WO1994002077A2 - Ablation catheter system - Google Patents
Ablation catheter system Download PDFInfo
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- WO1994002077A2 WO1994002077A2 PCT/US1993/006600 US9306600W WO9402077A2 WO 1994002077 A2 WO1994002077 A2 WO 1994002077A2 US 9306600 W US9306600 W US 9306600W WO 9402077 A2 WO9402077 A2 WO 9402077A2
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- Prior art keywords
- catheter
- ablation
- energy
- including means
- mapping
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
- A61B5/6855—Catheters with a distal curved tip
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
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- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
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- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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- A61M2230/00—Measuring parameters of the user
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Definitions
- the present invention is for a catheter system, and more particularly, pertains to a system of a mapping and guiding catheter and an ablation catheter for use in the mapping and guiding catheter for treatment of tachyarrhythmia.
- the identification of the correct arrythmogenic site is both difficult and time consuming.
- the correct site is found, it is advantageous to keep this location at all costs.
- the constant motion of the heart may make some positions difficult to hold.
- the catheter system is divided into two separate devices.
- the first device is a mapping guiding catheter, which has the ability to perform local activation mapping an to guide an ablation catheter to its target site.
- the second device is an ablation catheter which delivers energy to the myocardium to destroy selected myocardial tissue.
- Tachyarrhythmia is a form of cardiovascular disease in which the normal rhythm of the heart is accelerated leading to physiological symptoms and possibly death.
- Treatments for tachyarrhythmia include drugs, implantable devices, surgery and catheter ablation.
- the first two methods manage the disease, while the latter two try to effect a "cure" in that the underlying reason for the tachyarrhythmia is eliminated.
- Catheter based ablation offers the ability to "cure" the patient with risks comparable to that of coronary angioplasty.
- catheter-based ablation is becoming the therapy of choice.
- these patients have readily identifiable regions in the heart which are causing the tachyarrhythmia.
- Catheters are then used to identify these regions and then to destroy the electro- physiological properties of the tissue by heating or cooling the cells of the myocardium. The structure of the heart muscle is preserved while the conduction pathways are altered.
- a typical ablation procedure is divided into four phases.
- the first phase global activation mapping is performed from the endocardium.
- Mapping catheters are inserted into either arteries or veins, and placed inside one of the chambers of the heart for purposes of measuring electrical potentials and stimulation. These catheters contain metallic electrodes which are connected by small wires to electrophysiological mapping equipment and electrical stimulators.
- the electrodes sense the electrical signals of the tissue it contacts and these signals are displayed on monitors. By acquiring signals from different electrodes and by either moving the catheter or using several catheters, the electrical conduction patterns in the heart can be identified.
- the stimulation mode electrical signals similar to those generated by the heart are sent to the catheter electrodes and the electrical response of the heart is recorded from each of the catheter electrodes.
- the region of the heart which is responsible for the tachyarrhythmia may be identified.
- local activation mapping is done to isolate more specifically the tissue causing the tachyarrhythmia.
- a mapping catheter is placed in the identified region and moved in very small increments over the endocardial surface of the heart. The resulting electrical signals with and without stimulation are analyzed to identify the exact site for tissue ablation.
- phase one is repeated to confirm elimination of the tachyarrhythmia.
- Significant aspects and features of the present invention include a guiding and mapping catheter which can be utilized with any ablation catheter, which moves inside the heart, either the ventricle or the atrium, which is used to identify a specific myocardial tissue, which can maintain the identified position over a period of time, and which can accommodate an ablation catheter through a central lumen.
- the guiding mapping catheter can either be flexible or rigid, and may have steering to assist in positioning.
- an ablation catheter which monitors the tissue properties in response to the ablation, which provides for control the ablation energy, which monitors the heart signals for local activation times, which monitors other tissue properties in response to the ablation, including temperature, the spectral characteristics and the electrical properties of tissue, and which includes the ability to provide wash solutions to keep biological or blood products out of the field of view of the ablative energy.
- the particular ablation catheter can utilize a laser, RF, ultrasonic, or microwave energy source, or may use chemical fluids, toxic to myocardial cells.
- a catheter system including a guiding/mapping catheter which can also receive an ablation catheter, such as a laser ablation catheter.
- an ablation catheter such as a laser ablation catheter.
- One object of the present invention is a guiding/mapping catheter which moves inside the heart, identifies an active site, and holds a position at the active site.
- Another object of the present invention is an ablation catheter which monitors the tissue properties in response to the ablation.
- FIG. 1 illustrates a plan view of a guiding and mapping catheter
- FIG. 2 illustrates an end view of the tip
- FIG. 3 illustrates a plurality of ring electrodes about the tubular guiding catheter member
- FIG. 4 illustrates the guiding and mapping catheter with mechanical steering
- FIG. 5A illustrates a side view of the end of the guiding and mapping catheter with electrical steering
- FIG. 5B illustrates a view in cross section of the end of the guiding and mapping catheter with electrical steering
- FIG. 6 illustrates a plan view of an ablation catheter in partial cross section
- FIG. 7 illustrates a perspective view of the ablation catheter tip
- FIG. 8 illustrates a view in partial cross section of the ablation catheter tip
- FIG. 9 illustrates a plan view of the guiding and mapping catheter accommodating an ablation catheter
- FIG. 10 illustrates a cross-sectional view of an RF ablation catheter, a first alternative embodiment
- FIG. 11 illustrates a cross-sectional view of a microwave ablation catheter, a second alternative embodiment
- FIG. 12 illustrates a cross-sectional view of a chemical ablation catheter, a third alternative embodiment.
- FIG. 1 illustrates a plan view of a guiding/mapping catheter 10 and includes aligned Y-adapters 12 and 14.
- a tubular guiding catheter member 16 of braid reinforced plastic tubing extends through the Y- adapters 12 and 14, and contains a central lumen 17 which is large enough to pass an ablation catheter and to permit continuous flush of saline while in the body.
- the tubular guiding catheter member 16 itself contains two pin-like electrodes 18 and 20 at the very tip 29 and a multiplicity of ring electrodes 22a-22n perpendicular to its longitudinal axis as also illustrated in FIGS. 4 and 5. These electrodes provide for local activation mapping.
- the guiding mapping catheter 10 also contains a movable fixation wire 24 for attaching the tip 29 of the tubular guiding catheter member 16 to the myocardium once the desired position for the tip 29 is found.
- This fixation wire 24 is activated at a port 26 of the Y-adapter 12 by a syringe 28 or comparable assembly.
- the Y-adapters 12 and 14 and associated members of the guiding/mapping catheter 10 provide for all mechanical, electrical and hydraulic interfaces, as well as irrigation.
- the guiding/mapping catheter 10 has the capability to articulate its tip 29 such that the tip 29 can be maneuvered around within a given chamber of the heart.
- Such articulation can be comprised of an external or internal member.
- FIG. 1 shows an external system whereby a stiff sheath 30 is placed over the outside of the tubular guiding catheter member 16 to straighten out and support the tubular guiding catheter member 16.
- the tubular guiding catheter 16 conforms with the path of the artery or vein, or, in the alternative, can be preshaped to align with a particular arterial path.
- the articulation mechanism can be internal to the tip of the guiding mapping catheter, as illustrated in FIGS. 4 and 5, and can be activated by a mechanical or electrical means.
- the guiding mapping catheter 10 includes tip electrodes, ring electrodes and associated conducting wires, as also illustrated in FIGS. 2 and 3.
- the tip 29 of the guiding mapping catheter 10 is made of plastic.
- a pair of stainless steel electrodes 18 and 20 are housed in the tip 29 as also illustrated in FIG. 4.
- the tip 29 is attached to a braid-reinforced plastic tubing, which comprises the tubular guiding catheter member 16, with a central lumen 17 for the laser catheter.
- This braided tubing provides a flexible and torqueable guide for the laser catheter described in FIG. 6.
- the electrode wires between the electrode interface cable 16 and the ring electrodes 22a and the top electrodes 18 and 20 are incorporated into a spiral wound wrap.
- the braided tubing is attached to a Y-adapter 12, that provides an interface for the electrodes, and a luer fitting for a Tohey-Borst-type swivel adapter.
- the guiding/mapping catheter deflecting sheath 30 is comprised of a long TEFLON tube attached to the Y-connector 14.
- This Y-connector 14 contains a port for irrigating fluid and a Tohey- Borst-type gasket to seal around the tubular guiding catheter member 16.
- an ablation catheter port 32 and an irrigation port for the Y-adapter 12 an irrigation port 34 for the sheath 30 on the Y-adapter 14, and an electrode interface 36 and cable 38 intersecting the tubular guiding catheter member 16.
- FIG. 2 illustrates an end view of the tip 29 where all numerals correspond to those elements previously described. Illustrated in particular are the pin electrodes 18 and 20 and the fixation wire 24 located and aligned in the walls of the tubular guiding catheter member 16 with a through lumen 17.
- FIG. 3 illustrates a plurality of ring electrodes 22a-22n about the tubular guiding catheter member where all numerals correspond to those elements previously described.
- FIG. 4 illustrates the end of the guiding and mapping catheter 10 having mechanical steering.
- the mechanical steering includes at least one wire 25 which extends from a steering ring 27 in the tip 29 of the catheter to the Y-adapter 14 and are contained in at least one tube 40 in the wall of the tubular guiding catheter member 16.
- the wire or wires are pulled to move the distal tip 29 of the guiding catheter 10.
- Wires 42 and 44 are illustrated connecting the pin electrodes 18 and 20.
- a plurality of wires 46a and 46n are also illustrated connecting to the plurality of ring electrodes 22a-22n. Wires 42, 44 and 46a-46n secure appropriately to the electrode interface 36 via cable 38 of FIG. 1.
- FIG. 5A illustrates a side view of the end of the guiding and mapping catheter 10 with electrical steering where all numerals correspond to those elements previously described.
- the electrical system includes memory shaped metals or alloys which are heated and shaped by increasing the temperature of the metals or alloys by the introduction of electrical currents.
- These memory shaped metals includes a shaping element 47 and a retracting element 48 placed adjacent to a central member 49 containing the central lumen 17, as illustrated in FIG. 5B.
- Wires 51 and 53 connect to the shaping element 47 and retracting element 48 and are routed to the electrode interface 36 of FIG. 1.
- FIG. 5B illustrates a view in cross section of the end of the guiding and mapping catheter 10 with electrical steering where all numerals correspond to those elements previously described.
- FIG. 6 illustrates a plan view of an ablation catheter 50 in partial cross section.
- This catheter includes a Y-adapter 52 having an energy delivery port 54, an electrical connection port 56, an irrigation port 58, a catheter stop 60, a plastic tubular member 62 having a central lumen 64 for passage of an ablative energy delivery member 66 which may be an optical fiber as is the case with laser energy sources, or in the alternative, can be an insulated copper wire such as with RF energy, or a coaxial cable for the delivery of microwave energy.
- the plastic tubular member 62 and lumen 64 accommodate the ablative energy delivery member 66, and also channels fluid to the point of contact of the energy delivery member with the myocardial tissue.
- the ablation energy delivery member 66 is appropriately sized to allow passage of liquid between it and the walls forming the lumen 64 for passage of the tip 70.
- At the configured tip 70 of the catheter 50 are embedded sensing elements, which penetrate the myocardial tissue.
- two metallic needles 72 and 74 are shown in FIG. 7, each of which contains a thermocouple for measuring tissue temperature.
- the needles 72 and 74 also act as fixation elements to hold the position of the ablation catheter 50 during ablation.
- the fixation device could also be a separate part of the catheter which would run along side of the central lumen 64, and may be movable by a mechanism at the Y-adapter 52 of the ablation catheter 50.
- Also embedded in the tip 70 of the ablation catheter 50 are pin electrodes 76 and 78 for measuring local activation electrical signals. These electrodes help to confirm the position of the ablation catheter 50, as well as establish the degree of contact of the tip 70 with the endocardial surface.
- All interfaces are brought to the proximal Y-adapter 52 of the ablation catheter 50 for connection to other medical devices.
- the electrode wires are interfaced through a quick disconnect fitting 80, which then connects to standard EP monitoring and temperature measuring equipment.
- the irrigation port 58 uses a standard luer fitting which connects to an infusion pump capable of displacing the needed amount of saline solution.
- the ablation energy delivery member 66 connects to source generator, which could be radio frequency, microwave, laser or any other source which can destroy myocardial tissue.
- the outer diameter of the laser catheter plastic tubing sheath 68 is such that it will fit down the internal lumen 17 of the mapping guiding catheter 10 of FIG. 1.
- the body of the laser catheter 50 includes the following components as now described in detail, and also illustrated in FIG. 7 and 8.
- a plastic tube 62 provides central lumen 64 for internal components and flushing fluid.
- a stainless steel tip 70 is attached to the distal end of the plastic tube 62.
- the tip 70 is comprised of a through lumen 82 for placement and fixation of a single ablative energy delivery member 66, two small stainless steel hypodermic tubes/needles 72 and 74 that contain one thermocouple each, a plurality of small slots 84a-84n for irrigating the tip of ablative energy delivery member 66, and two stainless steel electrodes 76 and 78 for sensing electrical signals.
- the ablative energy delivery member 66 when used in the form of an optical fiber has a silica core, polymer clad, with a TEFLON jacket.
- the optical fiber extends beyond the tip 70 and is held in place in the metallic tip by a mechanical crimp 86.
- the annular space between the optical fiber (ablative energy delivery member 66) and the stainless steel wall of the tip 70 serves as a conduit for irrigating fluid, such as saline, which both cools the tissue and purges blood from the delivered energy field during irradiation by the desired energy delivery member 66.
- a thermocouple is soldered inside each hypodermic tubes or needles 72 and 74 near the distal end.
- the hypodermic tubes or needles 72 and 74 are soldered to the metallic tip 70; thus, the spatial relationship between the thermocouples and the distal face of the optical fiber is fixed.
- the thermocouples are standard types and the signals are carried to a temperature data acquisition and control system by small-diameter TEFLON-coated wire routed through the catheter tube 62 and the fitting/interface 80 in the laser catheter Y-adapter 52.
- the two stainless steel electrodes 76 and 78 are positioned opposite each other on the distal face of the tip 70 to sense electrical signals. These electrodes are insulated from the bulk of the tip 70 by polyamide tubing.
- EP signals are carried from these electrodes 76 and 78 to standard EP mapping equipment by small-diameter TEFLON-coated wire routed through the catheter tube and a connector in the laser catheter Y-adapter 52.
- a molded plastic Y-adapter 52 at the proximal end of the tubular member 62 contains an interface fitting for the temperature and EP monitoring systems, a port 58 for irrigating fluids, and the ablative energy delivery member 66.
- the ablation energy member extends 2 meters beyond the handle and is terminated with standard connectors, which mate with the ablative energy source.
- FIG. 7 illustrates a perspective view of the tip 70 where all numerals correspond to those elements previously described. Illustrated in particular are the needles 72 and 74 each having embedded thermocouples. A plurality of flat wire leads 75a-75n connect to the needles 72 and 74 and to the electrodes 76 and 78 for subsequent wire connection to the electrode interface 80.
- FIG. 8 illustrates a side view in partial cross section of the tip
- Thermocouples 77 and 79 are embedded in the needles 72 and 74, respectively.
- FIG. 9 illustrates a plan view of the guiding and mapping catheter 10 accommodating the ablation catheter 50 where all numerals correspond to those elements previously described.
- the mode of operation of this ablation catheter system is such that the guiding mapping catheter 10 of FIG. 1 is placed in one of the chambers of the heart using standard angiographic techniques. This would normally include use of a guide wire to insure that no perforation of the vasculature occurs.
- the tip of the guiding/mapping catheter 10 is then placed in contact with the endocardial surface of the heart such that the tip 29 of the guiding/mapping catheter 10 is perpendicular to the heart wall.
- the electrical signals from the two electrodes 18 and 20 embedded in the tip 29 are then analyzed and recorded as both unipolar and bipolar signals.
- the catheter tip 29 is then moved to another site on the endocardial surface using the steering mechanism. Positioning and subsequent analysis is continued until the desired location is identified.
- the fixation wire 24 is then activated attaching the tip 29 of the guiding/mapping catheter 10 to the endocardial surface of the heart.
- the primary functions of the guiding/mapping catheter 10 assembly is to identify the location of tachyarrhythmia sites through electrical activation mapping, and to mechanically guide the ablation catheter 50 to the desired irradiation sites.
- the guiding/mapping catheter electrodes 18, 20 and 22a-22n are coupled to standard hospital EP mapping equipment.
- the deflecting sheath 30 can be used to direct the distal tip 29 of the guiding/mapping catheter 10 by advancing the distal end of the deflecting sheath 30 toward the tip 29 of the guiding/mapping catheter, thereby straightening the curve. Deflecting sheath 30 advancement and return is accomplished by moving the deflecting sheath Y-connector 14 while maintaining the position of the tubular guiding catheter member 16.
- Standard hospital continuous-flow fluid pumps with flow monitoring capabilities are used to provide sterile saline irrigation for the guiding/mapping catheter 10.
- the ablation catheter of FIG. 6 is then inserted into the guiding mapping catheter 10 much like a balloon angioplasty catheter is inserted into a standard guiding catheter as illustrated in FIG. 9.
- the ablation catheter 50 is flushed with saline to keep blood and other biological tissue out of the field of view of the ablation catheter 50.
- the ablation catheter is then moved forward until it comes in contact or near contact with the endocardial surface.
- the fixation element and tip electrode then engage the myocardium and the ablation energy source is prepared for activation.
- the ablation source is used until the desired tissue damage is accomplished.
- the monitoring is continuous and the ablations source interrupted if a situation develops in which continued use of the ablative energy could damage either the catheter or the myocardium. This may be accomplished manually or by an automated system interfaced to the ablative energy source.
- FIG. 10 illustrates a cross-sectional view of an RF ablation catheter 100, a first alternative embodiment. Another embodiment is to use a standard RF catheter through an open catheter port 32 and lumen 17 through the center for ablation. A fixation and monitoring wire is passed down the center of the ablation catheter 100 for purposes of stabilization of the catheter during ablation and monitoring of tissue response.
- the RF ablation catheter 100 with monitoring capabilities is consistent with and incorporates the teaching of the present invention as previously described for use with an RF generator and Y-adapters of the previous embodiments.
- One of the dangers inherent in any ablation system is destruction of healthy tissue which is not part of the tachycardia. It is desirable to keep this collateral damage to a minimum so as to maximize the therapeutic value of this treatment.
- One way to minimize this damage is to monitor the effect of the energy on the myocardial tissue being irradiated. Such monitoring can be done by measuring tissue temperature, changes in optical properties of the tissue, or changes in electrical patterns of the tissue.
- An extension of the basic invention is to add the ability to monitor tissue response to RF irradiation. This is done via thermocouples placed at the surface or in the tissue, optical fibers placed in contact with the myocardium, or small electrodes placed in contact with the endocardial surface.
- the RF ablation catheter 100 has a lumen through it. Such a lumen can be centered or offset. Depending on the type of monitoring, the additional elements are terminated so as to interface with commercially available monitoring equipment.
- An additional feature which could be added to this system would be the use of feedback to control the input of energy to optimize the elimination of the tachycardia.
- the monitoring system would be connected to a system in which the signals can be continuously monitored and changes made in the energy inputted into the catheter.
- Such a system could be as simple as an on/off controller which turns the energy off above a specified value and on below a specified value.
- the system could be as complex as a microprocessor in which the signals are analyzed more complexly and the rates of changes or signal patterns incorporated into the decision process.
- the illustrated RF ablation catheter 100 has like and corresponding members relating expressly to previously described members which operate and are conceived in the same fashion, including mapping band electrodes 102 and 104, an internal coaxial cable 106, consisting of a center conductor antenna 108, and external conductor of either solid or braid serving as a shield 110, and dielectric material 111 and a covering 113, a signal wire lumen 112 extending to the distal tip 116, signal wires 118 and 120 connected to the mapping electrodes 102 and 104, and a plastic sheath 122 placed over and about the distal end of the center conductor antenna 108.
- Thermocouples 124 and 126 are placed near the distal end of the RF antenna radiator 108 having wires (not illustrated for purposes of brevity and clarity) which pass outwardly for external measurement and analysis.
- Another problem with catheters placed in a beating heart is that these catheters may be moved around by the mechanical action of the heart, thus irradiating undesirable area.
- One solution is to fixate the catheter via an integral fixation system. Such a system attaches to the wall of the heart and holds the catheter in its proper location in the heart.
- a fixation system wire 128 passes through the length of the RF ablation catheter 100 and through lumen 130, and consists of a type of wire with a special pointed end 131. The pointed end 131 is inserted into the myocardium.
- This system holds the RF ablation catheter 100 as a fixed surface location.
- a more complex system would be a helical coil which would be screwed into the heart muscle. This system would provide perpendicular, as well as lateral fixation.
- thermistors, thermocouples or optical temperature sensors 132 and 134 can be included in the fixation system wire 128 for temperature sensing of and about heart tissues in close proximity to the antenna radiator 108. The thermistor wires are not fully illustrated for purposes of brevity and clarity.
- FIG. 11 a second alternative embodiment, illustrates a cross- sectional view of microwave ablation catheter 150 with monitoring capabilities which is consistent with and incorporates the teaching of the present invention as previously described for use with the microwave generator and Y-adapters of the previous embodiment.
- One of the dangers inherent in any ablation system is destruction of healthy tissue which is not part of the tachycardia. It is desirable to keep this collateral damage to a minimum so as to maximize the therapeutic value of this treatment.
