Patent US5222501A successfully refreshed from Google Patents.
US5222501A
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Methods for the diagnosis and ablation treatment of ventricular tachycardia
Assignee: Duke University
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Filing: 1992-01-31
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Granted: 1993-06-29
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Expires: 2012-01-31
Abstract
Abstract A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia is disclosed. The method comprises, first, defining a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of the patient, and then ablating the thin layer of spared myocardial tissue by a closed-heart procedure with an ablation catheter. Apparatus for carrying out the method is also disclosed. Also disclosed is a method for prognosing the likelihood of ventricular tachycardia occuring in a myocardial infarct patient not previously diagnosed as afflicted with ventricular tachycardia. The method comprises detecting a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) in the patient.
Inventors
- 👤 Raymond E. Ideker
- 👤 Gregory P. Walcott
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-22 23:27
CPC Classifications
A; A61; A61B; A61B8/00; A61B8/12; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B18/1492; A61B5/00; A61B5/24; A61B5/316; A61B5/318; A61B5/346; A61B5/349; A61B5/363; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/05; A61N1/056; A61B17/00; A61B17/22; A61B17/22004; A61B17/22012; A61B18/08; A61B18/082; A61B18/18; A61B18/20; A61B18/22; A61B18/24; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00292
Claims Analysis
Total Claims: 43
Claim 1
Independent Claim
69 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient; and then (b) ablating said thin layer of spared myocardial tissue by a closed-heart procedure with an ablation catheter.
Claim 2
Dependent Claim
69 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient; and then (b) ablating said thin layer of spared myocardial tissue by a closed-heart procedure with an ablation catheter.
Claim 3
Dependent Claim
27 words
A method according to claim 1, wherein said defining step comprises the step of defining a thin layer having a thickness of up to about 5 millimeters.
Claim 4
Dependent Claim
28 words
A method according to claim 1, wherein said defining step comprises the step of defining a thin layer having a thickness of from about 25 to 2 millimeters.
Claim 5
Dependent Claim
29 words
A method according to claim 1, wherein said defining step comprises the step of defining a thin layer having an endocardial surface area of at least 15 square centimeters.
Claim 6
Dependent Claim
31 words
A method according to claim 1, wherein said defining step comprises the step of defining a thin layer having an endocardial surface area of from about 20 to 40 square centimeters.
Claim 7
Dependent Claim
19 words
A method according to claim 1, wherein said defining step is carried out in the absence of ventricular tachycardia.
Claim 8
Dependent Claim
24 words
A method according to claim 1, wherein said defining step is carried out by detecting said thin layer of spared myocardial tissue by echocardiography.
Claim 9
Dependent Claim
27 words
A method according to claim 1, wherein said defining step is carried out by detecting said infarct overlying said thin layer of spared myocardial tissue by echocardiography.
Claim 10
Dependent Claim
26 words
A method according to claim 1, wherein said defining step is carried out by visualization of endocardial fibrosis beneath said thin layer of spared myocardial tissue.
Claim 11
Dependent Claim
24 words
A method according to claim 1, wherein said defining step is carried out by electrically stimulating the endocardium to detect an increased pacing threshold.
Claim 12
Dependent Claim
31 words
A method according to claim 1, wherein said defining step is carried out with a catheter mounted echocardiographic ultrasound crystal sensor inserted into the interior of the heart of said patient.
Claim 13
Dependent Claim
26 words
A method according to claim 1, wherein said defining step is carried out with an echocardiographic ultrasound crystal sensor positioned in the esophagus of said patient.
Claim 14
Dependent Claim
21 words
A method according to claim 1, wherein said ablating step comprises destroying all of said thin layer of spared myocardial tissue.
Claim 15
Dependent Claim
35 words
A method according to claim 1, wherein said ablating step comprises the step of electrically separating a portion of said thin layer sufficient in size to combat ventricular tachycardia from the remainder of the endocardium.
