Basket Catheter with Solid Conductive Spine as Electrode for IRE

Abstract

To provide a medical apparatus.SOLUTION: The medical apparatus includes a probe, which includes: an insertion tube configured for insertion into a body cavity of a patient; and a basket assembly connected distally to the insertion tube and including a plurality of resilient conductive spines, which are configured to contact tissue within the body. The apparatus further includes an electrical signal generator configured to apply, to between one or more pairs of the spines, bipolar pulses having an amplitude sufficient to cause irreversible electroporation (IRE) in the tissue contacted by the spines.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates generally to medical devices, and more particularly to devices and methods for ablating tissue within the body. [Background technology]

[0002] Irreversible electroporation (IRE) is a soft tissue ablation technique that applies short pulses of intense electric fields to create permanent, and therefore lethal, nanopores in cell membranes, thereby disrupting cellular homeostasis (internal physical and chemical conditions). Cell death after IRE is due to apoptosis (programmed cell death) and not necrosis (cell injury that leads to the destruction of the cell through the action of the cell's own enzymes) as in other thermal and radiation-based ablation techniques. IRE is commonly used in the ablation of tumors in areas where precision and the preservation of the extracellular matrix, blood flow, and nerves are critical. Summary of the Invention [Means for solving the problem]

[0003] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The embodiments of the present invention described below provide improved systems and methods for ablating tissue within the body.

[0004] Thus, in accordance with an embodiment of the present invention, there is provided a medical device including a probe, the probe including an insertion tube configured for insertion into a body cavity of a patient, a basket assembly distally connected to the insertion tube, and a plurality of resilient, conductive spines configured to contact tissue within the body, the device further including an electrical signal generator configured to apply bipolar pulses between one or more pairs of the spines having an amplitude sufficient to induce irreversible electroporation (IRE) in tissue contacted by the spines.

[0005] In a disclosed embodiment, the spines have respective proximal and distal tips, the proximal tips of the spines are mechanically joined at the proximal end of the basket assembly and the distal tips of the spines are mechanically joined at the distal end of the basket assembly, and when the basket assembly is deployed within the body cavity, the spines deflect radially outward, thereby contacting tissue within the body cavity.

[0006] In further disclosed embodiments, the basket assembly has a stable folded state and the apparatus includes a traction tool attached to a distal end of the basket assembly and slidably disposed within the insertion tube such that the spine deflects radially outward in response to pulling the traction tool proximally through the insertion tube. Additionally or alternatively, the traction tool includes a reinforced polymer tube.

[0007] In some embodiments, the insertion tube includes a flexible catheter configured for insertion into a ventricle of the patient, and the spine is configured to contact myocardial tissue within the ventricle and apply an electrical signal to the myocardial tissue.

[0008] In a further embodiment, the spine comprises a drawn metal ribbon, which may be made from a nickel-titanium alloy. Additionally or alternatively, the spine comprises a flexible printed circuit board coupled to the structural member.

[0009] In a disclosed embodiment, the bipolar pulses applied by the electrical signal generator include a sequence of bipolar pulses having an amplitude of at least 200 V, each of the bipolar pulses having a duration of less than 20 μs. Additionally or alternatively, the sequence of bipolar pulses includes pairs of pulses, each pair including a positive pulse and a negative pulse.

[0010] In some embodiments, the electrical signal generator is configured to apply a bipolar pulse between a first set and a second set of spines, at least one of the sets including two or more of the spines.

[0011] In a further embodiment, the device includes a controller configured to send a control signal to the electrical signal generator, the electrical signal generator including a pulse generation assembly configured to receive a control signal from the controller and to transmit a sequence of bipolar pulses having an amplitude and duration responsive to the control signal, the electrical signal generator including a pulse routing assembly including a configurable network of switches configured to receive a control signal from the controller, receive a sequence of bipolar pulses from the pulse generation assembly, and select a set of spines in response to the received control signal, each set including one or more of the spines, to transmit the sequence of bipolar pulses via the selected set.

