WO1995007657A1 - Mapping and ablation system, catheter and method - Google Patents

Mapping and ablation system, catheter and method Download PDF

Info

Publication number
WO1995007657A1
WO1995007657A1 PCT/US1994/009810 US9409810W WO9507657A1 WO 1995007657 A1 WO1995007657 A1 WO 1995007657A1 US 9409810 W US9409810 W US 9409810W WO 9507657 A1 WO9507657 A1 WO 9507657A1
Authority
WO
WIPO (PCT)
Prior art keywords
ablation
catheter
arms
heart
carried
Prior art date
Application number
PCT/US1994/009810
Other languages
French (fr)
Inventor
Mir Imran
Original Assignee
Cardiac Pathways Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiac Pathways Corporation filed Critical Cardiac Pathways Corporation
Priority to AU78696/94A priority Critical patent/AU7869694A/en
Publication of WO1995007657A1 publication Critical patent/WO1995007657A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/445—Details of catheter construction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/4461—Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00778—Operations on blood vessels
    • 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
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • 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
    • 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
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • 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
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic

Definitions

  • This invention relates to an endocardial mapping and ablation system utilizing a separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method.
  • U.S. Patent No. 5,156,161 there is disclosed an endocardial mapping and ablation catheter with circumferentially spaced apart electrodes carried by a plurality of longitudinally extending circumferentially spaced-apart arms.
  • it has been found that it is important after the arms have been deployed in a chamber of the heart to ascertain the locations of the arms to ascertain whether or not the arms are equally spaced apart and if not the spacing between the arms so that corrections can be made in the mapping calculations to account for the various spacings between the arms.
  • Another object of the invention is to provide a catheter and method of the above character which makes it possible to ascertain the depth of a lesion formed by the ablation catheter.
  • FIG. 1 is a schematic illustration showing the use of an endocardial mapping and ablation system utilizing a separately controlled ablation catheter with ultrasonic imaging capabilities deployed in a chamber of the heart to be used for mapping and ablation.
  • FIG. 2 is a view of one of the arms shown in FIG. 1 looking along the line 2-2 of FIG. 1.
  • FIG. 3 is a cross-sectional view taken along the line 3-3 of FIG. 2.
  • FIG. 4 is an enlarged cross-sectional view of the distal extremity of the separately controlled steerable ablation catheter with ultrasonic imaging capabilities incorporating the present invention.
  • FIG. 5 is a cross-sectional view of another embodiment of an ablation catheter incorporating the present invention having forward looking ultrasonic capabilities.
  • FIG. 6 is a view looking along the line 6-6 of FIG. 5.
  • the endocardial mapping and ablation system incorporating the present invention is for introduction into a chamber of the heart formed by a wall and having a passage leading thereto.
  • a catheter probe is provided having a distal extremity which is provided with a plurality of longitudinally extending circumferentially spaced-apart arms. The arms carry a plurality of electrodes adapted to face the wall forming the chamber of the heart.
  • An ablation catheter is carried by and is slidably mounted in the catheter probe and has a distal extremity movable into the chamber of the heart in which the catheter probe is disposed.
  • the ablation catheter has control means whereby the distal extremity of the ablation catheter can be moved independently of movement of the catheter probe while the distal extremity of the catheter probe is disposed in the chamber.
  • the ablation catheter has an ablation electrode mounted on the distal extremity.
  • Ultrasonic viewing means is carried by the distal extremity of the ablation catheter.
  • the arms of the catheter probe having markers encoding said arms. The markers are visible ultrasonically whereby specific arms can be identified ultrasonically and the spacing between the arms can be ascertained.
  • the ultrasonic viewing capabilities of the ablation catheter also makes it possible to view the location in the wall where an ablation is to be performed to ensure that the ablation is in contact with the wall of the heart.
  • FIG. 1 the endocardial mapping and ablation system 11 utilizing a separately controlled steerable ablation catheter with ultrasonic imaging capabilities is shown in FIG. 1. It consists of a catheter probe 12 and an ablation catheter 13 carried thereby and slidably mounted therein.
  • the catheter probe 12 is described in detail in the U.S. Patent No. 5,156,161 and also in copending application Serial No. 07/894,529, filed on June 5, 1992.
  • As described therein it is comprised of a flexible elongate member 16 formed of a suitable material such as plastic which is provided with proximal and distal extremities 17 and 18.
  • the catheter probe 12 can be provided with a plurality of lumens (not shown) extending from the proximal extremity 17 to the distal extremity 18 as shown in copending application Serial No. 07/894,529, filed on June 5, 1992.
  • the catheter probe 12 is also provided with a plurality of longitudinally and radially spaced-apart electrodes 21.
  • Expandable means 22 is provided for carrying the electrodes 21 and as shown is formed of a plurality of longitudinally extending arms 23 the proximal extremities of which are secured to the distal extremity of the flexible elongate member 16 and the distal extremities of which are secured together in a cylindrical tip 24.
  • Various means can be provided (not shown) for moving the arms between contracted and expanded positions.
  • pull wires such as disclosed in the application Serial No. 07/894,529, filed on June 5, 1992 can be utilized or alternatively the arms can be formed with a shape memory material as disclosed in copending application Serial No.
  • the electrodes 26 are connected by conductors extending into the arms 23 and through one or more lumens of the flexible elongate member 16 to the proximal extremity 17 and thence to the power supply and control console 26 where mapping procedures can be carried out.
  • the ablation catheter 13 is a separate device slidably mounted in a lumen (not shown) of the flexible elongate member 16.
  • the flexible elongate member 31 can be formed of a suitable material such as a medical grade plastic and is provided with a plurality of lumens as described in Patent application, Serial No. 07/894,529, filed on June 5, 1992.
  • a cylindrical tip 36 is provided on the distal extremity 32 of the flexible elongate member 31 and typically is formed of a material which is transparent to ultrasonic energy for purposes hereinafter described.
  • the tip 36 is secured to the distal extremity 33 by a suitable means such as an adhesive.
  • the distal extremity of the cylindrical tip 36 is closed off by a hemispherical tip 37 formed of a suitable conductive material such as platinum and which is bonded to the distal extremity of the cylindrical tip member 36.
  • a conductor 38 is bonded to the tip 37 and extends to the proximal extremity of the flexible elongate member 31 and is connected to the power supply and control console 26 so that RF energy to be used for ablation can be supplied to the tip 37 when desired.
  • Means (not shown) is provided for steering the distal extremity 33 of the flexible elongate member 31 and can be of the type described in copending application, Serial No. 07/894,529, filed on June 5, 1992.
  • the distal extremity of the ablation catheter 13 is provided with ultrasonic imaging capabilities which takes the form of an ultrasonic transducer 41 of a conventional type which is secured to a support member 42 mounted within a cavity 43 of the cylindrical tip member 36.
  • the support member 42 is mounted in the fixed position immediately proximal of the tip 37 in such a manner so that the ultrasonic transducer 41 extends at an angle which is substantially perpendicular to the axis of the cylindrical tip member 36.
  • Conductors 46 are connected to the front and rear sides of the ultrasonic transducer 41 and extend through lumens (not shown) to the proximal extremity of the flexible elongate member 31 and are connected to the signal generator and processor 47.
  • a member 51 is disposed within the cavity 43 immediately proximal of the transducer 41 is formed of a material such as a reflecting metal which is capable of reflecting ultrasonic energy and is usually provided with an inclined surface which is inclined at a suitable angle, as for example 45° so that it is able to reflect and receive ultrasonic energy at a 45° angle with respect to the longitudinal axis of the cavity 43.
  • the inclined surface 52 on the member 51 which is circular in cross- section reflects an oval-shaped beam 53 through the wall of the cylindrical tip member 36 in a direction which is substantially perpendicular to the axis of the cylindrical member 51.
  • the cylindrical member 51 can remain stationary permitting a different angle of view to be achieved by steering the distal extremity 33 of the flexible elongate member 31 and viewing the reflected ultrasonic energy or echoes by the surface 52 which directs them to the transducer 41 that converts them to electrical energy.
  • This electrical energy in the form of electrical signals is transmitted through the wires 46 to the signal generator and processor 47 which supplies the information to a video display 56.
  • the cylindrical member 51 can be secured to a flexible cable 61 which can extend to the proximal extremity of the flexible elongate member 31 where it can be attached to a handle (not shown) and rotated manually.
  • the cylindrical member 51 can be moved longitudinally with respect to the tip member 36 toward and away from the transducer 41 to provide viewing of a larger region surrounding and extending longitudinally of the tip member 36.
  • the flexible cable 61 can be connected to a motor (not shown) also provided in the handle as described in Patent No. 4,794,931 so that the ultrasonic signals are directed outwardly and received inwardly relative to the longitudinal axis of rotation of the rotatable element 51 to thereby permit rapid and substantially continuous viewing of the region surrounding the distal extremity of the ablation catheter.
  • the arms 23 of the catheter probe 12 are encoded with markers 66 (see FIGS. 2 and 3) which are visible to ultrasonic energy.
  • markers 66 have been provided in the form of encapsulated air bubbles.
  • one of the markers 66 can be placed on one of the arms 23, two markers 66 on the second arm, three markers
  • Such air bubbles 66 can be formed in an arm 23 by providing a lumen
  • Patent No. 5,156,161 and as described therein can be introduced through the superior or inferior vena cava into the right atrium and then advanced into the right ventricle 71 which is in one of the chambers of the heart 72 formed by a wall 73 which has a passage 74 leading thereto as hereinafter described of a patient under examination.
  • the catheter probe 12 is operated to cause the expandable means 22 to expand from a contracted position and move the arms 23 and the electrodes 21 carried thereby into engagement with the wall 73 of the heart 72 as shown particularly in FIG. 1.
  • the various potentials which are detected by the electrodes 21 are supplied to a computer (not shown) to form an isochronal map which can be displayed on a computer screen (not shown) .
  • the computer in making computations for making the isochronal map generally assumes that the arms are spaced-apart equally in a circumferential direction. It has been found that this is not necessarily the case because of abnormalities in the wall of the heart forming the chamber in which the probe is disposed and for other reasons. In order to provide a more accurate isochronal map, it is therefore desirable that the spacing between the various arms be ascertained. This can be accomplished by appropriately positioning the distal extremity 33 of the ablation catheter 13.
  • the ablation catheter 13 can be inserted into the chamber of the heart at the same time the catheter probe 12 is inserted or if desired it can be inserted after the catheter probe 12 has been positioned in the chamber 71. In either event, the ablation catheter 13 has its distal extremity 33 moved into a position in which the arms 23 can be viewed interiorly and the markers 66 carried by the interior surfaces of the arms 23 can be viewed.
  • This ultrasonic viewing makes it possible to ascertain the spacing between the various arms and also to identify the arms.
  • This information is supplied to the signal generator and processor 47 and to the video display 56 as well as to the computer 76 so that it can be utilized for making corrections in the computations with respect to the spacing between the arms to provide a more accurate isochronal map of the potentials being mapped.
  • this ultrasonic imaging can be achieved by manually moving the distal extremity 33 of the ablation catheter 13 to obtain the desired ultrasonic viewing.
  • the cylindrical member 51 can be rotated manually or advanced longitudinally manually. Also, alternatively the cylindrical member 51 can be rotated by motor means.
  • the ablation catheter 13 can be utilized for viewing the area of the wall 73 in which an ablation is to be performed to ascertain whether or not the site for the ablation is appropriate and to be sure that critical parts of the heart within the chamber, as for example a valve will not be ablated.
  • the distal extremity 33 of the ablation catheter 13 is moved into engagement with the wall with the tip 37 engaging the wall.
  • the side viewing ultrasonic capabilities of the distal extremity 33 of the ablation catheter 13 can be utilized to view that region immediately prior to ablation being performed to be sure that the distal extremity of the ablation catheter is appropriately positioned. If not, the catheter can be moved until it is in the proper position. In this manner it is possible with the system and method of the present invention to ensure that the ablation will occur in the proper location and that critical parts of the heart, as for example valve apparatus will not be damaged.
  • FIGS. 1 and 2 Another embodiment of a separately controlled steerable ablation catheter 81 is shown in FIGS. 1 and 2, and as shown therein consists of a flexible elongate tubular member 82 of which only the distal extremity 83 is shown, which can be constructed in the manner disclosed in copending application Serial No. 07/983,732 filed on December 1, 1992.
  • An ablation tip 86 formed of a suitable material such as platinum and having a hemispherical extremity as shown is secured to the distal extremity 83. It is connected to a conductor 87 which extends through the flexible elongate tubular member 82 to the proximal extremity (not shown) and thence to a control console 91 of the type described in copending application Serial No.
  • the catheter 81 is provided with forward looking ultrasonic capabilities and is provided with an ultrasonic transducer 96 that is mounted within a circular recess 97 extending inwardly of the tip 86.
  • the ultrasonic transducer 96 is coated with an appropriate insulating material, as for example a hydrogel, which in addition to isolating the same from the tip 86 also serves to provide a good impedance match between the transducer 96 and the medium in which the catheter 81 is disposed, as for example in blood.
  • the front and back sides of the ultrasonic transducer 96 are connected to conductors 99 which extend from the transducer through a bore 101 in the tip electrode 86 to the proximal extremity where they are connected into the instrumentation 91 which is provided the capabilities for supplying electrical signals to the transducer and to receive electrical signals from the ultrasonic transducer 96.
  • the ablation catheter 81 in connection with performing an ablation in the myocardium 106 may now be briefly described as follows. Assuming that it has been established that it is desired to perform an ablation in the myocardium, the ablation catheter is introduced into the heart in a conventional manner. When it is in the heart during mapping procedures, the echoes which are returned and picked up by the transducer 96 are observed on the screen 92. By watching the screen, it is easy to determine when the tip 86 is in contact with the wall of the heart, as for example the myocardium of the heart. When it has been determined that the ablation catheter 81 is in the desired position, radiofrequency energy can be supplied to the tip 86 to cause ablation of the myocardium 106 to occur.
  • This ablation is depicted by a lesion 107 formed in the myocardium forward of the tip 86, which lesion can be increased in size by the continued application of RF energy to create a lesion of larger size, as for example 108 represented by the broken lines.
  • the ablation catheter of the present invention it is possible to ascertain the depth of the lesion created by observing the screen 92. Since the propagation properties of ultrasound in tissue in the myocardium are well known, it is relatively easy utilizing conventional computer technology to convert echo time to depth. This is true because the transition from the lesion 107 to the tissue in the myocardium is highly echogenic, making it readily possible to ascertain this depth and to thereby precisely monitor the depth as ablation is occurring so that a lesion of the desired depth can be created.
  • the catheter 81 of the present invention it is possible to ascertain when the tip 86 is in contact with the endocardium of the myocardium, and then to determine the depth of the lesion being made and to be able to stop ablation when the appropriate depth for the lesion has been reached.
  • the catheter 81 in utilizing the present method may be utilized for ablating accessory pathways to overcome the Wolf-Parkinson-White syndrome.
  • these accessory pathways are usually on the epicardium rather than the endocardium between the junction of the atrium and the ventricle.
  • the ultrasonic information which is generated may also be very helpful in ascertaining whether or not the tip 86 is close to a valve leaflet which helps to ensure that the ablation is being carried out in the optimal location.
  • the ablation catheter 81 should be very useful in diagnosing ventricular tachycardia, where an infarct area is present. Such infarct areas typically becomes fibrous and have a border which is very echogenic just over the layer of the infarct. Thus, prior to an ablation, the catheter could be utilized to determine where the viable myocardium is compared to the infarct area. In this way it is possible to diagnose the size and shape of the infarct.
  • an endocardial mapping and ablation system in which a separately controlled steerable ablation catheter having the ultrasonic capabilities can be utilized for visualizing the arms of the catheter probe and also to ensure that any ablation which takes place, takes place in a proper portion of the wall of the wall forming the chamber of the heart.
  • the ablation catheter also can be used to recognize when it is in close proximity to the wall of the heart and to what depth a lesion is being created.

