US6237605B1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Methods of epicardial ablation
Assignee: St Jude Medical Atrial Fibrillation Division Inc
•
Filing: 1998-09-21
•
Granted: 2001-05-29
•
Expires: 2018-09-21
Abstract
Abstract The invention provides apparatus and methods for mapping conduction pathways and creating transmural lesions in the heart wall for the treatment of atrial fibrillation. The apparatus may include at least one epicardial ablation probe having a plurality of electrodes for creating a transmural lesion. The apparatus and method facilitate the formation of a transmural lesion which electrically isolates the pulmonary veins from the surrounding myocardium without cutting or penetrating the pericardial reflections.
Inventors
- 👤 Matthias Vaska
- 👤 Daniel D. Merrick
- 👤 Ajit S. Shah
- 👤 Casper deClerq
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 09:54
CPC Classifications
A; A61; A61B; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B18/1482; A61B18/02; A61B18/1492; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/06; A61B18/149; A61B17/00; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00247; A61B2017/00292; A61B2017/003; A61B17/34; A61B17/3417; A61B2017/3419; A61B2018/00053; A61B2018/0016; A61B2018/00214; A61B2018/0022; A61B2018/00232; A61B2018/0025; A61B2018/00261; A61B2018/00273; A61B2018/00279; A61B2018/00285; A61B2018/00291; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00363; A61B2018/00392; A61B2018/00571; A61B2018/00577; A61B2018/00636; A61B2018/00773; A61B2018/00839; A61B18/1442; A61B2018/145; A61B2018/1467; A61B34/00; A61B34/20; A61B5/00; A61B5/24; A61B5/25; A61B5/279; A61B5/28; A61B5/283; A61B5/287
Claims Analysis
Total Claims: 57
Claim 1
Independent Claim
125 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablation device and a second ablation device each having at least one ablating element, the first ablation device passing through the second ablation device and being slidably received by the second ablation device: placing the first and second ablation devices through a thoracic incision and through a pericardial penetration so that the first and second ablation devices are disposed in contact with an epicardial surface of the heart wall; and ablating the heart wall to create at least one lesion with the ablating elements of the first and second ablation devices positioned at the epicardial surface of the heart wall.
Claim 2
Independent Claim
125 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablation device and a second ablation device each having at least one ablating element, the first ablation device passing through the second ablation device and being slidably received by the second ablation device: placing the first and second ablation devices through a thoracic incision and through a pericardial penetration so that the first and second ablation devices are disposed in contact with an epicardial surface of the heart wall; and ablating the heart wall to create at least one lesion with the ablating elements of the first and second ablation devices positioned at the epicardial surface of the heart wall.
Claim 3
Dependent Claim
26 words
The method of claim 1 wherein the at least one lesion formed by the first and second ablation devices extends continuously to form an elongate lesion.
Claim 4
Dependent Claim
19 words
The method of claim 1 wherein the at least one lesion extends continuously around four of the pulmonary veins.
Claim 5
Dependent Claim
23 words
The method of claim 1 wherein the at least one lesion electrically isolates the pulmonary veins from a portion of the heart wall.
Claim 6
Dependent Claim
42 words
The method of claim 1 wherein the first ablation device has a catch device, and the step of positioning comprises engaging the locating device with at least one of a pulmonary vein, vena cava, aorta, pulmonary artery, atrial appendage, or pericardial reflection.
Claim 7
Dependent Claim
38 words
The method of claim 1 wherein at least one of the first and second ablation devices has at least one electrode mounted thereto and the step of ablating comprises applying energy to the heart wall through said electrode.
Claim 8
Dependent Claim
48 words
The method of claim 1 wherein the at least one of the first and second ablation devices has a plurality of ablating elements and the step of ablating comprises applying energy to the heart wall through said plurality of ablating elements to create a substantially continuous lesion therebetween.
Claim 9
Dependent Claim
14 words
The method of claim 1 wherein the thoracic incision is in a subxiphoid position.
Claim 10
Dependent Claim
35 words
The method of claim 1 further comprising viewing the heart using a technique selected from fluoroscopy, echocardiography, endoscopy, transillumination and magnetic resonance imaging during at least one of the steps of placing, positioning and ablating.
Claim 11
Dependent Claim
22 words
The method of claim 1 further comprising urging at least one of the first and second ablation devices against the epicardial surface.
Claim 12
Dependent Claim
23 words
The method of claim 1 wherein the step of positioning comprises shaping a distal end of the ablation device in a preselected shape.
Claim 13
Dependent Claim
20 words
The method of claim 11 wherein the step of shaping comprises moving a steering mechanism coupled to the distal end.
Claim 14
Dependent Claim
19 words
The method of claim 12 wherein the step of moving comprises tensioning a wire coupled to the distal end.
Claim 15
Independent Claim
144 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and urging the ablation device against the epicardial surface, wherein the step of urging comprises applying suction through at least one suction port in the ablation device.
