US20080091193A1 - Irrigated ablation catheter having magnetic tip for magnetic field control and guidance - Google Patents
Irrigated ablation catheter having magnetic tip for magnetic field control and guidance Download PDFInfo
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- US20080091193A1 US20080091193A1 US11/953,615 US95361507A US2008091193A1 US 20080091193 A1 US20080091193 A1 US 20080091193A1 US 95361507 A US95361507 A US 95361507A US 2008091193 A1 US2008091193 A1 US 2008091193A1
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- electrode
- electrode assembly
- permanent magnet
- passageway
- irrigated ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00089—Thermal conductivity
- A61B2018/00095—Thermal conductivity high, i.e. heat conducting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00089—Thermal conductivity
- A61B2018/00101—Thermal conductivity low, i.e. thermally insulating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
Definitions
- the present invention pertains generally to ablation catheters and electrode assemblies. More particularly, the present invention is directed toward ablation electrode assemblies for use in the human body having a magnetic tip for magnetic field control and guidance, a mechanism for irrigating targeted areas, and mapping characteristics.
- Electrophysiology catheters are used for an ever-growing number of procedures.
- catheters are used for diagnostic, therapeutic, and ablative procedures, to name just a few examples.
- the catheter is manipulated through the patient's vasculature and to the intended site, for example, a site within the patient's heart.
- the catheter typically carries one or more electrodes, which may be used for ablation, diagnosis, or the like.
- electrodes which may be used for ablation, diagnosis, or the like.
- RF ablation is accomplished by transmission of radiofrequency energy to a desired target area through an electrode assembly to ablate tissue at the target site.
- RF ablation may generate significant heat, which if not carefully monitored and/or controlled can result in protein denaturation, blood coagulation, excess tissue damage, such as steam pop, tissue charring, and the like, it is desirable to monitor the temperature of the ablation assembly. It is further desirable to include a mechanism to irrigate certain target areas with biocompatible fluids, such as saline solution. This irrigation reduces or avoids excess, unwanted tissue damage, as well as blood coagulation and problems associated therewith. However, introduction of this irrigation solution may inhibit the ability to accurately monitor and/or control the temperature of the ablation assembly during use.
- biocompatible fluids such as saline solution
- irrigated electrode catheters There are typically two classes of irrigated electrode catheters, open and closed irrigation catheters. Closed ablation catheters typically circulate a cooling fluid within the inner cavity of the electrode. Open ablation catheters, on the other hand, typically deliver the cooling fluid through open orifices on the electrode. Examples of these known catheters include the THERMOCOOL brand of catheters marketed and sold by Biosense-Webster.
- the current open irrigated ablation catheters use the inner cavity of the electrode, or distal member, as a manifold to distribute saline solution. The saline thus flows directly through the open orifices of the distal electrode member. This direct flow through the distal electrode tip lowers the temperature of the distal tip during operation, rendering accurate monitoring and control of the ablative process more difficult.
- U.S. Patent Application Publication No. 2007/0016006 discloses an apparatus and a method for guiding, steering, and advancing invasive devices and for accurately controlling their positions for providing positioning of magnetic fields and field gradient, for providing fields configured to push/pull, bend/rotate, and by further enabling apparatus to align the distal end of the catheter tip so as to achieve controlled movement in 3D space and ability of apparatus to control the magnetic field characteristics, preferably without excessively large power and field intensities that are potentially dangerous to medical personnel and that can be disruptive to other equipment.
- the entire disclosure of US 2007/0016006 is incorporated herein by reference.
- Embodiments of the present invention provide an irrigated catheter configured to provide better electrode surface cooling and more accurate electrode tip temperature measurement, and having a magnetic tip that can be magnetically guided and controlled.
- the irrigated catheter may further include one or more monitoring or measuring electrodes for mapping or the like.
- the irrigation fluid is directed at target areas where coagulation is more likely to occur so as to minimize blood coagulation and the associated problems.
- the invention further provides for significant improvements over known irrigation catheters, including those disclosed by Wittkampf and Nakagawa et al., by providing a multiple piece irrigated ablation electrode assembly that has the advantages of irrigating the target area while simultaneously improving the operation, temperature response, temperature monitoring and/or control mechanisms of the ablation assembly, so as to prevent unwanted, unnecessary tissue damage and blood coagulation.
- the present invention is directed to improved irrigated ablation electrode assemblies and methods useful in conjunction with irrigated catheter and pump assemblies and RF generator assemblies designed to monitor and control the ablation process while minimizing blood coagulation and unnecessary tissue damage, and with catheter guidance control and imaging systems designed to guide and control the magnetic tips of the electrode assemblies and perform mapping and other imaging functions.
- the electrode forms at least a portion of the shield, and comprises an electrically conductive material that is substantially less oxidizable than the permanent magnet.
- the electrically conductive material is selected from the group consisting of platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof, and the electrically conductive material is plated onto a substrate made of a biocompatible material that is substantially less oxidizable than the permanent magnet.
- the shield comprises one or more materials selected from the group consisting of silicone, polyimide, platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof.
- the permanent magnet comprises NdFeB. At least one mapping electrode is spaced proximally from the electrode which is a distal electrode capable of ablation.
- the electrode is disposed at a distal portion of the electrode assembly and includes an external electrode surface
- the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion.
- the proximal portion comprises a material which is electrically nonconductive and has a lower thermal conductivity than a material of the electrode.
- the at least one proximal passageway extends toward the electrode at an acute angle with respect to the longitudinal axis of the proximal portion.
- the proximal portion comprises a material which is electrically nonconductive; the external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection; and the at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection.
- the permanent magnet is disposed in the distal portion, and the electrode assembly further comprises at least one temperature sensor disposed in the permanent magnet.
- the electrode includes an external electrode surface, and the electrode includes at least one electrode passageway for a fluid with an outlet disposed at the external electrode surface.
- the at least one electrode passageway is thermally insulated from the distal member by a poor thermal conductive material which is lower in thermal conductivity than a material of the electrode.
- the permanent magnet comprises an annular permanent magnet with an axial opening to permit fluid flow to the at least one electrode passageway
- the electrode assembly further comprises a fluid lumen extending through the axial opening of the annular permanent magnet to the at least one electrode passageway.
- the fluid lumen comprises stainless steel braided polyimide forming a portion of the shield, and the electrode forms another portion of the shield.
- the shield includes a silicone seal to prevent fluid from reaching the annular permanent magnet via a junction between the electrode and the fluid lumen.
- the electrode is disposed at a distal portion of the electrode assembly, and the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion.
- the proximal portion comprises a material which is electrically nonconductive.
- the external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection.
- the at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection.
- the inner shield comprises a fluid lumen supplying fluid to the at least one passageway.
- the electrode assembly includes an electrode that has an external electrode surface and forms at least a portion of the outer shield.
- the electrode is disposed at a distal portion of the electrode assembly; the electrode assembly further comprises a proximal portion having a material which is electrically nonconductive; and the proximal portion forms at least a portion of the inner shield.
- a catheter comprises a shaft; and an irrigated ablation electrode assembly coupled to a distal end of the shaft.
- the irrigated ablation electrode assembly has at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly; a permanent magnet; a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and an electrode having an external electrode surface.
- the catheter further comprises a second permanent magnet disposed near the distal end of the shaft and spaced from the permanent magnet in the irrigated ablation electrode assembly.
- FIG. 1 is an isometric view of an ablation electrode assembly according to an embodiment of the present invention in conjunction with an irrigated catheter assembly operably connected to an RF generator assembly and a pump assembly.
- FIG. 2 is an enlarged, isometric view of the ablation electrode assembly according to an embodiment of the present invention operably connected to an irrigated catheter assembly.
- FIG. 3 is a cross-sectional view of the ablation electrode assembly of FIG. 2 taken along line 4 - 4 of FIG. 2 .
- FIG. 4 is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention.
- FIG. 4A is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention.
- FIG. 5 is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention.
- FIG. 6 is a perspective view of the magnet structure of the Catheter Guidance Control and Imaging (CGCI) system.
- CGCI Catheter Guidance Control and Imaging
- FIG. 7A is a perspective view of the CGCI right section showing the hydraulically actuated core extended.
- FIG. 7B is a perspective view of the CGCI right section showing the hydraulically actuated core extracted.
- FIG. 7C is a system block diagram for a surgery system that includes an operator interface, a catheter guidance system, and surgical equipment.
- FIG. 7D is a block diagram of the imaging module for use in a CGCI surgery procedure that includes the catheter guidance system, a radar system, Hall Effect sensors, and a hydraulically actuating core extension mechanism.
- FIG. 8A is a first perspective view of a catheter assembly.
- FIG. 8B is a second perspective view of the catheter assembly.
- FIG. 9A is a side view of the apparatus of FIG. 6 .
- FIG. 9B is an underside view of the apparatus of FIG. 6 .
- FIG. 10 is an isometric view showing the apparatus of FIG. 6 in an open mode where the left and right clusters are separated.
- FIG. 11 is a side view of the configuration shown in FIG. 10 .
- FIG. 12 is an underside view of the configuration shown in FIG. 10 .
- FIG. 13 is an end view of the configuration shown in FIG. 10 .
- FIG. 14 is a block diagram of one embodiment of the CGCI apparatus with magnetic sensors.
- the instant invention relates to irrigated ablation electrode assemblies, and to methods of manufacturing and using such irrigated ablation electrode assemblies.
- similar aspects among the various embodiments described herein will be referred to by the same reference number. As will be appreciated, however, the structure of the various aspects may be different among the various embodiments.
- the ablation electrode assembly may comprise part of an irrigated ablation catheter assembly 12 , operably connected to a pump assembly 15 and an RF generator assembly 14 which serves to facilitate the operation of ablation procedures through monitoring any number of chosen variables (e.g., temperature of the ablation electrode, ablation energy, and position of the assembly), assist in manipulation of the assembly during use, and provide the requisite energy source delivered to the electrode assembly 10 .
- chosen variables e.g., temperature of the ablation electrode, ablation energy, and position of the assembly
- the present embodiments describe RF ablation electrode assemblies and methods, but it is contemplated that the present invention is equally applicable to any number of other ablation electrode assemblies where the temperature of the device and the targeted tissue areas is a factor during the procedure.
- FIG. 1 is a general perspective view of an irrigated ablation catheter assembly having an RF generator assembly 14 and a fluid pump assembly 15 operably connected to an irrigated catheter assembly 12 having an irrigated electrode assembly 10 according to the present invention operably attached thereto.
- the structural and functional features of the catheter assembly 12 and the RF generator assembly 14 and pump assembly 15 are well-known to those of skill in the art.
- the RF generator assembly could be an IBI-1500T RF Cardiac Ablation Generator available from Irvine Biomedical, Inc. in Irvine, Calif. 92614.
- the RF generator assembly could also be any other known assembly, including, for example, a Stockert RF generator available from Biosense, or one of the Atakr® series of RF generators available from Medtronic.
- the pump assembly can be any known assembly, including fixed volume rolling pumps, variable volume syringe pumps, and any other pump assembly known to those of skill in the art.
- FIGS. 2-5 discussed in more detail below, exemplify various embodiments of the irrigated ablation electrode assembly 10 according to the present invention.
- FIG. 2 is an isometric view of an ablation electrode assembly 11 connected to an irrigated ablation catheter assembly 12 having a fluid delivery tube 16 therein.
- the ablation electrode assembly 11 generally comprises an irrigation member 20 and an ablation electrode member 18 .
- the orientation of the members 18 , 20 are generally such that the ablation electrode assembly 18 is situated at the distal end of the assembly with the irrigation member 20 located at the proximal end of the assembly, although it is conceivable the orientation could be reversed.
- the proximal member 20 has at least one passageway 24 (see FIG. 3 ) and at least one outlet 22 for delivery of a fluid to targeted tissue areas and the outside of the electrode assembly 11 .
- the distal member 18 further comprises at least one temperature sensing mechanism 26 (see FIG.
- the distal member 18 is comprised of any electrically, and potentially thermally, conductive material known to those of ordinary skill in the art for delivery of ablative energy to target tissue areas.
- Examples of the electrically conductive material include gold, platinum, iridium, palladium, tantalum, stainless steel, and any mixtures thereof.
- there are a number of electrode designs contemplated within the scope of the present invention including tip electrodes, ring electrodes, and any combination thereof.
- the fluid passageway(s) 24 and outlet(s) 22 are separated from the distal member 18 , and accordingly the temperature sensing mechanism 26 , by at least one poor thermally conductive material.
- a poor thermally conductive material is one with physical attributes that decrease heat transfer between the passageway(s) 24 and the distal member 18 by about 10% or more, and more preferably by about 25% or more measured by known methods to one of ordinary skill in the art. In particular embodiments, materials that decreased heat transfer by more than approximately 75% performed favorably. It is further contemplated that a poor thermally conductive material could have physical attributes that decrease heat transfer less than about 10%, provided that the remaining structural components are selected with the appropriate characteristics and sensitivities to maintain adequate monitoring and control of the process.
- the poor thermally conductive material may be any material known to one of skill in the art consistent with the spirit of the invention.
- Examples of poor thermally conductive materials useful in conjunction with the present invention include, but are not limited to, high-density polyethylene (HDPE), polyimides, polyaryletherketones, polyetheretherketones, polyurethane, polypropylene, oriented polypropylene, polyethylene, crystallized polyethylene terephthalate, polyethylene terephthalate, polyester, ceramics, and plastics such as acetal, and mixtures thereof.
- HDPE high-density polyethylene
- polyimides polyaryletherketones
- polyetheretherketones polyurethane
- polypropylene oriented polypropylene
- polyethylene crystallized polyethylene terephthalate
- polyethylene terephthalate polyethylene terephthalate
- polyester ceramics
- plastics such as acetal, and mixtures thereof.
- the poor thermally conductive material may be the material comprising the proximal member 20 , or the distal member 18 , a separate material from the proximal member 20 and the distal member 18 , or any combination thereof.
- the passageway(s) 24 and outlet(s) 22 defined by the proximal member 18 may also be separated longitudinally from the end 46 (see FIG. 3 ) of the distal member 18 thereby providing the benefit of insulating the passageway(s) 24 from the temperature sensor(s) 26 for improved temperature monitoring of the ablated target area during operation.
- the poor thermally conductive material, and the separation from the temperature sensing mechanism 26 disposed near the end 46 of the distal member 18 serve individually, and cooperatively, to minimize the effect of the lower temperature of the fluid delivered through the passageway(s) 24 and outlet(s) 22 from the temperature sensing mechanism(s) 26 within the distal member 18 .
- the separation of the passageway(s) 24 and outlet(s) 22 from the distal member 18 , and more particularly the temperature sensing mechanism 26 facilitates the dual purposes of (1) effectively irrigating the electrode assembly 11 and the targeted tissue area to minimize coagulation and unwanted tissue damage and (2) effectively controlling the operation of the ablation electrode assembly 11 in accordance with objects of the present invention.
- FIG. 3 is a cross-sectional view of an embodiment of the ablation electrode assembly 11 .
- An ablation electrode assembly 11 is connected to an irrigated catheter assembly 12 having a fluid delivery tube 16 and a catheter shaft 17 .
- the ablation electrode assembly 11 comprises a proximal member or manifold 20 , a distal member 18 , and a temperature sensing mechanism 26 operably connected to the RF generator assembly 14 (see FIG. 1 ).
- the proximal member 20 itself is comprised of a poor thermally conducting material that serves to insulate the irrigation fluid from the remaining portions of the assembly 11 .
- the proximal member 20 is made from a poor thermally conductive polymer, more preferably from a polyether ether ketone (“PEEK”) because of this material's combination of thermal and physical properties. Another possible material is Ultem® polyetherimide.
- the proximal member 20 is configured to receive the fluid tube 16 of the catheter assembly 12 and comprises a plurality of passageways 24 (e.g., 4-8 passageways) extending from a central axis 28 of the assembly 11 axially toward the outer portion of the proximal member 20 terminating in corresponding outlets 22 .
- the plurality of passageways 24 are equally distributed around the proximal member 20 so as to provide equal distribution of fluid to the targeted tissue area and the outside of the assembly 11 .
- the passageway 24 may be a single, annular passageway, or a number of individual passageways equally distributed around the proximal member 20 . In this embodiment, the passageways 24 are at an acute angle with respect to the longitudinal axis 28 of the assembly 11 . In operation, fluid is pumped through the delivery tube 16 and passes through the passageways 24 and through the outlets 22 where it contacts with targeted tissue areas and the outside portion of the ablation electrode assembly 11 .
- the fluid delivery conduits or passageways 24 extend at an angle substantially less than perpendicular to the longitudinal axis 28 . Angling of the passageways 24 away from perpendicular, but less than parallel, further assists in the delivery of the fluid to the targeted tissue areas, further decreases the risk of coagulation of the bodily fluids during ablation procedures, and allows for improved measurement and control of the ablation assembly 11 during operation. More specifically, the passageways 24 are oriented to direct irrigation fluid flow at the target area adjacent, preferably immediately adjacent, the intersection between the proximal member 20 and the distal member 18 .
- the passageways 24 extend at an angle between approximately 20 and 70 degrees, preferably at an angle between approximately 30 and 60 degrees, and more preferably at an angle of approximately 30 degrees. It is also contemplated that the passageways may be further angled in a second dimension, such that the passageways and orifices are configured to provide fluid to the external portion of the assembly in a swirling, or helical fashion. This configuration also serves to keep the fluid in closer proximity to the electrode assembly, thereby further preventing against coagulation during operation.
- the distal member 18 of the ablation electrode assembly 11 has a generally cylindrical shape terminating in a rounded end which may be a hemispherical end or an end that is non-spherical.
- the distal member 18 includes a permanent magnet 48 at least partially encased in a distal electrode shell 50 and an electrode anchor 52 .
- the permanent magnet 48 is desirably made of NdFeB which has a strong magnetic field so that only one such permanent magnet is needed for magnetic field control and guidance of the catheter tip (instead of a plurality of magnets spaced apart from each other).
- Other rare earth permanent magnets with similar characteristics may be used in other embodiments. If two or more permanent magnets are used, additional materials may be considered.
- the permanent magnet 48 typically has a length of about 2-6 mm, typically about 4 mm, in the longitudinal direction.
- the distal electrode shell 50 provides most of the external surface of the distal electrode.
- the electrode anchor 52 is coupled to the proximal member 20 and connected to a power line or cable such as an RF wire 54 .
- the electrode anchor 52 may be connected to the proximal member 20 by any known mechanism including adhesives, press-fit configurations, snap-fit configurations, or the like.
- An inner tube 56 is connected to the electrode anchor 52 and/or the proximal member 20 to accommodate the power line 54 and the temperature sensor conductor for the temperature sensor 26 . Because the temperature sensor 26 is embedded in the permanent magnet 48 , the permanent magnet material preferably is a good thermal conductor (e.g., NdFeB) so that the temperature sensor 26 can measure the temperature of the distal electrode accurately.
- NdFeB good thermal conductor
- the distal electrode shell 50 , the electrode anchor 52 , and the inner tube 56 form a shield that keeps the permanent magnet 48 from exposure to irrigation and/or bodily fluids, comprising an inner shield that separates the permanent magnet 48 from the irrigation fluid including the passageways 24 and an outer shield that separates the permanent magnet 48 from the exterior.
- the permanent magnet 48 is highly oxidizable, any contact between the permanent magnet and liquid is undesirable since oxidation of the permanent magnet 48 can lead to corrosion problems.
- the shield prevents such contact from occurring.
- the materials for the shield are less oxidizable, preferably substantially less oxidizable, than the permanent magnet 48 .
- the oxidization rate of a shield material is less than about 50%, more preferably less than about 20%, most preferably less than about 5%, of the oxidation rate of the permanent magnet 48 .
- the distal electrode shell 50 and the electrode anchor 52 are made of an electrically conductive material such as platinum, gold, tantalum, iridium, stainless steel, palladium, tantalum, and mixtures thereof.
- the electrically conductive material selected is preferably biocompatible.
- the biocompatible electrically conductive material is plated onto a substrate made of copper or beryllium copper to improve the biocompatibility of the distal electrode shell 50 and the electrode anchor 52 .
- the electrode anchor 52 may be laser welded to the distal electrode shell 50 .
- the inner tube 56 may be made of silicone, polyimide, stainless steel braided polyimide, or the like.
- the inner tube 56 may be thermally bonded or molded onto the platinum anchor 52 .
- the distal electrode shell 50 and the electrode anchor 52 form a complete shield around the permanent magnet 48 without the need for the inner tube 56 for separating the permanent magnet 48 from irrigation fluid flow.
- the proximal member 20 preferably is made of a poor thermally conductive material (as discussed above) having a thermal conductivity that is lower, more preferably substantially lower, than the thermal conductivity of the material of the distal member 18 .
- the proximal passageways 24 do not come into contact with any interior portion of the distal member 18 . In this way, the irrigation fluid flowing through the proximal passageways 24 is substantially insulated from the electrode and the temperature sensor of the distal member 18 by distance and material of poor conductivity, so that the temperature sensor 26 can more accurately measure the temperature of the distal electrode.
- the proximal members may be made of a variety of materials that have insulating properties such as, for example, acetal, polyetheretherketone (PEEK), and high-density polyethylene (HDPE), as well as other materials of poor thermal conductivity mentioned above.
- PEEK polyetheretherketone
- HDPE high-density polyethylene
- FIG. 3 shows two monitoring electrodes 58 , 59 that are ring electrodes spaced from the distal electrode 18 .