[0012] There is also provided, in accordance with an embodiment of the present invention, a method for medical treatment comprising: inserting a basket assembly including a plurality of elastic, conductive spines into a patient's body cavity such that the spines contact tissue within the body cavity; and applying a bipolar pulse between two or more sets of spines having an amplitude sufficient to cause irreversible electroporation (IRE) in tissue contacted by the spines, each set including one or more of the spines.

[0013] The invention will be more fully understood from consideration of the following detailed description taken in conjunction with the drawings, in which: [Brief description of the drawings]

[0014] [Figure 1] 1 is a schematic, pictorial illustration of a system for use in an IRE ablation procedure, in accordance with an embodiment of the present invention. [Figure 2a] FIG. 2 is a schematic side view of a basket assembly according to one embodiment of the present invention. [Figure 2b] 1A-1C are schematic cross-sectional views of a spine in a basket assembly according to two embodiments of the present invention. [Figure 2c]1A-1C are schematic cross-sectional views of a spine in a basket assembly according to two embodiments of the present invention. [Figure 3a] 1A-1C are schematic side views of a basket assembly in a collapsed state and an expanded state, respectively, according to an alternative embodiment of the present invention. [Figure 3b] 1A-1C are schematic side views of a basket assembly in a collapsed state and an expanded state, respectively, according to an alternative embodiment of the present invention. [Figure 4] FIG. 2 is a schematic diagram of a bipolar IRE pulse, in accordance with one embodiment of the present invention. [Diagram 5] FIG. 2 is a schematic diagram of a burst of bipolar pulses, in accordance with one embodiment of the present invention. [Figure 6] FIG. 2 is a block diagram that illustrates a schematic of an IRE module, in accordance with an embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] Overview IRE is a primarily non-thermal process that raises tissue temperature by at most a few degrees for a few milliseconds. Thus, IRE is different from RF (radio frequency) ablation, which raises tissue temperature by 20-70°C and destroys cells by heating. IRE utilizes bipolar pulses, i.e., a combination of positive and negative pulses, to avoid muscle contraction due to DC voltage. The pulses are applied between two bipolar electrodes, for example, on a catheter. Typically, the electrodes are relatively small to achieve localized IRE in the tissue. However, the use of small electrodes reduces the size of the area to be electroporated.

[0016] The embodiments of the invention described herein address the problem of increasing the area of ​​electroporation by providing a basket-type catheter with conductive spines that contact tissue in a body cavity, such as myocardial tissue in the heart. Each spine acts as an electrode, and an electrical signal generator applies bipolar pulses between one or more pairs of spines with an amplitude sufficient to induce IRE in the tissue the spines contact. The pair of spines to which the pulse is applied is selected according to the area to be electroporated. Using a set of spines as electrodes in this manner allows for the simultaneous electroporation of a relatively large area.

[0017] Additionally or alternatively, multiple sets of spines may be electrically connected together to create larger “virtual electrodes.” The IRE signal may be applied between one or more pairs of these “virtual electrodes” or sets.

[0018] A catheter having an expandable basket assembly according to embodiments of the present invention is typically inserted into the heart through a narrow sheath with the basket assembly in a collapsed state. To deploy within the body cavity, the basket assembly exits the sheath and expands to its operating state. In some embodiments, the spine is made of an elastic material and is manufactured to curve outward into the basket configuration upon release from the sheath. The catheter may include a pusher tube within the catheter's insertion tube. This pusher tube may be pushed distally at the end of the ablation procedure to straighten the spine, thereby collapsing the basket assembly so that it can be pulled back into the sheath, thereby facilitating removal of the catheter from the subject.

[0019] In other embodiments, the spine is manufactured such that the basket assembly is stable in a folded state, rather than an expanded state. A tow tool passing through the insertion tube is connected to the distal end of the basket assembly. After the basket assembly exits the sheath in the body cavity, pulling the tow tool causes the assembly to expand from its stable folded state to an expanded state, thereby allowing for deployment. Releasing the tow tool causes the basket assembly to return to its folded state, allowing it to be pulled back into the insertion tube for removal of the catheter from the subject. This configuration is advantageous in that the tow tool is typically thinner and more flexible than the pusher tube, thus allowing the catheter to be made thinner and more flexible. The tow tool may include, for example, either a simple wire, or alternatively a more complex assembly, such as a polymer tube with braids or embedded wires to minimize its elongation.