Abstract

An endocardial mapping and ablation system (11) includes a catheter probe (12) comprised of a plurality of flexible longitudinally extending circumferentially spaced apart arms (23). Electrodes (21) are carried by the arms and are adapted to be moved into engagement with the wall of the heart. Markers (66) visibly ultrasonically are carried by the arms for encoding the arms from another. An ablation catheter (13) is carried by and is slidably mounted in probe (12) and has a distal extremity movable into the heart while the probe is disposed therein. An ablation electrode (86) and ultrasonic viewing means (41) are carried by the distal extremity of the ablation catheter. The distal extremity of the ablation catheter is movable into positions to view ultrasonically the markers carried by the arms of the catheter probe so that the arms can be identified and the spacing of the arms can be ascertained.

Description

MAPPING AND ABLATION SYSTEM, CATHETER AND METHOD
This invention relates to an endocardial mapping and ablation system utilizing a separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method. In U.S. Patent No. 5,156,161 there is disclosed an endocardial mapping and ablation catheter with circumferentially spaced apart electrodes carried by a plurality of longitudinally extending circumferentially spaced-apart arms. In such a catheter, it has been found that it is important after the arms have been deployed in a chamber of the heart to ascertain the locations of the arms to ascertain whether or not the arms are equally spaced apart and if not the spacing between the arms so that corrections can be made in the mapping calculations to account for the various spacings between the arms. In addition in connection with such mapping and ablation operations it is important to be able to visualize the portion of the wall forming the chamber of the heart which is to be ablated during the procedure to be sure that ablation is not taking place in an inappropriate location, as for example at a valve.
In the Patent No. 4,794,931 there has been disclosed a catheter apparatus and system which can be utilized for ultrasonic imaging. However, there is no disclosure to how such an apparatus and system can be utilized in conjunction with an endocardial mapping and ablation catheter to achieve the desired ultrasonic imaging capabilities. There is therefore a need for an endocardial mapping and ablation system which provides the desired capabilities.
In general, it is an object of the present invention to provide an endocardial mapping and ablation system utilizing a separately controlled steerable ablation catheter with ultrasonic imaging capabilities and a method which makes possible various diagnostic and therapeutic procedures.
Another object of the invention is to provide a system, catheter and method of the above character which makes it possible to ascertain the location of the arms after they have been deployed in a chamber of the heart. Another object of the invention is to provide a system, catheter and method which makes it possible to achieve accurate results while still having the arms positioned with different spacings between each other. Another object of the invention is to provide a catheter and method of the above character in which it is possible to view the area to be ablated prior to ablation to ensure that ablation is being carried out in the appropriate location. Another object of the invention is to provide a catheter and method of the above character which makes it possible to ascertain when the myocardium has been contacted.
Another object of the invention is to provide a catheter and method of the above character which makes it possible to ascertain the depth of a lesion formed by the ablation catheter.
Additional objects and features of the invention will appear from the following description in which the preferred embodiments are set forth in detail in conjunction with the accompanying drawings. FIG. 1 is a schematic illustration showing the use of an endocardial mapping and ablation system utilizing a separately controlled ablation catheter with ultrasonic imaging capabilities deployed in a chamber of the heart to be used for mapping and ablation.
FIG. 2 is a view of one of the arms shown in FIG. 1 looking along the line 2-2 of FIG. 1.
FIG. 3 is a cross-sectional view taken along the line 3-3 of FIG. 2. FIG. 4 is an enlarged cross-sectional view of the distal extremity of the separately controlled steerable ablation catheter with ultrasonic imaging capabilities incorporating the present invention.
FIG. 5 is a cross-sectional view of another embodiment of an ablation catheter incorporating the present invention having forward looking ultrasonic capabilities.
FIG. 6 is a view looking along the line 6-6 of FIG. 5. In general, the endocardial mapping and ablation system incorporating the present invention is for introduction into a chamber of the heart formed by a wall and having a passage leading thereto. A catheter probe is provided having a distal extremity which is provided with a plurality of longitudinally extending circumferentially spaced-apart arms. The arms carry a plurality of electrodes adapted to face the wall forming the chamber of the heart. An ablation catheter is carried by and is slidably mounted in the catheter probe and has a distal extremity movable into the chamber of the heart in which the catheter probe is disposed. The ablation catheter has control means whereby the distal extremity of the ablation catheter can be moved independently of movement of the catheter probe while the distal extremity of the catheter probe is disposed in the chamber. The ablation catheter has an ablation electrode mounted on the distal extremity. Ultrasonic viewing means is carried by the distal extremity of the ablation catheter. The arms of the catheter probe having markers encoding said arms. The markers are visible ultrasonically whereby specific arms can be identified ultrasonically and the spacing between the arms can be ascertained. The ultrasonic viewing capabilities of the ablation catheter also makes it possible to view the location in the wall where an ablation is to be performed to ensure that the ablation is in contact with the wall of the heart. More in particular, the endocardial mapping and ablation system 11 utilizing a separately controlled steerable ablation catheter with ultrasonic imaging capabilities is shown in FIG. 1. It consists of a catheter probe 12 and an ablation catheter 13 carried thereby and slidably mounted therein. The catheter probe 12 is described in detail in the U.S. Patent No. 5,156,161 and also in copending application Serial No. 07/894,529, filed on June 5, 1992. As described therein it is comprised of a flexible elongate member 16 formed of a suitable material such as plastic which is provided with proximal and distal extremities 17 and 18. The catheter probe 12 can be provided with a plurality of lumens (not shown) extending from the proximal extremity 17 to the distal extremity 18 as shown in copending application Serial No. 07/894,529, filed on June 5, 1992.
The catheter probe 12 is also provided with a plurality of longitudinally and radially spaced-apart electrodes 21. Expandable means 22 is provided for carrying the electrodes 21 and as shown is formed of a plurality of longitudinally extending arms 23 the proximal extremities of which are secured to the distal extremity of the flexible elongate member 16 and the distal extremities of which are secured together in a cylindrical tip 24. Various means can be provided (not shown) for moving the arms between contracted and expanded positions. For example, pull wires such as disclosed in the application Serial No. 07/894,529, filed on June 5, 1992 can be utilized or alternatively the arms can be formed with a shape memory material as disclosed in copending application Serial No. 08/044,255, filed April 7, 1993 which can be energized and de-energized to provide movement between contracted and expanded positions. The electrodes 26 are connected by conductors extending into the arms 23 and through one or more lumens of the flexible elongate member 16 to the proximal extremity 17 and thence to the power supply and control console 26 where mapping procedures can be carried out.
The ablation catheter 13 is a separate device slidably mounted in a lumen (not shown) of the flexible elongate member 16. The flexible elongate member 31 can be formed of a suitable material such as a medical grade plastic and is provided with a plurality of lumens as described in Patent application, Serial No. 07/894,529, filed on June 5, 1992. A cylindrical tip 36 is provided on the distal extremity 32 of the flexible elongate member 31 and typically is formed of a material which is transparent to ultrasonic energy for purposes hereinafter described. The tip 36 is secured to the distal extremity 33 by a suitable means such as an adhesive. The distal extremity of the cylindrical tip 36 is closed off by a hemispherical tip 37 formed of a suitable conductive material such as platinum and which is bonded to the distal extremity of the cylindrical tip member 36. A conductor 38 is bonded to the tip 37 and extends to the proximal extremity of the flexible elongate member 31 and is connected to the power supply and control console 26 so that RF energy to be used for ablation can be supplied to the tip 37 when desired.
Means (not shown) is provided for steering the distal extremity 33 of the flexible elongate member 31 and can be of the type described in copending application, Serial No. 07/894,529, filed on June 5, 1992. The distal extremity of the ablation catheter 13 is provided with ultrasonic imaging capabilities which takes the form of an ultrasonic transducer 41 of a conventional type which is secured to a support member 42 mounted within a cavity 43 of the cylindrical tip member 36. The support member 42 is mounted in the fixed position immediately proximal of the tip 37 in such a manner so that the ultrasonic transducer 41 extends at an angle which is substantially perpendicular to the axis of the cylindrical tip member 36. Conductors 46 are connected to the front and rear sides of the ultrasonic transducer 41 and extend through lumens (not shown) to the proximal extremity of the flexible elongate member 31 and are connected to the signal generator and processor 47.
A member 51 is disposed within the cavity 43 immediately proximal of the transducer 41 is formed of a material such as a reflecting metal which is capable of reflecting ultrasonic energy and is usually provided with an inclined surface which is inclined at a suitable angle, as for example 45° so that it is able to reflect and receive ultrasonic energy at a 45° angle with respect to the longitudinal axis of the cavity 43. Thus the inclined surface 52 on the member 51 which is circular in cross- section reflects an oval-shaped beam 53 through the wall of the cylindrical tip member 36 in a direction which is substantially perpendicular to the axis of the cylindrical member 51. The cylindrical member 51 can remain stationary permitting a different angle of view to be achieved by steering the distal extremity 33 of the flexible elongate member 31 and viewing the reflected ultrasonic energy or echoes by the surface 52 which directs them to the transducer 41 that converts them to electrical energy. This electrical energy in the form of electrical signals is transmitted through the wires 46 to the signal generator and processor 47 which supplies the information to a video display 56. Alternatively, the cylindrical member 51 can be secured to a flexible cable 61 which can extend to the proximal extremity of the flexible elongate member 31 where it can be attached to a handle (not shown) and rotated manually. In addition the cylindrical member 51 can be moved longitudinally with respect to the tip member 36 toward and away from the transducer 41 to provide viewing of a larger region surrounding and extending longitudinally of the tip member 36. Alternatively the flexible cable 61 can be connected to a motor (not shown) also provided in the handle as described in Patent No. 4,794,931 so that the ultrasonic signals are directed outwardly and received inwardly relative to the longitudinal axis of rotation of the rotatable element 51 to thereby permit rapid and substantially continuous viewing of the region surrounding the distal extremity of the ablation catheter. In order to enhance the usefulness of the ablation catheter 13 in conjunction with the catheter probe 12, the arms 23 of the catheter probe 12 are encoded with markers 66 (see FIGS. 2 and 3) which are visible to ultrasonic energy. Such markers 66 have been provided in the form of encapsulated air bubbles. Thus, by way of example, one of the markers 66 can be placed on one of the arms 23, two markers 66 on the second arm, three markers
66 on the third arm, four markers 66 on the fourth arm as shown in FIG. 2, and so forth so that each of the arms can be identified when viewed ultrasonically. Such air bubbles 66 can be formed in an arm 23 by providing a lumen
67 extending longitudinally of the arm 23 and providing walls or barriers 68 of a suitable epoxy at spaced intervals and inflating the chamber forming the bubble 66 by introducing air by a syringe (not shown) penetrating the wall or barrier 68. The syringe can then be withdrawn and another barrier is formed which thereafter is penetrated by the syringe to provide another bubble 66. This procedure is continued until the desired number of bubbles have been provided to encode that arm. The other arms are encoded in a similar manner. Operation and use of the endocardial mapping and ablation system in conjunction with the separately controlled steerable ablation catheter in performing the method of the present invention may now be briefly described as follows. The method for introducing the catheter probe 12 is described in U.S. Patent No. 5,156,161 and as described therein can be introduced through the superior or inferior vena cava into the right atrium and then advanced into the right ventricle 71 which is in one of the chambers of the heart 72 formed by a wall 73 which has a passage 74 leading thereto as hereinafter described of a patient under examination. The catheter probe 12 is operated to cause the expandable means 22 to expand from a contracted position and move the arms 23 and the electrodes 21 carried thereby into engagement with the wall 73 of the heart 72 as shown particularly in FIG. 1.
As described in copending application. Serial No. 07/894,529, filed on June 5, 1992, the various potentials which are detected by the electrodes 21 are supplied to a computer (not shown) to form an isochronal map which can be displayed on a computer screen (not shown) . The computer in making computations for making the isochronal map generally assumes that the arms are spaced-apart equally in a circumferential direction. It has been found that this is not necessarily the case because of abnormalities in the wall of the heart forming the chamber in which the probe is disposed and for other reasons. In order to provide a more accurate isochronal map, it is therefore desirable that the spacing between the various arms be ascertained. This can be accomplished by appropriately positioning the distal extremity 33 of the ablation catheter 13. The ablation catheter 13 can be inserted into the chamber of the heart at the same time the catheter probe 12 is inserted or if desired it can be inserted after the catheter probe 12 has been positioned in the chamber 71. In either event, the ablation catheter 13 has its distal extremity 33 moved into a position in which the arms 23 can be viewed interiorly and the markers 66 carried by the interior surfaces of the arms 23 can be viewed.
This ultrasonic viewing makes it possible to ascertain the spacing between the various arms and also to identify the arms. This information is supplied to the signal generator and processor 47 and to the video display 56 as well as to the computer 76 so that it can be utilized for making corrections in the computations with respect to the spacing between the arms to provide a more accurate isochronal map of the potentials being mapped. As pointed out previously, this ultrasonic imaging can be achieved by manually moving the distal extremity 33 of the ablation catheter 13 to obtain the desired ultrasonic viewing. Alternatively, the cylindrical member 51 can be rotated manually or advanced longitudinally manually. Also, alternatively the cylindrical member 51 can be rotated by motor means.
In addition to utilizing the ablation catheter 13 for ascertaining the locations of the arms 23, the ablation catheter 13 can be utilized for viewing the area of the wall 73 in which an ablation is to be performed to ascertain whether or not the site for the ablation is appropriate and to be sure that critical parts of the heart within the chamber, as for example a valve will not be ablated. To accomplish this, the distal extremity 33 of the ablation catheter 13 is moved into engagement with the wall with the tip 37 engaging the wall. The side viewing ultrasonic capabilities of the distal extremity 33 of the ablation catheter 13 can be utilized to view that region immediately prior to ablation being performed to be sure that the distal extremity of the ablation catheter is appropriately positioned. If not, the catheter can be moved until it is in the proper position. In this manner it is possible with the system and method of the present invention to ensure that the ablation will occur in the proper location and that critical parts of the heart, as for example valve apparatus will not be damaged.
Another embodiment of a separately controlled steerable ablation catheter 81 is shown in FIGS. 1 and 2, and as shown therein consists of a flexible elongate tubular member 82 of which only the distal extremity 83 is shown, which can be constructed in the manner disclosed in copending application Serial No. 07/983,732 filed on December 1, 1992. An ablation tip 86 formed of a suitable material such as platinum and having a hemispherical extremity as shown is secured to the distal extremity 83. It is connected to a conductor 87 which extends through the flexible elongate tubular member 82 to the proximal extremity (not shown) and thence to a control console 91 of the type described in copending application Serial No. 07/983,732 filed on December 1, 1992. Means (not shown) can be provided for steering the distal extremity as disclosed in said copending application. Also, means can be provided for cooling the ablation tip 86 in the manner described in copending application Serial No. 07/983,732 filed on December 1, 1992.
The catheter 81 is provided with forward looking ultrasonic capabilities and is provided with an ultrasonic transducer 96 that is mounted within a circular recess 97 extending inwardly of the tip 86. The ultrasonic transducer 96 is coated with an appropriate insulating material, as for example a hydrogel, which in addition to isolating the same from the tip 86 also serves to provide a good impedance match between the transducer 96 and the medium in which the catheter 81 is disposed, as for example in blood. The front and back sides of the ultrasonic transducer 96 are connected to conductors 99 which extend from the transducer through a bore 101 in the tip electrode 86 to the proximal extremity where they are connected into the instrumentation 91 which is provided the capabilities for supplying electrical signals to the transducer and to receive electrical signals from the ultrasonic transducer 96.
Operation and use of the catheter 81 in connection with performing an ablation in the myocardium 106 may now be briefly described as follows. Assuming that it has been established that it is desired to perform an ablation in the myocardium, the ablation catheter is introduced into the heart in a conventional manner. When it is in the heart during mapping procedures, the echoes which are returned and picked up by the transducer 96 are observed on the screen 92. By watching the screen, it is easy to determine when the tip 86 is in contact with the wall of the heart, as for example the myocardium of the heart. When it has been determined that the ablation catheter 81 is in the desired position, radiofrequency energy can be supplied to the tip 86 to cause ablation of the myocardium 106 to occur. This ablation is depicted by a lesion 107 formed in the myocardium forward of the tip 86, which lesion can be increased in size by the continued application of RF energy to create a lesion of larger size, as for example 108 represented by the broken lines. Utilizing the ablation catheter of the present invention, it is possible to ascertain the depth of the lesion created by observing the screen 92. Since the propagation properties of ultrasound in tissue in the myocardium are well known, it is relatively easy utilizing conventional computer technology to convert echo time to depth. This is true because the transition from the lesion 107 to the tissue in the myocardium is highly echogenic, making it readily possible to ascertain this depth and to thereby precisely monitor the depth as ablation is occurring so that a lesion of the desired depth can be created.
Thus it can be seen that with the catheter 81 of the present invention, it is possible to ascertain when the tip 86 is in contact with the endocardium of the myocardium, and then to determine the depth of the lesion being made and to be able to stop ablation when the appropriate depth for the lesion has been reached. By way of example, the catheter 81 in utilizing the present method may be utilized for ablating accessory pathways to overcome the Wolf-Parkinson-White syndrome. Typically, these accessory pathways are usually on the epicardium rather than the endocardium between the junction of the atrium and the ventricle. The ultrasonic information which is generated may also be very helpful in ascertaining whether or not the tip 86 is close to a valve leaflet which helps to ensure that the ablation is being carried out in the optimal location.
In addition, the ablation catheter 81 should be very useful in diagnosing ventricular tachycardia, where an infarct area is present. Such infarct areas typically becomes fibrous and have a border which is very echogenic just over the layer of the infarct. Thus, prior to an ablation, the catheter could be utilized to determine where the viable myocardium is compared to the infarct area. In this way it is possible to diagnose the size and shape of the infarct.
It is apparent from the foregoing that there has been provided an endocardial mapping and ablation system in which a separately controlled steerable ablation catheter having the ultrasonic capabilities can be utilized for visualizing the arms of the catheter probe and also to ensure that any ablation which takes place, takes place in a proper portion of the wall of the wall forming the chamber of the heart. The ablation catheter also can be used to recognize when it is in close proximity to the wall of the heart and to what depth a lesion is being created.