- the position of each electrode is determined. Calibration of the positioning system is achieved by the two monitoring electrodes 58 , 59 separated by a known interelectrode distance, or by the distal electrode 18 and one monitoring electrode ( 58 or 59 ) that are separated by a predetermined distance.
- a voltage is sensed between one electrode on the catheter assembly 12 (typically the distal electrode 18 ) and a reference electrode on the patient's body (suitably a surface electrode on the patient's skin).
- sensing is performed to gather data relating to the heart, such as the location of an arrhythmia focus.
- data gathering techniques are well known in the art.
- the location information is determined based on the calibration (see, e.g., U.S. Pat. Nos. 5,697,377 and 5,983,126, the entire disclosures of which are incorporated herein by reference), and the sensed information and location are stored and/or mapped.
- FIG. 4 is a cross-sectional view of another embodiment of the ablation electrode assembly 61 .
- the ablation electrode assembly 61 is connected to an irrigated catheter assembly 62 having a fluid delivery tube or lumen 64 and a catheter shaft 66 .
- the ablation electrode assembly 61 comprises a distal member 68 , a permanent magnet 70 disposed proximal to the distal member 68 , and a shell 72 surrounding the outer surface and the proximal surface of the permanent magnet 70 .
- the distal member 68 has a generally cylindrical shape terminating in a rounded end which may be a hemispherical end or an end that is non-spherical.
- the permanent magnet 70 is an annular member having an inner surface covered by a portion of the fluid delivery tube 64 .
- the permanent magnet 70 is desirably made of NdFeB which has a strong magnetic field so that only one such permanent magnet is needed for magnetic field control and guidance of the catheter tip (instead of a plurality of magnets spaced apart from each other).
- the permanent magnet 48 typically has a length of about 2-6 mm, typically about 4 mm in the longitudinal direction.
- the distal member 68 , shell 72 , and fluid delivery tube 64 form a shield that keeps the permanent magnet 70 from exposure to liquid, comprising an inner shield that separates the permanent magnet 70 from the irrigation fluid flowing through the catheter assembly 62 and an outer shield that separates the permanent magnet 70 from the exterior.
- a sealant 74 is preferably provided between the proximal surface of the distal member 68 and the distal surface of the permanent magnet 70 to further ensure no liquid reaches the permanent magnet 70 via the junction between the distal member 68 and the fluid delivery tube 64 .
- the distal member 68 provides the external surface of the distal electrode.
- the shell 72 may also be an electrically conductive surface to provide additional external surface of the distal electrode. In that case, the electrode shell 72 is connected to a power cable or line such as an RF wire 76 .
- One or more temperature sensors 77 may be provided in the distal member 68 and the temperature sensor conductor 78 for the temperature sensor 77 extends proximally through the catheter shaft 66 .
- the shield prevents such contact from occurring.
- the materials for the shield are less oxidizable, preferably substantially less oxidizable, than the permanent magnet 70 .
- the distal member 68 and the electrode shell 72 are made of an electrically conductive material such as platinum, gold, tantalum, iridium, stainless steel, palladium, tantalum, and mixtures thereof.
- the electrically conductive material selected is preferably biocompatible.
- the biocompatible electrically conductive material is plated onto a substrate made of copper or beryllium copper to improve the biocompatibility of the distal member 68 and the electrode shell 72 .
- the fluid delivery tube 64 is electrically nonconductive, and may be made of silicone, polyimide, stainless steel braided polyimide, or the like.
- the electrode shell 72 is connected to the distal member 68 by laser weld or the like.
- the distal member 68 and the electrode shell 72 form the distal electrode.
- the shell 72 may be connected to the catheter shaft 66 using adhesives or the like.
- the fluid delivery tube 64 may be connected to the shell 72 , permanent magnet 70 , and distal member 68 by thermal bonding, molding, adhesives, or the like.
- the fluid delivery tube 64 flows fluid through one or more distal passageways 79 in the distal member 68 to their external outlets.
- the passageways 79 are preferably lined with a poor thermally conducting material 75 such as a polyether ether ketone (“PEEK”) that serves to insulate the fluid from the material of the distal member 68 and from the temperature sensor 77 .
- PEEK polyether ether ketone
- the additional passageways are equally distributed around the central passageway so as to provide equal distribution of fluid to the targeted tissue area and the outside of the assembly 61 .
- FIG. 4 shows one monitoring electrode 80 that is a ring electrode spaced from the distal electrode (formed by the distal member 68 and the electrode shell 72 ) by a known interelectrode distance for calibration.
- a voltage is sensed between the distal electrode ( 68 and 72 ) and a reference electrode on the patient's body (suitably a surface electrode on the patient's skin).
- the location information is determined based on the calibration, and the sensed information and location are stored and/or mapped.
- FIG. 4A shows an irrigated catheter assembly 62 A that is virtually identical to the irrigated catheter assembly 62 of FIG. 4 .
- the assembly 62 A includes a second permanent magnet 70 A disposed near the distal end of the shaft 66 and spaced from the first permanent magnet 70 .
- the second permanent magnet 70 A is an annular magnet and is smaller in size and thickness than the first permanent magnet 70 .
- the second permanent magnet 70 A does not require an additional shield because it is disposed in a space between the catheter shaft 66 and the fluid delivery tube 64 which is free from exposure to liquid.
- the second permanent magnet may have other configurations in different embodiments, and may be formed in the irrigated ablation electrode assembly 61 instead of being inside the catheter shaft 66 and spaced proximally from the electrode assembly 61 . Additional permanent magnets in the assembly may provide additional options for magnetically controlling and guiding the catheter tip.
- FIG. 5 is a cross-sectional view of another embodiment of the ablation electrode assembly 81 which is connected to an irrigated catheter assembly 82 .
- the electrode assembly 81 of FIG. 5 is similar to the electrode assembly 61 of FIG. 4 , in that it also includes a distal member 68 , a permanent magnet 70 , a shell 72 connected to an RF wire 76 , a sealant 74 , and a temperature sensor 77 connected to a temperature sensor conductor 78 .
- the distal member 68 has a central passageway 79 that is preferably lined with a poor thermally conducting material 75 such as a polyether ether ketone (“PEEK”).
- a fluid delivery tube 64 extends through a catheter shaft 66 to the electrode assembly 81 .
- One or more monitoring or measuring electrodes 80 may be provided in the catheter assembly 62 for mapping or other monitoring or measuring functions.
- the ablation electrode assembly 81 includes a proximal member 84 located on the proximal side of the permanent magnet 70 and electrode shell 72 .
- the proximal member 84 has at least one proximal passageway 86 with at least one outlet 88 for delivery of a fluid to targeted tissue areas and the outside of the electrode assembly 81 .
- the proximal passageway(s) 86 and outlet(s) 88 are separated from the distal member 68 and electrode shell 72 , and accordingly the temperature sensing mechanism 77 , by at least one poor thermally conductive material.
- the poor thermally conductive material may be the material comprising the proximal member 84 , or the distal member 68 , a separate material from the proximal member 84 and the distal member 68 , or any combination thereof.
- the proximal member 84 is comprised of a poor thermally conducting material that serves to insulate the fluid from the remaining portions of the assembly 81 .
- the proximal member 84 is configured to receive the fluid tube 64 of the catheter assembly 82 and comprises a plurality of proximal passageways 86 (e.g., 4-8 passageways) extending from a central axis of the assembly 81 axially toward the outer portion of the proximal member 84 terminating in corresponding outlets 88 .
- the plurality of proximal passageways 86 are equally distributed around the proximal member 84 so as to provide equal distribution of fluid to the targeted tissue area and the outside of the assembly 81 .
- the proximal passageway 86 may be a single, annular passageway, or a number of individual passageways equally distributed around the proximal member 84 .
- the proximal passageways 86 are at an acute angle with respect to the longitudinal axis of the assembly 81 .
- fluid is pumped through the delivery tube 64 and passes through the proximal passageways 86 and through the outlets 88 where it contacts with targeted tissue areas and the outside portion of the ablation electrode assembly 81 .
- the proximal passageways 86 extend at an angle substantially less than perpendicular to the longitudinal axis. Angling of the passageways 86 away from perpendicular, but less than parallel, further assists in the delivery of the fluid to the targeted tissue areas, further decreases the risk of coagulation of the bodily fluids during ablation procedures, and allows for improved measurement and control of the ablation assembly 81 during operation. More specifically, the proximal passageways 86 are oriented to direct irrigation fluid flow at the target area adjacent, preferably immediately adjacent, the intersection between the proximal member 84 and the electrode shell 72 .
- the proximal passageways 24 extend at an angle between approximately 20 and 70 degrees, preferably at an angle between approximately 30 and 60 degrees, and more preferably at an angle of approximately 30 degrees. It is also contemplated that the proximal passageways may be further angled in a second dimension, such that the proximal passageways and orifices are configured to provide fluid to the external portion of the assembly in a swirling, or helical fashion. This configuration also serves to keep the fluid in closer proximity to the electrode assembly, thereby further preventing against coagulation during operation.
- the proximal member 84 further includes a longitudinal outlet that transfers fluid through a central conduit 90 to the central passageway 79 of the distal member 68 .
- the central conduit 90 is electrically nonconductive, and may be made of silicone, polyimide, stainless steel braided polyimide, or the like.
- the central conduit 90 may be connected to the electrode shell 72 , permanent magnet 70 , and distal member 68 by thermal bonding, molding, adhesives, or the like.
- the distal member 68 , electrode shell 72 , and central conduit 90 form a shield that separates the permanent magnet 70 from the irrigation fluid and the exterior.
- CGCI Catheter Guidance Control and Imaging
- FIGS. 6, 7A , and 7 B are isometric drawings of a Catheter Guidance Control and Imaging (CGCI) system 1500 ( FIG. 7C ), having a left coil cluster 100 and a right coil cluster 101 provided to rails 102 .
- the rails 102 act as guide alignment devices.
- the CGCI system workstation 1500 includes a structural support assembly 120 , a hydraulic system 140 , and a propulsion system 150 .
- a central arc 106 supports an upper cylindrical coil 110 and two shorter arcs 107 , 108 support two conical shaped coils 115 , 116 .
- the two shorter arcs 107 , 108 are displaced from the central arc 106 by approximately 35 degrees.
- the angle of separation between the two smaller arcs is approximately 70 degrees.
- At the end of each arc 106 , 107 and 108 is a machined block of 1010 steel with a connection that provides for attachment of the coil assemblies 115 , 116 , 110 .
- Two curved shield plates 105 form a shield to at least partially contain and shape the magnetic fields.
- the shields 105 also provide lateral strength to the assembly.
- a base 117 houses the propulsion system 150 and locking mechanism 118 .
- the plates 105 are made from steel, nickel, or other magnetic material.
- FIGS. 7A and 7B further show various mechanical details which form the CGCI cluster half section (right electromagnetic cluster 101 ).
- a locking hole 103 , a spur-drive rail 104 , cam rollers 118 , and the solenoid locking pin 119 are configured to allow portions of the CGCI to move along the tracks 102 .
- the cluster 101 includes three electromagnets forming a magnetic circuit.
- the left coil 116 and right coil 115 are mounted as shown and are supported by C-Arms 107 and 108 .
- the coil 110 includes a hydraulically actuated core 111 , supported by a coil clamping disc 127 made of stainless steel.
- a coil stress relief disc 113 is made of Teflon.
- the coil cylinder 110 is enclosed by a coil base disc 114 made of stainless steel.
- the coil core 111 is actuated (extended and retracted) by a hydraulic system 109 .
- FIG. 7B shows the right coil cluster 101 with the hydraulically actuated core 111 retracted by the use of the hydraulic system 109 which allows the CGCI to shape the magnetic field.
- FIG. 7C is a system block diagram for a surgery system 800 that includes an operator interface 500 , the CGCI system 1500 , surgical equipment 502 (e.g., a catheter tip 11 in FIG. 3 , a catheter tip 61 in FIG. 4 , a catheter tip 81 in FIG. 5 , or a catheter tip 377 in FIG. 8A , etc.), one or more user input devices 900 , and a patient 390 .
- the user input devices 900 can include one or more of a joystick, a mouse, a keyboard, a virtual tip 905 , and other devices to allow the surgeon to provide command inputs to control the motion and orientation of the catheter tip 377 (or tip 11 , 61 , 81 ).
- the CGCI system 1500 includes a controller 501 and an imaging synchronization module 701 .
- FIG. 7C shows the overall relationship between the various functional units and the operator interface 500 , auxiliary equipment 502 , and the patient 390 .
- the CGCI system controller 501 calculates the Actual Tip (AT) position of the distal end of a catheter. Using data from the Virtual Tip (VT) 905 and the imaging and synchronization module 701 , the CGCI system controller 501 determines the position error, which is the difference between actual tip position (AP) and the desired tip position (DP).
- the controller 501 controls electromagnets to move the catheter tip in a direction selected to minimize the position error (PE).
- the CGCI system controller 501 provides tactile feedback to the operator by providing force-feedback to the VT 905 .
- FIG. 7D is a block diagram of a surgery system 503 that represents one embodiment of the CGCI system 1500 .
- the system 503 includes the controller 501 , a radar system 1000 , a Hall effect sensor array 350 , and the hydraulically actuated mechanism 140 .
- the sensor 350 includes one or more Hall effect magnetic sensors.
- the radar system 1000 can be configured as an ultra-wideband radar, an impulse radar, a Continuous-Wave (CW) radar, a Frequency-Modulated CW (FM-CW) radar, a pulse-Doppler radar, etc.
- the radar system 1000 uses Synthetic Aperture Radar (SAR) processing to produce a radar image.
- the radar system 1000 includes an ultra-wideband radar such as described, for example, in U.S. Pat. No. 5,774,091, hereby incorporated by reference in its entirety.
- the radar 1000 is configured as a radar range finder to identify the location of the catheter tip 377 .
- the radar 1000 is configured to locate reference markers (fiduciary markers) placed on the patient 390 . Data regarding location of the reference markers can be used, for example, for image capture synchronization 701 .
- the motorized hydraulically and actuated motion control mechanism 140 allows the electromagnets of the cylindrical coils 51 AT and 51 DT (see FIG. 14 ) to be moved relative to the patient 390 .
- the use of the radar for identifying the position of the catheter tip 377 has advantages over the use of Fluoroscopy, Ultrasound, Magnetostrictive sensors, or SQUID.
- Radar can provide accurate dynamic position information, which provides for real-time, relatively high resolution, relatively high fidelity compatibility in the presence of strong magnetic fields.
- Self-calibration of the range measurement can be based on time-of-flight and/or Doppler processing. Radar further provides for measurement of catheter position while ignoring “Hard” surfaces such as a rib cage, bone structure, etc., as these do not interfere with measurement or hamper accuracy of the measurement.
- Radar can be used in the presence of movement since radar burst emission above 1 GHz can be used with sampling rates of 50 Hz or more, while heart movement and catheter dynamics occur at 0.1 Hz to 2 Hz.
- the use of the radar 1000 reduces the need for complex image capture techniques normally associated with expensive modalities such as fluoroscopy, ultrasound, Magnetostrictive technology, or SQUID which require computationally intensive processing in order to translate the pictorial view and reduce it to a coordinate data set. Position data synchronization of the catheter tip 377 and the organ in motion is readily available through the use of the radar 1000 .
- the radar 1000 can be used with phased-array or Synthetic Aperture processing to develop detailed images of the catheter location in the body and the structures of the body.
- the radar system includes an Ultra Wide Band (UWB) radar with a relatively high resolution swept range gate.
- UWB Ultra Wide Band
- a differential sampling receiver is used to effectively reduce ringing and other aberrations included in the receiver by the near proximity of the transmit antenna.
- the radar system can detect the presence of obstacles or objects located behind barriers such as bone structures. The presence of different substances with different dielectric constants such as fat tissue, muscle tissue, water, etc., can be detected and discerned.
- the outputs from the radar can be correlated with similar units such as multiple catheters used in electrophysiology (EP) studies while detecting spatial location of other catheters present in the heart lumen.
- the radar system 1000 can use a phased array antenna and/or SAR to produce 3D synthetic radar images of the body structures, catheter tip and organs.
- the location of the patient relative to the CGCI system can be determined by using the radar 1000 to locate a plurality of fiduciary markers.
- the data from the radar 1000 is used to locate the body with respect to an imaging system.
- the catheter position data from the radar 1000 can be superimposed (synchronized) with the images produced by the imaging system.
- the ability of the radar and the optional Hall effect sensors 350 to accurately position the catheter tip 377 relative to the stereotactic frame allows the pole pieces to be moved by the actuators 109 , 140 to optimize the location of the magnet poles with respect to the patient 390 and thus reduce the power needed to manipulate the catheter tip.
- FIGS. 8A and 8B shows one embodiment of a catheter assembly 375 and guidewire assembly 379 to be used with the CGCI apparatus 1500 .
- the catheter assembly 375 is a tubular tool that includes a catheter body 376 which extends into a flexible section 378 that possesses sufficient flexibility for allowing a relatively more rigid responsive tip 377 to be steered through the patient.
- the tip 377 can be replaced by the tip 21 of FIG. 3 , the tip 61 of FIG. 4 , or the tip 81 of FIG. 5 .
- the magnetic catheter assembly 375 in combination with the CGCI apparatus 1500 reduces or eliminates the need for the plethora of shapes normally needed to perform diagnostic and therapeutic procedures.
- the surgeon often encounters difficulty in guiding the conventional catheter to the desired position, since the process is manual and relies on manual dexterity to maneuver the catheter through a tortuous path of, for example, the cardiovascular system.
- a plethora of catheters in varying sizes and shapes are to be made available to the surgeon in order to assist him/her in the task, since such, tasks require different bends in different situations due to natural anatomical variations within and between patients.
- the catheterization procedure is now achieved with the help of the CGCI system 1500 that guides the magnetic catheter and guidewire assembly 375 and 379 to the desired position within the patient's body 390 as dictated by the surgeon's manipulation of the virtual tip 905 .
- the magnetic catheter and guidewire assembly 375 , 379 i.e. the magnetic tip 377 can be attracted or repelled by the electromagnets of the CGCI apparatus 1500 ) provides the flexibility needed to overcome tortuous paths, since the CGCI apparatus 1500 overcomes most, if not all the physical limitations faced by the surgeon while attempting to manually advance the catheter tip 377 through the patient's body.
- the catheter tip 377 includes a guidewire assembly 379 , a guidewire body 380 and a tip 381 response to magnetic fields.
- the tip 377 is steered around sharp bends so as to navigate a torturous path.
- the responsive tips 377 and 381 of both the catheter assembly 375 and the guidewire assembly 379 respectively, include magnetic elements such as permanent magnets.
- the tips 377 and 381 include permanent magnets that respond to the external flux generated by the electromagnets 110 , 115 , 116 and its symmetric counterpart 100 .
- the responsive tip 377 of the catheter assembly 375 is tubular, and the responsive tip 381 of the guidewire assembly 379 is a solid cylinder.
- the responsive tip 377 of the catheter assembly 375 is a dipole with longitudinal polar orientation created by the two ends of the magnetic element positioned longitudinally within it.
- the responsive tip 381 of the guidewire assembly 379 is a dipole with longitudinal polar orientation created by two ends of the magnetic element 377 positioned longitudinally within it.
- FIGS. 9A and 9B show additional views of the CGCI structural support assembly 120 .
- the structural support assembly 120 is configured so as to facilitate the use of X-Ray and/or other surgical medical equipment 502 in and around the patient during operation.
- the two symmetrical left 100 and right 101 electromagnetic clusters are mounted on the stainless steel guide rails 102 , allowing the two sections 100 and 101 to move away from each other as shown in FIGS. 10-12 .
- the rails 102 are bolted to a floor or mounting pad.
- the cluster on the CGCI structure 120 rolls inside the rails 102 , under relatively tight tolerance to prevent lateral or vertical movement during a seismic event.
- the rails 102 are designed to withstand the forces of a Zone 4 seismic event without allowing the CGCI structure to escape containment.
- a stainless steel spur toothed rail 104 is bolted to the floor or mounting pad under the CGCI structure 120 .
- a Servo Dynamic model HJ96 C-44 brushless servomotor 128 (max 27 lb.-in torque) with its associated servomotor amplifier model 815-BL 129 are provided to move the clusters 101 , 100 .
- the motor has a reduction gearbox with a ratio of 100:1.
- a stainless steel spur gear attached to the reduction gear shaft meshes with the spur toothed rail 104 .
- the propulsion system 150 is configured to exert up to 2700 lbs. of force to move the CGCI sections 100 and 101 .
- FIGS. 9A and 9B further show the CGCI assembly 120 when the system is set in the “operational mode.”
- the two symmetrical clusters 100 and 101 are engaged as described above.
- FIGS. 9A and 9B show the location of the spur toothed rail 104 and the brushless servo motor 128 .
- FIGS. 10-13 are isometric views of the CGCI assembly 120 when its main two symmetric left 100 and right 101 coil clusters are in a fully open mode (non operational) and the magnetic cores are retracted.
- the rear view of the symmetrical one half of the CGCI shows the parabolic flux collector shields 105 with the C-Arm upper cylinder coil support 106 .
- the CGCI assembly 120 is configured to meet the structural as well as safety considerations associated with the generation of a magnetic field of 2 Tesla.
- FIG. 14 depicts the CGCI system 1500 top architecture showing the major elements comprising the controller 501 of the magnetic circuit.
- the controller 501 includes a system memory, a torque/force matrix algorithm residing in 528 and a CPU/computer 527 .
- the CPU/computer such as PC 527 provides computation and regulation tasks.