- One way to minimize this damage is to monitor the effect of the energy on the myocardial tissue being irradiated. Such monitoring can be done by measuring tissue temperature, changes in optical properties of the tissue, or changes in electrical patterns of the tissue.
- An extension of the basic invention is to add the ability to monitor tissue response to microwave irradiation. This is done via thermocouples placed at the surface or in the tissue, optical fibers placed in contact with the myocardium, or small electrodes placed in contact with the endocardial surface.
- the catheter has a lumen through it. Depending on the type of monitoring, the additional elements would be terminated so as to interface with commercially available monitoring equipment.
- An additional feature which could be added to this system would be the use of feedback to control the input of energy to optimize the elimination of the tachycardia.
- the monitoring system would be connected to a system in which the signals can be continuously monitored and changes made in the energy inputted into the catheter.
- Such a system could be as simple as an on/off controller which turns the energy off above a specified value and on below a specified value.
- the system could be as complex as a microprocessor in which the signals are analyzed more complexly and the rates of changes or signal patterns incorporated into the decision process.
- the illustrated microwave ablation catheter 150 has like and corresponding members relating expressly to previously described members which operate and are conceived in the same fashion, including mapping band electrodes 152 and 154, an internal coaxial cable 156, consisting of a center conductor 160, an external conductor either solid or braid serving as a shield 158, and dielectric material 162, a signal wire lumen 164, a lumen 166 extending through a distal tip 167, signal wire 168 and 170 connected to the mapping band electrodes l ⁇ and 154, a microwave antenna coil 172, a plastic sheath 173, and other corresponding members.
- Thermocouples 174 and 176 are placed near the microwave coil 172 having wires (not illustrated for purposes of brevity and clarity) which pass outwardly through the signal wire lumen 164 for external measurement and analysis.
- a fixation system wire 178 passes through the length of the microwave ablation catheter 150 and through lumen 166, and consists of a type of wire with a special pointed end 180. The pointed end 180 is inserted into the myocardium. This system holds the microwave ablation catheter 150 at a fixed surface location.
- a more complex system would be a helical coil which would be screwed into the heart muscle.
- thermistors or thermocouples or optical temperature sensors 182 and 184 can be included in the fixation system wire 178 for temperature sensing of and about heart tissues in close proximity to the microwave antenna coil 172.
- the thermistor wires are not fully illustrated for purposes of brevity and clarity, but route through the fixation wire 178.
- FIG. 12 illustrates a cross-sectional view of a chemical ablation catheter 200, a third alternative embodiment.
- a needle 210 pierces myocardium and chemical such as ethanol is injected into myocardium, while the guiding/mapping catheter is being flushed.
- Pin electrodes 202 and 204 are located at the distal end of the ablation catheter 200 and include connection wires 206 and 208 leading to external connector blocks.
- the needle 210 located at the distal end includes a plurality of ports 212a-212n for injection of liquid ablation chemicals into the myocardium.
- a luer connector 214 connects to an external drug pump.
Abstract
An ablation catheter system, includes a guiding/mapping catheter assembly (10) and a laser catheter (50). The guiding/mapping catheter includes ring electrodes (22), tip electrodes (18, 20), a movable fixation wire (24), and a central catheter lumen (17) for an ablation catheter. A laser catheter includes an optical fiber (66) for passing laser energy, tip electrodes (76, 78), an optical fiber port, and thermocouples (72, 74) on the end of hypodermic tubing. The laser catheter electrodes are used to monitor the progress of the tissue ablation or disruption process, and to help minimise damage to healthy tissue.
Description
ABLATION CATHETER SYSTEM
Background of the Invention
1. Field of the Invention - The present invention is for a catheter system, and more particularly, pertains to a system of a mapping and guiding catheter and an ablation catheter for use in the mapping and guiding catheter for treatment of tachyarrhythmia.
2. Description of the Prior Art - Ablation of myocardial tissue as it is practiced today has several problems.
First, the identification of the correct arrythmogenic site is both difficult and time consuming. Thus, once the correct site is found, it is advantageous to keep this location at all costs. The constant motion of the heart may make some positions difficult to hold.
Second, current ablation procedures perform both mapping and ablation with the same catheter. Many times, blood is coagulated onto the electrodes during ablation, necessitating the removal of catheter from the heart for cleaning. This results in the loss of position, necessitating another mapping period to find the correct site.
Third, most catheter systems do not measure the response of myocardial tissue to the application of energy. As a result, it is sometimes difficult to know whether the tissue is being destroyed or whether the energy is being diverted to the catheter or blood. This may cause procedures to take longer or have unwanted side effects to the patient. The present invention overcomes these problems. The catheter system is divided into two separate devices. The first device is a mapping guiding catheter, which has the ability to perform local activation mapping an to guide an ablation catheter to its target site. The second device is an ablation catheter which delivers energy to the myocardium to destroy selected myocardial tissue.
Summary of the Invention Tachyarrhythmia is a form of cardiovascular disease in which the normal rhythm of the heart is accelerated leading to physiological symptoms and possibly death. Treatments for tachyarrhythmia include drugs, implantable devices, surgery and catheter ablation. The first two methods manage the disease, while the latter two try to effect a "cure" in that the underlying reason for the tachyarrhythmia is eliminated.
Catheter based ablation offers the ability to "cure" the patient with risks comparable to that of coronary angioplasty. For patients whose disease is amenable to such treatment, catheter-based ablation is becoming the therapy of choice. Generally, these patients have readily identifiable regions in the heart which are causing the tachyarrhythmia. Catheters are then used to identify these regions and then to destroy the electro- physiological properties of the tissue by heating or cooling the cells of the myocardium. The structure of the heart muscle is preserved while the conduction pathways are altered.
A typical ablation procedure is divided into four phases. During the first phase, global activation mapping is performed from the endocardium. Mapping catheters are inserted into either arteries or veins, and placed inside one of the chambers of the heart for purposes of measuring electrical potentials and stimulation. These catheters contain metallic electrodes which are connected by small wires to electrophysiological mapping equipment and electrical stimulators. In the mapping mode, the electrodes sense the electrical signals of the tissue it contacts and these signals are displayed on monitors. By acquiring signals from different electrodes and by either moving the catheter or using several catheters, the electrical conduction patterns in the heart can be identified. In the stimulation mode, electrical signals similar to those generated by the heart are sent to the catheter electrodes and the electrical response of the heart is recorded from each of the catheter electrodes. By analyzing the response of the heart to various stimuli, the region of the heart which is responsible for the tachyarrhythmia may be identified.
During the second phase, local activation mapping is done to isolate more specifically the tissue causing the tachyarrhythmia. A mapping catheter is placed in the identified region and moved in very small increments over the endocardial surface of the heart. The resulting electrical signals with and without stimulation are analyzed to identify the exact site for tissue ablation.
During the third phase, energy is applied to the identified tissue to destroy its electrophysiological properties. This may take the form of heat via electromagnetic energy or cold via cryogenic fluids. Once the myocardial cells are destroyed, they no longer can conduct electrophysiological signals. Thus, if the mapping has identified the true arrythmogenic tissue, the tachyarrhythmia is eliminated.
During the fourth phase, the global activation of phase one is repeated to confirm elimination of the tachyarrhythmia. Significant aspects and features of the present invention include a guiding and mapping catheter which can be utilized with any ablation catheter, which moves inside the heart, either the ventricle or the atrium, which is used to identify a specific myocardial tissue, which can maintain the identified position over a period of time, and which can accommodate an ablation catheter through a central lumen. The guiding mapping catheter can either be flexible or rigid, and may have steering to assist in positioning.
Another significant aspect and feature of the present invention is an ablation catheter which monitors the tissue properties in response to the ablation, which provides for control the ablation energy, which monitors the heart signals for local activation times, which monitors other tissue properties in response to the ablation, including temperature, the spectral characteristics and the electrical properties of tissue, and which includes the ability to provide wash solutions to keep biological or blood products out of the field of view of the ablative energy. The particular ablation catheter can utilize a laser, RF, ultrasonic, or microwave energy source, or may use chemical fluids, toxic to myocardial cells.
Having thus described the embodiments of the present invention, it is a principal object hereof to provide a catheter system, including a guiding/mapping catheter which can also receive an ablation catheter, such as a laser ablation catheter. One object of the present invention is a guiding/mapping catheter which moves inside the heart, identifies an active site, and holds a position at the active site.
Another object of the present invention is an ablation catheter which monitors the tissue properties in response to the ablation.
Brief Description of the Drawings
Other objects of the present invention and many of the attendant advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, in which like references numerals designate like parts throughout the figures thereof and wherein:
FIG. 1 illustrates a plan view of a guiding and mapping catheter;
FIG. 2 illustrates an end view of the tip; FIG. 3 illustrates a plurality of ring electrodes about the tubular guiding catheter member;
FIG. 4 illustrates the guiding and mapping catheter with mechanical steering;
FIG. 5A illustrates a side view of the end of the guiding and mapping catheter with electrical steering;
FIG. 5B illustrates a view in cross section of the end of the guiding and mapping catheter with electrical steering;
FIG. 6 illustrates a plan view of an ablation catheter in partial cross section; FIG. 7 illustrates a perspective view of the ablation catheter tip;
FIG. 8 illustrates a view in partial cross section of the ablation catheter tip;
FIG. 9 illustrates a plan view of the guiding and mapping catheter accommodating an ablation catheter; FIG. 10 illustrates a cross-sectional view of an RF ablation catheter, a first alternative embodiment;
FIG. 11 illustrates a cross-sectional view of a microwave ablation catheter, a second alternative embodiment; and,
FIG. 12 illustrates a cross-sectional view of a chemical ablation catheter, a third alternative embodiment.
Description of the Preferred Embodiment FIG. 1 illustrates a plan view of a guiding/mapping catheter 10 and includes aligned Y-adapters 12 and 14. A tubular guiding catheter member 16 of braid reinforced plastic tubing extends through the Y- adapters 12 and 14, and contains a central lumen 17 which is large enough to pass an ablation catheter and to permit continuous flush of saline while in the body. The tubular guiding catheter member 16 itself contains two pin-like electrodes 18 and 20 at the very tip 29 and a multiplicity of ring electrodes 22a-22n perpendicular to its longitudinal axis as also illustrated in FIGS. 4 and 5. These electrodes provide for local activation mapping. The guiding mapping catheter 10 also contains a movable fixation wire 24 for attaching the tip 29 of the tubular guiding catheter member 16 to the myocardium once the desired position for the tip 29 is found. This fixation wire 24 is activated at a port 26 of the Y-adapter 12 by a syringe 28 or comparable assembly. The Y-adapters 12 and 14 and associated members of the guiding/mapping catheter 10 provide for all mechanical, electrical and hydraulic interfaces, as well as irrigation.
The guiding/mapping catheter 10 has the capability to articulate its tip 29 such that the tip 29 can be maneuvered around within a given chamber of the heart. Such articulation can be comprised of an external or internal member. FIG. 1 shows an external system whereby a
stiff sheath 30 is placed over the outside of the tubular guiding catheter member 16 to straighten out and support the tubular guiding catheter member 16. The tubular guiding catheter 16 conforms with the path of the artery or vein, or, in the alternative, can be preshaped to align with a particular arterial path. By controlling the relationship between the tubular guiding catheter member 16 and the sheath 30, many different positions of the tip 29 can be obtained.
Alternatively, the articulation mechanism can be internal to the tip of the guiding mapping catheter, as illustrated in FIGS. 4 and 5, and can be activated by a mechanical or electrical means.
The guiding mapping catheter 10 includes tip electrodes, ring electrodes and associated conducting wires, as also illustrated in FIGS. 2 and 3. The tip 29 of the guiding mapping catheter 10 is made of plastic. A pair of stainless steel electrodes 18 and 20 are housed in the tip 29 as also illustrated in FIG. 4. The tip 29 is attached to a braid-reinforced plastic tubing, which comprises the tubular guiding catheter member 16, with a central lumen 17 for the laser catheter. This braided tubing provides a flexible and torqueable guide for the laser catheter described in FIG. 6. The electrode wires between the electrode interface cable 16 and the ring electrodes 22a and the top electrodes 18 and 20 are incorporated into a spiral wound wrap. The braided tubing is attached to a Y-adapter 12, that provides an interface for the electrodes, and a luer fitting for a Tohey-Borst-type swivel adapter. The guiding/mapping catheter deflecting sheath 30 is comprised of a long TEFLON tube attached to the Y-connector 14. This Y-connector 14 contains a port for irrigating fluid and a Tohey- Borst-type gasket to seal around the tubular guiding catheter member 16. Also included are an ablation catheter port 32 and an irrigation port for the Y-adapter 12, an irrigation port 34 for the sheath 30 on the Y-adapter 14, and an electrode interface 36 and cable 38 intersecting the tubular guiding catheter member 16.
FIG. 2 illustrates an end view of the tip 29 where all numerals correspond to those elements previously described. Illustrated in
particular are the pin electrodes 18 and 20 and the fixation wire 24 located and aligned in the walls of the tubular guiding catheter member 16 with a through lumen 17.
FIG. 3 illustrates a plurality of ring electrodes 22a-22n about the tubular guiding catheter member where all numerals correspond to those elements previously described.
FIG. 4 illustrates the end of the guiding and mapping catheter 10 having mechanical steering. The mechanical steering includes at least one wire 25 which extends from a steering ring 27 in the tip 29 of the catheter to the Y-adapter 14 and are contained in at least one tube 40 in the wall of the tubular guiding catheter member 16. The wire or wires are pulled to move the distal tip 29 of the guiding catheter 10. Wires 42 and 44 are illustrated connecting the pin electrodes 18 and 20. A plurality of wires 46a and 46n are also illustrated connecting to the plurality of ring electrodes 22a-22n. Wires 42, 44 and 46a-46n secure appropriately to the electrode interface 36 via cable 38 of FIG. 1.
FIG. 5A illustrates a side view of the end of the guiding and mapping catheter 10 with electrical steering where all numerals correspond to those elements previously described. The electrical system, includes memory shaped metals or alloys which are heated and shaped by increasing the temperature of the metals or alloys by the introduction of electrical currents. These memory shaped metals includes a shaping element 47 and a retracting element 48 placed adjacent to a central member 49 containing the central lumen 17, as illustrated in FIG. 5B. Wires 51 and 53 connect to the shaping element 47 and retracting element 48 and are routed to the electrode interface 36 of FIG. 1.
FIG. 5B illustrates a view in cross section of the end of the guiding and mapping catheter 10 with electrical steering where all numerals correspond to those elements previously described. FIG. 6 illustrates a plan view of an ablation catheter 50 in partial cross section. This catheter includes a Y-adapter 52 having an energy delivery port 54, an electrical connection port 56, an irrigation port
58, a catheter stop 60, a plastic tubular member 62 having a central lumen 64 for passage of an ablative energy delivery member 66 which may be an optical fiber as is the case with laser energy sources, or in the alternative, can be an insulated copper wire such as with RF energy, or a coaxial cable for the delivery of microwave energy. The plastic tubular member 62 and lumen 64 accommodate the ablative energy delivery member 66, and also channels fluid to the point of contact of the energy delivery member with the myocardial tissue. The ablation energy delivery member 66 is appropriately sized to allow passage of liquid between it and the walls forming the lumen 64 for passage of the tip 70. At the configured tip 70 of the catheter 50 are embedded sensing elements, which penetrate the myocardial tissue. For purposes of illustration, two metallic needles 72 and 74 are shown in FIG. 7, each of which contains a thermocouple for measuring tissue temperature. The needles 72 and 74 also act as fixation elements to hold the position of the ablation catheter 50 during ablation. The fixation device could also be a separate part of the catheter which would run along side of the central lumen 64, and may be movable by a mechanism at the Y-adapter 52 of the ablation catheter 50. Also embedded in the tip 70 of the ablation catheter 50 are pin electrodes 76 and 78 for measuring local activation electrical signals. These electrodes help to confirm the position of the ablation catheter 50, as well as establish the degree of contact of the tip 70 with the endocardial surface.
All interfaces are brought to the proximal Y-adapter 52 of the ablation catheter 50 for connection to other medical devices. The electrode wires are interfaced through a quick disconnect fitting 80, which then connects to standard EP monitoring and temperature measuring equipment. The irrigation port 58 uses a standard luer fitting which connects to an infusion pump capable of displacing the needed amount of saline solution. The ablation energy delivery member 66 connects to source generator, which could be radio frequency, microwave, laser or any other source which can destroy myocardial tissue.
The outer diameter of the laser catheter plastic tubing sheath 68 is such that it will fit down the internal lumen 17 of the mapping guiding catheter 10 of FIG. 1.
The body of the laser catheter 50 includes the following components as now described in detail, and also illustrated in FIG. 7 and 8. A plastic tube 62 provides central lumen 64 for internal components and flushing fluid. A stainless steel tip 70 is attached to the distal end of the plastic tube 62. The tip 70 is comprised of a through lumen 82 for placement and fixation of a single ablative energy delivery member 66, two small stainless steel hypodermic tubes/needles 72 and 74 that contain one thermocouple each, a plurality of small slots 84a-84n for irrigating the tip of ablative energy delivery member 66, and two stainless steel electrodes 76 and 78 for sensing electrical signals. The ablative energy delivery member 66 when used in the form of an optical fiber has a silica core, polymer clad, with a TEFLON jacket. The optical fiber extends beyond the tip 70 and is held in place in the metallic tip by a mechanical crimp 86. The annular space between the optical fiber (ablative energy delivery member 66) and the stainless steel wall of the tip 70 serves as a conduit for irrigating fluid, such as saline, which both cools the tissue and purges blood from the delivered energy field during irradiation by the desired energy delivery member 66. A thermocouple is soldered inside each hypodermic tubes or needles 72 and 74 near the distal end. The hypodermic tubes or needles 72 and 74 are soldered to the metallic tip 70; thus, the spatial relationship between the thermocouples and the distal face of the optical fiber is fixed. The thermocouples are standard types and the signals are carried to a temperature data acquisition and control system by small-diameter TEFLON-coated wire routed through the catheter tube 62 and the fitting/interface 80 in the laser catheter Y-adapter 52. The two stainless steel electrodes 76 and 78 are positioned opposite each other on the distal face of the tip 70 to sense electrical signals. These electrodes are insulated from the bulk of the tip 70 by polyamide tubing. EP signals are carried from these electrodes 76 and 78 to standard EP
mapping equipment by small-diameter TEFLON-coated wire routed through the catheter tube and a connector in the laser catheter Y-adapter 52. A molded plastic Y-adapter 52 at the proximal end of the tubular member 62 contains an interface fitting for the temperature and EP monitoring systems, a port 58 for irrigating fluids, and the ablative energy delivery member 66. The ablation energy member extends 2 meters beyond the handle and is terminated with standard connectors, which mate with the ablative energy source.
FIG. 7 illustrates a perspective view of the tip 70 where all numerals correspond to those elements previously described. Illustrated in particular are the needles 72 and 74 each having embedded thermocouples. A plurality of flat wire leads 75a-75n connect to the needles 72 and 74 and to the electrodes 76 and 78 for subsequent wire connection to the electrode interface 80. FIG. 8 illustrates a side view in partial cross section of the tip
70 where all numerals correspond to those elements previously described. Thermocouples 77 and 79 are embedded in the needles 72 and 74, respectively.
FIG. 9 illustrates a plan view of the guiding and mapping catheter 10 accommodating the ablation catheter 50 where all numerals correspond to those elements previously described.
Mode of Operation The mode of operation of this ablation catheter system is such that the guiding mapping catheter 10 of FIG. 1 is placed in one of the chambers of the heart using standard angiographic techniques. This would normally include use of a guide wire to insure that no perforation of the vasculature occurs. The tip of the guiding/mapping catheter 10 is then placed in contact with the endocardial surface of the heart such that the tip 29 of the guiding/mapping catheter 10 is perpendicular to the heart wall. The electrical signals from the two electrodes 18 and 20 embedded in the tip 29 are then analyzed and recorded as both unipolar and bipolar
signals. The catheter tip 29 is then moved to another site on the endocardial surface using the steering mechanism. Positioning and subsequent analysis is continued until the desired location is identified. The fixation wire 24 is then activated attaching the tip 29 of the guiding/mapping catheter 10 to the endocardial surface of the heart.
The primary functions of the guiding/mapping catheter 10 assembly is to identify the location of tachyarrhythmia sites through electrical activation mapping, and to mechanically guide the ablation catheter 50 to the desired irradiation sites. The guiding/mapping catheter electrodes 18, 20 and 22a-22n are coupled to standard hospital EP mapping equipment.
The deflecting sheath 30 can be used to direct the distal tip 29 of the guiding/mapping catheter 10 by advancing the distal end of the deflecting sheath 30 toward the tip 29 of the guiding/mapping catheter, thereby straightening the curve. Deflecting sheath 30 advancement and return is accomplished by moving the deflecting sheath Y-connector 14 while maintaining the position of the tubular guiding catheter member 16.
Standard hospital continuous-flow fluid pumps with flow monitoring capabilities are used to provide sterile saline irrigation for the guiding/mapping catheter 10.