Claim 16
Independent Claim
144 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and urging the ablation device against the epicardial surface, wherein the step of urging comprises applying suction through at least one suction port in the ablation device.
Claim 17
Independent Claim
150 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; and ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and expanding an expandable member on the ablation device between the pericardium and the epicardium, the expandable member being configured to engage the pericardium to urge the ablation device toward the epicardium.
Claim 18
Independent Claim
150 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; and ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and expanding an expandable member on the ablation device between the pericardium and the epicardium, the expandable member being configured to engage the pericardium to urge the ablation device toward the epicardium.
Claim 19
Independent Claim
131 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and retracting extracardiac tissue away from the ablation device during the step of ablating.
Claim 20
Independent Claim
131 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and retracting extracardiac tissue away from the ablation device during the step of ablating.
Claim 21
Dependent Claim
33 words
The method of claim 16 wherein the step of retracting comprises expanding and expandable member on the ablation device, the expandable member engaging and retracting the extracardiac tissue away from the ablation device.
Claim 22
Independent Claim
161 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall, wherein the at least one ablation device comprises first and second free ends; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and positioning the first and second free ends on opposite sides of a tissue layer and approximating the first and second free ends in opposing alignment separated by the tissue layer.
Claim 23
Independent Claim
161 words
A method of forming a transmural lesion in a wall of the heart adjacent to or on the pulmonary veins, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall, wherein the at least one ablation device comprises first and second free ends; positioning the at least one ablation device adjacent to the pulmonary veins on a posterior aspect of the heart while leaving the pericardial reflections intact; ablating the heart wall to create a lesion around the pulmonary veins with at least one ablation device positioned at the epicardial surface of the heart wall; and positioning the first and second free ends on opposite sides of a tissue layer and approximating the first and second free ends in opposing alignment separated by the tissue layer.
Claim 24
Dependent Claim
22 words
The method of claim 18 wherein the step of approximating comprises magnetically attracting the first free end to the second free end.
Claim 25
Independent Claim
144 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablating device having an ablating element and at least one suction port, the at least one suction port being coupled to a source of vacuum; placing the first ablation device through a thoracic incision and through a pericardial penetration so that the first ablation device is disposed in contact with an epicardial surface of the heart wall; ablating the heart wall with the first ablating device to create an elongate continuous lesion in the heart wall with the first ablation device positioned at the epicardial surface of the heart wall; and applying suction through the at least one suction port in the ablation device to urge the ablating device into contact with the epicardial surface of the heart wall.
Claim 26
Independent Claim
144 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablating device having an ablating element and at least one suction port, the at least one suction port being coupled to a source of vacuum; placing the first ablation device through a thoracic incision and through a pericardial penetration so that the first ablation device is disposed in contact with an epicardial surface of the heart wall; ablating the heart wall with the first ablating device to create an elongate continuous lesion in the heart wall with the first ablation device positioned at the epicardial surface of the heart wall; and applying suction through the at least one suction port in the ablation device to urge the ablating device into contact with the epicardial surface of the heart wall.
Claim 27
Dependent Claim
31 words
The method of claim 20 , wherein: the placing step is carried out with the first ablating device having a plurality of ablating elements which are spaced apart from one another.
Claim 28
Dependent Claim
19 words
The method of claim 21 , wherein: the ablating step is carried out to create an elongate continuous lesion.
Claim 29
Dependent Claim
18 words
The method of claim 22 , wherein: the ablating step is carried out to create a closed loop.
Claim 30
Dependent Claim
23 words
The method of claim 23 , wherein: the ablating step is carried out to create an elongate continuous lesion around the pulmonary veins.
Claim 31
Dependent Claim
29 words
The method of claim 20 , wherein: the ablating step is carried out with the first ablating device having a curved shape to conform to the epicardial surface heart.
Claim 32
Dependent Claim
26 words
The method of claim 20 , wherein: the positioning step is carried out with the device having means for locating the device at an anatomical structure.
Claim 33
Dependent Claim
38 words
The method of claim 26 , wherein: the positioning step is carried out with the locating means positioned at an exterior surface of one of a pulmonary vein, vena cava, aorta, pulmonary artery, atrial appendage, and pericardial reflection.
Claim 34
Independent Claim
115 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablation device having an expandable member; placing the first ablation device through a thoracic incision and through a pericardial penetration so that the first ablation device is disposed in contact with a location on an epicardial surface of the heart wall; ablating the heart wall to create a lesion with the first ablation device positioned at the epicardial surface of the heart wall; and expanding the expandable member on the first ablation device to hold the first ablation device at the location on the epicardial surface of the heart wall.
Claim 35
Independent Claim
115 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: providing a first ablation device having an expandable member; placing the first ablation device through a thoracic incision and through a pericardial penetration so that the first ablation device is disposed in contact with a location on an epicardial surface of the heart wall; ablating the heart wall to create a lesion with the first ablation device positioned at the epicardial surface of the heart wall; and expanding the expandable member on the first ablation device to hold the first ablation device at the location on the epicardial surface of the heart wall.