- FIG. 14 further shows the six-coil electromagnetic circuit formed out of coils 51 A, 51 B, 51 C, 51 D, 51 AT and 51 DT and the magnetic field sensors (MFS) 351 , 352 , 353 , 354 , 355 and 356 such as Hall sensor ring 350 mounted on an assembly forming the X, Y, and Z axis controls.
- a D/A converter 550 and an I/O block 551 provide communication between the controller 501 and the coils 51 A and the hydraulic systems 140 .
- the six channel DC amplifier 525 provides current to the coils.
- FIG. 14 shows the relationship and command structure between the joystick 900 , the virtual tip 905 , and the CPU 701 .
- the CPU 701 displays control conveying real time images generated by the X-ray, radar 1000 , or other medical imaging technologies such as fluoroscopy, MRI, PET SCAN, CAT SCAN, etc., on a display 730 .
- a flow diagram of the command structure of the control scheme is shown by the use of the 2D virtual plane coil polarity matrixes.
- a computer program such as MathLab or Math Cad is able to sift through the combination matrixes and compute the proper combination for the six coil current polarities and amplitudes.
- a boundary condition controller is used for regulating the field strength 405 and field gradient 406 in the effective region.
- the controller 501 computes the fields in the neighborhood of the catheter tip 377 and as defined by the fields on the 2D planes in the effective area. Rules for computing the fields with rotated coil on the surface of the sphere are set forth in US 2007/0016066.
- look-up tables are used as a reference library for use by the controller 501 .
- Lookup tables of the setting of various scenarios of force as well as torque position and magnitude allow the controller 501 to use a learning algorithm for the control computations.
- the look-up tables shorten the computational process for optimal configuration and setting of the coil currents and pole positions.
- the D/A and A/D system 550 allows the connection of voltage and current measuring instruments as well as input from the magnetic field sensor (MFS) 350 array, the MFS 351 , 352 , 353 , 354 , 355 and 356 .
- the magnetic field sensor measuring the boundary plane field strength allows the CGCI to use a low-level logic algorithm to compute the positions, settings, coil currents, etc.
- the low-level simulation is performed prior to activating the power section of the CGCI apparatus 1500 , thus providing a “soft” level check prior to action performed by actual machine.
- the two-level control architecture that starts with low-level simulation architecture of low-level simulation allows the surgeon or operator of the CGCI apparatus 1500 to test each movement prior to actually performing the move.
- US 2007/0016066 describes the field regulator loop outlined in FIG. 14 using the Hall effect ring 350 .
- the present invention may rely on the use of the monitoring or measuring electrodes ( 58 , 59 in FIG. 3 ; 80 in FIGS. 4 and 5 ), optionally in conjunction with a visualization and mapping tool such as the EnSite NavXTM technology available from St. Jude Medical, Inc. See, e.g., U.S. Pat. Nos. 6,990,370 and 6,939,309, the entire disclosures of which are incorporated herein by reference.
- a visualization and mapping tool such as the EnSite NavXTM technology available from St. Jude Medical, Inc. See, e.g., U.S. Pat. Nos. 6,990,370 and 6,939,309, the entire disclosures of which are incorporated herein by reference.
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Abstract
Embodiments of the present invention provide an irrigated ablation electrode assembly for use with an irrigated catheter device comprises at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly; a permanent magnet; a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and an electrode having an external electrode surface. A catheter guidance control and imaging system drives the permanent magnet to guide and control the catheter tip. In specific embodiments, the irrigation fluid flow paths through the electrode assembly are thermally insulated from the electrode and temperature sensor. The irrigation fluid is directed at target areas where coagulation is more likely to occur. One or more monitoring electrodes are provided for mapping or other monitoring functions.
Description
- This application is a continuation-in-part of U.S. patent application Ser. No. 11/948,362, filed on Nov. 30, 2007, which is a continuation-in-part of U.S. patent application Ser. No. 11/434,200, filed May 16, 2006, the entire disclosures of which are incorporated herein by reference.
- a. Field of the Invention
- The present invention pertains generally to ablation catheters and electrode assemblies. More particularly, the present invention is directed toward ablation electrode assemblies for use in the human body having a magnetic tip for magnetic field control and guidance, a mechanism for irrigating targeted areas, and mapping characteristics.
- b. Background Art
- Electrophysiology catheters are used for an ever-growing number of procedures. For example, catheters are used for diagnostic, therapeutic, and ablative procedures, to name just a few examples. Typically, the catheter is manipulated through the patient's vasculature and to the intended site, for example, a site within the patient's heart.
- The catheter typically carries one or more electrodes, which may be used for ablation, diagnosis, or the like. There are a number of methods used for ablation of desired areas, including for example, radiofrequency (RF) ablation. RF ablation is accomplished by transmission of radiofrequency 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 carefully monitored and/or controlled can result in protein denaturation, blood coagulation, excess tissue damage, such as steam pop, tissue charring, and the like, it is desirable to monitor the temperature of the ablation assembly. It is further desirable to include a mechanism to irrigate certain target areas with biocompatible fluids, such as saline solution. This irrigation reduces or avoids excess, unwanted tissue damage, as well as blood coagulation and problems associated therewith. However, introduction of this irrigation solution may inhibit the ability to accurately monitor and/or control the temperature of the ablation assembly during use.
- There are typically two classes of irrigated electrode catheters, open and closed irrigation catheters. Closed ablation catheters typically circulate a cooling fluid within the inner cavity of the electrode. Open ablation catheters, on the other hand, typically deliver the cooling fluid through open orifices on the electrode. Examples of these known catheters include the THERMOCOOL brand of catheters marketed and sold by Biosense-Webster. The current open irrigated ablation catheters use the inner cavity of the electrode, or distal member, as a manifold to distribute saline solution. The saline thus flows directly through the open orifices of the distal electrode member. This direct flow through the distal electrode tip lowers the temperature of the distal tip during operation, rendering accurate monitoring and control of the ablative process more difficult.
- In these open electrode irrigated catheters, it has been determined that insulating the irrigation channels from the ablation electrode is beneficial. One such example was published on or around March 2005 in an article entitled “Saline-Irrigated Radiofrequency Ablation Electrode with Electrode Cooling,” by Drs. Wittkampf and Nakagawa et al., the content of which is hereby incorporated by reference in its entirety. Similarly, the content of PCT International Publication No. WO 05/048858, published on Jun. 2, 2005, is hereby incorporated by reference in its entirety.
- Recently, magnetic systems have been proposed, wherein magnetic fields produced by one or more electromagnets are used to guide and advance a magnetically tipped catheter. For example, U.S. Patent Application Publication No. 2007/0016006 discloses an apparatus and a method for guiding, steering, and advancing invasive devices and for accurately controlling their positions for providing positioning of magnetic fields and field gradient, for providing fields configured to push/pull, bend/rotate, and by further enabling apparatus to align the distal end of the catheter tip so as to achieve controlled movement in 3D space and ability of apparatus to control the magnetic field characteristics, preferably without excessively large power and field intensities that are potentially dangerous to medical personnel and that can be disruptive to other equipment. The entire disclosure of US 2007/0016006 is incorporated herein by reference.
- Embodiments of the present invention provide an irrigated catheter configured to provide better electrode surface cooling and more accurate electrode tip temperature measurement, and having a magnetic tip that can be magnetically guided and controlled. The irrigated catheter may further include one or more monitoring or measuring electrodes for mapping or the like. The irrigation fluid is directed at target areas where coagulation is more likely to occur so as to minimize blood coagulation and the associated problems. In some embodiments, the invention further provides for significant improvements over known irrigation catheters, including those disclosed by Wittkampf and Nakagawa et al., by providing a multiple piece irrigated ablation electrode assembly that has the advantages of irrigating the target area while simultaneously improving the operation, temperature response, temperature monitoring and/or control mechanisms of the ablation assembly, so as to prevent unwanted, unnecessary tissue damage and blood coagulation.
- The present invention is directed to improved irrigated ablation electrode assemblies and methods useful in conjunction with irrigated catheter and pump assemblies and RF generator assemblies designed to monitor and control the ablation process while minimizing blood coagulation and unnecessary tissue damage, and with catheter guidance control and imaging systems designed to guide and control the magnetic tips of the electrode assemblies and perform mapping and other imaging functions.
- In accordance with an aspect of the present invention, an irrigated ablation electrode assembly for use with an irrigated catheter device comprises at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly; a permanent magnet; a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and an electrode having an external electrode surface.
- In some embodiments, the electrode forms at least a portion of the shield, and comprises an electrically conductive material that is substantially less oxidizable than the permanent magnet. The electrically conductive material is selected from the group consisting of platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof, and the electrically conductive material is plated onto a substrate made of a biocompatible material that is substantially less oxidizable than the permanent magnet. The shield comprises one or more materials selected from the group consisting of silicone, polyimide, platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof. In one example, the permanent magnet comprises NdFeB. At least one mapping electrode is spaced proximally from the electrode which is a distal electrode capable of ablation.
- In specific embodiments, the electrode is disposed at a distal portion of the electrode assembly and includes an external electrode surface, and the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion. The proximal portion comprises a material which is electrically nonconductive and has a lower thermal conductivity than a material of the electrode. The at least one proximal passageway extends toward the electrode at an acute angle with respect to the longitudinal axis of the proximal portion. The proximal portion comprises a material which is electrically nonconductive; the external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection; and the at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection. The permanent magnet is disposed in the distal portion, and the electrode assembly further comprises at least one temperature sensor disposed in the permanent magnet. The electrode includes an external electrode surface, and the electrode includes at least one electrode passageway for a fluid with an outlet disposed at the external electrode surface. The at least one electrode passageway is thermally insulated from the distal member by a poor thermal conductive material which is lower in thermal conductivity than a material of the electrode.
- In some embodiments, the permanent magnet comprises an annular permanent magnet with an axial opening to permit fluid flow to the at least one electrode passageway, and the electrode assembly further comprises a fluid lumen extending through the axial opening of the annular permanent magnet to the at least one electrode passageway. The fluid lumen comprises stainless steel braided polyimide forming a portion of the shield, and the electrode forms another portion of the shield. The shield includes a silicone seal to prevent fluid from reaching the annular permanent magnet via a junction between the electrode and the fluid lumen. The electrode is disposed at a distal portion of the electrode assembly, and the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion. The proximal portion comprises a material which is electrically nonconductive. The external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection. The at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection.
- In accordance with another aspect of the invention, an irrigated ablation electrode assembly for use with an irrigated catheter device comprises a permanent magnet, at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly, the at least one passageway extending through the permanent magnet; an inner shield separating the permanent magnet from the at least one passageway, the inner shield being substantially less oxidizable than the permanent magnet; and an outer shield separating the permanent magnet from an exterior, the inner shield being substantially less oxidizable than the permanent magnet.
- In some embodiments, the inner shield comprises a fluid lumen supplying fluid to the at least one passageway. The electrode assembly includes an electrode that has an external electrode surface and forms at least a portion of the outer shield. The electrode is disposed at a distal portion of the electrode assembly; the electrode assembly further comprises a proximal portion having a material which is electrically nonconductive; and the proximal portion forms at least a portion of the inner shield.
- In accordance with another aspect of this invention, a catheter comprises a shaft; and an irrigated ablation electrode assembly coupled to a distal end of the shaft. The irrigated ablation electrode assembly has at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly; a permanent magnet; a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and an electrode having an external electrode surface.
- In some embodiments, the catheter further comprises a second permanent magnet disposed near the distal end of the shaft and spaced from the permanent magnet in the irrigated ablation electrode assembly.
- The foregoing and other aspects, features, details, utilities, and advantages of the present invention will be apparent from reading the following description and claims, and from reviewing the accompanying drawings.
-
FIG. 1 is an isometric view of an ablation electrode assembly according to an embodiment of the present invention in conjunction with an irrigated catheter assembly operably connected to an RF generator assembly and a pump assembly. -
FIG. 2 is an enlarged, isometric view of the ablation electrode assembly according to an embodiment of the present invention operably connected to an irrigated catheter assembly. -
FIG. 3 is a cross-sectional view of the ablation electrode assembly ofFIG. 2 taken along line 4-4 ofFIG. 2 . -
FIG. 4 is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention. -
FIG. 4A is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention. -
FIG. 5 is a cross-sectional view of an ablation electrode assembly according to another embodiment of the present invention. -
FIG. 6 is a perspective view of the magnet structure of the Catheter Guidance Control and Imaging (CGCI) system. -
FIG. 7A is a perspective view of the CGCI right section showing the hydraulically actuated core extended. -
FIG. 7B is a perspective view of the CGCI right section showing the hydraulically actuated core extracted. -
FIG. 7C is a system block diagram for a surgery system that includes an operator interface, a catheter guidance system, and surgical equipment. -
FIG. 7D is a block diagram of the imaging module for use in a CGCI surgery procedure that includes the catheter guidance system, a radar system, Hall Effect sensors, and a hydraulically actuating core extension mechanism. -
FIG. 8A is a first perspective view of a catheter assembly. -
FIG. 8B is a second perspective view of the catheter assembly. -
FIG. 9A is a side view of the apparatus ofFIG. 6 . -
FIG. 9B is an underside view of the apparatus ofFIG. 6 . -
FIG. 10 is an isometric view showing the apparatus ofFIG. 6 in an open mode where the left and right clusters are separated. -
FIG. 11 is a side view of the configuration shown inFIG. 10 . -
FIG. 12 is an underside view of the configuration shown inFIG. 10 . -
FIG. 13 is an end view of the configuration shown inFIG. 10 . -
FIG. 14 is a block diagram of one embodiment of the CGCI apparatus with magnetic sensors. - Irrigated Catheter with Magnetic Tip
- In general, the instant invention relates to irrigated ablation electrode assemblies, and to methods of manufacturing and using such irrigated ablation electrode assemblies. For purposes of this description, similar aspects among the various embodiments described herein will be referred to by the same reference number. As will be appreciated, however, the structure of the various aspects may be different among the various embodiments.
- As seen in
FIG. 1 , the ablation electrode assembly may comprise part of an irrigatedablation catheter assembly 12, operably connected to apump assembly 15 and anRF generator assembly 14 which serves to facilitate the operation of ablation procedures through monitoring any number of chosen variables (e.g., temperature of the ablation electrode, ablation energy, and position of the assembly), assist in manipulation of the assembly during use, and provide the requisite energy source delivered to theelectrode assembly 10. The present embodiments describe RF ablation electrode assemblies and methods, but it is contemplated that the present invention is equally applicable to any number of other ablation electrode assemblies where the temperature of the device and the targeted tissue areas is a factor during the procedure. -
FIG. 1 is a general perspective view of an irrigated ablation catheter assembly having anRF generator assembly 14 and afluid pump assembly 15 operably connected to an irrigatedcatheter assembly 12 having an irrigatedelectrode assembly 10 according to the present invention operably attached thereto. The structural and functional features of thecatheter assembly 12 and theRF generator assembly 14 and pumpassembly 15 are well-known to those of skill in the art. For example, the RF generator assembly could be an IBI-1500T RF Cardiac Ablation Generator available from Irvine Biomedical, Inc. in Irvine, Calif. 92614. The RF generator assembly could also be any other known assembly, including, for example, a Stockert RF generator available from Biosense, or one of the Atakr® series of RF generators available from Medtronic. The pump assembly can be any known assembly, including fixed volume rolling pumps, variable volume syringe pumps, and any other pump assembly known to those of skill in the art.FIGS. 2-5 , discussed in more detail below, exemplify various embodiments of the irrigatedablation electrode assembly 10 according to the present invention. -
FIG. 2 is an isometric view of anablation electrode assembly 11 connected to an irrigatedablation catheter assembly 12 having afluid delivery tube 16 therein. Theablation electrode assembly 11 generally comprises anirrigation member 20 and anablation electrode member 18. The orientation of themembers ablation electrode assembly 18 is situated at the distal end of the assembly with theirrigation member 20 located at the proximal end of the assembly, although it is conceivable the orientation could be reversed. Theproximal member 20 has at least one passageway 24 (seeFIG. 3 ) and at least oneoutlet 22 for delivery of a fluid to targeted tissue areas and the outside of theelectrode assembly 11. Thedistal member 18 further comprises at least one temperature sensing mechanism 26 (seeFIG. 3 ) disposed therein and operably connected to theRF generator assembly 14. Thedistal member 18 is comprised of any electrically, and potentially thermally, conductive material known to those of ordinary skill in the art for delivery of ablative energy to target tissue areas. Examples of the electrically conductive material include gold, platinum, iridium, palladium, tantalum, stainless steel, and any mixtures thereof. Moreover, there are a number of electrode designs contemplated within the scope of the present invention including tip electrodes, ring electrodes, and any combination thereof. - In general accordance with the embodiments described herein, the fluid passageway(s) 24 and outlet(s) 22 are separated from the
distal member 18, and accordingly thetemperature sensing mechanism 26, by at least one poor thermally conductive material. A poor thermally conductive material is one with physical attributes that decrease heat transfer between the passageway(s) 24 and thedistal member 18 by about 10% or more, and more preferably by about 25% or more measured by known methods to one of ordinary skill in the art. In particular embodiments, materials that decreased heat transfer by more than approximately 75% performed favorably. It is further contemplated that a poor thermally conductive material could have physical attributes that decrease heat transfer less than about 10%, provided that the remaining structural components are selected with the appropriate characteristics and sensitivities to maintain adequate monitoring and control of the process. Thus, while these properties are preferred, the poor thermally conductive material may be any material known to one of skill in the art consistent with the spirit of the invention. Examples of poor thermally conductive materials useful in conjunction with the present invention include, but are not limited to, high-density polyethylene (HDPE), polyimides, polyaryletherketones, polyetheretherketones, polyurethane, polypropylene, oriented polypropylene, polyethylene, crystallized polyethylene terephthalate, polyethylene terephthalate, polyester, ceramics, and plastics such as acetal, and mixtures thereof. - As shown in more detail with respect to specific embodiments below, the poor thermally conductive material may be the material comprising the