The ablation catheter of FIG. 6 is then inserted into the guiding mapping catheter 10 much like a balloon angioplasty catheter is inserted into a standard guiding catheter as illustrated in FIG. 9. The ablation catheter 50 is flushed with saline to keep blood and other biological tissue out of the field of view of the ablation catheter 50. The ablation catheter is then moved forward until it comes in contact or near contact with the endocardial surface. The fixation element and tip electrode then engage the myocardium and the ablation energy source is prepared for activation. The ablation source is used until the desired tissue damage is accomplished. The monitoring is continuous and the ablations source interrupted if a situation develops in which continued use of the ablative
energy could damage either the catheter or the myocardium. This may be accomplished manually or by an automated system interfaced to the ablative energy source.
Description of the First Alternative Embodiment FIG. 10 illustrates a cross-sectional view of an RF ablation catheter 100, a first alternative embodiment. Another embodiment is to use a standard RF catheter through an open catheter port 32 and lumen 17 through the center for ablation. A fixation and monitoring wire is passed down the center of the ablation catheter 100 for purposes of stabilization of the catheter during ablation and monitoring of tissue response.
The RF ablation catheter 100 with monitoring capabilities is consistent with and incorporates the teaching of the present invention as previously described for use with an RF generator and Y-adapters of the previous embodiments. One of the dangers inherent in any ablation system is destruction of healthy tissue which is not part of the tachycardia. It is desirable to keep this collateral damage to a minimum so as to maximize the therapeutic value of this treatment. One way to minimize this damage is to monitor the effect of the energy on the myocardial tissue being irradiated. Such monitoring can be done by measuring tissue temperature, changes in optical properties of the tissue, or changes in electrical patterns of the tissue.
An extension of the basic invention is to add the ability to monitor tissue response to RF irradiation. This is done via thermocouples placed at the surface or in the tissue, optical fibers placed in contact with the myocardium, or small electrodes placed in contact with the endocardial surface.
To accommodate these additional elements, the RF ablation catheter 100 has a lumen through it. Such a lumen can be centered or offset. Depending on the type of monitoring, the additional elements are
terminated so as to interface with commercially available monitoring equipment.
An additional feature which could be added to this system would be the use of feedback to control the input of energy to optimize the elimination of the tachycardia. The monitoring system would be connected to a system in which the signals can be continuously monitored and changes made in the energy inputted into the catheter. Such a system could be as simple as an on/off controller which turns the energy off above a specified value and on below a specified value. The system could be as complex as a microprocessor in which the signals are analyzed more complexly and the rates of changes or signal patterns incorporated into the decision process.
The illustrated RF ablation catheter 100 has like and corresponding members relating expressly to previously described members which operate and are conceived in the same fashion, including mapping band electrodes 102 and 104, an internal coaxial cable 106, consisting of a center conductor antenna 108, and external conductor of either solid or braid serving as a shield 110, and dielectric material 111 and a covering 113, a signal wire lumen 112 extending to the distal tip 116, signal wires 118 and 120 connected to the mapping electrodes 102 and 104, and a plastic sheath 122 placed over and about the distal end of the center conductor antenna 108. Thermocouples 124 and 126 are placed near the distal end of the RF antenna radiator 108 having wires (not illustrated for purposes of brevity and clarity) which pass outwardly for external measurement and analysis.
Another problem with catheters placed in a beating heart is that these catheters may be moved around by the mechanical action of the heart, thus irradiating undesirable area. One solution is to fixate the catheter via an integral fixation system. Such a system attaches to the wall of the heart and holds the catheter in its proper location in the heart.
Such a system is activated once the proper location is found in the heart.
A fixation system wire 128 passes through the length of the RF ablation catheter 100 and through lumen 130, and consists of a type of wire with a special pointed end 131. The pointed end 131 is inserted into the myocardium. This system holds the RF ablation catheter 100 as a fixed surface location. A more complex system would be a helical coil which would be screwed into the heart muscle. This system would provide perpendicular, as well as lateral fixation. Alternatively, thermistors, thermocouples or optical temperature sensors 132 and 134 can be included in the fixation system wire 128 for temperature sensing of and about heart tissues in close proximity to the antenna radiator 108. The thermistor wires are not fully illustrated for purposes of brevity and clarity.
Description of the Second Alternative Embodiment FIG. 11, a second alternative embodiment, illustrates a cross- sectional view of microwave ablation catheter 150 with monitoring capabilities which is consistent with and incorporates the teaching of the present invention as previously described for use with the microwave generator and Y-adapters of the previous embodiment.
One of the dangers inherent in any ablation system is destruction of healthy tissue which is not part of the tachycardia. It is desirable to keep this collateral damage to a minimum so as to maximize the therapeutic value of this treatment. One way to minimize this damage is to monitor the effect of the energy on the myocardial tissue being irradiated. Such monitoring can be done by measuring tissue temperature, changes in optical properties of the tissue, or changes in electrical patterns of the tissue.
An extension of the basic invention is to add the ability to monitor tissue response to microwave irradiation. This is done via thermocouples placed at the surface or in the tissue, optical fibers placed in contact with the myocardium, or small electrodes placed in contact with the endocardial surface.
To accommodate these additional elements, the catheter has a lumen through it. Depending on the type of monitoring, the additional elements would be terminated so as to interface with commercially available monitoring equipment. An additional feature which could be added to this system would be the use of feedback to control the input of energy to optimize the elimination of the tachycardia. The monitoring system would be connected to a system in which the signals can be continuously monitored and changes made in the energy inputted into the catheter. Such a system could be as simple as an on/off controller which turns the energy off above a specified value and on below a specified value. The system could be as complex as a microprocessor in which the signals are analyzed more complexly and the rates of changes or signal patterns incorporated into the decision process. The illustrated microwave ablation catheter 150 has like and corresponding members relating expressly to previously described members which operate and are conceived in the same fashion, including mapping band electrodes 152 and 154, an internal coaxial cable 156, consisting of a center conductor 160, an external conductor either solid or braid serving as a shield 158, and dielectric material 162, a signal wire lumen 164, a lumen 166 extending through a distal tip 167, signal wire 168 and 170 connected to the mapping band electrodes lϊ and 154, a microwave antenna coil 172, a plastic sheath 173, and other corresponding members. Thermocouples 174 and 176 are placed near the microwave coil 172 having wires (not illustrated for purposes of brevity and clarity) which pass outwardly through the signal wire lumen 164 for external measurement and analysis.
Another problem with catheters placed in a beating heart is that these catheters may be moved around by the mechanical action of the heart, thus irradiating undesirable areas. One solution is to fixate the catheter via an integral fixation system. Such a system attaches to the wall
of the heart and holds the catheter in its proper location in the heart. Such a system is activated once the proper location is found in the heart. A fixation system wire 178 passes through the length of the microwave ablation catheter 150 and through lumen 166, and consists of a type of wire with a special pointed end 180. The pointed end 180 is inserted into the myocardium. This system holds the microwave ablation catheter 150 at a fixed surface location. A more complex system would be a helical coil which would be screwed into the heart muscle. This system would provide perpendicular, as well as lateral fixation. Alternatively, thermistors or thermocouples or optical temperature sensors 182 and 184 can be included in the fixation system wire 178 for temperature sensing of and about heart tissues in close proximity to the microwave antenna coil 172. The thermistor wires are not fully illustrated for purposes of brevity and clarity, but route through the fixation wire 178.
Description of the Third Alternative Embodiment
FIG. 12 illustrates a cross-sectional view of a chemical ablation catheter 200, a third alternative embodiment. In the chemical ablation catheter 200, a needle 210 pierces myocardium and chemical such as ethanol is injected into myocardium, while the guiding/mapping catheter is being flushed. Pin electrodes 202 and 204 are located at the distal end of the ablation catheter 200 and include connection wires 206 and 208 leading to external connector blocks. The needle 210 located at the distal end includes a plurality of ports 212a-212n for injection of liquid ablation chemicals into the myocardium. A luer connector 214 connects to an external drug pump.
Various modifications can be made to the present invention without departing from the apparent scope hereof.
Claims
1. A guiding/mapping catheter comprising: a) a plurality of electrodes for finding arrythmogenic tissue at an identified location via local activation mapping.
2. The guiding mapping catheter of claim 1 including means for affixing to the wall of the heart to hold the identified location in the heart.
3. The guiding/mapping catheter of claim 1 including means for flushing to keep biological material out of the field of influence of the ablative catheter.
4. The guiding/mapping catheter of claim 1 including means for receiving an ablative catheter down a central lumen.
5. The guiding/mapping catheter of claim 1 including means for articulating inside the heart to move along the wall of the heart.
6. An ablation catheter including means for measuring directly the effect of the ablative energy source on myocardium.
7. The ablation catheter of claim 6 including means for flushing which baths the contact point of the catheter with the myocardium to prevent coagulation of blood and other biological material on the contact with the myocardium.
8. The ablation catheter of claim 6 including means for measuring the local activation so that the electrophysiological response of the tissue can be monitored.
9. The ablation catheter of claim 6 including means for integral movable or fixed mechanism for attaching the ablation catheter to the wall of the endocardium to ensure good contact between the catheter and the myocardium during ablation.
10. The ablation catheter of claim 6 including means which can be exchanged easily by removing it from the guiding/mapping catheter without losing the precise location for ablation.
11. The ablation catheter system of claim 6 which is percutaneous.
12. The ablation catheter system of claim 6 wherein said ablation energy is laser energy.
13. The ablation catheter system of claim 6 wherein said ablation energy is RF energy.
14. The ablation catheter system of claim 6 wherein said ablation energy is microwave energy.
15. The ablation catheter system of claim 6 wherein said ablation energy is chemical energy.
16. A catheter system comprising: a) a guiding/mapping catheter including a plurality of electrodes for finding arrythmogenic tissue at an identified location via local activation mapping; and, b) an ablation catheter including means for measuring directly the effect of the ablative energy source on myocardium.
17. The catheter system of claim 16 including means for affixing to the wall of the heart to hold the identified location in the heart.
18. The catheter system of claim 16 including means for flushing to keep biological material out of the field of influence of the ablative catheter.
19. The catheter system of claim 16 including means for receiving an ablative catheter down a central lumen.
20. The catheter system of claim 16 including means for articulating inside the heart to move perpendicularly along the wall of the heart.
21. The catheter system of claim 16 including means for flushing which baths to the contact point of the catheter with the myocardium to prevent coagulation of blood and other biological material on the contact with the myocardium.
22. The catheter system of claim 16 including means for measuring the local activation so that the electrophysiological response of the tissue can be monitored.
23. The catheter system of claim 16 including means for integral movable or fixed mechanism for attaching the catheter system to the wall of the endocardium to ensure good contact between the catheter and the myocardium during ablation.
24. The catheter system of claim 16 including means which can be exchanged easily by removing it from the guiding/mapping catheter without losing the precise location for ablation.
25. The catheter system of claim 16 which is percutaneous.
26. The catheter system of claim 16 wherein said ablation energy is laser energy.
27. The catheter system of claim 16 wherein said ablation energy is RF energy.
28. The catheter system of claim 16 wherein said ablation energy is microwave energy.
29. The catheter system of claim 16 wherein said ablation energy is chemical energy.
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US91338092A | 1992-07-15 | 1992-07-15 | |
US07/913,380 | 1992-07-15 |
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Cited By (37)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1995005867A1 (en) * | 1993-08-27 | 1995-03-02 | Medtronic, Inc. | Apparatus for ablation |
US5464404A (en) * | 1993-09-20 | 1995-11-07 | Abela Laser Systems, Inc. | Cardiac ablation catheters and method |
EP0737486A2 (en) * | 1995-04-14 | 1996-10-16 | Daig Corporation | Guiding introducer used for medical procedures within the right ventricle associated with the right ventricular outflow track |
EP0738518A2 (en) * | 1995-04-17 | 1996-10-23 | Daig Corporation | Guiding introducers used for medical procedures within the right ventricle associated with the tricuspid valve |
WO1996035469A1 (en) * | 1995-05-10 | 1996-11-14 | Cardiogenesis Corporation | System for treating or diagnosing heart tissue |
DE19537897A1 (en) * | 1995-09-19 | 1997-03-20 | Erbe Elektromedizin | Multi=functional surgical instrument suitable for variable surgical methods |
WO1997017009A2 (en) * | 1995-11-08 | 1997-05-15 | Laser- Und Medizin-Technologie Ggmbh Berlin | Arrangement for electrothermal treatment of the human or animal body |
US5651786A (en) * | 1993-09-20 | 1997-07-29 | Abela Laser Systems, Inc. | Mapping catheter and method |
US5651785A (en) * | 1993-09-20 | 1997-07-29 | Abela Laser Systems, Inc. | Optical fiber catheter and method |
EP0832602A1 (en) * | 1996-09-27 | 1998-04-01 | Sulzer Osypka GmbH | Device for carrying out diagnostic and/or therapeutic heart procedures with a catheter |
US5782824A (en) * | 1993-09-20 | 1998-07-21 | Abela Laser Systems, Inc. | Cardiac catheter anchoring |
WO1998038912A1 (en) * | 1995-05-23 | 1998-09-11 | Cardima, Inc. | Over-the-wire ep catheter |
US5807383A (en) * | 1996-05-13 | 1998-09-15 | United States Surgical Corporation | Lasing device |
US5814027A (en) * | 1993-11-03 | 1998-09-29 | Daig Corporation | Guiding introducer used for medical procedures within the right ventricle associated with the right ventricular outflow track |
US5947989A (en) * | 1996-12-12 | 1999-09-07 | United States Surgical Corporation | Method and apparatus for transmyocardial revascularization |
US5980545A (en) * | 1996-05-13 | 1999-11-09 | United States Surgical Corporation | Coring device and method |
EP0957758A1 (en) * | 1995-08-22 | 1999-11-24 | Board of Regents, The University of Texas System | A maneuverable electrophysiology catheter for percutaneous or intraoperative ablation of cardiac arrhythmias |
US6002956A (en) * | 1995-05-23 | 1999-12-14 | Cardima, Inc. | Method of treating using an over-the-wire EP catheter |
US6135996A (en) * | 1998-04-17 | 2000-10-24 | Baxter International, Inc. | Controlled advancement lasing device |
US6251104B1 (en) | 1995-05-10 | 2001-06-26 | Eclipse Surgical Technologies, Inc. | Guiding catheter system for ablating heart tissue |
US6283955B1 (en) | 1996-05-13 | 2001-09-04 | Edwards Lifesciences Corp. | Laser ablation device |
EP1181896A1 (en) * | 2000-08-21 | 2002-02-27 | Biosense Webster, Inc. | Ablation catheter with cooled linear electrode |
US6949098B2 (en) | 1995-02-22 | 2005-09-27 | Medtronic, Inc. | Pen-type electrosurgical instrument |
WO2006086882A1 (en) * | 2005-02-17 | 2006-08-24 | Baylis Medical Company Inc. | Electrosurgical device and method |
US7811282B2 (en) | 2000-03-06 | 2010-10-12 | Salient Surgical Technologies, Inc. | Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof |
US7815634B2 (en) | 2000-03-06 | 2010-10-19 | Salient Surgical Technologies, Inc. | Fluid delivery system and controller for electrosurgical devices |
US7945331B2 (en) | 2005-01-11 | 2011-05-17 | Bradley D. Vilims | Combination electrical stimulating and infusion medical device and method |
US7998140B2 (en) | 2002-02-12 | 2011-08-16 | Salient Surgical Technologies, Inc. | Fluid-assisted medical devices, systems and methods |
US8066702B2 (en) | 2005-01-11 | 2011-11-29 | Rittman Iii William J | Combination electrical stimulating and infusion medical device and method |
US8195307B2 (en) | 2005-01-11 | 2012-06-05 | Vilims Bradley D | Combination electrical stimulating and infusion device and method |
CN104665922A (en) * | 2015-02-26 | 2015-06-03 | 首都医科大学附属北京安贞医院 | Marshall ligament absolute ethyl alcohol ablation system |
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US9820808B2 (en) | 2002-03-05 | 2017-11-21 | Avent, Inc. | Method for treating the thoracic region of a patient's body |
US9949789B2 (en) | 2002-03-05 | 2018-04-24 | Avent, Inc. | Methods of treating the sacroiliac region of a patient's body |
US10206739B2 (en) | 2002-03-05 | 2019-02-19 | Avent, Inc. | Electrosurgical device and methods |
US10786300B2 (en) | 2015-04-13 | 2020-09-29 | Carlos Fernando Bazoberry | Radiofrequency denervation needle and method |
