CN101856271A - 心外膜标测和消融导管 - Google Patents
心外膜标测和消融导管 Download PDFInfo
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- CN101856271A CN101856271A CN201010167123A CN201010167123A CN101856271A CN 101856271 A CN101856271 A CN 101856271A CN 201010167123 A CN201010167123 A CN 201010167123A CN 201010167123 A CN201010167123 A CN 201010167123A CN 101856271 A CN101856271 A CN 101856271A
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- Surgical Instruments (AREA)
Abstract
本发明提供了一种适于从心包腔标测和消融心外膜组织的导管,其包括导管主体和电极组件,所述电极组件具有通常位于一个平面内的顶端部分和套环构件,其中所述顶端部分包括暴露于所述套环构件一侧的消融电极和暴露于所述套环构件相对侧的绝缘构件。所述导管还包括在所述导管主体与所述电极组件之间的中间部分,其中所述中间部分可使所述套环构件和所述顶端部分在同一平面内双向地挠曲。如此布置,所述导管可在所述心包囊中安全操纵,使其在所述心外膜上进行左右扫动,其中所述消融电极牢靠地面向和接触所述心外膜。所述顶端部分可以包括气囊,所述气囊可以充胀以推开周围的心包组织。所述导管还可以包括注射针,其远端可以从所述顶端部分伸出,以刺入心外膜组织。所述注射针中的管腔可允许将药剂直接传送至所述刺穿的组织,所述管腔中可以附带用于感测治疗部位温度的热电偶线。
Description
技术领域
本发明涉及尤其适用于心外膜心脏组织的消融和电活动感测的电生理导管。
背景技术
心律失常,尤其是心房纤颤,一直是常见和危险的医疗疾病,在老年人中尤为如此。对于具有正常窦性心律的病人,由心房、心室和兴奋传导组织构成的心脏在电刺激的作用下可按同步、模式化方式搏动。对于心律失常的病人,心脏组织的异常区域不会像具有正常窦性心律的病人那样遵循与正常传导组织相关的同步搏动周期。相反,心脏组织的异常区域不正常地向相邻组织传导,从而将心脏周期破坏为非同步心律。之前已知这种异常传导发生于心脏的各个区域,例如窦房(SA)结区域中、沿房室(AV)结和希氏束的传导通道或形成心室和心房心腔壁的心肌组织中。
包括房性心律失常在内的心律失常可以为多子波折返型,其特征在于电脉冲的多个异步环分散在心房腔室周围,并且这些环通常是自传播的。另一方面,或者除多子波折返型之外,心律失常还可以具有局灶性起源,例如当心房中孤立的组织区域以快速重复的方式自主搏动时。
室性心动过速(V-tach或VT)是一种源于某一个心室的心动过速或快速心律。这是一种可能危及生命的心律失常,因为它可以导致心室纤颤和猝死。
心律失常的诊断和治疗包括标测心脏组织(尤其是心内膜和心脏容量)的电性质,以及通过施加能量来选择性地消融心脏组织。此类消融可以终止或改变无用的电信号从心脏的一部分向另一部分的传播。消融方法通过形成不传导的机能障碍来破坏无用的电学通路。基于导管的装置和治疗方法的例子通常使用适合在限定心房心腔的壁组织中形成直线或曲线机能障碍的消融导管装置和方法来以心房部分作为目标,例如授予Munsif的美国专利No.5,617,854、授予Jang等人的美国专利No.4,898,591、授予Avitall的美国专利No.5,487,385和授予Swanson的美国专利No.5,582,609中所公开的那些,这些专利的公开内容均以引用方式并入本文中。此外,已经公开了用于形成此类心房壁机能障碍的多种能量供给方式,包括使用微波、激光以及更常见的射频能量来产生沿着心脏组织壁的传导阻滞,如授予Stem等人的WO 93/20767、授予Isner等人的美国专利No.5,104,393和授予Swartz等人的美国专利No.5,575,766中分别公开的那些,这些专利的全部公开内容均以引用方式并入本文中。
在标测然后消融的两步法中,通常通过向心脏中***包含一个或多个电传感器的导管并获取多个点处的数据来感应并测量心脏中各个点的电活动。然后利用这些数据来选择将要在该处进行消融的心内膜目标区域。然而,一些新近的技术已经考虑到通过心外膜标测和消融来治疗室性心动过速。此类技术涉及使用剑突下心包穿刺技术将标准消融导管引入心包腔。
心包壁层是包围心脏的外部保护层或囊,而心脏包括三层:心外膜、心肌膜和心内膜。心包腔将心包壁层与心外膜分开。心包壁层的组织可分泌少量润滑表面的体液,使得心脏可以在心包壁层内自由移动。显然,心包壁层与心外膜之间的粘着会妨碍心脏的肌肉收缩。
侵入心外膜的另一种潜在并发症由膈神经引起。膈神经主要由产生隔膜收缩的运动神经纤维组成。此外,它可以提供纵隔和胸膜以及上腹的许多部分,尤其是肝脏和胆囊的感觉神经分布。右膈神经越过右心房,左膈神经越过左心室,并分别进入隔膜。这两条神经都可为隔膜提供运动纤维,以及为纤维心包、纵膈胸膜和横膈腹膜提供感觉纤维。膈神经的任何损坏(尤其是老年病人)都会引起严重的呼吸困难,特别是在发生永久性损伤时。在消融心外膜时,肺本身是另一个易受损伤的器官,然而如果烧焦肺组织也更易于自行修复。
为心内膜应用而开发的导管通常具有支承在柔性轴上的全向消融顶端。尽管此类导管尤其适用于在心脏或靠近心脏的腔体和其他管状区域中进行标测和消融,但全向消融顶端在心外膜上使用时会显著增加有害的和不必要的消融风险,例如对心包壁层、膈神经和/或肺的消融。此外,其上装有此类全向消融顶端的柔性轴不会对着润滑的心外膜表面提供牵引力或支承。轴通常会在心包腔内翻转和滑动。
具有套索组件的导管也是已知的。此类导管在例如美国专利No.6728455、6973339、7003342、7142903和7412273中有所公开,它们的全部公开内容据此以引用方式并入本文。“套索”导管尤其适用于环肺静脉口消融,因为“套索”通常横向安装在导管上,使得套索可以位于肺静脉口上。然而,这种取向不适合较狭窄和平坦的空间,例如心包腔。
因此,要求提供适合心外膜的导管,其消融顶端是定向的,而且轴可支承接触消融顶端的组织,并让使用者在消融顶端的定位中有更多的控制和预测。为此,要求轴可以紧靠心外膜保持稳定,并可以进行可挠曲的面偏离,使得消融顶端可以在心包腔范围内扫过心外膜的表面,而造成组织创伤的风险甚微。还要求在消融过程中导管可对内部的电势记录或心电图(ECG)提供连续的反馈,以使得使用者可以知道不想要的电势是否已被心外膜消融成功阻滞。
发明内容
本发明涉及适用于从心包囊标测和消融心外膜组织的导管。在一个实施例中,导管包括导管主体、中间部分和电极组件,其中电极组件具有通常位于一个平面内的顶端部分和套环构件。顶端部分包括暴露于套环构件的一侧而面向心外膜的消融电极以及暴露于套环构件的相对侧而面向心包膜的绝缘构件,其中中间部分可将电极组件在平面内双向挠曲。如此配置,导管便可在心包囊内安全地操作,并可以在心外膜上左右扫动,同时消融电极可靠地面向并接触心外膜。
在一详述的实施例中,套环构件的末端开口并具有形状记忆,使得其呈现可防止损伤的形状,这一形状适形于心包腔的狭窄范围,但将导管***病人体内时又可以伸直。套环构件还可以带有适用于执行电生理学功能(例如起搏、标测和感测)的环形电极。
可以将从其伸出电极组件的中间部分预成形为具有朝向消融电极一侧的弯曲或曲率,以进一步确保组织接触稳定构件和顶端部分。中间可挠曲部分可以由编织的和预成形的管件构成,从而对导管提供一定的刚度,以有利于组织接触。
顶端部分可以包括气囊,气囊可以充胀以推开周围的心包组织,包括顶端部分上方和侧面的组织。可以通过与气囊入口连接的充气管给气囊充气,其中充气管伸入顶端部分中的通道。
导管还可以包括冲洗管,其远端被接纳到在顶端部分中形成的通道内。冲洗管传送的流体可以穿过通道以冷却顶端部分,并经由开口离开顶端部分,以冷却被消融的心外膜组织。
导管还可以包括注射针,其远端可以延伸到顶端部分之外,以刺入心外膜组织。针的内腔可以用来直接向被穿刺组织供给药剂。内腔中可以带有热电偶线,用于在治疗部位进行温度感测。
附图说明
通过参考以下与附图结合考虑的详细说明,将更好地理解本发明的这些和其他特征以及优点,其中:
图1为本发明导管的一个实施例的俯视平面图。
图2a为沿第一直径截取的图1所示导管的导管主体与中间部分的接合处的侧向剖面图。
图2b为沿大致垂直于第一直径的第二直径截取的图2a所示接合处的侧向剖面图。
图2c为沿线c--c截取的图2a所示导管主体的纵向剖面图。
图2d为沿线d--d截取的图2a所示中间部分的纵向剖面图。
图3为设置在心脏的心包壁层与心外膜之间的心包腔中的图1所示导管的侧向剖面图。
图4a为沿第一直径截取的图1所示导管的中间部分与顶端部分的接合处的侧向剖面图。
图4b为沿大致垂直于第一直径的第二直径截取的图4a所示接合处的侧向剖面图。
图5为包括顶端部分和稳定构件的电极组件的实施例的俯视平面图。
图6a为中间部分与顶端部分之间的连接管的实施例的侧向剖面图,示出了稳定构件的近端。
图6b为图1所示连接管与顶端部分之间的接合处的侧向剖面图。
图7a为远侧顶端的实施例的分解透视图,其包括消融电极和绝缘构件。
图7b为沿线b--b截取的图7a所示远侧顶端的纵向视图。
图7c为沿线c--c截取的图7a所示远侧顶端的纵向视图。
图8为沿线d--d截取的图7a所示远侧顶端的侧向剖面图。
图9a-9c根据本发明导管的实施例示出了通过操纵控制手柄进行控制的导管远端部分的双向挠曲。
图10为设置在心脏的心包壁层与心外膜之间的心包腔内的本发明导管的替代实施例的侧向剖面图,其具有适于将心包膜从远侧顶端抬升的充气构件。
图11a为具有充气构件的根据本发明的特征的远侧顶端的替代实施例的顶部透视图。
图11b为图11a所示远侧顶端的底部透视图。
图12为根据本发明的特征的充气构件的实施例的透视图。
图13为图11a和图11b的远侧顶端的侧向剖面图,其充气构件已被充胀。
图13a为沿线a--a截取的图13所示远侧顶端的纵向剖面图。
图13b为沿线b--b截取的图13所示远侧顶端的纵向剖面图。
图13c为沿线c--c截取的图13所示远侧顶端的纵向剖面图。
图13d为沿线d--d截取的图13所示远侧顶端的纵向剖面图。
图14为适合与图13所示的远侧顶端一起使用的连接管的实施例的侧向剖面图。
图15为适合与图13所示的远侧顶端一起使用的中间部分的实施例的纵向剖面图。
图16a为具有充气构件的根据本发明的特征的远侧顶端的替代实施例的顶部透视图。
图16b为具有注射针开口的图16a所示远侧顶端的底部透视图。
图17为注射针的实施例的纵向剖面图。
图18a为图16a所示远侧顶端的侧向剖面图,其中示出了根据本发明特征的充胀的充气构件和所配置的注射针。
图18b为沿线b--b截取的图18a所示远侧顶端的纵向剖面图。
图19为适合与图16a和图16b所示的远侧顶端一起使用的中间部分的实施例的纵向剖面图。
图20为连接管的实施例与图18a所示远侧顶端的接合处的侧向剖面图。
具体实施方式
参见图1,用于心外膜标测和消融的导管10的实施例包括具有近端和远端的细长导管主体12、位于导管主体12远端的中间可挠曲部分14以及在中间部分远侧的标测和消融电极组件17。导管还包括位于导管主体12近端的控制手柄16,用于控制中间部分14的挠曲。有利的是,电极组件17具有位于远侧顶端部分15的定向消融电极19以及多个安装在稳定构件21上的感测电极20,其中稳定构件21有助于消融电极19在心外膜治疗部位上的移动和放置。
参照图2a、2b和2c,导管主体12包括具有单个轴向或中央管腔18的细长管状结构。导管主体12具有柔性即可弯曲,但沿其长度方向基本上不可压缩。导管主体12可为任何合适的结构,并且可由任何合适的材料制成。目前优选的结构包括由聚氨酯或PEBAX制成的外壁20。外壁20包括由不锈钢等制成的嵌入式编织网,以增大导管主体12的抗扭刚度,使得当旋转控制手柄16时,导管10的中间部分14以相应的方式进行旋转。
导管主体12的外径并非决定性因素,但优选为不大于约8F(french),更优选地不大于约7F。同样,外壁20的厚度也不是决定性因素,但要足够薄,以使得中央管腔18可容纳拉线、导线和任何其他所需的金属线、电缆或配管。如果需要,外壁20的内表面可衬有加强管22,以得到改善的扭转稳定性。在本发明所公开的实施例中,导管具有外径为约0.090英寸至约0.94英寸和内径为0.061英寸至约0.065英寸的外壁20。提供粘结接合(未示出)以使加强管22和外壁20彼此相互固定。可以将它们设置在导管主体12的近端和远端处。
