodiments, the shaft member first body and the shaft member second body may be welded together. The plurality of longitudinally oriented shaft member passages may be separated from one another along a common weld line or seam.
Throughout the description, like reference numerals and letters indicate corresponding structure throughout the several views. Also, any particular feature(s) of a particular exemplary embodiment may be equally applied to any other exemplary embodiment(s) of this specification as suitable. In other words, features between the various exemplary embodiments described herein are interchangeable as suitable, and not exclusive. From the specification, it should be clear that any use of the terms “distal” and “proximal” are made in reference from the user of the device, and not the patient.
The invention provides systems, devices and methods for treating tissue at a tissue treatment site during an electrosurgical procedure. This is particularly useful for procedures where it is desirable to shrink, coagulate and seal tissue against blood loss, for example, by shrinking lumens of blood vessels (e.g., arteries, veins).
The invention will now be discussed with reference to the figures, with
As shown in
As shown in
In one embodiment, the fluid 22 is liquid saline solution, and even more particularly, normal (physiologic) saline solution. However, although the description herein may make reference to saline as the fluid 22, other electrically conductive fluids may be used in accordance with the invention.
In addition to the use of an electrically conductive fluid, as will become more apparent with further reading of this specification, fluid 22 may also be an electrically non-conductive fluid. The use of a non-conductive fluid may not offer as many advantages as a conductive fluid, however, the use of a non-conductive fluid still provides certain advantages over the use of a dry electrode including, for example, reduced occurrence of tissue sticking to the electrode(s) of device 30 and cooling of the electrode(s) and/or tissue. Therefore, it is also within the scope of the invention to include the use of a non-conductive fluid, such as, for example, deionized water.
As shown in
An exemplary RF power output curve for electrosurgical unit 10 is shown in
Electrosurgical unit 10 has also been configured such that the speed of pump 28, and therefore the throughput of fluid 22 expelled by the pump 28, is predetermined based on two input variables, the RF power setting and the fluid flow rate setting. In
As shown, electrosurgical unit 10 has been configured to increase the fluid flow rate Q linearly with an increasing RF power setting PS for each of three fluid flow rate settings of low, medium and high corresponding to QL, QM and QH, respectively. Conversely, electrosurgical unit 10 has been configured to decrease the fluid flow rate Q linearly with an decrease RF power setting PS for each of three fluid flow rate settings of low, medium and high corresponding to QL, QM and QH, respectively.
Electrosurgical unit 10 may be particularly configured for use with an electrosurgical device 30 which is a bipolar device. With a bipolar device, an alternating current (AC) electrical circuit is created between first and second electrical poles/electrodes of the device 30. An exemplary bipolar electrosurgical device of the present invention which may be used in conjunction with electrosurgical unit 10 of the present invention is shown at reference character 30a in
As shown in
As shown in
Handswitch assembly 46 comprises a push button 52 which overlies a domed switch. Upon depression of button 52, the domed switch forms a closed circuit which is sensed by electrosurgical unit 10, which then provides RF power to the electrodes 100, 102.
Referring to
At a proximal end 56 of shaft member 50, fluid delivery tubing 26 of device 30a is connected within handle 40 to a proximal barbed connector portion 54 of shaft member 50, which is defined by at least one of shaft member first body 60 and shaft member second body 62. To connect fluid delivery tubing 26 to barbed connector portion 54, the lumen of fluid delivery tubing 26 preferably interference (friction or press) fit over the outside diameter of barbed connector portion 54 to provide an interference fit and seal therebetween.
As shown in
Shaft member 50 includes a plurality of longitudinally oriented, tubular (enclosed), shaft member passages 64, 66, 82 and 84, with each having a length defined by the shaft member first body 60 and the shaft member second body 62. The passages 64, 66, 82 and 84 may be parallel and positioned to a side of one another. As shown, adjacent shaft member passages may be separated from one another by a common weld line or seam 65 which may hermetically seal the passages 64 and 66 from 82 and 84.
Outer (lateral) passages 64, 66 of shaft member 50 more particularly comprise electrical passages which are parallel and isolated from one another, and which contain planar electrical conductors 70, 72. Electrical conductors 70, 72 extend along the complete length of passages 64, 66, and extend from entrance apertures 74, 76, respectively, of passages 64, 66 at a proximal end 56 of shaft member 50, as well as extend from exit apertures 78, 80 of passages 64, 66 at a distal end 58 of shaft member 50. In a particular embodiment, electrical conductors 70, 72 are made of metal, and may more particularly be made of sheet metal. In this manner, conductors are rigid and may contribute to the overall stiffness of shaft member 50.
Also at a proximal end 56 of shaft member 50, electrical conductors 70, 72 are electrically coupled to wire conductors 42 within handle 40 whereby they may receive RF energy conducted through wire conductors 42 from electrosurgical unit 10. At the distal end 58 of shaft member 50, electrical conductors are electrically coupled (via direct physical contact) to electrodes 100, 102, whereby they may conduct the RF energy from electrosurgical unit 10 to electrodes 100, 102. As shown, electrodes 100, 102 are seated in distal end electrode receptacles 88, 90 and electrical conductors 70, 72 extend through apertures 78, 80 within the receptacles 88, 90 at the base thereof for the electrical conductors 70, 72 to make contact with electrodes 100, 102.