US11291496B2 (en) | 2002-03-05 | 2022-04-05 | Avent, Inc. | Methods of treating the sacroiliac region of a patient's body |
Families Citing this family (674)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5370675A (en) | 1992-08-12 | 1994-12-06 | Vidamed, Inc. | Medical probe device and method |
US6106546A (en) * | 1988-10-11 | 2000-08-22 | The General Hospital Corporation | Inducing vasodilation |
US5409453A (en) * | 1992-08-12 | 1995-04-25 | Vidamed, Inc. | Steerable medical probe with stylets |
US5683366A (en) | 1992-01-07 | 1997-11-04 | Arthrocare Corporation | System and method for electrosurgical tissue canalization |
US5902272A (en) * | 1992-01-07 | 1999-05-11 | Arthrocare Corporation | Planar ablation probe and method for electrosurgical cutting and ablation |
US5830209A (en) * | 1992-02-05 | 1998-11-03 | Angeion Corporation | Multi-fiber laser catheter |
US5586982A (en) * | 1992-04-10 | 1996-12-24 | Abela; George S. | Cell transfection apparatus and method |
US5324284A (en) * | 1992-06-05 | 1994-06-28 | Cardiac Pathways, Inc. | Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method |
US7189208B1 (en) * | 1992-09-23 | 2007-03-13 | Endocardial Solutions, Inc. | Method for measuring heart electrophysiology |
ATE205066T1 (en) * | 1993-01-29 | 2001-09-15 | Cardima Inc | MULTIPLE SENSOR FOR DISPLAYING ELECTRICAL SIGNALS IN BLOOD VESSELS |
US6161543A (en) * | 1993-02-22 | 2000-12-19 | Epicor, Inc. | Methods of epicardial ablation for creating a lesion around the pulmonary veins |
US6233491B1 (en) * | 1993-03-16 | 2001-05-15 | Ep Technologies, Inc. | Cardiac mapping and ablation systems |
US5921982A (en) * | 1993-07-30 | 1999-07-13 | Lesh; Michael D. | Systems and methods for ablating body tissue |
AU7404994A (en) * | 1993-07-30 | 1995-02-28 | Regents Of The University Of California, The | Endocardial infusion catheter |
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 |
EP0754075B1 (en) | 1993-10-14 | 2006-03-15 | Boston Scientific Limited | Electrode elements for forming lesion patterns |
US5575810A (en) * | 1993-10-15 | 1996-11-19 | Ep Technologies, Inc. | Composite structures and methods for ablating tissue to form complex lesion patterns in the treatment of cardiac conditions and the like |
US6001093A (en) * | 1993-10-15 | 1999-12-14 | Ep Technologies, Inc. | Systems and methods for creating long, thin lesions in body tissue |
WO1995010320A1 (en) | 1993-10-15 | 1995-04-20 | Ep Technologies, Inc. | Device for lengthening cardiac conduction pathways |
US6146379A (en) * | 1993-10-15 | 2000-11-14 | Ep Technologies, Inc. | Systems and methods for creating curvilinear lesions in body tissue |
US6071280A (en) | 1993-11-08 | 2000-06-06 | Rita Medical Systems, Inc. | Multiple electrode ablation apparatus |
US5928229A (en) | 1993-11-08 | 1999-07-27 | Rita Medical Systems, Inc. | Tumor ablation apparatus |
EP0861676B1 (en) * | 1993-11-10 | 2003-10-01 | Medtronic Cardiorhythm | Electrode array catheter |
US6099524A (en) * | 1994-01-28 | 2000-08-08 | Cardiac Pacemakers, Inc. | Electrophysiological mapping and ablation catheter and method |
US5458596A (en) | 1994-05-06 | 1995-10-17 | Dorsal Orthopedic Corporation | Method and apparatus for controlled contraction of soft tissue |
US20050187599A1 (en) * | 1994-05-06 | 2005-08-25 | Hugh Sharkey | Method and apparatus for controlled contraction of soft tissue |
US6056744A (en) * | 1994-06-24 | 2000-05-02 | Conway Stuart Medical, Inc. | Sphincter treatment apparatus |
US5827277A (en) * | 1994-06-24 | 1998-10-27 | Somnus Medical Technologies, Inc. | Minimally invasive apparatus for internal ablation of turbinates |
US6405732B1 (en) | 1994-06-24 | 2002-06-18 | Curon Medical, Inc. | Method to treat gastric reflux via the detection and ablation of gastro-esophageal nerves and receptors |
US6733495B1 (en) | 1999-09-08 | 2004-05-11 | Curon Medical, Inc. | Systems and methods for monitoring and controlling use of medical devices |
US6009877A (en) | 1994-06-24 | 2000-01-04 | Edwards; Stuart D. | Method for treating a sphincter |
JP3578460B2 (en) * | 1994-06-27 | 2004-10-20 | ボストン サイエンティフィック リミテッド | Systems and methods for sensing body temperature |
US5735846A (en) * | 1994-06-27 | 1998-04-07 | Ep Technologies, Inc. | Systems and methods for ablating body tissue using predicted maximum tissue temperature |
US5853409A (en) * | 1994-06-27 | 1998-12-29 | E.P. Technologies, Inc. | Systems and apparatus for sensing temperature in body tissue |
IT1273015B (en) * | 1994-07-27 | 1997-07-01 | Piefrancesco Pavoni | "DEVICE FOR INVASIVE THERMOMETRIC DETECTION AND FOR THE INTRODUCTION OF A MEDICATION FOR SURFACE AND DEEP HYPERTHERMIA APPLICATIONS". |
US5967976A (en) * | 1994-08-19 | 1999-10-19 | Novoste Corporation | Apparatus and methods for procedures related to the electrophysiology of the heart |
US5529067A (en) * | 1994-08-19 | 1996-06-25 | Novoste Corporation | Methods for procedures related to the electrophysiology of the heart |
US5876398A (en) * | 1994-09-08 | 1999-03-02 | Medtronic, Inc. | Method and apparatus for R-F ablation |
US6676656B2 (en) | 1994-09-09 | 2004-01-13 | Cardiofocus, Inc. | Surgical ablation with radiant energy |
US6579285B2 (en) | 1994-09-09 | 2003-06-17 | Cardiofocus, Inc. | Photoablation with infrared radiation |
US6558375B1 (en) | 2000-07-14 | 2003-05-06 | Cardiofocus, Inc. | Cardiac ablation instrument |
US6464700B1 (en) | 1994-10-07 | 2002-10-15 | Scimed Life Systems, Inc. | Loop structures for positioning a diagnostic or therapeutic element on the epicardium or other organ surface |
US6071274A (en) | 1996-12-19 | 2000-06-06 | Ep Technologies, Inc. | Loop structures for supporting multiple electrode elements |
US7175619B2 (en) * | 1994-10-07 | 2007-02-13 | Boston Scientific Scimed, Inc. | Loop structures for positioning a diagnostic or therapeutic element on the epicardium or other organ surface |
US6690963B2 (en) * | 1995-01-24 | 2004-02-10 | Biosense, Inc. | System for determining the location and orientation of an invasive medical instrument |
US6461353B1 (en) | 1995-02-17 | 2002-10-08 | Oratec Interventions, Inc. | Orthopedic apparatus for controlled contraction of collagen tissue |
US6409722B1 (en) | 1998-07-07 | 2002-06-25 | Medtronic, Inc. | Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue |
US6030379A (en) * | 1995-05-01 | 2000-02-29 | Ep Technologies, Inc. | Systems and methods for seeking sub-surface temperature conditions during tissue ablation |
US6235021B1 (en) * | 1995-05-01 | 2001-05-22 | Scimed Life Systems, Inc. | Ablation sheath |
US5688267A (en) * | 1995-05-01 | 1997-11-18 | Ep Technologies, Inc. | Systems and methods for sensing multiple temperature conditions during tissue ablation |
ATE308930T1 (en) * | 1995-05-04 | 2005-11-15 | Sherwood Serv Ag | THERMO-SURGERY SYSTEM WITH COLD ELECTRIC TIP |
US6575969B1 (en) | 1995-05-04 | 2003-06-10 | Sherwood Services Ag | Cool-tip radiofrequency thermosurgery electrode system for tumor ablation |
SE505332C2 (en) * | 1995-05-18 | 1997-08-11 | Lund Instr Ab | Device for heat treatment of body tissue |
US5782760A (en) * | 1995-05-23 | 1998-07-21 | Cardima, Inc. | Over-the-wire EP catheter |
US6190379B1 (en) * | 1995-06-06 | 2001-02-20 | Sun Star Technology, Inc. | Hot tip catheter |
US5840059A (en) * | 1995-06-07 | 1998-11-24 | Cardiogenesis Corporation | Therapeutic and diagnostic agent delivery |
US6224584B1 (en) | 1997-01-14 | 2001-05-01 | Eclipse Surgical Technologies, Inc. | Therapeutic and diagnostic agent delivery |
US6156031A (en) * | 1995-08-09 | 2000-12-05 | Eclipse Surgical Technologies | Transmyocardial revascularization using radiofrequency energy |
US6267757B1 (en) | 1995-08-09 | 2001-07-31 | Eclipse Surgical Technologies, Inc. | Revascularization with RF ablation |
US6689127B1 (en) | 1995-08-15 | 2004-02-10 | Rita Medical Systems | Multiple antenna ablation apparatus and method with multiple sensor feedback |
US6059780A (en) | 1995-08-15 | 2000-05-09 | Rita Medical Systems, Inc. | Multiple antenna ablation apparatus and method with cooling element |
US6080150A (en) | 1995-08-15 | 2000-06-27 | Rita Medical Systems, Inc. | Cell necrosis apparatus |
US5913855A (en) | 1995-08-15 | 1999-06-22 | Rita Medical Systems, Inc. | Multiple antenna ablation apparatus and method |
US6132425A (en) | 1995-08-15 | 2000-10-17 | Gough; Edward J. | Cell necrosis apparatus |
US5925042A (en) | 1995-08-15 | 1999-07-20 | Rita Medical Systems, Inc. | Multiple antenna ablation apparatus and method |
US5735847A (en) | 1995-08-15 | 1998-04-07 | Zomed International, Inc. | Multiple antenna ablation apparatus and method with cooling element |
US5951547A (en) | 1995-08-15 | 1999-09-14 | Rita Medical Systems, Inc. | Multiple antenna ablation apparatus and method |
US6090105A (en) | 1995-08-15 | 2000-07-18 | Rita Medical Systems, Inc. | Multiple electrode ablation apparatus and method |
US5980517A (en) | 1995-08-15 | 1999-11-09 | Rita Medical Systems, Inc. | Cell necrosis apparatus |
US5836875A (en) * | 1995-10-06 | 1998-11-17 | Cordis Webster, Inc. | Split tip electrode catheter |
US5980504A (en) | 1996-08-13 | 1999-11-09 | Oratec Interventions, Inc. | Method for manipulating tissue of an intervertebral disc |
US6007570A (en) | 1996-08-13 | 1999-12-28 | Oratec Interventions, Inc. | Apparatus with functional element for performing function upon intervertebral discs |
US6283960B1 (en) | 1995-10-24 | 2001-09-04 | Oratec Interventions, Inc. | Apparatus for delivery of energy to a surgical site |
US20030212393A1 (en) * | 1996-01-05 | 2003-11-13 | Knowlton Edward W. | Handpiece with RF electrode and non-volatile memory |
US7267675B2 (en) | 1996-01-05 | 2007-09-11 | Thermage, Inc. | RF device with thermo-electric cooler |
US7229436B2 (en) * | 1996-01-05 | 2007-06-12 | Thermage, Inc. | Method and kit for treatment of tissue |
US7189230B2 (en) * | 1996-01-05 | 2007-03-13 | Thermage, Inc. | Method for treating skin and underlying tissue |
US6350276B1 (en) * | 1996-01-05 | 2002-02-26 | Thermage, Inc. | Tissue remodeling apparatus containing cooling fluid |
US7006874B2 (en) | 1996-01-05 | 2006-02-28 | Thermage, Inc. | Treatment apparatus with electromagnetic energy delivery device and non-volatile memory |
US7115123B2 (en) * | 1996-01-05 | 2006-10-03 | Thermage, Inc. | Handpiece with electrode and non-volatile memory |
US7141049B2 (en) * | 1999-03-09 | 2006-11-28 | Thermage, Inc. | Handpiece for treatment of tissue |
US7452358B2 (en) * | 1996-01-05 | 2008-11-18 | Thermage, Inc. | RF electrode assembly for handpiece |
US7022121B2 (en) | 1999-03-09 | 2006-04-04 | Thermage, Inc. | Handpiece for treatment of tissue |
US5824031A (en) * | 1996-02-28 | 1998-10-20 | Cardio Source | Apparatus and method for deflecting a tip of a lead or catheter |
NL1003024C2 (en) * | 1996-05-03 | 1997-11-06 | Tjong Hauw Sie | Stimulus conduction blocking instrument. |
US5882346A (en) * | 1996-07-15 | 1999-03-16 | Cardiac Pathways Corporation | Shapable catheter using exchangeable core and method of use |
US6645203B2 (en) | 1997-02-12 | 2003-11-11 | Oratec Interventions, Inc. | Surgical instrument with off-axis electrode |
US6126682A (en) * | 1996-08-13 | 2000-10-03 | Oratec Interventions, Inc. | Method for treating annular fissures in intervertebral discs |
US6733496B2 (en) | 2001-06-06 | 2004-05-11 | Oratec Interventions, Inc. | Intervertebral disc device employing flexible probe |
US6135999A (en) | 1997-02-12 | 2000-10-24 | Oratec Internationals, Inc. | Concave probe for arthroscopic surgery |
US6832997B2 (en) | 2001-06-06 | 2004-12-21 | Oratec Interventions, Inc. | Electromagnetic energy delivery intervertebral disc treatment devices |
US6726685B2 (en) | 2001-06-06 | 2004-04-27 | Oratec Interventions, Inc. | Intervertebral disc device employing looped probe |
US6068628A (en) | 1996-08-20 | 2000-05-30 | Oratec Interventions, Inc. | Apparatus for treating chondromalacia |
WO1998007375A1 (en) * | 1996-08-22 | 1998-02-26 | The Trustees Of Columbia University | Endovascular flexible stapling device |
US8353908B2 (en) | 1996-09-20 | 2013-01-15 | Novasys Medical, Inc. | Treatment of tissue in sphincters, sinuses, and orifices |
US5737384A (en) * | 1996-10-04 | 1998-04-07 | Massachusetts Institute Of Technology | X-ray needle providing heating with microwave energy |
WO1998016161A1 (en) * | 1996-10-11 | 1998-04-23 | Transvascular, Inc. | Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures |
US6464697B1 (en) * | 1998-02-19 | 2002-10-15 | Curon Medical, Inc. | Stomach and adjoining tissue regions in the esophagus |
US5810803A (en) * | 1996-10-16 | 1998-09-22 | Fidus Medical Technology Corporation | Conformal positioning assembly for microwave ablation catheter |
US6805128B1 (en) | 1996-10-22 | 2004-10-19 | Epicor Medical, Inc. | Apparatus and method for ablating tissue |
US6311692B1 (en) * | 1996-10-22 | 2001-11-06 | Epicor, Inc. | Apparatus and method for diagnosis and therapy of electrophysiological disease |
US6840936B2 (en) * | 1996-10-22 | 2005-01-11 | Epicor Medical, Inc. | Methods and devices for ablation |
US7052493B2 (en) * | 1996-10-22 | 2006-05-30 | Epicor Medical, Inc. | Methods and devices for ablation |
US6719755B2 (en) * | 1996-10-22 | 2004-04-13 | Epicor Medical, Inc. | Methods and devices for ablation |
US5893848A (en) * | 1996-10-24 | 1999-04-13 | Plc Medical Systems, Inc. | Gauging system for monitoring channel depth in percutaneous endocardial revascularization |
US5782826A (en) * | 1996-11-01 | 1998-07-21 | Ep Technologies, Inc. | System and methods for detecting ancillary tissue near tissue targeted for ablation |
US6216704B1 (en) * | 1997-08-13 | 2001-04-17 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
EP0984727A4 (en) * | 1996-11-08 | 2000-05-24 | Thomas J Fogarty | Transvascular tmr device and method |
US6042581A (en) * | 1996-11-08 | 2000-03-28 | Thomas J. Fogarty | Transvascular TMR device and method |
JP2002516582A (en) * | 1996-11-27 | 2002-06-04 | クック バスキュラー インコーポレーティッド. | Sheath for radio frequency dilator |
US6102926A (en) * | 1996-12-02 | 2000-08-15 | Angiotrax, Inc. | Apparatus for percutaneously performing myocardial revascularization having means for sensing tissue parameters and methods of use |
US6076012A (en) * | 1996-12-19 | 2000-06-13 | Ep Technologies, Inc. | Structures for supporting porous electrode elements |
US6071279A (en) | 1996-12-19 | 2000-06-06 | Ep Technologies, Inc. | Branched structures for supporting multiple electrode elements |
US6332880B1 (en) | 1996-12-19 | 2001-12-25 | Ep Technologies, Inc. | Loop structures for supporting multiple electrode elements |
US6048329A (en) | 1996-12-19 | 2000-04-11 | Ep Technologies, Inc. | Catheter distal assembly with pull wires |
US6203525B1 (en) | 1996-12-19 | 2001-03-20 | Ep Technologies, Inc. | Catheterdistal assembly with pull wires |
JP2001511048A (en) * | 1997-02-12 | 2001-08-07 | オーレイテック インターヴェンションズ インコーポレイテッド | Electrode for electrosurgical removal of tissue and method of manufacturing the same |
US5954716A (en) * | 1997-02-19 | 1999-09-21 | Oratec Interventions, Inc | Method for modifying the length of a ligament |
US6063078A (en) * | 1997-03-12 | 2000-05-16 | Medtronic, Inc. | Method and apparatus for tissue ablation |
US6012457A (en) * | 1997-07-08 | 2000-01-11 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
US6024740A (en) * | 1997-07-08 | 2000-02-15 | The Regents Of The University Of California | Circumferential ablation device assembly |
US5849028A (en) * | 1997-05-16 | 1998-12-15 | Irvine Biomedical, Inc. | Catheter and method for radiofrequency ablation of cardiac tissue |
US5891137A (en) * | 1997-05-21 | 1999-04-06 | Irvine Biomedical, Inc. | Catheter system having a tip with fixation means |
US6241726B1 (en) | 1997-05-21 | 2001-06-05 | Irvine Biomedical, Inc. | Catheter system having a tip section with fixation means |
US7255693B1 (en) * | 1997-05-23 | 2007-08-14 | Csa Medical, Inc. | Heated catheter used in cryotherapy |
US6582423B1 (en) | 1997-06-13 | 2003-06-24 | Arthrocare Corporation | Electrosurgical systems and methods for recanalization of occluded body lumens |
US6251109B1 (en) * | 1997-06-27 | 2001-06-26 | Daig Corporation | Process and device for the treatment of atrial arrhythmia |
US5938660A (en) * | 1997-06-27 | 1999-08-17 | Daig Corporation | Process and device for the treatment of atrial arrhythmia |
US6652515B1 (en) * | 1997-07-08 | 2003-11-25 | Atrionix, Inc. | Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall |
US6997925B2 (en) * | 1997-07-08 | 2006-02-14 | Atrionx, Inc. | Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall |
US6966908B2 (en) | 1997-07-08 | 2005-11-22 | Atrionix, Inc. | Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall |
US6096037A (en) * | 1997-07-29 | 2000-08-01 | Medtronic, Inc. | Tissue sealing electrosurgery device and methods of sealing tissue |
US5935119A (en) * | 1997-08-06 | 1999-08-10 | United States Surgical Corporation | Perfusion structure |
DE19734220C2 (en) | 1997-08-07 | 2000-01-13 | Pulsion Verwaltungs Gmbh & Co | Catheter system with an insertion wire |
US9023031B2 (en) | 1997-08-13 | 2015-05-05 | Verathon Inc. | Noninvasive devices, methods, and systems for modifying tissues |
US6027473A (en) * | 1997-09-05 | 2000-02-22 | Cordis Webster, Inc. | Handle for steerable DMR catheter |
US5964757A (en) * | 1997-09-05 | 1999-10-12 | Cordis Webster, Inc. | Steerable direct myocardial revascularization catheter |
US6402719B1 (en) * | 1997-09-05 | 2002-06-11 | Cordis Webster, Inc. | Steerable DMR catheter with infusion tube |
US6024739A (en) * | 1997-09-05 | 2000-02-15 | Cordis Webster, Inc. | Method for detecting and revascularizing ischemic myocardial tissue |
EP0900547B1 (en) * | 1997-09-05 | 2007-05-30 | Biosense Webster, Inc. | Steerable catheter for detecting and revascularizing ischemic myocardial tissue |
US6371943B1 (en) * | 1997-09-08 | 2002-04-16 | Epimed International, Inc. | Spring tip needle combination |
US6004320A (en) | 1997-09-19 | 1999-12-21 | Oratec Interventions, Inc. | Clip on electrocauterizing sheath for orthopedic shave devices |
US6214001B1 (en) | 1997-09-19 | 2001-04-10 | Oratec Interventions, Inc. | Electrocauterizing tool for orthopedic shave devices |
US6007533A (en) | 1997-09-19 | 1999-12-28 | Oratec Interventions, Inc. | Electrocauterizing tip for orthopedic shave devices |
US6610055B1 (en) | 1997-10-10 | 2003-08-26 | Scimed Life Systems, Inc. | Surgical method for positioning a diagnostic or therapeutic element on the epicardium or other organ surface |
US8709007B2 (en) | 1997-10-15 | 2014-04-29 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Devices and methods for ablating cardiac tissue |
US6176857B1 (en) | 1997-10-22 | 2001-01-23 | Oratec Interventions, Inc. | Method and apparatus for applying thermal energy to tissue asymmetrically |
US6120476A (en) * | 1997-12-01 | 2000-09-19 | Cordis Webster, Inc. | Irrigated tip catheter |
WO1999035987A1 (en) * | 1998-01-14 | 1999-07-22 | Conway-Stuart Medical, Inc. | Gerd treatment apparatus and method |
US6440128B1 (en) | 1998-01-14 | 2002-08-27 | Curon Medical, Inc. | Actively cooled electrode assemblies for forming lesions to treat dysfunction in sphincters and adjoining tissue regions |
AU2114299A (en) * | 1998-01-14 | 1999-08-02 | Conway-Stuart Medical, Inc. | Electrosurgical device for sphincter treatment |
US6790207B2 (en) | 1998-06-04 | 2004-09-14 | Curon Medical, Inc. | Systems and methods for applying a selected treatment agent into contact with tissue to treat disorders of the gastrointestinal tract |