[0020] System Description 1 is a schematic, pictorial illustration of a system 20 for use in an IRE ablation procedure (also referred to as "IRE ablation" or "IRE procedure" in the following description), in accordance with an embodiment of the present invention. In the depicted embodiment, a physician 22 is using system 20 to perform an IRE ablation procedure on a heart 23 of a subject 24. The physician 22 performs the procedure using an ablation catheter 26 that includes an insertion tube 28 having a longitudinal axis 27, the distal end 29 of which is connected to a basket assembly 31 that includes a plurality of conductive spines 30 (shown in more detail in FIGS. 2a, 2b, and 2c).

[0021] The IRE system 20 comprises a processor 32 and an IRE module 34. The IRE module 34 includes an IRE generator 36 and an IRE controller 38, the IRE generator including a dedicated pulse generator as further described below. The IRE generator 36 generates an IRE signal under the control of the IRE controller 38, which generates an IRE signal including a train of bipolar electrical pulses. The pulses are targeted to selected spines 30, which act as electrodes for performing an IRE procedure. The processor 32 handles the input and output interface between the IRE system 20 and the physician 22, as well as communications to the IRE controller 38. The bipolar electrical pulses and the IRE module 34 are further described below with reference to FIGS. 4 and 5.

[0022] Processor 32 and IRE controller 38 each typically include a programmable processor that is programmed with software and / or firmware to perform the functions described herein. Alternatively or additionally, each of them may include hardwired and / or programmable hardware logic circuitry that performs at least some of these functions. IRE generator 36 comprises analog and digital components and assemblies for generating the IRE signal directed to spine 30. Processor 32, IRE generator 36, and IRE controller 38 are shown in the figures as separate monolithic functional blocks for simplicity, although in practice some of these functions may be combined within a single processing and control unit.

[0023] The processor 32 and the IRE module 34 typically reside within a console 40. The console 40 includes input devices 42, such as a keyboard and mouse. A display screen 44 is located adjacent to (or integral with) the console 40. The display screen 44 may optionally include a touch screen, thereby providing another input device.

[0024] The IRE system 20 may further include one or both of the following modules (typically resident within the console 40 ), connected to suitable interfaces and devices within the system 20 . An electrocardiogram (ECG) module 46 is coupled via a cable 48 to ECG electrodes 50 attached to the subject 24. The ECG module 46 is configured to measure the electrical activity of the heart 23. The tracking module 52 is coupled to one or more electromagnetic position sensors 54 at the distal end of the insertion tube 28 and, optionally, within the basket assembly 31. In the presence of an external magnetic field generated by one or more magnetic field generators 56, the electromagnetic position sensors 54 output signals that vary with the position of the sensor. Based on these signals, the tracking module 52 tracks the position of the spine 30 within the heart 23.

[0025] The above-mentioned modules 46 and 52 typically include both analog and digital components and are configured to receive analog signals and transmit digital signals. Each module may further include hardwired and / or programmable hardware logic circuitry that performs at least a portion of the module's functionality.

[0026] The catheter 26 is coupled to the console 40 via an electrical interface 58, such as a port or socket. Thus, the IRE signal is transmitted from the IRE generator 36 through the interface 58 and wiring inside the insertion tube 28 to the spine 30 within the basket assembly 31. Similarly, signals for tracking the position and orientation of the distal end 28 may be received by the tracking module 52 via the interface 58.

[0027] An external electrode 60, or “return patch,” may additionally be coupled externally between the subject 24, typically on the skin of the subject's torso, and the IRE module 34. The external electrode 60 may be used to couple the IRE signal between one of the spines 30 and the external electrode, and thus may be used to achieve deeper localized electroporation within the tissue 62.