在控制手柄16与可挠曲部分14和/或顶端部分15之间延伸的组件穿过导管主体12的中央管腔18。这些组件包括用于电极组件17的每个标测和消融电极的导线30、用于从顶端部分15向消融部位供送流体的冲洗管37、用于电磁位置传感器75的电缆34、用于使中间部分14挠曲的一对拉线36以及一对感测顶端部分15处的温度的热电偶线40和41。
图2a、2b和2d示出了中间部分14的实施例,其包括一短段配管13。配管具有编织网构造,带有多个离轴的管腔,例如管腔24、25、26和27。正好相对的管腔26和27中的每一个都附带各自的拉线36,以便使导管可以在平面内以两个相反的方向进行双向挠曲(图1),这种运动非常适合心包腔内心外膜组织表面的标测和消融。第一管腔24附带导线30、电缆34、热电偶线40和41,以及稳定构件21的支承构件32(具有形状记忆)。如本领域技术人员所理解的,可以用(例如)T型锚33将支承构件32的远端锚定到配管13的侧壁上。第二管腔25附带冲洗管37。
中间部分14的配管13由合适的无毒材料制成,该无毒材料最好只是稍比导管主体12稍微柔韧一些。用于配管13的合适材料为带编织网的聚氨酯,即具有由编织不锈钢等制成的嵌入网的聚氨酯。每个管腔的大小并非决定性因素,只要足以容纳贯穿其中的各部件就可以。
导管的可用长度,即除组件17外可以***患者体内的轴12和部分14的长度可以根据需要变化。在一个实施例中,可用长度为约110cm至约120cm,更优选为约115cm至约117cm,还更有选地为约116cm。中间部分14的长度是可用长度的相对较短部分,优选为约6.35cm至约7.62cm,更优选为约6.43cm至约6.5cm,最优选为约6.4cm。
图2a和图2b中示出了将导管主体12附接到中间部分14上的方式。中间部分14的近端包括接纳导管主体12的外壁20内表面的外周凹口31。中间部分14和导管主体12通过胶粘物等附接在一起。
如果需要,可在导管主体内的加强管(如果提供)的远端与中间部分的近端之间设置间隔区(未示出)。该间隔区使导管主体和中间部分的接合处形成柔性过渡区,其使此接合处平滑地弯曲而不会折叠或扭结。具有此类间隔区的导管在美国专利No.5,964,757中有所描述,该专利的公开内容以引用方式并入本文。
中间轴14的管腔26和27中的每一个都附带优选地用特氟隆(Teflon.RTM.)涂覆的拉线34。拉线36可以用任何合适的金属制成,例如不锈钢或镍钛诺(Nitinol),或者用强度更大的材料制成,例如Vectran.RTM.尼龙管,其中特氟隆涂层可赋予拉线润滑性。拉线的直径优选地在约0.006至约0.010英寸的范围内。
如图2a所示,每条拉线36穿过与拉线36成围绕关系的压缩螺旋弹簧35。压缩螺旋弹簧35从导管主体12的近端延伸至中间部分14的近端,并可以通过粘结接合(未示出)将其近端和远端分别固定到加强管22上和中间部分14的近端上。压缩螺旋弹簧35由任何合适的金属制成,优选为不锈钢,并且压缩螺旋弹簧自身紧密地缠绕,以提供柔韧性,即弯曲性,但可抗压缩。压缩螺旋弹簧的内径优选地稍大于拉线34的直径。在导管主体12内,压缩螺旋弹簧35的外表面也用柔韧的非导电外皮39(如用聚酰亚胺管制成)覆盖。通过近侧粘接点将压缩螺旋弹簧35的近端固定于导管主体12的外壁20上,并通过远侧粘接点固定于中间轴14上。在中间部分14内,每条拉线都延伸穿过保护外皮49,以防止拉线在挠曲过程中进入中间部分14的配管13中。
拉线36的近端固定在控制手柄16中。拉线36的远端固定在中间部分14的配管13的远端附近,如图4a所示。具体地讲,形成了T型锚,该锚包括短的管状不锈钢59,例如皮下柄状物,其安装在拉线的远端上,通过卷曲拉线可以将其牢固地固定在拉线上。(例如)通过焊接将管状不锈钢59的远端牢固地连接到由不锈钢带或类似物制成的联接件45上。联接件45延伸穿过在配管13中形成的孔(未示出),并由于联接件45比孔大,因此不能从孔中拉出,联接件45将拉线的远端锚定到中间部分14的远端。如图所示,拉线36的远端的锚定位置彼此稍有偏移。在编织网已从配管13取消的区域中,偏移的配置方式可以减小在挠曲过程中锚构件施加的应力。而且,如本领域所知,可以具有不同的挠曲度,这取决于压缩螺旋弹簧的远端和近端的位置。挠曲度的范围在约90到180度之间,优选在约90到135度之间,更优选为约±90度。
如图3所示,可挠曲部分14有利地预成形为在其远端附近具有角度θ,以使得电极组件17以角度θ从中间可挠曲部分14伸出。该角度给中间可挠曲部分14和顶端部分15提供更贴合又窄又弯的心包腔24的外形。当电极组件在心包腔内从一处移至另一处时,这种角度关系可改善电极组件17与心外膜表面22的组织接触。角度θ的范围可以在约10到15度之间,更优选地在约10到12度之间。根据本发明的特征,结合了以大致垂直于双向挠曲平面的方向弯曲的预定角度θ的电极组件17的双向挠曲能够使电极组件17进行左右扫动,这可改善心包腔范围内的组织接触和贴合性。如本领域的技术人员所理解,角度θ可以形成到配管13中,包括在夹具中烧制配管。
用连接管43连接的顶端部分15位于中间部分14的远端。在图4a和图4b所示的实施例中,连接管43具有单个管腔,让导线30、稳定构件21的支承构件32、电磁传感器电缆34和冲洗管37穿过。连接管43的单个管腔允许这些组件适当地从其在中间部分14中的各自管腔朝其在稳定构件21和远侧顶端部分15中的位置进行重新定向。如图所示,多个组件彼此交叉,以使其自身在顶端部分15内适当地对齐。
电极组件17包括远侧顶端15(附带定向消融电极19)和稳定构件21(附带多个环电极20S)。连接管43上也可以有环电极20R。根据本发明的特征,稳定构件21的套环在两个维度上张开,并通常位于也包括远侧顶端15的平面内。电极组件17的整体可以限定在该平面内。如图3所示,电极组件17采用基本平坦的或平面的外形。
如图5所示,稳定构件21为末端开口的、大体成圆形的套环或轮,其具有围绕消融电极19向远侧延伸的大体圆形的主要区段23,以及从连接管43伸出的大体直的区段25。这样,远侧顶端15和稳定构件21直接彼此连接,使得电极组件17不大可能翻转或从选定的心外膜治疗部位滑落或滚走。
区段25与连接管43偏离较小的角度(如小于约45度),连接管43和顶端电极19沿着大体成圆形的主要区段23的直径设置,其中区段23围绕顶端电极19向远侧延伸。区段25的暴露长度在约70mm到78mm的范围内,优选地在约73mm到76mm的范围内,更优选地在约75mm到76mm的范围内,但可以根据需要变化。区段23的长度在约70mm到75mm的范围内,优选地在约73mm到75mm的范围内,更优选地在约72mm到73mm的范围内,但可以根据需要变化。
稳定构件21的区段23和区段25有利地与顶端电极19共平面,使得它们三个都位于一个平面内,以提供平面外形。而且由于在中间可挠曲部分14的配管13中的拉线36及其管腔26和27通常也位于该平面内,因此稳定构件21可以在顶端部分15和中间部分14的双向挠曲过程中进行横向扫动。
包括区段23和25的稳定构件21具有跨越区段23和25的长度的不导电包覆层或配管50(如图5中局部断开处所示)。包覆层或配管50可由任何柔性的和生物相容性的合适材料制成,优选为塑料,例如聚氨酯或PEBAX。配管50(与本文中所有的管或配管一样)可以具有任何横截面形状,并且可以具有单个管腔或多个管腔。在所示的实施例中,配管50具有被导线30S、或用于环电极20S或任何其他电或电磁元件(可安装在稳定构件21上)的其他电连接线占据的单个管腔。管腔也被支承元件32占据,支承元件可具有形状记忆或被预成形为具有区段23和25的大体直线的和大体圆形的形状。形状记忆元件在施加力时可以从其初始形状伸直或弯曲,并且在撤去力后能够基本上恢复其初始形状。形状记忆元件的合适材料为镍钛合金。此类合金通常包含约55%的镍和45%的钛,但也可以包含约54%至约57%的镍,其余的则为钛。优选的镍钛合金为具有优异形状记忆性以及延展性、强度、抗腐蚀性、电阻率和温度稳定性的镍钛诺。
如上所述,大体圆形的区段23以自由远端51在末端开口。这允许稳定构件21被拉长,使远端51位于顶端电极20R的远侧,以使得稳定构件21可更容易地穿过导引器和/或扩张器进入患者体内。如本领域技术人员所知,一旦稳定构件21位于导引器或扩张器外,它就易于呈现其预成形的形状。末端51用由聚氨酯胶等形成的圆顶密封。由金属或塑料,优选地由聚酰亚胺制成的短环安装在不导电包覆层50的远端内。短环可防止不导电包覆层50的远端萎陷,从而维持不导电包覆层在其远端处的直径。
图6a示出了将稳定构件21的配管50连接到连接管43上的方法。在连接管43的壁中切开或用其他方法形成开口58,以接纳配管50的近端,其被***开口约1mm深并用胶61粘附,另外胶61还密封开口58。从中间部分14的配管13的管腔24伸出的稳定构件21的导线30S和支承构件32被接纳在配管50中,其中它们穿过大体直线的区段25,然后根据需要穿过大体圆形的主要区段23。在大体圆形的主要区段23上,多个环电极20S彼此均匀地分开,每个都与各自的导线30S连接,如图5所示。如上所述,构件32的近端固定在中间部分14的管腔24的近端附近(图2b)。
参见图6b,环电极20R安装在连接管43上,位于稳定构件21的连接位置的远侧。环电极与从中间部分14的配管13的管腔24伸出的导线30R相连。
如图7a所示,远侧顶端15具有大体成圆柱形的整体式构造65,其具有远端和接纳在连接管43的远端中的开孔近端。圆柱形构造65由消融电极19和可使组织与消融电极热绝缘且电绝缘的绝缘构件60形成。绝缘构件有效地赋予消融电极19方向性,使得只有电极19的暴露面可以接触组织。
参见图7a-7c的实施例,消融电极19和绝缘构件60通常是两个沿着圆柱形构造65的纵向轴线连接的纵向半块或配对件。有利的是,消融电极19与绝缘构件60之间的***面62与稳定构件21以及被中间部分14赋能的电极组件17的双向挠曲的平面重合。因此,电极组件17有效地使消融电极19暴露于稳定构件21的一侧,使绝缘构件60暴露于稳定构件21的相对侧,其中电极组件17在双向挠曲过程中进行左右扫动时保持其取向。而且,如果操作者已操纵了电极组件17,使消融电极19面向心外膜,绝缘构件60面向心包膜,那么在电极组件静止或挠曲以进行左右扫动时,稳定构件21趋于保持该取向。
图8中进一步示出了消融顶端电极19中的多种构造。冲洗管37的细长通道70沿着电极19的长度方向形成,其中开口位于电极19的近侧表面。在通道70的远端72处,多个分支74可允许远端72与电极19的外部之间连通。在所示实施例中,存在三个大体垂直的分支74。第二细长盲孔80沿着电极19的长度方向形成,供为给消融顶端电极19供电的导线30T使用。第三细长盲孔82沿着电极19的长度方向形成,供感测顶端温度的热电偶线40和41使用。在电极19与绝缘构件60的连接表面92之间,另一个盲孔90沿着电磁位置传感器75的纵向轴线有效地形成。用胶和/或其他合适粘结剂的涂层95将连接表面92连接在一起。
环电极20S和20R通过导线30S和30R电连接到合适的标测或监测***(未示出)上。远侧顶端电极19通过导线30T电连接到消融能量源(未示出)上。每条电极导线都具有终止于连接器中的近端,其中连接器位于控制手柄16的近端。更远侧,电极导线穿过导管主体12中的中央管腔18,并穿过中间部分14的管腔24。导线穿过导管主体12的中央管腔18和管腔24的近端的部分可以包封在保护外皮(未示出)中,保护外皮可以用任何合适的材料制成,优选为聚酰亚胺。通过用聚氨酯胶等材料将保护外皮粘附在管腔24中,使保护外皮的远端固定在中间部分14的近端上。
可以用任何合适的方法将每条导线连接到其对应的环电极上。将导线连接到环形电极上的优选方法涉及首先穿过不导电包覆层或配管的壁开一个小孔。例如,可通过将足以形成永久性孔的针头穿过不导电包覆层来形成这样的孔。然后使用微型钩或类似物拉动导线穿过此孔。剥去导线末端的任何涂层并将末端焊接在环电极的下侧,然后将环电极滑动到孔上方并用聚氨酯胶等将其固定到位。或者,可通过在不导电包覆层周围多次缠绕导线并剥去导线外表层的自身绝缘层来形成每个环形电极。
环电极可由任何合适的固体导电材料制成,例如铂或金,优选为铂和铱的组合物。可以用胶等将环电极安装到配管上。或者,可通过用导电材料,如铂、金和/或铱涂覆配管来形成环电极。可采用溅射、离子束淀积或等同技术来涂敷涂层。尽管本发明所公开的实施例在稳定构件21上使用双极性环电极,在连接管43上使用单极性环电极,但应当知道,可以根据需要使用任何数量的单极性和双极性环电极或其组合。
可根据需要改变组件上环电极的数量。优选的是,稳定构件21上的环电极数量在约6至约20个的范围内,优选为约8至约12个,各个电极彼此均匀地分开。在连接管43上,环电极的数量在约1至约4个的范围内。在本发明所公开的实施例中,稳定构件21上的每个环电极之间的距离为大约5mm。如果连接管43附带多个环电极,那么每个环电极之间的理想距离为大约2mm。
