Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical energy applicator
Patent
1997-04-24
1998-09-22
Jastrzab, Jeffrey R.
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical energy applicator
A61N 105
Patent
active
058108874
DESCRIPTION:
BRIEF SUMMARY
This application claims priority to U.S. Provisional Patent Application No. 60/002,815, filed Aug. 25, 1995, and to U.S. Provisional Patent Application No. 60/019,835, filed Jun. 17, 1996.
TECHNICAL FIELD
This invention relates to a disposable catheter for temporary insertion into the body, for example, through a venepuncture, and more specifically, to a diagnostic electrophysiology catheter which can diagnose underlying cardiac arrhythmias and can treat the diagnosed arrhythmias by stimulating the human heart with pacing, cardioversion, defibrillation, and/or radiofrequency ablation energies.
BACKGROUND ART
The human heart is a complex muscular organ which is responsible for pumping blood throughout the body. The heart contains four chambers, namely, the right atrium, the right ventricle, the left atrium, and the left ventricle. Blood enters the right chambers of the heart from veins all over the body, is pumped into the lungs where it becomes saturated with oxygen, and then is pumped into the left ventricle where it is pumped throughout the body.
To accomplish this task, the human heart has "pacemaker cells" which are responsible for the rhythmic contraction of the heart. These pacemaker cells are made of nerve bundles and fibers and consist of several nodes and branches. The atrial contractions are governed by the sino-atrial node. Nerve tracts from the sino-atrial node extend to the atrial-ventricular node at the base of the right atrium. The sino-atrial node and its corresponding nerve tracts are responsible for rhythmic atrial contractions. Large nerve tracts extend from the atrial-ventricular node to the ventricular chambers of the heart. These tracts are called the right and left bundle branches. These nerve fibers extend throughout the ventricles and are responsible for synchronous ventricular contractions. Occasionally, abnormal heart rhythms or contractions can occur due to other cells acting as pacemaker cells or blocking the accessory conduction pathways. These irregular heart rhythms or arrhythmias can be lethal, resulting in strokes and cardiac arrest. Arrhythmias can originate in the atrium resulting in atrial tachyarrhythmias and/or atrial fibrillation which may be a precursor to strokes. Ventricular tachyarrhythmias may result in minimal blood pumping through the heart and may possibly lead to cardiac arrest or ventricular fibrillation, both which can be fatal.
Electrophysiological (EP) testing is typically used to diagnose arrhythmias in a patient and this testing involves the passing of several diagnostic EP catheters into the right side of the heart. These EP catheters typically include several sensing rings and a distal tip electrode for the delivery of low energy pacing pulses directly to the heart. The electrical signals of the heart are sensed with the ring electrodes and once an aberrant pathway is determined, low energy pacing pulses are applied to the heart tissue at various intervals or frequencies in order to induce or start the arrhythmia. Once the arrhythmia is induced, it must be terminated and this termination of the arrhythmia is typically accomplished by delivering a high energy defibrillation shock across the patient's chest (transthoracic shocks) with paddles. A specific very high voltage or voltage gradient, namely, a therapeutic voltage, is required within the heart to terminate the induced arrhythmias. Since the thoracic cavity and the skin dissipate much of the applied voltage through resistance, the voltage delivered through a transthoracic defibrillator paddle is substantially greater than the necessary therapeutic voltage in order to compensate for the energy losses through the skin and the thoracic cavity and to ensure that the necessary therapeutic voltage does reach the heart. Unfortunately, the delivery of these external shocks are painful to the patient because these external shocks produce skin burns and, since these external shocks are not directly applied to the heart, a misalignment of the paddles may also result in insufficient voltage reaching t
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Accorti, Jr. Peter R.
Luceri Richard
Scott Steven E.
Jastrzab Jeffrey R.
Rhythm Technologies, Inc.
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