[0028] The processor 32 receives setup parameters 66 for the treatment from the physician 22 (or from another user) prior to and / or during the IRE treatment. Using one or more suitable input devices 42, the physician 22 sets the setup parameters 66 to select one or more pairs of spines 30 and electrodes for activation (to receive the IRE signal) and the order in which the electrodes are activated, and to define the characteristics (timing and amplitude) of the IRE signal. Additionally, the processor 32 may display the setup parameters 66 on the display screen 26. As used herein, a pair of spines is not limited to adjacent spines, but is in all possible configurations that allow for the delivery of biphasic energy between (a) two single spines acting as two separate electrodes, or (b) two groups of spines. In case (a), an example of two single spines acting as an electrode "pair" in (a) is spine 30a in FIG. 2 adjacent to spine 30b, defining an "electrode pair" when a biphasic voltage is delivered to these spines 30a and 30b. Alternatively, spine 30a can be paired with non-adjacent spine 30c as an "alternate pair," spine 30a can be further "paired" with non-adjacent spine 30d, spine 30a can be further "paired" with distal spine 30f, spine 30b can be further "paired" with distal spine 30d, etc. In further variations, spines 30a and 30c can be energized as one "electrode pair," and spines 30b and 30d can be energized as a different "electrode pair," with various permutations possible. In case (b), with a group of spines acting as one electrode in cooperation with another group of different spines acting as another electrode to arrive at an "electrode pair," two or more spines (e.g., 30a and 30b) can act as one electrode and work with two or more spines (30c and 30d) grouped together as another electrode to define an electrode "pair" to deliver biphasic energy to the electrodes (i.e., spines 30a and 30b as one electrode and spines 30c and 30d as the other electrode to define an "electrode pair").Various permutations of single spines acting as a pair of electrodes can be combined with groups of spines acting as electrode pairs and utilized and are considered within the scope of the present invention. For example, the spines shown in FIG. 2 can be utilized to define two electrode pairs. Spines 30a and 30b define one electrode pair, and a group of spines 30c+30d (as one electrode) and another group of spines 30e+30f (as another electrode) define the second electrode pair of FIG. 2 (i.e., 30a+30b as the first electrode pair and 30c and 30d+30e and 30f as the second electrode pair).

[0029] In some embodiments, based on signals received from the tracking module 60, the processor 32 displays on the display 44 a relevant image 68 of the subject's anatomy, e.g., a map of the ventricles of the heart 23, annotated to indicate the current position and orientation of the basket assembly 31. Alternatively or additionally, based on signals received from the ECG module 46, the processor 32 may display the electrical activity of the heart 23 on the display screen 44.

[0030] To begin the procedure, the physician 22 inserts the catheter 26 into the subject 24, for example, via the subject's vascular system, and then navigates the insertion tube 28 with the control handle 70 to an appropriate site inside or outside the heart 23. During the insertion and navigation phase, the basket assembly 31 is generally in a folded configuration inside a sheath (not shown) to provide for easy insertion into the subject 24.

[0031] Once the insertion tube 28 is positioned in the required region within the heart 23, the basket assembly 31 is advanced from the sheath, assuming an expanded configuration. A more detailed description of the basket assembly 31 is shown in FIG. 2 below. Now, as shown diagrammatically in inset 71, the physician 22 brings the basket assembly 31 into contact with tissue 62 of the heart 23, such as myocardial or epicardial tissue. The IRE generator 36 under the control of the IRE controller 38 then generates an IRE signal comprising a train of pulses (shown in detail in FIG. 5). The IRE signal is delivered via the catheter 26 to pairs of spines 30 via different corresponding electrical conductors (not shown), causing a current 72 generated by the IRE signal to flow between each pair of spines (bipolar ablation) and to effect the desired irreversible electroporation of the tissue 62 across the expanded region between the spines.

[0032] FIG 2a is a schematic side view of a basket assembly 31, according to one embodiment of the present invention. The basket assembly 31 includes spines 30, individually labeled in FIG 2 as 30a, 30b, 30c, 30d, 30e, and 30f. The spines 30a-30f include long segments of resilient material that are electrically conductive or have a conductive coating or member attached thereto. For example, the spines 30a-30f may include a nickel-titanium alloy known as Nitinol.