Claim 16
Dependent Claim
64 words
A method according to claim 1, wherein said ablating step comprises the step of creating at least one elongate lesion in said thin layer extending from the endocardium to said myocardial infarct scar tissue, wherein said at least one elongate lesion divides said thin layer into a plurality of electrically separated portions, and wherein each of said portions is incapable of originating ventricular tachycardia.
Claim 17
Dependent Claim
19 words
A method according to claim 15, wherein said at least one elongate lesion comprises a plurality of elongate lesions.
Claim 18
Dependent Claim
34 words
A method according to claim 1, wherein said ablating step is followed by the step of verifying that said thin layer of spared myocardial tissue is no longer capable of originating a ventricular tachycardia.
Claim 19
Dependent Claim
19 words
A method according to claim 17, wherein said verifying step comprises a programmed pacing technique to induce ventricular tachycardia.
Claim 20
Dependent Claim
152 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient, said thin layer having a thickness up to about five millimeters and an endocardial surface area of at least 15 square centimeters; and then (b) ablating said thin layer of spared myocardial tissue by creating at least one elongate lesion in said thin layer extending from the endocardium to said myocardial infarct scar tissue in a closed-heart procedure with an ablation catheter, wherein said at least one elongate lesion is configured to reduce any portion of said thin layer in electrical contact with the remainder of the endocardium to a size, in surface area, sufficient to combat ventricular tachycardia in said patient.
Claim 21
Dependent Claim
152 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient, said thin layer having a thickness up to about five millimeters and an endocardial surface area of at least 15 square centimeters; and then (b) ablating said thin layer of spared myocardial tissue by creating at least one elongate lesion in said thin layer extending from the endocardium to said myocardial infarct scar tissue in a closed-heart procedure with an ablation catheter, wherein said at least one elongate lesion is configured to reduce any portion of said thin layer in electrical contact with the remainder of the endocardium to a size, in surface area, sufficient to combat ventricular tachycardia in said patient.
Claim 22
Dependent Claim
38 words
A method according to claim 19, wherein said ablating step comprises the step of electrically separating from the remainder of the endocardium a portion of said thin layer sufficient in size, in surface area to combat ventricular tachycardia.
Claim 23
Dependent Claim
54 words
A method according to claim 19, wherein said electrically separating step comprises the step of creating a continuous lesion extending from the endocardium to said myocardial infarct scar tissue around said thin layer of spared myocardial tissue, said continuous lesion encircling said thin layer to electrically separate said thin layer from adjacent myocardial tissue.
Claim 24
Dependent Claim
71 words
A method according to claim 19, wherein said ablating step comprises the step of creating at least one elongate lesion in said thin layer extending from the endocardium to said myocardial infarct scar tissue, wherein said at least one elongate lesion divides said thin layer into a plurality of electrically separated portions, and wherein each of said portions is reduced to a size, in surface area, sufficient to combat ventricular tachycardia.
Claim 25
Dependent Claim
19 words
A method according to claim 19, wherein said at least one elongate lesion comprises a plurality of elongate lesions.
Claim 26
Independent Claim
56 words
A method for prognosing the likelihood of ventricular tachycardia occuring in a myocardial infarct patient not previously diagnosed as afflicted with ventricular tachycardia, said method comprising detecting the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) in said patient.
Claim 27
Independent Claim
56 words
A method for prognosing the likelihood of ventricular tachycardia occuring in a myocardial infarct patient not previously diagnosed as afflicted with ventricular tachycardia, said method comprising detecting the boundaries of a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) in said patient.
Claim 28
Dependent Claim
13 words
A method according to claim 24, wherein said method is a closed-heart method.
Claim 29
Dependent Claim
83 words
A method according to claim 24, wherein said detecting step is carried out by: (a) determining if a thin layer of spared tissue exists between the infarct and the endocardium, and then (b) creating a map of the locations of the thin layer identified in said determining step to define the thin layer areas, and (c) evaluating the dimensions of said thin layer areas to determine if the contiguous portions of said thin layer areas are of sufficient size to support reentrant pathways.
