US20090030412A1
Active / In Force
US
⏱️ 1.5 years remaining
Visual electrode ablation systems
Assignee: Intuitive Surgical Operations Inc
•
Filing: 2008-05-09
•
Granted: —
•
Expires: 2028-05-09
Abstract
Abstract Visual electrode ablation systems are described herein which include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. An electric current may be passed through the fluid such that it passes directly to the tissue region being imaged and the electrical energy is conducted through the fluid without the need for a separate ablation probe or instrument to ablate the tissue being viewed.
Inventors
- 👤 N. Parker Willis
- 👤 Zachary J. Malchano
- 👤 Chris A. Rothe
- 👤 Vahid Saadat
- 👤 Ruey-Feng Peh
- 👤 David Miller
- 👤 Edmund Tam
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 05:17
CPC Classifications
A; A61; A61B; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B18/1492; A61B1/00; A61B1/00064; A61B1/00071; A61B1/0008; A61B1/00089; A61B1/012; A61B17/00; A61B2017/00017; A61B2017/00022; A61B2017/00106; A61B2018/00053; A61B2018/00214; A61B2018/00571; A61B2018/00577; A61B2018/00636; A61B2018/00642; A61B2018/00773; A61B2018/00791; A61B2018/00809; A61B2018/00839; A61B2018/1472; A61B2218/00; A61B2218/001; A61B2218/002
Claims Analysis
Total Claims: 76
Claim 1
Independent Claim
101 words
1 . A tissue ablation apparatus adapted for deployment within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a field when the barrier or membrane is expanded in the blood-filled environment from an insertion configuration to a deployed configuration, wherein the barrier or membrane further defines at least one aperture through which fluid is permeable; and an electrode coupled to a purging fluid within the barrier or membrane and spaced from the aperture such that, in use, electrical energy from the electrode is conducted by the fluid into the tissue surface adjacent the aperture.
Claim 2
Dependent Claim
101 words
1 . A tissue ablation apparatus adapted for deployment within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a field when the barrier or membrane is expanded in the blood-filled environment from an insertion configuration to a deployed configuration, wherein the barrier or membrane further defines at least one aperture through which fluid is permeable; and an electrode coupled to a purging fluid within the barrier or membrane and spaced from the aperture such that, in use, electrical energy from the electrode is conducted by the fluid into the tissue surface adjacent the aperture.
Claim 3
Dependent Claim
16 words
2 . The apparatus of claim 1 wherein the barrier or membrane defines a conical structure.
Claim 4
Dependent Claim
13 words
3 . The apparatus of claim 1 wherein the transparent fluid comprises saline.
Claim 5
Dependent Claim
25 words
4 . The apparatus of claim 1 wherein the barrier or membrane forms an expandable membrane defining an angled contact surface relative to the catheter.
Claim 6
Dependent Claim
22 words
5 . The apparatus of claim 1 wherein the barrier or membrane comprises a distal membrane along which the aperture is defined.
Claim 7
Dependent Claim
20 words
6 . The apparatus of claim 1 further comprising a handle coupled to a proximal end of the deployment catheter.
Claim 8
Dependent Claim
44 words
7 . The apparatus of claim 1 further comprising an imaging element positioned within or along the barrier or membrane and adapted to image a tissue surface adjacent to the barrier or membrane when the field is purged of blood via the purging fluid.
Claim 9
Dependent Claim
67 words
8 . The apparatus of claim 7 wherein the barrier or membrane define one or more directional indicators visible through the field via the imaging element, wherein a handle coupled to the catheter further defines one or more directional indicators correlating to the directional indicators on the barrier or membrane such that articulation of a control on the handle articulates the deployment catheter in a corresponding direction.
Claim 10
Dependent Claim
25 words
9 . The apparatus of claim 7 wherein the barrier or membrane define one or more gradations visible through the field via the imaging element.
Claim 11
Dependent Claim
21 words
10 . The apparatus of claim 1 wherein the electrode is positioned within the barrier or membrane proximally of the field.