proximal member 20, or thedistal member 18, a separate material from theproximal member 20 and thedistal member 18, or any combination thereof. Additionally, the passageway(s) 24 and outlet(s) 22 defined by theproximal member 18 may also be separated longitudinally from the end 46 (seeFIG. 3 ) of thedistal member 18 thereby providing the benefit of insulating the passageway(s) 24 from the temperature sensor(s) 26 for improved temperature monitoring of the ablated target area during operation. The poor thermally conductive material, and the separation from thetemperature sensing mechanism 26 disposed near the end 46 of thedistal member 18, serve individually, and cooperatively, to minimize the effect of the lower temperature of the fluid delivered through the passageway(s) 24 and outlet(s) 22 from the temperature sensing mechanism(s) 26 within thedistal member 18. The separation of the passageway(s) 24 and outlet(s) 22 from thedistal member 18, and more particularly thetemperature sensing mechanism 26, facilitates the dual purposes of (1) effectively irrigating theelectrode assembly 11 and the targeted tissue area to minimize coagulation and unwanted tissue damage and (2) effectively controlling the operation of theablation electrode assembly 11 in accordance with objects of the present invention. -
FIG. 3 is a cross-sectional view of an embodiment of theablation electrode assembly 11. Anablation electrode assembly 11 is connected to an irrigatedcatheter assembly 12 having afluid delivery tube 16 and a catheter shaft 17. Theablation electrode assembly 11 comprises a proximal member ormanifold 20, adistal member 18, and atemperature sensing mechanism 26 operably connected to the RF generator assembly 14 (seeFIG. 1 ). In this embodiment, theproximal member 20 itself is comprised of a poor thermally conducting material that serves to insulate the irrigation fluid from the remaining portions of theassembly 11. Preferably theproximal member 20 is made from a poor thermally conductive polymer, more preferably from a polyether ether ketone (“PEEK”) because of this material's combination of thermal and physical properties. Another possible material is Ultem® polyetherimide. Theproximal member 20 is configured to receive thefluid tube 16 of thecatheter assembly 12 and comprises a plurality of passageways 24 (e.g., 4-8 passageways) extending from acentral axis 28 of theassembly 11 axially toward the outer portion of theproximal member 20 terminating in correspondingoutlets 22. Preferably, the plurality ofpassageways 24 are equally distributed around theproximal member 20 so as to provide equal distribution of fluid to the targeted tissue area and the outside of theassembly 11. Thepassageway 24 may be a single, annular passageway, or a number of individual passageways equally distributed around theproximal member 20. In this embodiment, thepassageways 24 are at an acute angle with respect to thelongitudinal axis 28 of theassembly 11. In operation, fluid is pumped through thedelivery tube 16 and passes through thepassageways 24 and through theoutlets 22 where it contacts with targeted tissue areas and the outside portion of theablation electrode assembly 11. - In this embodiment, the fluid delivery conduits or
passageways 24 extend at an angle substantially less than perpendicular to thelongitudinal axis 28. Angling of thepassageways 24 away from perpendicular, but less than parallel, further assists in the delivery of the fluid to the targeted tissue areas, further decreases the risk of coagulation of the bodily fluids during ablation procedures, and allows for improved measurement and control of theablation assembly 11 during operation. More specifically, thepassageways 24 are oriented to direct irrigation fluid flow at the target area adjacent, preferably immediately adjacent, the intersection between theproximal member 20 and thedistal member 18. Blood coagulation is more likely to occur in the target area due to a sharp rise in RF intensity, material discontinuity, and potentially geometric discontinuity caused by manufacturing imperfection in joining theproximal member 20 and thedistal member 18. In specific embodiments, thepassageways 24 extend at an angle between approximately 20 and 70 degrees, preferably at an angle between approximately 30 and 60 degrees, and more preferably at an angle of approximately 30 degrees. It is also contemplated that the passageways may be further angled in a second dimension, such that the passageways and orifices are configured to provide fluid to the external portion of the assembly in a swirling, or helical fashion. This configuration also serves to keep the fluid in closer proximity to the electrode assembly, thereby further preventing against coagulation during operation. - The
distal member 18 of theablation electrode assembly 11 has a generally cylindrical shape terminating in a rounded end which may be a hemispherical end or an end that is non-spherical. Thedistal member 18 includes apermanent magnet 48 at least partially encased in adistal electrode shell 50 and anelectrode anchor 52. Thepermanent magnet 48 is desirably made of NdFeB which has a strong magnetic field so that only one such permanent magnet is needed for magnetic field control and guidance of the catheter tip (instead of a plurality of magnets spaced apart from each other). Other rare earth permanent magnets with similar characteristics may be used in other embodiments. If two or more permanent magnets are used, additional materials may be considered. Thepermanent magnet 48 typically has a length of about 2-6 mm, typically about 4 mm, in the longitudinal direction. Thedistal electrode shell 50 provides most of the external surface of the distal electrode. Theelectrode anchor 52 is coupled to theproximal member 20 and connected to a power line or cable such as anRF wire 54. Theelectrode anchor 52 may be connected to theproximal member 20 by any known mechanism including adhesives, press-fit configurations, snap-fit configurations, or the like. Aninner tube 56 is connected to theelectrode anchor 52 and/or theproximal member 20 to accommodate thepower line 54 and the temperature sensor conductor for thetemperature sensor 26. Because thetemperature sensor 26 is embedded in thepermanent magnet 48, the permanent magnet material preferably is a good thermal conductor (e.g., NdFeB) so that thetemperature sensor 26 can measure the temperature of the distal electrode accurately. - In the embodiment shown, the
distal electrode shell 50, theelectrode anchor 52, and theinner tube 56 form a shield that keeps thepermanent magnet 48 from exposure to irrigation and/or bodily fluids, comprising an inner shield that separates thepermanent magnet 48 from the irrigation fluid including thepassageways 24 and an outer shield that separates thepermanent magnet 48 from the exterior. Because thepermanent magnet 48 is highly oxidizable, any contact between the permanent magnet and liquid is undesirable since oxidation of thepermanent magnet 48 can lead to corrosion problems. The shield prevents such contact from occurring. The materials for the shield are less oxidizable, preferably substantially less oxidizable, than thepermanent magnet 48. For instance, the oxidization rate of a shield material is less than about 50%, more preferably less than about 20%, most preferably less than about 5%, of the oxidation rate of thepermanent magnet 48. Thedistal electrode shell 50 and theelectrode anchor 52 are made of an electrically conductive material such as platinum, gold, tantalum, iridium, stainless steel, palladium, tantalum, and mixtures thereof. The electrically conductive material selected is preferably biocompatible. In some embodiments, the biocompatible electrically conductive material is plated onto a substrate made of copper or beryllium copper to improve the biocompatibility of thedistal electrode shell 50 and theelectrode anchor 52. Theelectrode anchor 52 may be laser welded to thedistal electrode shell 50. Theinner tube 56 may be made of silicone, polyimide, stainless steel braided polyimide, or the like. Theinner tube 56 may be thermally bonded or molded onto theplatinum anchor 52. In alternate embodiments, thedistal electrode shell 50 and theelectrode anchor 52 form a complete shield around thepermanent magnet 48 without the need for theinner tube 56 for separating thepermanent magnet 48 from irrigation fluid flow. - The
proximal member 20 preferably is made of a poor thermally conductive material (as discussed above) having a thermal conductivity that is lower, more preferably substantially lower, than the thermal conductivity of the material of thedistal member 18. Theproximal passageways 24 do not come into contact with any interior portion of thedistal member 18. In this way, the irrigation fluid flowing through theproximal passageways 24 is substantially insulated from the electrode and the temperature sensor of thedistal member 18 by distance and material of poor conductivity, so that thetemperature sensor 26 can more accurately measure the temperature of the distal electrode. The proximal members may be made of a variety of materials that have insulating properties such as, for example, acetal, polyetheretherketone (PEEK), and high-density polyethylene (HDPE), as well as other materials of poor thermal conductivity mentioned above. - One or more monitoring or measuring electrodes may be provided in the
catheter assembly 12 for mapping or other monitoring or measuring functions.FIG. 3 shows twomonitoring electrodes distal electrode 18. To facilitate catheter tip positioning and location in a mapping system, the position of each electrode is determined. Calibration of the positioning system is achieved by the twomonitoring electrodes distal electrode 18 and one monitoring electrode (58 or 59) that are separated by a predetermined distance. In use, a voltage is sensed between one electrode on the catheter assembly 12 (typically the distal electrode 18) and a reference electrode on the patient's body (suitably a surface electrode on the patient's skin). For a catheterization procedure which is to lead to ablation, sensing is performed to gather data relating to the heart, such as the location of an arrhythmia focus. Such data gathering techniques are well known in the art. The location information is determined based on the calibration (see, e.g., U.S. Pat. Nos. 5,697,377 and 5,983,126, the entire disclosures of which are incorporated herein by reference), and the sensed information and location are stored and/or mapped. -
FIG. 4 is a cross-sectional view of another embodiment of theablation electrode assembly 61. Theablation electrode assembly 61 is connected to an irrigatedcatheter assembly 62 having a fluid delivery tube orlumen 64 and acatheter shaft 66. Theablation electrode assembly 61 comprises adistal member 68, apermanent magnet 70 disposed proximal to thedistal member 68, and ashell 72 surrounding the outer surface and the proximal surface of thepermanent magnet 70. Thedistal member 68 has a generally cylindrical shape terminating in a rounded end which may be a hemispherical end or an end that is non-spherical. Thepermanent magnet 70 is an annular member having an inner surface covered by a portion of thefluid delivery tube 64. Thepermanent magnet 70 is desirably made of NdFeB which has a strong magnetic field so that only one such permanent magnet is needed for magnetic field control and guidance of the catheter tip (instead of a plurality of magnets spaced apart from each other). Thepermanent magnet 48 typically has a length of about 2-6 mm, typically about 4 mm in the longitudinal direction. Thedistal member 68,shell 72, andfluid delivery tube 64 form a shield that keeps thepermanent magnet 70 from exposure to liquid, comprising an inner shield that separates thepermanent magnet 70 from the irrigation fluid flowing through thecatheter assembly 62 and an outer shield that separates thepermanent magnet 70 from the exterior. Asealant 74 is preferably provided between the proximal surface of thedistal member 68 and the distal surface of thepermanent magnet 70 to further ensure no liquid reaches thepermanent magnet 70 via the junction between thedistal member 68 and thefluid delivery tube 64. - The
distal member 68 provides the external surface of the distal electrode. Theshell 72 may also be an electrically conductive surface to provide additional external surface of the distal electrode. In that case, theelectrode shell 72 is connected to a power cable or line such as anRF wire 76. One ormore temperature sensors 77 may be provided in thedistal member 68 and thetemperature sensor conductor 78 for thetemperature sensor 77 extends proximally through thecatheter shaft 66. - Because the
permanent magnet 70 is highly oxidizable, any contact between the permanent magnet and liquid is undesirable. The shield prevents such contact from occurring. The materials for the shield are less oxidizable, preferably substantially less oxidizable, than thepermanent magnet 70. Thedistal member 68 and theelectrode shell 72 are made of an electrically conductive material such as platinum, gold, tantalum, iridium, stainless steel, palladium, tantalum, and mixtures thereof. The electrically conductive material selected is preferably biocompatible. In some embodiments, the biocompatible electrically conductive material is plated onto a substrate made of copper or beryllium copper to improve the biocompatibility of thedistal member 68 and theelectrode shell 72. Thefluid delivery tube 64 is electrically nonconductive, and may be made of silicone, polyimide, stainless steel braided polyimide, or the like. Theelectrode shell 72 is connected to thedistal member 68 by laser weld or the like. Thedistal member 68 and theelectrode shell 72 form the distal electrode. Theshell 72 may be connected to thecatheter shaft 66 using adhesives or the like. Thefluid delivery tube 64 may be connected to theshell 72,permanent magnet 70, anddistal member 68 by thermal bonding, molding, adhesives, or the like. - The
fluid delivery tube 64 flows fluid through one or moredistal passageways 79 in thedistal member 68 to their external outlets. There is preferably a central passageway along the longitudinal axis of thedistal member 68 and, optionally, additional passageways distributed around the central passageway. Thepassageways 79 are preferably lined with a poor thermally conductingmaterial 75 such as a polyether ether ketone (“PEEK”) that serves to insulate the fluid from the material of thedistal member 68 and from thetemperature sensor 77. In this way, the fluid flow through thepassageways 79 does not influence the measurement of thetemperature sensor 77, so that thetemperature sensor 77 can more accurately measure the temperature of the distal electrode. Preferably, the additional passageways are equally distributed around the central passageway so as to provide equal distribution of fluid to the targeted tissue area and the outside of theassembly 61. - One or more monitoring or measuring electrodes may be provided in the
catheter assembly 62 for mapping or other monitoring or measuring functions.FIG. 4 shows onemonitoring electrode 80 that is a ring electrode spaced from the distal electrode (formed by thedistal member 68 and the electrode shell 72) by a known interelectrode distance for calibration. In use, a voltage is sensed between the distal electrode (68 and 72) and a reference electrode on the patient's body (suitably a surface electrode on the patient's skin). The location information is determined based on the calibration, and the sensed information and location are stored and/or mapped. -
FIG. 4A shows an irrigatedcatheter assembly 62A that is virtually identical to the irrigatedcatheter assembly 62 ofFIG. 4 . Theassembly 62A includes a second permanent magnet 70A disposed near the distal end of theshaft 66 and spaced from the firstpermanent magnet 70. In the embodiment shown, the second permanent magnet 70A is an annular magnet and is smaller in size and thickness than the firstpermanent magnet 70. The second permanent magnet 70A does not require an additional shield because it is disposed in a space between thecatheter shaft 66 and thefluid delivery tube 64 which is free from exposure to liquid. Of course, the second permanent magnet may have other configurations in different embodiments, and may be formed in the irrigatedablation electrode assembly 61 instead of being inside thecatheter shaft 66 and spaced proximally from theelectrode assembly 61. Additional permanent magnets in the assembly may provide additional options for magnetically controlling and guiding the catheter tip. -
FIG. 5 is a cross-sectional view of another embodiment of the ablation electrode assembly 81 which is connected to an irrigatedcatheter assembly 82. The electrode assembly 81 ofFIG. 5 is similar to theelectrode assembly 61 ofFIG. 4 , in that it also includes adistal member 68, apermanent magnet 70, ashell 72 connected to anRF wire 76, asealant 74, and atemperature sensor 77 connected to atemperature sensor conductor 78. In this embodiment, thedistal member 68 has acentral passageway 79 that is preferably lined with a poor thermally conductingmaterial 75 such as a polyether ether ketone (“PEEK”). Afluid delivery tube 64 extends through acatheter shaft 66 to the electrode assembly 81. One or more monitoring or measuringelectrodes 80 may be provided in thecatheter assembly 62 for mapping or other monitoring or measuring functions. - In
FIG. 5 , the ablation electrode assembly 81 includes aproximal member 84 located on the proximal side of thepermanent magnet 70 andelectrode shell 72. Theproximal member 84 has at least oneproximal passageway 86 with at least oneoutlet 88 for delivery of a fluid to targeted tissue areas and the outside of the electrode assembly 81. The proximal passageway(s) 86 and outlet(s) 88 are separated from thedistal member 68 andelectrode shell 72, and accordingly thetemperature sensing mechanism 77, by at least one poor thermally conductive material. The poor thermally conductive material may be the material comprising theproximal member 84, or thedistal member 68, a separate material from theproximal member 84 and thedistal member 68, or any combination thereof. In this embodiment, theproximal member 84 is comprised of a poor thermally conducting material that serves to insulate the fluid from the remaining portions of the assembly 81. Theproximal member 84 is configured to receive thefluid tube 64 of thecatheter assembly 82 and comprises a plurality of proximal passageways 86 (e.g., 4-8 passageways) extending from a central axis of the assembly 81 axially toward the outer portion of theproximal member 84 terminating in correspondingoutlets 88. Preferably, the plurality ofproximal passageways 86 are equally distributed around theproximal member 84 so as to provide equal distribution of fluid to the targeted tissue area and the outside of the assembly 81. Theproximal passageway 86 may be a single, annular passageway, or a number of individual passageways equally distributed around theproximal member 84. In this embodiment, theproximal passageways 86 are at an acute angle with respect to the longitudinal axis of the assembly 81. In operation, fluid is pumped through thedelivery tube 64 and passes through theproximal passageways 86 and through theoutlets 88 where it contacts with targeted tissue areas and the outside portion of the ablation electrode assembly 81. - In this embodiment, the
proximal passageways 86 extend at an angle substantially less than perpendicular to the longitudinal axis. Angling of thepassageways 86 away from perpendicular, but less than parallel, further assists in the delivery of the fluid to the targeted tissue areas, further decreases the risk of coagulation of the bodily fluids during ablation procedures, and allows for improved measurement and control of the ablation assembly 81 during operation. More specifically, theproximal passageways 86 are oriented to direct irrigation fluid flow at the target area adjacent, preferably immediately adjacent, the intersection between theproximal member 84 and theelectrode shell 72. Blood coagulation is more likely to occur in the target area due to a sharp rise in RF intensity, material discontinuity, and potentially geometric discontinuity caused by manufacturing imperfection in joining theproximal member 84 and theelectrode shell 72. In specific embodiments, theproximal passageways 24 extend at an angle between approximately 20 and 70 degrees, preferably at an angle between approximately 30 and 60 degrees, and more preferably at an angle of approximately 30 degrees. It is also contemplated that the proximal passageways may be further angled in a second dimension, such that the proximal passageways and orifices are configured to provide fluid to the external portion of the assembly in a swirling, or helical fashion. This configuration also serves to keep the fluid in closer proximity to the electrode assembly, thereby further preventing against coagulation during operation. - The
proximal member 84 further includes a longitudinal outlet that transfers fluid through acentral conduit 90 to thecentral passageway 79 of thedistal member 68. Thecentral conduit 90 is electrically nonconductive, and may be made of silicone, polyimide, stainless steel braided polyimide, or the like. Thecentral conduit 90 may be connected to theelectrode shell 72,permanent magnet 70, anddistal member 68 by thermal bonding, molding, adhesives, or the like. Thedistal member 68,electrode shell 72, andcentral conduit 90 form a shield that separates thepermanent magnet 70 from the irrigation fluid and the exterior. - Catheter Guidance Control and Imaging (CGCI)
- One example of a system for magnetically guiding and controlling a catheter having a magnetic tip is found in U.S. Patent Application Publication No. 2007/0016006, the entire disclosure of which is incorporated herein by reference.
FIGS. 6, 7A , and 7B are isometric drawings of a Catheter Guidance Control and Imaging (CGCI) system 1500 (FIG. 7C ), having aleft coil cluster 100 and aright coil cluster 101 provided torails 102. Therails 102 act as guide alignment devices. TheCGCI system workstation 1500 includes astructural support assembly 120, ahydraulic system 140, and apropulsion system 150. - A
central arc 106 supports an uppercylindrical coil 110 and twoshorter arcs coils shorter arcs central arc 106 by approximately 35 degrees. The angle of separation between the two smaller arcs is approximately 70 degrees. At the end of eacharc coil assemblies - Two
curved shield plates 105 form a shield to at least partially contain and shape the magnetic fields. Theshields 105 also provide lateral strength to the assembly. A base 117 houses thepropulsion system 150 andlocking mechanism 118. In one embodiment, theplates 105 are made from steel, nickel, or other magnetic material. - In addition to
FIG. 6 ,FIGS. 7A and 7B further show various mechanical details which form the CGCI cluster half section (right electromagnetic cluster 101). A lockinghole 103, a spur-drive rail 104,cam rollers 118, and thesolenoid locking pin 119, are configured to allow portions of the CGCI to move along thetracks 102. Thecluster 101 includes three electromagnets forming a magnetic circuit. Theleft coil 116 andright coil 115 are mounted as shown and are supported by C-Arms coil 110 includes a hydraulically actuatedcore 111, supported by acoil clamping disc 127 made of stainless steel. A coilstress relief disc 113 is made of Teflon. Thecoil cylinder 110, is enclosed by acoil base disc 114 made of stainless steel. Thecoil core 111 is actuated (extended and retracted) by ahydraulic system 109.FIG. 7B shows theright coil cluster 101 with the hydraulically actuatedcore 111 retracted by the use of thehydraulic system 109 which allows the CGCI to shape the magnetic field. -