Claims

WHAT IS CLAIMED IS:
1. In an endocardial mapping and ablation system for introduction into a chamber of the heart formed by a wall and having a passage leading thereto, a catheter probe having a distal extremity adapted to be positioned in the chamber of the heart, a plurality of flexible longitudinally extending circumferentially spaced-apart arms adapted to be disposed within the chamber of the heart, electrodes are carried by the arms and are adapted to be moved into engagement with the wall of the heart, markers visibly ultrasonically are carried by the arms for encoding the arms so that the one arm can be distinguished from another, an ablation catheter is carried by and is slidably mounted in the catheter probe and has a distal extremity movable into the chamber of the heart while the catheter probe is disposed therein, said ablation catheter having control means whereby the distal extremity can be moved independently of movement of the catheter probe while the distal extremity of the catheter probe is in the chamber of the heart, an ablation electrode is carried by the distal extremity of the ablation catheter, ultrasonic viewing means is carried by the distal extremity of the ablation catheter, the distal extremity of the ablation catheter being movable into positions to view ultrasonically the markers carried by the arms of the catheter probe so that the arms can be identified and the spacing of the arms can be ascertained.
2. A system as in Claim 1 wherein said ultrasonic viewing means is disposed in close proximity to the ablation electrode so that when the ablation electrode is moved into contact with the wall of a heart to form an ablation, the area to be ablated can be viewed ultrasonically.
3. A system as in Claim 2 together with means for creating an isochronal map of potentials being mapped within the chamber of the heart and means for correcting the isochronal map in accordance with the spacing in between the arms of the catheter probe.
4. A system as in Claim 2 wherein said ultrasonic viewing means comprises a transducer disposed in the ablation electrode and insulated therefrom and facing forwardly therefrom to propagate ultrasonic energy in a forward direction.
5. A system as in Claim 2 wherein the ultrasonic viewing means includes means for directing ultrasonic energy in a direction at right angles to the longitudinal axis of the ablation catheter.
6. An ablation catheter for introduction into a chamber of the heart formed by a wall and having a passage leading thereto, a flexible elongate member, said flexible elongate member having proximal and distal extremities, a cylindrical tip member carried by the distal extremity, a metallic conducting ablation tip carried by the tip member and ultrasonic viewing means carried by the tip member proximal of the tip for viewing in a direction which is perpendicular to the axis of the flexible elongate member.
7. A catheter as in Claim 6 wherein said ultrasonic viewing means includes means proximal of the ablation tip for viewing in a direction at right angles to the longitudinal axis of the tip member.
8. A catheter as in Claim 6 wherein said ultrasonic viewing means is disposed in the ablation tip and views in a direction forward of the ablation tip.
9. A method for endocardial mapping and ablation of the wall of a heart forming a chamber in the heart and having a passage leading thereto by the utilization of a catheter probe having a plurality of longitudinally extending circumferentially spaced-apart flexible arms with electrodes carried thereby and having ultrasonically visible markers carried by the arms encoding the arms, and an ablation catheter having a distal extremity with ultrasonic viewing capabilities carried by the distal extremity comprising introducing the catheter probe into the chamber of the heart and expanding the arms so that the electrodes carried thereby are moved into engagement with the wall forming the chamber of the heart, advancing the ablation catheter into the same chamber of the heart while the catheter probe is disposed therein, and viewing the arms with ultrasonic energy by the ablation catheter to view the ultrasonic markers carried by the arms to ascertain the identity of the arms and to ascertain the spacing between the arms.
10. A method as in Claim 9 together with the step of creating an isochronal map of the potentials measured by the electrodes in contact with the wall forming the chamber and revising the isochronal map in accordance with the spacing between the arms.
11. A method as in Claim 9 together with the step of advancing the ablation catheter so that an ablation electrode carried thereby is in engagement with the wall of the heart and viewing ultrasonically the portion of the wall engaged by the electrode to ascertain whether or not the ablation electrode is located appropriately to perform the desired ablation.
12. A method for ablation of the wall of the heart to forming a chamber in the heart and having a passage leading thereto by the utilization of an ablation catheter having a distal extremity with an ablation electrode carried thereby and having ultrasonic viewing capabilities carried by the distal extremity in close proximity to the ablation electrode comprising introducing the ablation catheter into the vessel, ascertaining where an ablation is to be performed, advancing the ablation electrodes to contact with the portion of the wall of the heart in which an ablation is to be performed, and viewing the region in which the ablation is to be performed to ascertain whether it is an appropriate location for performing an ablation.
13. A method as in Claim 12 together with the step of ultrasonically ascertaining the depth of a lesion and terminating an ablation when the appropriate depth has been reached.
PCT/US1994/009810 1993-09-14 1994-09-01 Mapping and ablation system, catheter and method WO1995007657A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU78696/94A AU7869694A (en) 1993-09-14 1994-09-01 Mapping and ablation system, catheter and method

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/121,166 US5409000A (en) 1993-09-14 1993-09-14 Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method
US08/121,166 1993-09-14

Publications (1)

Publication Number Publication Date
WO1995007657A1 true WO1995007657A1 (en) 1995-03-23

Family

ID=22394996

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/009810 WO1995007657A1 (en) 1993-09-14 1994-09-01 Mapping and ablation system, catheter and method

Country Status (3)

Country Link
US (1) US5409000A (en)
AU (1) AU7869694A (en)
WO (1) WO1995007657A1 (en)