Claim 12
Dependent Claim
22 words
11 . The apparatus of claim 1 wherein the electrode is configured as a support strut positioned along the barrier or membrane.
Claim 13
Dependent Claim
29 words
12 . The apparatus of claim 1 wherein the electrode is configured as a ring electrode extending from a support member positioned within the field proximally of the aperture.
Claim 14
Dependent Claim
29 words
13 . The apparatus of claim 1 wherein the electrode is configured as a ring electrode positioned upon a surface of the barrier or membrane proximal to the aperture.
Claim 15
Dependent Claim
27 words
14 . The apparatus of claim 1 further comprising an electrocardiogram electrode positioned along an outer surface of the barrier or membrane for contacting the tissue region.
Claim 16
Dependent Claim
28 words
15 . The apparatus of claim 1 further comprising one or more ultrasound transducers along an outer surface of the barrier or membrane for contacting the tissue region.
Claim 17
Dependent Claim
35 words
16 . The apparatus of claim 1 wherein the deployment catheter comprises a proximal steering section configured to articulate within a plane and a distal steering section configured to articulate within at least four planes.
Claim 18
Dependent Claim
35 words
17 . The apparatus of claim 1 further comprising at least one thermochromic indicator along a surface of the barrier or membrane for visually indicating a temperature change of the transparent fluid and/or tissue surface.
Claim 19
Dependent Claim
134 words
18 . A tissue ablation system adapted for ablating a target tissue region within a blood-filled environment, the target tissue region disposed along a tissue surface, the ablation system comprising: a deployment catheter having a fluid lumen, an electrode, and an imaging element; a fluid source in fluid communication with the fluid lumen so as to direct fluid distally through the fluid lumen and into a visualization field extending between the imaging element and the target tissue; an imaging monitor coupled to the imaging element so as to image the tissue surface through the fluid within the visualization field; and an electrical energy source coupled to the electrode, the electrode coupled to the fluid from the lumen so that the fluid within the visualization field conducts ablating electrical energy to the target tissue region.
Claim 20
Dependent Claim
134 words
18 . A tissue ablation system adapted for ablating a target tissue region within a blood-filled environment, the target tissue region disposed along a tissue surface, the ablation system comprising: a deployment catheter having a fluid lumen, an electrode, and an imaging element; a fluid source in fluid communication with the fluid lumen so as to direct fluid distally through the fluid lumen and into a visualization field extending between the imaging element and the target tissue; an imaging monitor coupled to the imaging element so as to image the tissue surface through the fluid within the visualization field; and an electrical energy source coupled to the electrode, the electrode coupled to the fluid from the lumen so that the fluid within the visualization field conducts ablating electrical energy to the target tissue region.
Claim 21
Dependent Claim
65 words
19 . The system of claim 18 wherein the deployment catheter has a flexible intracardial catheter body, and further comprising a steering system coupled to the deployment catheter so as to selectively bend the catheter body and reposition the visualization field from a proximal end of the deployment catheter when the distal end of the deployment catheter is disposed in a chamber of a heart.
Claim 22
Dependent Claim
52 words
20 . A method of ablating a tissue region within a blood-filled environment, comprising: restraining a fluid within a visualization field in a portion of the blood-filled environment; visualizing the tissue region through the fluid within the visualization field; and transmitting ablating electrical energy from the fluid into the visualized tissue region.
Claim 23
Dependent Claim
52 words
20 . A method of ablating a tissue region within a blood-filled environment, comprising: restraining a fluid within a visualization field in a portion of the blood-filled environment; visualizing the tissue region through the fluid within the visualization field; and transmitting ablating electrical energy from the fluid into the visualized tissue region.
Claim 24
Dependent Claim
108 words
21 . The method of claim 20 wherein the tissue region comprises a target tissue surface region within a chamber of a heart, wherein the target surface region is visualized during ablation and while the heart is beating, and wherein the fluid is restrained by a membrane or barrier, and further comprising: expanding the membrane or barrier from an insertion configuration to a deployed configuration within the chamber of the heart; and positioning an aperture of the membrane or barrier in alignment with the target tissue surface region so that fluid is exposed to the tissue region and so that the ablating mitigates an arrhythmia of the heart.
