CN111248996B - 用于补偿细胞尺寸和取向的定向的不可逆电穿孔(ire)脉冲 - Google Patents
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Abstract
本发明题为“用于补偿细胞尺寸和取向的定向的不可逆电穿孔(IRE)脉冲”。提供了一种***,所述***包括不可逆电穿孔(IRE)脉冲发生器、切换组件和处理器。所述IRE脉冲发生器被配置为生成IRE脉冲。所述切换组件被配置为将所述IRE脉冲递送至设置在导管的可膨胀远侧端部上的多个电极,所述导管被放置成与器官中的组织接触,用于向所述组织施加所述IRE脉冲。所述处理器被配置为(a)接收一个或多个预先指定的取向,沿所述一个或多个预先指定的取向,将由所述IRE脉冲生成所述组织中的电场,(b)选择将以所述预先指定的取向施加所述IRE脉冲的一对或多对电极,以及(c)使用所述切换组件将所述IRE脉冲发生器连接至所选择的所述电极对。
Description
技术领域
本发明整体涉及侵入式医疗探头,并且具体地涉及用于不可逆电穿孔的球囊导管。
背景技术
先前在专利文献中提出了使用多电极导管向组织递送不可逆电穿孔(IRE)能量。例如,美国专利No.9,289,606描述了导管***,该导管***包括用于电穿孔介导的治疗、电穿孔诱导的原发性坏死治疗和电场诱导的细胞凋亡治疗的方向敏感的多极尖端电极组件,包括用于产生窄的线性损伤以及分布的广区损伤的配置。
又如,美国专利申请公布2019/0030328描述了被配置为电穿孔组织区域的医疗装置,该医疗装置包括具有远侧部分和近侧部分的球囊,以及设置在球囊的远侧部分上的多个电极,这些多个电极中的每个电极被配置为将电穿孔能量递送至组织区域。
美国专利No.8,992,517描述了用于体内治疗细胞增生性疾病的方法、装置和***。本发明可用于治疗固体肿瘤,诸如脑肿瘤。该方法依赖于非热不可逆电穿孔(IRE)致使经治疗的肿瘤中的细胞死亡。该方法包括使用多个电极以及为每个电极施加不同的电压来精确地控制电场的三维形状以进行组织消融。更具体地,已发现改变由放置在待处理的组织中的不同电极所发射的电能的量允许从业者精细地调谐不可逆地破坏细胞膜从而导致细胞死亡的电场的三维形状。同样,可改变电极的极性以实现不同的三维电场。
发明内容
本发明的示例性实施方案提供了一种包括不可逆电穿孔(IRE)脉冲发生器、切换组件和处理器的***。IRE脉冲发生器被配置为生成IRE脉冲。该切换组件被配置为将IRE脉冲递送至设置在导管的可膨胀远侧端部上的多个电极,该导管被放置成与器官中的组织接触,用于向组织施加IRE脉冲。该处理器被配置为(a)接收一个或多个预先指定的取向,沿该一个或多个预先指定的取向,将由IRE脉冲生成组织中的电场,(b)选择将以预先指定的取向施加IRE脉冲的一对或多对电极,以及(c)使用切换组件将IRE脉冲发生器连接至所选择的电极对。
在一些示例性实施方案中,电极中的每个电极包括多个电极区段,并且其中切换组件和处理器被配置为各自包括该一对或多对电极中的电极区段中的任一电极区段。
在一些示例性实施方案中,电极围绕远侧端部的纵向轴线等距设置。
在示例性实施方案中,处理器被配置为沿相互正交的取向选择第一对电极和第二对电极。在另一个示例性实施方案中,一个或多个预先指定的取向是相对于远侧端部的纵向轴线预先指定的。
在一些示例性实施方案中,处理器被配置为通过施加双相IRE脉冲来施加IRE脉冲。
根据本发明的示例性实施方案,还提供了一种方法,该方法包括将导管的可膨胀远侧端部的多个电极放置成与器官中的组织接触,用于向组织施加IRE脉冲。使用IRE脉冲发生器生成不可逆电穿孔(IRE)脉冲。接收一个或多个预先指定的取向,沿这些一个或多个预先指定的取向,将由IRE脉冲生成组织中的电场。选择将以预先指定的取向施加IRE脉冲的一对或多对电极。通过将IRE脉冲发生器连接至所选择的电极对,将IRE脉冲以预先指定的取向施加于组织。
根据本发明的示例性实施方案,还提供了一种***,该***包括不可逆电穿孔(IRE)脉冲发生器、切换组件和处理器。IRE脉冲发生器被配置为生成IRE脉冲。该切换组件被配置为将IRE脉冲递送至设置在导管的可膨胀远侧端部上的多个电极,该导管被放置成与器官中的组织接触,用于向组织施加IRE脉冲。处理器被配置为选择第一对电极和第二对电极,该第一对电极和第二对电极将IRE脉冲施加到处于彼此不平行的两个取向的相同组织区域,并且使用切换组件将IRE脉冲发生器连接至所选择的第一对电极和第二对电极。
附图说明
结合附图,通过以下对本发明的实施方案的详细描述,将更全面地理解本发明,其中:
图1为根据本发明的示例性实施方案的基于导管的不可逆电穿孔(IRE)***的示意性图解;
图2为根据本发明的示例性实施方案的部署在肺静脉(PV)及其窦口的区域中的图1的不可逆电穿孔(IRE)球囊导管的示意性绘画侧视图;并且
图3为示意性地示出根据本发明的示例性实施方案的使用图2的IRE球囊导管来施加定向IRE脉冲的方法的流程图。
具体实施方式
概述
不可逆电穿孔(IRE)还被称为脉冲场消融(PFA),可以用作侵入式治疗模态,以通过使组织细胞经受高压脉冲来杀死组织细胞。IRE可以与DC脉冲或单相脉冲相关联,其中当IRE消融被称为PFA(脉冲场消融)时,将使用双相IRE脉冲。然而,术语IRE可用于指任何类型的上述脉冲形状。
具体地,IRE脉冲可用于杀死心肌组织细胞以便治疗心律失常。尤其值得关注的是使用双极性电脉冲(例如,使用与组织接触的一对电极)来杀死电极之间的组织细胞。当跨膜电势超过阈值时会发生细胞破坏,从而导致细胞死亡,并且因此导致组织病变的发展。
心肌组织包括传导电生理信号的特化心肌细胞。例如,这些特化心肌细胞(窦口节点)的集合引发心跳。每个心肌细胞通常是长且薄的。心脏组织包括聚集成所谓的传导组织的肌纤维的多个心肌细胞。传导组织的肌纤维的空间对准(即,心肌细胞的取向)在很大程度上取决于它们在心脏中的位置。
细胞死亡是由所施加的电场引起的,并且不同的细胞对不同的场水平的反应不同,即,针对被杀死具有不同的阈值。此外,非球形细胞对所施加的电场的响应方式取决于细胞相对于场的几何取向。心肌细胞具有相对较大的椭圆形偏心度,长度为约100μm,直径为10μm至25μm。因此,虽然IRE可用于杀死心肌细胞,但细胞的非球形细胞形状意味着需要了解细胞取向来设定最佳致死电场。