DE69923291T2 (en) | 1998-02-19 | 2005-06-09 | Curon Medical Inc., Sunnyvale | ELECTRO-SURGERY DEVICE FOR THE TREATMENT OF CLOSURE MUSCLES |
US6273886B1 (en) | 1998-02-19 | 2001-08-14 | Curon Medical, Inc. | Integrated tissue heating and cooling apparatus |
US6402744B2 (en) | 1998-02-19 | 2002-06-11 | Curon Medical, Inc. | Systems and methods for forming composite lesions to treat dysfunction in sphincters and adjoining tissue regions |
US7165551B2 (en) * | 1998-02-19 | 2007-01-23 | Curon Medical, Inc. | Apparatus to detect and treat aberrant myoelectric activity |
US6355031B1 (en) | 1998-02-19 | 2002-03-12 | Curon Medical, Inc. | Control systems for multiple electrode arrays to create lesions in tissue regions at or near a sphincter |
US6258087B1 (en) | 1998-02-19 | 2001-07-10 | Curon Medical, Inc. | Expandable electrode assemblies for forming lesions to treat dysfunction in sphincters and adjoining tissue regions |
US8906010B2 (en) * | 1998-02-19 | 2014-12-09 | Mederi Therapeutics, Inc. | Graphical user interface for association with an electrode structure deployed in contact with a tissue region |
US6423058B1 (en) | 1998-02-19 | 2002-07-23 | Curon Medical, Inc. | Assemblies to visualize and treat sphincters and adjoining tissue regions |
US6358245B1 (en) | 1998-02-19 | 2002-03-19 | Curon Medical, Inc. | Graphical user interface for association with an electrode structure deployed in contact with a tissue region |
US6325798B1 (en) | 1998-02-19 | 2001-12-04 | Curon Medical, Inc. | Vacuum-assisted systems and methods for treating sphincters and adjoining tissue regions |
US6659105B2 (en) | 1998-02-26 | 2003-12-09 | Senorx, Inc. | Tissue specimen isolating and damaging device and method |
US6540693B2 (en) | 1998-03-03 | 2003-04-01 | Senorx, Inc. | Methods and apparatus for securing medical instruments to desired locations in a patients body |
JP2002504390A (en) | 1998-02-27 | 2002-02-12 | キューロン メディカル,インコーポレイテッド | Apparatus for electrosurgically treating esophageal sphincter |
US20030135206A1 (en) * | 1998-02-27 | 2003-07-17 | Curon Medical, Inc. | Method for treating a sphincter |
AU3104999A (en) | 1998-03-19 | 1999-10-11 | Oratec Interventions, Inc. | Catheter for delivery of energy to a surgical site |
US8016823B2 (en) * | 2003-01-18 | 2011-09-13 | Tsunami Medtech, Llc | Medical instrument and method of use |
US7892229B2 (en) | 2003-01-18 | 2011-02-22 | Tsunami Medtech, Llc | Medical instruments and techniques for treating pulmonary disorders |
US6053909A (en) * | 1998-03-27 | 2000-04-25 | Shadduck; John H. | Ionothermal delivery system and technique for medical procedures |
AU3672299A (en) * | 1998-04-30 | 1999-11-16 | Stuart D Edwards | Electrosurgical sphincter treatment apparatus |
US6592581B2 (en) | 1998-05-05 | 2003-07-15 | Cardiac Pacemakers, Inc. | Preformed steerable catheter with movable outer sleeve and method for use |
US7494488B2 (en) * | 1998-05-28 | 2009-02-24 | Pearl Technology Holdings, Llc | Facial tissue strengthening and tightening device and methods |
US6432101B1 (en) * | 1998-05-28 | 2002-08-13 | Pearl Technology Holdings, Llc | Surgical device for performing face-lifting using electromagnetic radiation |
US6802841B2 (en) * | 1998-06-04 | 2004-10-12 | Curon Medical, Inc. | Systems and methods for applying a selected treatment agent into contact with tissue to treat sphincter dysfunction |
US20110071468A1 (en) * | 1998-06-04 | 2011-03-24 | Mederi Therapeutics, Inc. | Systems and methods for applying a selected treatment agent into contact with tissue to treat sphincter dysfunction |
US6064905A (en) * | 1998-06-18 | 2000-05-16 | Cordis Webster, Inc. | Multi-element tip electrode mapping catheter |
US6471692B1 (en) | 1998-06-24 | 2002-10-29 | Laser Industries Ltd. | System and method for manipulating movement of an energy emitting device within a body cavity |
US6251107B1 (en) | 1998-06-25 | 2001-06-26 | Cardima, Inc. | Ep catheter |
US6537248B2 (en) * | 1998-07-07 | 2003-03-25 | Medtronic, Inc. | Helical needle apparatus for creating a virtual electrode used for the ablation of tissue |
US6706039B2 (en) * | 1998-07-07 | 2004-03-16 | Medtronic, Inc. | Method and apparatus for creating a bi-polar virtual electrode used for the ablation of tissue |
GB9816011D0 (en) | 1998-07-22 | 1998-09-23 | Habib Nagy A | Monitoring treatment using implantable telemetric sensors |
US6139543A (en) | 1998-07-22 | 2000-10-31 | Endovasix, Inc. | Flow apparatus for the disruption of occlusions |
US6440124B1 (en) | 1998-07-22 | 2002-08-27 | Endovasix, Inc. | Flexible flow apparatus and method for the disruption of occlusions |
GB9816012D0 (en) | 1998-07-22 | 1998-09-23 | Habib Nagy A | Treatment using implantable devices |
US6210400B1 (en) * | 1998-07-22 | 2001-04-03 | Endovasix, Inc. | Flexible flow apparatus and method for the disruption of occlusions |
SE521014C2 (en) | 1999-02-04 | 2003-09-23 | Prostalund Operations Ab | Apparatus for heat treatment of prostate |
GB9817078D0 (en) * | 1998-08-05 | 1998-10-07 | Habib Nagy A | Device for liver surgery |
US6196230B1 (en) * | 1998-09-10 | 2001-03-06 | Percardia, Inc. | Stent delivery system and method of use |
US6261304B1 (en) | 1998-09-10 | 2001-07-17 | Percardia, Inc. | Delivery methods for left ventricular conduit |
US8308719B2 (en) * | 1998-09-21 | 2012-11-13 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Apparatus and method for ablating tissue |
US6208881B1 (en) | 1998-10-20 | 2001-03-27 | Micropure Medical, Inc. | Catheter with thin film electrodes and method for making same |
US7901400B2 (en) | 1998-10-23 | 2011-03-08 | Covidien Ag | Method and system for controlling output of RF medical generator |
US7364577B2 (en) | 2002-02-11 | 2008-04-29 | Sherwood Services Ag | Vessel sealing system |
US7137980B2 (en) | 1998-10-23 | 2006-11-21 | Sherwood Services Ag | Method and system for controlling output of RF medical generator |
US6245062B1 (en) * | 1998-10-23 | 2001-06-12 | Afx, Inc. | Directional reflector shield assembly for a microwave ablation instrument |
US6221039B1 (en) * | 1998-10-26 | 2001-04-24 | Scimed Life Systems, Inc. | Multi-function surgical instrument |
US20050004642A1 (en) * | 1998-11-09 | 2005-01-06 | Medtronic, Inc. | Implantable medical lead including overlay |
US6171275B1 (en) | 1998-12-03 | 2001-01-09 | Cordis Webster, Inc. | Irrigated split tip electrode catheter |
US6210406B1 (en) | 1998-12-03 | 2001-04-03 | Cordis Webster, Inc. | Split tip electrode catheter and signal processing RF ablation system |
US20070066972A1 (en) * | 2001-11-29 | 2007-03-22 | Medwaves, Inc. | Ablation catheter apparatus with one or more electrodes |
US7449019B2 (en) * | 1999-01-25 | 2008-11-11 | Smith & Nephew, Inc. | Intervertebral decompression |
US6217528B1 (en) | 1999-02-11 | 2001-04-17 | Scimed Life Systems, Inc. | Loop structure having improved tissue contact capability |
US20020156471A1 (en) * | 1999-03-09 | 2002-10-24 | Stern Roger A. | Method for treatment of tissue |
US8285393B2 (en) * | 1999-04-16 | 2012-10-09 | Laufer Michael D | Device for shaping infarcted heart tissue and method of using the device |
AU4696100A (en) | 1999-05-04 | 2000-11-17 | Curon Medical, Inc. | Electrodes for creating lesions in tissue regions at or near a sphincter |
US6277113B1 (en) * | 1999-05-28 | 2001-08-21 | Afx, Inc. | Monopole tip for ablation catheter and methods for using same |
US6478793B1 (en) | 1999-06-11 | 2002-11-12 | Sherwood Services Ag | Ablation treatment of bone metastases |
US6306132B1 (en) * | 1999-06-17 | 2001-10-23 | Vivant Medical | Modular biopsy and microwave ablation needle delivery apparatus adapted to in situ assembly and method of use |
US20070282324A1 (en) * | 1999-07-19 | 2007-12-06 | Matthias Vaska | Apparatus and method for diagnosis and therapy of electrophysiological disease |
CA2377583A1 (en) * | 1999-07-19 | 2001-01-25 | Epicor, Inc. | Apparatus and method for ablating tissue |
US20050137715A1 (en) * | 1999-08-05 | 2005-06-23 | Broncus Technologies, Inc. | Methods and devices for maintaining patency of surgically created channels in a body organ |
US20040073155A1 (en) * | 2000-01-14 | 2004-04-15 | Broncus Technologies, Inc. | Methods and devices for maintaining patency of surgically created channels in tissue |
US7022088B2 (en) * | 1999-08-05 | 2006-04-04 | Broncus Technologies, Inc. | Devices for applying energy to tissue |
US20030130657A1 (en) * | 1999-08-05 | 2003-07-10 | Tom Curtis P. | Devices for applying energy to tissue |
US7815590B2 (en) * | 1999-08-05 | 2010-10-19 | Broncus Technologies, Inc. | Devices for maintaining patency of surgically created channels in tissue |
US20050060044A1 (en) * | 1999-08-05 | 2005-03-17 | Ed Roschak | Methods and devices for maintaining patency of surgically created channels in a body organ |
EP1143864B1 (en) * | 1999-08-05 | 2004-02-04 | Broncus Technologies, Inc. | Methods and devices for creating collateral channels in the lungs |
US7422563B2 (en) * | 1999-08-05 | 2008-09-09 | Broncus Technologies, Inc. | Multifunctional tip catheter for applying energy to tissue and detecting the presence of blood flow |
US6165372A (en) * | 1999-08-11 | 2000-12-26 | Betzdearborn Inc. | Injection quill for water treatment |
AU7880600A (en) * | 1999-08-12 | 2001-03-13 | Somnus Medical Technologies, Inc. | Nerve stimulation and tissue ablation apparatus and method |
US20040147911A1 (en) * | 1999-08-25 | 2004-07-29 | Cardiofocus, Inc. | Surgical ablation instruments for forming an encircling lesion |
US20040167503A1 (en) * | 1999-08-25 | 2004-08-26 | Cardiofocus, Inc. | Malleable surgical ablation instruments |
US6332881B1 (en) | 1999-09-01 | 2001-12-25 | Cardima, Inc. | Surgical ablation tool |
EP1218801A4 (en) | 1999-09-08 | 2009-07-01 | Mederi Therapeutics Inc | Systems and methods for monitoring and controlling use of medical devices |
EP1210024A1 (en) | 1999-09-08 | 2002-06-05 | Curon Medical, Inc. | System for controlling a family of treatment devices |
US6514248B1 (en) * | 1999-10-15 | 2003-02-04 | Neothermia Corporation | Accurate cutting about and into tissue volumes with electrosurgically deployed electrodes |
US20060095032A1 (en) | 1999-11-16 | 2006-05-04 | Jerome Jackson | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
US20040215235A1 (en) | 1999-11-16 | 2004-10-28 | Barrx, Inc. | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
US6551310B1 (en) * | 1999-11-16 | 2003-04-22 | Robert A. Ganz | System and method of treating abnormal tissue in the human esophagus |
US6542781B1 (en) | 1999-11-22 | 2003-04-01 | Scimed Life Systems, Inc. | Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue |
US6529756B1 (en) | 1999-11-22 | 2003-03-04 | Scimed Life Systems, Inc. | Apparatus for mapping and coagulating soft tissue in or around body orifices |
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 |
US6645199B1 (en) | 1999-11-22 | 2003-11-11 | Scimed Life Systems, Inc. | Loop structures for supporting diagnostic and therapeutic elements contact with body tissue and expandable push devices for use with same |
US6547776B1 (en) | 2000-01-03 | 2003-04-15 | Curon Medical, Inc. | Systems and methods for treating tissue in the crura |
US7033352B1 (en) * | 2000-01-18 | 2006-04-25 | Afx, Inc. | Flexible ablation instrument |
US7706882B2 (en) * | 2000-01-19 | 2010-04-27 | Medtronic, Inc. | Methods of using high intensity focused ultrasound to form an ablated tissue area |
US6447443B1 (en) * | 2001-01-13 | 2002-09-10 | Medtronic, Inc. | Method for organ positioning and stabilization |
US6595934B1 (en) * | 2000-01-19 | 2003-07-22 | Medtronic Xomed, Inc. | Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
US6692450B1 (en) * | 2000-01-19 | 2004-02-17 | Medtronic Xomed, Inc. | Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same |
US8221402B2 (en) * | 2000-01-19 | 2012-07-17 | Medtronic, Inc. | Method for guiding a medical device |
US7137395B2 (en) * | 2000-02-29 | 2006-11-21 | The Johns Hopkins University | Circumferential pulmonary vein ablation using a laser and fiberoptic balloon catheter |
US6558385B1 (en) | 2000-09-22 | 2003-05-06 | Tissuelink Medical, Inc. | Fluid-assisted medical device |
US6689131B2 (en) | 2001-03-08 | 2004-02-10 | Tissuelink Medical, Inc. | Electrosurgical device having a tissue reduction sensor |
US7386341B2 (en) * | 2000-03-13 | 2008-06-10 | Arrow International, Inc. | Instrument and method for delivery of anaesthetic drugs |
US6530899B1 (en) * | 2000-03-27 | 2003-03-11 | Jomed Inc. | Catheter having a spear shaped tip |
US6673068B1 (en) * | 2000-04-12 | 2004-01-06 | Afx, Inc. | Electrode arrangement for use in a medical instrument |
WO2001082811A1 (en) * | 2000-04-27 | 2001-11-08 | Medtronic, Inc. | System and method for assessing transmurality of ablation lesions |
AU2001253654A1 (en) | 2000-04-27 | 2001-11-12 | Medtronic, Inc. | Vibration sensitive ablation apparatus and method |
US6546935B2 (en) * | 2000-04-27 | 2003-04-15 | Atricure, Inc. | Method for transmural ablation |
US6905498B2 (en) | 2000-04-27 | 2005-06-14 | Atricure Inc. | Transmural ablation device with EKG sensor and pacing electrode |
US6932811B2 (en) | 2000-04-27 | 2005-08-23 | Atricure, Inc. | Transmural ablation device with integral EKG sensor |
US20020107514A1 (en) | 2000-04-27 | 2002-08-08 | Hooven Michael D. | Transmural ablation device with parallel jaws |
US6514250B1 (en) * | 2000-04-27 | 2003-02-04 | Medtronic, Inc. | Suction stabilized epicardial ablation devices |
US8845632B2 (en) | 2000-05-18 | 2014-09-30 | Mederi Therapeutics, Inc. | Graphical user interface for monitoring and controlling use of medical devices |
US6547784B1 (en) * | 2000-06-23 | 2003-04-15 | Ethicon, Inc. | System and method for placement of a surgical instrument in a body cavity |
US7306591B2 (en) | 2000-10-02 | 2007-12-11 | Novasys Medical, Inc. | Apparatus and methods for treating female urinary incontinence |
US6926669B1 (en) * | 2000-10-10 | 2005-08-09 | Medtronic, Inc. | Heart wall ablation/mapping catheter and method |
US20040087936A1 (en) * | 2000-11-16 | 2004-05-06 | Barrx, Inc. | System and method for treating abnormal tissue in an organ having a layered tissue structure |
US7549987B2 (en) | 2000-12-09 | 2009-06-23 | Tsunami Medtech, Llc | Thermotherapy device |
US9433457B2 (en) | 2000-12-09 | 2016-09-06 | Tsunami Medtech, Llc | Medical instruments and techniques for thermally-mediated therapies |
US20020087151A1 (en) * | 2000-12-29 | 2002-07-04 | Afx, Inc. | Tissue ablation apparatus with a sliding ablation instrument and method |
US7740623B2 (en) | 2001-01-13 | 2010-06-22 | Medtronic, Inc. | Devices and methods for interstitial injection of biologic agents into tissue |
US20040138621A1 (en) | 2003-01-14 | 2004-07-15 | Jahns Scott E. | Devices and methods for interstitial injection of biologic agents into tissue |
US6695839B2 (en) | 2001-02-08 | 2004-02-24 | Oratec Interventions, Inc. | Method and apparatus for treatment of disrupted articular cartilage |
US6918906B2 (en) * | 2001-03-30 | 2005-07-19 | Gary L. Long | Endoscopic ablation system with improved electrode geometry |
US20020177847A1 (en) * | 2001-03-30 | 2002-11-28 | Long Gary L. | Endoscopic ablation system with flexible coupling |
US7097644B2 (en) * | 2001-03-30 | 2006-08-29 | Ethicon Endo-Surgery, Inc. | Medical device with improved wall construction |
US20030181900A1 (en) * | 2002-03-25 | 2003-09-25 | Long Gary L. | Endoscopic ablation system with a plurality of electrodes |
US6663627B2 (en) | 2001-04-26 | 2003-12-16 | Medtronic, Inc. | Ablation system and method of use |
US7959626B2 (en) | 2001-04-26 | 2011-06-14 | Medtronic, Inc. | Transmural ablation systems and methods |
US6699240B2 (en) * | 2001-04-26 | 2004-03-02 | Medtronic, Inc. | Method and apparatus for tissue ablation |
US6648883B2 (en) * | 2001-04-26 | 2003-11-18 | Medtronic, Inc. | Ablation system and method of use |
US6807968B2 (en) * | 2001-04-26 | 2004-10-26 | Medtronic, Inc. | Method and system for treatment of atrial tachyarrhythmias |
US6837867B2 (en) * | 2001-04-30 | 2005-01-04 | Biosense Webster, Inc. | Steerable catheter with reinforced tip |
US7846096B2 (en) * | 2001-05-29 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Method for monitoring of medical treatment using pulse-echo ultrasound |
US20030092988A1 (en) | 2001-05-29 | 2003-05-15 | Makin Inder Raj S. | Staging medical treatment using ultrasound |
US6638276B2 (en) | 2001-06-06 | 2003-10-28 | Oratec Interventions, Inc. | Intervertebral disc device employing prebent sheath |
US7077842B1 (en) * | 2001-08-03 | 2006-07-18 | Cosman Jr Eric R | Over-the-wire high frequency electrode |
DE10141487B4 (en) | 2001-08-24 | 2005-09-15 | Lascor Gmbh Laser-Medizintechnik | Cardiac catheter with probe body with cavity |
US6569114B2 (en) | 2001-08-31 | 2003-05-27 | Biosense Webster, Inc. | Steerable catheter with struts |
US20050060042A1 (en) * | 2001-09-04 | 2005-03-17 | Broncus Technologies, Inc. | Methods and devices for maintaining surgically created channels in a body organ |
US20050137611A1 (en) * | 2001-09-04 | 2005-06-23 | Broncus Technologies, Inc. | Methods and devices for maintaining surgically created channels in a body organ |
US7708712B2 (en) | 2001-09-04 | 2010-05-04 | Broncus Technologies, Inc. | Methods and devices for maintaining patency of surgically created channels in a body organ |
JP4341907B2 (en) | 2001-09-05 | 2009-10-14 | セイリアント・サージカル・テクノロジーズ・インコーポレーテッド | Fluid-assisted medical device, system and method |
US7128739B2 (en) * | 2001-11-02 | 2006-10-31 | Vivant Medical, Inc. | High-strength microwave antenna assemblies and methods of use |
US6878147B2 (en) * | 2001-11-02 | 2005-04-12 | Vivant Medical, Inc. | High-strength microwave antenna assemblies |
WO2003047448A1 (en) * | 2001-11-29 | 2003-06-12 | Medwaves, Inc. | Radio-frequency-based catheter system with improved deflection and steering mechanisms |
US8444636B2 (en) | 2001-12-07 | 2013-05-21 | Tsunami Medtech, Llc | Medical instrument and method of use |
US6656175B2 (en) * | 2001-12-11 | 2003-12-02 | Medtronic, Inc. | Method and system for treatment of atrial tachyarrhythmias |
US6827715B2 (en) * | 2002-01-25 | 2004-12-07 | Medtronic, Inc. | System and method of performing an electrosurgical procedure |
US7967816B2 (en) | 2002-01-25 | 2011-06-28 | Medtronic, Inc. | Fluid-assisted electrosurgical instrument with shapeable electrode |
US20080275439A1 (en) * | 2002-01-25 | 2008-11-06 | David Francischelli | Cardiac ablation and electrical interface system and instrument |
US6790206B2 (en) * | 2002-01-31 | 2004-09-14 | Scimed Life Systems, Inc. | Compensation for power variation along patient cables |
EP1474057B1 (en) * | 2002-02-12 | 2007-03-28 | Oratec Interventions, Inc | Radiofrequency arthroscopic ablation device |
US7192427B2 (en) * | 2002-02-19 | 2007-03-20 | Afx, Inc. | Apparatus and method for assessing transmurality of a tissue ablation |
US9216053B2 (en) | 2002-03-05 | 2015-12-22 | Avent, Inc. | Elongate member providing a variation in radiopacity |
US7137981B2 (en) * | 2002-03-25 | 2006-11-21 | Ethicon Endo-Surgery, Inc. | Endoscopic ablation system with a distally mounted image sensor |
US7197363B2 (en) | 2002-04-16 | 2007-03-27 | Vivant Medical, Inc. | Microwave antenna having a curved configuration |
US6752767B2 (en) * | 2002-04-16 | 2004-06-22 | Vivant Medical, Inc. | Localization element with energized tip |