Claim 25
Dependent Claim
22 words
22 . The method of claim 21 wherein positioning comprises intravascularly advancing the barrier or membrane into a chamber of a heart.
Claim 26
Dependent Claim
27 words
23 . The method of claim 20 further comprising monitoring a change in color of the tissue region whereby a blanched color is indicative of lesion formation.
Claim 27
Dependent Claim
17 words
24 . The method of claim 20 further comprising monitoring the tissue region for formation of bubbles.
Claim 28
Dependent Claim
17 words
25 . The method of claim 24 further comprising monitoring a quantity and/or rate of bubble formation.
Claim 29
Dependent Claim
27 words
26 . The method of claim 25 further comprising automatically adjusting a power level of the electrical energy based upon the quantity and/or rate of bubble formation.
Claim 30
Dependent Claim
18 words
27 . The method of claim 20 wherein visualizing comprises inspecting the tissue region for discontiguous lesion formations.
Claim 31
Dependent Claim
24 words
28 . The method of claim 27 wherein transmitting comprises transmitting electrical energy through an aperture along one or more gaps between discontiguous lesions.
Claim 32
Dependent Claim
23 words
29 . The method of claim 20 further comprising monitoring a thermochromic indicator positioned upon the barrier or membrane for changes in temperature.
Claim 33
Dependent Claim
23 words
30 . The method of claim 29 further comprising adjusting a power level of the electrical energy based upon the changes in temperature.
Claim 34
Dependent Claim
28 words
31 . The method of claim 20 wherein restraining comprises creating a negative pressure within the visualization field such that the tissue region is adhered to the aperture.
Claim 35
Dependent Claim
17 words
32 . The method of claim 31 further comprising recirculating the transparent fluid within the visualization field.
Claim 36
Dependent Claim
145 words
33 . A tissue ablation apparatus adapted for deployment within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a visualization field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture through which fluid is permeable; an imaging element positioned within or along the barrier or membrane and adapted to image a tissue surface adjacent to the barrier or membrane within a field of view of the imaging element when the visualization field is purged of blood via a transparent fluid; and an electrode positioned within or along the barrier or membrane such that the electrode is outside the field of view and spaced from the aperture such that energy discharged from the electrode is directed through the transparent fluid and into the tissue surface being visualized.
Claim 37
Dependent Claim
145 words
33 . A tissue ablation apparatus adapted for deployment within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a visualization field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture through which fluid is permeable; an imaging element positioned within or along the barrier or membrane and adapted to image a tissue surface adjacent to the barrier or membrane within a field of view of the imaging element when the visualization field is purged of blood via a transparent fluid; and an electrode positioned within or along the barrier or membrane such that the electrode is outside the field of view and spaced from the aperture such that energy discharged from the electrode is directed through the transparent fluid and into the tissue surface being visualized.
Claim 38
Dependent Claim
16 words
34 . The apparatus of claim 33 wherein the barrier or membrane defines a conical structure.
Claim 39
Dependent Claim
13 words
35 . The apparatus of claim 33 wherein the transparent fluid comprises saline.
Claim 40
Dependent Claim
25 words
36 . The apparatus of claim 33 wherein the barrier or membrane forms an expandable membrane defining an angled contact surface relative to the catheter.
Claim 41
Dependent Claim
22 words
37 . The apparatus of claim 33 wherein the barrier or membrane comprises a distal membrane along which the aperture is defined.
Claim 42
Dependent Claim
20 words
38 . The apparatus of claim 33 further comprising a handle coupled to a proximal end of the deployment catheter.
Claim 43
Dependent Claim
64 words
39 . The apparatus of claim 38 wherein the barrier or membrane define one or more directional indicators visible through the visualization field via the imaging element, wherein the handle further defines one or more directional indicators correlating to the directional indicators on the barrier or membrane such that articulation of a control on the handle articulates the deployment catheter in a corresponding direction.
