Cardiac ablation system and method for treatment of cardiac arrhthmias and transmyocardial revascularization

Abstract

A medical device, and related method, use epicardial ablators and detectors for intraoperative epicardial approaches to ablation therapy of cardiac conduction pathways. An epicardial gripper is sized to grasp the cardiac circumference or smaller structures on the epicardial surface of the heart. Ablators are disposed on the arms of the gripper for epicardial ablation of cardiac conduction tissue. In another embodiment of the invention, an electrode system includes a flexible, adjustable probe forming a loop for epicardial ablation. Ablators are provided on one or multiple surfaces of the probe for epicardial ablation of cardiac conduction tissue. In yet another embodiment of the invention, an endocardial ablator detection system provides an indicator adjacent an ablator on an endocardial catheter, and a detector on an epicardial probe. The epicardial probe detects signals transmitted by the indicator on the endocardial catheter to localize the position of the endocardial ablator relative to the epicardial surface. The surgeon uses this information for guidance in adjusting the position of the endocardial ablator according to therapeutic objectives of cardiac ablation.

Description

[0001] This application is a continuation of application Ser. No. 10 / 695,110, filed on Oct. 28, 2003 (to issue as U.S. Pat. No. 7,041,095) which is a continuation of U.S. application Ser. No. 10 / 032,302, filed on Dec. 21, 2001, now abandoned, which is a continuation of U.S. application Ser. No. 09 / 082,047, filed on May 20, 1998 (now U.S. Pat. No. 6,527,767). The entire disclosures of the foregoing patents and applications are hereby incorporated by reference.BACKGROUND OF THE INVENTION [0002] Tachycardia is a type of cardiac arrhythmia and is a serious, often-times, fatal condition characterized by rapid, uncontrolled, and ineffective beating of the heart. Most tachycardia is one of two broad categories: ventricular tachycardia (hereinafter VT) and supraventricular tachycardia (hereinafter SVT). VT occurs in the lower chambers of the heart, the ventricles, and frequently leads to serious complications, including sudden cardiac death. Atrial fibrillation and flutter, forms of SVT, or...

AI Technical Summary

Problems solved by technology

Tachycardia is a type of cardiac arrhythmia and is a serious, often-times, fatal condition characterized by rapid, uncontrolled, and ineffective beating of the heart.

VT occurs in the lower chambers of the heart, the ventricles, and frequently leads to serious complications, including sudden cardiac death.

Atrial fibrillation and flutter, forms of SVT, originate in the upper chambers of the heart, the atria, and often result in chest pain, fatigue and dizziness and, while generally not life-threatening, is a leading cause of stroke in the United States.

However, the drugs do not eliminate or may not completely control the arrhythmia.

Concurrent treatment with drugs is standard therapy and each implantation of a cardiac defibrillator, of which there may be more than one per patient, is very expensive.

In atrial fibrillation the regular pumping action of the atria is replaced by a disorganized, ineffective quivering caused by chaotic conduction of electrical signals through the upper chambers of the heart.

Although not immediately life threatening, atrial fibrillation may cause up to a 30% reduction in cardiac output and can lead to more serious conditions, including the formation of blood clots in the atria that can dislodge and travel to the brain resulting in stroke.

Currently, the only curative treatment for atrial fibrillation is the surgical “maze procedure”, an open heart procedure in which the surgeon makes several incisions in the right and left atria creating scar tissue to electrically separate portions of the atria Despite clinical success of the maze procedure, it is time-consuming and demanding.

The procedure requires open heart surgery and is very expensive.

Images