US6932813B2 (en) * | 2002-05-03 | 2005-08-23 | Scimed Life Systems, Inc. | Ablation systems including insulated energy transmitting elements |
DE60315970T2 (en) | 2002-05-06 | 2008-05-21 | Covidien Ag | BLOOD DETECTOR FOR CHECKING AN ELECTROSURGICAL UNIT |
US6932804B2 (en) | 2003-01-21 | 2005-08-23 | The Regents Of The University Of California | System and method for forming a non-ablative cardiac conduction block |
US20040106896A1 (en) * | 2002-11-29 | 2004-06-03 | The Regents Of The University Of California | System and method for forming a non-ablative cardiac conduction block |
US20040002740A1 (en) * | 2002-05-08 | 2004-01-01 | The Regents Of The University Of California | System and method for forming a non-ablative cardiac conduction block |
US7294143B2 (en) * | 2002-05-16 | 2007-11-13 | Medtronic, Inc. | Device and method for ablation of cardiac tissue |
US7118566B2 (en) * | 2002-05-16 | 2006-10-10 | Medtronic, Inc. | Device and method for needle-less interstitial injection of fluid for ablation of cardiac tissue |
US6960203B2 (en) * | 2002-06-26 | 2005-11-01 | Ethicon, Inc. | Thermal ablation with deployable cage |
US7151965B2 (en) * | 2002-07-19 | 2006-12-19 | Oscor Inc. | Device and method for delivering cardiac leads |
US7560269B2 (en) * | 2002-12-20 | 2009-07-14 | Acea Biosciences, Inc. | Real time electronic cell sensing system and applications for cytotoxicity profiling and compound assays |
US7291161B2 (en) | 2002-10-02 | 2007-11-06 | Atricure, Inc. | Articulated clamping member |
AU2003288945A1 (en) | 2002-10-29 | 2004-05-25 | Tissuelink Medical, Inc. | Fluid-assisted electrosurgical scissors and methods |
US7083620B2 (en) * | 2002-10-30 | 2006-08-01 | Medtronic, Inc. | Electrosurgical hemostat |
US7317950B2 (en) * | 2002-11-16 | 2008-01-08 | The Regents Of The University Of California | Cardiac stimulation system with delivery of conductive agent |
US7130700B2 (en) * | 2002-11-19 | 2006-10-31 | Medtronic, Inc. | Multilumen body for an implantable medical device |
US7255694B2 (en) * | 2002-12-10 | 2007-08-14 | Sherwood Services Ag | Variable output crest factor electrosurgical generator |
US7044948B2 (en) | 2002-12-10 | 2006-05-16 | Sherwood Services Ag | Circuit for controlling arc energy from an electrosurgical generator |
US7481798B2 (en) | 2003-03-20 | 2009-01-27 | Boston Scientific Scimed, Inc. | Devices and methods for delivering therapeutic or diagnostic agents |
US20050020965A1 (en) * | 2003-03-20 | 2005-01-27 | Scimed Life Systems, Inc. | Devices and methods for delivering agents to tissue region while preventing leakage |
US8512290B2 (en) * | 2003-03-20 | 2013-08-20 | Boston Scientific Scimed, Inc. | Devices and methods for delivering therapeutic or diagnostic agents |
US7293562B2 (en) * | 2003-03-27 | 2007-11-13 | Cierra, Inc. | Energy based devices and methods for treatment of anatomic tissue defects |
US7186251B2 (en) | 2003-03-27 | 2007-03-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US7972330B2 (en) | 2003-03-27 | 2011-07-05 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
US8021362B2 (en) * | 2003-03-27 | 2011-09-20 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
WO2004087235A2 (en) * | 2003-03-27 | 2004-10-14 | Cierra, Inc. | Methods and apparatus for treatment of patent foramen ovale |
US6939348B2 (en) | 2003-03-27 | 2005-09-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US7165552B2 (en) * | 2003-03-27 | 2007-01-23 | Cierra, Inc. | Methods and apparatus for treatment of patent foramen ovale |
US7288092B2 (en) * | 2003-04-23 | 2007-10-30 | Atricure, Inc. | Method and apparatus for ablating cardiac tissue with guide facility |
US7497857B2 (en) * | 2003-04-29 | 2009-03-03 | Medtronic, Inc. | Endocardial dispersive electrode for use with a monopolar RF ablation pen |
US7722601B2 (en) | 2003-05-01 | 2010-05-25 | Covidien Ag | Method and system for programming and controlling an electrosurgical generator system |
US7311701B2 (en) * | 2003-06-10 | 2007-12-25 | Cierra, Inc. | Methods and apparatus for non-invasively treating atrial fibrillation using high intensity focused ultrasound |
US7311703B2 (en) | 2003-07-18 | 2007-12-25 | Vivant Medical, Inc. | Devices and methods for cooling microwave antennas |
US8308682B2 (en) | 2003-07-18 | 2012-11-13 | Broncus Medical Inc. | Devices for maintaining patency of surgically created channels in tissue |
US8002740B2 (en) * | 2003-07-18 | 2011-08-23 | Broncus Technologies, Inc. | Devices for maintaining patency of surgically created channels in tissue |
US20050059448A1 (en) * | 2003-09-11 | 2005-03-17 | Scott Sims | Method and apparatus for playing card game |
EP1691681A4 (en) * | 2003-09-26 | 2009-06-24 | Hansen Medical Inc | Left atrial access apparatus and methods |
GB0322766D0 (en) * | 2003-09-29 | 2003-10-29 | Emcision Ltd | Surgical resection device |
US8579892B2 (en) | 2003-10-07 | 2013-11-12 | Tsunami Medtech, Llc | Medical system and method of use |
AU2003284929B2 (en) | 2003-10-23 | 2010-07-22 | Covidien Ag | Redundant temperature monitoring in electrosurgical systems for safety mitigation |
WO2005050151A1 (en) | 2003-10-23 | 2005-06-02 | Sherwood Services Ag | Thermocouple measurement circuit |
US7232437B2 (en) * | 2003-10-30 | 2007-06-19 | Medical Cv, Inc. | Assessment of lesion transmurality |
US7396336B2 (en) | 2003-10-30 | 2008-07-08 | Sherwood Services Ag | Switched resonant ultrasonic power amplifier system |
WO2005044124A1 (en) * | 2003-10-30 | 2005-05-19 | Medical Cv, Inc. | Apparatus and method for laser treatment |
US7238179B2 (en) * | 2003-10-30 | 2007-07-03 | Medical Cv, Inc. | Apparatus and method for guided ablation treatment |
US7238180B2 (en) * | 2003-10-30 | 2007-07-03 | Medicalcv Inc. | Guided ablation with end-fire fiber |
US7131860B2 (en) | 2003-11-20 | 2006-11-07 | Sherwood Services Ag | Connector systems for electrosurgical generator |
US7150745B2 (en) | 2004-01-09 | 2006-12-19 | Barrx Medical, Inc. | Devices and methods for treatment of luminal tissue |
US7727232B1 (en) | 2004-02-04 | 2010-06-01 | Salient Surgical Technologies, Inc. | Fluid-assisted medical devices and methods |
US7766905B2 (en) | 2004-02-12 | 2010-08-03 | Covidien Ag | Method and system for continuity testing of medical electrodes |
US7780662B2 (en) | 2004-03-02 | 2010-08-24 | Covidien Ag | Vessel sealing system using capacitive RF dielectric heating |
US20050228286A1 (en) * | 2004-04-07 | 2005-10-13 | Messerly Jeffrey D | Medical system having a rotatable ultrasound source and a piercing tip |
US7530980B2 (en) * | 2004-04-14 | 2009-05-12 | Atricure, Inc | Bipolar transmural ablation method and apparatus |
US20050240123A1 (en) * | 2004-04-14 | 2005-10-27 | Mast T D | Ultrasound medical treatment system and method |
US20050240124A1 (en) * | 2004-04-15 | 2005-10-27 | Mast T D | Ultrasound medical treatment system and method |
US7494467B2 (en) * | 2004-04-16 | 2009-02-24 | Ethicon Endo-Surgery, Inc. | Medical system having multiple ultrasound transducers or an ultrasound transducer and an RF electrode |
US20050251116A1 (en) * | 2004-05-05 | 2005-11-10 | Minnow Medical, Llc | Imaging and eccentric atherosclerotic material laser remodeling and/or ablation catheter |
US7704249B2 (en) * | 2004-05-07 | 2010-04-27 | Arthrocare Corporation | Apparatus and methods for electrosurgical ablation and resection of target tissue |
US8333764B2 (en) * | 2004-05-12 | 2012-12-18 | Medtronic, Inc. | Device and method for determining tissue thickness and creating cardiac ablation lesions |
WO2005112812A1 (en) | 2004-05-14 | 2005-12-01 | Medtronic, Inc. | Method and devices for treating atrial fibrillation by mass ablation |
US20050256405A1 (en) * | 2004-05-17 | 2005-11-17 | Makin Inder Raj S | Ultrasound-based procedure for uterine medical treatment |
US7883468B2 (en) * | 2004-05-18 | 2011-02-08 | Ethicon Endo-Surgery, Inc. | Medical system having an ultrasound source and an acoustic coupling medium |
US20050261587A1 (en) * | 2004-05-20 | 2005-11-24 | Makin Inder R S | Ultrasound medical system and method |
US7951095B2 (en) * | 2004-05-20 | 2011-05-31 | Ethicon Endo-Surgery, Inc. | Ultrasound medical system |
US7695436B2 (en) * | 2004-05-21 | 2010-04-13 | Ethicon Endo-Surgery, Inc. | Transmit apodization of an ultrasound transducer array |
US7473250B2 (en) * | 2004-05-21 | 2009-01-06 | Ethicon Endo-Surgery, Inc. | Ultrasound medical system and method |
US20050261588A1 (en) * | 2004-05-21 | 2005-11-24 | Makin Inder Raj S | Ultrasound medical system |
WO2005120374A1 (en) * | 2004-06-02 | 2005-12-22 | Medtronic, Inc. | Compound bipolar ablation device and method |
EP1750608B1 (en) * | 2004-06-02 | 2012-10-03 | Medtronic, Inc. | Ablation device with jaws |
US20100145331A1 (en) * | 2004-06-02 | 2010-06-10 | Chrisitian Steven C | Loop Ablation Apparatus and Method |
WO2005120375A2 (en) * | 2004-06-02 | 2005-12-22 | Medtronic, Inc. | Loop ablation apparatus and method |
ATE516762T1 (en) * | 2004-06-02 | 2011-08-15 | Medtronic Inc | ABLATION AND STAPLE INSTRUMENT |
US7806839B2 (en) * | 2004-06-14 | 2010-10-05 | Ethicon Endo-Surgery, Inc. | System and method for ultrasound therapy using grating lobes |
US8663245B2 (en) | 2004-06-18 | 2014-03-04 | Medtronic, Inc. | Device for occlusion of a left atrial appendage |
US8409219B2 (en) | 2004-06-18 | 2013-04-02 | Medtronic, Inc. | Method and system for placement of electrical lead inside heart |
US8926635B2 (en) * | 2004-06-18 | 2015-01-06 | Medtronic, Inc. | Methods and devices for occlusion of an atrial appendage |
WO2006009729A2 (en) * | 2004-06-18 | 2006-01-26 | Medtronic, Inc. | Methods and devices for occlusion of an atrial appendage |
US7367975B2 (en) | 2004-06-21 | 2008-05-06 | Cierra, Inc. | Energy based devices and methods for treatment of anatomic tissue defects |
US7533439B2 (en) * | 2004-06-25 | 2009-05-19 | Healthy Gain Investments Limited | Handle assembly for a cleaning apparatus |
US7232438B2 (en) | 2004-07-09 | 2007-06-19 | Ethicon Endo-Surgery, Inc. | Ablation device with clear probe |
EP1786499A2 (en) * | 2004-07-19 | 2007-05-23 | Broncus Technologies, Inc. | Methods and devices for maintaining patency of surgically created channels in a body organ |
US8409167B2 (en) | 2004-07-19 | 2013-04-02 | Broncus Medical Inc | Devices for delivering substances through an extra-anatomic opening created in an airway |
US7134543B2 (en) * | 2004-09-22 | 2006-11-14 | Frito-Lay North America, Inc. | Containment apparatus for multi-pass ovens |
US7776035B2 (en) | 2004-10-08 | 2010-08-17 | Covidien Ag | Cool-tip combined electrode introducer |
US7282049B2 (en) | 2004-10-08 | 2007-10-16 | Sherwood Services Ag | Electrosurgical system employing multiple electrodes and method thereof |
US7553309B2 (en) | 2004-10-08 | 2009-06-30 | Covidien Ag | Electrosurgical system employing multiple electrodes and method thereof |
US7628786B2 (en) | 2004-10-13 | 2009-12-08 | Covidien Ag | Universal foot switch contact port |
ES2645340T3 (en) * | 2004-11-16 | 2017-12-05 | Uptake Medical Technology Inc. | Lung treatment device |
US7731715B2 (en) * | 2004-12-10 | 2010-06-08 | Edwards Lifesciences Corporation | Ablative treatment of atrial fibrillation via the coronary sinus |
US7467075B2 (en) * | 2004-12-23 | 2008-12-16 | Covidien Ag | Three-dimensional finite-element code for electrosurgery and thermal ablation simulations |
US7156570B2 (en) * | 2004-12-30 | 2007-01-02 | Cotapaxi Custom Design And Manufacturing, Llc | Implement grip |
US8029528B2 (en) * | 2005-01-03 | 2011-10-04 | Atricure, Inc. | Instrument guide and method for use |
US20060149121A1 (en) * | 2005-01-03 | 2006-07-06 | Hughett James D Sr | Instrument guide and method for use |
US20070156210A1 (en) * | 2005-01-14 | 2007-07-05 | Co-Repair, Inc., A California Corporation | Method for the treatment of heart tissue |
US20070156209A1 (en) * | 2005-01-14 | 2007-07-05 | Co-Repair, Inc. | System for the treatment of heart tissue |
US7455670B2 (en) * | 2005-01-14 | 2008-11-25 | Co-Repair, Inc. | System and method for the treatment of heart tissue |
US7959601B2 (en) | 2005-02-14 | 2011-06-14 | Biosense Webster, Inc. | Steerable catheter with in-plane deflection |
US7862563B1 (en) | 2005-02-18 | 2011-01-04 | Cosman Eric R | Integral high frequency electrode |
US9474564B2 (en) | 2005-03-31 | 2016-10-25 | Covidien Ag | Method and system for compensating for external impedance of an energy carrying component when controlling an electrosurgical generator |
JP5033787B2 (en) * | 2005-04-11 | 2012-09-26 | テルモ株式会社 | Method and apparatus for effecting closure of a lamellar tissue defect |
US20060253025A1 (en) * | 2005-04-21 | 2006-11-09 | Kaufman Jonathan J | Ultrasonic Bone Assessment Apparatus and Method |
US7799019B2 (en) * | 2005-05-10 | 2010-09-21 | Vivant Medical, Inc. | Reinforced high strength microwave antenna |
US8376990B2 (en) | 2005-05-19 | 2013-02-19 | Biosense Webster, Inc. | Steerable catheter with distal tip orientation sheaths |
US8932208B2 (en) * | 2005-05-26 | 2015-01-13 | Maquet Cardiovascular Llc | Apparatus and methods for performing minimally-invasive surgical procedures |
US20060270900A1 (en) * | 2005-05-26 | 2006-11-30 | Chin Albert K | Apparatus and methods for performing ablation |
AU2006252347A1 (en) * | 2005-06-01 | 2006-12-07 | Broncus Technologies, Inc. | Methods and devices for maintaining surgically created channels in a body organ |
US20070016184A1 (en) * | 2005-07-14 | 2007-01-18 | Ethicon Endo-Surgery, Inc. | Medical-treatment electrode assembly and method for medical treatment |
US20070032785A1 (en) * | 2005-08-03 | 2007-02-08 | Jennifer Diederich | Tissue evacuation device |
US8784336B2 (en) | 2005-08-24 | 2014-07-22 | C. R. Bard, Inc. | Stylet apparatuses and methods of manufacture |
US20070049911A1 (en) * | 2005-08-26 | 2007-03-01 | Brown Joe D | Endovascular method and apparatus with feedback |
US20180250073A9 (en) * | 2005-08-26 | 2018-09-06 | Joe Denton Brown | Endovascular Method and Apparatus with Electrical Feedback |
US20070073281A1 (en) * | 2005-09-16 | 2007-03-29 | Medicalcv, Inc. | Guided ablation with motion control |
US20070073277A1 (en) * | 2005-09-16 | 2007-03-29 | Medicalcv, Inc. | Controlled guided ablation treatment |
US20070073280A1 (en) * | 2005-09-16 | 2007-03-29 | Medicalcv, Inc. | End-fire guided ablation |
US7879031B2 (en) * | 2005-09-27 | 2011-02-01 | Covidien Ag | Cooled RF ablation needle |
US20070078454A1 (en) * | 2005-09-30 | 2007-04-05 | Mcpherson James W | System and method for creating lesions using bipolar electrodes |
US20070078453A1 (en) * | 2005-10-04 | 2007-04-05 | Johnson Kristin D | System and method for performing cardiac ablation |
US8734438B2 (en) | 2005-10-21 | 2014-05-27 | Covidien Ag | Circuit and method for reducing stored energy in an electrosurgical generator |
US7997278B2 (en) | 2005-11-23 | 2011-08-16 | Barrx Medical, Inc. | Precision ablating method |
US7959627B2 (en) | 2005-11-23 | 2011-06-14 | Barrx Medical, Inc. | Precision ablating device |
US8702694B2 (en) | 2005-11-23 | 2014-04-22 | Covidien Lp | Auto-aligning ablating device and method of use |
US7947039B2 (en) | 2005-12-12 | 2011-05-24 | Covidien Ag | Laparoscopic apparatus for performing electrosurgical procedures |
EP1971386B1 (en) * | 2005-12-23 | 2013-11-13 | Cathrx Ltd | Irrigation catheter |
CA2574934C (en) | 2006-01-24 | 2015-12-29 | Sherwood Services Ag | System and method for closed loop monitoring of monopolar electrosurgical apparatus |
US8685016B2 (en) | 2006-01-24 | 2014-04-01 | Covidien Ag | System and method for tissue sealing |
US7972328B2 (en) | 2006-01-24 | 2011-07-05 | Covidien Ag | System and method for tissue sealing |
US8147485B2 (en) | 2006-01-24 | 2012-04-03 | Covidien Ag | System and method for tissue sealing |
US8216223B2 (en) | 2006-01-24 | 2012-07-10 | Covidien Ag | System and method for tissue sealing |
US7513896B2 (en) | 2006-01-24 | 2009-04-07 | Covidien Ag | Dual synchro-resonant electrosurgical apparatus with bi-directional magnetic coupling |
US9186200B2 (en) | 2006-01-24 | 2015-11-17 | Covidien Ag | System and method for tissue sealing |
CA2574935A1 (en) | 2006-01-24 | 2007-07-24 | Sherwood Services Ag | A method and system for controlling an output of a radio-frequency medical generator having an impedance based control algorithm |
US20070185479A1 (en) * | 2006-02-06 | 2007-08-09 | Liming Lau | Methods and devices for performing ablation and assessing efficacy thereof |
US7976542B1 (en) | 2006-03-02 | 2011-07-12 | Cosman Eric R | Adjustable high frequency electrode |
US7651493B2 (en) | 2006-03-03 | 2010-01-26 | Covidien Ag | System and method for controlling electrosurgical snares |
US7648499B2 (en) | 2006-03-21 | 2010-01-19 | Covidien Ag | System and method for generating radio frequency energy |
US20070225697A1 (en) * | 2006-03-23 | 2007-09-27 | Ketan Shroff | Apparatus and methods for cardiac ablation |
US7651492B2 (en) | 2006-04-24 | 2010-01-26 | Covidien Ag | Arc based adaptive control system for an electrosurgical unit |
US8795270B2 (en) * | 2006-04-24 | 2014-08-05 | Covidien Ag | System and method for ablating tissue |
US20070258838A1 (en) * | 2006-05-03 | 2007-11-08 | Sherwood Services Ag | Peristaltic cooling pump system |
US20070260240A1 (en) | 2006-05-05 | 2007-11-08 | Sherwood Services Ag | Soft tissue RF transection and resection device |
US8753334B2 (en) | 2006-05-10 | 2014-06-17 | Covidien Ag | System and method for reducing leakage current in an electrosurgical generator |
US20080039746A1 (en) | 2006-05-25 | 2008-02-14 | Medtronic, Inc. | Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
DE102006034389B4 (en) * | 2006-07-25 | 2018-06-07 | Siemens Healthcare Gmbh | Catheter for use in magnetic resonance assisted interventional procedures |
US7763018B2 (en) * | 2006-07-28 | 2010-07-27 | Covidien Ag | Cool-tip thermocouple including two-piece hub |
US20080039727A1 (en) * | 2006-08-08 | 2008-02-14 | Eilaz Babaev | Ablative Cardiac Catheter System |
US7731717B2 (en) | 2006-08-08 | 2010-06-08 | Covidien Ag | System and method for controlling RF output during tissue sealing |
US8034049B2 (en) | 2006-08-08 | 2011-10-11 | Covidien Ag | System and method for measuring initial tissue impedance |
US20080039879A1 (en) * | 2006-08-09 | 2008-02-14 | Chin Albert K | Devices and methods for atrial appendage exclusion |
WO2008024714A1 (en) | 2006-08-21 | 2008-02-28 | Mayo Foundation For Medical Education And Research | Coagulum formation controlling apparatus |
US7794457B2 (en) | 2006-09-28 | 2010-09-14 | Covidien Ag | Transformer for RF voltage sensing |
US8068921B2 (en) | 2006-09-29 | 2011-11-29 | Vivant Medical, Inc. | Microwave antenna assembly and method of using the same |
WO2008045877A2 (en) * | 2006-10-10 | 2008-04-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Electrode tip and ablation system |
US8388546B2 (en) | 2006-10-23 | 2013-03-05 | Bard Access Systems, Inc. | Method of locating the tip of a central venous catheter |
US7794407B2 (en) | 2006-10-23 | 2010-09-14 | Bard Access Systems, Inc. | Method of locating the tip of a central venous catheter |
US20100286477A1 (en) * | 2009-05-08 | 2010-11-11 | Ouyang Xiaolong | Internal tissue visualization system comprising a rf-shielded visualization sensor module |
US7993323B2 (en) | 2006-11-13 | 2011-08-09 | Uptake Medical Corp. | High pressure and high temperature vapor catheters and systems |
US8986298B2 (en) * | 2006-11-17 | 2015-03-24 | Biosense Webster, Inc. | Catheter with omni-directional optical tip having isolated optical paths |