By design, electrical conductors 70, 72 are orientation sensitive and configured to inhibit improper installation within shaft member 50. Furthermore, electrical conductors 70, 72 and at least one of the shaft member first body 60 and the shaft member second body 62 have interconnecting mating features to position each electrical conductor 70, 72 relative to at least one of the shaft member first body 60 and the shaft member second body 62. As shown in
Returning to
At the distal end 58 of shaft member 50, passages 82, 84 may be in fluid communication with fluid delivery passages 104, 106 which pass through electrodes 100, 102 and terminate in exit apertures 108, 110. As shown, apertures 108, 110 are at least partially defined by electrodes 100, 102, respectively, and more particularly, are completely defined by electrodes 100, 102, respectively. In the foregoing manner, exit apertures 108, 110 provide fluid outlets or exits configured to provide fluid 22 therefrom directly onto electrodes 100, 102. Furthermore, as shown, exit apertures 108, 110 are proximal to a distal end of electrodes 100, 102, as well as located on lateral portions of electrodes 100, 102.
Thus, during use of device 30a, fluid 22 from fluid source 20 is communicated through a tubular passage provided by lumen of fluid delivery tubing 26, after which it flows through tubular fluid delivery passage 86 and tubular fluid delivery passages 82, 84 of shaft member 50, and then to tubular fluid delivery passages 104, 106 of electrodes 100, 102. After flowing through tubular fluid delivery passages 104, 106 of electrodes 100, 102, fluid 22 may be expelled from fluid outlets 108, 110 onto electrodes 100, 102.
As shown in
In the illustrated embodiment, electrodes 100, 102 may be configured to slide across a tissue surface in a presence of the RF energy from electrosurgical unit 10 and fluid 22 from the fluid source 20. As shown, electrodes 100, 102 may be laterally and spatially separated (by empty space), and configured as mirror images in size and shape with a blunt distal end surface 116, 118 devoid of edges (to provide a uniform current density and treat tissue without necessarily cutting). More particularly, each distal end surface 116, 118 of electrodes 100, 102 may comprise a spherical surface, and more particularly comprise a hemispherical surface with an arc of 180 degrees. The spherical surface may be defined by a uniform radius along the arc, which may be in the range between and including 1.25 mm to about 2.5 mm. Electrodes 100, 102 may particularly comprise an electrically conductive metal, such as stainless steel. Other suitable materials may include titanium, gold, silver and platinum.
During manufacture of the device 30a, electrical conductors 70, 72 are first installed and positioned with shaft member first body 60. Thereafter, shaft member first body 60 and shaft member second body 62 may be joined by ultrasonic welding. Thereafter, electrodes 100, 102 may be joined to shaft member 50 by inserting male connector portions 112, 114 of electrodes 100, 102 into female connector portions 92, 94 of electrode receptacles 88, 90 of shaft member 50. Prior to inserting male connector portions 112, 114 of electrodes 100, 102 into female connector portions 92, 94, electrodes 100, 102 may be heated. In this manner, electrodes 100, 102 may heat and soften the female connector portions 92, 94 of electrode receptacles 88, 90 during insertion thereof. In this manner, which may be referred to as heat-staking, the insertion force may be reduced, and the plastic material defining female connector portions 92, 94 may flow to better join/grasp with the barbs and adhesively bond, as well as mechanically bond, to electrodes 100, 102. In this manner a hermetic seal may be provided between electrodes 100, 102 and electrode receptacles 88, 90. Alternatively, electrodes 100, 102 may be ultrasonically welded to electrode receptacles 88, 90 of shaft member 50.
At the same time electrodes 100, 102 are joined to shaft member 50 by inserting male connector portions 112, 114 of electrodes 100, 102 into female connector portions 92, 94 of electrode receptacles 88, 90 of shaft member 50, a distal portion 124, 126 of electrical conductors 70, 72 may be inserted into receptacles 128, 130 of electrodes 100, 102 to establish physical contact therewith for electrical communication.
As shown in
Fluid 22, in addition to providing an electrical coupling between the device 30a and tissue 200, lubricates surface 202 of tissue 200 and facilitates the movement of electrodes 100, 102 across surface 202 of tissue 200. During movement of electrodes 100, 102, electrodes 100, 102 typically slide across the surface 202 of tissue 200. Typically the user of device 30a slides electrodes 100, 102 across surface 202 of tissue 200 back and forth with a painting motion while using fluid 22 as, among other things, a lubricating coating. Preferably the thickness of the fluid 22 between the distal end surface of electrodes 100, 102 and surface 202 of tissue 200 at the outer edge of couplings 204, 206 is in the range between and including about 0.05 mm to 1.5 mm. Also, in certain embodiments, the distal end tip of electrodes 100, 102 may contact surface 202 of tissue 200 without any fluid 22 in between.
As shown in
Device 30a disclosed herein may be particularly useful as non-coaptive tissue sealer in providing hemostasis during surgery. In other words, grasping of the tissue is not necessary to shrink, coagulate and seal tissue against blood loss, for example, by shrinking collagen and associated lumens of blood vessels (e.g., arteries, veins) to provided the desired hemostasis of the tissue. Furthermore, the control system of the electrosurgical unit 10 is not necessarily dependent on tissue feedback such as temperature or impedance to operate. Thus, the control system of electrosurgical unit 10 may be open loop with respect to the tissue which simplifies use.
Device 30a disclosed herein may be particularly useful to surgeons to achieve hemostasis after dissecting through soft tissue, as part of hip or knee arthroplasty. The tissue treating portions can be painted over the raw, oozing surface 202 of tissue 200 to seal the tissue 200 against bleeding, or focused on individual larger bleeding vessels to stop vessel bleeding. As part of the same or different procedure, device 30a is also useful to stop bleeding from the surface of cut bone, or osseous, tissue as part of any orthopaedic procedure that requires bone to be cut. Device 30a may be particularly useful for use during orthopedic knee, hip, shoulder and spine procedures. Additional discussion concerning such procedures may be found in U.S. Publication No. 2006/0149225, published Jul. 6, 2006, and U.S. Publication No. 2005/0090816, published Apr. 28, 2005, which are assigned to the assignee of the present invention and are hereby incorporated by reference in there entirety to the extent they are consistent.