Cited By (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0774232A1 (en) * 1995-11-09 1997-05-21 Cordis Corporation Guiding catheter with ultrasound imaging capability
EP0812568A2 (en) * 1996-06-11 1997-12-17 Roke Manor Research Limited Catheter tracking system and method
WO1998018388A1 (en) * 1996-10-28 1998-05-07 Ep Technologies, Inc. Systems and methods for visualizing interior tissue regions
US5770599A (en) * 1995-04-27 1998-06-23 Zeneca Limited Quinazoline derivatives
US5848969A (en) * 1996-10-28 1998-12-15 Ep Technologies, Inc. Systems and methods for visualizing interior tissue regions using expandable imaging structures
WO1999005971A1 (en) * 1997-08-01 1999-02-11 Cardiac Pathways Corporation System for electrode localization using ultrasound
US6200310B1 (en) 1997-01-08 2001-03-13 Biosense, Inc. Monitoring of myocardial revascularization
US6203493B1 (en) 1996-02-15 2001-03-20 Biosense, Inc. Attachment with one or more sensors for precise position determination of endoscopes
US6211666B1 (en) 1996-02-27 2001-04-03 Biosense, Inc. Object location system and method using field actuation sequences having different field strengths
US6253770B1 (en) 1996-02-15 2001-07-03 Biosense, Inc. Catheter with lumen
US6266551B1 (en) 1996-02-15 2001-07-24 Biosense, Inc. Catheter calibration and usage monitoring system
US6285898B1 (en) 1993-07-20 2001-09-04 Biosense, Inc. Cardiac electromechanics
US6314310B1 (en) 1997-02-14 2001-11-06 Biosense, Inc. X-ray guided surgical location system with extended mapping volume
US6321109B2 (en) 1996-02-15 2001-11-20 Biosense, Inc. Catheter based surgery
US6332089B1 (en) 1996-02-15 2001-12-18 Biosense, Inc. Medical procedures and apparatus using intrabody probes
US6366799B1 (en) 1996-02-15 2002-04-02 Biosense, Inc. Movable transmit or receive coils for location system
US6443974B1 (en) 1996-07-28 2002-09-03 Biosense, Inc. Electromagnetic cardiac biostimulation
US6447504B1 (en) 1998-07-02 2002-09-10 Biosense, Inc. System for treatment of heart tissue using viability map
US6618612B1 (en) 1996-02-15 2003-09-09 Biosense, Inc. Independently positionable transducers for location system
EP1362553A1 (en) * 1996-06-11 2003-11-19 Roke Manor Research Limited Catheter tracking system and method
US6788967B2 (en) 1997-05-14 2004-09-07 Biosense, Inc. Medical diagnosis, treatment and imaging systems
US6915149B2 (en) 1996-01-08 2005-07-05 Biosense, Inc. Method of pacing a heart using implantable device
US6983179B2 (en) 1993-07-20 2006-01-03 Biosense, Inc. Method for mapping a heart using catheters having ultrasonic position sensors
WO2011014804A1 (en) 2009-07-31 2011-02-03 St. Jude Medical, Atrial Fibrillation Division, Inc. Methods and apparatus for detecting and mapping tissue interfaces
WO2016079659A1 (en) * 2014-11-18 2016-05-26 Koninklijke Philips N.V. Visualization apparatus for property change of a tissue