拉线36的近端固定在控制手柄16中。分别导致中间部分14和顶端部分15沿着平面65挠曲的挠曲线36相对于导管主体12的单独和独立运动可通过控制手柄16的合适操作来完成。合适的控制手柄在公布于2008年5月27日、名称为“STEERING MECHANISM FORBI-DIRECTIONAL CATHETER”(用于双向导管的操纵装置)的美国专利No.7,377,906以及提交于2008年9月16日、名称为“CATHETERWITH ADJUSTABLE DEFLECTION SENSITIVITY”(具有可调的挠曲灵敏度的导管)的美国专利申请No.12/211,728中有所公开,以上专利的全部公开内容据此以引用方式并入本文。
在图9a-9c所示的实施例中,控制手柄16具有挠曲组件148,其具有挠曲臂118和支承一对滑轮134的可旋转臂或摇臂131,滑轮作用于拉线36,使中间部分14并因此使顶端部分15挠曲。挠曲臂118和摇臂131旋转对齐和联接,使得使用者旋转挠曲臂时可以使滑轮臂旋转。当通过挠曲臂118使摇臂131旋转时,滑轮134从空档位置(图9a)发生位移,一个滑轮紧靠其锚定的近端牵拉导管一侧的拉线36,以便使部分14朝该侧挠曲(图9b和9c)。通过交替旋转挠曲臂,电极组件17可以左右扫动。
使用时,采用剑突下进路将合适的导引鞘管***患者体内,使其远端设置在心包囊中。可与本发明一起使用的合适的导引鞘管的例子为Preface.TM.Braiding Guiding Sheath(编织导引鞘管),其可从Biosense Webster,Inc.(Diamond Bar,Calif.)商购获得。将稳定构件21的自由端51向顶端电极19的远侧拉直,以使得顶端部分15可以容易地进入并穿过导引鞘管。将导管10穿过导引鞘管,直到顶端部分15位于组织治疗部位处或其附近。向近侧拉动导引鞘管,使顶端部分15露出,这可以使得稳定构件21恢复其大体圆形的形状,并可以根据需要露出中间部分14。
如图3所示,使用者将电极组件17的方向设定为使消融电极19面向心外膜,绝缘构件60面向心包膜。由于稳定构件21被有效地夹在心外膜与心包膜之间,因此电极组件17适于保持该取向。当使用者操纵控制手柄的挠曲臂118时,电极组件17在心外膜组织的表面区域上进行左右扫动,对周围组织造成损伤的风险极微。具体地讲,稳定构件21的圆形形状可防止损伤,并允许顶端部分15在心包囊内扫动,而不会打磨组织。此外,中间部分14中朝向消融电极19侧的预定弯曲可提供确保电极接触心外膜的弯曲或弧形轮廓。另外,中间部分14的编织配管13可对导管提供“背部”支承和一定的刚度,从而进一步确保组织接触电极组件17并最小化电极组件17滚动或翻动而偏离合适位置的风险。
可以用环电极20S和20R进行标测,用顶端电极19通过射频能量或其他类型的能量(包括微波和激光)进行消融。环电极还允许测量消融部位周围的电活动,以使得在进行消融时,导管可以提供心外膜组织的电势记录或心电图(ECG)的实时和连续反馈。绝缘构件60通过提供物理屏障使相邻的组织(尤其是心包膜)与消融热绝缘且电绝缘。
可以将流体(例如生理盐水或肝素)从顶端电极输送到消融部位,以冷却组织、减弱凝结作用和/或促进更深杀伤的形成。应当知道,也可以传送其他流体,包括任何诊断和治疗流体,例如用于改变神经节丛状态的神经抑制剂和神经刺激剂。
在另一个实施例中,顶端部分15′包括可充胀构件,如气囊100,它可以使定向顶端电极19′与相邻和相对的组织(包括心包组织)热和电绝缘。如图10所示,气囊100充胀时可将心包膜26抬离电极组件19′。如下文所述,顶端部分15′和上述顶端部分15之间既有相似的地方,也有不同之处。
参见图11a-11b所示的实施例,顶端部分15′包括绝缘构件60′,其与消融电极19′一起形成大体细长的圆柱形构型65′。圆柱形构型65′具有防止损伤的远端66′和接纳在连接管43′远端中的开孔近端67′。在所示实施例中,细长通道70′在消融电极19′中形成,供冲洗管37′使用。在通道70′的远端72′处,多个分支74′可使远端72′与顶端电极19′的外部之间连通。在通道70′旁边形成的细长盲孔80′和82′分别供导线30T′和热电偶线40′与41′使用。但是,电磁传感器75′封装在连接管43′(图14)中,以便在顶端部分15′中留出更多的空间。在消融电极19′中形成的凹槽112中使用胶和/或其他合适的粘结剂195以将电极19′与绝缘构件60′连接在一起。另外,在顶端部分15的远端66′形成了插件114和凹槽116形式的闩锁(图11b),使得电极19′和绝缘构件60′保持彼此相互固定。
如图12的实施例所示,顶端部分15′的气囊100具有大致矩形的形状并为双层构造,其中顶片102和底片103围绕周边边缘(包括末端边缘104和纵向边缘109)彼此连接,从而形成流体密封性的密封件。顶片102和底片103由合适的高弹性和生物相容性材料制成,例如聚异戊二烯(polyisopreme)。底片103被成形为具有适合安装在充气管106的远端上的入口105,可以通过控制手柄16用某个来源(未示出)的泵(未示出)将流体通过充气管送入和送出气囊。适用于充胀气囊的流体包括空气和生理盐水。应当知道,流体也可以是其温度适合冷却周围心包组织的流体。
通过在绝缘构件60′的外表面110与气囊的底片103之间涂覆胶或粘结剂115将气囊100粘附在表面110上。气囊还具有远端部分108,其接纳在充满胶111等的凹槽或口袋109中,以便将气囊的远侧边缘固定到绝缘构件60′上。该安全特征可防止气囊的远侧边缘脱离顶端部分15′。此外,将气囊100的片102和103的纵向边缘109向内塞入,并用胶或粘结剂沿着消融电极19′与绝缘构件60′之间的侧边113将其固定。细长通道116在消融电极19′中形成,供进入气囊100的充气管106使用。在通道116的远端形成横向通道117以接纳气囊的入口105。
在本发明所公开的实施例中,气囊100,尤其是顶片102被构造成使得气囊充胀时,顶片可膨胀成明显在消融电极19′的上面和侧面伸展的大体球形形状(图13c),以使得消融电极上面和侧面的组织被抬离。
应当知道,在替代实施例中,气囊100不必包括底片103。也就是说,顶片102单独地可以沿着其周边边缘与绝缘构件60′的外表面110一起形成流体密封性的密封件,可将充气管106密封到通道116的远端,以有效地将流体送入和送出气囊进行充胀和缩小。
无论气囊的结构如何,充气管106都向近侧延伸穿过连接电极组件17′和中间部分14的连接管43′,如图14所示。充气管106向近侧延伸穿过中间部分的配管13′的第一管腔24′。
在另一个实施例中,注射针120适于从在顶端消融电极19″中形成的细长通道132的开口130伸出。注射针120包括渐缩远端(图18a),其适于刺穿组织,并通过贯穿注射针的管腔134供给药剂(图17)。管腔134的内部为热电偶线41和45,其远端固定在针的远端附近,用于测量针所***的组织的温度。用胶或粘结剂136将线41和45的远端固定在管腔的内壁上。如图19所示,注射针120向近侧延伸穿过连接管43和中间部分的配管13″中的第五管腔140。
注射针120由任何合适的刚性材料制成,包括塑料或金属,金属包括不锈钢和镍钛诺。材料还可以具有形状记忆,使得针的远端部分具有预成形的弯曲,从而使针成角地刺入电极组件下面的组织(参见图18a)。
还设想任何上述顶端部分15、15′、15″可以完全地或部分地用磁性材料构造,以便结合使用远程磁技术(RMT)。例如,任何顶端电极和/或绝缘构件都可以用磁性材料制成或带有磁性构件,以使得操作者可以从较远的位置通过磁力指引导管。这样的导管在提交于2008年5月22日、名称为“MAGNETICALLY GUIDED CATHETER WITHCONCENTRIC NEEDLE PORT”(具有同心针口的磁力引导式导管)的美国专利申请No.12/125,903中有所描述,其全部公开内容据此以引用方式并入本文。
已参照本发明的某些示例性实施例进行了以上描述。本发明所属技术领域内的技术人员应认识到,在不有意脱离本发明的原则、精神和范围的前提下,可对所述结构进行更改和修改。因此,以上描述不应该被理解为只涉及附图中所描绘和示出的具体结构。相反,以上描述应被理解为与以下涵盖其最完整和最清楚范围的权利要求书一致,并支持该权利要求书。
Claims (19)
1.一种适合在心脏的心外膜与心包组织之间的腔体中使用的导管,包括:
细长导管主体;
位于所述导管主体远侧的电极组件,所述电极组件包括大致位于一个平面内的顶端部分和套环构件,所述顶端部分包括暴露于所述套环构件一侧的消融电极,以及暴露于所述套环构件相对侧的绝缘构件;
在所述导管主体与所述电极组件之间延伸的中间部分,所述中间部分适于大体在所述平面内双向地挠曲所述套环构件和所述顶端部分。
2.根据权利要求1所述的导管,其中所述消融电极适于消融所述心外膜组织,所述绝缘构件适于将所述心包组织与所述消融电极绝缘。
3.根据权利要求1所述的导管,其中所述套环构件具有形状记忆,从而呈现围绕所述远侧顶端向远侧延伸的预定构型。
4.根据权利要求1所述的导管,其中所述套环构件是末端开口的。
5.根据权利要求2所述的导管,其中所述顶端部分包括可充胀构件。
6.根据权利要求2所述的导管,其中所述顶端部分为具有纵向轴线的大体圆柱形形状,而且所述消融电极和所述绝缘构件沿着所述纵向轴线彼此相互固定。
7.根据权利要求6所述的导管,其中所述消融电极和所述绝缘构件各自具有大体半圆形横截面。
8.根据权利要求6所述的导管,还包括冲洗管,其远端被接纳在形成于所述顶端部分的通道中,所述冲洗管适于传送通过所述通道的流体。
9.根据权利要求5所述的导管,还包括充气管,其远端被接纳到所述顶端部分中,所述充气管适于传送进出所述可充胀构件的流体。
10.根据权利要求1所述的导管,其中所述中间部分构成为具有预定角度。
11.根据权利要求11所述的导管,其中所述顶端部分包含可响应对所述顶端部分的远程磁导航的磁性材料。
12.根据权利要求3所述的导管,其中所述预定构型通常为圆形。
13.根据权利要求1所述的导管,还包括注射针,其远端被接纳到在所述顶端部分形成的通道中,所述注射针适于从所述顶端部分伸出以刺入组织。
14.根据权利要求1所述的导管,其中所述套环构件带有环电极。
15.根据权利要求1所述的导管,其中所述套环构件具有大体直线的部分和大体圆形的部分,这两个部分都位于所述双向挠曲的平面内。
16.根据权利要求1所述的导管,其中所述可充胀构件安装在所述绝缘构件的外表面上。
17.根据权利要求13所述的导管,还包括延伸穿过所述针的热电偶线。
18.根据权利要求1所述的导管,还包括延伸穿过所述导管主体和所述中间部分以实现所述双向挠曲的拉线。
19.根据权利要求18所述的导管,还包括位于所述导管主体近侧的控制手柄,所述拉线的近端被锚定在所述控制手柄中,其中所述控制手柄被成形为供使用者操纵所述拉线。
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Families Citing this family (268)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
KR20110104504A (ko) | 2008-11-17 | 2011-09-22 | 미노우 메디컬, 인코포레이티드 | 조직 토폴로지의 지식 여하에 따른 에너지의 선택적 축적 |
WO2010088301A1 (en) * | 2009-01-27 | 2010-08-05 | Boveda Marco Medical Llc | Catheters and methods for performing electrophysiological interventions |
US8551096B2 (en) | 2009-05-13 | 2013-10-08 | Boston Scientific Scimed, Inc. | Directional delivery of energy and bioactives |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
US8954161B2 (en) | 2012-06-01 | 2015-02-10 | Advanced Cardiac Therapeutics, Inc. | Systems and methods for radiometrically measuring temperature and detecting tissue contact prior to and during tissue ablation |