As established above, device 30a of the present invention inhibit such undesirable effects of tissue desiccation, electrode sticking, char formation and smoke generation, and thus do not suffer from the same drawbacks as prior art dry tip electrosurgical devices. The use of the disclosed devices can result in significantly lower blood loss during surgical procedures. Such a reduction in blood loss can reduce or eliminate the need for blood transfusions, and thus the cost and negative clinical consequences associated with blood transfusions, such as prolonged hospitalization.
In an alternative embodiment, device 30a may only have a single electrode 100 and comprise a monopolar device.
While a preferred embodiment of the present invention has been described, it should be understood that various changes, adaptations and modifications can be made therein without departing from the spirit of the invention and the scope of the appended claims. The scope of the invention should, therefore, be determined not with reference to the above description, but instead should be determined with reference to the appended claims along with their full scope of equivalents. Furthermore, it should be understood that the appended claims do not necessarily comprise the broadest scope of the invention which the Applicant is entitled to claim, or the only manner(s) in which the invention may be claimed, or that all recited features are necessary.
All publications and patent documents cited in this application are incorporated by reference in their entirety for all purposes to the extent they are consistent.
This application is a continuation of U.S. application Ser. No. 12/790,309, filed May 28, 2010, now abandoned, and entitled “Fluid-Assisted Electrosurgical Devices, and Methods of Manufacture Thereof”, the entire teachings of which are incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
2888928 | Seiger | Jun 1959 | A |
3682130 | Jeffers | Aug 1972 | A |
3750650 | Ruttgers | Aug 1973 | A |
3827436 | Stumpf et al. | Aug 1974 | A |
3830239 | Stumpf et al. | Aug 1974 | A |
3859986 | Okada et al. | Jan 1975 | A |
3862627 | Hans, Sr. | Jan 1975 | A |
3886945 | Stumpf et al. | Jun 1975 | A |
3907339 | Stumpf et al. | Sep 1975 | A |
3910277 | Zimmer | Oct 1975 | A |
3913581 | Ritson et al. | Oct 1975 | A |
3924628 | Droegemueller et al. | Dec 1975 | A |
4018227 | Wallach | Apr 1977 | A |
4022215 | Benson | May 1977 | A |
4060088 | Morrison et al. | Nov 1977 | A |
4061135 | Widran et al. | Dec 1977 | A |
4063560 | Thomas et al. | Dec 1977 | A |
4072152 | Linehan | Feb 1978 | A |
4082096 | Benson | Apr 1978 | A |
4207897 | Lloyd et al. | Jun 1980 | A |
4244371 | Farin | Jan 1981 | A |
4248224 | Jones | Feb 1981 | A |
4275734 | Mitchiner | Jun 1981 | A |
4276874 | Wolvek et al. | Jul 1981 | A |
4278090 | van Gerven | Jul 1981 | A |
4321931 | Hon | Mar 1982 | A |
4342218 | Fox | Aug 1982 | A |
4355642 | Alferness | Oct 1982 | A |
4377168 | Rzasa et al. | Mar 1983 | A |
4381007 | Doss | Apr 1983 | A |
4519389 | Gudkin et al. | May 1985 | A |
4598698 | Siegmund | Jul 1986 | A |
4601290 | Effron et al. | Jul 1986 | A |
4664110 | Schanzlin | May 1987 | A |
4671274 | Scrochenko | Jun 1987 | A |
4736749 | Lundback | Apr 1988 | A |
4779611 | Grooters et al. | Oct 1988 | A |
4802475 | Weshahy | Feb 1989 | A |
4815470 | Curtis et al. | Mar 1989 | A |
4872346 | Kelly-Fry et al. | Oct 1989 | A |
4916922 | Mullens | Apr 1990 | A |
4917095 | Fry et al. | Apr 1990 | A |
4919129 | Weber et al. | Apr 1990 | A |
4931047 | Broadwin et al. | Jun 1990 | A |
4932952 | Wojciechowicz, Jr. | Jun 1990 | A |
4936281 | Stasz | Jun 1990 | A |
4943290 | Rexroth et al. | Jul 1990 | A |
4946460 | Merry et al. | Aug 1990 | A |
4950232 | Ruzicka et al. | Aug 1990 | A |
4985030 | Melzer et al. | Jan 1991 | A |
4998933 | Eggers et al. | Mar 1991 | A |
5013312 | Parins et al. | May 1991 | A |
5029574 | Shimamura et al. | Jul 1991 | A |