Claim 44
Dependent Claim
26 words
40 . The apparatus of claim 33 wherein the barrier or membrane define one or more gradations visible through the visualization field via the imaging element.
Claim 45
Dependent Claim
22 words
41 . The apparatus of claim 33 wherein the electrode is positioned within the barrier or membrane proximally of the visualization field.
Claim 46
Dependent Claim
22 words
42 . The apparatus of claim 33 wherein the electrode is configured as a support strut positioned along the barrier or membrane.
Claim 47
Dependent Claim
30 words
43 . The apparatus of claim 33 wherein the electrode is configured as a ring electrode extending from a support member positioned within the visualization field proximally of the aperture.
Claim 48
Dependent Claim
29 words
44 . The apparatus of claim 33 wherein the electrode is configured as a ring electrode positioned upon a surface of the barrier or membrane proximal to the aperture.
Claim 49
Dependent Claim
27 words
45 . The apparatus of claim 33 further comprising an electrocardiogram electrode positioned along an outer surface of the barrier or membrane for contacting the tissue region.
Claim 50
Dependent Claim
28 words
46 . The apparatus of claim 33 further comprising one or more ultrasound transducers along an outer surface of the barrier or membrane for contacting the tissue region.
Claim 51
Dependent Claim
35 words
47 . The apparatus of claim 33 wherein the deployment catheter comprises a proximal steering section configured to articulate within a plane and a distal steering section configured to articulate within at least four planes.
Claim 52
Dependent Claim
35 words
48 . The apparatus of claim 33 further comprising at least one thermochromic indicator along a surface of the barrier or membrane for visually indicating a temperature change of the transparent fluid and/or tissue surface.
Claim 53
Dependent Claim
136 words
49 . A tissue ablation apparatus adapted for ablating a tissue region within an isolated region contained in a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a therapy field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture therethrough; an electrode positioned within or along the barrier or membrane and spaced from the aperture, wherein the aperture is positionable against a tissue region to be ablated such that an electrolytic fluid introduced through the catheter and into the therapy field forms a conductive path between the electrode and the tissue region through the aperture, and wherein energy delivered through the electrolytic fluid to the tissue region is contained within the therapy field of the barrier or membrane.
Claim 54
Dependent Claim
136 words
49 . A tissue ablation apparatus adapted for ablating a tissue region within an isolated region contained in a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a therapy field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture therethrough; an electrode positioned within or along the barrier or membrane and spaced from the aperture, wherein the aperture is positionable against a tissue region to be ablated such that an electrolytic fluid introduced through the catheter and into the therapy field forms a conductive path between the electrode and the tissue region through the aperture, and wherein energy delivered through the electrolytic fluid to the tissue region is contained within the therapy field of the barrier or membrane.
Claim 55
Dependent Claim
13 words
50 . The apparatus of claim 49 wherein the electrolytic fluid comprises saline.
Claim 56
Dependent Claim
22 words
51 . The apparatus of claim 49 wherein the barrier or membrane comprises a distal membrane along which the aperture is defined.
Claim 57
Dependent Claim
22 words
52 . The apparatus of claim 49 wherein the electrode is positioned within the barrier or membrane proximally of the therapy field.
Claim 58
Dependent Claim
22 words
53 . The apparatus of claim 49 wherein the electrode is configured as a support strut positioned along the barrier or membrane.
Claim 59
Dependent Claim
30 words
54 . The apparatus of claim 49 wherein the electrode is configured as a ring electrode extending from a support member positioned within the therapy field proximally of the aperture.
Claim 60
Dependent Claim
29 words
55 . The apparatus of claim 49 wherein the electrode is configured as a ring electrode positioned upon a surface of the barrier or membrane proximal to the aperture.