下文描述的本发明的示例性实施方案使用具有多个电极的导管,这些多个电极可以被选择用于生成(在大小和方向上)不同的电场。为了克服不了解电极附近的心肌细胞取向,在一些示例性实施方案中,以通常彼此正交的至少两个不同取向施加电场。这降低了所需的脉冲电压幅值,因为以其他方式,需要高脉冲电压来克服沿细胞的细长方向的场细胞对准的“最坏情况”场景。如果心肌细胞取向已知(通常通过其他方式),则可以优化用于生成致死电场的电极的配置。
在一些示例性实施方案中,具有设置有多个电极(诸如球囊导管或篮形导管)的可膨胀机架的医疗探头用于沿两个大致正交的取向在可膨胀机架之上的多个位置施加高压脉冲,如下所述。为了能够施加定向电场,通过处理器控制的切换箱(也称为切换组件)将多个电极连接至IRE脉冲发生器的输出端。
如本文所用,针对任何数值或范围的术语“约”或“大致”表示允许部件或多个构件的集合可以完成如本文所描述的其想要达到的目的的适当的尺寸公差。更具体地,“约”或“大致”可以指列举值的值±20%的范围,例如“约90%”可以指71%至99%的值范围。
在一个实施方案中,在由多对电极施加双极IRE脉冲之前,处理器接收一个或多个预先指定的取向(例如,相对于远侧端部的纵向轴线),沿这些一个或多个预先指定的取向,应该由IRE脉冲生成组织中的电场。处理器因此确定可膨胀机架之上的电极对的配置。然后处理器控制切换箱以根据所确定的配置连接电极,即,将电极连接至IRE脉冲发生器以在电极之间沿一个或多个预先指定的取向施加IRE脉冲。
例如,如果已知血管内腔的组织的肌纤维在内腔的壁组织的整个周边上纵向(即,沿内腔)对准,则电极对被配置为在每个电极对之间生成局部横向电场。
通过沿正交取向或沿预先指定的方向施加电场的IRE脉冲,本发明所公开的基于导管的IRE处理技术提高了组织对处理的选择性,因此可以改善侵入式IRE处理的临床结果,诸如心律失常的IRE处理。
***描述
图1为根据本发明的示例性实施方案的基于导管的不可逆电穿孔(IRE)***20的示意性图解。***20包括导管21,其中导管的轴22通过护套23***到患者28的心脏26中。导管21的近侧端部连接到控制台24。
控制台24包括被配置为生成IRE脉冲的IRE发生器38。IRE脉冲经由导管21递送,以消融心脏26的左心房45中的组织。例如,IRE脉冲可以是被成型为正脉冲区段(例如,具有+1000V)然后是负脉冲区段(例如,具有-1000V)的双相脉冲。
在本文所述的示例性实施方案中,导管21可用于任何合适的治疗目的和/或诊断目的,诸如心脏26的左心房45中的肺静脉的窦口51组织的电感测和/或IRE隔离。
医师30将轴22***穿过患者28的血管***。如插图25所示,装配在轴22的远侧端部22a处的可膨胀球囊导管40包括多个IRE电极50,在图2中进一步描述。在轴22的***期间,球囊40在护套23内部保持塌缩构型。通过将球囊40包含在收缩构型中,护套23还用于使目标位置沿途的血管创伤最小化。医师30将轴22的远侧端部定位到心脏26中的目标位置。
一旦轴22的远侧端部22a已到达目标位置,医师30便通常通过将盐水泵送到球囊40中来回缩护套23,并且使球囊40膨胀。然后,医师30操纵轴22,使得设置在球囊导管40上的电极55接合窦口的内壁,以经由电极50向窦口51组织施加定向高电压IRE脉冲。为了施加定向IRE脉冲,电极50被分成区段55,以便围绕球囊40之上的每个位置形成大体为二维的电极区段阵列,如图2中进一步描述的。
控制台24包括切换箱46(也称为切换组件),该切换箱可以在作为一对电极区段的一部分之间切换分段电极50的任何区段55,一对电极区段的一部分在给定方向上或在与给定方向大致正交的方向上施加电场,如下所述。
电极50通过延伸穿过轴22的导线连接至控制位于控制台24中的接口电路37的切换箱46的处理器41。包括IRE参数诸如电极区段对配置的定向IRE协议被存储在控制台24的存储器48中。
控制台24包括处理器41,通常为通用计算机,该通用计算机具有合适的前端和接口电路37,以用于接收来自导管21和来自通常围绕患者28的胸部放置的外部电极49的信号。为此,处理器41通过延伸穿过电缆39的导线连接至外部电极49。
处理器41通常被编程(软件)用于执行本文所述的功能。该软件可通过网络以电子形式被下载到计算机,例如或者其可另选地或另外地设置和/或存储在非临时性有形介质(诸如磁存储器、光存储器或电子存储器)上。
尽管所示的示例性实施方案具体涉及使用球囊用于心脏组织的IRE,但是***20的元件和本文所述的方法可以另选地应用于使用其他种类的多电极消融装置来控制消融,诸如使用篮形导管,该篮形导管在可膨胀机架的脊上承载多个电极。
用于补偿细胞尺寸和取向的定向的IRE脉冲
图2为根据本发明的示例性实施方案的部署在肺静脉(PV)及其窦口51的区域中的图1的不可逆电穿孔(IRE)球囊导管40的示意性绘画侧视图。球囊导管40用于消融窦口51组织以隔离心律失常的源。球囊40具有设置在球囊的膜71之上的十个区段电极50(501…5010)。
可以从IRE发生器38将双极性IRE脉冲独立地递送至十个电极50中的每个电极的每对区段55(551…554),在相同电极的区段之间或在相邻电极的区段之间。当双极性IRE脉冲被施加在相同电极50的区段之间时,其产生大致平行于由轴22的远侧端部22a限定的纵向轴线61的电场。例如,施加在电极5010的区段552和区段553之间的双极性脉冲和施加在电极501的区段552和区段553之间的双极性脉冲在球囊40的整个周边上在与球囊40接触的不同组织位置处生成电场Ex 60。这两个场均平行于纵向轴线61。
当双极性IRE脉冲被施加在相邻电极50的对应区段55之间时,其产生大致平行于方位角轴或局部横向轴线y的电场。例如,施加在电极5010的区段552与电极501的区段552之间的双极性脉冲和施加在电极5010的区段553与电极501的区段553之间的双极脉冲,在球囊40的整个周边上在与球囊40接触的不同组织位置处生成电场Ey 62。这两个场都正交于纵向轴线61。
在一些示例性实施方案中,使用切换箱46来连接区段,以产生相对于纵向轴线61倾斜的正交场。例如,施加在电极5010的区段552与电极501的区段554之间的双极性脉冲产生电场63,该电场大致正交于施加在电极501的区段552与电极5010的区段554之间的双极性脉冲所产生的电场65,这两个场相对于纵向轴线61分别旋转大致(+45)度和(-45)度。