Claim 30
Dependent Claim
27 words
A method according to claim 24, wherein said detecting step comprises the step of detecting a thin layer having a thickness of up to about 5 millimeters.
Claim 31
Dependent Claim
28 words
A method according to claim 24, wherein said detecting step comprises the step of detecting a thin layer having a thickness of from about 0.25 to 2 millimeters.
Claim 32
Dependent Claim
29 words
A method according to claim 24, wherein said detecting step comprises the step of detecting a thin layer having an endocardial surface area of at least 15 square centimeters.
Claim 33
Dependent Claim
31 words
A method according to claim 24, wherein said detecting step comprises the step of detecting a thin layer having an endocardial surface area of from about 20 to 40 square centimeters.
Claim 34
Independent Claim
69 words
An apparatus for the ablation treatment of ventricular tachycardia, comprising: an intraventricular catheter; detecting means for detecting the boundaries of a thin layer of spared endocardial tissue connected to said intraventricular catheter; ablation means for ablating said thin layer of spared endocardial tissue connected to said intraventricular catheter; and analyzing means operatively associated with said detecting means for prognosing the likelihood of ventricular tachycardia arising from said thin layer.
Claim 35
Independent Claim
69 words
An apparatus for the ablation treatment of ventricular tachycardia, comprising: an intraventricular catheter; detecting means for detecting the boundaries of a thin layer of spared endocardial tissue connected to said intraventricular catheter; ablation means for ablating said thin layer of spared endocardial tissue connected to said intraventricular catheter; and analyzing means operatively associated with said detecting means for prognosing the likelihood of ventricular tachycardia arising from said thin layer.
Claim 36
Dependent Claim
18 words
An apparatus according to claim 31, wherein said analyzing means comprises a software program running in a computer.
Claim 37
Dependent Claim
113 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient; and then (b) ablating said thin layer of spaced myocardial tissue by a closed-heart procedure with an ablation catheter; wherein said ablating step comprises the step of creating a continuous lesion extending from the endocardium to said myocardial infarct scar tissue around said thin layer of spared myocardial tissue, said continuous lesion encircling said thin layer to electrically separate said thin layer from adjacent myocardial tissue.
Claim 38
Dependent Claim
113 words
A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia, said method comprising: (a) defining a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of said patient; and then (b) ablating said thin layer of spaced myocardial tissue by a closed-heart procedure with an ablation catheter; wherein said ablating step comprises the step of creating a continuous lesion extending from the endocardium to said myocardial infarct scar tissue around said thin layer of spared myocardial tissue, said continuous lesion encircling said thin layer to electrically separate said thin layer from adjacent myocardial tissue.
Claim 39
Dependent Claim
19 words
A method according to claim 33, wherein said defining step is carried out in the absence of ventricular tachycardia.
Claim 40
Dependent Claim
24 words
A method according to claim 33, wherein said defining step is carried out by detecting said thin layer of spared myocardial tissue by echocardiography.
Claim 41
Dependent Claim
27 words
A method according to claim 33, wherein said defining step is carried out by detecting said infarct overlying said thin layer of spared myocardial tissue by echocardiography.
Claim 42
Dependent Claim
26 words
A method according to claim 33, wherein said defining step is carried out by visualization of endocardial fibrosis beneath said thin layer of spared myocardial tissue.
Claim 43
Dependent Claim
24 words
A method according to claim 33, wherein said defining step is carried out by electrically stimulating the endocardium to detect an increased pacing threshold.
References Cited (Backward Citations)
US4940064A
Cited
US4862887A
Cited
US4928695A
Cited
US4936281A
Cited
US5056517A
Cited
US5010886A
Cited
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1996-06-28 | 1996-12-28 | 1997-06-29 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2000-06-28 | 2000-12-28 | 2001-06-29 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2004-06-28 | 2004-12-28 | 2005-06-29 | $7700.00 | Window Closed / Lapsed |