5044165 | Linner et al. | Sep 1991 | A |
5078713 | Varney | Jan 1992 | A |
5080102 | Dory | Jan 1992 | A |
5080660 | Buelna | Jan 1992 | A |
5100388 | Behl et al. | Mar 1992 | A |
5108390 | Potocky et al. | Apr 1992 | A |
5147355 | Friedman et al. | Sep 1992 | A |
5178133 | Pena | Jan 1993 | A |
5190541 | Abele et al. | Mar 1993 | A |
5195959 | Smith | Mar 1993 | A |
5197964 | Parins | Mar 1993 | A |
5207674 | Hamilton | May 1993 | A |
5217860 | Fahy et al. | Jun 1993 | A |
5222501 | Ideker et al. | Jun 1993 | A |
5224943 | Goddard | Jul 1993 | A |
5228923 | Hed | Jul 1993 | A |
5231995 | Desai | Aug 1993 | A |
5232516 | Hed | Aug 1993 | A |
5234428 | Kaufman | Aug 1993 | A |
5254116 | Baust et al. | Oct 1993 | A |
5254117 | Rigby et al. | Oct 1993 | A |
5263493 | Avitall | Nov 1993 | A |
5269291 | Carter | Dec 1993 | A |
5275595 | Dobak, III | Jan 1994 | A |
5277201 | Stern | Jan 1994 | A |
5281213 | Milder et al. | Jan 1994 | A |
5281215 | Milder | Jan 1994 | A |
5295484 | Marcus et al. | Mar 1994 | A |
5309896 | Moll et al. | May 1994 | A |
5316000 | Chapelon et al. | May 1994 | A |
5317878 | Bradshaw et al. | Jun 1994 | A |
5318525 | West et al. | Jun 1994 | A |
5322520 | Milder | Jun 1994 | A |
5323781 | Ideker et al. | Jun 1994 | A |
5324255 | Passafaro et al. | Jun 1994 | A |
5324284 | Imran | Jun 1994 | A |
5324286 | Fowle | Jun 1994 | A |
5330521 | Cohen | Jul 1994 | A |
5334181 | Rubinsky et al. | Aug 1994 | A |
5334193 | Nardella | Aug 1994 | A |
5336220 | Ryan et al. | Aug 1994 | A |
5348554 | Imran et al. | Sep 1994 | A |
5353783 | Nakao et al. | Oct 1994 | A |
5354258 | Dory | Oct 1994 | A |
5361752 | Moll et al. | Nov 1994 | A |
5383874 | Jackson et al. | Jan 1995 | A |
5385148 | Lesh et al. | Jan 1995 | A |
5395312 | Desai | Mar 1995 | A |
5396887 | Imran | Mar 1995 | A |
5397304 | Truckai | Mar 1995 | A |
5400770 | Nakao et al. | Mar 1995 | A |
5400783 | Pomeranz et al. | Mar 1995 | A |
5401272 | Perkins | Mar 1995 | A |
5403309 | Coleman et al. | Apr 1995 | A |
5403311 | Abele et al. | Apr 1995 | A |
5405376 | Mulier et al. | Apr 1995 | A |
5409483 | Campbell et al. | Apr 1995 | A |
5417709 | Slater | May 1995 | A |
5423807 | Milder | Jun 1995 | A |
5423811 | Imran et al. | Jun 1995 | A |
5427119 | Swartz et al. | Jun 1995 | A |
5431168 | Webster, Jr. | Jul 1995 | A |
5431649 | Mulier et al. | Jul 1995 | A |
5433708 | Nichols et al. | Jul 1995 | A |
5435308 | Gallup et al. | Jul 1995 | A |
5437651 | Todd et al. | Aug 1995 | A |
5441503 | Considine et al. | Aug 1995 | A |
5443463 | Stern et al. | Aug 1995 | A |
5443470 | Stern et al. | Aug 1995 | A |
5445638 | Rydell et al. | Aug 1995 | A |
5450843 | Moll et al. | Sep 1995 | A |
5452582 | Longsworth | Sep 1995 | A |
5452733 | Sterman et al. | Sep 1995 | A |
5460629 | Shlain et al. | Oct 1995 | A |
5462545 | Wang et al. | Oct 1995 | A |
5465717 | Imran et al. | Nov 1995 | A |
5469853 | Law et al. | Nov 1995 | A |
5472876 | Fahy | Dec 1995 | A |
5478309 | Sweezer et al. | Dec 1995 | A |
5478330 | Imran et al. | Dec 1995 | A |
5486193 | Bourne et al. | Jan 1996 | A |
5487385 | Avitall | Jan 1996 | A |
5487757 | Truckai et al. | Jan 1996 | A |
5490819 | Nicholas et al. | Feb 1996 | A |
5496312 | Klicek | Mar 1996 | A |
5497774 | Swartz et al. | Mar 1996 | A |
5498248 | Milder | Mar 1996 | A |
5500012 | Brucker et al. | Mar 1996 | A |
5505730 | Edwards | Apr 1996 | A |
5516505 | McDow | May 1996 | A |
5520682 | Baust et al. | May 1996 | A |
5522870 | Ben-Zion | Jun 1996 | A |
5536267 | Edwards et al. | Jul 1996 | A |
5540562 | Giter | Jul 1996 | A |
5542945 | Fritzsch | Aug 1996 | A |
5545195 | Lennox et al. | Aug 1996 | A |
5545200 | West et al. | Aug 1996 | A |
5549661 | Kordis et al. | Aug 1996 | A |
5555883 | Avitall | Sep 1996 | A |
5556397 | Long et al. | Sep 1996 | A |
5558671 | Yates | Sep 1996 | A |
5560362 | Sliwa et al. | Oct 1996 | A |
5562702 | Huitema et al. | Oct 1996 | A |
5569241 | Edwards | Oct 1996 | A |
