Surgery – Instruments – Electrical application
Reexamination Certificate
1999-03-25
2001-09-11
Gibson, Roy (Department: 3739)
Surgery
Instruments
Electrical application
C606S042000, C607S099000, C607S101000
Reexamination Certificate
active
06287306
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to ablation catheters. In particular, the present invention relates to a linear lesion ablation catheter for producing a generally even temperature profile along the length of the catheter.
2. Description of Related Art
Ablation catheters are well recognized and important tools for conveying an electrical stimulus to selected locations within the human body. Ablation catheters have been used for many years for the treatment of certain types of cardiac arrhythmia. For example, ablation catheters have been used to interrupt or modify existing conduction pathways associated with arrhythmias within the heart. Ablation procedures also are used for the treatment of atrial ventricular (AV) nodal re-entrant tachycardia. Accepted treatments of this condition include ablation of the fast or slow AV nodal pathways. Known cardiac ablation procedures focus on the formation of lesions within the chambers of the heart at selected locations which will either prevent the passage of electrical signals associated with atrial premature contractions or prevent the formation of improper electrical pathways within the heart which can result in atrial arrhythmia.
Radio frequency (RF) catheter ablation has become increasingly popular for many symptomatic arrhythmias such as AV nodal re-entrant tachycardia, AV reciprocating tachycardia, idiopathic ventricular tachycardia, and primary atrial tachycardias. Nath, S., et al., “Basic Aspects Of Radio Frequency Catheter Ablation,”
J Cardiovasc Electrophysiol,
Vol. 5, pgs. 863-876, October 1994. RF ablation is also a common technique for treating disorders of the endometrium and other body tissues including the brain.
A typical RF ablation system in its most basic form comprises an RF generator which feeds current to a catheter containing a conductive electrode for contacting targeted tissue. The system is completed by a return path to the RF generator, provided through the patient and a large conductive plate, which is in contact with the patient's back.
The standard RF generator used in catheter ablation produces an unmodulated sine wave alternating current at frequencies of approximately 500 to 1000 kHz. The RF energy is typically delivered into the patient between the electrode of the catheter and the large conductive plate in contact with the patient's back. During the delivery of the RF energy, alternating electrical current traverses from the electrode through the intervening tissue to the back plate. The passage of current through the tissue results in electromagnetic heating. Heating tissue to temperatures above 50° C. is required to cause irreversible myocardial tissue injury. However, heating tissue to temperatures above approximately 100° C. at the electrode/tissue interface can result in boiling of plasma and adherence of denatured plasma proteins to the ablation electrode. The formation of this coagulum on the electrode causes a rapid rise in electrical impedance and a fall in the thermal conductivity, resulting in loss of effective myocardial heating. Nath, S., et al., “Basic Aspects Of Radio Frequency Catheter Ablation,”
J Cardiovasc Electrophysiol,
Vol. 5, pgs. 863-876, October 1994. Moreover, such extreme heating of the tissues can damage healthy tissue surrounding the targeted lesion.
Ablation catheters for burning lines in tissue are known. Examples of ablation catheters capable of forming linear lesions are shown in U.S. Pat. No. 5,720,775 to Larnard; U.S. Pat. No. 5,528,609 to Swanson; U.S. Pat. No. 5,549,661 to Kordis; U.S. Pat. No. 5,545,193 to Fleischmann; and U.S. Pat. No. 5,575,810 to Swanson. In these known linear ablation catheters, the current density of the linear conductive electrode portion is typically relatively stable in the center of the conductive electrode and tends to approach infinity at the ends of the conductive electrode. These areas of high current density lead to “edge effects” which can cause blood coagulation in these regions, which as stated above, causes a rapid rise in electrical impedance and a fall in the thermal conductivity resulting in a loss of effective myocardial heating. “Edge effects” also can cause extreme heating in the edge areas which can cause undesired tissue damage to healthy tissue surrounding the target tissue.
SUMMARY OF THE INVENTION
A linear lesion ablation catheter and method of the present invention includes a conductive ablating portion having a predetermined resistivity profile and/or voltage potential pattern for ablating tissue in a generally even temperature profile. In one embodiment, the conductive ablating portion is disposed on a distal portion of an elongate flexible member and has a resistance that increases exponentially along a portion of its length from a center of the ablating portion to a non-infinite value at opposite ends of the ablating portion. The ablating portion is adapted to produce a generally even temperature profile along a length of its surface when the ablating portion is in contact with a target tissue within a patient's body and an electrical ablating signal is applied to the ablating portion.
In one embodiment, the conductive ablating portion comprises a plurality of electrically connected conductive regions which extend from the center to the opposite ends of the ablating portion. In an even more specific embodiment, each of the conductive regions has a resistance value wherein the resistance values increase from section to section in successive orders of magnitude from the center of the ablating portion to the opposite ends of the ablating portion exponentially up to a non-infinite value.
The predetermined resistivity profile produces linear lesions on target tissue without the resulting “edge effects” or “hot spots” at the ends of the electrode common in prior art linear lesion ablation catheters.
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Kroll Mark W.
Ockuly John D.
Pendakanti Rajesh
Cox Scott R.
Daig Corporation
Gibson Roy
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