US9277961B2 (en) | 2009-06-12 | 2016-03-08 | Advanced Cardiac Therapeutics, Inc. | Systems and methods of radiometrically determining a hot-spot temperature of tissue being treated |
US8926605B2 (en) | 2012-02-07 | 2015-01-06 | Advanced Cardiac Therapeutics, Inc. | Systems and methods for radiometrically measuring temperature during tissue ablation |
US9226791B2 (en) | 2012-03-12 | 2016-01-05 | Advanced Cardiac Therapeutics, Inc. | Systems for temperature-controlled ablation using radiometric feedback |
US8319400B2 (en) | 2009-06-24 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
USRE47996E1 (en) | 2009-10-09 | 2020-05-19 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US9168054B2 (en) | 2009-10-09 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US9050093B2 (en) | 2009-10-09 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US8579928B2 (en) | 2010-02-11 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Outer sheath and blade arrangements for ultrasonic surgical instruments |
US8961547B2 (en) | 2010-02-11 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with moving cutting implement |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
CA2795229A1 (en) | 2010-04-09 | 2011-10-13 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US8906013B2 (en) | 2010-04-09 | 2014-12-09 | Endosense Sa | Control handle for a contact force ablation catheter |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US9918787B2 (en) | 2010-05-05 | 2018-03-20 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Monitoring, managing and/or protecting system and method for non-targeted tissue |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US8473067B2 (en) | 2010-06-11 | 2013-06-25 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter 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 |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires 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 |
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 |
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 |
US20120259269A1 (en) | 2011-04-08 | 2012-10-11 | Tyco Healthcare Group Lp | Iontophoresis drug delivery system and method for denervation of the renal sympathetic nerve and iontophoretic drug delivery |
CN102166385A (zh) * | 2011-04-20 | 2011-08-31 | 河南中医学院 | 单向膜瓣侧孔指引导管 |
TW201242570A (en) | 2011-04-25 | 2012-11-01 | Medtronic Ardian Luxembourg | Apparatus and methods related to constrained deployment of cryogenic balloons for limited cryogenic ablation of vessel walls |
EP2734259B1 (en) | 2011-07-20 | 2016-11-23 | Boston Scientific Scimed, Inc. | Percutaneous device to visualize, target and ablate nerves |
JP6106669B2 (ja) | 2011-07-22 | 2017-04-05 | 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. | ヘリカル・ガイド内に配置可能な神経調節要素を有する神経調節システム |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
RU2553187C1 (ru) | 2011-08-25 | 2015-06-10 | КАВИДИН ЭлПи | Системы, устройства и способы лечения внутрипросветной ткани |
WO2013055826A1 (en) | 2011-10-10 | 2013-04-18 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
WO2013055815A1 (en) | 2011-10-11 | 2013-04-18 | Boston Scientific Scimed, Inc. | Off -wall electrode device for nerve modulation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
JP2013085619A (ja) * | 2011-10-14 | 2013-05-13 | Nidec Copal Electronics Corp | アブレーションカテーテル |
WO2013058962A1 (en) | 2011-10-18 | 2013-04-25 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
EP2768568B1 (en) | 2011-10-18 | 2020-05-06 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
EP3366250A1 (en) | 2011-11-08 | 2018-08-29 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | 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 |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
CN104244856B (zh) | 2011-12-23 | 2017-03-29 | 维西克斯血管公司 | 重建身体通道的组织或身体通路附近的组织的方法及设备 |
EP2797534A1 (en) | 2011-12-28 | 2014-11-05 | 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 |
WO2013119545A1 (en) | 2012-02-10 | 2013-08-15 | Ethicon-Endo Surgery, Inc. | Robotically controlled surgical instrument |
US9241731B2 (en) | 2012-04-09 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Rotatable electrical connection for ultrasonic surgical instruments |
US9237921B2 (en) | 2012-04-09 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US9226766B2 (en) | 2012-04-09 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Serial communication protocol for medical device |
US9724118B2 (en) | 2012-04-09 | 2017-08-08 | Ethicon Endo-Surgery, Llc | Techniques for cutting and coagulating tissue for ultrasonic surgical instruments |
US10660703B2 (en) | 2012-05-08 | 2020-05-26 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
EP2679275B1 (de) * | 2012-06-28 | 2014-05-14 | Peter Osypka Stiftung | Epikardiale Mapping-Elektrode |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9283045B2 (en) | 2012-06-29 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Surgical instruments with fluid management system |
US9370398B2 (en) * | 2012-08-07 | 2016-06-21 | Covidien Lp | Microwave ablation catheter and method of utilizing the same |
CA2881462C (en) | 2012-08-09 | 2020-07-14 | University Of Iowa Research Foundation | Catheters, catheter systems, and methods for puncturing through a tissue structure |
WO2014032016A1 (en) | 2012-08-24 | 2014-02-27 | Boston Scientific Scimed, Inc. | Intravascular catheter with a balloon comprising separate microporous regions |
EP2895095A2 (en) | 2012-09-17 | 2015-07-22 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