5569243 | Kortenbach et al. | Oct 1996 | A |
5571088 | Lennox et al. | Nov 1996 | A |
5571215 | Sterman et al. | Nov 1996 | A |
5573532 | Chang et al. | Nov 1996 | A |
5575766 | Swartz et al. | Nov 1996 | A |
5575788 | Baker et al. | Nov 1996 | A |
5575810 | Swanson et al. | Nov 1996 | A |
5578007 | Imran | Nov 1996 | A |
5582609 | Swanson et al. | Dec 1996 | A |
5588432 | Crowley | Dec 1996 | A |
5590657 | Cain et al. | Jan 1997 | A |
5595183 | Swanson et al. | Jan 1997 | A |
5599346 | Edwards et al. | Feb 1997 | A |
5605539 | Buelna et al. | Feb 1997 | A |
5607462 | Imran | Mar 1997 | A |
5617854 | Munsif | Apr 1997 | A |
5630837 | Crowley | May 1997 | A |
5637090 | McGee et al. | Jun 1997 | A |
5643197 | Brucker et al. | Jul 1997 | A |
5647869 | Goble et al. | Jul 1997 | A |
5656029 | Imran et al. | Aug 1997 | A |
5658278 | Imran et al. | Aug 1997 | A |
5671747 | Connor | Sep 1997 | A |
5673695 | McGee et al. | Oct 1997 | A |
5676662 | Fleischhacker et al. | Oct 1997 | A |
5676692 | Sanghvi et al. | Oct 1997 | A |
5676693 | LaFontaine | Oct 1997 | A |
5678550 | Bassen et al. | Oct 1997 | A |
5680860 | Imran | Oct 1997 | A |
5681278 | Igo et al. | Oct 1997 | A |
5681294 | Osborne et al. | Oct 1997 | A |
5681308 | Edwards et al. | Oct 1997 | A |
5687723 | Avitall | Nov 1997 | A |
5687737 | Branham et al. | Nov 1997 | A |
5688267 | Panescu et al. | Nov 1997 | A |
5690611 | Swartz et al. | Nov 1997 | A |
5697536 | Eggers et al. | Dec 1997 | A |
5697882 | Eggers et al. | Dec 1997 | A |
5697925 | Taylor | Dec 1997 | A |
5697927 | Imran et al. | Dec 1997 | A |
5697928 | Walcott et al. | Dec 1997 | A |
5713942 | Stern | Feb 1998 | A |
5716389 | Walinsky et al. | Feb 1998 | A |
5718241 | Ben-Haim et al. | Feb 1998 | A |
5718701 | Shai et al. | Feb 1998 | A |
5720775 | Larnard | Feb 1998 | A |
5722402 | Swanson et al. | Mar 1998 | A |
5730074 | Peter | Mar 1998 | A |
5730127 | Avitall | Mar 1998 | A |
5730704 | Avitall | Mar 1998 | A |
5733280 | Avitall | Mar 1998 | A |
5735280 | Sherman et al. | Apr 1998 | A |
5735290 | Sterman et al. | Apr 1998 | A |
5743903 | Stern et al. | Apr 1998 | A |
5755760 | Maguire et al. | May 1998 | A |
5766167 | Eggers et al. | Jun 1998 | A |
5769846 | Edwards et al. | Jun 1998 | A |
5782828 | Chen et al. | Jul 1998 | A |
5785706 | Bednarek | Jul 1998 | A |
5788636 | Curley | Aug 1998 | A |
5792140 | Tu et al. | Aug 1998 | A |
5797905 | Fleischman et al. | Aug 1998 | A |
5797960 | Stevens et al. | Aug 1998 | A |
5800428 | Nelson et al. | Sep 1998 | A |
5800482 | Pomeranz et al. | Sep 1998 | A |
5810764 | Eggers et al. | Sep 1998 | A |
5810802 | Panescu et al. | Sep 1998 | A |
5827216 | Igo et al. | Oct 1998 | A |
5836947 | Fleischman et al. | Nov 1998 | A |
5840030 | Ferek-Petric et al. | Nov 1998 | A |
5843021 | Edwards et al. | Dec 1998 | A |
5843152 | Tu et al. | Dec 1998 | A |
5844349 | Oakley et al. | Dec 1998 | A |
5846187 | Wells et al. | Dec 1998 | A |
5846191 | Wells et al. | Dec 1998 | A |
5849028 | Chen | Dec 1998 | A |
5861021 | Thome et al. | Jan 1999 | A |
5871523 | Fleischman et al. | Feb 1999 | A |
5871525 | Edwards et al. | Feb 1999 | A |
5873845 | Cline et al. | Feb 1999 | A |
5873855 | Eggers et al. | Feb 1999 | A |
5876399 | Chia et al. | Mar 1999 | A |
5879295 | Li et al. | Mar 1999 | A |
5879296 | Ockuly et al. | Mar 1999 | A |
5879348 | Owens et al. | Mar 1999 | A |
5881732 | Sung et al. | Mar 1999 | A |
5882346 | Pomeranz et al. | Mar 1999 | A |
5885278 | Fleischman | Mar 1999 | A |
5891142 | Eggers et al. | Apr 1999 | A |
5893848 | Negus et al. | Apr 1999 | A |
5895355 | Schaer | Apr 1999 | A |
5895417 | Pomeranz et al. | Apr 1999 | A |
5897553 | Mulier et al. | Apr 1999 | A |
5897554 | Chia et al. | Apr 1999 | A |
5899898 | Arless et al. | May 1999 | A |
5899899 | Arless et al. | May 1999 | A |
5902289 | Swartz et al. | May 1999 | A |
5904711 | Flom et al. | May 1999 | A |
5906580 | Kline-Schoder et al. | May 1999 | A |