FIG. 7C is a system block diagram for asurgery system 800 that includes anoperator interface 500, theCGCI system 1500, surgical equipment 502 (e.g., acatheter tip 11 inFIG. 3 , acatheter tip 61 inFIG. 4 , a catheter tip 81 inFIG. 5 , or acatheter tip 377 inFIG. 8A , etc.), one or moreuser input devices 900, and apatient 390. Theuser input devices 900 can include one or more of a joystick, a mouse, a keyboard, avirtual tip 905, and other devices to allow the surgeon to provide command inputs to control the motion and orientation of the catheter tip 377 (ortip - In one embodiment, the
CGCI system 1500 includes acontroller 501 and animaging synchronization module 701.FIG. 7C shows the overall relationship between the various functional units and theoperator interface 500,auxiliary equipment 502, and thepatient 390. In one embodiment, theCGCI system controller 501 calculates the Actual Tip (AT) position of the distal end of a catheter. Using data from the Virtual Tip (VT) 905 and the imaging andsynchronization module 701, theCGCI system controller 501 determines the position error, which is the difference between actual tip position (AP) and the desired tip position (DP). In one embodiment, thecontroller 501 controls electromagnets to move the catheter tip in a direction selected to minimize the position error (PE). In one embodiment, theCGCI system controller 501 provides tactile feedback to the operator by providing force-feedback to theVT 905. -
FIG. 7D is a block diagram of asurgery system 503 that represents one embodiment of theCGCI system 1500. Thesystem 503 includes thecontroller 501, aradar system 1000, a Halleffect sensor array 350, and the hydraulically actuatedmechanism 140. In one embodiment, thesensor 350 includes one or more Hall effect magnetic sensors. Theradar system 1000 can be configured as an ultra-wideband radar, an impulse radar, a Continuous-Wave (CW) radar, a Frequency-Modulated CW (FM-CW) radar, a pulse-Doppler radar, etc. In one embodiment, theradar system 1000 uses Synthetic Aperture Radar (SAR) processing to produce a radar image. In one embodiment, theradar system 1000 includes an ultra-wideband radar such as described, for example, in U.S. Pat. No. 5,774,091, hereby incorporated by reference in its entirety. - In one embodiment, the
radar 1000 is configured as a radar range finder to identify the location of thecatheter tip 377. Theradar 1000 is configured to locate reference markers (fiduciary markers) placed on thepatient 390. Data regarding location of the reference markers can be used, for example, forimage capture synchronization 701. The motorized hydraulically and actuatedmotion control mechanism 140 allows the electromagnets of the cylindrical coils 51AT and 51DT (seeFIG. 14 ) to be moved relative to thepatient 390. - In one embodiment, the use of the radar for identifying the position of the
catheter tip 377 has advantages over the use of Fluoroscopy, Ultrasound, Magnetostrictive sensors, or SQUID. Radar can provide accurate dynamic position information, which provides for real-time, relatively high resolution, relatively high fidelity compatibility in the presence of strong magnetic fields. Self-calibration of the range measurement can be based on time-of-flight and/or Doppler processing. Radar further provides for measurement of catheter position while ignoring “Hard” surfaces such as a rib cage, bone structure, etc., as these do not interfere with measurement or hamper accuracy of the measurement. In addition, movement and displacement of organs (e.g., pulmonary expansion and rib cage displacement as well as cardio output during diastole or systole) do not require an adjustment or correction of the radar signal. Radar can be used in the presence of movement since radar burst emission above 1 GHz can be used with sampling rates of 50 Hz or more, while heart movement and catheter dynamics occur at 0.1 Hz to 2 Hz. - In one embodiment, the use of the
radar 1000 reduces the need for complex image capture techniques normally associated with expensive modalities such as fluoroscopy, ultrasound, Magnetostrictive technology, or SQUID which require computationally intensive processing in order to translate the pictorial view and reduce it to a coordinate data set. Position data synchronization of thecatheter tip 377 and the organ in motion is readily available through the use of theradar 1000. Theradar 1000 can be used with phased-array or Synthetic Aperture processing to develop detailed images of the catheter location in the body and the structures of the body. In one embodiment, the radar system includes an Ultra Wide Band (UWB) radar with a relatively high resolution swept range gate. In one embodiment, a differential sampling receiver is used to effectively reduce ringing and other aberrations included in the receiver by the near proximity of the transmit antenna. As with X-ray systems, the radar system can detect the presence of obstacles or objects located behind barriers such as bone structures. The presence of different substances with different dielectric constants such as fat tissue, muscle tissue, water, etc., can be detected and discerned. The outputs from the radar can be correlated with similar units such as multiple catheters used in electrophysiology (EP) studies while detecting spatial location of other catheters present in the heart lumen. Theradar system 1000 can use a phased array antenna and/or SAR to produce 3D synthetic radar images of the body structures, catheter tip and organs. - In one embodiment, the location of the patient relative to the CGCI system (including the radar system 1000) can be determined by using the
radar 1000 to locate a plurality of fiduciary markers. In one embodiment, the data from theradar 1000 is used to locate the body with respect to an imaging system. The catheter position data from theradar 1000 can be superimposed (synchronized) with the images produced by the imaging system. The ability of the radar and the optionalHall effect sensors 350 to accurately position thecatheter tip 377 relative to the stereotactic frame allows the pole pieces to be moved by theactuators patient 390 and thus reduce the power needed to manipulate the catheter tip. -
FIGS. 8A and 8B shows one embodiment of acatheter assembly 375 andguidewire assembly 379 to be used with theCGCI apparatus 1500. Thecatheter assembly 375 is a tubular tool that includes acatheter body 376 which extends into aflexible section 378 that possesses sufficient flexibility for allowing a relatively more rigidresponsive tip 377 to be steered through the patient. Thetip 377 can be replaced by the tip 21 ofFIG. 3 , thetip 61 ofFIG. 4 , or the tip 81 ofFIG. 5 . - In one embodiment, the
magnetic catheter assembly 375 in combination with theCGCI apparatus 1500 reduces or eliminates the need for the plethora of shapes normally needed to perform diagnostic and therapeutic procedures. During a conventional catheterization procedure, the surgeon often encounters difficulty in guiding the conventional catheter to the desired position, since the process is manual and relies on manual dexterity to maneuver the catheter through a tortuous path of, for example, the cardiovascular system. Thus, a plethora of catheters in varying sizes and shapes are to be made available to the surgeon in order to assist him/her in the task, since such, tasks require different bends in different situations due to natural anatomical variations within and between patients. - By using the
CGCI apparatus 1500, only a single catheter is needed for most, if not all patients. The catheterization procedure is now achieved with the help of theCGCI system 1500 that guides the magnetic catheter andguidewire assembly body 390 as dictated by the surgeon's manipulation of thevirtual tip 905. The magnetic catheter andguidewire assembly 375, 379 (i.e. themagnetic tip 377 can be attracted or repelled by the electromagnets of the CGCI apparatus 1500) provides the flexibility needed to overcome tortuous paths, since theCGCI apparatus 1500 overcomes most, if not all the physical limitations faced by the surgeon while attempting to manually advance thecatheter tip 377 through the patient's body. - In one embodiment, the
catheter tip 377 includes aguidewire assembly 379, aguidewire body 380 and atip 381 response to magnetic fields. Thetip 377 is steered around sharp bends so as to navigate a torturous path. Theresponsive tips catheter assembly 375 and theguidewire assembly 379, respectively, include magnetic elements such as permanent magnets. Thetips electromagnets symmetric counterpart 100. - In one embodiment, the
responsive tip 377 of thecatheter assembly 375 is tubular, and theresponsive tip 381 of theguidewire assembly 379 is a solid cylinder. Theresponsive tip 377 of thecatheter assembly 375 is a dipole with longitudinal polar orientation created by the two ends of the magnetic element positioned longitudinally within it. Theresponsive tip 381 of theguidewire assembly 379 is a dipole with longitudinal polar orientation created by two ends of themagnetic element 377 positioned longitudinally within it. These longitudinal dipoles allow the manipulation of bothresponsive tip CGCI apparatus 1500, as theelectromagnet assemblies tips -
FIGS. 9A and 9B show additional views of the CGCIstructural support assembly 120. Thestructural support assembly 120 is configured so as to facilitate the use of X-Ray and/or other surgicalmedical equipment 502 in and around the patient during operation. The twosymmetrical left 100 and right 101 electromagnetic clusters are mounted on the stainlesssteel guide rails 102, allowing the twosections FIGS. 10-12 . Therails 102 are bolted to a floor or mounting pad. The cluster on theCGCI structure 120 rolls inside therails 102, under relatively tight tolerance to prevent lateral or vertical movement during a seismic event. In one embodiment, therails 102 are designed to withstand the forces of a Zone 4 seismic event without allowing the CGCI structure to escape containment. - A stainless steel spur
toothed rail 104 is bolted to the floor or mounting pad under theCGCI structure 120. A Servo Dynamic model HJ96 C-44 brushless servomotor 128 (max 27 lb.-in torque) with its associated servomotor amplifier model 815-BL 129 are provided to move theclusters toothed rail 104. Thepropulsion system 150 is configured to exert up to 2700 lbs. of force to move theCGCI sections -
FIGS. 9A and 9B further show theCGCI assembly 120 when the system is set in the “operational mode.” The twosymmetrical clusters FIGS. 9A and 9B show the location of the spurtoothed rail 104 and thebrushless servo motor 128. -
FIGS. 10-13 are isometric views of theCGCI assembly 120 when its main twosymmetric left 100 and right 101 coil clusters are in a fully open mode (non operational) and the magnetic cores are retracted. The rear view of the symmetrical one half of the CGCI shows the parabolic flux collector shields 105 with the C-Arm uppercylinder coil support 106. In one embodiment, theCGCI assembly 120 is configured to meet the structural as well as safety considerations associated with the generation of a magnetic field of 2 Tesla. -
FIG. 14 depicts theCGCI system 1500 top architecture showing the major elements comprising thecontroller 501 of the magnetic circuit. Thecontroller 501 includes a system memory, a torque/force matrix algorithm residing in 528 and a CPU/computer 527. The CPU/computer such asPC 527 provides computation and regulation tasks.FIG. 14 further shows the six-coil electromagnetic circuit formed out ofcoils Hall sensor ring 350 mounted on an assembly forming the X, Y, and Z axis controls. A D/A converter 550 and an I/O block 551 provide communication between thecontroller 501 and thecoils 51A and thehydraulic systems 140. The sixchannel DC amplifier 525 provides current to the coils. -
FIG. 14 shows the relationship and command structure between thejoystick 900, thevirtual tip 905, and theCPU 701. TheCPU 701 displays control conveying real time images generated by the X-ray,radar 1000, or other medical imaging technologies such as fluoroscopy, MRI, PET SCAN, CAT SCAN, etc., on adisplay 730. A flow diagram of the command structure of the control scheme is shown by the use of the 2D virtual plane coil polarity matrixes. By assigning the coil position and polarity elements to the directions of torque rotation and force field gradient on each 2D plane of a six coil cluster 414, a computer program such as MathLab or Math Cad is able to sift through the combination matrixes and compute the proper combination for the six coil current polarities and amplitudes. In one embodiment, a boundary condition controller is used for regulating the field strength 405 and field gradient 406 in the effective region. Thecontroller 501 computes the fields in the neighborhood of thecatheter tip 377 and as defined by the fields on the 2D planes in the effective area. Rules for computing the fields with rotated coil on the surface of the sphere are set forth in US 2007/0016066. - In one embodiment, look-up tables are used as a reference library for use by the
controller 501. Lookup tables of the setting of various scenarios of force as well as torque position and magnitude allow thecontroller 501 to use a learning algorithm for the control computations. The look-up tables shorten the computational process for optimal configuration and setting of the coil currents and pole positions. The D/A and A/D system 550 allows the connection of voltage and current measuring instruments as well as input from the magnetic field sensor (MFS) 350 array, theMFS CGCI apparatus 1500, thus providing a “soft” level check prior to action performed by actual machine. The two-level control architecture that starts with low-level simulation architecture of low-level simulation allows the surgeon or operator of theCGCI apparatus 1500 to test each movement prior to actually performing the move. US 2007/0016066 describes the field regulator loop outlined inFIG. 14 using theHall effect ring 350. - Instead of using the radar system to identify the position of the
catheter tip 377, the present invention may rely on the use of the monitoring or measuring electrodes (58, 59 inFIG. 3 ; 80 inFIGS. 4 and 5 ), optionally in conjunction with a visualization and mapping tool such as the EnSite NavX™ technology available from St. Jude Medical, Inc. See, e.g., U.S. Pat. Nos. 6,990,370 and 6,939,309, the entire disclosures of which are incorporated herein by reference. - All directional references (e.g., 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.
Claims (25)
1. An irrigated ablation electrode assembly for use with an irrigated catheter device, the irrigated ablation electrode assembly comprising:
at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly;
a permanent magnet;
a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and
an electrode having an external electrode surface.
2. The irrigated ablation electrode assembly of claim 1 , wherein the electrode forms at least a portion of the shield, and wherein the electrode comprises an electrically conductive material that is substantially less oxidizable than the permanent magnet.
3. The irrigated ablation electrode assembly of claim 2 wherein the electrically conductive material is selected from the group consisting of platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof, and wherein the electrically conductive material is plated onto a substrate made of a biocompatible material that is substantially less oxidizable than the permanent magnet.
4. The irrigated ablation electrode assembly of claim 1 wherein the shield comprises one or more materials selected from the group consisting of silicone, polyimide, platinum, gold, tantalum, iridium, stainless steel, palladium, and mixtures thereof.
5. The irrigated ablation electrode assembly of claim 1 wherein the permanent magnet comprises NdFeB.
6. The irrigated ablation electrode assembly of claim 1 further comprising at least one mapping electrode spaced proximally from the electrode which is a distal electrode capable of ablation.
7. The irrigated ablation electrode assembly of claim 1 wherein the electrode is disposed at a distal portion of the electrode assembly, and wherein the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion.
8. The irrigated ablation electrode assembly of claim 7 wherein the proximal portion comprises a material which is electrically nonconductive and has a lower thermal conductivity than a material of the electrode.
9. The irrigated ablation electrode assembly of claim 7 wherein the at least one proximal passageway extends toward the electrode at an acute angle with respect to the longitudinal axis of the proximal portion.
10. The irrigated ablation electrode assembly of claim 7 wherein the proximal portion comprises a material which is electrically nonconductive, and wherein the external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection, and wherein the at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection.
11. The irrigated ablation electrode assembly of claim 7 wherein the permanent magnet is disposed in the distal portion, and wherein the electrode assembly further comprises at least one temperature sensor disposed in the permanent magnet.
12. The irrigated ablation electrode assembly of claim 1 wherein the electrode includes at least one electrode passageway for a fluid with an outlet disposed at the external electrode surface.
13. The irrigated ablation electrode assembly of claim 12 wherein the at least one electrode passageway is thermally insulated from the distal member by a poor thermal conductive material which is lower in thermal conductivity than a material of the electrode.
14. The irrigated ablation electrode assembly of claim 12 wherein the permanent magnet comprises an annular permanent magnet with an axial opening to permit fluid flow to the at least one electrode passageway, and wherein the electrode assembly further comprises a fluid lumen extending through the axial opening of the annular permanent magnet to the at least one electrode passageway.
15. The irrigated ablation electrode assembly of claim 14 wherein the fluid lumen comprises stainless steel braided polyimide forming a portion of the shield, and wherein the electrode forms another portion of the shield.
16. The irrigated ablation electrode assembly of claim 15 wherein the shield includes a silicone seal to prevent fluid from reaching the annular permanent magnet via a junction between the electrode and the fluid lumen.
17. The irrigated ablation electrode assembly of claim 12 wherein the electrode is disposed at a distal portion of the electrode assembly, and wherein the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion, wherein the proximal portion comprises a material which is electrically nonconductive, wherein the external surface of the proximal portion and the external electrode surface of the electrode at the distal portion meet at an intersection, and wherein the at least one proximal passageway is configured to direct a fluid flow through the outlet toward a region adjacent the intersection.
18. An irrigated ablation electrode assembly for use with an irrigated catheter device, the irrigated ablation electrode assembly comprising:
a permanent magnet,
at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly, the at least one passageway extending through the permanent magnet;
an inner shield separating the permanent magnet from the at least one passageway, the inner shield being substantially less oxidizable than the permanent magnet; and
an outer shield separating the permanent magnet from an exterior, the outer shield being substantially less oxidizable than the permanent magnet.
19. The irrigated ablation electrode assembly of claim 18 wherein the inner shield comprises a fluid lumen supplying fluid to the at least one passageway.
20. The irrigated ablation electrode assembly of claim 18 further comprising an electrode having an external electrode surface, and wherein the electrode forms at least a portion of the outer shield.
21. The irrigated ablation electrode assembly of claim 20 wherein the electrode is disposed at a distal portion of the electrode assembly, wherein the electrode assembly further comprises a proximal portion having a material which is electrically nonconductive, and wherein the proximal portion forms at least a portion of the inner shield.
22. A catheter comprising:
a shaft; and
an irrigated ablation electrode assembly coupled to a distal end of the shaft, the irrigated ablation electrode assembly having at least one passageway for a fluid with an outlet disposed at an external surface of the electrode assembly; a permanent magnet; a shield separating the permanent magnet from the at least one passageway and from an exterior, the shield being substantially less oxidizable than the permanent magnet; and an electrode having an external electrode surface.
23. The catheter of claim 22 wherein the electrode is disposed at a distal portion of the electrode assembly, and wherein the electrode assembly further comprises a proximal portion which includes at least one proximal passageway for a fluid with an outlet disposed at an external surface of the proximal portion.
24. The catheter of claim 22 wherein the electrode includes at least one electrode passageway for a fluid with an outlet disposed at the external electrode surface, wherein the permanent magnet comprises an annular permanent magnet with an axial opening to permit fluid flow to the at least one electrode passageway, and wherein the catheter further comprises a fluid lumen extending through the axial opening of the annular permanent magnet to the at least one electrode passageway.
25. The catheter of claim 22 further comprising a second permanent magnet disposed near the distal end of the shaft and spaced from the permanent magnet in the irrigated ablation electrode assembly.
Priority Applications (8)
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US11/953,615 US20080091193A1 (en) | 2005-05-16 | 2007-12-10 | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
JP2010536050A JP5460610B2 (en) | 2007-11-30 | 2008-11-12 | Perfusion ablation catheter with magnetic tip for magnetic field control and guidance |
CN200880119298.0A CN101888807B (en) | 2007-11-30 | 2008-11-12 | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
PCT/US2008/083250 WO2009070448A1 (en) | 2007-11-30 | 2008-11-12 | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
EP08855141.1A EP2211710B1 (en) | 2007-11-30 | 2008-11-12 | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
US14/821,054 US9549777B2 (en) | 2005-05-16 | 2015-08-07 | Irrigated ablation electrode assembly and method for control of temperature |
US15/413,024 US10499985B2 (en) | 2006-05-16 | 2017-01-23 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US16/678,475 US11478300B2 (en) | 2006-05-16 | 2019-11-08 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
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JP2005142690A JP4795718B2 (en) | 2005-05-16 | 2005-05-16 | Image processing apparatus and method, and program |
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US11/434,200 US8068645B2 (en) | 2005-05-16 | 2006-05-16 | Apparatus, method, and program for image processing |
US11/948,362 US8128621B2 (en) | 2005-05-16 | 2007-11-30 | Irrigated ablation electrode assembly and method for control of temperature |
US11/953,615 US20080091193A1 (en) | 2005-05-16 | 2007-12-10 | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