在图2所示的示例性实施方案中,球囊导管包括四十个区段55(每个电极四个),但区段的数量和形状可以不同。
处理器41控制切换箱46,以根据例如给定心脏组织的IRE球囊材料方案中应用的预先指定的配置来连接区段对。
图3为示意性地示出根据本发明的示例性实施方案的使用图2的球囊来施加定向IRE脉冲的方法的流程图。根据所呈现的示例性实施方案,算法执行过程,该过程始于在球囊导管导航步骤80处,医师30使用例如电极50作为ACL感测电极,将球囊导管导航至患者器官中的目标组织位置,诸如在窦口51处。
接着,在球囊导管定位步骤82处,医师30将球囊导管定位在窦口51处。下一步,在球囊充胀步骤84处,医师30使球囊40完全充胀以在管腔的整个周长上使目标组织与电极50接触。
接下来,在IRE规划步骤86处,处理器41接收(例如,相对于远侧端部的纵向轴线的)一个或多个预先指定的取向,IRE脉冲应该沿这些一个或多个预先指定的取向在组织中生成电场。例如,初始取向接收自协议,并且在被接收在处理器中之前由位置跟踪***调节。在窦口51周围,预先指定的取向在一个区域与另一个区域之间可以不同。
基于所要求的取向,在电极配置设置步骤88处,处理器41确定电极连接配置,该电极连接配置的示例在图2中进行了描述。
接着,在电极连接步骤90处,处理器41控制切换箱46以根据所确定的配置来连接电极。
最后,在IRE处理步骤92处,处理器41向组织施加定向IRE脉冲。
图3的流程图为示例性流程,仅仅是为了清楚起见而描述。在另选的实施方案中,可以使用任何其他合适的方法流程。例如,图2的方法假设心肌细胞的取向是已知的,即,在步骤86处存在足够的信息用于指定IRE脉冲的取向。在另选的示例性实施方案中,例如,在不存在关于心肌细胞取向的足够多的信息的情况下,处理器41可以控制切换箱46以将IRE脉冲以多个(通常为两个)不同取向施加于相同的组织区域。例如,处理器41可以控制切换箱46以施加具有正交取向的IRE脉冲,例如,在电极5010的区段552与电极501的区段554之间的一个双极性脉冲,以及在电极501的区段552与电极5010的区段554之间的另一个双极性脉冲。还可以应用任何其他合适的配置。
尽管本文所述的示例性实施方案主要涉及心脏应用,但本文所述的方法和***也可以用于其他医疗应用,诸如治疗不同类型的癌症,例如肺癌和肝癌,以及神经病学和耳鼻喉学。
因此应当理解,上面描述的实施方案以举例的方式被引用,并且本发明不限于上文特定示出和描述的内容。相反,本发明的范围包括上文描述的各种特征的组合和子组合以及它们的变型和修改,本领域的技术人员在阅读上述描述时将会想到该变型和修改,并且该变型和修改并未在现有技术中公开。以引用方式并入本专利申请的文献被视为本申请的整体部分,不同的是如果这些并入的文献中限定的任何术语与本说明书中明确或隐含地给出的定义相冲突,则应仅考虑本说明书中的定义。
Claims (6)
1.一种用于不可逆电穿孔的***,所述***包括:
不可逆电穿孔(IRE)脉冲发生器,所述不可逆电穿孔脉冲发生器被配置为生成IRE脉冲;
切换组件,所述切换组件被配置为将所述IRE脉冲递送至设置在导管的可膨胀远侧端部上的多个电极,所述导管被放置成与器官中的组织接触,以向所述组织施加所述IRE脉冲;和
处理器,所述处理器被配置为:
接收一个或多个预先指定的取向,沿所述一个或多个预先指定的取向,将由所述IRE脉冲生成所述组织中的电场;
选择将以所述预先指定的取向施加所述IRE脉冲的一对或多对所述电极;以及
使用所述切换组件将所述IRE脉冲发生器连接至所选择的一对或多对所述电极。
2.根据权利要求1所述的***,其中所述电极中的每个电极包括多个电极区段,并且其中所述切换组件和所述处理器被配置为各自包括所述一对或多对所述电极中的任何所述电极区段。
3.根据权利要求1所述的***,其中所述电极围绕所述远侧端部的纵向轴线等距设置。
4.根据权利要求1所述的***,其中所述处理器被配置为沿相互正交的取向选择第一对所述电极和第二对所述电极。
5.根据权利要求1所述的***,其中所述一个或多个预先指定的取向相对于所述远侧端部的纵向轴线是预先指定的。
6.根据权利要求1所述的***,其中所述处理器被配置为通过施加双相IRE脉冲来施加所述IRE脉冲。
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Families Citing this family (58)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10905329B2 (en) | 2016-06-09 | 2021-02-02 | Biosense Webster (Israel) Ltd. | Multi-function conducting elements for a catheter |
US12029545B2 (en) | 2017-05-30 | 2024-07-09 | Biosense Webster (Israel) Ltd. | Catheter splines as location sensors |
US20190314083A1 (en) | 2018-04-11 | 2019-10-17 | Biosense Webster (Israel) Ltd. | Flexible Multi-Arm Catheter with Diametrically Opposed Sensing Electrodes |
US11045628B2 (en) | 2018-12-11 | 2021-06-29 | Biosense Webster (Israel) Ltd. | Balloon catheter with high articulation |
US11850051B2 (en) | 2019-04-30 | 2023-12-26 | Biosense Webster (Israel) Ltd. | Mapping grid with high density electrode array |