Claim 36
Dependent Claim
28 words
The method of claim 28 , wherein: the expanding step is carried out to retract extracardiac tissue away from the first ablation device during the step of ablating.
Claim 37
Dependent Claim
41 words
The method of claim 28 , further comprising the step of: applying suction through the at least one suction port in the first ablation device to urge the first ablation device into contact with the epicardial surface of the heart wall.
Claim 38
Dependent Claim
31 words
The method of claim 28 , wherein: the placing step is carried out with the first ablating device having a plurality of ablating elements which are spaced apart from one another.
Claim 39
Dependent Claim
19 words
The method of claim 28 , wherein: the ablating step is carried out to create an elongate continuous lesion.
Claim 40
Dependent Claim
18 words
The method of claim 32 , wherein: the ablating step is carried out to create a closed loop.
Claim 41
Dependent Claim
23 words
The method of claim 33 , wherein: the ablating step is carried out to create an elongate continuous lesion around the pulmonary veins.
Claim 42
Dependent Claim
29 words
The method of claim 28 , wherein: the ablating step is carried out with the first ablating device having a curved shape to conform to the epicardial surface heart.
Claim 43
Dependent Claim
26 words
The method of claim 28 , wherein: the positioning step is carried out with the device having means for locating the device at an anatomical structure.
Claim 44
Dependent Claim
38 words
The method of claim 36 , wherein: the positioning step is carried out with the locating means positioned at an exterior surface of one of a pulmonary vein, vena cava, aorta, pulmonary artery, atrial appendage, and pericardial reflection.
Claim 45
Independent Claim
137 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall, wherein the at least one ablation device has a first end and a second free end; positioning the at least one ablation device at an epicardial location while leaving a pericardial reflection intact; ablating the heart wall to create a lesion at the epicardial location of the heart wall; and positioning the first and second free ends on opposite sides of the pericardial reflection and approximating the first and second free ends in opposing alignment separated by the pericardial reflection.
Claim 46
Independent Claim
137 words
A method of forming a lesion in a wall of the heart, the heart being surrounded by a pericardium, the method comprising: placing at least one ablation device through a thoracic incision and through a pericardial penetration so that the at least one ablation device is disposed in contact with an epicardial surface of the heart wall, wherein the at least one ablation device has a first end and a second free end; positioning the at least one ablation device at an epicardial location while leaving a pericardial reflection intact; ablating the heart wall to create a lesion at the epicardial location of the heart wall; and positioning the first and second free ends on opposite sides of the pericardial reflection and approximating the first and second free ends in opposing alignment separated by the pericardial reflection.
Claim 47
Dependent Claim
32 words
The method of claim 38 , wherein: the ablating step is carried out with the at least one ablation device ablating tissue beneath the pericardial reflection while leaving the pericardial reflection intact.
Claim 48
Dependent Claim
47 words
The method of claim 38 , wherein: the providing step is carried out with the at least one ablating device comprising a first ablating device and a second ablating device, the first ablating device having the first end and the second ablating element having the second end.
Claim 49
Dependent Claim
25 words
The method of claim 38 , wherein: the positioning step is carried out by magnetically attracting the first free end to the second free end.
Claim 50
Dependent Claim
33 words
The method of claim 38 , further comprising the step of: applying suction through at least one suction port to urge the at least one ablating device into contact with an epicardial surface.
Claim 51
Dependent Claim
33 words
The method of claim 38 , wherein: the placing step is carried out with the at least one ablating device having a plurality of ablating elements which are spaced apart from one another.
Claim 52
Dependent Claim
19 words
The method of claim 43 , wherein: the ablating step is carried out to create an elongate continuous lesion.
Claim 53
Dependent Claim
18 words
The method of claim 44 , wherein: the ablating step is carried out to create a closed loop.
Claim 54
Dependent Claim
23 words
The method of claim 45 , wherein: the ablating step is carried out to create an elongate continuous lesion around the pulmonary veins.
Claim 55
Dependent Claim
30 words
The method of claim 38 , wherein: the ablating step is carried out with the at least one ablating device having a curved shape to conform to an epicardial surface.
Claim 56
Dependent Claim
34 words
The method of claim 38 , wherein: the positioning step is carried out with the at least one ablating device having means for locating the at least one ablating device at an anatomical structure.
Claim 57
Dependent Claim
38 words
The method of claim 48 , wherein: the positioning step is carried out with the locating means positioned at an exterior surface of one of a pulmonary vein, vena cava, aorta, pulmonary artery, atrial appendage, and pericardial reflection.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 2004-05-28 | 2004-11-27 | 2005-05-29 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2008-05-28 | 2008-11-27 | 2009-05-29 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2012-05-28 | 2012-11-27 | 2013-05-29 | $7700.00 | Window Closed / Lapsed |