[0033] The proximal tips 74 of the spines 30a-30f are mechanically joined at the proximal end 76 of the basket assembly 31, and the distal tips 78 of the spines are mechanically joined at the distal end 80 of the basket assembly (however, the proximal and distal tips 74, 78 of the spines 30a-30f are each electrically insulated from one another so that the spines can function as separate electrodes). The spines 30a-30f are fabricated such that the basket assembly 31 has an expanded state as its stable state. Thus, the spines 30a-30f bow radially outward when the basket assembly is placed in the body cavity, thereby contacting tissue 62 within the body cavity. The spines 30a-30f are electrically coupled to the IRE generator 36 (FIG. 1) via conductors in the catheter 26 to receive IRE ablation signals.

[0034] The IRE signal received from IRE generator 36 is coupled, for example, between spines 30a and 30b, causing electroporation to occur between these two spines. Due to the applied IRE signal, a current 72 (FIG. 1) flows along the entire length between spines 30a and 30b, thus causing electroporation over a large area within tissue 62. For example, application of basket assembly 31 to pulmonary vein ablation will cause electroporation over a 6-12 mm wide ring around the pulmonary vein.

[0035] The IRE signal may be coupled between any pair of spines 30a-30f, but typically the signal is applied between adjacent pairs of spines. Additionally or alternatively, the signal may be applied simultaneously or alternately between several pairs of spines. Although the basket assembly 31 is shown in FIG. 2 as including six spines, other numbers of spines (both more and less than six) may be used. Additionally or alternatively, a set of multiple spines 30 may be electrically connected together to form a larger "virtual electrode" that includes multiple spines. The IRE signal may be applied between one or more pairs of these "virtual electrodes" or sets.

[0036] 2b and 2c are schematic cross-sectional views of a spine 30 according to two embodiments of the present invention.

[0037] 2b is a schematic cross-sectional view of a spine 30, which includes a drawn Nitinol ribbon 33. The Nitinol ribbon 33 functions as a structural member of the spine 30 and as an electrical conductor for electrical current 72 (FIG. 1). Forming the Nitinol ribbon 33 by drawing is advantageous in that the edges 35 of the resulting ribbon are rounded (as opposed to the sharp edges formed in ribbons cut from a sheet of Nitinol), thus avoiding damage to tissue 62 contacted by the spine 30.

[0038] 2c is a schematic cross-sectional view of an alternative embodiment of a spine 30, which includes a composite of a structural member 37 and a conductive member 39. The structural member 37 includes a drawn Nitinol ribbon, for example, as in FIG. 2b. The conductive member 39 includes a conductive film, such as gold, that is disposed on a flexible printed circuit board (PCB) 41, which is then bonded to the structural member 37 with a suitable bonding and insulating member 43, such as a biocompatible epoxy or other adhesive. Thus, the structural member 37 is insulated from the tissue 62, and the current 72 is conducted to the tissue by the conductive member 39 exposed to the tissue.

[0039] Alternatively, the spine 30 may comprise a conductive or non-conductive structural member having a conductive coating (not shown).

[0040] Figures 3a and 3b are schematic side views of a basket assembly 90 in a collapsed and expanded state, respectively, in accordance with an alternative embodiment of the present invention. The same numerical labels as in Figures 1 and 2 are used for similar items in Figures 3a and 3b. As in Figures 2a, 3a, and 3b, the spine 30 comprises a long segment of resilient material that is conductive or has a conductive coating or has a conductive member attached thereto.

[0041] FIG. 3a shows the basket assembly 90 in a collapsed state, with the spines 30 straight and aligned parallel to the longitudinal axis 27. This is the stable state of the basket assembly 90, which will remain in the collapsed state unless it is forced into an expanded state when pushed out of the sheath. The ablation catheter 26 includes a tow tool 92 that extends through the insertion tube 28 and is capable of moving longitudinally within the insertion tube 28. The tow tool 92 has a distal end 94 attached to the distal end 80 of the basket assembly 90 and a proximal end (not shown) attached to the control handle 70. The proximal ends 74 of the spines 30 are fixed to the insertion tube 28, so that pulling the tow tool 92 from its proximal end shortens the distance between the distal end 78 and the proximal end 74 of each of the spines 30, thereby flexing the spines outward to unfold, as shown in FIG. 3b. When the traction tool 92 is released, the resilience of the spine 30 causes the basket assembly 90 to collapse to its original stable state (FIG. 3 a ), allowing the catheter 26 to be removed from the subject 24 .