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 |
BR112015007010B1 (pt) | 2012-09-28 | 2022-05-31 | Ethicon Endo-Surgery, Inc | Atuador de extremidade |
EP2906135A2 (en) | 2012-10-10 | 2015-08-19 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices and methods |
US10201365B2 (en) | 2012-10-22 | 2019-02-12 | Ethicon Llc | Surgeon feedback sensing and display methods |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
CN102908191A (zh) * | 2012-11-13 | 2013-02-06 | 陈绍良 | 多极同步肺动脉射频消融导管 |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
US9078667B2 (en) | 2012-12-11 | 2015-07-14 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter having reduced force concentration at tissue contact site |
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 |
US9278187B2 (en) | 2013-03-13 | 2016-03-08 | Biosense Webster (Israel) Ltd. | Method for making a low OHMIC pressure-contact electrical connection between split ring electrode and lead wire |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
EP2967725B1 (en) | 2013-03-15 | 2019-12-11 | Boston Scientific Scimed, Inc. | Control unit for detecting electrical leakage between electrode pads and system comprising such a control unit |
WO2014150553A1 (en) | 2013-03-15 | 2014-09-25 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9241728B2 (en) | 2013-03-15 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument with multiple clamping mechanisms |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
EP3019104A4 (en) * | 2013-04-30 | 2017-08-02 | Lake Region Manufacturing, Inc. d/b/a Lake Region Medical | Reverse loop ablation device |
JP2016523147A (ja) | 2013-06-21 | 2016-08-08 | 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. | 同乗型電極支持体を備えた腎除神経バルーンカテーテル |
CN105473092B (zh) | 2013-06-21 | 2019-05-17 | 波士顿科学国际有限公司 | 具有可旋转轴的用于肾神经消融的医疗器械 |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
AU2014284558B2 (en) | 2013-07-01 | 2017-08-17 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
EP3019105B1 (en) | 2013-07-11 | 2017-09-13 | Boston Scientific Scimed, Inc. | Devices for nerve modulation |
CN105377170A (zh) | 2013-07-11 | 2016-03-02 | 波士顿科学国际有限公司 | 具有可伸展电极组件的医疗装置 |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
CN105555220B (zh) | 2013-07-22 | 2019-05-17 | 波士顿科学国际有限公司 | 用于肾神经消融的医疗器械 |
EP3024405A1 (en) | 2013-07-22 | 2016-06-01 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
CN105473093B (zh) | 2013-08-22 | 2019-02-05 | 波士顿科学国际有限公司 | 具有至肾神经调制球囊的改善的粘附力的柔性电路 |
WO2015035047A1 (en) | 2013-09-04 | 2015-03-12 | Boston Scientific Scimed, Inc. | Radio frequency (rf) balloon catheter having flushing and cooling capability |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
US10952790B2 (en) | 2013-09-13 | 2021-03-23 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
EP3057488B1 (en) | 2013-10-14 | 2018-05-16 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
JP6259098B2 (ja) | 2013-10-15 | 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. | 医療デバイスおよび同医療デバイスを製造する方法 |
CN105636538B (zh) | 2013-10-18 | 2019-01-15 | 波士顿科学国际有限公司 | 具有柔性导线的球囊导管及其使用和制造的相关方法 |
JP2016534842A (ja) | 2013-10-25 | 2016-11-10 | 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. | 除神経フレックス回路における埋め込み熱電対 |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
EP3091921B1 (en) | 2014-01-06 | 2019-06-19 | Farapulse, Inc. | Apparatus for renal denervation ablation |
CN105899157B (zh) | 2014-01-06 | 2019-08-09 | 波士顿科学国际有限公司 | 抗撕裂柔性电路组件 |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
EP3424453A1 (en) | 2014-02-04 | 2019-01-09 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
CN106255451B (zh) | 2014-05-06 | 2020-03-17 | 圣犹达医疗用品心脏病学部门有限公司 | 电极支撑结构组件 |
EP3139997B1 (en) | 2014-05-07 | 2018-09-19 | Farapulse, Inc. | Apparatus for selective tissue ablation |
US10709490B2 (en) | 2014-05-07 | 2020-07-14 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter assemblies comprising a direct heating element for renal neuromodulation and associated systems and methods |
US10118022B2 (en) | 2014-06-05 | 2018-11-06 | St. Jude Medical, Cardiology Division, Inc. | Deflectable catheter shaft section |
EP3154463B1 (en) | 2014-06-12 | 2019-03-27 | Farapulse, Inc. | Apparatus for rapid and selective transurethral tissue ablation |
WO2015192018A1 (en) | 2014-06-12 | 2015-12-17 | Iowa Approach Inc. | Method and apparatus for rapid and selective tissue ablation with cooling |
US9844645B2 (en) | 2014-06-17 | 2017-12-19 | St. Jude Medical, Cardiology Division, Inc. | Triple coil catheter support |
US9821097B2 (en) * | 2014-06-27 | 2017-11-21 | Merit Medical Systems, Inc. | Body cavity drainage devices including drainage tubes having inline portions and related methods |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
WO2016060983A1 (en) | 2014-10-14 | 2016-04-21 | Iowa Approach Inc. | Method and apparatus for rapid and safe pulmonary vein cardiac ablation |
SG11201703943VA (en) | 2014-11-19 | 2017-06-29 | Advanced Cardiac Therapeutics Inc | Ablation devices, systems and methods of using a high-resolution electrode assembly |
WO2016081611A1 (en) | 2014-11-19 | 2016-05-26 | Advanced Cardiac Therapeutics, Inc. | High-resolution mapping of tissue with pacing |
EP3220844B1 (en) | 2014-11-19 | 2020-11-11 | EPiX Therapeutics, Inc. | Systems for high-resolution mapping of tissue |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