US20080140069A1 (en) * | 2006-12-07 | 2008-06-12 | Cierra, Inc. | Multi-electrode apparatus for tissue welding and ablation |
US8211099B2 (en) | 2007-01-31 | 2012-07-03 | Tyco Healthcare Group Lp | Thermal feedback systems and methods of using the same |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
WO2008112870A2 (en) * | 2007-03-13 | 2008-09-18 | University Of Virginia Patent Foundation | Epicardial ablation catheter and method of use |
WO2008118737A1 (en) * | 2007-03-22 | 2008-10-02 | University Of Virginia Patent Foundation | Electrode catheter for ablation purposes and related method thereof |
US7998139B2 (en) | 2007-04-25 | 2011-08-16 | Vivant Medical, Inc. | Cooled helical antenna for microwave ablation |
WO2008137757A1 (en) | 2007-05-04 | 2008-11-13 | Barrx Medical, Inc. | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US8777941B2 (en) | 2007-05-10 | 2014-07-15 | Covidien Lp | Adjustable impedance electrosurgical electrodes |
US8353901B2 (en) | 2007-05-22 | 2013-01-15 | Vivant Medical, Inc. | Energy delivery conduits for use with electrosurgical devices |
US9023024B2 (en) | 2007-06-20 | 2015-05-05 | Covidien Lp | Reflective power monitoring for microwave applications |
US8784338B2 (en) | 2007-06-22 | 2014-07-22 | Covidien Lp | Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size |
US9486269B2 (en) * | 2007-06-22 | 2016-11-08 | Covidien Lp | Electrosurgical systems and cartridges for use therewith |
US20090005766A1 (en) * | 2007-06-28 | 2009-01-01 | Joseph Brannan | Broadband microwave applicator |
US8251992B2 (en) | 2007-07-06 | 2012-08-28 | Tyco Healthcare Group Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight-loss operation |
CA2692669A1 (en) * | 2007-07-06 | 2009-01-15 | Barrx Medical, Inc. | Ablation in the gastrointestinal tract to achieve hemostasis and eradicate lesions with a propensity for bleeding |
US20090012518A1 (en) * | 2007-07-06 | 2009-01-08 | Utley David S | Method and Apparatus for Ablation of Benign, Pre-Cancerous and Early Cancerous Lesions That Originate Within the Epithelium and are Limited to the Mucosal Layer of the Gastrointestinal Tract |
US7834484B2 (en) | 2007-07-16 | 2010-11-16 | Tyco Healthcare Group Lp | Connection cable and method for activating a voltage-controlled generator |
US8273012B2 (en) | 2007-07-30 | 2012-09-25 | Tyco Healthcare Group, Lp | Cleaning device and methods |
US8646460B2 (en) | 2007-07-30 | 2014-02-11 | Covidien Lp | Cleaning device and methods |
ATE556667T1 (en) | 2007-08-23 | 2012-05-15 | Aegea Medical Inc | UTERUS THERAPY DEVICE |
US8181995B2 (en) * | 2007-09-07 | 2012-05-22 | Tyco Healthcare Group Lp | Cool tip junction |
US8216220B2 (en) | 2007-09-07 | 2012-07-10 | Tyco Healthcare Group Lp | System and method for transmission of combined data stream |
US20090082762A1 (en) * | 2007-09-20 | 2009-03-26 | Ormsby Theodore C | Radio frequency energy transmission device for the ablation of biological tissues |
US8512332B2 (en) | 2007-09-21 | 2013-08-20 | Covidien Lp | Real-time arc control in electrosurgical generators |
US8651146B2 (en) * | 2007-09-28 | 2014-02-18 | Covidien Lp | Cable stand-off |
EP2209517A4 (en) * | 2007-10-05 | 2011-03-30 | Maquet Cardiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US8322335B2 (en) * | 2007-10-22 | 2012-12-04 | Uptake Medical Corp. | Determining patient-specific vapor treatment and delivery parameters |
WO2009055410A1 (en) | 2007-10-22 | 2009-04-30 | Uptake Medical Corp. | Determining patient-specific vapor treatment and delivery parameters |
US20100241185A1 (en) * | 2007-11-09 | 2010-09-23 | University Of Virginia Patent Foundation | Steerable epicardial pacing catheter system placed via the subxiphoid process |
US10751509B2 (en) | 2007-11-26 | 2020-08-25 | C. R. Bard, Inc. | Iconic representations for guidance of an indwelling medical device |
US9649048B2 (en) * | 2007-11-26 | 2017-05-16 | C. R. Bard, Inc. | Systems and methods for breaching a sterile field for intravascular placement of a catheter |
US10449330B2 (en) | 2007-11-26 | 2019-10-22 | C. R. Bard, Inc. | Magnetic element-equipped needle assemblies |
CN103750858B (en) | 2007-11-26 | 2017-04-12 | C·R·巴德股份有限公司 | Integrated system for intravascular placement of a catheter |
US9521961B2 (en) | 2007-11-26 | 2016-12-20 | C. R. Bard, Inc. | Systems and methods for guiding a medical instrument |
US8781555B2 (en) | 2007-11-26 | 2014-07-15 | C. R. Bard, Inc. | System for placement of a catheter including a signal-generating stylet |
US8849382B2 (en) | 2007-11-26 | 2014-09-30 | C. R. Bard, Inc. | Apparatus and display methods relating to intravascular placement of a catheter |
US10524691B2 (en) | 2007-11-26 | 2020-01-07 | C. R. Bard, Inc. | Needle assembly including an aligned magnetic element |
US8292880B2 (en) * | 2007-11-27 | 2012-10-23 | Vivant Medical, Inc. | Targeted cooling of deployable microwave antenna |
JP5443386B2 (en) * | 2007-12-28 | 2014-03-19 | サリエント・サージカル・テクノロジーズ・インコーポレーテッド | Fluid-assisted electrosurgical device, method and system |
US8235988B2 (en) | 2008-01-24 | 2012-08-07 | Coherex Medical, Inc. | Systems and methods for reduction of atrial fibrillation |
US8353902B2 (en) | 2008-01-31 | 2013-01-15 | Vivant Medical, Inc. | Articulating ablation device and method |
US8262703B2 (en) * | 2008-01-31 | 2012-09-11 | Vivant Medical, Inc. | Medical device including member that deploys in a spiral-like configuration and method |
US8221418B2 (en) | 2008-02-07 | 2012-07-17 | Tyco Healthcare Group Lp | Endoscopic instrument for tissue identification |
US8478382B2 (en) | 2008-02-11 | 2013-07-02 | C. R. Bard, Inc. | Systems and methods for positioning a catheter |
US20090209986A1 (en) * | 2008-02-15 | 2009-08-20 | Stewart Michael C | Devices, Tools and Methods for Atrial Appendage Exclusion |
US9924992B2 (en) * | 2008-02-20 | 2018-03-27 | Tsunami Medtech, Llc | Medical system and method of use |
US8821488B2 (en) * | 2008-05-13 | 2014-09-02 | Medtronic, Inc. | Tissue lesion evaluation |
US8692117B2 (en) * | 2008-05-28 | 2014-04-08 | Cardia Access, Inc. | Durable fine wire electrical conductor suitable for extreme environment applications |
US9513443B2 (en) | 2008-05-28 | 2016-12-06 | John Lawrence Erb | Optical fiber-fine wire conductor and connectors |
US9242100B2 (en) | 2012-08-07 | 2016-01-26 | Nuax, Inc. | Optical fiber-fine wire lead for electrostimulation and sensing |
US9193313B2 (en) | 2012-03-22 | 2015-11-24 | Nuax, Inc. | Methods and apparatuses involving flexible cable/guidewire/interconnects |
US8133222B2 (en) * | 2008-05-28 | 2012-03-13 | Medwaves, Inc. | Tissue ablation apparatus and method using ultrasonic imaging |
US9025598B1 (en) | 2012-03-22 | 2015-05-05 | Nuax, Inc. | Cable/guidewire/interconnects communication apparatus and methods |
US8721632B2 (en) | 2008-09-09 | 2014-05-13 | Tsunami Medtech, Llc | Methods for delivering energy into a target tissue of a body |
US8226639B2 (en) | 2008-06-10 | 2012-07-24 | Tyco Healthcare Group Lp | System and method for output control of electrosurgical generator |
US8579888B2 (en) | 2008-06-17 | 2013-11-12 | Tsunami Medtech, Llc | Medical probes for the treatment of blood vessels |
US20090318914A1 (en) * | 2008-06-18 | 2009-12-24 | Utley David S | System and method for ablational treatment of uterine cervical neoplasia |
US8679106B2 (en) * | 2008-07-01 | 2014-03-25 | Medwaves, Inc. | Angioplasty and tissue ablation apparatus and method |
US8888792B2 (en) | 2008-07-14 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Tissue apposition clip application devices and methods |
US8608739B2 (en) | 2008-07-22 | 2013-12-17 | Covidien Lp | Electrosurgical devices, systems and methods of using the same |
WO2010019481A1 (en) | 2008-08-11 | 2010-02-18 | Conceptx Medical, Inc. | Systems and methods for treating dyspnea, including via electrical afferent signal blocking |
WO2010022370A1 (en) * | 2008-08-22 | 2010-02-25 | C.R. Bard, Inc. | Catheter assembly including ecg sensor and magnetic assemblies |
US10695126B2 (en) | 2008-10-06 | 2020-06-30 | Santa Anna Tech Llc | Catheter with a double balloon structure to generate and apply a heated ablative zone to tissue |
US9561066B2 (en) | 2008-10-06 | 2017-02-07 | Virender K. Sharma | Method and apparatus for tissue ablation |
US10064697B2 (en) | 2008-10-06 | 2018-09-04 | Santa Anna Tech Llc | Vapor based ablation system for treating various indications |
EP2341859B1 (en) | 2008-10-06 | 2017-04-05 | Virender K. Sharma | Apparatus for tissue ablation |
US9561068B2 (en) | 2008-10-06 | 2017-02-07 | Virender K. Sharma | Method and apparatus for tissue ablation |
US8437833B2 (en) | 2008-10-07 | 2013-05-07 | Bard Access Systems, Inc. | Percutaneous magnetic gastrostomy |
US20100121139A1 (en) * | 2008-11-12 | 2010-05-13 | Ouyang Xiaolong | Minimally Invasive Imaging Systems |
US20100121155A1 (en) * | 2008-11-12 | 2010-05-13 | Ouyang Xiaolong | Minimally Invasive Tissue Modification Systems With Integrated Visualization |
US20100121142A1 (en) * | 2008-11-12 | 2010-05-13 | Ouyang Xiaolong | Minimally Invasive Imaging Device |
US8157834B2 (en) | 2008-11-25 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Rotational coupling device for surgical instrument with flexible actuators |
US9161773B2 (en) | 2008-12-23 | 2015-10-20 | Benvenue Medical, Inc. | Tissue removal tools and methods of use |
US8470043B2 (en) * | 2008-12-23 | 2013-06-25 | Benvenue Medical, Inc. | Tissue removal tools and methods of use |
US8361066B2 (en) | 2009-01-12 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8262652B2 (en) | 2009-01-12 | 2012-09-11 | Tyco Healthcare Group Lp | Imaginary impedance process monitoring and intelligent shut-off |
WO2010085501A1 (en) * | 2009-01-20 | 2010-07-29 | Old Dominion University Research Foundation | System and methods of treatment using electromagnetic illumination |
US9254168B2 (en) * | 2009-02-02 | 2016-02-09 | Medtronic Advanced Energy Llc | Electro-thermotherapy of tissue using penetrating microelectrode array |
US11284931B2 (en) * | 2009-02-03 | 2022-03-29 | Tsunami Medtech, Llc | Medical systems and methods for ablating and absorbing tissue |
US8945117B2 (en) | 2009-02-11 | 2015-02-03 | Boston Scientific Scimed, Inc. | Insulated ablation catheter devices and methods of use |
WO2010096809A1 (en) | 2009-02-23 | 2010-08-26 | Salient Surgical Technologies, Inc. | Fluid-assisted electrosurgical device and methods of use thereof |
US20100256735A1 (en) * | 2009-04-03 | 2010-10-07 | Board Of Regents, The University Of Texas System | Intraluminal stent with seam |
CA2761652C (en) | 2009-05-11 | 2019-10-01 | Leigh E. Colby | Therapeutic tooth bud ablation |
WO2014143014A1 (en) | 2013-03-15 | 2014-09-18 | Triagenics, Llc | Therapeutic tooth bud ablation |
US10022202B2 (en) | 2013-03-15 | 2018-07-17 | Triagenics, Llc | Therapeutic tooth bud ablation |
US8235981B2 (en) * | 2009-06-02 | 2012-08-07 | Vivant Medical, Inc. | Electrosurgical devices with directional radiation pattern |
RU2691318C2 (en) | 2009-06-12 | 2019-06-11 | Бард Аксесс Системс, Инк. | Method for positioning catheter end |
US9532724B2 (en) | 2009-06-12 | 2017-01-03 | Bard Access Systems, Inc. | Apparatus and method for catheter navigation using endovascular energy mapping |
US9125578B2 (en) | 2009-06-12 | 2015-09-08 | Bard Access Systems, Inc. | Apparatus and method for catheter navigation and tip location |
US20100331834A1 (en) * | 2009-06-29 | 2010-12-30 | Vivant Medical,Inc. | Ablation Probe Fixation |
EP3106116B1 (en) | 2009-06-30 | 2018-08-01 | Boston Scientific Scimed, Inc. | Map and ablate open irrigated hybrid catheter |
EP2464407A4 (en) | 2009-08-10 | 2014-04-02 | Bard Access Systems Inc | Devices and methods for endovascular electrography |
CN102497832B (en) * | 2009-09-08 | 2015-09-09 | 显著外科技术公司 | For case assembly and the using method thereof of electro-surgical device, electrosurgical unit |
US9642534B2 (en) | 2009-09-11 | 2017-05-09 | University Of Virginia Patent Foundation | Systems and methods for determining location of an access needle in a subject |
US9474565B2 (en) | 2009-09-22 | 2016-10-25 | Mederi Therapeutics, Inc. | Systems and methods for treating tissue with radiofrequency energy |
US9750563B2 (en) | 2009-09-22 | 2017-09-05 | Mederi Therapeutics, Inc. | Systems and methods for treating tissue with radiofrequency energy |
US10386990B2 (en) | 2009-09-22 | 2019-08-20 | Mederi Rf, Llc | Systems and methods for treating tissue with radiofrequency energy |
EP2480152B1 (en) | 2009-09-22 | 2018-08-29 | Mederi Therapeutics Inc. | Systems for controlling use and operation of a family of different treatment devices |
US9775664B2 (en) | 2009-09-22 | 2017-10-03 | Mederi Therapeutics, Inc. | Systems and methods for treating tissue with radiofrequency energy |
AU2010300677B2 (en) | 2009-09-29 | 2014-09-04 | C.R. Bard, Inc. | Stylets for use with apparatus for intravascular placement of a catheter |
US9101733B2 (en) * | 2009-09-29 | 2015-08-11 | Biosense Webster, Inc. | Catheter with biased planar deflection |
US11103213B2 (en) * | 2009-10-08 | 2021-08-31 | C. R. Bard, Inc. | Spacers for use with an ultrasound probe |
US20110098704A1 (en) | 2009-10-28 | 2011-04-28 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8900223B2 (en) * | 2009-11-06 | 2014-12-02 | Tsunami Medtech, Llc | Tissue ablation systems and methods of use |
US10660697B2 (en) | 2009-11-10 | 2020-05-26 | Cardea Medsystems (Tianjin) Co., Ltd. | Hollow body cavity ablation apparatus |
BR112012011021B1 (en) | 2009-11-10 | 2022-03-29 | Cardea Medsystems (Tianjin) Co., Ltd | Body cavity ablation device |
CN102711648B (en) * | 2009-11-30 | 2015-07-29 | 麦迪威公司 | There is the radio frequency ablation system of tracking transducer |
US9028483B2 (en) | 2009-12-18 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US9161801B2 (en) * | 2009-12-30 | 2015-10-20 | Tsunami Medtech, Llc | Medical system and method of use |
EP2540247B1 (en) * | 2010-02-26 | 2016-04-27 | Keio University | Catheter for photodynamic ablation of cardiac muscle tissue |
US9980772B2 (en) | 2010-03-10 | 2018-05-29 | Biosense Webster (Israel) Ltd. | Monitoring tissue temperature while using an irrigated catheter |
US9265574B2 (en) * | 2010-03-10 | 2016-02-23 | Biosense Webster (Israel) Ltd. | Monitoring tissue temperature while using an irrigated catheter |
EP2544616B1 (en) | 2010-03-11 | 2017-09-06 | Medtronic Advanced Energy LLC | Bipolar electrosurgical cutter with position insensitive return electrode contact |
US8834388B2 (en) | 2010-04-30 | 2014-09-16 | Medtronic Ablation Frontiers Llc | Method and apparatus to regulate a tissue temperature |
WO2011150376A1 (en) | 2010-05-28 | 2011-12-01 | C.R. Bard, Inc. | Apparatus for use with needle insertion guidance system |
WO2011150358A1 (en) | 2010-05-28 | 2011-12-01 | C.R. Bard, Inc. | Insertion guidance system for needles and medical components |
US20110295249A1 (en) * | 2010-05-28 | 2011-12-01 | Salient Surgical Technologies, Inc. | Fluid-Assisted Electrosurgical Devices, and Methods of Manufacture Thereof |
US9138289B2 (en) | 2010-06-28 | 2015-09-22 | Medtronic Advanced Energy Llc | Electrode sheath for electrosurgical device |
US8906012B2 (en) | 2010-06-30 | 2014-12-09 | Medtronic Advanced Energy Llc | Electrosurgical devices with wire electrode |
US8920417B2 (en) | 2010-06-30 | 2014-12-30 | Medtronic Advanced Energy Llc | Electrosurgical devices and methods of use thereof |
CN103228219B (en) | 2010-08-09 | 2016-04-27 | C·R·巴德股份有限公司 | For support and the covered structure of ultrasound probe head |
US9943353B2 (en) | 2013-03-15 | 2018-04-17 | Tsunami Medtech, Llc | Medical system and method of use |
KR101856267B1 (en) | 2010-08-20 | 2018-05-09 | 씨. 알. 바드, 인크. | Reconfirmation of ecg-assisted catheter tip placement |
US9023040B2 (en) | 2010-10-26 | 2015-05-05 | Medtronic Advanced Energy Llc | Electrosurgical cutting devices |
WO2012058461A1 (en) | 2010-10-29 | 2012-05-03 | C.R.Bard, Inc. | Bioimpedance-assisted placement of a medical device |
ES2912362T3 (en) | 2010-11-09 | 2022-05-25 | Aegea Medical Inc | Method of placement and apparatus for delivering steam to the uterus |
US9089340B2 (en) | 2010-12-30 | 2015-07-28 | Boston Scientific Scimed, Inc. | Ultrasound guided tissue ablation |
US9233241B2 (en) | 2011-02-28 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9254169B2 (en) | 2011-02-28 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9427281B2 (en) | 2011-03-11 | 2016-08-30 | Medtronic Advanced Energy Llc | Bronchoscope-compatible catheter provided with electrosurgical device |
US9049987B2 (en) | 2011-03-17 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Hand held surgical device for manipulating an internal magnet assembly within a patient |
US10278774B2 (en) | 2011-03-18 | 2019-05-07 | Covidien Lp | Selectively expandable operative element support structure and methods of use |
US8709034B2 (en) | 2011-05-13 | 2014-04-29 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US9345532B2 (en) | 2011-05-13 | 2016-05-24 | Broncus Medical Inc. | Methods and devices for ablation of tissue |
JP2014516723A (en) | 2011-06-01 | 2014-07-17 | 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 | Ablation probe with ultrasound imaging capability |
US9119636B2 (en) | 2011-06-27 | 2015-09-01 | Boston Scientific Scimed Inc. | Dispersive belt for an ablation system |
US9381010B2 (en) | 2011-06-27 | 2016-07-05 | Covidien Lp | Surgical instrument with adapter for facilitating multi-direction end effector articulation |
WO2013006817A1 (en) | 2011-07-06 | 2013-01-10 | C.R. Bard, Inc. | Needle length determination and calibration for insertion guidance system |
USD724745S1 (en) | 2011-08-09 | 2015-03-17 | C. R. Bard, Inc. | Cap for an ultrasound probe |
USD699359S1 (en) | 2011-08-09 | 2014-02-11 | C. R. Bard, Inc. | Ultrasound probe head |
WO2013040201A2 (en) | 2011-09-14 | 2013-03-21 | Boston Scientific Scimed, Inc. | Ablation device with multiple ablation modes |
AU2012308464B2 (en) | 2011-09-14 | 2016-10-20 | Boston Scientific Scimed, Inc. | Ablation device with ionically conductive balloon |
US9750565B2 (en) | 2011-09-30 | 2017-09-05 | Medtronic Advanced Energy Llc | Electrosurgical balloons |
CN104135960B (en) | 2011-10-07 | 2017-06-06 | 埃杰亚医疗公司 | A kind of uterine therapy device |
US8870864B2 (en) | 2011-10-28 | 2014-10-28 | Medtronic Advanced Energy Llc | Single instrument electrosurgery apparatus and its method of use |
US9211107B2 (en) | 2011-11-07 | 2015-12-15 | C. R. Bard, Inc. | Ruggedized ultrasound hydrogel insert |
WO2013078235A1 (en) | 2011-11-23 | 2013-05-30 | Broncus Medical Inc | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
WO2013102072A1 (en) | 2011-12-28 | 2013-07-04 | Boston Scientific Scimed, Inc. | Ablation probe with ultrasonic imaging capability |
CN104039257A (en) | 2012-01-10 | 2014-09-10 | 波士顿科学医学有限公司 | Electrophysiology system |
EP2809253B8 (en) | 2012-01-31 | 2016-09-21 | Boston Scientific Scimed, Inc. | Ablation probe with fluid-based acoustic coupling for ultrasonic tissue imaging |
US8403927B1 (en) | 2012-04-05 | 2013-03-26 | William Bruce Shingleton | Vasectomy devices and methods |
CN107693114A (en) | 2012-04-24 | 2018-02-16 | 西比姆公司 | The catheter in blood vessel and method extractd for carotid body |
US9427255B2 (en) | 2012-05-14 | 2016-08-30 | Ethicon Endo-Surgery, Inc. | Apparatus for introducing a steerable camera assembly into a patient |
WO2013181660A1 (en) | 2012-06-01 | 2013-12-05 | Cibiem, Inc. | Methods and devices for cryogenic carotid body ablation |