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US14/821,054 Active US9549777B2 (en) | 2005-05-16 | 2015-08-07 | Irrigated ablation electrode assembly and method for control of temperature |
US15/413,024 Active 2027-05-04 US10499985B2 (en) | 2006-05-16 | 2017-01-23 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US16/678,475 Active 2026-12-18 US11478300B2 (en) | 2006-05-16 | 2019-11-08 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
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US15/413,024 Active 2027-05-04 US10499985B2 (en) | 2006-05-16 | 2017-01-23 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US16/678,475 Active 2026-12-18 US11478300B2 (en) | 2006-05-16 | 2019-11-08 | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
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Cited By (166)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20070088347A1 (en) * | 2005-10-13 | 2007-04-19 | Boston Scientific Scimed, Inc. | Magnetically augmented radio frequency ablation |
US20080249522A1 (en) * | 2007-04-04 | 2008-10-09 | Carlo Pappone | Irrigated Catheter with Improved fluid flow |
US20090125056A1 (en) * | 2007-08-15 | 2009-05-14 | Cardiodex Ltd. | Systems and methods for puncture closure |
US20090187186A1 (en) * | 2008-01-17 | 2009-07-23 | Jakus Laszlo | Ablation catheter arrangement and cooling control |
US20090306655A1 (en) * | 2008-06-09 | 2009-12-10 | Stangenes Todd R | Catheter assembly with front-loaded tip and multi-contact connector |
US20090306651A1 (en) * | 2008-06-09 | 2009-12-10 | Clint Schneider | Catheter assembly with front-loaded tip |
US20100105984A1 (en) * | 2008-10-21 | 2010-04-29 | Reuben Brewer | System and Method for Guiding a Medical Instrument with Magnetic Force Control |
US20100130854A1 (en) * | 2008-11-25 | 2010-05-27 | Magnetecs, Inc. | System and method for a catheter impedance seeking device |
US20100168728A1 (en) * | 2008-12-31 | 2010-07-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter and method of assembly |
US20100168729A1 (en) * | 2008-12-31 | 2010-07-01 | Huisun Wang | Irrigated ablation electrode assembly having off-center irrigation passageway |
US20100168550A1 (en) * | 2008-12-31 | 2010-07-01 | Byrd Israel A | Multiple shell construction to emulate chamber contraction with a mapping system |
US20100174177A1 (en) * | 2007-07-03 | 2010-07-08 | Kirk Wu | Magnetically guided catheter |
CN101849825A (en) * | 2009-03-30 | 2010-10-06 | 微创医疗器械(上海)有限公司 | Weaving silk strengthening tube and electrophysiology conduit using same |
WO2010142438A3 (en) * | 2009-06-10 | 2011-02-24 | Erbe Elektromedizin Gmbh | Supply device for providing an hf output voltage, hf surgical instrument comprising a corresponding supply device, and method for the operation of an hf generator unit |
US20110112476A1 (en) * | 2009-11-09 | 2011-05-12 | Kauphusman James V | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
WO2011057289A2 (en) * | 2009-11-09 | 2011-05-12 | Magnetecs, Inc. | System and method for targeting catheter electrodes |
US20110118582A1 (en) * | 2007-05-23 | 2011-05-19 | De La Rama Alan | Magnetically Guided Catheter With Flexible Tip |
WO2011115787A1 (en) * | 2010-03-15 | 2011-09-22 | Boston Scientific Scimed, Inc. | Ablation catheter with isolated temperature sensing tip |
US20110257649A1 (en) * | 2010-04-20 | 2011-10-20 | Vascomed Gmbh | Electrode For An Electrophysiological Ablation Catheter |
US20110282342A1 (en) * | 2010-05-10 | 2011-11-17 | Giovanni Leo | Irrigated finned ablation head |
US20110288544A1 (en) * | 2008-07-17 | 2011-11-24 | Maestroheart Sa | Medical device for tissue ablation |
US20120017923A1 (en) * | 2010-07-26 | 2012-01-26 | Lior Sobe | Removable Navigation System and Method for a Medical Device |
US20120035460A1 (en) * | 2010-08-05 | 2012-02-09 | Stangenes Todd R | Movable magnet for magnetically guided catheter |
WO2012018439A1 (en) * | 2010-08-04 | 2012-02-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
EP2470101A1 (en) * | 2009-12-31 | 2012-07-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
WO2012173673A1 (en) * | 2011-06-16 | 2012-12-20 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for flexible electrodes |
US8372072B2 (en) | 2003-02-04 | 2013-02-12 | Cardiodex Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US8435236B2 (en) | 2004-11-22 | 2013-05-07 | Cardiodex, Ltd. | Techniques for heat-treating varicose veins |
US8601185B2 (en) * | 2010-07-16 | 2013-12-03 | St. Jude Medical, Atrial Fibrillation Divison, Inc. | System and methods for avoiding data collisions over a data bus |
US8715279B2 (en) | 2007-07-03 | 2014-05-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
US8880185B2 (en) | 2010-06-11 | 2014-11-04 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US20140378969A1 (en) * | 2013-06-24 | 2014-12-25 | Gyrus Medical Limited | Electrosurgical instrument |
US8939970B2 (en) | 2004-09-10 | 2015-01-27 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
US20150038961A1 (en) * | 2013-08-02 | 2015-02-05 | Biosense Webster (Israel), Ltd. | Catheter with improved irrigated tip electrode having two-piece construction, and method of manufacturing therefor |
US8951251B2 (en) | 2011-11-08 | 2015-02-10 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US8974454B2 (en) | 2009-12-31 | 2015-03-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Kit for non-invasive electrophysiology procedures and method of its use |
US8979840B2 (en) | 2010-12-17 | 2015-03-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for flexible electrodes |
US8998890B2 (en) | 2005-12-06 | 2015-04-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US9028472B2 (en) | 2011-12-23 | 2015-05-12 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US20150157381A1 (en) * | 2013-12-09 | 2015-06-11 | Biosense Webster (Israel) Ltd. | Pericardial catheter with temperature sensing array |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9066725B2 (en) | 2012-12-06 | 2015-06-30 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for electrodes |
US9079000B2 (en) | 2011-10-18 | 2015-07-14 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9125667B2 (en) | 2004-09-10 | 2015-09-08 | Vessix Vascular, Inc. | System for inducing desirable temperature effects on body tissue |
US9125666B2 (en) | 2003-09-12 | 2015-09-08 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation of atherosclerotic material |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9162046B2 (en) | 2011-10-18 | 2015-10-20 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9173586B2 (en) | 2005-12-06 | 2015-11-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing coupling between an electrode and tissue |
US9173696B2 (en) | 2012-09-17 | 2015-11-03 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
US9186210B2 (en) | 2011-10-10 | 2015-11-17 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
US9186209B2 (en) | 2011-07-22 | 2015-11-17 | Boston Scientific Scimed, Inc. | Nerve modulation system having helical guide |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US9204927B2 (en) | 2009-05-13 | 2015-12-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9220561B2 (en) | 2011-01-19 | 2015-12-29 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
US9254163B2 (en) | 2005-12-06 | 2016-02-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
US9271782B2 (en) | 2005-12-06 | 2016-03-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling of tissue ablation |
US9277955B2 (en) | 2010-04-09 | 2016-03-08 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US9297845B2 (en) | 2013-03-15 | 2016-03-29 | Boston Scientific Scimed, Inc. | Medical devices and methods for treatment of hypertension that utilize impedance compensation |
US9301713B2 (en) | 2013-11-19 | 2016-04-05 | Pacesetter, Inc. | Method and system to assess mechanical dyssynchrony based on motion data collected by a navigation system |
US9302099B2 (en) | 2014-05-05 | 2016-04-05 | Pacesetter, Inc. | System and method for evaluating lead stability of an implantable medical device |
US9314191B2 (en) | 2013-11-19 | 2016-04-19 | Pacesetter, Inc. | Method and system to measure cardiac motion using a cardiovascular navigation system |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9327100B2 (en) | 2008-11-14 | 2016-05-03 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US9339325B2 (en) | 2005-12-06 | 2016-05-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9364170B2 (en) | 2014-05-05 | 2016-06-14 | Pacesetter, Inc. | Method and system to characterize motion data based on neighboring map points |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US9380940B2 (en) | 2014-05-05 | 2016-07-05 | Pacesetter, Inc. | Method and system for displaying a three dimensional visualization of cardiac motion |
WO2016112227A1 (en) * | 2015-01-07 | 2016-07-14 | Stereotaxis, Inc. | Method and apparatus for automated control of multiple medical devices with a single interventional remote navigation system |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US20160228180A1 (en) * | 2013-11-07 | 2016-08-11 | St. Jude Medical, Cardiology Division, Inc. | Medical device with contact force sensing tip |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9433760B2 (en) | 2011-12-28 | 2016-09-06 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9456867B2 (en) | 2013-03-15 | 2016-10-04 | Boston Scientific Scimed Inc. | Open irrigated ablation catheter |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9486355B2 (en) | 2005-05-03 | 2016-11-08 | Vessix Vascular, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
US9492226B2 (en) | 2005-12-06 | 2016-11-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Graphical user interface for real-time RF lesion depth display |
US9549777B2 (en) | 2005-05-16 | 2017-01-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly and method for control of temperature |
US9579030B2 (en) | 2011-07-20 | 2017-02-28 | Boston Scientific Scimed, Inc. | Percutaneous devices and methods to visualize, target and ablate nerves |
US9588191B1 (en) | 2008-08-18 | 2017-03-07 | Hypres, Inc. | High linearity superconducting radio frequency magnetic field detector |
US9610119B2 (en) | 2005-12-06 | 2017-04-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing the formation of a lesion in tissue |
US9615879B2 (en) | 2013-03-15 | 2017-04-11 | Boston Scientific Scimed, Inc. | Open irrigated ablation catheter with proximal cooling |
US9618591B1 (en) | 2009-11-24 | 2017-04-11 | Hypres, Inc. | Magnetic resonance system and method employing a digital squid |
US9636173B2 (en) | 2010-10-21 | 2017-05-02 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for renal neuromodulation |
US9649156B2 (en) | 2010-12-15 | 2017-05-16 | Boston Scientific Scimed, Inc. | Bipolar off-wall electrode device for renal nerve ablation |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9687166B2 (en) | 2013-10-14 | 2017-06-27 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9693821B2 (en) | 2013-03-11 | 2017-07-04 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9700233B2 (en) | 2014-05-05 | 2017-07-11 | Pacesetter, Inc. | Method and system to equalizing cardiac cycle length between map points |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US9763591B2 (en) | 2014-05-05 | 2017-09-19 | Pacesetter, Inc. | Method and system to subdivide a mapping area for mechanical activation analysis |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
US9788891B2 (en) | 2010-12-28 | 2017-10-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assemblies and methods for using same |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9808300B2 (en) | 2006-05-02 | 2017-11-07 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US9814406B2 (en) | 2013-11-19 | 2017-11-14 | Pacesetter, Inc. | Method and system to identify motion data associated with consistent electrical and mechanical behavior for a region of interest |
US9827039B2 (en) | 2013-03-15 | 2017-11-28 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9833283B2 (en) | 2013-07-01 | 2017-12-05 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US9855094B2 (en) | 2010-12-28 | 2018-01-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures |
US9895194B2 (en) | 2013-09-04 | 2018-02-20 | Boston Scientific Scimed, Inc. | Radio frequency (RF) balloon catheter having flushing and cooling capability |
US9895076B2 (en) | 2014-05-05 | 2018-02-20 | Pacesetter, Inc. | Method and system to determine cardiac cycle length in connection with cardiac mapping |
US9907609B2 (en) | 2014-02-04 | 2018-03-06 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US20180078306A1 (en) * | 2011-07-29 | 2018-03-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Universal shaft for magnetic manipulation of catheters |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
US9943365B2 (en) | 2013-06-21 | 2018-04-17 | Boston Scientific Scimed, Inc. | Renal denervation balloon catheter with ride along electrode support |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9962223B2 (en) | 2013-10-15 | 2018-05-08 | Boston Scientific Scimed, Inc. | Medical device balloon |
US9974607B2 (en) | 2006-10-18 | 2018-05-22 | Vessix Vascular, Inc. | Inducing desirable temperature effects on body tissue |
US10022182B2 (en) | 2013-06-21 | 2018-07-17 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation having rotatable shafts |
US10028764B2 (en) | 2013-02-21 | 2018-07-24 | Boston Scientific Scimed, Inc. | Ablation catheter with wireless temperature sensor |
US10085799B2 (en) | 2011-10-11 | 2018-10-02 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US10105077B2 (en) | 2014-05-05 | 2018-10-23 | Pacesetter, Inc. | Method and system for calculating strain from characterization data of a cardiac chamber |
US10166069B2 (en) | 2014-01-27 | 2019-01-01 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US10188829B2 (en) | 2012-10-22 | 2019-01-29 | Medtronic Ardian Luxembourg S.A.R.L. | Catheters with enhanced flexibility and associated devices, systems, and methods |
US10195467B2 (en) | 2013-02-21 | 2019-02-05 | Boston Scientific Scimed, Inc. | Ablation catheter system with wireless radio frequency temperature sensor |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
US10271898B2 (en) | 2013-10-25 | 2019-04-30 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
US10285647B2 (en) | 2014-05-05 | 2019-05-14 | Pacesetter Inc. | Method and system to automatically assign map points to anatomical segments and determine mechanical activation time |
EP3491994A1 (en) * | 2011-10-31 | 2019-06-05 | Boston Scientific Scimed, Inc. | An endoscopic instrument having a deflectable distal tool |
US20190175282A1 (en) * | 2017-12-12 | 2019-06-13 | Acclarent, Inc. | Tissue shaving instrument with navigation sensor |
US10321946B2 (en) | 2012-08-24 | 2019-06-18 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices with weeping RF ablation balloons |
US10342609B2 (en) | 2013-07-22 | 2019-07-09 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10362959B2 (en) | 2005-12-06 | 2019-07-30 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing the proximity of an electrode to tissue in a body |
US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
US10413357B2 (en) | 2013-07-11 | 2019-09-17 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
US10433903B2 (en) | 2007-04-04 | 2019-10-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter |
US10502802B1 (en) | 2010-04-14 | 2019-12-10 | Hypres, Inc. | System and method for noise reduction in magnetic resonance imaging |
US10543037B2 (en) | 2013-03-15 | 2020-01-28 | Medtronic Ardian Luxembourg S.A.R.L. | Controlled neuromodulation systems and methods of use |
US10548663B2 (en) | 2013-05-18 | 2020-02-04 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters with shafts for enhanced flexibility and control and associated devices, systems, and methods |
US10549127B2 (en) | 2012-09-21 | 2020-02-04 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
US10555685B2 (en) | 2007-12-28 | 2020-02-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method and apparatus for determining tissue morphology based on phase angle |
US10660703B2 (en) | 2012-05-08 | 2020-05-26 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
US10660698B2 (en) | 2013-07-11 | 2020-05-26 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
US10702170B2 (en) | 2013-07-01 | 2020-07-07 | Zurich Medical Corporation | Apparatus and method for intravascular measurements |
US10722300B2 (en) | 2013-08-22 | 2020-07-28 | Boston Scientific Scimed, Inc. | Flexible circuit having improved adhesion to a renal nerve modulation balloon |
US10736690B2 (en) | 2014-04-24 | 2020-08-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US10806511B1 (en) * | 2014-11-14 | 2020-10-20 | William Sauer | Partially insulated focused radiofrequency ablation catheter |
WO2020198150A3 (en) * | 2019-03-22 | 2020-11-05 | Stryker Corporation | Systems for ablating tissue |
US10835305B2 (en) | 2012-10-10 | 2020-11-17 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices and methods |
US10835183B2 (en) | 2013-07-01 | 2020-11-17 | Zurich Medical Corporation | Apparatus and method for intravascular measurements |
US10945786B2 (en) | 2013-10-18 | 2021-03-16 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires and related methods of use and manufacture |
US10952790B2 (en) | 2013-09-13 | 2021-03-23 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US20210369373A1 (en) * | 2020-05-28 | 2021-12-02 | The Chinese University Of Hong Kong | Mobile-electromagnetic coil-based magnetic actuation systems |
US11202671B2 (en) | 2014-01-06 | 2021-12-21 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
US11246658B2 (en) | 2016-10-04 | 2022-02-15 | St. Jude Medical, Cardiology Division, Inc. | Ablation catheter tip |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
US11284572B2 (en) | 2014-12-05 | 2022-03-29 | Pivot Pup Irrigation, LLC | Irrigating soils and crops |
US11318280B2 (en) | 2009-01-15 | 2022-05-03 | Koninklijke Philips N.V. | Catheter being usable in a magnetic resonance imaging system |
US11317967B2 (en) * | 2008-07-03 | 2022-05-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetic guided ablation catheter |
US11350986B2 (en) | 2015-03-31 | 2022-06-07 | St. Jude Medical, Cardiology Division, Inc. | High-thermal-sensitivity ablation catheters and catheter tips |
WO2023034319A1 (en) * | 2021-08-30 | 2023-03-09 | Stereotaxis, Inc. | Magnetically steerable irrigated ablation catheters, and systems and methods thereof |
WO2023129842A3 (en) * | 2021-12-28 | 2023-08-31 | Atricure, Inc. | Magnetically coupled ablation components |
Families Citing this family (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN103796604B (en) | 2011-08-26 | 2017-03-01 | 苏州信迈医疗器械有限公司 | For the conduit of functional nerve, system and method in mapping arterial wall |
US8702619B2 (en) | 2011-08-26 | 2014-04-22 | Symap Holding Limited | Mapping sympathetic nerve distribution for renal ablation and catheters for same |
JP2013103075A (en) * | 2011-11-16 | 2013-05-30 | Olympus Corp | Guidance medical system |
CN105854095B (en) * | 2016-06-20 | 2018-06-29 | 成都美创医疗科技股份有限公司 | Liposuction knife |
WO2019217759A1 (en) | 2018-05-09 | 2019-11-14 | Amtek Research International Llc | Acid stratification mitigation, electrolytes, devices, and methods related thereto |
JP7335366B2 (en) * | 2019-08-29 | 2023-08-29 | セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド | Force Sensing Catheter Including Sealed Electrode Tip Assembly and Method of Assembling Same |
Citations (43)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5056517A (en) * | 1989-07-24 | 1991-10-15 | Consiglio Nazionale Delle Ricerche | Biomagnetically localizable multipurpose catheter and method for magnetocardiographic guided intracardiac mapping, biopsy and ablation of cardiac arrhythmias |
US5061823A (en) * | 1990-07-13 | 1991-10-29 | W. L. Gore & Associates, Inc. | Crush-resistant coaxial transmission line |
US5230349A (en) * | 1988-11-25 | 1993-07-27 | Sensor Electronics, Inc. | Electrical heating catheter |
US5348554A (en) * | 1992-12-01 | 1994-09-20 | Cardiac Pathways Corporation | Catheter for RF ablation with cooled electrode |
US5456682A (en) * | 1991-11-08 | 1995-10-10 | Ep Technologies, Inc. | Electrode and associated systems using thermally insulated temperature sensing elements |
US5462521A (en) * | 1993-12-21 | 1995-10-31 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US5545161A (en) * | 1992-12-01 | 1996-08-13 | Cardiac Pathways Corporation | Catheter for RF ablation having cooled electrode with electrically insulated sleeve |
US5688267A (en) * | 1995-05-01 | 1997-11-18 | Ep Technologies, Inc. | Systems and methods for sensing multiple temperature conditions during tissue ablation |
US5792140A (en) * | 1997-05-15 | 1998-08-11 | Irvine Biomedical, Inc. | Catheter having cooled multiple-needle electrode |
US5843152A (en) * | 1997-06-02 | 1998-12-01 | Irvine Biomedical, Inc. | Catheter system having a ball electrode |
US5913856A (en) * | 1997-05-19 | 1999-06-22 | Irvine Biomedical, Inc. | Catheter system having a porous shaft and fluid irrigation capabilities |
US5989249A (en) * | 1996-04-29 | 1999-11-23 | Kirwan Surgical Products, Inc. | Bipolar suction coagulator |
US6080151A (en) * | 1997-07-21 | 2000-06-27 | Daig Corporation | Ablation catheter |
US6120500A (en) * | 1997-11-12 | 2000-09-19 | Daig Corporation | Rail catheter ablation and mapping system |
US6171275B1 (en) * | 1998-12-03 | 2001-01-09 | Cordis Webster, Inc. | Irrigated split tip electrode catheter |
US6210406B1 (en) * | 1998-12-03 | 2001-04-03 | Cordis Webster, Inc. | Split tip electrode catheter and signal processing RF ablation system |
US6217576B1 (en) * | 1997-05-19 | 2001-04-17 | Irvine Biomedical Inc. | Catheter probe for treating focal atrial fibrillation in pulmonary veins |
US6241724B1 (en) * | 1993-10-19 | 2001-06-05 | Ep Technologies, Inc. | Systems and methods for creating lesions in body tissue using segmented electrode assemblies |
US6322558B1 (en) * | 1995-06-09 | 2001-11-27 | Engineering & Research Associates, Inc. | Apparatus and method for predicting ablation depth |
US6425894B1 (en) * | 2000-07-12 | 2002-07-30 | Biosense Webster, Inc. | Ablation catheter with electrode temperature monitoring |
US6575969B1 (en) * | 1995-05-04 | 2003-06-10 | Sherwood Services Ag | Cool-tip radiofrequency thermosurgery electrode system for tumor ablation |
US6602242B1 (en) * | 1997-12-01 | 2003-08-05 | Biosense Webster, Inc. | Irrigated tip catheter |
US6611699B2 (en) * | 2001-06-28 | 2003-08-26 | Scimed Life Systems, Inc. | Catheter with an irrigated composite tip electrode |
US20030199867A1 (en) * | 2001-09-28 | 2003-10-23 | Ethicon, Inc. | Surgical treatment for atrial fibrillation using radiofrequency technology |
US6650923B1 (en) * | 2000-04-13 | 2003-11-18 | Ev3 Sunnyvale, Inc. | Method for accessing the left atrium of the heart by locating the fossa ovalis |
US6662034B2 (en) * | 2000-11-15 | 2003-12-09 | Stereotaxis, Inc. | Magnetically guidable electrophysiology catheter |
US6757565B2 (en) * | 2002-02-08 | 2004-06-29 | Oratec Interventions, Inc. | Electrosurgical instrument having a predetermined heat profile |
US20040243121A1 (en) * | 2003-06-02 | 2004-12-02 | Lee James K. | Enhanced ablation and mapping catheter and method for treating atrial fibrillation |
US20040267106A1 (en) * | 2001-01-29 | 2004-12-30 | Segner Garland L | Electrophysiology catheter |
US6852120B1 (en) * | 1999-08-10 | 2005-02-08 | Biosense Webster, Inc | Irrigation probe for ablation during open heart surgery |