CN105982730B (zh) * | 2015-01-30 | 2018-08-07 | 乐普(北京)医疗器械股份有限公司 | 一种磁导航消融导管用推送装置 |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US9636164B2 (en) | 2015-03-25 | 2017-05-02 | Advanced Cardiac Therapeutics, Inc. | Contact sensing systems and methods |
US10602983B2 (en) | 2015-05-08 | 2020-03-31 | St. Jude Medical International Holding S.À R.L. | Integrated sensors for medical devices and method of making integrated sensors for medical devices |
US10034684B2 (en) | 2015-06-15 | 2018-07-31 | Ethicon Llc | Apparatus and method for dissecting and coagulating tissue |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US10765470B2 (en) | 2015-06-30 | 2020-09-08 | Ethicon Llc | Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
US11058475B2 (en) | 2015-09-30 | 2021-07-13 | Cilag Gmbh International | Method and apparatus for selecting operations of a surgical instrument based on user intention |
US10433870B2 (en) | 2015-10-08 | 2019-10-08 | Medtronic, Inc. | Interventional medical systems and methods for delivering a medical electrical lead to an epicardial implant site |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
JP6445742B1 (ja) | 2015-10-21 | 2018-12-26 | セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド | 高密度電極マッピングカテーテル |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
US20170189097A1 (en) | 2016-01-05 | 2017-07-06 | Iowa Approach Inc. | Systems, apparatuses and methods for delivery of ablative energy to tissue |
US10130423B1 (en) | 2017-07-06 | 2018-11-20 | Farapulse, Inc. | Systems, devices, and methods for focal ablation |
US10660702B2 (en) | 2016-01-05 | 2020-05-26 | Farapulse, Inc. | Systems, devices, and methods for focal ablation |
US10172673B2 (en) | 2016-01-05 | 2019-01-08 | Farapulse, Inc. | Systems devices, and methods for delivery of pulsed electric field ablative energy to endocardial tissue |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US10828058B2 (en) | 2016-01-15 | 2020-11-10 | Ethicon Llc | Modular battery powered handheld surgical instrument with motor control limits based on tissue characterization |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
SG11201807618QA (en) | 2016-03-15 | 2018-10-30 | Epix Therapeutics Inc | Improved devices, systems and methods for irrigated ablation |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
WO2017218734A1 (en) | 2016-06-16 | 2017-12-21 | Iowa Approach, Inc. | Systems, apparatuses, and methods for guide wire delivery |
US11090100B2 (en) | 2016-07-05 | 2021-08-17 | Biosense Webster (Israel) Ltd. | Catheter with micro-peltier cooling components |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10912475B2 (en) | 2016-08-24 | 2021-02-09 | Biosense Webster (Israel) Ltd | Catheter with split electrode sleeve and related methods |
US10702177B2 (en) | 2016-08-24 | 2020-07-07 | Biosense Webster (Israel) Ltd. | Catheter with bipole electrode spacer and related methods |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
US10736649B2 (en) | 2016-08-25 | 2020-08-11 | Ethicon Llc | Electrical and thermal connections for ultrasonic transducer |
US11786705B2 (en) | 2016-10-24 | 2023-10-17 | St. Jude Medical, Cardiology Division, Inc. | Catheter insertion devices |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
EP3531903B1 (en) | 2017-01-19 | 2021-02-17 | St. Jude Medical, Cardiology Division, Inc. | Sheath visualization |
US9987081B1 (en) | 2017-04-27 | 2018-06-05 | Iowa Approach, Inc. | Systems, devices, and methods for signal generation |
CN110809448B (zh) | 2017-04-27 | 2022-11-25 | Epix疗法公司 | 确定导管尖端与组织之间接触的性质 |
US10617867B2 (en) | 2017-04-28 | 2020-04-14 | Farapulse, Inc. | Systems, devices, and methods for delivery of pulsed electric field ablative energy to esophageal tissue |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
US11647935B2 (en) | 2017-07-24 | 2023-05-16 | St. Jude Medical, Cardiology Division, Inc. | Masked ring electrodes |
CN115844523A (zh) | 2017-09-12 | 2023-03-28 | 波士顿科学医学有限公司 | 用于心室局灶性消融的***、设备和方法 |
CN111491582B (zh) | 2017-11-28 | 2023-12-05 | 圣犹达医疗用品心脏病学部门有限公司 | 受控式可膨胀导管 |
US11253189B2 (en) | 2018-01-24 | 2022-02-22 | Medtronic Ardian Luxembourg S.A.R.L. | Systems, devices, and methods for evaluating neuromodulation therapy via detection of magnetic fields |
WO2019217433A1 (en) | 2018-05-07 | 2019-11-14 | Farapulse, Inc. | Systems, apparatuses and methods for delivery of ablative energy to tissue |
EP3790483A1 (en) | 2018-05-07 | 2021-03-17 | Farapulse, Inc. | Systems, apparatuses, and methods for filtering high voltage noise induced by pulsed electric field ablation |
EP3809962A2 (en) | 2018-08-23 | 2021-04-28 | St. Jude Medical, Cardiology Division, Inc. | Curved high density electrode mapping catheter |
US10687892B2 (en) | 2018-09-20 | 2020-06-23 | Farapulse, Inc. | Systems, apparatuses, and methods for delivery of pulsed electric field ablative energy to endocardial tissue |
US11918762B2 (en) | 2018-10-03 | 2024-03-05 | St. Jude Medical, Cardiology Division, Inc. | Reduced actuation force electrophysiology catheter handle |
US10625080B1 (en) | 2019-09-17 | 2020-04-21 | Farapulse, Inc. | Systems, apparatuses, and methods for detecting ectopic electrocardiogram signals during pulsed electric field ablation |
US11065047B2 (en) | 2019-11-20 | 2021-07-20 | Farapulse, Inc. | Systems, apparatuses, and methods for protecting electronic components from high power noise induced by high voltage pulses |
US11497541B2 (en) | 2019-11-20 | 2022-11-15 | Boston Scientific Scimed, Inc. | Systems, apparatuses, and methods for protecting electronic components from high power noise induced by high voltage pulses |