Families Citing this family (395)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6014590A (en) * 1974-03-04 2000-01-11 Ep Technologies, Inc. Systems and methods employing structures having asymmetric mechanical properties to support diagnostic or therapeutic elements in contact with tissue in interior body regions
US5324284A (en) * 1992-06-05 1994-06-28 Cardiac Pathways, Inc. Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method
US6240307B1 (en) 1993-09-23 2001-05-29 Endocardial Solutions, Inc. Endocardial mapping system
US5662108A (en) * 1992-09-23 1997-09-02 Endocardial Solutions, Inc. Electrophysiology mapping system
US7189208B1 (en) 1992-09-23 2007-03-13 Endocardial Solutions, Inc. Method for measuring heart electrophysiology
US7930012B2 (en) * 1992-09-23 2011-04-19 St. Jude Medical, Atrial Fibrillation Division, Inc. Chamber location method
ATE160273T1 (en) * 1992-09-23 1997-12-15 Endocardial Solutions Inc ENDOCARDIAL MAPPING SYSTEM
US5566096A (en) * 1992-11-13 1996-10-15 Quinton Electrophysiology Corporation Integrated electrical signal switching and amplifying system
US6233491B1 (en) 1993-03-16 2001-05-15 Ep Technologies, Inc. Cardiac mapping and ablation systems
US5630837A (en) * 1993-07-01 1997-05-20 Boston Scientific Corporation Acoustic ablation
US5391199A (en) * 1993-07-20 1995-02-21 Biosense, Inc. Apparatus and method for treating cardiac arrhythmias
US5881727A (en) * 1993-10-14 1999-03-16 Ep Technologies, Inc. Integrated cardiac mapping and ablation probe
ES2129803T3 (en) * 1993-12-22 1999-06-16 Sulzer Osypka Gmbh ULTRASONICALLY MARKED CARDIAC ABLATION CATHETER.
US5577509A (en) * 1994-01-28 1996-11-26 Ep Technologies, Inc. Systems and methods for examining the electrical characteristics and timing of electrical events in cardiac tissue
US6216043B1 (en) 1994-03-04 2001-04-10 Ep Technologies, Inc. Asymmetric multiple electrode support structures
US6405732B1 (en) * 1994-06-24 2002-06-18 Curon Medical, Inc. Method to treat gastric reflux via the detection and ablation of gastro-esophageal nerves and receptors
US6245068B1 (en) 1994-08-08 2001-06-12 Scimed Life Systems, Inc. Resilient radiopaque electrophysiology electrodes and probes including the same
US5876336A (en) * 1994-10-11 1999-03-02 Ep Technologies, Inc. Systems and methods for guiding movable electrode elements within multiple-electrode structure
US5722402A (en) * 1994-10-11 1998-03-03 Ep Technologies, Inc. Systems and methods for guiding movable electrode elements within multiple-electrode structures
US5941251A (en) * 1994-10-11 1999-08-24 Ep Technologies, Inc. Systems for locating and guiding operative elements within interior body regions
US5605157A (en) * 1995-02-17 1997-02-25 Ep Technologies, Inc. Systems and methods for filtering signals derived from biological events
DE69622256T2 (en) * 1995-02-17 2003-02-06 Boston Scient Ltd ARRANGEMENT FOR SEQUENTIAL MEASUREMENT OF BIOLOGICAL EVENTS
US5609157A (en) * 1995-02-17 1997-03-11 Ep Technologies, Inc. Systems and methods for analyzing biopotential morphologies in body tissue using iterative techniques
US6101409A (en) * 1995-02-17 2000-08-08 Ep Technologies, Inc. Systems and methods for analyzing biopotential morphologies in body tissue
US5722416A (en) * 1995-02-17 1998-03-03 Ep Technologies, Inc. Systems and methods for analyzing biopotential morphologies in heart tissue to locate potential ablation sites
US5595183A (en) * 1995-02-17 1997-01-21 Ep Technologies, Inc. Systems and methods for examining heart tissue employing multiple electrode structures and roving electrodes
US5711305A (en) 1995-02-17 1998-01-27 Ep Technologies, Inc. Systems and methods for acquiring endocardially or epicardially paced electrocardiograms
US5601088A (en) * 1995-02-17 1997-02-11 Ep Technologies, Inc. Systems and methods for filtering artifacts from composite signals
US5630425A (en) * 1995-02-17 1997-05-20 Ep Technologies, Inc. Systems and methods for adaptive filtering artifacts from composite signals
US6575969B1 (en) 1995-05-04 2003-06-10 Sherwood Services Ag Cool-tip radiofrequency thermosurgery electrode system for tumor ablation
AU5727096A (en) 1995-05-04 1996-11-21 Eric R. Cosman Cool-tip electrode thermosurgery system
US6152899A (en) * 1996-03-05 2000-11-28 Vnus Medical Technologies, Inc. Expandable catheter having improved electrode design, and method for applying energy
JP4060887B2 (en) 1996-03-05 2008-03-12 ヴィナス メディカル テクノロジーズ インコーポレイテッド Vascular catheter utilization system for heating tissue
US6139527A (en) * 1996-03-05 2000-10-31 Vnus Medical Technologies, Inc. Method and apparatus for treating hemorrhoids
US6036687A (en) * 1996-03-05 2000-03-14 Vnus Medical Technologies, Inc. Method and apparatus for treating venous insufficiency
US6033397A (en) * 1996-03-05 2000-03-07 Vnus Medical Technologies, Inc. Method and apparatus for treating esophageal varices
US8353908B2 (en) 1996-09-20 2013-01-15 Novasys Medical, Inc. Treatment of tissue in sphincters, sinuses, and orifices
US5830210A (en) * 1996-10-21 1998-11-03 Plc Medical Systems, Inc. Catheter navigation apparatus
US6016437A (en) * 1996-10-21 2000-01-18 Irvine Biomedical, Inc. Catheter probe system with inflatable soft shafts
US5893848A (en) * 1996-10-24 1999-04-13 Plc Medical Systems, Inc. Gauging system for monitoring channel depth in percutaneous endocardial revascularization
US5904651A (en) * 1996-10-28 1999-05-18 Ep Technologies, Inc. Systems and methods for visualizing tissue during diagnostic or therapeutic procedures
US5722403A (en) * 1996-10-28 1998-03-03 Ep Technologies, Inc. Systems and methods using a porous electrode for ablating and visualizing interior tissue regions
US6059726A (en) * 1996-11-08 2000-05-09 The Regents Of The University Of California Method for locating the atrio-ventricular (AV) junction of the heart and injecting active substances therein
US5941893A (en) * 1996-12-02 1999-08-24 Angiotrax, Inc. Apparatus for transluminally performing surgery
US6102926A (en) 1996-12-02 2000-08-15 Angiotrax, Inc. Apparatus for percutaneously performing myocardial revascularization having means for sensing tissue parameters and methods of use
US6165188A (en) * 1996-12-02 2000-12-26 Angiotrax, Inc. Apparatus for percutaneously performing myocardial revascularization having controlled cutting depth and methods of use
US6120520A (en) 1997-05-27 2000-09-19 Angiotrax, Inc. Apparatus and methods for stimulating revascularization and/or tissue growth
US6051008A (en) * 1996-12-02 2000-04-18 Angiotrax, Inc. Apparatus having stabilization members for percutaneously performing surgery and methods of use
US5782828A (en) * 1996-12-11 1998-07-21 Irvine Biomedical, Inc. Ablation catheter with multiple flexible curves
US5853368A (en) * 1996-12-23 1998-12-29 Hewlett-Packard Company Ultrasound imaging catheter having an independently-controllable treatment structure
US5916213A (en) * 1997-02-04 1999-06-29 Medtronic, Inc. Systems and methods for tissue mapping and ablation
US5788636A (en) * 1997-02-25 1998-08-04 Acuson Corporation Method and system for forming an ultrasound image of a tissue while simultaneously ablating the tissue
EP0969773B1 (en) * 1997-03-04 2007-01-03 Vnus Medical Technologies, Inc. Apparatus for treating venous insufficiency using directionally applied energy
US6086534A (en) * 1997-03-07 2000-07-11 Cardiogenesis Corporation Apparatus and method of myocardial revascularization using ultrasonic pulse-echo distance ranging
US5876340A (en) * 1997-04-17 1999-03-02 Irvine Biomedical, Inc. Ablation apparatus with ultrasonic imaging capabilities
US6050267A (en) * 1997-04-28 2000-04-18 American Cardiac Ablation Co. Inc. Catheter positioning system
US5944022A (en) * 1997-04-28 1999-08-31 American Cardiac Ablation Co. Inc. Catheter positioning system
US6024703A (en) * 1997-05-07 2000-02-15 Eclipse Surgical Technologies, Inc. Ultrasound device for axial ranging
US6024740A (en) * 1997-07-08 2000-02-15 The Regents Of The University Of California Circumferential ablation device assembly
US6012457A (en) * 1997-07-08 2000-01-11 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US5913856A (en) * 1997-05-19 1999-06-22 Irvine Biomedical, Inc. Catheter system having a porous shaft and fluid irrigation capabilities
US6312426B1 (en) 1997-05-30 2001-11-06 Sherwood Services Ag Method and system for performing plate type radiofrequency ablation
US6231507B1 (en) 1997-06-02 2001-05-15 Vnus Medical Technologies, Inc. Pressure tourniquet with ultrasound window and method of use
US6966908B2 (en) 1997-07-08 2005-11-22 Atrionix, Inc. Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall
US6117101A (en) 1997-07-08 2000-09-12 The Regents Of The University Of California Circumferential ablation device assembly
US6500174B1 (en) * 1997-07-08 2002-12-31 Atrionix, Inc. Circumferential ablation device assembly and methods of use and manufacture providing an ablative circumferential band along an expandable member
US6869431B2 (en) 1997-07-08 2005-03-22 Atrionix, Inc. Medical device with sensor cooperating with expandable member
US6997925B2 (en) * 1997-07-08 2006-02-14 Atrionx, Inc. Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall
US6652515B1 (en) 1997-07-08 2003-11-25 Atrionix, Inc. Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall
US6514249B1 (en) 1997-07-08 2003-02-04 Atrionix, Inc. Positioning system and method for orienting an ablation element within a pulmonary vein ostium
US6014579A (en) * 1997-07-21 2000-01-11 Cardiac Pathways Corp. Endocardial mapping catheter with movable electrode
US9023031B2 (en) 1997-08-13 2015-05-05 Verathon Inc. Noninvasive devices, methods, and systems for modifying tissues
US6179832B1 (en) 1997-09-11 2001-01-30 Vnus Medical Technologies, Inc. Expandable catheter having two sets of electrodes
US6258084B1 (en) 1997-09-11 2001-07-10 Vnus Medical Technologies, Inc. Method for applying energy to biological tissue including the use of tumescent tissue compression
US6401719B1 (en) * 1997-09-11 2002-06-11 Vnus Medical Technologies, Inc. Method of ligating hollow anatomical structures
US6200312B1 (en) * 1997-09-11 2001-03-13 Vnus Medical Technologies, Inc. Expandable vein ligator catheter having multiple electrode leads
US6014589A (en) * 1997-11-12 2000-01-11 Vnus Medical Technologies, Inc. Catheter having expandable electrodes and adjustable stent
US6083167A (en) 1998-02-10 2000-07-04 Emory University Systems and methods for providing radiation therapy and catheter guides
US7165551B2 (en) 1998-02-19 2007-01-23 Curon Medical, Inc. Apparatus to detect and treat aberrant myoelectric activity
US6423058B1 (en) * 1998-02-19 2002-07-23 Curon Medical, Inc. Assemblies to visualize and treat sphincters and adjoining tissue regions
US6327490B1 (en) 1998-02-27 2001-12-04 Varian Medical Systems, Inc. Brachytherapy system for prostate cancer treatment with computer implemented systems and processes to facilitate pre-implantation planning and post-implantation evaluations with storage of multiple plan variations for a single patient
US6360116B1 (en) 1998-02-27 2002-03-19 Varian Medical Systems, Inc. Brachytherapy system for prostate cancer treatment with computer implemented systems and processes to facilitate pre-operative planning and post-operative evaluations
JPH11267133A (en) 1998-03-25 1999-10-05 Olympus Optical Co Ltd Therapeutic apparatus
US7806829B2 (en) 1998-06-30 2010-10-05 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method for navigating an ultrasound catheter to image a beating heart
US7263397B2 (en) 1998-06-30 2007-08-28 St. Jude Medical, Atrial Fibrillation Division, Inc. Method and apparatus for catheter navigation and location and mapping in the heart
US7670297B1 (en) 1998-06-30 2010-03-02 St. Jude Medical, Atrial Fibrillation Division, Inc. Chamber mapping system
US6241678B1 (en) 1998-08-21 2001-06-05 Aga Medical Corporation Sizing catheter for measuring septal defects
US6210338B1 (en) 1998-08-21 2001-04-03 Aga Medical Corp. Sizing catheter for measuring cardiovascular structures
JP2002526188A (en) 1998-09-24 2002-08-20 スーパー ディメンション リミテッド System and method for determining the position of a catheter during a medical procedure inside the body
US20030074011A1 (en) * 1998-09-24 2003-04-17 Super Dimension Ltd. System and method of recording and displaying in context of an image a location of at least one point-of-interest in a body during an intra-body medical procedure
IL126333A0 (en) 1998-09-24 1999-05-09 Super Dimension Ltd System and method of recording and displaying in context of an image a location of at least one point-of-interest in body during an intra-body medical procedure
US20040006268A1 (en) * 1998-09-24 2004-01-08 Super Dimension Ltd Was Filed In Parent Case System and method of recording and displaying in context of an image a location of at least one point-of-interest in a body during an intra-body medical procedure
US6241665B1 (en) 1998-10-21 2001-06-05 Plc Medical System, Inc. Percutaneous mapping system
US7901400B2 (en) 1998-10-23 2011-03-08 Covidien Ag Method and system for controlling output of RF medical generator
US7364577B2 (en) 2002-02-11 2008-04-29 Sherwood Services Ag Vessel sealing system
US7137980B2 (en) 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
US6607502B1 (en) 1998-11-25 2003-08-19 Atrionix, Inc. Apparatus and method incorporating an ultrasound transducer onto a delivery member
US6206831B1 (en) 1999-01-06 2001-03-27 Scimed Life Systems, Inc. Ultrasound-guided ablation catheter and methods of use
US7194294B2 (en) * 1999-01-06 2007-03-20 Scimed Life Systems, Inc. Multi-functional medical catheter and methods of use
US6556695B1 (en) 1999-02-05 2003-04-29 Mayo Foundation For Medical Education And Research Method for producing high resolution real-time images, of structure and function during medical procedures
US8285393B2 (en) * 1999-04-16 2012-10-09 Laufer Michael D Device for shaping infarcted heart tissue and method of using the device
WO2000067832A2 (en) 1999-05-11 2000-11-16 Atrionix, Inc. Balloon anchor wire
US6758830B1 (en) 1999-05-11 2004-07-06 Atrionix, Inc. Catheter positioning system
US6641553B1 (en) * 1999-06-02 2003-11-04 Boston Scientific Corporation Devices and methods for delivering a drug
US7147633B2 (en) * 1999-06-02 2006-12-12 Boston Scientific Scimed, Inc. Method and apparatus for treatment of atrial fibrillation
US6478793B1 (en) * 1999-06-11 2002-11-12 Sherwood Services Ag Ablation treatment of bone metastases
US6315732B1 (en) 1999-07-20 2001-11-13 Scimed Life Systems, Inc. Imaging catheter and methods of use for ultrasound-guided ablation
US6315778B1 (en) 1999-09-10 2001-11-13 C. R. Bard, Inc. Apparatus for creating a continuous annular lesion
US6385476B1 (en) 1999-09-21 2002-05-07 Biosense, Inc. Method and apparatus for intracardially surveying a condition of a chamber of a heart
US6368285B1 (en) 1999-09-21 2002-04-09 Biosense, Inc. Method and apparatus for mapping a chamber of a heart
US6546271B1 (en) 1999-10-01 2003-04-08 Bioscience, Inc. Vascular reconstruction
US6663622B1 (en) * 2000-02-11 2003-12-16 Iotek, Inc. Surgical devices and methods for use in tissue ablation procedures
EP1284670B1 (en) 2000-05-03 2009-06-03 C.R. Bard, Inc. Apparatus for mapping and ablation in electrophysiology procedures
AU2001263213B2 (en) * 2000-05-16 2005-05-19 Atrionix, Inc. Apparatus and method incorporating an ultrasound transducer onto a delivery member
AU6682401A (en) 2000-06-13 2001-12-24 Atrionix Inc Surgical ablation probe for forming a circumferential lesion
US6408199B1 (en) 2000-07-07 2002-06-18 Biosense, Inc. Bipolar mapping of intracardiac potentials with electrode having blood permeable covering
US6546270B1 (en) 2000-07-07 2003-04-08 Biosense, Inc. Multi-electrode catheter, system and method
US6569160B1 (en) 2000-07-07 2003-05-27 Biosense, Inc. System and method for detecting electrode-tissue contact
WO2002005866A2 (en) * 2000-07-13 2002-01-24 Bioheart, Inc. Deployment system for myocardial cellular material
US6650927B1 (en) 2000-08-18 2003-11-18 Biosense, Inc. Rendering of diagnostic imaging data on a three-dimensional map
US6436059B1 (en) 2000-09-12 2002-08-20 Claudio I. Zanelli Detection of imd contact and alignment based on changes in frequency response characteristics
US6546276B1 (en) 2000-09-12 2003-04-08 Claudio I. Zanelli Ultrasonic based detection of interventional medical device contact and alignment
US6725085B2 (en) 2000-09-22 2004-04-20 Armin Schwartzman Method and apparatus for characterizing cardiac tissue from local electrograms
US6633773B1 (en) 2000-09-29 2003-10-14 Biosene, Inc. Area of interest reconstruction for surface of an organ using location data
US7306591B2 (en) 2000-10-02 2007-12-11 Novasys Medical, Inc. Apparatus and methods for treating female urinary incontinence
US20020082679A1 (en) * 2000-12-22 2002-06-27 Avantec Vascular Corporation Delivery or therapeutic capable agents
US7077859B2 (en) 2000-12-22 2006-07-18 Avantec Vascular Corporation Apparatus and methods for variably controlled substance delivery from implanted prostheses
US20030033007A1 (en) * 2000-12-22 2003-02-13 Avantec Vascular Corporation Methods and devices for delivery of therapeutic capable agents with variable release profile
US20030050692A1 (en) * 2000-12-22 2003-03-13 Avantec Vascular Corporation Delivery of therapeutic capable agents
US6939375B2 (en) 2000-12-22 2005-09-06 Avantac Vascular Corporation Apparatus and methods for controlled substance delivery from implanted prostheses
US20050203612A1 (en) * 2000-12-22 2005-09-15 Avantec Vascular Corporation Devices delivering therapeutic agents and methods regarding the same
US7083642B2 (en) * 2000-12-22 2006-08-01 Avantec Vascular Corporation Delivery of therapeutic capable agents
US6471980B2 (en) 2000-12-22 2002-10-29 Avantec Vascular Corporation Intravascular delivery of mycophenolic acid
US6781691B2 (en) * 2001-02-02 2004-08-24 Tidal Photonics, Inc. Apparatus and methods relating to wavelength conditioning of illumination
US20030181940A1 (en) * 2001-02-28 2003-09-25 Gregory Murphy Ventricular restoration shaping apparatus and method of use
US6702763B2 (en) * 2001-02-28 2004-03-09 Chase Medical, L.P. Sizing apparatus and method for use during ventricular restoration
US20020133227A1 (en) * 2001-02-28 2002-09-19 Gregory Murphy Ventricular restoration patch apparatus and method of use
WO2002072176A1 (en) * 2001-03-14 2002-09-19 Scimed Life Systems, Inc. Intervention heart catheter with locating means and method
ATE418287T1 (en) * 2001-04-27 2009-01-15 Bard Inc C R CATHETER FOR THREE-DIMENSIONAL IMAGING OF ELECTRICAL ACTIVITY IN BLOOD VESSELS
US7727229B2 (en) 2001-05-01 2010-06-01 C.R. Bard, Inc. Method and apparatus for altering conduction properties in the heart and in adjacent vessels
ES2278952T3 (en) * 2001-07-26 2007-08-16 Avantec Vascular Corporation DEVICES FOR MANAGING THERAPEUTIC AGENTS WITH VARIABLE LIBERATION PROFILE.
US7485088B2 (en) * 2001-09-05 2009-02-03 Chase Medical L.P. Method and device for percutaneous surgical ventricular repair
US20040243170A1 (en) * 2001-09-05 2004-12-02 Mitta Suresh Method and device for percutaneous surgical ventricular repair
US7187964B2 (en) * 2001-09-27 2007-03-06 Dirar S. Khoury Cardiac catheter imaging system
US6895267B2 (en) 2001-10-24 2005-05-17 Scimed Life Systems, Inc. Systems and methods for guiding and locating functional elements on medical devices positioned in a body
US8175680B2 (en) * 2001-11-09 2012-05-08 Boston Scientific Scimed, Inc. Systems and methods for guiding catheters using registered images
US20030120144A1 (en) * 2001-11-16 2003-06-26 Grabek James R. Intrapericardial temperature measurement device and method
BR0307544A (en) 2002-02-01 2004-12-07 Ariad Gene Therapeutics Inc Phosphorus-containing compounds, components and composition as well as their use by treatment methods
DE10210648A1 (en) * 2002-03-11 2003-10-02 Siemens Ag Medical 3-D imaging method for organ and catheter type instrument portrayal in which 2-D ultrasound images, the location and orientation of which are known, are combined in a reference coordinate system to form a 3-D image
JP4490807B2 (en) 2002-05-06 2010-06-30 コヴィディエン アクチェンゲゼルシャフト System for electrically detecting blood and controlling the generator during electrosurgical procedures
CN1649641A (en) * 2002-05-08 2005-08-03 加利福尼亚大学董事会 System and method for forming a non-ablative cardiac conduction block
US6932804B2 (en) 2003-01-21 2005-08-23 The Regents Of The University Of California System and method for forming a non-ablative cardiac conduction block
US20040106896A1 (en) * 2002-11-29 2004-06-03 The Regents Of The University Of California System and method for forming a non-ablative cardiac conduction block
US20070167804A1 (en) * 2002-09-18 2007-07-19 Byong-Ho Park Tubular compliant mechanisms for ultrasonic imaging systems and intravascular interventional devices
EP1551306A4 (en) * 2002-09-18 2008-03-05 Univ Leland Stanford Junior Tubular compliant mechanisms for ultrasonic imaging systems and intravascular interventional devices
US6786202B2 (en) * 2002-09-24 2004-09-07 Caterpillar Inc Hydraulic pump circuit
US7317950B2 (en) * 2002-11-16 2008-01-08 The Regents Of The University Of California Cardiac stimulation system with delivery of conductive agent
US7044948B2 (en) 2002-12-10 2006-05-16 Sherwood Services Ag Circuit for controlling arc energy from an electrosurgical generator
US7819866B2 (en) * 2003-01-21 2010-10-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation catheter and electrode
JP4728224B2 (en) * 2003-03-28 2011-07-20 シー・アール・バード・インコーポレーテッド Improved electrophysiological loop catheter
JP2006525096A (en) 2003-05-01 2006-11-09 シャーウッド・サービシーズ・アクチェンゲゼルシャフト Method and system for programming and controlling an electrosurgical generator system
US7879024B2 (en) * 2003-06-26 2011-02-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Splittable cannula having radiopaque marker
US7101362B2 (en) 2003-07-02 2006-09-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Steerable and shapable catheter employing fluid force
US7235070B2 (en) * 2003-07-02 2007-06-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation fluid manifold for ablation catheter
US8308708B2 (en) * 2003-07-15 2012-11-13 Abbott Cardiovascular Systems Inc. Deployment system for myocardial cellular material
CA2938411C (en) * 2003-09-12 2019-03-05 Minnow Medical, Llc Selectable eccentric remodeling and/or ablation of atherosclerotic material
WO2005031436A1 (en) * 2003-09-26 2005-04-07 Tidal Photonics, Inc. Apparatus and methods relating to expanded dynamic range imaging endoscope systems
CA2581735A1 (en) * 2003-09-26 2005-04-07 Tidal Photonics, Inc. Apparatus and methods relating to enhanced spectral measurement systems
CA2581656A1 (en) * 2003-09-26 2005-04-07 Tidal Photonics, Inc. Apparatus and methods relating to color imaging endoscope systems
CA2542849C (en) 2003-10-23 2013-08-20 Sherwood Services Ag Redundant temperature monitoring in electrosurgical systems for safety mitigation
EP1676108B1 (en) 2003-10-23 2017-05-24 Covidien AG Thermocouple measurement circuit
US7396336B2 (en) 2003-10-30 2008-07-08 Sherwood Services Ag Switched resonant ultrasonic power amplifier system
US7131860B2 (en) 2003-11-20 2006-11-07 Sherwood Services Ag Connector systems for electrosurgical generator
WO2005051229A2 (en) * 2003-11-24 2005-06-09 Avantec Vascular Corporation Devices delivering therapeutic agents and methods regarding the same
US7766905B2 (en) 2004-02-12 2010-08-03 Covidien Ag Method and system for continuity testing of medical electrodes
US7780662B2 (en) 2004-03-02 2010-08-24 Covidien Ag Vessel sealing system using capacitive RF dielectric heating
US8249685B2 (en) * 2004-05-17 2012-08-21 C.R. Bard, Inc. Method and apparatus for mapping and/or ablation of cardiac tissue
EP1765151A2 (en) * 2004-05-17 2007-03-28 C.R.Bard, Inc. Mapping and ablation method for the treatment of ventricular tachycardia
US8755864B2 (en) 2004-05-28 2014-06-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for diagnostic data mapping
US10863945B2 (en) * 2004-05-28 2020-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system with contact sensing feature
US10258285B2 (en) * 2004-05-28 2019-04-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated creation of ablation lesions
US7632265B2 (en) * 2004-05-28 2009-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Radio frequency ablation servo catheter and method
US8528565B2 (en) 2004-05-28 2013-09-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated therapy delivery
US7974674B2 (en) * 2004-05-28 2011-07-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for surface modeling