US20050177151A1 (en) * | 2001-06-20 | 2005-08-11 | Coen Thomas P. | Irrigation sheath |
US20050267467A1 (en) * | 2004-01-16 | 2005-12-01 | Saurav Paul | Bipolar conforming electrode catheter and methods for ablation |
US20050273006A1 (en) * | 2000-10-10 | 2005-12-08 | Medtronic, Inc. | Heart wall ablation/mapping catheter and method |
US6977469B2 (en) * | 2001-05-08 | 2005-12-20 | Koninklijke Philips Electronics N.V. | Low-pressure mercury vapor discharge lamp |
US20050288654A1 (en) * | 2004-06-07 | 2005-12-29 | Tim Nieman | Methods and devices for delivering ablative energy |
US6984232B2 (en) * | 2003-01-17 | 2006-01-10 | St. Jude Medical, Daig Division, Inc. | Ablation catheter assembly having a virtual electrode comprising portholes |
US20060089638A1 (en) * | 2004-10-27 | 2006-04-27 | Yuval Carmel | Radio-frequency device for passivation of vascular plaque and method of using same |
US20060287650A1 (en) * | 2005-06-21 | 2006-12-21 | Hong Cao | Ablation catheter with fluid distribution structures |
US7166105B2 (en) * | 1995-02-22 | 2007-01-23 | Medtronic, Inc. | Pen-type electrosurgical instrument |
US20070270791A1 (en) * | 2006-05-16 | 2007-11-22 | Huisun Wang | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US20080045943A1 (en) * | 2003-10-29 | 2008-02-21 | Frederik Henricus Wittkampf | Catheter and Method, in Particular for Ablation and Like Technique |
US20080161794A1 (en) * | 2006-12-28 | 2008-07-03 | Huisun Wang | Irrigated ablation catheter having a pressure sensor to detect tissue contact |
US8128621B2 (en) * | 2005-05-16 | 2012-03-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly and method for control of temperature |
Family Cites Families (78)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3331371A (en) | 1965-03-09 | 1967-07-18 | Prosit Service Corp | Catheter having internal flow valve at distal end thereof |
US3671979A (en) | 1969-09-23 | 1972-06-27 | Univ Utah | Catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve |
US4084606A (en) | 1974-04-23 | 1978-04-18 | Baxter Travenol Laboratories, Inc. | Fluid transfer device |
US4026298A (en) | 1975-12-03 | 1977-05-31 | Grausz Investment Co. | Artificial urethra |
US4841984A (en) | 1985-09-16 | 1989-06-27 | Armoor Ophthalmics, Inc. | Fluid-carrying components of apparatus for automatic control of intraocular pressure |
US4857054A (en) | 1988-07-15 | 1989-08-15 | Eastman Kodak Company | Perfusion angioplasty catheter with pump assist |
US5290263A (en) | 1989-02-02 | 1994-03-01 | Regents Of The University Of Minnesota | Bidirectional check valve catheter |
US5098431A (en) * | 1989-04-13 | 1992-03-24 | Everest Medical Corporation | RF ablation catheter |
US5092844A (en) | 1990-04-10 | 1992-03-03 | Mayo Foundation For Medical Education And Research | Intracatheter perfusion pump apparatus and method |
US5122137A (en) * | 1990-04-27 | 1992-06-16 | Boston Scientific Corporation | Temperature controlled rf coagulation |
US5112301A (en) | 1991-06-19 | 1992-05-12 | Strato Medical Corporation | Bidirectional check valve catheter |
US20060058775A1 (en) | 1991-07-16 | 2006-03-16 | Stevens John H | System and methods for performing endovascular procedures |
US5334193A (en) * | 1992-11-13 | 1994-08-02 | American Cardiac Ablation Co., Inc. | Fluid cooled ablation catheter |
US5403276A (en) | 1993-02-16 | 1995-04-04 | Danek Medical, Inc. | Apparatus for minimally invasive tissue removal |
US5427114A (en) | 1993-08-19 | 1995-06-27 | Fiberoptic Sensor Technologies, Inc. | Dual pressure sensing catheter |
US5431168A (en) | 1993-08-23 | 1995-07-11 | Cordis-Webster, Inc. | Steerable open-lumen catheter |
EP2314244A1 (en) * | 1994-12-13 | 2011-04-27 | Torben Lorentzen | An electrosurgical instrument for tissue ablation, an apparatus, and a method for providing a lesion in damaged and diseased tissue from a mammal |
US5660205A (en) | 1994-12-15 | 1997-08-26 | Epstein; Alan B. | One-way valve |
ATE207726T1 (en) | 1995-05-01 | 2001-11-15 | Boston Scient Ltd | SYSTEM FOR FEELING UNDER-THE-SKIN TEMPERATURES IN BODY TISSUE DURING ABLATION |
WO1996034571A1 (en) * | 1995-05-04 | 1996-11-07 | Cosman Eric R | Cool-tip electrode thermosurgery system |
US5782760A (en) | 1995-05-23 | 1998-07-21 | Cardima, Inc. | Over-the-wire EP catheter |
JPH09140801A (en) | 1995-11-21 | 1997-06-03 | Nippon Zeon Co Ltd | Electrode catheter |
US5961513A (en) * | 1996-01-19 | 1999-10-05 | Ep Technologies, Inc. | Tissue heating and ablation systems and methods using porous electrode structures |
US5755760A (en) * | 1996-03-11 | 1998-05-26 | Medtronic, Inc. | Deflectable catheter |
US5800428A (en) * | 1996-05-16 | 1998-09-01 | Angeion Corporation | Linear catheter ablation system |
US6689085B1 (en) | 1996-07-11 | 2004-02-10 | Eunoe, Inc. | Method and apparatus for treating adult-onset dementia of the Alzheimer's type |
US5779669A (en) * | 1996-10-28 | 1998-07-14 | C. R. Bard, Inc. | Steerable catheter with fixed curve |
US5893885A (en) * | 1996-11-01 | 1999-04-13 | Cordis Webster, Inc. | Multi-electrode ablation catheter |
US20040176801A1 (en) | 1997-03-12 | 2004-09-09 | Neomend, Inc. | Pretreatment method for enhancing tissue adhesion |
US20030191496A1 (en) | 1997-03-12 | 2003-10-09 | Neomend, Inc. | Vascular sealing device with microwave antenna |
US6296615B1 (en) | 1999-03-05 | 2001-10-02 | Data Sciences International, Inc. | Catheter with physiological sensor |
AU1464099A (en) * | 1997-11-25 | 1999-06-15 | Arthrocare Corporation | Systems and methods for electrosurgical treatment of the skin |
US6050986A (en) | 1997-12-01 | 2000-04-18 | Scimed Life Systems, Inc. | Catheter system for the delivery of a low volume liquid bolus |
US6719779B2 (en) | 2000-11-07 | 2004-04-13 | Innercool Therapies, Inc. | Circulation set for temperature-controlled catheter and method of using the same |
US6044845A (en) | 1998-02-03 | 2000-04-04 | Salient Interventional Systems, Inc. | Methods and systems for treating ischemia |
US6522930B1 (en) | 1998-05-06 | 2003-02-18 | Atrionix, Inc. | Irrigated ablation device assembly |
US6537272B2 (en) | 1998-07-07 | 2003-03-25 | Medtronic, Inc. | Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue |
US6405078B1 (en) * | 1999-01-15 | 2002-06-11 | Biosense Webster, Inc. | Porous irrigated tip electrode catheter |
US6911026B1 (en) * | 1999-07-12 | 2005-06-28 | Stereotaxis, Inc. | Magnetically guided atherectomy |
US5971968A (en) | 1999-04-08 | 1999-10-26 | Irvine Biomedical, Inc. | Catheter probe having contrast media delivery means |
US6436071B1 (en) | 1999-06-08 | 2002-08-20 | The Trustees Of Columbia University In The City Of New York | Intravascular systems for corporeal cooling |
US6628976B1 (en) * | 2000-01-27 | 2003-09-30 | Biosense Webster, Inc. | Catheter having mapping assembly |
US6770070B1 (en) | 2000-03-17 | 2004-08-03 | Rita Medical Systems, Inc. | Lung treatment apparatus and method |
JP4723156B2 (en) | 2000-03-31 | 2011-07-13 | アンジオ ダイナミクス インコーポレイテッド | Tissue biopsy and treatment equipment |
US6475214B1 (en) * | 2000-05-01 | 2002-11-05 | Biosense Webster, Inc. | Catheter with enhanced ablation electrode |
JP2002065692A (en) | 2000-09-01 | 2002-03-05 | Aloka Co Ltd | Electric operation apparatus |
US7081114B2 (en) | 2000-11-29 | 2006-07-25 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Electrophysiology/ablation catheter having lariat configuration of variable radius |
US7422586B2 (en) | 2001-02-28 | 2008-09-09 | Angiodynamics, Inc. | Tissue surface treatment apparatus and method |
US6666862B2 (en) | 2001-03-01 | 2003-12-23 | Cardiac Pacemakers, Inc. | Radio frequency ablation system and method linking energy delivery with fluid flow |
US20020177846A1 (en) | 2001-03-06 | 2002-11-28 | Mulier Peter M.J. | Vaporous delivery of thermal energy to tissue sites |
US7540854B2 (en) | 2001-07-10 | 2009-06-02 | Medrad, Inc. | Method of substituting a first fluid delivery device with a second fluid delivery device |
US20050085769A1 (en) | 2001-07-17 | 2005-04-21 | Kerberos Proximal Solutions | Fluid exchange system for controlled and localized irrigation and aspiration |
US6827701B2 (en) | 2001-07-17 | 2004-12-07 | Kerberos Proximal Solutions | Fluid exchange system for controlled and localized irrigation and aspiration |
AU2002357166A1 (en) | 2001-12-12 | 2003-06-23 | Tissuelink Medical, Inc. | Fluid-assisted medical devices, systems and methods |
EP1487366B1 (en) | 2002-03-15 | 2007-08-08 | C.R. Bard, Inc. | Apparatus for control of ablation energy and electrogram acquisition through multiple common electrodes in an electrophysiology catheter |
CA2498962A1 (en) | 2002-06-04 | 2003-12-11 | Office Of Technology Licensing Stanford University | Device and method for rapid aspiration and collection of body tissue from within an enclosed body space |
US6887263B2 (en) | 2002-10-18 | 2005-05-03 | Radiant Medical, Inc. | Valved connector assembly and sterility barriers for heat exchange catheters and other closed loop catheters |
US20040098022A1 (en) | 2002-11-14 | 2004-05-20 | Barone David D. | Intraluminal catheter with hydraulically collapsible self-expanding protection device |
US6945957B2 (en) | 2002-12-30 | 2005-09-20 | Scimed Life Systems, Inc. | Valve treatment catheter and methods |
US10182734B2 (en) * | 2003-07-18 | 2019-01-22 | Biosense Webster, Inc. | Enhanced ablation and mapping catheter and method for treating atrial fibrillation |
US20050049453A1 (en) | 2003-08-25 | 2005-03-03 | Faulkner Roger W. | Hydraulically driven vibrating massagers |
US7347859B2 (en) | 2003-12-18 | 2008-03-25 | Boston Scientific, Scimed, Inc. | Tissue treatment system and method for tissue perfusion using feedback control |
EP2368512A1 (en) | 2004-05-17 | 2011-09-28 | C.R. Bard, Inc. | Irrigated catheter |
US20060058854A1 (en) | 2004-09-14 | 2006-03-16 | Scimed Life Systems, Inc. | Method for stimulating neural tissue in response to a sensed physiological event |
US7496394B2 (en) * | 2004-11-15 | 2009-02-24 | Biosense Webster, Inc. | Internal reference coronary sinus catheter |
US20080091193A1 (en) | 2005-05-16 | 2008-04-17 | James Kauphusman | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
US20070062546A1 (en) | 2005-06-02 | 2007-03-22 | Viswanathan Raju R | Electrophysiology catheter and system for gentle and firm wall contact |
JP2009545338A (en) | 2006-07-12 | 2009-12-24 | レ オピトー ユニヴェルシテール ド ジュネーヴ | Medical device for tissue resection |
EP2066251B1 (en) | 2006-10-10 | 2017-05-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assembly with insulated distal outlet |
US7824406B2 (en) | 2006-12-28 | 2010-11-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having a valve to prevent backflow |
US7951143B2 (en) | 2006-12-28 | 2011-05-31 | St. Jude Medical, Artial Fibrillation Divsion, Inc. | Cooled ablation catheter with reciprocating flow |
US8690870B2 (en) | 2006-12-28 | 2014-04-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter system with pulsatile flow to prevent thrombus |
WO2009006616A1 (en) * | 2007-07-03 | 2009-01-08 | Irvine Biomedical, Inc. | Magnetically guided catheter |
US8052684B2 (en) * | 2007-11-30 | 2011-11-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having parallel external flow and proximally tapered electrode |
US8221409B2 (en) * | 2007-12-21 | 2012-07-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Thermally insulated irrigation catheter assembly |
US8206385B2 (en) * | 2008-06-09 | 2012-06-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter assembly with front-loaded tip and multi-contact connector |
WO2013101452A1 (en) * | 2011-12-28 | 2013-07-04 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
CN104837430A (en) * | 2013-01-31 | 2015-08-12 | 雷纳尔动力有限公司 | Ablation catheter with insulation |
-
2007
- 2007-12-10 US US11/953,615 patent/US20080091193A1/en not_active Abandoned
-
2008
- 2008-11-12 EP EP08855141.1A patent/EP2211710B1/en active Active
- 2008-11-12 WO PCT/US2008/083250 patent/WO2009070448A1/en active Application Filing
-
2015
- 2015-08-07 US US14/821,054 patent/US9549777B2/en active Active
-
2017
- 2017-01-23 US US15/413,024 patent/US10499985B2/en active Active
-
2019
- 2019-11-08 US US16/678,475 patent/US11478300B2/en active Active
Patent Citations (49)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5230349A (en) * | 1988-11-25 | 1993-07-27 | Sensor Electronics, Inc. | Electrical heating catheter |
US5056517A (en) * | 1989-07-24 | 1991-10-15 | Consiglio Nazionale Delle Ricerche | Biomagnetically localizable multipurpose catheter and method for magnetocardiographic guided intracardiac mapping, biopsy and ablation of cardiac arrhythmias |
US5061823A (en) * | 1990-07-13 | 1991-10-29 | W. L. Gore & Associates, Inc. | Crush-resistant coaxial transmission line |
US5456682A (en) * | 1991-11-08 | 1995-10-10 | Ep Technologies, Inc. | Electrode and associated systems using thermally insulated temperature sensing elements |
US5423811A (en) * | 1992-12-01 | 1995-06-13 | Cardiac Pathways Corporation | Method for RF ablation using cooled electrode |
US5545161A (en) * | 1992-12-01 | 1996-08-13 | Cardiac Pathways Corporation | Catheter for RF ablation having cooled electrode with electrically insulated sleeve |
US5348554A (en) * | 1992-12-01 | 1994-09-20 | Cardiac Pathways Corporation | Catheter for RF ablation with cooled electrode |
US6241724B1 (en) * | 1993-10-19 | 2001-06-05 | Ep Technologies, Inc. | Systems and methods for creating lesions in body tissue using segmented electrode assemblies |
US5462521A (en) * | 1993-12-21 | 1995-10-31 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US5643197A (en) * | 1993-12-21 | 1997-07-01 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US6017338A (en) * | 1993-12-21 | 2000-01-25 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US7166105B2 (en) * | 1995-02-22 | 2007-01-23 | Medtronic, Inc. | Pen-type electrosurgical instrument |
US5688267A (en) * | 1995-05-01 | 1997-11-18 | Ep Technologies, Inc. | Systems and methods for sensing multiple temperature conditions during tissue ablation |
US6575969B1 (en) * | 1995-05-04 | 2003-06-10 | Sherwood Services Ag | Cool-tip radiofrequency thermosurgery electrode system for tumor ablation |
US6322558B1 (en) * | 1995-06-09 | 2001-11-27 | Engineering & Research Associates, Inc. | Apparatus and method for predicting ablation depth |
US5989249A (en) * | 1996-04-29 | 1999-11-23 | Kirwan Surgical Products, Inc. | Bipolar suction coagulator |
US5792140A (en) * | 1997-05-15 | 1998-08-11 | Irvine Biomedical, Inc. | Catheter having cooled multiple-needle electrode |
US5913856A (en) * | 1997-05-19 | 1999-06-22 | Irvine Biomedical, Inc. | Catheter system having a porous shaft and fluid irrigation capabilities |
US6217576B1 (en) * | 1997-05-19 | 2001-04-17 | Irvine Biomedical Inc. | Catheter probe for treating focal atrial fibrillation in pulmonary veins |
US5843152A (en) * | 1997-06-02 | 1998-12-01 | Irvine Biomedical, Inc. | Catheter system having a ball electrode |
US6080151A (en) * | 1997-07-21 | 2000-06-27 | Daig Corporation | Ablation catheter |
US6120500A (en) * | 1997-11-12 | 2000-09-19 | Daig Corporation | Rail catheter ablation and mapping system |
US6602242B1 (en) * | 1997-12-01 | 2003-08-05 | Biosense Webster, Inc. | Irrigated tip catheter |
US6217573B1 (en) * | 1998-12-03 | 2001-04-17 | Cordis Webster | System and method for measuring surface temperature of tissue during ablation |
US6171275B1 (en) * | 1998-12-03 | 2001-01-09 | Cordis Webster, Inc. | Irrigated split tip electrode catheter |
US6210406B1 (en) * | 1998-12-03 | 2001-04-03 | Cordis Webster, Inc. | Split tip electrode catheter and signal processing RF ablation system |
US6852120B1 (en) * | 1999-08-10 | 2005-02-08 | Biosense Webster, Inc | Irrigation probe for ablation during open heart surgery |
US6650923B1 (en) * | 2000-04-13 | 2003-11-18 | Ev3 Sunnyvale, Inc. | Method for accessing the left atrium of the heart by locating the fossa ovalis |
US6425894B1 (en) * | 2000-07-12 | 2002-07-30 | Biosense Webster, Inc. | Ablation catheter with electrode temperature monitoring |
US20050273006A1 (en) * | 2000-10-10 | 2005-12-08 | Medtronic, Inc. | Heart wall ablation/mapping catheter and method |
US6662034B2 (en) * | 2000-11-15 | 2003-12-09 | Stereotaxis, Inc. | Magnetically guidable electrophysiology catheter |
US20040267106A1 (en) * | 2001-01-29 | 2004-12-30 | Segner Garland L | Electrophysiology catheter |
US6977469B2 (en) * | 2001-05-08 | 2005-12-20 | Koninklijke Philips Electronics N.V. | Low-pressure mercury vapor discharge lamp |
US20050177151A1 (en) * | 2001-06-20 | 2005-08-11 | Coen Thomas P. | Irrigation sheath |
US20040054272A1 (en) * | 2001-06-28 | 2004-03-18 | Scimed Life Systems, Inc. | Catheter with an irrigated composite tip electrode |
US6611699B2 (en) * | 2001-06-28 | 2003-08-26 | Scimed Life Systems, Inc. | Catheter with an irrigated composite tip electrode |
US20030199867A1 (en) * | 2001-09-28 | 2003-10-23 | Ethicon, Inc. | Surgical treatment for atrial fibrillation using radiofrequency technology |
US6757565B2 (en) * | 2002-02-08 | 2004-06-29 | Oratec Interventions, Inc. | Electrosurgical instrument having a predetermined heat profile |
US6984232B2 (en) * | 2003-01-17 | 2006-01-10 | St. Jude Medical, Daig Division, Inc. | Ablation catheter assembly having a virtual electrode comprising portholes |
US20040243121A1 (en) * | 2003-06-02 | 2004-12-02 | Lee James K. | Enhanced ablation and mapping catheter and method for treating atrial fibrillation |
US20080045943A1 (en) * | 2003-10-29 | 2008-02-21 | Frederik Henricus Wittkampf | Catheter and Method, in Particular for Ablation and Like Technique |
US20050267467A1 (en) * | 2004-01-16 | 2005-12-01 | Saurav Paul | Bipolar conforming electrode catheter and methods for ablation |
US20050288654A1 (en) * | 2004-06-07 | 2005-12-29 | Tim Nieman | Methods and devices for delivering ablative energy |
US20060089638A1 (en) * | 2004-10-27 | 2006-04-27 | Yuval Carmel | Radio-frequency device for passivation of vascular plaque and method of using same |
US8128621B2 (en) * | 2005-05-16 | 2012-03-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly and method for control of temperature |
US20060287650A1 (en) * | 2005-06-21 | 2006-12-21 | Hong Cao | Ablation catheter with fluid distribution structures |
US20070270791A1 (en) * | 2006-05-16 | 2007-11-22 | Huisun Wang | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US20080161794A1 (en) * | 2006-12-28 | 2008-07-03 | Huisun Wang | Irrigated ablation catheter having a pressure sensor to detect tissue contact |
US7591816B2 (en) * | 2006-12-28 | 2009-09-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having a pressure sensor to detect tissue contact |
Cited By (251)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8372072B2 (en) | 2003-02-04 | 2013-02-12 | Cardiodex Ltd. | Methods and apparatus for hemostasis following arterial catheterization |
US9125666B2 (en) | 2003-09-12 | 2015-09-08 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation of atherosclerotic material |
US9510901B2 (en) | 2003-09-12 | 2016-12-06 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation |
US10188457B2 (en) | 2003-09-12 | 2019-01-29 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US8939970B2 (en) | 2004-09-10 | 2015-01-27 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
US9125667B2 (en) | 2004-09-10 | 2015-09-08 | Vessix Vascular, Inc. | System for inducing desirable temperature effects on body tissue |
US8435236B2 (en) | 2004-11-22 | 2013-05-07 | Cardiodex, Ltd. | Techniques for heat-treating varicose veins |
US9486355B2 (en) | 2005-05-03 | 2016-11-08 | Vessix Vascular, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
US9549777B2 (en) | 2005-05-16 | 2017-01-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly and method for control of temperature |
US20070088347A1 (en) * | 2005-10-13 | 2007-04-19 | Boston Scientific Scimed, Inc. | Magnetically augmented radio frequency ablation |
US7744596B2 (en) * | 2005-10-13 | 2010-06-29 | Boston Scientific Scimed, Inc. | Magnetically augmented radio frequency ablation |
US9610119B2 (en) | 2005-12-06 | 2017-04-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing the formation of a lesion in tissue |
US11517372B2 (en) | 2005-12-06 | 2022-12-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US9283025B2 (en) | 2005-12-06 | 2016-03-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9283026B2 (en) | 2005-12-06 | 2016-03-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9271782B2 (en) | 2005-12-06 | 2016-03-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling of tissue ablation |
US10182860B2 (en) | 2005-12-06 | 2019-01-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9254163B2 (en) | 2005-12-06 | 2016-02-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US10362959B2 (en) | 2005-12-06 | 2019-07-30 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing the proximity of an electrode to tissue in a body |
US9339325B2 (en) | 2005-12-06 | 2016-05-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing lesions in tissue |
US9492226B2 (en) | 2005-12-06 | 2016-11-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Graphical user interface for real-time RF lesion depth display |
US10201388B2 (en) | 2005-12-06 | 2019-02-12 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Graphical user interface for real-time RF lesion depth display |
US9173586B2 (en) | 2005-12-06 | 2015-11-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for assessing coupling between an electrode and tissue |
US8998890B2 (en) | 2005-12-06 | 2015-04-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Assessment of electrode coupling for tissue ablation |
US9808300B2 (en) | 2006-05-02 | 2017-11-07 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US11478300B2 (en) | 2006-05-16 | 2022-10-25 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US10499985B2 (en) | 2006-05-16 | 2019-12-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US9974607B2 (en) | 2006-10-18 | 2018-05-22 | Vessix Vascular, Inc. | Inducing desirable temperature effects on body tissue |
US10213252B2 (en) | 2006-10-18 | 2019-02-26 | Vessix, Inc. | Inducing desirable temperature effects on body tissue |
US10413356B2 (en) | 2006-10-18 | 2019-09-17 | Boston Scientific Scimed, Inc. | System for inducing desirable temperature effects on body tissue |
US11559658B2 (en) | 2007-04-04 | 2023-01-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
US8517999B2 (en) | 2007-04-04 | 2013-08-27 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter with improved fluid flow |
US20080249522A1 (en) * | 2007-04-04 | 2008-10-09 | Carlo Pappone | Irrigated Catheter with Improved fluid flow |
US8979837B2 (en) | 2007-04-04 | 2015-03-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
US11596470B2 (en) | 2007-04-04 | 2023-03-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter |
US10576244B2 (en) | 2007-04-04 | 2020-03-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
US9561075B2 (en) | 2007-04-04 | 2017-02-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter with improved fluid flow |
US9962224B2 (en) | 2007-04-04 | 2018-05-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter with improved fluid flow |
US9724492B2 (en) | 2007-04-04 | 2017-08-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
US10433903B2 (en) | 2007-04-04 | 2019-10-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter |
US8790341B2 (en) | 2007-05-23 | 2014-07-29 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter with flexible tip |
US8480669B2 (en) | 2007-05-23 | 2013-07-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter with flexible tip |
US20110118582A1 (en) * | 2007-05-23 | 2011-05-19 | De La Rama Alan | Magnetically Guided Catheter With Flexible Tip |