US10842572B1 (en) | 2019-11-25 | 2020-11-24 | Farapulse, Inc. | Methods, systems, and apparatuses for tracking ablation devices and generating lesion lines |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11950797B2 (en) | 2019-12-30 | 2024-04-09 | Cilag Gmbh International | Deflectable electrode with higher distal bias relative to proximal bias |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11589916B2 (en) | 2019-12-30 | 2023-02-28 | Cilag Gmbh International | Electrosurgical instruments with electrodes having variable energy densities |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US20210196363A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with electrodes operable in bipolar and monopolar modes |
US11986201B2 (en) | 2019-12-30 | 2024-05-21 | Cilag Gmbh International | Method for operating a surgical instrument |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US12023086B2 (en) | 2019-12-30 | 2024-07-02 | Cilag Gmbh International | Electrosurgical instrument for delivering blended energy modalities to tissue |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US11744636B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Electrosurgical systems with integrated and external power sources |
CN111658134B (zh) * | 2020-07-10 | 2021-09-21 | 四川锦江电子科技有限公司 | 一种心脏脉冲电场消融导管 |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5643255A (en) * | 1994-12-12 | 1997-07-01 | Hicor, Inc. | Steerable catheter with rotatable tip electrode and method of use |
US20030208195A1 (en) * | 2002-05-03 | 2003-11-06 | Scimed Life Systems, Inc. | Ablation systems including insulated energy transmitting elements |
US20050090818A1 (en) * | 2003-10-27 | 2005-04-28 | Pike Robert W.Jr. | Method for ablating with needle electrode |
US7412273B2 (en) * | 2004-11-15 | 2008-08-12 | Biosense Webster, Inc. | Soft linear mapping catheter with stabilizing tip |
Family Cites Families (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4898591A (en) | 1988-08-09 | 1990-02-06 | Mallinckrodt, Inc. | Nylon-PEBA copolymer catheter |
US5104393A (en) | 1989-08-30 | 1992-04-14 | Angelase, Inc. | Catheter |
JPH03221036A (ja) * | 1990-01-25 | 1991-09-30 | Inter Noba Kk | 心筋焼灼用バルーン電極カテーテル |
US5454787A (en) * | 1991-02-15 | 1995-10-03 | Lundquist; Ingemar H. | Torquable tubular assembly and torquable catheter utilizing the same |
AU660444B2 (en) * | 1991-02-15 | 1995-06-29 | Ingemar H. Lundquist | Torquable catheter and method |
US5555883A (en) | 1992-02-24 | 1996-09-17 | Avitall; Boaz | Loop electrode array mapping and ablation catheter for cardiac chambers |
US5314466A (en) | 1992-04-13 | 1994-05-24 | Ep Technologies, Inc. | Articulated unidirectional microwave antenna systems for cardiac ablation |
US6086581A (en) | 1992-09-29 | 2000-07-11 | Ep Technologies, Inc. | Large surface cardiac ablation catheter that assumes a low profile during introduction into the heart |
IT1266217B1 (it) | 1993-01-18 | 1996-12-27 | Xtrode Srl | Elettrocatetere per la mappatura e l'intervento su cavita' cardiache. |
US5582609A (en) | 1993-10-14 | 1996-12-10 | Ep Technologies, Inc. | Systems and methods for forming large lesions in body tissue using curvilinear electrode elements |
DE69434664T2 (de) * | 1993-10-14 | 2006-11-09 | Boston Scientific Ltd., Barbados | Elektroden zur erzeugung bestimmter muster von pathologisch verändertem gewebe |
US5575766A (en) | 1993-11-03 | 1996-11-19 | Daig Corporation | Process for the nonsurgical mapping and treatment of atrial arrhythmia using catheters guided by shaped guiding introducers |
US5487385A (en) | 1993-12-03 | 1996-01-30 | Avitall; Boaz | Atrial mapping and ablation catheter system |
US5617854A (en) | 1994-06-22 | 1997-04-08 | Munsif; Anand | Shaped catheter device and method |
DE4425195C1 (de) | 1994-07-16 | 1995-11-16 | Osypka Peter | Katheter mit Mehrfachelektrode |
US5885278A (en) | 1994-10-07 | 1999-03-23 | E.P. Technologies, Inc. | Structures for deploying movable electrode elements |
US7052493B2 (en) * | 1996-10-22 | 2006-05-30 | Epicor Medical, Inc. | Methods and devices for ablation |
EP0842640A1 (de) * | 1996-11-13 | 1998-05-20 | Sulzer Osypka GmbH | Herzkatheter mit Elektrode auf aufspannbarer Einrichtung |
US6332880B1 (en) * | 1996-12-19 | 2001-12-25 | Ep Technologies, Inc. | Loop structures for supporting multiple electrode elements |
AU2284497A (en) | 1997-04-11 | 1998-11-11 | Taccor, Inc. | Steerable catheter with rotatable tip electrode and method of use |
US5964757A (en) | 1997-09-05 | 1999-10-12 | Cordis Webster, Inc. | Steerable direct myocardial revascularization catheter |
US6183463B1 (en) * | 1997-12-01 | 2001-02-06 | Cordis Webster, Inc. | Bidirectional steerable cathether with bidirectional control handle |
US6702811B2 (en) * | 1999-04-05 | 2004-03-09 | Medtronic, Inc. | Ablation catheter assembly with radially decreasing helix and method of use |
US6852120B1 (en) | 1999-08-10 | 2005-02-08 | Biosense Webster, Inc | Irrigation probe for ablation during open heart surgery |
US6613046B1 (en) | 1999-11-22 | 2003-09-02 | Scimed Life Systems, Inc. | Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue |
US6728455B2 (en) | 2001-09-04 | 2004-04-27 | Fujikura Ltd. | Optical fiber drop cable and manufacturing method thereof |
US7142903B2 (en) | 2003-03-12 | 2006-11-28 | Biosense Webster, Inc. | Catheter with contractable mapping assembly |
US7003342B2 (en) | 2003-06-02 | 2006-02-21 | Biosense Webster, Inc. | Catheter and method for mapping a pulmonary vein |