US11950930B2 (en) | 2019-12-12 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Multi-dimensional acquisition of bipolar signals from a catheter |
US11517218B2 (en) | 2019-12-20 | 2022-12-06 | Biosense Webster (Israel) Ltd. | Selective graphical presentation of electrophysiological parameters |
US11987017B2 (en) | 2020-06-08 | 2024-05-21 | Biosense Webster (Israel) Ltd. | Features to assist in assembly and testing of devices |
US12048479B2 (en) | 2020-09-10 | 2024-07-30 | Biosense Webster (Israel) Ltd. | Surface mounted electrode catheter |
US11950841B2 (en) | 2020-09-22 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Basket catheter having insulated ablation electrodes and diagnostic electrodes |
US11950840B2 (en) | 2020-09-22 | 2024-04-09 | Biosense Webster (Israel) Ltd. | Basket catheter having insulated ablation electrodes |
US20220104872A1 (en) * | 2020-10-07 | 2022-04-07 | Biosense Webster (Israel) Ltd. | Printed Proximal Electrodes of an Expandable Catheter for Use as a Common Electrode |
US11974803B2 (en) | 2020-10-12 | 2024-05-07 | Biosense Webster (Israel) Ltd. | Basket catheter with balloon |
US11918383B2 (en) | 2020-12-21 | 2024-03-05 | Biosense Webster (Israel) Ltd. | Visualizing performance of catheter electrodes |
US20230009191A1 (en) | 2021-07-09 | 2023-01-12 | Biosense Webster (Israel) Ltd. | Irreversible electroporation and thermal ablation by focal catheter |
US20230008044A1 (en) | 2021-07-09 | 2023-01-12 | Biosense Webster (Israel) Ltd. | Pulsed field ablation catheter |
US20230009573A1 (en) | 2021-07-09 | 2023-01-12 | Biosense Webster (Israel) Ltd. | Ablation and mapping with a singular multi-electrode catheter |
US12004804B2 (en) | 2021-09-09 | 2024-06-11 | Biosense Webster (Israel) Ltd. | Basket catheter with mushroom shape distal tip |
US12011280B2 (en) | 2021-10-04 | 2024-06-18 | Biosense Webster (Israel) Ltd. | Electrophysiological mapping in the presence of injury current |
US20230190366A1 (en) | 2021-12-17 | 2023-06-22 | Biosense Webster (Israel) Ltd. | High-frequency tissue ablation using coated electrodes |
US20230225783A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Systems and methods for a single spiral electrode assembly forming a spherical basket for improved tissue contact and current delivery |
US20230225788A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Systems and methods for c-shaped spines forming a spherical basket for improved tissue contact and current delivery |
US20230225790A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Mechanical retainer systems for electrodes of a basket catheter, and methods of the same |
US20230225789A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Systems and methods for linear spines and spine retention hub for improved tissue contact and current delivery |
