Catheter apparatus for treatment of heart arrhythmia

21 Pages·2013·1.71 MB·English

US00731 l705B2
United States Patent
(12) (10) Patent N0.: US 7,311,705 B2
Sra (45) Date of Patent: Dec. 25, 2007
(54) CATHETER APPARATUS FOR TREATMENT EP 1321101 A2 12/2002
OF HEART ARRHYTHMIA GB 2 239 802 A 7/1991
W0 WO 91/07726 5/1991
(75) Inventor: Jasbir S. Sra, PeWaukee, WI (US) W0 WO 96/10949 4/1996
(73) Ass1_ gnee: Medtronlc_ , Inc., M1n_ neapol1s_ , MN OTHER PUBLICATIONS
(Us) C.L. Grines et al.; “Functional Abnormalities in Isolated Left
Bundle Branch Block: The Effect of Interventricular Asynchrony,”
( * ) Notice: Subject to any disclaimer, the term of this Circulation; 1989; 79:845'53'
patent is extended or adjusted under 35 (Continued)
U.S.C. 154(b) by 494 days.
Primary ExamineriMichael Pef?ey
(21) Appl. No.: 10/916,662 (74) Attorney, Agent, or Firmilansson Shupe & Munger
Ltd.
(22) F1led: Aug. 12, 2004 (57) ABSTRACT
(65) Prior Publication Data A catheter apparatus is provided for use in the treatment of
heart arrhythmia having a catheter shaft, a mapping and
Us Zoos/0038333 A1 Feb- 17> 2005 ablation catheter disposed Within the shaft, and a control
_ _ mechanism coupled to both the shaft and catheter. The
Related U-s- APPhcatmn Data catheter shaft includes a main body and a coaxial tip section
(63) continuation_in_pan of application NO 10/353,625, Jomed to the~ma1n body. The up sectlon can be rotated about
?led on Jan 29 2003 HOW Pat NO 6 926 714 a central ax1s and curved aWay from the central ax1s 1n a
' ’ ’ ' ' ’ ’ ' controlled manner. The mapping and ablation catheter can
(60) Provisional application No. 60/53 1 ,293, ?led on Dec. be extended outward from the catheter shaft Where it is able
19, 2003, provisional application No. 60/494,607, to take the form of a pre-stressed curve. The control mecha
?led on Aug, 12, 2003, provisional application No, nism controls axial rotation of the tip section, the degree of
60/354,561, ?led on Feb, 5, 2002, de?ection of the tip section and longitudinal movement of
the mapping and ablation catheter With respect to the cath
(51) Int, Cl, eter shaft. Preferably, the mapping and ablation catheter
A613 18/18 (200601) forms a pre-stressed loop When it is fully extended from the
(52) us. Cl. ....................................... .. 606/41; 607/122 Catheter Shaft
(58) Field of Classi?cation Search ................ .. 606/41, In another aspect Of this invention, it Provides a method for
606/48i50; 607/101, 102, 122 treatment of a heart arrhythmia having the steps of (1)
See application ?le for Complete Search history obtalmng cardlac 1mage data from a medlcal 1mag1ng sys
tem, (2) creatlng a 3D model from th1s card1ac 1mage data,
(56) References Cited (3) registering the 3D model to an interventional system, (4)
positioning a catheter apparatus Within a chamber of the
Us‘ PATENT DOCUMENTS heart, (5) displaying the catheter apparatus over the regis
3 954 098 A 5/1976 Dick et a1‘ tered 3D model on the interventional system, (6) navigating
, , the catheter apparatus Within the heart guided by the regis
(Continued) tered 3D model, and (7) having the catheter apparatus ablate
11 IT I' I l I l I' .
FOREIGN PATENT DOCUMENTS ea Issue a Se e0 002‘ Ions
EP 1182619 A2 2/2002 17 Claims, 11 Drawing Sheets
US 7,311,705 B2
Page 2
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U.S. Patent Dec. 25, 2007 Sheet 1 0f 11 US 7,311,705 B2
Sinus Node
Surface ECG
Right Atrium
Right Bundle
Right Ventricle
AV Node
FIG. 1
n
Catheters Positioned) \‘ .
during EP studies , > \ \
and ablation l \ \\ ‘
FIG. 2
U.S. Patent Dec. 25, 2007 Sheet 2 0f 11 US 7,311,705 B2
Initiation of AF with PAC Originating
In Left Superior Pulmonary Vein - LSPV
1M
VIITMWWWTTWW
HRA . L 1 L II/PAC
LS PVWMWWLLUW
Rvijf i J’ i Jr i i J] i IFJFJHJW"
|-_-| 1000 ms
FIG. 3
U.S. Patent
Dec. 25, 2007 Sheet 3 0f 11 US 7,311,705 B2
Registration of 3D Visualization of Isolation of Pulmonary
and Endocardial Catheter Over Veins-Areas Ablated by
Images on the the CT Image the Catheter are
lnterventional System Shown by Circular Tags
FIG. 4A FIG. 45 FIG. 4C
U.S. Patent Dec. 25, 2007 Sheet 4 0f 11 US 7,311,705 B2
FIG. 6
U.S. Patent Dec. 25, 2007 Sheet 5 0f 11 US 7,311,705 B2
U.S. Patent Dec. 25, 2007 Sheet 6 0f 11 US 7,311,705 B2
FIG. 8A FIG. 8B
36
55
FIG. 9A FIG. 9B
U.S. Patent Dec. 25, 2007 Sheet 7 0f 11 US 7,311,705 B2
50 M 54/
- i
52 /4/
FIG. 10A