EP2861153A4 (en) | 2012-06-15 | 2016-10-19 | Bard Inc C R | Apparatus and methods for detection of a removable cap on an ultrasound probe |
US9955946B2 (en) | 2014-03-12 | 2018-05-01 | Cibiem, Inc. | Carotid body ablation with a transvenous ultrasound imaging and ablation catheter |
US9078662B2 (en) * | 2012-07-03 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Endoscopic cap electrode and method for using the same |
US9545290B2 (en) | 2012-07-30 | 2017-01-17 | Ethicon Endo-Surgery, Inc. | Needle probe guide |
US9572623B2 (en) | 2012-08-02 | 2017-02-21 | Ethicon Endo-Surgery, Inc. | Reusable electrode and disposable sheath |
US10314649B2 (en) | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
US9277957B2 (en) | 2012-08-15 | 2016-03-08 | Ethicon Endo-Surgery, Inc. | Electrosurgical devices and methods |
CN104640513A (en) | 2012-09-18 | 2015-05-20 | 波士顿科学医学有限公司 | Map and ablate closed-loop cooled ablation catheter |
US9211156B2 (en) | 2012-09-18 | 2015-12-15 | Boston Scientific Scimed, Inc. | Map and ablate closed-loop cooled ablation catheter with flat tip |
US9901399B2 (en) | 2012-12-17 | 2018-02-27 | Covidien Lp | Ablation probe with tissue sensing configuration |
EP3964151A3 (en) | 2013-01-17 | 2022-03-30 | Virender K. Sharma | Apparatus for tissue ablation |
US10098527B2 (en) | 2013-02-27 | 2018-10-16 | Ethidcon Endo-Surgery, Inc. | System for performing a minimally invasive surgical procedure |
US9872719B2 (en) | 2013-07-24 | 2018-01-23 | Covidien Lp | Systems and methods for generating electrosurgical energy using a multistage power converter |
US9636165B2 (en) | 2013-07-29 | 2017-05-02 | Covidien Lp | Systems and methods for measuring tissue impedance through an electrosurgical cable |
US10631914B2 (en) | 2013-09-30 | 2020-04-28 | Covidien Lp | Bipolar electrosurgical instrument with movable electrode and related systems and methods |
US9782211B2 (en) | 2013-10-01 | 2017-10-10 | Uptake Medical Technology Inc. | Preferential volume reduction of diseased segments of a heterogeneous lobe |
WO2015095806A2 (en) | 2013-12-20 | 2015-06-25 | Microvention, Inc. | Device delivery system |
US9370295B2 (en) | 2014-01-13 | 2016-06-21 | Trice Medical, Inc. | Fully integrated, disposable tissue visualization device |
US11547446B2 (en) | 2014-01-13 | 2023-01-10 | Trice Medical, Inc. | Fully integrated, disposable tissue visualization device |
US10342579B2 (en) | 2014-01-13 | 2019-07-09 | Trice Medical, Inc. | Fully integrated, disposable tissue visualization device |
EP3073910B1 (en) | 2014-02-06 | 2020-07-15 | C.R. Bard, Inc. | Systems for guidance and placement of an intravascular device |
US10179019B2 (en) | 2014-05-22 | 2019-01-15 | Aegea Medical Inc. | Integrity testing method and apparatus for delivering vapor to the uterus |
WO2015179666A1 (en) | 2014-05-22 | 2015-11-26 | Aegea Medical Inc. | Systems and methods for performing endometrial ablation |
US10314605B2 (en) | 2014-07-08 | 2019-06-11 | Benvenue Medical, Inc. | Apparatus and methods for disrupting intervertebral disc tissue |
US9974599B2 (en) | 2014-08-15 | 2018-05-22 | Medtronic Ps Medical, Inc. | Multipurpose electrosurgical device |
JP2017529169A (en) | 2014-10-13 | 2017-10-05 | 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. | Tissue diagnosis and treatment using mini-electrodes |
WO2016065337A1 (en) | 2014-10-24 | 2016-04-28 | Boston Scientific Scimed Inc. | Medical devices with a flexible electrode assembly coupled to an ablation tip |
US9956029B2 (en) | 2014-10-31 | 2018-05-01 | Medtronic Advanced Energy Llc | Telescoping device with saline irrigation line |
PL227986B1 (en) * | 2014-11-07 | 2018-02-28 | Medinice Społka Akcyjna | Multipurpose, electrophysiological diagnostic catheter for treatments in electrocardiology |
US10485604B2 (en) | 2014-12-02 | 2019-11-26 | Uptake Medical Technology Inc. | Vapor treatment of lung nodules and tumors |
CN106999080B (en) | 2014-12-18 | 2020-08-18 | 波士顿科学医学有限公司 | Real-time morphological analysis for lesion assessment |
US10973584B2 (en) | 2015-01-19 | 2021-04-13 | Bard Access Systems, Inc. | Device and method for vascular access |
US10531906B2 (en) | 2015-02-02 | 2020-01-14 | Uptake Medical Technology Inc. | Medical vapor generator |
US10022243B2 (en) | 2015-02-06 | 2018-07-17 | Benvenue Medical, Inc. | Graft material injector system and method |
WO2016210325A1 (en) | 2015-06-26 | 2016-12-29 | C.R. Bard, Inc. | Connector interface for ecg-based catheter positioning system |
CN108024695B (en) | 2015-08-11 | 2021-05-04 | 特里斯医疗有限公司 | Fully integrated disposable tissue visualization device |
US10264981B2 (en) * | 2015-08-18 | 2019-04-23 | Saranas, Inc. | Introducer sheath with electrodes |
US11389227B2 (en) | 2015-08-20 | 2022-07-19 | Medtronic Advanced Energy Llc | Electrosurgical device with multivariate control |
US11051875B2 (en) | 2015-08-24 | 2021-07-06 | Medtronic Advanced Energy Llc | Multipurpose electrosurgical device |
US10716612B2 (en) | 2015-12-18 | 2020-07-21 | Medtronic Advanced Energy Llc | Electrosurgical device with multiple monopolar electrode assembly |
US11000207B2 (en) | 2016-01-29 | 2021-05-11 | C. R. Bard, Inc. | Multiple coil system for tracking a medical device |
CN114983553A (en) | 2016-02-19 | 2022-09-02 | 埃杰亚医疗公司 | Method and apparatus for determining the integrity of a body cavity |
US10893899B2 (en) | 2016-03-26 | 2021-01-19 | Paul Weber | Apparatus and systems for minimally invasive dissection of tissues |
US11510730B2 (en) | 2016-03-26 | 2022-11-29 | Paul Joseph Weber | Apparatus and methods for minimally invasive dissection and modification of tissues |
US10603101B2 (en) | 2016-03-26 | 2020-03-31 | Paul Joseph Weber | Apparatus, systems and methods for minimally invasive dissection of tissues |
US11331140B2 (en) | 2016-05-19 | 2022-05-17 | Aqua Heart, Inc. | Heated vapor ablation systems and methods for treating cardiac conditions |
US10758286B2 (en) | 2017-03-22 | 2020-09-01 | Benvenue Medical, Inc. | Minimal impact access system to disc space |
EP3606457A4 (en) | 2017-04-03 | 2021-04-21 | Broncus Medical Inc. | Electrosurgical access sheath |
US11129673B2 (en) | 2017-05-05 | 2021-09-28 | Uptake Medical Technology Inc. | Extra-airway vapor ablation for treating airway constriction in patients with asthma and COPD |
US11344364B2 (en) | 2017-09-07 | 2022-05-31 | Uptake Medical Technology Inc. | Screening method for a target nerve to ablate for the treatment of inflammatory lung disease |
US11350988B2 (en) | 2017-09-11 | 2022-06-07 | Uptake Medical Technology Inc. | Bronchoscopic multimodality lung tumor treatment |
USD845467S1 (en) | 2017-09-17 | 2019-04-09 | Uptake Medical Technology Inc. | Hand-piece for medical ablation catheter |
US11419658B2 (en) | 2017-11-06 | 2022-08-23 | Uptake Medical Technology Inc. | Method for treating emphysema with condensable thermal vapor |
US11490946B2 (en) | 2017-12-13 | 2022-11-08 | Uptake Medical Technology Inc. | Vapor ablation handpiece |
US11583327B2 (en) | 2018-01-29 | 2023-02-21 | Spinal Elements, Inc. | Minimally invasive interbody fusion |
WO2019178575A1 (en) | 2018-03-16 | 2019-09-19 | Benvenue Medical, Inc. | Articulated instrumentation and methods of using the same |
EP3773235B1 (en) | 2018-03-29 | 2023-07-19 | Trice Medical, Inc. | Fully integrated endoscope with biopsy capabilities |
US11246644B2 (en) | 2018-04-05 | 2022-02-15 | Covidien Lp | Surface ablation using bipolar RF electrode |
WO2019232432A1 (en) | 2018-06-01 | 2019-12-05 | Santa Anna Tech Llc | Multi-stage vapor-based ablation treatment methods and vapor generation and delivery systems |
WO2020081373A1 (en) | 2018-10-16 | 2020-04-23 | Bard Access Systems, Inc. | Safety-equipped connection systems and methods thereof for establishing electrical connections |
US11653927B2 (en) | 2019-02-18 | 2023-05-23 | Uptake Medical Technology Inc. | Vapor ablation treatment of obstructive lung disease |
CN113924057A (en) * | 2019-05-24 | 2022-01-11 | 堪萨斯州立大学研究基金会 | Micro-wound microwave ablation device |
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Citations (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4699147A (en) * | 1985-09-25 | 1987-10-13 | Cordis Corporation | Intraventricular multielectrode cardial mapping probe and method for using same |
US4785815A (en) * | 1985-10-23 | 1988-11-22 | Cordis Corporation | Apparatus for locating and ablating cardiac conduction pathways |
DE3718139C1 (en) * | 1987-05-29 | 1988-12-08 | Strahlen Umweltforsch Gmbh | Cardiac catheter |
US4813425A (en) * | 1987-08-26 | 1989-03-21 | American Home Products Corporation | Fetal electrode product |
US4860743A (en) * | 1986-10-27 | 1989-08-29 | University Of Florida | Laser method and apparatus for the recanalization of vessels and the treatment of other cardiac conditions |
US4940064A (en) * | 1986-11-14 | 1990-07-10 | Desai Jawahar M | Catheter for mapping and ablation and method therefor |
EP0422363A1 (en) * | 1989-08-23 | 1991-04-17 | Medtronic, Inc. | Screw-in drug eluting medical lead for implantation |
EP0428812A1 (en) * | 1989-07-24 | 1991-05-29 | Consiglio Nazionale Delle Ricerche | Intracardiac catheter, magneto-cardiographically localizable, for mapping and pacing provided with means for ablation of arrythmogenic tissue |
US5083565A (en) * | 1990-08-03 | 1992-01-28 | Everest Medical Corporation | Electrosurgical instrument for ablating endocardial tissue |
EP0481684A2 (en) * | 1990-10-19 | 1992-04-22 | ANGELASE, Inc. | Location and ablation of an active site of ventricular tachycardia |
DE4108269C1 (en) * | 1991-03-14 | 1992-06-17 | Peter Dr.-Ing. 7889 Grenzach-Wyhlen De Osypka | Electrode catheter for monitoring and/or stimulation of heart or coagulation - has insulation layer on electrode lead which is inert for bodily tissue and working head of memory metal |
US5125896A (en) * | 1990-10-10 | 1992-06-30 | C. R. Bard, Inc. | Steerable electrode catheter |
EP0500215A1 (en) * | 1991-01-30 | 1992-08-26 | ANGELASE, Inc. | Process and apparatus for mapping of tachyarrhythmia |
Family Cites Families (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4576177A (en) * | 1983-02-18 | 1986-03-18 | Webster Wilton W Jr | Catheter for removing arteriosclerotic plaque |
WO1985002101A1 (en) * | 1983-11-08 | 1985-05-23 | Laserscope, Inc. | Endoscopic device having handle assembly and catheter assembly |
US5106387A (en) * | 1985-03-22 | 1992-04-21 | Massachusetts Institute Of Technology | Method for spectroscopic diagnosis of tissue |
US4850351A (en) * | 1985-05-22 | 1989-07-25 | C. R. Bard, Inc. | Wire guided laser catheter |
US4660571A (en) * | 1985-07-18 | 1987-04-28 | Cordis Corporation | Percutaneous lead having radially adjustable electrode |
US4784133A (en) * | 1987-01-28 | 1988-11-15 | Mackin Robert A | Working well balloon angioscope and method |
US4819630A (en) * | 1987-03-20 | 1989-04-11 | Laser Photonics, Inc. | Flexible light transmissive apparatus and method |
US4854315A (en) * | 1987-06-25 | 1989-08-08 | Stack Richard S | Laser catheter |
DE3803697A1 (en) * | 1988-02-08 | 1989-08-17 | Wolfgang Arno Karl Dr Radtke | LASER - VALVOTOMY - CATHETER (HEART CATHETER FOR PERCUTANICALLY TARGETED VALVOTOMY OF NARROWED HEART VALVES) |
US4890898A (en) * | 1988-08-18 | 1990-01-02 | Hgm Medical Laser Systems, Inc. | Composite microsize optical fiber-electric lead cable |
JP2882814B2 (en) * | 1989-08-24 | 1999-04-12 | 株式会社エス・エル・ティ・ジャパン | Laser irradiation equipment |
US4985028A (en) * | 1989-08-30 | 1991-01-15 | Angeion Corporation | Catheter |
US5169396A (en) * | 1990-06-08 | 1992-12-08 | Kambiz Dowlatshahi | Method for interstitial laser therapy |
US5053033A (en) * | 1990-10-10 | 1991-10-01 | Boston Advanced Technologies, Inc. | Inhibition of restenosis by ultraviolet radiation |
US5156151A (en) * | 1991-02-15 | 1992-10-20 | Cardiac Pathways Corporation | Endocardial mapping and ablation system and catheter probe |
US5281212A (en) * | 1992-02-18 | 1994-01-25 | Angeion Corporation | Laser catheter with monitor and dissolvable tip |
-
1993
- 1993-07-13 WO PCT/US1993/006600 patent/WO1994002077A2/en active Application Filing
-
1994
- 1994-07-08 US US08/272,268 patent/US5500012A/en not_active Expired - Lifetime
Patent Citations (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4699147A (en) * | 1985-09-25 | 1987-10-13 | Cordis Corporation | Intraventricular multielectrode cardial mapping probe and method for using same |
US4785815A (en) * | 1985-10-23 | 1988-11-22 | Cordis Corporation | Apparatus for locating and ablating cardiac conduction pathways |
US4860743A (en) * | 1986-10-27 | 1989-08-29 | University Of Florida | Laser method and apparatus for the recanalization of vessels and the treatment of other cardiac conditions |
US4940064A (en) * | 1986-11-14 | 1990-07-10 | Desai Jawahar M | Catheter for mapping and ablation and method therefor |
DE3718139C1 (en) * | 1987-05-29 | 1988-12-08 | Strahlen Umweltforsch Gmbh | Cardiac catheter |
US4813425A (en) * | 1987-08-26 | 1989-03-21 | American Home Products Corporation | Fetal electrode product |
EP0428812A1 (en) * | 1989-07-24 | 1991-05-29 | Consiglio Nazionale Delle Ricerche | Intracardiac catheter, magneto-cardiographically localizable, for mapping and pacing provided with means for ablation of arrythmogenic tissue |
EP0422363A1 (en) * | 1989-08-23 | 1991-04-17 | Medtronic, Inc. | Screw-in drug eluting medical lead for implantation |
US5083565A (en) * | 1990-08-03 | 1992-01-28 | Everest Medical Corporation | Electrosurgical instrument for ablating endocardial tissue |
US5125896A (en) * | 1990-10-10 | 1992-06-30 | C. R. Bard, Inc. | Steerable electrode catheter |
EP0481684A2 (en) * | 1990-10-19 | 1992-04-22 | ANGELASE, Inc. | Location and ablation of an active site of ventricular tachycardia |
EP0500215A1 (en) * | 1991-01-30 | 1992-08-26 | ANGELASE, Inc. | Process and apparatus for mapping of tachyarrhythmia |
DE4108269C1 (en) * | 1991-03-14 | 1992-06-17 | Peter Dr.-Ing. 7889 Grenzach-Wyhlen De Osypka | Electrode catheter for monitoring and/or stimulation of heart or coagulation - has insulation layer on electrode lead which is inert for bodily tissue and working head of memory metal |
Cited By (62)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1995005867A1 (en) * | 1993-08-27 | 1995-03-02 | Medtronic, Inc. | Apparatus for ablation |
US5782824A (en) * | 1993-09-20 | 1998-07-21 | Abela Laser Systems, Inc. | Cardiac catheter anchoring |
US5651786A (en) * | 1993-09-20 | 1997-07-29 | Abela Laser Systems, Inc. | Mapping catheter and method |
US5464404A (en) * | 1993-09-20 | 1995-11-07 | Abela Laser Systems, Inc. | Cardiac ablation catheters and method |
US5651785A (en) * | 1993-09-20 | 1997-07-29 | Abela Laser Systems, Inc. | Optical fiber catheter and method |
US5575787A (en) * | 1993-09-20 | 1996-11-19 | Abela Laser Systems, Inc. | Cardiac ablation catheters and method |
US5814027A (en) * | 1993-11-03 | 1998-09-29 | Daig Corporation | Guiding introducer used for medical procedures within the right ventricle associated with the right ventricular outflow track |
US6949098B2 (en) | 1995-02-22 | 2005-09-27 | Medtronic, Inc. | Pen-type electrosurgical instrument |
EP0737486A3 (en) * | 1995-04-14 | 1997-02-26 | Daig Corp | Guiding introducer used for medical procedures within the right ventricle associated with the right ventricular outflow track |
EP0737486A2 (en) * | 1995-04-14 | 1996-10-16 | Daig Corporation | Guiding introducer used for medical procedures within the right ventricle associated with the right ventricular outflow track |
EP0738518A3 (en) * | 1995-04-17 | 1997-03-12 | Daig Corp | Guiding introducers used for medical procedures within the right ventricle associated with the tricuspid valve |
EP0738518A2 (en) * | 1995-04-17 | 1996-10-23 | Daig Corporation | Guiding introducers used for medical procedures within the right ventricle associated with the tricuspid valve |
US6830568B1 (en) | 1995-05-10 | 2004-12-14 | Randy J. Kesten | Guiding catheter system for ablating heart tissue |
US6251104B1 (en) | 1995-05-10 | 2001-06-26 | Eclipse Surgical Technologies, Inc. | Guiding catheter system for ablating heart tissue |
WO1996035469A1 (en) * | 1995-05-10 | 1996-11-14 | Cardiogenesis Corporation | System for treating or diagnosing heart tissue |
US6592575B1 (en) | 1995-05-10 | 2003-07-15 | Randy J. Kesten | Guiding catheter system for ablating heart tissue |
US5895355A (en) * | 1995-05-23 | 1999-04-20 | Cardima, Inc. | Over-the-wire EP catheter |
US6002956A (en) * | 1995-05-23 | 1999-12-14 | Cardima, Inc. | Method of treating using an over-the-wire EP catheter |
WO1998038912A1 (en) * | 1995-05-23 | 1998-09-11 | Cardima, Inc. | Over-the-wire ep catheter |
EP0957758A4 (en) * | 1995-08-22 | 1999-11-24 | ||
EP0957758A1 (en) * | 1995-08-22 | 1999-11-24 | Board of Regents, The University of Texas System | A maneuverable electrophysiology catheter for percutaneous or intraoperative ablation of cardiac arrhythmias |
US6143019A (en) * | 1995-08-22 | 2000-11-07 | Board Of Regents, The University Of Texas System | Method for emitting therapeutic energy within tissue |
DE19537897A1 (en) * | 1995-09-19 | 1997-03-20 | Erbe Elektromedizin | Multi=functional surgical instrument suitable for variable surgical methods |
EP1044654A3 (en) * | 1995-11-08 | 2000-10-25 | Desinger, Kai, Dr. | Arrangement for electrothermal treatment of the human or animal body |
US6379349B1 (en) | 1995-11-08 | 2002-04-30 | Celon Ag Medical Instruments | Arrangement for electrothermal treatment of the human or animal body |
EP1044654A2 (en) * | 1995-11-08 | 2000-10-18 | Desinger, Kai, Dr. | Arrangement for electrothermal treatment of the human or animal body |
WO1997017009A3 (en) * | 1995-11-08 | 1997-07-17 | Laser & Med Tech Gmbh | Arrangement for electrothermal treatment of the human or animal body |
WO1997017009A2 (en) * | 1995-11-08 | 1997-05-15 | Laser- Und Medizin-Technologie Ggmbh Berlin | Arrangement for electrothermal treatment of the human or animal body |
US6283955B1 (en) | 1996-05-13 | 2001-09-04 | Edwards Lifesciences Corp. | Laser ablation device |
US5980545A (en) * | 1996-05-13 | 1999-11-09 | United States Surgical Corporation | Coring device and method |
US5807383A (en) * | 1996-05-13 | 1998-09-15 | United States Surgical Corporation | Lasing device |
US5843154A (en) * | 1996-09-27 | 1998-12-01 | Sulzer Osypka Gmbh | Apparatus for performing diagnostic and/or therapeutical heart interventions with a catheter |
EP0832602A1 (en) * | 1996-09-27 | 1998-04-01 | Sulzer Osypka GmbH | Device for carrying out diagnostic and/or therapeutic heart procedures with a catheter |
US5947989A (en) * | 1996-12-12 | 1999-09-07 | United States Surgical Corporation | Method and apparatus for transmyocardial revascularization |
US6135996A (en) * | 1998-04-17 | 2000-10-24 | Baxter International, Inc. | Controlled advancement lasing device |
US7811282B2 (en) | 2000-03-06 | 2010-10-12 | Salient Surgical Technologies, Inc. | Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof |
US8038670B2 (en) | 2000-03-06 | 2011-10-18 | Salient Surgical Technologies, Inc. | Fluid-assisted medical devices, systems and methods |
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US6986769B2 (en) | 2000-08-21 | 2006-01-17 | Biosense Webster, Inc. | Ablation catheter with cooled linear electrode |
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US5500012A (en) | 1996-03-19 |
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