US20230226638A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Intravascular device including high voltage coaxial conductor wiring |
US20230226336A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Electrode assemblies of a basket catheter having mechanical retainers and methods of the same |
US20230225784A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Systems and methods for tripodic spines forming a spherical basket for improved tissue contact and current delivery |
US20230225787A1 (en) | 2022-01-20 | 2023-07-20 | Biosense Webster (Israel) Ltd. | Systems and methods for linear spines forming a spherical basket for improved tissue contact and current delivery |
US20230301712A1 (en) | 2022-03-25 | 2023-09-28 | Biosense Webster (Israel) Ltd. | Elongated trapezoidal electrodes of a basket catheter and methods of making the same |
US20230301713A1 (en) | 2022-03-25 | 2023-09-28 | Biosense Webster (Israel) Ltd. | Expandable basket assemblies with linear spine patterns for improved tissue contact and methods for making thereof |
US20230301707A1 (en) | 2022-03-25 | 2023-09-28 | Biosense Webster (Israel) Ltd. | Elongated cylindrical electrodes of a basket catheter and methods of making the same |
WO2023192863A1 (en) * | 2022-03-29 | 2023-10-05 | Medtronic, Inc. | Directed pulsed electric field ablation |
US20230346463A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Barrel electrodes for a basket catheter, and methods of the same |
US20230346461A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Systems and devices for improved irrigation flow during cardiac procedure |
US20230346462A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Strengthened expandable baskets for medical probes and medical probes containing strengthen expandable baskets |
US20230346464A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Basket catheter with cloverleaf structure to prevent buckling and retention feature for electrodes |
US20230346455A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Basket catheter with force sensor having bayonet mount |
US20230346466A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Basket catheter with cloverleaf structure to provide predetermined lateral stiffness and axial strain |
US20230346465A1 (en) | 2022-04-28 | 2023-11-02 | Biosense Webster (Israel) Ltd. | Irrigation hub for an ablation catheter |
US20240065755A1 (en) | 2022-08-23 | 2024-02-29 | Biosense Webster (Israel) Ltd. | Planar multi-electrode catheters |
US20240180614A1 (en) | 2022-12-01 | 2024-06-06 | Biosense Webster (Israel) Ltd. | Basket assembly, spines, and electrodes for a catheter, and methods of the same |