Claim 61
Dependent Claim
45 words
56 . The apparatus of claim 49 further comprising an imaging element positioned within or along the barrier or membrane and adapted to image a tissue surface adjacent to the barrier or membrane when the therapy field is purged of blood via the electrolytic fluid.
Claim 62
Dependent Claim
34 words
57 . The apparatus of claim 49 wherein the barrier or membrane comprises a distal membrane with a surface area at least twice as large as a cross sectional area of the deployment catheter.
Claim 63
Dependent Claim
106 words
58 . A tissue ablation apparatus adapted for ablating a tissue region within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a therapy field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture therethrough; an electrode positioned within or along the barrier or membrane and spaced from the aperture, and wherein energy delivered from the electrode and through an electrolytic fluid introduced through the catheter within the therapy field enters the tissue region uniformly over an area isolated by the barrier or membrane against the tissue region.
Claim 64
Dependent Claim
106 words
58 . A tissue ablation apparatus adapted for ablating a tissue region within a blood-filled environment, comprising: a barrier or membrane projecting from a deployment catheter and defining a therapy field when the barrier or membrane is in a deployed configuration, wherein the barrier or membrane further defines at least one aperture therethrough; an electrode positioned within or along the barrier or membrane and spaced from the aperture, and wherein energy delivered from the electrode and through an electrolytic fluid introduced through the catheter within the therapy field enters the tissue region uniformly over an area isolated by the barrier or membrane against the tissue region.
Claim 65
Dependent Claim
13 words
59 . The apparatus of claim 58 wherein the electrolytic fluid comprises saline.
Claim 66
Dependent Claim
32 words
60 . The apparatus of claim 58 wherein the tissue region area isolated by the barrier or membrane is at least twice as large as a cross-sectional area of the deployment catheter.
Claim 67
Dependent Claim
22 words
61 . The apparatus of claim 58 wherein the barrier or membrane comprises a distal membrane along which the aperture is defined.
Claim 68
Dependent Claim
22 words
62 . The apparatus of claim 58 wherein the electrode is positioned within the barrier or membrane proximally of the therapy field.
Claim 69
Dependent Claim
22 words
63 . The apparatus of claim 58 wherein the electrode is configured as a support strut positioned along the barrier or membrane.
Claim 70
Dependent Claim
30 words
64 . The apparatus of claim 58 wherein the electrode is configured as a ring electrode extending from a support member positioned within the therapy field proximally of the aperture.
Claim 71
Dependent Claim
29 words
65 . The apparatus of claim 58 wherein the electrode is configured as a ring electrode positioned upon a surface of the barrier or membrane proximal to the aperture.
Claim 72
Dependent Claim
45 words
66 . The apparatus of claim 58 further comprising an imaging element positioned within or along the barrier or membrane and adapted to image a tissue surface adjacent to the barrier or membrane when the therapy field is purged of blood via the electrolytic fluid.
Claim 73
Dependent Claim
46 words
67 . A method of ablating a target tissue region, the target tissue region being disposed along a tissue surface, the method comprising selectively directing ablating energy into the target tissue region through the tissue surface while imaging the tissue surface along the target tissue region.
Claim 74
Dependent Claim
46 words
67 . A method of ablating a target tissue region, the target tissue region being disposed along a tissue surface, the method comprising selectively directing ablating energy into the target tissue region through the tissue surface while imaging the tissue surface along the target tissue region.
Claim 75
Dependent Claim
65 words
68 . An apparatus for ablating a target tissue region, the target tissue region being disposed along a tissue surface, the apparatus comprising: means for selectively directing ablating energy into the target tissue region through the tissue surface; and means for imaging the tissue surface along the target tissue region while selectively directing the ablating energy, the imaging means coupled to the energy directing means.
Claim 76
Dependent Claim
65 words
68 . An apparatus for ablating a target tissue region, the target tissue region being disposed along a tissue surface, the apparatus comprising: means for selectively directing ablating energy into the target tissue region through the tissue surface; and means for imaging the tissue surface along the target tissue region while selectively directing the ablating energy, the imaging means coupled to the energy directing means.
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