US9782130B2 (en) * 2004-05-28 2017-10-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system
US7850610B2 (en) * 2004-06-28 2010-12-14 Medtronic, Inc. Electrode location mapping system and method
US9713730B2 (en) 2004-09-10 2017-07-25 Boston Scientific Scimed, Inc. Apparatus and method for treatment of in-stent restenosis
US8396548B2 (en) * 2008-11-14 2013-03-12 Vessix Vascular, Inc. Selective drug delivery in a lumen
US7776035B2 (en) 2004-10-08 2010-08-17 Covidien Ag Cool-tip combined electrode introducer
US7282049B2 (en) 2004-10-08 2007-10-16 Sherwood Services Ag Electrosurgical system employing multiple electrodes and method thereof
US7553309B2 (en) * 2004-10-08 2009-06-30 Covidien Ag Electrosurgical system employing multiple electrodes and method thereof
US7628786B2 (en) 2004-10-13 2009-12-08 Covidien Ag Universal foot switch contact port
US7467075B2 (en) * 2004-12-23 2008-12-16 Covidien Ag Three-dimensional finite-element code for electrosurgery and thermal ablation simulations
US8287583B2 (en) * 2005-01-10 2012-10-16 Taheri Laduca Llc Apparatus and method for deploying an implantable device within the body
US20070150051A1 (en) * 2005-01-10 2007-06-28 Duke Fiduciary, Llc Vascular implants and methods of fabricating the same
US20070156210A1 (en) * 2005-01-14 2007-07-05 Co-Repair, Inc., A California Corporation Method for the treatment of heart tissue
US7455670B2 (en) * 2005-01-14 2008-11-25 Co-Repair, Inc. System and method for the treatment of heart tissue
US20070156209A1 (en) * 2005-01-14 2007-07-05 Co-Repair, Inc. System for the treatment of heart tissue
US8075498B2 (en) 2005-03-04 2011-12-13 Endosense Sa Medical apparatus system having optical fiber load sensing capability
US8182433B2 (en) * 2005-03-04 2012-05-22 Endosense Sa Medical apparatus system having optical fiber load sensing capability
CN102125430A (en) * 2005-03-28 2011-07-20 明诺医学有限公司 Intraluminal electrical tissue characterization and tuned RF energy for selective treatment of target tissues
US9474564B2 (en) 2005-03-31 2016-10-25 Covidien Ag Method and system for compensating for external impedance of an energy carrying component when controlling an electrosurgical generator
WO2006119416A2 (en) * 2005-05-04 2006-11-09 Fluid Medical, Inc. Miniature actuator mechanism for intravascular imaging
US20060270900A1 (en) * 2005-05-26 2006-11-30 Chin Albert K Apparatus and methods for performing ablation
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US8155910B2 (en) 2005-05-27 2012-04-10 St. Jude Medical, Atrial Fibrillation Divison, Inc. Robotically controlled catheter and method of its calibration
US7819868B2 (en) * 2005-06-21 2010-10-26 St. Jude Medical, Atrial Fibrilation Division, Inc. Ablation catheter with fluid distribution structures
US20070021744A1 (en) * 2005-07-07 2007-01-25 Creighton Francis M Iv Apparatus and method for performing ablation with imaging feedback
DE102005032755B4 (en) * 2005-07-13 2014-09-04 Siemens Aktiengesellschaft System for performing and monitoring minimally invasive procedures
US7569015B2 (en) * 2005-07-15 2009-08-04 General Electric Company Integrated physiology and imaging workstation
US20070016029A1 (en) * 2005-07-15 2007-01-18 General Electric Company Physiology workstation with real-time fluoroscopy and ultrasound imaging
EP2363073B1 (en) 2005-08-01 2015-10-07 St. Jude Medical Luxembourg Holding S.à.r.l. Medical apparatus system having optical fiber load sensing capability
US7740584B2 (en) 2005-08-16 2010-06-22 The General Electric Company Method and system for mapping physiology information onto ultrasound-based anatomic structure
US20070043596A1 (en) * 2005-08-16 2007-02-22 General Electric Company Physiology network and workstation for use therewith
US7879031B2 (en) * 2005-09-27 2011-02-01 Covidien Ag Cooled RF ablation needle
US20070078454A1 (en) * 2005-09-30 2007-04-05 Mcpherson James W System and method for creating lesions using bipolar electrodes
US20070078453A1 (en) * 2005-10-04 2007-04-05 Johnson Kristin D System and method for performing cardiac ablation
US8734438B2 (en) 2005-10-21 2014-05-27 Covidien Ag Circuit and method for reducing stored energy in an electrosurgical generator
US7947039B2 (en) 2005-12-12 2011-05-24 Covidien Ag Laparoscopic apparatus for performing electrosurgical procedures
US7513896B2 (en) 2006-01-24 2009-04-07 Covidien Ag Dual synchro-resonant electrosurgical apparatus with bi-directional magnetic coupling
CA2574934C (en) 2006-01-24 2015-12-29 Sherwood Services Ag System and method for closed loop monitoring of monopolar electrosurgical apparatus
US8147485B2 (en) 2006-01-24 2012-04-03 Covidien Ag System and method for tissue sealing
CA2574935A1 (en) 2006-01-24 2007-07-24 Sherwood Services Ag A method and system for controlling an output of a radio-frequency medical generator having an impedance based control algorithm
EP1810634B8 (en) 2006-01-24 2015-06-10 Covidien AG System for tissue sealing
US9186200B2 (en) 2006-01-24 2015-11-17 Covidien Ag System and method for tissue sealing
US8216223B2 (en) 2006-01-24 2012-07-10 Covidien Ag System and method for tissue sealing
US8685016B2 (en) 2006-01-24 2014-04-01 Covidien Ag System and method for tissue sealing
US7651493B2 (en) 2006-03-03 2010-01-26 Covidien Ag System and method for controlling electrosurgical snares
US7648499B2 (en) 2006-03-21 2010-01-19 Covidien Ag System and method for generating radio frequency energy
US8795270B2 (en) * 2006-04-24 2014-08-05 Covidien Ag System and method for ablating tissue
US7651492B2 (en) 2006-04-24 2010-01-26 Covidien Ag Arc based adaptive control system for an electrosurgical unit
US8019435B2 (en) 2006-05-02 2011-09-13 Boston Scientific Scimed, Inc. Control of arterial smooth muscle tone
US20070258838A1 (en) * 2006-05-03 2007-11-08 Sherwood Services Ag Peristaltic cooling pump system
US20070260240A1 (en) 2006-05-05 2007-11-08 Sherwood Services Ag Soft tissue RF transection and resection device
US8753334B2 (en) 2006-05-10 2014-06-17 Covidien Ag System and method for reducing leakage current in an electrosurgical generator
US8567265B2 (en) 2006-06-09 2013-10-29 Endosense, SA Triaxial fiber optic force sensing catheter
US8048063B2 (en) 2006-06-09 2011-11-01 Endosense Sa Catheter having tri-axial force sensor
US20080260242A1 (en) * 2006-06-22 2008-10-23 Tidal Photonics Inc. Apparatus and methods for measuring and controlling illumination for imaging objects, performances and the like
US7763018B2 (en) 2006-07-28 2010-07-27 Covidien Ag Cool-tip thermocouple including two-piece hub
US8034049B2 (en) 2006-08-08 2011-10-11 Covidien Ag System and method for measuring initial tissue impedance
US7731717B2 (en) 2006-08-08 2010-06-08 Covidien Ag System and method for controlling RF output during tissue sealing
US8273081B2 (en) * 2006-09-08 2012-09-25 Stereotaxis, Inc. Impedance-based cardiac therapy planning method with a remote surgical navigation system
JP4201037B2 (en) * 2006-09-14 2008-12-24 ソニー株式会社 Lens barrel rotation imaging device
US7794457B2 (en) 2006-09-28 2010-09-14 Covidien Ag Transformer for RF voltage sensing
EP2954868A1 (en) * 2006-10-18 2015-12-16 Vessix Vascular, Inc. Tuned rf energy and electrical tissue characterization for selective treatment of target tissues
EP2455034B1 (en) 2006-10-18 2017-07-19 Vessix Vascular, Inc. System for inducing desirable temperature effects on body tissue
ES2560006T3 (en) * 2006-10-18 2016-02-17 Vessix Vascular, Inc. Induction of desirable temperature effects on body tissue
DE102006061178A1 (en) * 2006-12-22 2008-06-26 Siemens Ag Medical system for carrying out and monitoring a minimal invasive intrusion, especially for treating electro-physiological diseases, has X-ray equipment and a control/evaluation unit
US8211099B2 (en) 2007-01-31 2012-07-03 Tyco Healthcare Group Lp Thermal feedback systems and methods of using the same
US9526642B2 (en) * 2007-02-09 2016-12-27 Taheri Laduca Llc Vascular implants and methods of fabricating the same
US20080221448A1 (en) * 2007-03-07 2008-09-11 Khuri-Yakub Butrus T Image-guided delivery of therapeutic tools duing minimally invasive surgeries and interventions
US8496653B2 (en) * 2007-04-23 2013-07-30 Boston Scientific Scimed, Inc. Thrombus removal
AU2008245600B2 (en) 2007-04-27 2013-07-04 Covidien Lp Systems and methods for treating hollow anatomical structures
US8777941B2 (en) 2007-05-10 2014-07-15 Covidien Lp Adjustable impedance electrosurgical electrodes
US20080287783A1 (en) * 2007-05-16 2008-11-20 General Electric Company System and method of tracking delivery of an imaging probe
US8989842B2 (en) * 2007-05-16 2015-03-24 General Electric Company System and method to register a tracking system with intracardiac echocardiography (ICE) imaging system
US8527032B2 (en) * 2007-05-16 2013-09-03 General Electric Company Imaging system and method of delivery of an instrument to an imaged subject
US8428690B2 (en) * 2007-05-16 2013-04-23 General Electric Company Intracardiac echocardiography image reconstruction in combination with position tracking system
US8364242B2 (en) * 2007-05-17 2013-01-29 General Electric Company System and method of combining ultrasound image acquisition with fluoroscopic image acquisition
US8157789B2 (en) 2007-05-24 2012-04-17 Endosense Sa Touch sensing catheter
US8622935B1 (en) 2007-05-25 2014-01-07 Endosense Sa Elongated surgical manipulator with body position and distal force sensing
US9486269B2 (en) * 2007-06-22 2016-11-08 Covidien Lp Electrosurgical systems and cartridges for use therewith
US7834484B2 (en) 2007-07-16 2010-11-16 Tyco Healthcare Group Lp Connection cable and method for activating a voltage-controlled generator
US8216220B2 (en) 2007-09-07 2012-07-10 Tyco Healthcare Group Lp System and method for transmission of combined data stream
US8181995B2 (en) * 2007-09-07 2012-05-22 Tyco Healthcare Group Lp Cool tip junction
US8512332B2 (en) 2007-09-21 2013-08-20 Covidien Lp Real-time arc control in electrosurgical generators
EP2209517A4 (en) 2007-10-05 2011-03-30 Maquet Cardiovascular Llc Devices and methods for minimally-invasive surgical procedures
US8292880B2 (en) 2007-11-27 2012-10-23 Vivant Medical, Inc. Targeted cooling of deployable microwave antenna
US20090163801A1 (en) * 2007-12-19 2009-06-25 St. Jude Medical, Atrial Fibrillation Division, Inc. System for displaying data relating to energy emitting treatment devices together with electrophysiological mapping data
US9592100B2 (en) 2007-12-31 2017-03-14 St. Jude Medical, Atrial Fibrillation Division, Inc. Method and apparatus for encoding catheters with markers for identifying with imaging systems
US9445772B2 (en) 2007-12-31 2016-09-20 St. Jude Medical, Atrial Fibrillatin Division, Inc. Reduced radiation fluoroscopic system
US9575140B2 (en) 2008-04-03 2017-02-21 Covidien Lp Magnetic interference detection system and method
US8298227B2 (en) * 2008-05-14 2012-10-30 Endosense Sa Temperature compensated strain sensing catheter
EP2297673B1 (en) 2008-06-03 2020-04-22 Covidien LP Feature-based registration method
US9770297B2 (en) * 2008-06-04 2017-09-26 Covidien Lp Energy devices and methods for treating hollow anatomical structures
US8218847B2 (en) 2008-06-06 2012-07-10 Superdimension, Ltd. Hybrid registration method
US8226639B2 (en) 2008-06-10 2012-07-24 Tyco Healthcare Group Lp System and method for output control of electrosurgical generator
WO2009155300A1 (en) * 2008-06-17 2009-12-23 Lifeflow Technologies, Inc. Fluid monitor
US20100049099A1 (en) * 2008-07-18 2010-02-25 Vytronus, Inc. Method and system for positioning an energy source
US8608739B2 (en) 2008-07-22 2013-12-17 Covidien Lp Electrosurgical devices, systems and methods of using the same
US20100063400A1 (en) * 2008-09-05 2010-03-11 Anne Lindsay Hall Method and apparatus for catheter guidance using a combination of ultrasound and x-ray imaging
WO2010033940A1 (en) * 2008-09-22 2010-03-25 Minnow Medical, Inc Inducing desirable temperature effects on body tissue using alternate energy sources
US9795442B2 (en) 2008-11-11 2017-10-24 Shifamed Holdings, Llc Ablation catheters
EP2355737B1 (en) 2008-11-17 2021-08-11 Boston Scientific Scimed, Inc. Selective accumulation of energy without knowledge of tissue topography
US8900150B2 (en) 2008-12-30 2014-12-02 St. Jude Medical, Atrial Fibrillation Division, Inc. Intracardiac imaging system utilizing a multipurpose catheter
US8948476B2 (en) 2010-12-20 2015-02-03 St. Jude Medical, Atrial Fibrillation Division, Inc. Determination of cardiac geometry responsive to doppler based imaging of blood flow characteristics
US20100168557A1 (en) * 2008-12-30 2010-07-01 Deno D Curtis Multi-electrode ablation sensing catheter and system
US9610118B2 (en) * 2008-12-31 2017-04-04 St. Jude Medical, Atrial Fibrillation Division, Inc. Method and apparatus for the cancellation of motion artifacts in medical interventional navigation
US8262652B2 (en) 2009-01-12 2012-09-11 Tyco Healthcare Group Lp Imaginary impedance process monitoring and intelligent shut-off
JP5829526B2 (en) * 2009-01-14 2015-12-09 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． Monitoring device to monitor ablation treatment
US20100256735A1 (en) * 2009-04-03 2010-10-07 Board Of Regents, The University Of Texas System Intraluminal stent with seam
US8551096B2 (en) 2009-05-13 2013-10-08 Boston Scientific Scimed, Inc. Directional delivery of energy and bioactives
WO2010140069A1 (en) * 2009-06-04 2010-12-09 Koninklijke Philips Electronics N.V. Visualization apparatus
CA2795229A1 (en) 2010-04-09 2011-10-13 Vessix Vascular, Inc. Power generating and control apparatus for the treatment of tissue
US9795765B2 (en) 2010-04-09 2017-10-24 St. Jude Medical International Holding S.À R.L. Variable stiffness steering mechanism for catheters
US9192790B2 (en) 2010-04-14 2015-11-24 Boston Scientific Scimed, Inc. Focused ultrasonic renal denervation
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
JP5792802B2 (en) 2010-05-12 2015-10-14 シファメド・ホールディングス・エルエルシー Low profile electrode assembly
US8473067B2 (en) 2010-06-11 2013-06-25 Boston Scientific Scimed, Inc. Renal denervation and stimulation employing wireless vascular energy transfer arrangement
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
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
US9028485B2 (en) 2010-11-15 2015-05-12 Boston Scientific Scimed, Inc. Self-expanding cooling electrode for renal nerve ablation
US9668811B2 (en) 2010-11-16 2017-06-06 Boston Scientific Scimed, Inc. Minimally invasive access 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
US9326751B2 (en) 2010-11-17 2016-05-03 Boston Scientific Scimed, Inc. Catheter guidance of external energy for renal denervation
EP2640273B1 (en) 2010-11-18 2019-05-22 Koninklijke Philips N.V. Filtering apparatus for filtering an ultrasound signal
US9060761B2 (en) 2010-11-18 2015-06-23 Boston Scientific Scime, Inc. Catheter-focused magnetic field induced renal nerve ablation
US9023034B2 (en) 2010-11-22 2015-05-05 Boston Scientific Scimed, Inc. Renal ablation electrode with force-activatable conduction apparatus
US9192435B2 (en) 2010-11-22 2015-11-24 Boston Scientific Scimed, Inc. Renal denervation catheter with cooled RF electrode
US20120157993A1 (en) 2010-12-15 2012-06-21 Jenson Mark L Bipolar Off-Wall Electrode Device for Renal Nerve Ablation
WO2012100095A1 (en) 2011-01-19 2012-07-26 Boston Scientific Scimed, Inc. Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury
WO2012142588A1 (en) 2011-04-14 2012-10-18 Endosense S.A. Compact force sensor for catheters
US8777857B2 (en) * 2011-04-14 2014-07-15 St. Jude Medical, Inc. Single transducer with angular orientation for lesion feedback in ablation catheter
JP5746421B2 (en) 2011-04-22 2015-07-08 トペラ インコーポレイテッド Basket-style cardiac mapping catheter with spline bend for detecting cardiac rhythm disorders
CN103813745B (en) 2011-07-20 2016-06-29 波士顿科学西美德公司 In order to visualize, be directed at and to melt transcutaneous device and the method for nerve
AU2012287189B2 (en) 2011-07-22 2016-10-06 Boston Scientific Scimed, Inc. Nerve modulation system with a nerve modulation element positionable in a helical guide
US9186210B2 (en) 2011-10-10 2015-11-17 Boston Scientific Scimed, Inc. Medical devices including ablation electrodes
US9420955B2 (en) 2011-10-11 2016-08-23 Boston Scientific Scimed, Inc. Intravascular temperature monitoring system and method
EP2765940B1 (en) 2011-10-11 2015-08-26 Boston Scientific Scimed, Inc. Off-wall electrode device for nerve modulation
US9364284B2 (en) 2011-10-12 2016-06-14 Boston Scientific Scimed, Inc. Method of making an off-wall spacer cage
US8632467B2 (en) 2011-10-12 2014-01-21 Volcano Corporation Rotational shape-memory actuators and associated devices, systems, and methods
US9079000B2 (en) 2011-10-18 2015-07-14 Boston Scientific Scimed, Inc. Integrated crossing balloon catheter
US9162046B2 (en) 2011-10-18 2015-10-20 Boston Scientific Scimed, Inc. Deflectable medical devices
US8951251B2 (en) 2011-11-08 2015-02-10 Boston Scientific Scimed, Inc. Ostial renal nerve ablation
EP2779929A1 (en) 2011-11-15 2014-09-24 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
EP2785252B1 (en) * 2011-11-28 2018-05-16 Acist Medical Systems, Inc. Catheters for imaging and ablating tissue
US9265969B2 (en) 2011-12-21 2016-02-23 Cardiac Pacemakers, Inc. Methods for modulating cell function
AU2012358227B2 (en) 2011-12-23 2015-06-11 Boston Scientific Scimed, 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
EP2809253B8 (en) * 2012-01-31 2016-09-21 Boston Scientific Scimed, Inc. Ablation probe with fluid-based acoustic coupling for ultrasonic tissue imaging
US8403927B1 (en) 2012-04-05 2013-03-26 William Bruce Shingleton Vasectomy devices and methods
WO2013169927A1 (en) 2012-05-08 2013-11-14 Boston Scientific Scimed, Inc. Renal nerve modulation devices
US9341238B2 (en) 2012-06-15 2016-05-17 Gkn Driveline North America, Inc. Power transfer unit straddle mount ring gear disconnect
WO2014032016A1 (en) 2012-08-24 2014-02-27 Boston Scientific Scimed, Inc. Intravascular catheter with a balloon comprising separate microporous regions
CN104780859B (en) 2012-09-17 2017-07-25 波士顿科学西美德公司 Self-positioning electrode system and method for renal regulation
US10398464B2 (en) 2012-09-21 2019-09-03 Boston Scientific Scimed, Inc. System for nerve modulation and innocuous thermal gradient nerve block
US10549127B2 (en) 2012-09-21 2020-02-04 Boston Scientific Scimed, Inc. Self-cooling ultrasound ablation catheter
US10835305B2 (en) 2012-10-10 2020-11-17 Boston Scientific Scimed, Inc. Renal nerve modulation devices and methods
US9956033B2 (en) 2013-03-11 2018-05-01 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
WO2014143571A1 (en) 2013-03-11 2014-09-18 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9808311B2 (en) 2013-03-13 2017-11-07 Boston Scientific Scimed, Inc. Deflectable medical devices
WO2014152344A2 (en) * 2013-03-15 2014-09-25 St. Jude Medical, Atrial Fibrillation Division, Inc. Device for intravascular therapy and/or diagnosis
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
CN105228546B (en) 2013-03-15 2017-11-14 波士顿科学国际有限公司 Utilize the impedance-compensated medicine equipment and method that are used to treat hypertension
EP2968919B1 (en) 2013-03-15 2021-08-25 Medtronic Ardian Luxembourg S.à.r.l. Controlled neuromodulation systems
US10265122B2 (en) 2013-03-15 2019-04-23 Boston Scientific Scimed, Inc. Nerve ablation devices and related methods of use
US10098694B2 (en) 2013-04-08 2018-10-16 Apama Medical, Inc. Tissue ablation and monitoring thereof
US10349824B2 (en) 2013-04-08 2019-07-16 Apama Medical, Inc. Tissue mapping and visualization systems
EP2983603B1 (en) 2013-04-08 2020-03-25 Apama Medical, Inc. Cardiac ablation catheters
US9855404B2 (en) 2013-05-03 2018-01-02 St. Jude Medical International Holding S.À R.L. Dual bend radii steering catheter
JP2016526958A (en) 2013-06-03 2016-09-08 ファカルティ・フィジシャンズ・アンド・サージャンズ・オブ・ロマ・リンダ・ユニヴァーシティ・スクール・オブ・メディシン Method and apparatus for non-fluorescent percutaneous surgical access or low-fluorescence percutaneous surgical access
US10792067B2 (en) 2013-06-03 2020-10-06 Faculty Physicians And Surgeons Of Loma Linda University Of Medicine Methods and apparatuses for fluoro-less or near fluoro-less percutaneous surgery access
US10405943B2 (en) 2015-09-22 2019-09-10 Faculty Physicians And Surgeons Of Loma Linda University School Of Medicine Kit and method for reduced radiation procedures
CN105473091B (en) 2013-06-21 2020-01-21 波士顿科学国际有限公司 Renal denervation balloon catheter with co-movable electrode supports
JP2016524949A (en) 2013-06-21 2016-08-22 ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． Medical device for renal nerve ablation having a rotatable shaft
US9707036B2 (en) 2013-06-25 2017-07-18 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation using localized indifferent electrodes
WO2015002787A1 (en) 2013-07-01 2015-01-08 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
EP3019106A1 (en) 2013-07-11 2016-05-18 Boston Scientific Scimed, Inc. Medical device with stretchable electrode assemblies
CN105377169B (en) 2013-07-11 2019-04-19 波士顿科学国际有限公司 Device and method for neuromodulation
CN105682594B (en) 2013-07-19 2018-06-22 波士顿科学国际有限公司 Helical bipolar electrodes renal denervation dominates air bag
JP6122217B2 (en) 2013-07-22 2017-04-26 ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． Renal nerve ablation medical device
US10342609B2 (en) 2013-07-22 2019-07-09 Boston Scientific Scimed, Inc. Medical devices for renal nerve ablation
US9872719B2 (en) 2013-07-24 2018-01-23 Covidien Lp Systems and methods for generating electrosurgical energy using a multistage power converter
US9655670B2 (en) 2013-07-29 2017-05-23 Covidien Lp Systems and methods for measuring tissue impedance through an electrosurgical cable
CN105473093B (en) 2013-08-22 2019-02-05 波士顿科学国际有限公司 Flexible circuit with the improved adhesion strength to renal nerve modulation sacculus
CN105555218B (en) 2013-09-04 2019-01-15 波士顿科学国际有限公司 With radio frequency (RF) foley's tube rinsed with cooling capacity
WO2015038947A1 (en) 2013-09-13 2015-03-19 Boston Scientific Scimed, Inc. Ablation balloon with vapor deposited cover layer
US9687166B2 (en) 2013-10-14 2017-06-27 Boston Scientific Scimed, Inc. High resolution cardiac mapping electrode array catheter
US11246654B2 (en) 2013-10-14 2022-02-15 Boston Scientific Scimed, Inc. Flexible renal nerve ablation devices and related methods of use and manufacture
EP3057520A1 (en) 2013-10-15 2016-08-24 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
JP6259099B2 (en) 2013-10-18 2018-01-10 ボストン サイエンティフィック サイムド，インコーポレイテッドＢｏｓｔｏｎ Ｓｃｉｅｎｔｉｆｉｃ Ｓｃｉｍｅｄ，Ｉｎｃ． Balloon catheter comprising a conductive wire with flexibility, and related uses and manufacturing methods
CN105658163B (en) 2013-10-25 2020-08-18 波士顿科学国际有限公司 Embedded thermocouple in denervation flexible circuit
CN105899157B (en) 2014-01-06 2019-08-09 波士顿科学国际有限公司 Tear-proof flexible circuit assembly
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
CN108348146A (en) 2015-11-16 2018-07-31 阿帕玛医疗公司 Energy transmission device
WO2017118949A1 (en) 2016-01-07 2017-07-13 St. Jude Medical International Holding S.À R.L. Medical device with multi-core fiber for optical sensing
US10792106B2 (en) 2016-10-28 2020-10-06 Covidien Lp System for calibrating an electromagnetic navigation system
US10638952B2 (en) 2016-10-28 2020-05-05 Covidien Lp Methods, systems, and computer-readable media for calibrating an electromagnetic navigation system
US10446931B2 (en) 2016-10-28 2019-10-15 Covidien Lp Electromagnetic navigation antenna assembly and electromagnetic navigation system including the same
US10517505B2 (en) 2016-10-28 2019-12-31 Covidien Lp Systems, methods, and computer-readable media for optimizing an electromagnetic navigation system
US10418705B2 (en) 2016-10-28 2019-09-17 Covidien Lp Electromagnetic navigation antenna assembly and electromagnetic navigation system including the same
US10722311B2 (en) 2016-10-28 2020-07-28 Covidien Lp System and method for identifying a location and/or an orientation of an electromagnetic sensor based on a map
US10751126B2 (en) 2016-10-28 2020-08-25 Covidien Lp System and method for generating a map for electromagnetic navigation
US10615500B2 (en) 2016-10-28 2020-04-07 Covidien Lp System and method for designing electromagnetic navigation antenna assemblies
US20230008606A1 (en) * 2021-07-06 2023-01-12 Biosense Webster (Israel) Ltd. Contact assessment for balloon catheter
CN114145840B (en) * 2021-12-03 2024-01-02 陕西省中医医院 Intracardiac ultrasonic catheter with ablation and mapping functions