[0042] The puller 92 may include any suitable elongated component having sufficient tensile strength and bending flexibility. For example, the puller 92 may include a simple wire. Alternatively, the puller 92 may include a more complex structure, such as a polymer tube with reinforcement in the form of a braid or embedded wires to minimize its elongation.

[0043] FIG. 5 is a schematic diagram of a bipolar IRE pulse 100, in accordance with one embodiment of the present invention.

[0044] Curve 102 shows the voltage V of a bipolar IRE pulse 100 as a function of time t during an IRE ablation procedure. The bipolar IRE pulse 100 includes a positive pulse 104 and a negative pulse 106, where the terms "positive" and "negative" refer to the arbitrarily selected polarities of the two spines 30 to which the bipolar pulse is applied. The amplitude of the positive pulse 104 is denoted as V+, and the time width of the pulse is denoted as t+. Similarly, the amplitude of the negative pulse 106 is denoted as V-, and the time width of the pulse is denoted as t-. The time interval between the positive pulse 104 and the negative pulse 106 is denoted as t 間隔 Exemplary values ​​for the parameters of the bipolar pulse 100 are shown in Table 1 below.

[0045] FIG. 5 is a schematic diagram of a burst 200 of bipolar pulses, according to one embodiment of the present invention.

[0046] In an IRE procedure, the IRE signal is delivered to the spine 30 as one or more bursts 200, as shown by curve 202. The bursts 200 are arranged in a series of N P N bipolar pulses, 100 T The length of the pulse train 204 is t T The period of the bipolar pulse 100 in the pulse train 204 is denoted as t PP and the spacing between successive columns is Δ T and during which no signal is applied. Exemplary values ​​for the parameters of burst 200 are shown in Table 1 below.

[0047] [Table 1]

[0048] Figure 6 is a block diagram that illustrates in schematic form details of the IRE module 34, in accordance with an embodiment of the present invention. As described above with reference to Figure 1, the IRE module 34 includes an IRE generator 36 and an IRE controller 38. The IRE generator 36 comprises a pulse generation assembly 406 and a pulse routing assembly 408. The pulse generation assembly 406 is configured to receive a control signal from the IRE controller 38 (as described below) and transmit a sequence of bipolar pulses having an amplitude and duration responsive to the control signal. The pulse routing assembly 408 comprises a configurable network of switches that receives a control signal from the IRE controller 38, receives a sequence of bipolar pulses from the pulse generation assembly 405, and selects a pair of spines 30 responsive to the received control signal and transmits the sequence of bipolar pulses via the selected pair.

[0049] The IRE controller 38 communicates with the processor 32 via bidirectional signals 410, which communicates commands to the IRE controller that reflect the setup parameters 66. The IRE controller 38 further communicates digital command signals 418 derived from the setup parameters 66 to the pulse generation assembly 406 that instruct the IRE generator 36 to generate IRE pulses, such as those shown in Figure 4 above. These IRE pulses are sent to the pulse routing assembly 408 as analog pulse signals 420 that are directed by the IRE controller 38.

[0050] The pulse routing assembly 408 is coupled to the spines 30 via output channels 422 and (optionally) to the return patch 60 via connections 424. For example, if the pulse routing assembly 408 is coupled to the six spines 30a-30f of the basket assembly 31 (FIG. 2), then six of the output channels 422 are coupled to the spines. The pulse routing assembly 408 is driven by the IRE controller 38 to couple IRE pulses to the spines 30 as defined by the setup parameters 66. Specifically, the IRE controller 38 drives the pulse routing assembly 408 to couple IRE pulses to one or more selected pairs of spines 30. The routing assembly 408 may also electrically couple multiple spines 30 together to form a set that can function as a "virtual electrode." Thus, the IRE controller 38 controls both the generation and routing of IRE pulses to the spines 30.