US6973339B2 (en) | 2003-07-29 | 2005-12-06 | Biosense, Inc | Lasso for pulmonary vein mapping and ablation |
US7245955B2 (en) | 2004-02-23 | 2007-07-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Electrophysiology/ablation catheter having deflection assembly |
US7377906B2 (en) | 2004-06-15 | 2008-05-27 | Biosense Webster, Inc. | Steering mechanism for bi-directional catheter |
US7918851B2 (en) | 2005-02-14 | 2011-04-05 | Biosense Webster, Inc. | Irrigated tip catheter and method for manufacturing therefor |
US9861836B2 (en) * | 2005-06-16 | 2018-01-09 | Biosense Webster, Inc. | Less invasive methods for ablation of fat pads |
US8480653B2 (en) | 2007-05-23 | 2013-07-09 | Biosense Webster, Inc. | Magnetically guided catheter with concentric needle port |
US8137308B2 (en) | 2008-09-16 | 2012-03-20 | Biosense Webster, Inc. | Catheter with adjustable deflection sensitivity |
-
2009
- 2009-04-13 US US12/384,992 patent/US8287532B2/en active Active
-
2010
- 2010-03-22 IL IL204664A patent/IL204664A/en active IP Right Grant
- 2010-03-30 AU AU2010201269A patent/AU2010201269B2/en not_active Ceased
- 2010-03-31 EP EP10250703.5A patent/EP2241279B1/en not_active Not-in-force
- 2010-04-09 CA CA2699536A patent/CA2699536C/en not_active Expired - Fee Related
- 2010-04-09 JP JP2010090509A patent/JP5717976B2/ja active Active
- 2010-04-13 CN CN201010167123.6A patent/CN101856271B/zh active Active
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5643255A (en) * | 1994-12-12 | 1997-07-01 | Hicor, Inc. | Steerable catheter with rotatable tip electrode and method of use |
US20030208195A1 (en) * | 2002-05-03 | 2003-11-06 | Scimed Life Systems, Inc. | Ablation systems including insulated energy transmitting elements |
US20050090818A1 (en) * | 2003-10-27 | 2005-04-28 | Pike Robert W.Jr. | Method for ablating with needle electrode |
US7412273B2 (en) * | 2004-11-15 | 2008-08-12 | Biosense Webster, Inc. | Soft linear mapping catheter with stabilizing tip |
Cited By (61)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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US10743932B2 (en) | 2011-07-28 | 2020-08-18 | Biosense Webster (Israel) Ltd. | Integrated ablation system using catheter with multiple irrigation lumens |
CN103405226A (zh) * | 2012-03-21 | 2013-11-27 | 韦伯斯特生物官能(以色列)有限公司 | 复杂碎裂电图的自动化分析 |
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US11096736B2 (en) | 2013-12-09 | 2021-08-24 | Biosense Webster (Israel) Ltd. | Pericardial catheter with temperature sensing array |
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US10368767B2 (en) | 2014-06-20 | 2019-08-06 | Boston Scientific Scimed Inc. | Medical devices for mapping cardiac tissue |
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US11039772B2 (en) | 2015-06-29 | 2021-06-22 | Biosense Webster (Israel) Ltd. | Catheter with stacked spine electrode assembly |
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US11690552B2 (en) | 2015-06-29 | 2023-07-04 | Biosense Webster (Israel) Ltd. | Catheter with stacked spine electrode assembly |
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US11116436B2 (en) | 2015-06-30 | 2021-09-14 | Biosense Webster (Israel) Ltd. | Catheter having closed electrode assembly with spines of uniform length |
US11723574B2 (en) | 2015-06-30 | 2023-08-15 | Biosense Webster (Israel) Ltd. | Catheter having closed electrode assembly with spines of uniform length |
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US10939956B2 (en) | 2016-05-02 | 2021-03-09 | Affera, Inc. | Pulsed radiofrequency ablation |
US11986237B2 (en) | 2016-05-02 | 2024-05-21 | Affera, Inc. | Catheter with ablation electrode |
CN109414286A (zh) * | 2016-05-02 | 2019-03-01 | 阿弗拉公司 | 导管感应以及冲洗 |
US11471216B2 (en) | 2016-05-02 | 2022-10-18 | Affera, Inc. | Catheter insertion |
US10932850B2 (en) | 2016-05-02 | 2021-03-02 | Affera, Inc. | Lesion formation |
US11246656B2 (en) | 2016-05-02 | 2022-02-15 | Affera, Inc. | Therapeutic catheter with imaging |
US11826095B2 (en) | 2016-05-02 | 2023-11-28 | Affera, Inc. | Catheter with deformable electrode |
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US11793567B2 (en) | 2016-05-02 | 2023-10-24 | Affera, Inc. | Catheter insertion |
US11759255B2 (en) | 2016-05-02 | 2023-09-19 | Affera, Inc. | Lesion formation |
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CN112087978A (zh) * | 2018-05-07 | 2020-12-15 | 法拉普尔赛股份有限公司 | 心外膜消融导管 |
CN112087978B (zh) * | 2018-05-07 | 2023-01-17 | 波士顿科学医学有限公司 | 心外膜消融导管 |
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CN111728693A (zh) * | 2020-07-06 | 2020-10-02 | 白龙腾 | 一种采用脉冲电场消融技术治疗心律失常的*** |
CN111772783A (zh) * | 2020-08-21 | 2020-10-16 | 白龙腾 | 一种具有可弯曲电极的消融*** |
US12035965B2 (en) | 2020-12-18 | 2024-07-16 | Affera, Inc. | Catheter sensing and irrigating |
USD1014762S1 (en) | 2021-06-16 | 2024-02-13 | Affera, Inc. | Catheter tip with electrode panel(s) |
CN114145841A (zh) * | 2021-12-06 | 2022-03-08 | 杭州维纳安可医疗科技有限责任公司 | 脉冲消融装置及其控制方法、存储介质 |
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US8287532B2 (en) | 2012-10-16 |
IL204664A0 (en) | 2010-11-30 |
JP2010246914A (ja) | 2010-11-04 |
IL204664A (en) | 2013-07-31 |
CA2699536C (en) | 2019-08-20 |
JP5717976B2 (ja) | 2015-05-13 |
AU2010201269B2 (en) | 2014-04-17 |
AU2010201269A1 (en) | 2010-10-28 |
CN101856271B (zh) | 2015-01-07 |
US20120130366A1 (en) | 2012-05-24 |
CA2699536A1 (en) | 2010-10-13 |
EP2241279B1 (en) | 2016-09-14 |
EP2241279A1 (en) | 2010-10-20 |
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