US20240180615A1 (en) | 2022-12-06 | 2024-06-06 | Biosense Webster (Israel) Ltd. | Electrodes for basket catheters |
US20240189023A1 (en) | 2022-12-09 | 2024-06-13 | Biosense Webster (Israel) Ltd. | Force sensors for basket catheters |
US20240197391A1 (en) | 2022-12-15 | 2024-06-20 | Biosense Webster (Israel) Ltd. | Basket assembly with atraumatic tip electrode and methods of making thereof |
US20240197392A1 (en) | 2022-12-20 | 2024-06-20 | Biosense Webster (Israel) Ltd. | Multi-electrode basket end effector of a catheter |
US20240207587A1 (en) | 2022-12-23 | 2024-06-27 | Biosense Webster (Israel) Ltd. | Rapid depressurization of irrigated balloon catheter |
US20240206965A1 (en) | 2022-12-27 | 2024-06-27 | Biosense Webster (Israel) Ltd. | Deformed spine electrode basket and methods of the same |
US20240216045A1 (en) | 2022-12-28 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Basket end effector with distal position sensor |
US20240215854A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Cylindrical cage systems and methods for distributed tissue contact for mapping and ablation |
US20240216051A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Contact force sensors for basket catheters and methods of using thereof |
US20240216046A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Systems and methods for linear spines forming a spherical basket for improved tissue contact and current delivery |
US20240216054A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Systems and methods for cylindrical cage mapping and ablation catheters comprising flexible circuits |
US20240216055A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Fractal cylindrical cage systems and methods for distributed tissue contact for mapping and ablation |
US20240216053A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Systems and methods for cylindrical cage mapping and ablation catheters having integrated electrodes |
US20240216049A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Ablation catheter with expandable woven mesh having electrically conductive strands |
US20240216050A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Multi-electrode catheter with interlaced substrate |
US20240216052A1 (en) | 2022-12-29 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Systems and methods for cylindrical cage mapping and ablation catheters having flexible circuits |
US20240216075A1 (en) | 2022-12-30 | 2024-07-04 | Biosense Webster (Israel) Ltd. | Position and force sensors for catheters |
Family Cites Families (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6994706B2 (en) * | 2001-08-13 | 2006-02-07 | Minnesota Medical Physics, Llc | Apparatus and method for treatment of benign prostatic hyperplasia |