5906587 | Zimmon | May 1999 | A |
5906606 | Chee et al. | May 1999 | A |
5908029 | Knudson et al. | Jun 1999 | A |
5913854 | Maguire et al. | Jun 1999 | A |
5916213 | Haissaguerre et al. | Jun 1999 | A |
5916214 | Cosio et al. | Jun 1999 | A |
5921924 | Avitall | Jul 1999 | A |
5921982 | Lesh et al. | Jul 1999 | A |
5925045 | Reimels et al. | Jul 1999 | A |
5927284 | Borst et al. | Jul 1999 | A |
5928191 | Houser et al. | Jul 1999 | A |
5931810 | Grabek | Aug 1999 | A |
5931848 | Saadat | Aug 1999 | A |
5935123 | Edwards et al. | Aug 1999 | A |
5944715 | Goble et al. | Aug 1999 | A |
5954661 | Greenspon et al. | Sep 1999 | A |
5957919 | Laufer | Sep 1999 | A |
5971980 | Sherman | Oct 1999 | A |
5971983 | Lesh | Oct 1999 | A |
5975919 | Arnett et al. | Nov 1999 | A |
5980516 | Mulier et al. | Nov 1999 | A |
5989248 | Tu et al. | Nov 1999 | A |
5993412 | Deily et al. | Nov 1999 | A |
5993447 | Blewett et al. | Nov 1999 | A |
6004316 | Laufer | Dec 1999 | A |
6004319 | Goble et al. | Dec 1999 | A |
6007499 | Martin et al. | Dec 1999 | A |
6010500 | Sherman et al. | Jan 2000 | A |
6012457 | Lesh | Jan 2000 | A |
6015391 | Rishton et al. | Jan 2000 | A |
6016811 | Knopp et al. | Jan 2000 | A |
6018676 | Davis et al. | Jan 2000 | A |
6019757 | Scheldrup | Feb 2000 | A |
6024733 | Eggers et al. | Feb 2000 | A |
6030381 | Jones et al. | Feb 2000 | A |
6036687 | Laufer et al. | Mar 2000 | A |
6042556 | Beach et al. | Mar 2000 | A |
6048333 | Lennox et al. | Apr 2000 | A |
6056744 | Edwards | May 2000 | A |
6056745 | Panescu et al. | May 2000 | A |
6056746 | Goble | May 2000 | A |
6056747 | Saadat et al. | May 2000 | A |
6063081 | Mulier et al. | May 2000 | A |
6066139 | Ryan et al. | May 2000 | A |
6068653 | LaFontaine | May 2000 | A |
6071279 | Whayne et al. | Jun 2000 | A |
6083237 | Huitema et al. | Jul 2000 | A |
6086585 | Hovda et al. | Jul 2000 | A |
6088894 | Oakley | Jul 2000 | A |
6096037 | Mulier et al. | Aug 2000 | A |
6113592 | Taylor | Sep 2000 | A |
6113596 | Hooven et al. | Sep 2000 | A |
6117101 | Diederich et al. | Sep 2000 | A |
6120496 | Whayne et al. | Sep 2000 | A |
6141576 | Littmann et al. | Oct 2000 | A |
6142993 | Whayne et al. | Nov 2000 | A |
6142994 | Swanson et al. | Nov 2000 | A |
6149620 | Baker et al. | Nov 2000 | A |
6152920 | Thompson et al. | Nov 2000 | A |
6161543 | Cox et al. | Dec 2000 | A |
6165174 | Jacobs et al. | Dec 2000 | A |
6190384 | Ouchi | Feb 2001 | B1 |
6193716 | Shannon, Jr. | Feb 2001 | B1 |
6210406 | Webster | Apr 2001 | B1 |
6210410 | Farin et al. | Apr 2001 | B1 |
6210411 | Hofmann et al. | Apr 2001 | B1 |
6212426 | Swanson | Apr 2001 | B1 |
6217528 | Koblish et al. | Apr 2001 | B1 |
6217575 | DeVore et al. | Apr 2001 | B1 |
6217576 | Tu et al. | Apr 2001 | B1 |
6224592 | Eggers et al. | May 2001 | B1 |
6231518 | Grabek et al. | May 2001 | B1 |
6231591 | Desai | May 2001 | B1 |
6235020 | Cheng et al. | May 2001 | B1 |
6235024 | Tu | May 2001 | B1 |
6237605 | Vaska et al. | May 2001 | B1 |
6238347 | Nix et al. | May 2001 | B1 |
6238387 | Miller, III | May 2001 | B1 |
6238393 | Mulier et al. | May 2001 | B1 |
6245061 | Panescu et al. | Jun 2001 | B1 |
6245064 | Lesh et al. | Jun 2001 | B1 |
6245065 | Panescu et al. | Jun 2001 | B1 |
6251092 | Qin et al. | Jun 2001 | B1 |
6251110 | Wampler | Jun 2001 | B1 |
6251128 | Knopp et al. | Jun 2001 | B1 |
6258087 | Edwards et al. | Jul 2001 | B1 |
6264650 | Hovda et al. | Jul 2001 | B1 |
6266551 | Osadchy et al. | Jul 2001 | B1 |
6270471 | Hechel et al. | Aug 2001 | B1 |
6283988 | Laufer et al. | Sep 2001 | B1 |
6283989 | Laufer et al. | Sep 2001 | B1 |
6293943 | Panescu et al. | Sep 2001 | B1 |
6296619 | Brisken et al. | Oct 2001 | B1 |
6299633 | Laufer | Oct 2001 | B1 |
6302880 | Schaer | Oct 2001 | B1 |
6311692 | Vaska et al. | Nov 2001 | B1 |
6312383 | Lizzi et al. | Nov 2001 | B1 |
6314962 | Vaska et al. | Nov 2001 | B1 |
6314963 | Vaska et al. | Nov 2001 | B1 |
6322559 | Daulton et al. | Nov 2001 | B1 |