US10188459B2 (en) | 2007-05-23 | 2019-01-29 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter with flexible electrode |
US11337750B2 (en) | 2007-05-23 | 2022-05-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter with flexible electrode |
US9510903B2 (en) | 2007-05-23 | 2016-12-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated flexible ablation catheter |
US8827910B2 (en) | 2007-05-23 | 2014-09-09 | St. Jude Medical, Atrial Fibrillation Divsion, Inc. | Magnetically guided catheter with flexible tip |
US10039598B2 (en) | 2007-07-03 | 2018-08-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
US8734440B2 (en) * | 2007-07-03 | 2014-05-27 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
US8715279B2 (en) | 2007-07-03 | 2014-05-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
US20100174177A1 (en) * | 2007-07-03 | 2010-07-08 | Kirk Wu | Magnetically guided catheter |
US8366706B2 (en) | 2007-08-15 | 2013-02-05 | Cardiodex, Ltd. | Systems and methods for puncture closure |
US20090125056A1 (en) * | 2007-08-15 | 2009-05-14 | Cardiodex Ltd. | Systems and methods for puncture closure |
US10555685B2 (en) | 2007-12-28 | 2020-02-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method and apparatus for determining tissue morphology based on phase angle |
US20090187186A1 (en) * | 2008-01-17 | 2009-07-23 | Jakus Laszlo | Ablation catheter arrangement and cooling control |
US8323274B2 (en) * | 2008-01-17 | 2012-12-04 | Biotronik Crm Patent Ag | Ablation catheter arrangement and cooling control |
US8206385B2 (en) | 2008-06-09 | 2012-06-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter assembly with front-loaded tip and multi-contact connector |
EP2303170A1 (en) * | 2008-06-09 | 2011-04-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter assembly with front-loaded tip and multi-contact connector |
US20090306655A1 (en) * | 2008-06-09 | 2009-12-10 | Stangenes Todd R | Catheter assembly with front-loaded tip and multi-contact connector |
US20090306651A1 (en) * | 2008-06-09 | 2009-12-10 | Clint Schneider | Catheter assembly with front-loaded tip |
WO2009152151A1 (en) * | 2008-06-09 | 2009-12-17 | St. Jude Medical | Catheter assembly with front-loaded tip and multi-contact connector |
EP2303170A4 (en) * | 2008-06-09 | 2013-07-17 | St Jude Medical Atrial Fibrill | Catheter assembly with front-loaded tip and multi-contact connector |
US11317967B2 (en) * | 2008-07-03 | 2022-05-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetic guided ablation catheter |
US20110288544A1 (en) * | 2008-07-17 | 2011-11-24 | Maestroheart Sa | Medical device for tissue ablation |
US10333049B1 (en) | 2008-08-18 | 2019-06-25 | Hypres, Inc. | High linearity superconducting radio frequency magnetic field detector |
US9588191B1 (en) | 2008-08-18 | 2017-03-07 | Hypres, Inc. | High linearity superconducting radio frequency magnetic field detector |
US8316861B2 (en) * | 2008-10-21 | 2012-11-27 | The Board Of Trustees Of The Leland Stanford Junior University | System and method for guiding a medical instrument with magnetic force control |
US20100105984A1 (en) * | 2008-10-21 | 2010-04-29 | Reuben Brewer | System and Method for Guiding a Medical Instrument with Magnetic Force Control |
US9327100B2 (en) | 2008-11-14 | 2016-05-03 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US8457714B2 (en) | 2008-11-25 | 2013-06-04 | Magnetecs, Inc. | System and method for a catheter impedance seeking device |
US20100130854A1 (en) * | 2008-11-25 | 2010-05-27 | Magnetecs, Inc. | System and method for a catheter impedance seeking device |
US20100168550A1 (en) * | 2008-12-31 | 2010-07-01 | Byrd Israel A | Multiple shell construction to emulate chamber contraction with a mapping system |
US10105177B2 (en) | 2008-12-31 | 2018-10-23 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly having off-center irrigation passageway |
US20100168728A1 (en) * | 2008-12-31 | 2010-07-01 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter and method of assembly |
US9307931B2 (en) | 2008-12-31 | 2016-04-12 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multiple shell construction to emulate chamber contraction with a mapping system |
US8348937B2 (en) * | 2008-12-31 | 2013-01-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter |
US20100168729A1 (en) * | 2008-12-31 | 2010-07-01 | Huisun Wang | Irrigated ablation electrode assembly having off-center irrigation passageway |
US10653481B2 (en) | 2008-12-31 | 2020-05-19 | St. Jude Medical, Atrial Fibrillation Divison, Inc. | Irrigated ablation electrode assembly having off-center irrigation passageway |
US11318280B2 (en) | 2009-01-15 | 2022-05-03 | Koninklijke Philips N.V. | Catheter being usable in a magnetic resonance imaging system |
CN101849825A (en) * | 2009-03-30 | 2010-10-06 | 微创医疗器械(上海)有限公司 | Weaving silk strengthening tube and electrophysiology conduit using same |
US10675086B2 (en) | 2009-05-13 | 2020-06-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US9204927B2 (en) | 2009-05-13 | 2015-12-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
WO2010142438A3 (en) * | 2009-06-10 | 2011-02-24 | Erbe Elektromedizin Gmbh | Supply device for providing an hf output voltage, hf surgical instrument comprising a corresponding supply device, and method for the operation of an hf generator unit |
JP2012529317A (en) * | 2009-06-10 | 2012-11-22 | エルベ エレクトロメディジン ゲーエムベーハー | Supply device for supplying HF output voltage, HF surgical device including the supply device, and method for operating HF generation unit |
US9247984B2 (en) | 2009-06-10 | 2016-02-02 | Erbe Elektromedizin Gmbh | Supply device for providing an HF output voltage, HF surgical instrument comprising a corresponding supply device, and method for the operation of an HF generator unit |
US9655539B2 (en) | 2009-11-09 | 2017-05-23 | Magnetecs, Inc. | System and method for targeting catheter electrodes |
WO2011057289A2 (en) * | 2009-11-09 | 2011-05-12 | Magnetecs, Inc. | System and method for targeting catheter electrodes |
US10675444B2 (en) | 2009-11-09 | 2020-06-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
US9486612B2 (en) | 2009-11-09 | 2016-11-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
US8376991B2 (en) | 2009-11-09 | 2013-02-19 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
WO2011057289A3 (en) * | 2009-11-09 | 2011-11-17 | Magnetecs, Inc. | System and method for targeting catheter electrodes |
US20110112476A1 (en) * | 2009-11-09 | 2011-05-12 | Kauphusman James V | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
US9618591B1 (en) | 2009-11-24 | 2017-04-11 | Hypres, Inc. | Magnetic resonance system and method employing a digital squid |
US10509084B1 (en) | 2009-11-24 | 2019-12-17 | Hypres, Inc. | Magnetic resonance system and method employing a digital SQUID |
EP2470101A4 (en) * | 2009-12-31 | 2013-06-26 | St Jude Medical Atrial Fibrill | Flexible tip catheter with extended fluid lumen |
EP2470101A1 (en) * | 2009-12-31 | 2012-07-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Flexible tip catheter with extended fluid lumen |
US8974454B2 (en) | 2009-12-31 | 2015-03-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Kit for non-invasive electrophysiology procedures and method of its use |
WO2011112814A1 (en) * | 2010-03-12 | 2011-09-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
WO2011115787A1 (en) * | 2010-03-15 | 2011-09-22 | Boston Scientific Scimed, Inc. | Ablation catheter with isolated temperature sensing tip |
US9277955B2 (en) | 2010-04-09 | 2016-03-08 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US10502802B1 (en) | 2010-04-14 | 2019-12-10 | Hypres, Inc. | System and method for noise reduction in magnetic resonance imaging |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US20110257649A1 (en) * | 2010-04-20 | 2011-10-20 | Vascomed Gmbh | Electrode For An Electrophysiological Ablation Catheter |
US9179968B2 (en) * | 2010-05-10 | 2015-11-10 | St. Jude Medical Luxembourg Holding S.À.R.L. | Irrigated finned ablation head |
US20110282342A1 (en) * | 2010-05-10 | 2011-11-17 | Giovanni Leo | Irrigated finned ablation head |
US10631926B2 (en) | 2010-05-10 | 2020-04-28 | St. Jude Medical International Holding S.À R.L. | Irrigated finned ablation head |
US8880185B2 (en) | 2010-06-11 | 2014-11-04 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US8601185B2 (en) * | 2010-07-16 | 2013-12-03 | St. Jude Medical, Atrial Fibrillation Divison, Inc. | System and methods for avoiding data collisions over a data bus |
US10390889B2 (en) * | 2010-07-26 | 2019-08-27 | St Jude Medical International Holding S.Á R.L. | Removable navigation system and method for a medical device |
US20120017923A1 (en) * | 2010-07-26 | 2012-01-26 | Lior Sobe | Removable Navigation System and Method for a Medical Device |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9023033B2 (en) | 2010-08-04 | 2015-05-05 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
US10052152B2 (en) | 2010-08-04 | 2018-08-21 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter electrode assembly |
US8876819B2 (en) | 2010-08-04 | 2014-11-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
WO2012018439A1 (en) * | 2010-08-04 | 2012-02-09 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
US20120035460A1 (en) * | 2010-08-05 | 2012-02-09 | Stangenes Todd R | Movable magnet for magnetically guided catheter |
US9463302B2 (en) | 2010-08-05 | 2016-10-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Movable magnet for magnetically guided catheter |
US8532743B2 (en) * | 2010-08-05 | 2013-09-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Movable magnet for magnetically guided catheter |
US9636173B2 (en) | 2010-10-21 | 2017-05-02 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for renal neuromodulation |
US9855097B2 (en) | 2010-10-21 | 2018-01-02 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses, systems, and methods for renal neuromodulation |
US10342612B2 (en) | 2010-10-21 | 2019-07-09 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses, systems, and methods for renal neuromodulation |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9848946B2 (en) | 2010-11-15 | 2017-12-26 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US9649156B2 (en) | 2010-12-15 | 2017-05-16 | Boston Scientific Scimed, Inc. | Bipolar off-wall electrode device for renal nerve ablation |
US8979840B2 (en) | 2010-12-17 | 2015-03-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for flexible electrodes |
US9788891B2 (en) | 2010-12-28 | 2017-10-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assemblies and methods for using same |
US9855094B2 (en) | 2010-12-28 | 2018-01-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures |
US10973571B2 (en) | 2010-12-28 | 2021-04-13 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures |
US11399889B2 (en) | 2010-12-28 | 2022-08-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assemblies and methods for using same |
US9220561B2 (en) | 2011-01-19 | 2015-12-29 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
WO2012173673A1 (en) * | 2011-06-16 | 2012-12-20 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for flexible electrodes |
US9579030B2 (en) | 2011-07-20 | 2017-02-28 | Boston Scientific Scimed, Inc. | Percutaneous devices and methods to visualize, target and ablate nerves |
US9186209B2 (en) | 2011-07-22 | 2015-11-17 | Boston Scientific Scimed, Inc. | Nerve modulation system having helical guide |
US20180078306A1 (en) * | 2011-07-29 | 2018-03-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Universal shaft for magnetic manipulation of catheters |
US9186210B2 (en) | 2011-10-10 | 2015-11-17 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
US10085799B2 (en) | 2011-10-11 | 2018-10-02 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US9162046B2 (en) | 2011-10-18 | 2015-10-20 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9079000B2 (en) | 2011-10-18 | 2015-07-14 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
EP3491994A1 (en) * | 2011-10-31 | 2019-06-05 | Boston Scientific Scimed, Inc. | An endoscopic instrument having a deflectable distal tool |
US8951251B2 (en) | 2011-11-08 | 2015-02-10 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
US9028472B2 (en) | 2011-12-23 | 2015-05-12 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9037259B2 (en) | 2011-12-23 | 2015-05-19 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9174050B2 (en) | 2011-12-23 | 2015-11-03 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9402684B2 (en) | 2011-12-23 | 2016-08-02 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9186211B2 (en) | 2011-12-23 | 2015-11-17 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9592386B2 (en) | 2011-12-23 | 2017-03-14 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9072902B2 (en) | 2011-12-23 | 2015-07-07 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9433760B2 (en) | 2011-12-28 | 2016-09-06 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US10660703B2 (en) | 2012-05-08 | 2020-05-26 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
US10321946B2 (en) | 2012-08-24 | 2019-06-18 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices with weeping RF ablation balloons |
US9173696B2 (en) | 2012-09-17 | 2015-11-03 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
US10549127B2 (en) | 2012-09-21 | 2020-02-04 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
US10835305B2 (en) | 2012-10-10 | 2020-11-17 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices and methods |
US10188829B2 (en) | 2012-10-22 | 2019-01-29 | Medtronic Ardian Luxembourg S.A.R.L. | Catheters with enhanced flexibility and associated devices, systems, and methods |
US11147948B2 (en) | 2012-10-22 | 2021-10-19 | Medtronic Ardian Luxembourg S.A.R.L. | Catheters with enhanced flexibility and associated devices, systems, and methods |
US9066725B2 (en) | 2012-12-06 | 2015-06-30 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for electrodes |
US10070919B2 (en) | 2012-12-06 | 2018-09-11 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigant distribution system for electrodes |
US10028764B2 (en) | 2013-02-21 | 2018-07-24 | Boston Scientific Scimed, Inc. | Ablation catheter with wireless temperature sensor |
US10195467B2 (en) | 2013-02-21 | 2019-02-05 | Boston Scientific Scimed, Inc. | Ablation catheter system with wireless radio frequency temperature sensor |
US9693821B2 (en) | 2013-03-11 | 2017-07-04 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US10543037B2 (en) | 2013-03-15 | 2020-01-28 | Medtronic Ardian Luxembourg S.A.R.L. | Controlled neuromodulation systems and methods of use |
US9827039B2 (en) | 2013-03-15 | 2017-11-28 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9456867B2 (en) | 2013-03-15 | 2016-10-04 | Boston Scientific Scimed Inc. | Open irrigated ablation catheter |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
US9615879B2 (en) | 2013-03-15 | 2017-04-11 | Boston Scientific Scimed, Inc. | Open irrigated ablation catheter with proximal cooling |
US9297845B2 (en) | 2013-03-15 | 2016-03-29 | Boston Scientific Scimed, Inc. | Medical devices and methods for treatment of hypertension that utilize impedance compensation |
US10548663B2 (en) | 2013-05-18 | 2020-02-04 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters with shafts for enhanced flexibility and control and associated devices, systems, and methods |
US9943365B2 (en) | 2013-06-21 | 2018-04-17 | Boston Scientific Scimed, Inc. | Renal denervation balloon catheter with ride along electrode support |
US10022182B2 (en) | 2013-06-21 | 2018-07-17 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation having rotatable shafts |
US9820809B2 (en) * | 2013-06-24 | 2017-11-21 | Gyrus Medical Limited | Electrosurgical instrument |
US20140378969A1 (en) * | 2013-06-24 | 2014-12-25 | Gyrus Medical Limited | Electrosurgical instrument |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
US10702170B2 (en) | 2013-07-01 | 2020-07-07 | Zurich Medical Corporation | Apparatus and method for intravascular measurements |
US10835183B2 (en) | 2013-07-01 | 2020-11-17 | Zurich Medical Corporation | Apparatus and method for intravascular measurements |
US11471061B2 (en) | 2013-07-01 | 2022-10-18 | Zurich Medical Corporation | Apparatus and method for intravascular measurements |
US9833283B2 (en) | 2013-07-01 | 2017-12-05 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10413357B2 (en) | 2013-07-11 | 2019-09-17 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
US10660698B2 (en) | 2013-07-11 | 2020-05-26 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
US10342609B2 (en) | 2013-07-22 | 2019-07-09 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
US20210052324A1 (en) * | 2013-08-02 | 2021-02-25 | Biosense Webster (Israel) Ltd. | Catheter with improved irrigated tip electrode having two-piece construction, and method of manufacturing therefor |
US10828089B2 (en) * | 2013-08-02 | 2020-11-10 | Biosense Webster (Israel) Ltd. | Catheter with improved irrigated tip electrode having two-piece construction, and method of manufacturing therefor |
US11819266B2 (en) * | 2013-08-02 | 2023-11-21 | Biosense Webster (Israel) Ltd. | Catheter with improved irrigated tip electrode having two-piece construction, and method of manufacturing therefor |
US20150038961A1 (en) * | 2013-08-02 | 2015-02-05 | Biosense Webster (Israel), Ltd. | Catheter with improved irrigated tip electrode having two-piece construction, and method of manufacturing therefor |
US10722300B2 (en) | 2013-08-22 | 2020-07-28 | Boston Scientific Scimed, Inc. | Flexible circuit having improved adhesion to a renal nerve modulation balloon |
US9895194B2 (en) | 2013-09-04 | 2018-02-20 | Boston Scientific Scimed, Inc. | Radio frequency (RF) balloon catheter having flushing and cooling capability |
US10952790B2 (en) | 2013-09-13 | 2021-03-23 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
US9687166B2 (en) | 2013-10-14 | 2017-06-27 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9962223B2 (en) | 2013-10-15 | 2018-05-08 | Boston Scientific Scimed, Inc. | Medical device balloon |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
US10945786B2 (en) | 2013-10-18 | 2021-03-16 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires and related methods of use and manufacture |
US10271898B2 (en) | 2013-10-25 | 2019-04-30 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
US20160228180A1 (en) * | 2013-11-07 | 2016-08-11 | St. Jude Medical, Cardiology Division, Inc. | Medical device with contact force sensing tip |
US11051877B2 (en) * | 2013-11-07 | 2021-07-06 | St. Jude Medical, Cardiology Division, Inc. | Medical device with contact force sensing tip |
US9814406B2 (en) | 2013-11-19 | 2017-11-14 | Pacesetter, Inc. | Method and system to identify motion data associated with consistent electrical and mechanical behavior for a region of interest |
US9314191B2 (en) | 2013-11-19 | 2016-04-19 | Pacesetter, Inc. | Method and system to measure cardiac motion using a cardiovascular navigation system |
US9301713B2 (en) | 2013-11-19 | 2016-04-05 | Pacesetter, Inc. | Method and system to assess mechanical dyssynchrony based on motion data collected by a navigation system |
US11096736B2 (en) * | 2013-12-09 | 2021-08-24 | Biosense Webster (Israel) Ltd. | Pericardial catheter with temperature sensing array |
US20150157381A1 (en) * | 2013-12-09 | 2015-06-11 | Biosense Webster (Israel) Ltd. | Pericardial catheter with temperature sensing array |
US11202671B2 (en) | 2014-01-06 | 2021-12-21 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
US10166069B2 (en) | 2014-01-27 | 2019-01-01 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US11154353B2 (en) | 2014-01-27 | 2021-10-26 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US9907609B2 (en) | 2014-02-04 | 2018-03-06 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US11464563B2 (en) | 2014-04-24 | 2022-10-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US10736690B2 (en) | 2014-04-24 | 2020-08-11 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation catheters and associated systems and methods |
US10105077B2 (en) | 2014-05-05 | 2018-10-23 | Pacesetter, Inc. | Method and system for calculating strain from characterization data of a cardiac chamber |
US10285647B2 (en) | 2014-05-05 | 2019-05-14 | Pacesetter Inc. | Method and system to automatically assign map points to anatomical segments and determine mechanical activation time |
US9895076B2 (en) | 2014-05-05 | 2018-02-20 | Pacesetter, Inc. | Method and system to determine cardiac cycle length in connection with cardiac mapping |
US9763591B2 (en) | 2014-05-05 | 2017-09-19 | Pacesetter, Inc. | Method and system to subdivide a mapping area for mechanical activation analysis |
US9700233B2 (en) | 2014-05-05 | 2017-07-11 | Pacesetter, Inc. | Method and system to equalizing cardiac cycle length between map points |
US9380940B2 (en) | 2014-05-05 | 2016-07-05 | Pacesetter, Inc. | Method and system for displaying a three dimensional visualization of cardiac motion |
US9364170B2 (en) | 2014-05-05 | 2016-06-14 | Pacesetter, Inc. | Method and system to characterize motion data based on neighboring map points |
US9302099B2 (en) | 2014-05-05 | 2016-04-05 | Pacesetter, Inc. | System and method for evaluating lead stability of an implantable medical device |
US10806511B1 (en) * | 2014-11-14 | 2020-10-20 | William Sauer | Partially insulated focused radiofrequency ablation catheter |
US11284572B2 (en) | 2014-12-05 | 2022-03-29 | Pivot Pup Irrigation, LLC | Irrigating soils and crops |
US11234767B2 (en) | 2015-01-07 | 2022-02-01 | Stereotaxis, Inc. | Method and apparatus for automated control and steering of multiple medical devices with a single interventional remote navigation system |
WO2016112227A1 (en) * | 2015-01-07 | 2016-07-14 | Stereotaxis, Inc. | Method and apparatus for automated control of multiple medical devices with a single interventional remote navigation system |
US11419674B2 (en) | 2015-03-31 | 2022-08-23 | St. Jude Medical, Cardiology Division, Inc. | Methods and devices for delivering pulsed RF energy during catheter ablation |
US11350986B2 (en) | 2015-03-31 | 2022-06-07 | St. Jude Medical, Cardiology Division, Inc. | High-thermal-sensitivity ablation catheters and catheter tips |
US11246658B2 (en) | 2016-10-04 | 2022-02-15 | St. Jude Medical, Cardiology Division, Inc. | Ablation catheter tip |
US20190175282A1 (en) * | 2017-12-12 | 2019-06-13 | Acclarent, Inc. | Tissue shaving instrument with navigation sensor |
US10959785B2 (en) * | 2017-12-12 | 2021-03-30 | Acclarent, Inc. | Tissue shaving instrument with navigation sensor |
WO2020198150A3 (en) * | 2019-03-22 | 2020-11-05 | Stryker Corporation | Systems for ablating tissue |
US20210369373A1 (en) * | 2020-05-28 | 2021-12-02 | The Chinese University Of Hong Kong | Mobile-electromagnetic coil-based magnetic actuation systems |
WO2023034319A1 (en) * | 2021-08-30 | 2023-03-09 | Stereotaxis, Inc. | Magnetically steerable irrigated ablation catheters, and systems and methods thereof |
WO2023129842A3 (en) * | 2021-12-28 | 2023-08-31 | Atricure, Inc. | Magnetically coupled ablation components |
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US10499985B2 (en) | 2019-12-10 |
US20200129232A1 (en) | 2020-04-30 |
EP2211710A4 (en) | 2010-12-15 |
EP2211710B1 (en) | 2015-04-29 |
EP2211710A1 (en) | 2010-08-04 |
US11478300B2 (en) | 2022-10-25 |
US9549777B2 (en) | 2017-01-24 |
US20160030110A1 (en) | 2016-02-04 |
US20170143417A1 (en) | 2017-05-25 |
WO2009070448A1 (en) | 2009-06-04 |
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