EP1494720A4 (en) * | 2002-03-22 | 2009-12-30 | Univ California | METHOD AND APPARATUS FOR USING ELECTROMAGNETIC FIELD IN CELLULAR TRANSPLANTATION |
US7756583B2 (en) * | 2002-04-08 | 2010-07-13 | Ardian, Inc. | Methods and apparatus for intravascularly-induced neuromodulation |
US8150519B2 (en) * | 2002-04-08 | 2012-04-03 | Ardian, Inc. | Methods and apparatus for bilateral renal neuromodulation |
CN101124011B (zh) * | 2004-12-27 | 2011-08-31 | 斯坦顿有限公司 | 利用电场从不同方向***等 |
WO2009036468A1 (en) * | 2007-09-14 | 2009-03-19 | Lazure Technologies, Llc | Transurethral systems and methods for ablation treatment of prostate tissue |
US8992517B2 (en) | 2008-04-29 | 2015-03-31 | Virginia Tech Intellectual Properties Inc. | Irreversible electroporation to treat aberrant cell masses |
US9289606B2 (en) | 2010-09-02 | 2016-03-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System for electroporation therapy |
US10314649B2 (en) * | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
EP3142584A1 (en) * | 2014-05-16 | 2017-03-22 | Iowa Approach Inc. | Methods and apparatus for multi-catheter tissue ablation |
WO2017079459A2 (en) * | 2015-11-04 | 2017-05-11 | Boston Scientific Scimed, Inc. | Medical device and related methods |
CN114098949B (zh) * | 2016-06-27 | 2023-12-19 | 盖能适治疗股份有限公司 | 发生器和具有电极的导管 |
CN106388933B (zh) * | 2016-09-14 | 2017-10-10 | 上海睿刀医疗科技有限公司 | 用于不可逆电穿孔设备的电极 |
US11364072B2 (en) * | 2017-01-27 | 2022-06-21 | Medtronic, Inc. | Catheter electrodes for energy management |
JP7165141B2 (ja) * | 2017-04-10 | 2022-11-02 | 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 | エレクトロポレーションシステム及びカテーテルへの通電方法 |
US11052246B2 (en) | 2017-07-28 | 2021-07-06 | Medtronic, Inc. | Expandable elements for delivery of electric fields |
US10959784B2 (en) * | 2017-10-24 | 2021-03-30 | Biosense Webster (Israel) Ltd. | Determining balloon catheter contact with anatomy using ultrasound |
US20190336198A1 (en) * | 2018-05-03 | 2019-11-07 | Farapulse, Inc. | Systems, devices, and methods for ablation using surgical clamps |
-
2019
- 2019-12-09 US US16/707,371 patent/US20210169568A1/en active Pending
-
2020
- 2020-01-29 WO PCT/IB2020/050679 patent/WO2021116774A1/en unknown
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- 2020-01-29 CN CN202080085220.2A patent/CN114786600A/zh active Pending
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EP4072453A1 (en) | 2022-10-19 |
US20210169568A1 (en) | 2021-06-10 |
JP2023510489A (ja) | 2023-03-14 |
JP2024088759A (ja) | 2024-07-02 |
CN111248996A (zh) | 2020-06-09 |
CN114786600A (zh) | 2022-07-22 |
IL272340A (en) | 2021-06-30 |
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