6325797 | Stewart et al. | Dec 2001 | B1 |
6328735 | Curley et al. | Dec 2001 | B1 |
6328736 | Mulier | Dec 2001 | B1 |
6332881 | Carner et al. | Dec 2001 | B1 |
6352533 | Ellman et al. | Mar 2002 | B1 |
6358248 | Mulier | Mar 2002 | B1 |
6361531 | Hissong | Mar 2002 | B1 |
6364876 | Erb et al. | Apr 2002 | B1 |
6368275 | Sliwa et al. | Apr 2002 | B1 |
6371955 | Fuimaono et al. | Apr 2002 | B1 |
6371956 | Wilson et al. | Apr 2002 | B1 |
6383151 | Diederich et al. | May 2002 | B1 |
6385472 | Hall et al. | May 2002 | B1 |
6398792 | O'Connor | Jun 2002 | B1 |
6409722 | Hoey et al. | Jun 2002 | B1 |
6413254 | Hissong et al. | Jul 2002 | B1 |
6416509 | Goble et al. | Jul 2002 | B1 |
6419648 | Vitek et al. | Jul 2002 | B1 |
6425867 | Vaezy et al. | Jul 2002 | B1 |
6430426 | Avitall | Aug 2002 | B2 |
6440130 | Mulier | Aug 2002 | B1 |
6443952 | Mulier | Sep 2002 | B1 |
6447507 | Bednarek et al. | Sep 2002 | B1 |
6461314 | Pant et al. | Oct 2002 | B1 |
6461956 | Hsuan et al. | Oct 2002 | B1 |
6464700 | Koblish et al. | Oct 2002 | B1 |
6471697 | Lesh | Oct 2002 | B1 |
6471698 | Edwards et al. | Oct 2002 | B1 |
6474340 | Vaska et al. | Nov 2002 | B1 |
6475216 | Mulier | Nov 2002 | B2 |
6477396 | Mest et al. | Nov 2002 | B1 |
6478793 | Cosman et al. | Nov 2002 | B1 |
6484727 | Vaska et al. | Nov 2002 | B1 |
6488680 | Francischelli et al. | Dec 2002 | B1 |
6502575 | Jacobs et al. | Jan 2003 | B1 |
6508815 | Strul et al. | Jan 2003 | B1 |
6514250 | Jahns et al. | Feb 2003 | B1 |
6517536 | Hooven et al. | Feb 2003 | B2 |
6527767 | Wang et al. | Mar 2003 | B2 |
6537248 | Mulier et al. | Mar 2003 | B2 |
6537272 | Christopherson et al. | Mar 2003 | B2 |
6558382 | Jahns et al. | May 2003 | B2 |
6558385 | McClurken et al. | May 2003 | B1 |
6575969 | Rittman et al. | Jun 2003 | B1 |
6579288 | Swanson et al. | Jun 2003 | B1 |
6584360 | Francischelli et al. | Jun 2003 | B2 |
6585732 | Mulier | Jul 2003 | B2 |
6602248 | Sharps et al. | Aug 2003 | B1 |
6603988 | Dowlatshahi | Aug 2003 | B2 |
6605084 | Acker et al. | Aug 2003 | B2 |
6610055 | Swanson et al. | Aug 2003 | B1 |
6610060 | Mulier | Aug 2003 | B2 |
6613048 | Mulier | Sep 2003 | B2 |
6635034 | Cosmescu | Oct 2003 | B1 |
6645199 | Jenkins et al. | Nov 2003 | B1 |
6645202 | Pless et al. | Nov 2003 | B1 |
6648883 | Francischelli et al. | Nov 2003 | B2 |
6656175 | Francischelli et al. | Dec 2003 | B2 |
6663627 | Francischelli et al. | Dec 2003 | B2 |
6666862 | Jain et al. | Dec 2003 | B2 |
6679882 | Kornerup | Jan 2004 | B1 |
6682501 | Nelson et al. | Jan 2004 | B1 |
6689131 | McClurken | Feb 2004 | B2 |
6692450 | Coleman | Feb 2004 | B1 |
6699240 | Francischelli | Mar 2004 | B2 |
6702810 | McClurken et al. | Mar 2004 | B2 |
6702811 | Stewart et al. | Mar 2004 | B2 |
6706038 | Francischelli | Mar 2004 | B2 |
6706039 | Mulier et al. | Mar 2004 | B2 |
6716211 | Mulier | Apr 2004 | B2 |
6736810 | Hoey | May 2004 | B2 |
6755827 | Mulier | Jun 2004 | B2 |
6764487 | Mulier | Jul 2004 | B2 |
6766202 | Underwood et al. | Jul 2004 | B2 |
6766817 | da Silva | Jul 2004 | B2 |
6773433 | Stewart et al. | Aug 2004 | B2 |
6775575 | Bommannan et al. | Aug 2004 | B2 |
6776780 | Mulier | Aug 2004 | B2 |
6807968 | Francischelli et al. | Oct 2004 | B2 |
6827713 | Bek et al. | Dec 2004 | B2 |
6827715 | Francischelli et al. | Dec 2004 | B2 |
6832996 | Woloszko et al. | Dec 2004 | B2 |
6849073 | Hoey | Feb 2005 | B2 |
6858028 | Mulier | Feb 2005 | B2 |
6887238 | Jahns | May 2005 | B2 |
6899711 | Stewart et al. | May 2005 | B2 |
6911019 | Mulier | Jun 2005 | B2 |
6915806 | Pacek et al. | Jul 2005 | B2 |
6916318 | Francischelli | Jul 2005 | B2 |
6918404 | Dias da Silva | Jul 2005 | B2 |
6936046 | Hissong | Aug 2005 | B2 |
6942661 | Swanson | Sep 2005 | B2 |
6949097 | Stewart et al. | Sep 2005 | B2 |
6949098 | Mulier | Sep 2005 | B2 |
6953461 | McClurken et al. | Oct 2005 | B2 |
6960205 | Jahns | Nov 2005 | B2 |
6962589 | Mulier | Nov 2005 | B2 |