[0051] Although FIG. 6 shows ten channels 422, the IRE generator 36 may alternatively include a different number of channels, such as, for example, eight, sixteen, or twenty channels, or any other suitable number of channels.

[0052] It will be understood that the embodiments described above are given by way of example, and that the present invention is not limited to what is specifically shown and described herein above. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described herein above, as well as variations and modifications thereof not disclosed in the prior art that would occur to one skilled in the art upon reading the foregoing description.

[0053] [Embodiment] (1) A medical device comprising: A probe comprising: an insertion tube configured for insertion into a body cavity of a patient; a basket assembly distally connected to the insertion tube and including a plurality of conductive spines configured to contact tissue within the body; and an electrical signal generator configured to apply a bipolar pulse between one or more pairs of the spines having an amplitude sufficient to cause irreversible electroporation (IRE) in the tissue contacted by the spines. (2) The device of embodiment 1, wherein the spines have respective proximal and distal tips, the proximal tips of the spines are mechanically joined at the proximal end of the basket assembly, and the distal tips of the spines are mechanically joined at the distal end of the basket assembly, and when the basket assembly is deployed within the body cavity, the spines bend radially outward, thereby contacting the tissue within the body cavity. (3) The device of embodiment 2, wherein the basket assembly has a stable folded state, and the device includes a traction tool attached to the distal end of the basket assembly and slidably disposed within the insertion tube, such that the spine is adapted to deflect radially outward in response to pulling the traction tool in a proximal direction through the insertion tube. (4) The apparatus of claim 3, wherein the traction device comprises a reinforced polymer tube. (5) The device of embodiment 1, wherein the insertion tube comprises a catheter configured for insertion into a ventricle of the patient, and the spine is configured to contact myocardial tissue within the ventricle and apply the electrical signal to the myocardial tissue.

[0054] (6) The device of claim 1, wherein the spine comprises a drawn metal ribbon. (7) The apparatus of claim 6, wherein the metal ribbon comprises a nickel-titanium alloy. (8) The device of embodiment 1, wherein the spine comprises a flexible printed circuit board coupled to a structural member. (9) The device of embodiment 1, wherein the bipolar pulses applied by the electrical signal generator include a sequence of bipolar pulses having an amplitude of at least 200 V, each of the bipolar pulses having a duration of less than 20 μs. (10) The apparatus of embodiment 9, wherein the sequence of bipolar pulses includes pairs of pulses, each pair including a positive pulse and a negative pulse.

[0055] (11) The device of embodiment 1, wherein the electrical signal generator is configured to apply the bipolar pulse between a first set and a second set of the spines, at least one of the sets including two or more of the spines. (12) A controller configured to transmit a control signal to the electrical signal generator, the electrical signal generator comprising: a pulse-generating assembly configured to receive the control signal from the controller and to transmit a sequence of bipolar pulses having an amplitude and duration responsive to the control signal; The apparatus of embodiment 1, comprising: a pulse routing assembly including a configurable network of switches configured to receive the control signal from the controller, receive the sequence of bipolar pulses from the pulse generating assembly, and select a set of the spines in response to the received control signal, each set including one or more of the spines, and to transmit the sequence of bipolar pulses via the selected set. (13) A method of medical treatment comprising: inserting a basket assembly including a plurality of conductive spines into a body cavity of a patient such that the spines contact tissue within the body cavity; applying a bipolar pulse between two or more sets of spines having an amplitude sufficient to cause irreversible electroporation (IRE) in the tissue contacted by the spines, each set including one or more of the spines. (14) The method of embodiment 13, wherein at least one of the sets of spines comprises a plurality of spines. (15) The method of embodiment 13, wherein the spines have respective proximal and distal tips, the proximal tips of the spines are mechanically joined at the proximal end of the basket assembly, and the distal tips of the spines are mechanically joined at the distal end of the basket assembly, and when the basket assembly is deployed within the body cavity, the spines bend radially outward, thereby contacting the tissue within the body cavity.