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4794931A (en) * 1986-02-28 1989-01-03 Cardiovascular Imaging Systems, Inc. Catheter apparatus, system and method for intravascular two-dimensional ultrasonography
US5029588A (en) * 1989-06-15 1991-07-09 Cardiovascular Imaging Systems, Inc. Laser catheter with imaging capability
US5228442A (en) * 1991-02-15 1993-07-20 Cardiac Pathways Corporation Method for mapping, ablation, and stimulation using an endocardial catheter
US5295484A (en) * 1992-05-19 1994-03-22 Arizona Board Of Regents For And On Behalf Of The University Of Arizona Apparatus and method for intra-cardiac ablation of arrhythmias
US5325860A (en) * 1991-11-08 1994-07-05 Mayo Foundation For Medical Education And Research Ultrasonic and interventional catheter and method

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2504394A1 (en) * 1981-04-28 1982-10-29 Seirmi Test probe for monitoring action of cardiac electrode - comprises flexible tube carrying X=ray opaque markings introduced via blood vessel and detectable from outside patients body
US4582061A (en) * 1981-11-18 1986-04-15 Indianapolis Center For Advanced Research, Inc. Needle with ultrasonically reflective displacement scale
YU132884A (en) * 1984-07-26 1987-12-31 Branko Breyer Electrode cateter with ultrasonic marking
US5054492A (en) * 1990-12-17 1991-10-08 Cardiovascular Imaging Systems, Inc. Ultrasonic imaging catheter having rotational image correlation
US5327889A (en) * 1992-12-01 1994-07-12 Cardiac Pathways Corporation Mapping and ablation catheter with individually deployable arms and method
US5156151A (en) * 1991-02-15 1992-10-20 Cardiac Pathways Corporation Endocardial mapping and ablation system and catheter probe
US5263493A (en) * 1992-02-24 1993-11-23 Boaz Avitall Deflectable loop electrode array mapping and ablation catheter for cardiac chambers
US5255679A (en) * 1992-06-02 1993-10-26 Cardiac Pathways Corporation Endocardial catheter for mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith, and method
US5324284A (en) * 1992-06-05 1994-06-28 Cardiac Pathways, Inc. Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4794931A (en) * 1986-02-28 1989-01-03 Cardiovascular Imaging Systems, Inc. Catheter apparatus, system and method for intravascular two-dimensional ultrasonography
US5029588A (en) * 1989-06-15 1991-07-09 Cardiovascular Imaging Systems, Inc. Laser catheter with imaging capability
US5228442A (en) * 1991-02-15 1993-07-20 Cardiac Pathways Corporation Method for mapping, ablation, and stimulation using an endocardial catheter
US5325860A (en) * 1991-11-08 1994-07-05 Mayo Foundation For Medical Education And Research Ultrasonic and interventional catheter and method
US5345940A (en) * 1991-11-08 1994-09-13 Mayo Foundation For Medical Education And Research Transvascular ultrasound hemodynamic and interventional catheter and method
US5295484A (en) * 1992-05-19 1994-03-22 Arizona Board Of Regents For And On Behalf Of The University Of Arizona Apparatus and method for intra-cardiac ablation of arrhythmias