7066586 | da Silva | Jun 2006 | B2 |
7115139 | McClurken et al. | Oct 2006 | B2 |
7156845 | Mulier et al. | Jan 2007 | B2 |
7166106 | Bartel et al. | Jan 2007 | B2 |
7207471 | Heinrich et al. | Apr 2007 | B2 |
7232440 | Dumbauld et al. | Jun 2007 | B2 |
7247155 | Hoey et al. | Jul 2007 | B2 |
7261711 | Mulier et al. | Aug 2007 | B2 |
7309325 | Mulier et al. | Dec 2007 | B2 |
7311708 | McClurken | Dec 2007 | B2 |
7322974 | Swoyer et al. | Jan 2008 | B2 |
7361175 | Suslov | Apr 2008 | B2 |
7364579 | Mulier et al. | Apr 2008 | B2 |
7537595 | McClurken | May 2009 | B2 |
7604635 | McClurken et al. | Oct 2009 | B2 |
7645277 | McClurken et al. | Jan 2010 | B2 |
7651494 | McClurken et al. | Jan 2010 | B2 |
7736361 | Palanker et al. | Jun 2010 | B2 |
7815634 | McClurken et al. | Oct 2010 | B2 |
7909820 | Lipson et al. | Mar 2011 | B2 |
7976544 | McClurken | Jul 2011 | B2 |
7998140 | McClurken | Aug 2011 | B2 |
8012154 | Livneh | Sep 2011 | B2 |
8038670 | McClurken | Oct 2011 | B2 |
8083736 | McClurken et al. | Dec 2011 | B2 |
8177783 | Davison et al. | May 2012 | B2 |
8216233 | McClurken et al. | Jul 2012 | B2 |
8323276 | Palanker et al. | Dec 2012 | B2 |
8348946 | McClurken | Jan 2013 | B2 |
8361068 | McClurken | Jan 2013 | B2 |
20020049483 | Knowlton | Apr 2002 | A1 |
20030014050 | Sharkey et al. | Jan 2003 | A1 |
20030032954 | Carranza et al. | Feb 2003 | A1 |
20030045872 | Jacobs | Mar 2003 | A1 |
20030073993 | Ciarrocca | Apr 2003 | A1 |
20030144656 | Ocel et al. | Jul 2003 | A1 |
20030191462 | Jacobs | Oct 2003 | A1 |
20030204185 | Sherman et al. | Oct 2003 | A1 |
20030216724 | Jahns | Nov 2003 | A1 |
20040015106 | Coleman | Jan 2004 | A1 |
20040015219 | Francischelli | Jan 2004 | A1 |
20040024395 | Ellman et al. | Feb 2004 | A1 |
20040044340 | Francischelli | Mar 2004 | A1 |
20040049179 | Francischelli | Mar 2004 | A1 |
20040078069 | Francischelli | Apr 2004 | A1 |
20040082948 | Stewart et al. | Apr 2004 | A1 |
20040087940 | Jahns et al. | May 2004 | A1 |
20040092926 | Hoey | May 2004 | A1 |
20040111136 | Sharkey et al. | Jun 2004 | A1 |
20040111137 | Shankey et al. | Jun 2004 | A1 |
20040116923 | Desinger | Jun 2004 | A1 |
20040138621 | Jahns et al. | Jul 2004 | A1 |
20040138656 | Francischelli | Jul 2004 | A1 |
20040143260 | Francischelli | Jul 2004 | A1 |
20040186465 | Francischelli et al. | Sep 2004 | A1 |
20040215183 | Hoey | Oct 2004 | A1 |
20040220560 | Briscoe | Nov 2004 | A1 |
20040236322 | Mulier | Nov 2004 | A1 |
20040267326 | Ocel | Dec 2004 | A1 |
20050010095 | Stewart et al. | Jan 2005 | A1 |
20050033280 | Francischelli | Feb 2005 | A1 |
20050090815 | Francischelli et al. | Apr 2005 | A1 |
20050143729 | Francischelli | Jun 2005 | A1 |
20050165392 | Francischelli | Jul 2005 | A1 |
20050209564 | Bonner et al. | Sep 2005 | A1 |
20050267454 | Hissong et al. | Dec 2005 | A1 |
20060009756 | Francischelli et al. | Jan 2006 | A1 |
20060009759 | Chrisitian et al. | Jan 2006 | A1 |
20060064085 | Schechter et al. | Mar 2006 | A1 |
20070049920 | McClurken et al. | Mar 2007 | A1 |
20070093808 | Mulier et al. | Apr 2007 | A1 |
20070118114 | Miller et al. | May 2007 | A1 |
20070208332 | Mulier et al. | Sep 2007 | A1 |
20080015563 | Hoey et al. | Jan 2008 | A1 |
20080021450 | Couture | Jan 2008 | A1 |
20080058796 | O'Brien et al. | Mar 2008 | A1 |
20080071270 | Desinger et al. | Mar 2008 | A1 |
20080103494 | Rioux et al. | May 2008 | A1 |
20090264879 | McClurken et al. | Oct 2009 | A1 |
20100100095 | McClurken et al. | Apr 2010 | A1 |
20110028965 | McClurken | Feb 2011 | A1 |
20120004657 | Conley et al. | Jan 2012 | A1 |
20120101496 | McClurken et al. | Apr 2012 | A1 |
20120116397 | Rencher et al. | May 2012 | A1 |
20120191084 | Davison et al. | Jul 2012 | A1 |
Number | Date | Country |
---|---|---|
2011088387 | Jul 2011 | WO |
Number | Date | Country | |
---|---|---|---|
20140026395 A1 | Jan 2014 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 12790309 | May 2010 | US |
Child | 14045185 | US |