[0056] (16) The method of embodiment 15, wherein the basket assembly has a stable folded state, and inserting the basket assembly includes pulling a traction device attached to the distal end of the basket assembly in a proximal direction to cause the spine to bend radially outward. (17) The method of embodiment 13, wherein inserting the basket assembly includes inserting a catheter into the patient's ventricle with the basket assembly connected to a distal end of the catheter, whereby the spine contacts myocardial tissue in the ventricle and applies the electrical signal to the myocardial tissue. 18. The method of claim 13, wherein the spine comprises a nickel-titanium alloy. (19) The method of embodiment 13, wherein applying the bipolar pulses comprises applying a sequence of bipolar pulses having an amplitude of at least 200 V, each of the bipolar pulses having a duration of less than 20 μs. (20) The method of embodiment 19, wherein applying the sequence of bipolar pulses includes applying pairs of pulses, each pair including a positive pulse and a negative pulse.

[0057] (21) The applying of the bipolar pulse comprises: generating a sequence of bipolar pulses having a specific amplitude and duration; selecting the set of spines; transmitting the sequence of bipolar pulses over a selected set.

Claims

1. 1. A medical device, comprising: A probe comprising: an insertion tube configured for insertion into a body cavity of a patient; a basket assembly distally connected to the insertion tube and including a plurality of conductive spines configured to contact tissue within the body; and an electrical signal generator configured to apply a bipolar pulse between a first and a second conductive spine of the plurality of conductive spines, the bipolar pulse having an amplitude sufficient to cause irreversible electroporation (IRE) in the tissue contacted by the first and second conductive spines; A medical device, wherein when the bipolar pulse is applied between the first conductive spine and the second conductive spine, a current flows between an entire length of the first conductive spine and an entire length of the second conductive spine.

2. 2. The medical device of claim 1, wherein the conductive spines have respective proximal and distal tips, the proximal tips of the conductive spines are mechanically joined at a proximal end of the basket assembly and the distal tips of the conductive spines are mechanically joined at a distal end of the basket assembly, and when the basket assembly is deployed within the body cavity, the conductive spines deflect radially outward, thereby contacting the tissue within the body cavity.

3. 3. The medical device of claim 2, wherein the basket assembly has a stable folded state, and the medical device comprises a traction tool attached to the distal end of the basket assembly and slidably disposed within the insertion tube, such that the conductive spines are adapted to deflect radially outward in response to pulling the traction tool in a proximal direction through the insertion tube.

4. The medical device of claim 3 , wherein the traction tool comprises a reinforced polymer tube.

5. 10. The medical device of claim 1, wherein the insertion tube comprises a catheter configured for insertion into a ventricle of the patient, and the conductive spines are configured to contact and apply an electrical signal to myocardial tissue within the ventricle.

6. The medical device of claim 1 , wherein the conductive spine comprises a drawn metal ribbon.

7. The medical device of claim 6 , wherein the metal ribbon comprises a nickel-titanium alloy.

8. The medical device of claim 1 , wherein the conductive spine comprises a flexible printed circuit board coupled to a structural member.

9. 2. The medical device of claim 1, wherein the bipolar pulses applied by the electrical signal generator include a sequence of bipolar pulses having an amplitude of at least 200 V, each of the bipolar pulses having a duration of less than 20 μs.

10. 10. The medical device of claim 9, wherein the sequence of bipolar pulses includes pairs of pulses, each pair including a positive pulse and a negative pulse.

11. 2. The medical device of claim 1, wherein the electrical signal generator is configured to apply the bipolar pulse between a first set and a second set of the conductive spines, at least one of the first set and the second set including two or more of the conductive spines.

12. a controller configured to send a control signal to the electrical signal generator, the electrical signal generator comprising: a pulse-generating assembly configured to receive the control signal from the controller and to transmit a sequence of bipolar pulses having an amplitude and duration responsive to the control signal; 2. The medical device of claim 1, comprising: a pulse-routing assembly including a configurable network of switches configured to receive the control signals from the controller, receive the sequence of bipolar pulses from the pulse-generating assembly, and select a set of the conductive spines in response to the received control signals, each set including one or more of the conductive spines, for transmitting the sequence of bipolar pulses via the selected set.

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