Cited By (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6285898B1 (en) 1993-07-20 2001-09-04 Biosense, Inc. Cardiac electromechanics
US6983179B2 (en) 1993-07-20 2006-01-03 Biosense, Inc. Method for mapping a heart using catheters having ultrasonic position sensors
US6751492B2 (en) 1993-07-20 2004-06-15 Biosense, Inc. System for mapping a heart using catheters having ultrasonic position sensors
US5770599A (en) * 1995-04-27 1998-06-23 Zeneca Limited Quinazoline derivatives
EP0774232A1 (en) * 1995-11-09 1997-05-21 Cordis Corporation Guiding catheter with ultrasound imaging capability
US6915149B2 (en) 1996-01-08 2005-07-05 Biosense, Inc. Method of pacing a heart using implantable device
US6321109B2 (en) 1996-02-15 2001-11-20 Biosense, Inc. Catheter based surgery
US6266551B1 (en) 1996-02-15 2001-07-24 Biosense, Inc. Catheter calibration and usage monitoring system
US6366799B1 (en) 1996-02-15 2002-04-02 Biosense, Inc. Movable transmit or receive coils for location system
US6203493B1 (en) 1996-02-15 2001-03-20 Biosense, Inc. Attachment with one or more sensors for precise position determination of endoscopes
US6618612B1 (en) 1996-02-15 2003-09-09 Biosense, Inc. Independently positionable transducers for location system
US6332089B1 (en) 1996-02-15 2001-12-18 Biosense, Inc. Medical procedures and apparatus using intrabody probes
US6253770B1 (en) 1996-02-15 2001-07-03 Biosense, Inc. Catheter with lumen
US6211666B1 (en) 1996-02-27 2001-04-03 Biosense, Inc. Object location system and method using field actuation sequences having different field strengths
EP1362553A1 (en) * 1996-06-11 2003-11-19 Roke Manor Research Limited Catheter tracking system and method
EP0812568A3 (en) * 1996-06-11 1998-01-07 Roke Manor Research Limited Catheter tracking system and method
EP0812568A2 (en) * 1996-06-11 1997-12-17 Roke Manor Research Limited Catheter tracking system and method
US5938602A (en) * 1996-06-11 1999-08-17 Roke Manor Research Limited Catheter tracking system and method
US6443974B1 (en) 1996-07-28 2002-09-03 Biosense, Inc. Electromagnetic cardiac biostimulation
WO1998018388A1 (en) * 1996-10-28 1998-05-07 Ep Technologies, Inc. Systems and methods for visualizing interior tissue regions
US5848969A (en) * 1996-10-28 1998-12-15 Ep Technologies, Inc. Systems and methods for visualizing interior tissue regions using expandable imaging structures
US6436095B1 (en) 1997-01-08 2002-08-20 Biosense, Inc. Method for monitoring revascularization treatment using pre-pmr data and post-pmr data
US6200310B1 (en) 1997-01-08 2001-03-13 Biosense, Inc. Monitoring of myocardial revascularization
US6314310B1 (en) 1997-02-14 2001-11-06 Biosense, Inc. X-ray guided surgical location system with extended mapping volume
US6788967B2 (en) 1997-05-14 2004-09-07 Biosense, Inc. Medical diagnosis, treatment and imaging systems
WO1999005971A1 (en) * 1997-08-01 1999-02-11 Cardiac Pathways Corporation System for electrode localization using ultrasound
US6216027B1 (en) 1997-08-01 2001-04-10 Cardiac Pathways Corporation System for electrode localization using ultrasound
US6447504B1 (en) 1998-07-02 2002-09-10 Biosense, Inc. System for treatment of heart tissue using viability map
WO2011014804A1 (en) 2009-07-31 2011-02-03 St. Jude Medical, Atrial Fibrillation Division, Inc. Methods and apparatus for detecting and mapping tissue interfaces
EP2459074A1 (en) * 2009-07-31 2012-06-06 St. Jude Medical Atrial Fibrillation Division, Inc. Methods and apparatus for detecting and mapping tissue interfaces
EP2459074B1 (en) * 2009-07-31 2018-07-11 St. Jude Medical, Atrial Fibrillation Division, Inc. Methods and apparatus for detecting and mapping tissue interfaces
WO2016079659A1 (en) * 2014-11-18 2016-05-26 Koninklijke Philips N.V. Visualization apparatus for property change of a tissue

Also Published As

Publication number Publication date
AU7869694A (en) 1995-04-03
US5409000A (en) 1995-04-25

Similar Documents

Publication Publication Date Title
US5409000A (en) Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method
AU2018204229B2 (en) Lasso catheter with tip electrode
US6004269A (en) Catheters for imaging, sensing electrical potentials, and ablating tissue
EP2468205B1 (en) Lasso catheter with ultrasound transducer
US5840031A (en) Catheters for imaging, sensing electrical potentials and ablating tissue
US5588432A (en) Catheters for imaging, sensing electrical potentials, and ablating tissue
EP2713888B1 (en) Ablation probe with ultrasonic imaging capabilities
US6216027B1 (en) System for electrode localization using ultrasound
US5637090A (en) Multiple electrode element for mapping and ablating heart tissue
JP2002522106A (en) Dynamically changeable 3D graphic model of the human body
EP2734118B1 (en) Ablation apparatus
EP3675757B1 (en) Ablation catheter, catheter arrangement and system for providing ablative treatment
CN109700523A (en) Esophageal probe with transmission coil
US20210128106A1 (en) Introducer sheath with imaging capability
EP4115828A1 (en) Contact assessment for balloon catheter
JP2021074549A (en) Accurate positioning and shape visualization of balloon catheter ablation tags
EP4134006A1 (en) Presenting quality measures of tissue ablation in a blood vessel using a two-dimensional map
EP4133996A1 (en) Assessing lesions formed in an ablation procedure
CA2471106A1 (en) Imaging, electrical potential sensing and ablation catheters
WO2023118995A1 (en) Visualization of change in anatomical slope using 4d ultrasound catheter
WO2023248032A1 (en) Applying ablation signals to both sides of tissue
CN115462890A (en) Following wave propagation

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AU CA JP

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: CA