Surgery – Diagnostic testing – Structure of body-contacting electrode or electrode inserted...
Utility Patent
1999-08-27
2001-01-02
Dvorak, Linda C. M. (Department: 3739)
Surgery
Diagnostic testing
Structure of body-contacting electrode or electrode inserted...
C600S374000, C600S585000, C604S264000, C604S528000, C606S041000, C607S119000, C607S122000
Utility Patent
active
06169916
ABSTRACT:
BACKGROUND OF THE INVENTION
Electrophysiology catheters are designed for use in mapping and/or ablation of the heart. Electrophysiology catheters typically include a number of band electrodes mounted to the tip portion of the catheter shaft and a tip electrode at the distal end of the catheter shaft. To properly manipulate the electrodes against the target sites within a heart, the tip portion must be flexible and capable of being manipulated into a variety of shapes. U.S. Pat. application Ser. No. 5,487,757, entitled “Multicurved Deflectable Catheter,” the disclosure of which is incorporated by reference, discloses an electrophysiology catheter in which the tip portion can be deflected radially by pulling on a manipulator wire and also defected laterally by rotating a core wire which extends into the tip section. In addition to the manipulator and core wires, this patent discloses the use of an axially slidable stiffener wire, the distal end of which can be located at different positions along the tip portion to change the stiffness of the tip, and thus the general size of the curve in the tip.
SUMMARY OF THE INVENTION
The present invention is directed to an electrophysiology catheter which combines the function of a torquable core wire and a slideable stiffener wire into a single element. In addition, the invention provides for the construction of the electrophysiology catheter in a manner so that the lateral deflection can be substantially in-plane lateral deflection.
The electrophysiology catheter includes a handle from which a catheter shaft extends. The catheter shaft has a flexible tip portion carrying one or more electrodes. A radial deflection element, typically a manipulator wire, connects the tip portion to a first manipulator mounted to the handle. operating the first manipulator causes the tip portion to be deflected or curved radially. A multifunction wire extends from the handle to within the tip portion. The multifunction wire has a distal end which slides within a multifunction lumen formed in the tip portion. This effectively changes the stiffness of the tip portion so to change the general size of the curve in the tip. The multifunction wire is coupled to a second manipulator mounted to the handle. The second manipulator is constructed to allow the user to slide the multifunction wire longitudinally along the catheter shaft so to position the distal end of the multifunction wire at a chosen position along the multifunction lumen within the tip portion. The distal end of the multifunctional wire and the multifunction lumen are configured, that is keyed to one another, to provide interfering torquing surfaces. The user uses a third manipulator to rotate the proximal end of the multifunction wire about its longitudinal axis. This causes the distal end of the multifunction wire to exert a torquing force against the interfering torquing surface of the multifunction lumen, thus causing lateral deflection of the radially curved tip portion.
Another aspect of the invention relates to the ability to maintain the lateral deflection as substantially in-plane lateral deflection. That is, after the tip portion has been deflected radially to its desired curved shape by the manipulator wire, rotating or torquing the multifunction wire preferably results in lateral deflection of the tip portion such that the longitudinal position of the distal end of the tip portion does not change substantially. In-plane lateral deflection can be achieved by one or both of the following. One way is to ensure that the radial curvature of the tip portion is not proximal of the engaged torque-transmitting, interfering torquing surfaces. Because the main portion of the catheter shaft is commonly torsionally stiff, and thus difficult to torque, it is often preferred to limit the longitudinal sliding movement of the multifunction wire so that at its most proximal position, the distal end of the multifunction wire is at least a chosen, minimum distance from the junction of the tip and main portions of the catheter shaft. A second way to achieve in-plane lateral deflection is to ensure that the catheter shaft adjacent to the junction of the tip and main portions of the catheter shaft is torsionally permissive; that is it has low torsional stiffness and is highly torquable or twistable. This can be achieved either by selecting the catheter shaft material at the junction to be highly torquable, by using a rotary joint at the junction, or by other means as well. Using one or both of these approaches, lateral deflection can therefore be totally, or at least substantially, in-plane lateral deflection.
In the preferred embodiment the torque-transmitting distal end of the multifunction wire is sufficiently flexible so it can be bent or flexed radially by pulling or pushing on the manipulator wire; however the remainder of the multifunction wire is preferably stiff enough so not to be bent, to any substantial extent, by pulling or pushing on the manipulator wire. This effectively ensures that the radially-deflected part of the tip portion will not be proximal of the engaged torque-transmitting, interfering torquing surfaces.
Another advantage arises from the fact that only two wires, instead of three wires as in the past, need to be used to obtain the three functions of radial deflection, lateral deflection and change of tip curvature. This permits a larger-diameter manipulator wire to be used because there is more room available for the manipulator wire. The larger diameter manipulator wire has greater columnar strength so to permit the radially-deflected tip portion to be returned to its original, straight shape by pushing on the manipulator wire. This is unlike smaller-diameter, less-stiff manipulator wires which may not have the columnar strength to completely re-straighten the tip portion when the manipulator wire is pushed distally from the handle. This aspect can also permit the tip portion to be deflected in opposite directions depending on whether the manipulator wire is pulled or pushed.
Other features and advantages of the invention will appear from the following description from which the preferred embodiment has been set forth in detail in conjunction with the accompanying drawings.
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Dvorak Linda C. M.
Latham Daniel W.
Medtronic Inc.
Patton Harold R.
Ruddy David M.
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