Voltage-controlled pulse sequences for irreversible electroporation ablation

Abstract

At least some embodiments of the present disclosure are directed to an electroporation ablation system for treating a target tissue of a patient. The electroporation ablation system includes an ablation catheter including a catheter electrode configured to generate an electric field at the target tissue in response to a plurality of electrical pulse sequences delivered in a plurality of treatment sections, a controller configured to receive a first pulse voltage of a first electrical pulse sequence measured during a first treatment section of the plurality of treatment sections and determine a charging voltage based on the first pulse voltage, and an electroporation generator. The electroporation generator is operably coupled to the catheter electrode and the controller and configured to deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the plurality of treatment sections.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to medical devices, systems, and methods for ablating tissue in a patient, and more particularly, to medical devices, systems, and methods for ablation of tissue by electroporation. [Background technology]

[0002] Ablation procedures are used to treat many different conditions in patients. Ablation can be used to treat cardiac arrhythmias, benign tumors, cancerous tumors, and to control bleeding during surgery. Ablation is typically performed by thermal ablation techniques, including radiofrequency (RF) ablation and cryoablation. In RF ablation, a probe is inserted into the patient, and radiofrequency waves are transmitted through the probe to surrounding tissue. The radiofrequency waves generate heat, which destroys surrounding tissue and cauterizes blood vessels. In cryoablation, a hollow needle or cryoprobe is inserted into the patient, and a low-temperature, heat-conducting fluid is circulated through the probe, freezing and destroying surrounding tissue. RF ablation and cryoablation techniques indiscriminately destroy tissue through cell necrosis, which can damage or destroy otherwise healthy tissue, such as tissue in the esophagus, phrenic nerve cells, and tissue in the coronary arteries.

[0003] Another ablation technique uses electroporation. Electroporation, or electropermeabilization, involves applying an electric field to cells to increase the permeability of the cell membrane. Electroporation can be reversible or irreversible, depending on the strength of the electric field. If electroporation is reversible, the increased permeability of the cell membrane can be used to introduce chemicals, drugs, and / or deoxyribonucleic acid (DNA) into the cells prior to cellular healing and recovery. If electroporation is irreversible, the affected cells die by apoptosis.

[0004] Irreversible electroporation (IRE) can be used as a non-thermal ablation technique. IRE uses a train of short, high-voltage pulses to generate an electric field strong enough to kill cells by apoptosis. For cardiac tissue ablation, IRE may be a safe and effective alternative to the indiscriminate destruction of thermal ablation techniques such as RF ablation and cryoablation. IRE can be used to kill target tissue, such as myocardial tissue, by using an electric field strength and duration that kills the target tissue but does not permanently damage other cells or tissues, such as non-target myocardial tissue, red blood cells, vascular smooth muscle tissue, endothelial tissue, and nerve cells. Summary of the Invention

[0005] As described in the Examples, Example 1 is an electroporation ablation system for treating target tissue of a patient. The electroporation ablation system includes an ablation catheter including a catheter electrode configured to generate an electric field at the target tissue in response to multiple electrical pulse sequences delivered in multiple treatment sections, a controller configured to receive a first pulse voltage of the first electrical pulse sequence measured during a first treatment section of the multiple treatment sections and determine a charging voltage based on the first pulse voltage, and an electroporation generator. The electroporation generator is operably coupled to the catheter electrode and the controller and configured to deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the multiple treatment sections, the second treatment section being after the first treatment section, and the controlled pulse voltage being related to the charging voltage.

[0006] Example 2 is the electroporation ablation system of Example 1, wherein the electroporation generator includes a capacitor bank, and the electroporation generator is configured to charge the capacitor bank to a voltage level of the charging voltage before initiation of the second treatment section.

[0007] Example 3 is the electroporation ablation system of Example 1 or 2, wherein the first electrical pulse sequence includes a plurality of first electrical pulses. Example 4 is the electroporation ablation system of Example 3, wherein the first pulse voltage comprises one or more pulse voltages of the plurality of first electrical pulses measured during the first treatment section.

[0008] Example 5 is an electroporation ablation system according to any one of Examples 1-4, wherein the controller is further configured to receive a first pulse current of a first electrical pulse sequence delivered during the first treatment section, and the controller is further configured to determine a charging voltage based on the first pulse voltage and the first pulse current.

[0009] Example 6 is the electroporation ablation system of Example 5, wherein the controller is further configured to determine a first tissue impedance based on the first pulse voltage and the first pulse current.

[0010] Example 7 is an electroporation ablation system as described in Example 6, in which the controlled pulse voltage is a fraction of the charging voltage. Example 8 is the electroporation ablation system of Example 7, wherein the ratio of the controlled pulse voltage to the charging voltage is related to the first tissue impedance.

[0011] Example 9 is an electroporation ablation system according to any one of Examples 1 to 8, wherein the electroporation generator is further configured to deliver a scan electrical pulse sequence at a scan voltage during a scan section preceding the plurality of treatment sections, the controller is further configured to determine an initial tissue impedance based on an initial pulse voltage of the scan electrical pulse sequence and an initial pulse current of the scan electrical pulse sequence measured during the scan section, and the controller is further configured to determine an initial charging voltage based on the initial tissue impedance.

[0012] Example 10 is the electroporation ablation system described in Example 9, in which the scan voltage is less than the controlled pulse voltage. Example 11 is the electroporation ablation system of Example 9, wherein the scanning electrical pulse sequence includes a single non-ablative electrical pulse.

[0013] Example 12 is a method of using an electroporation ablation device, the method including: positioning a catheter of the electroporation ablation device anatomically proximate to a target ablation location, the catheter including one or more catheter electrodes and configured to generate an electric field in response to multiple electrical pulse sequences delivered in multiple treatment sections; receiving a first pulse voltage of the first electrical pulse sequence measured during a first treatment section of the multiple treatment sections; determining a charging voltage based on the first pulse voltage; and delivering a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the multiple treatment sections, the second treatment section being after the first treatment section, the controlled pulse voltage being related to the charging voltage.

[0014] Example 13 is the method of Example 12, further including receiving a first pulse current of the first electrical pulse sequence measured during the first treatment section, and determining the charging voltage includes determining the charging voltage based on the first pulse voltage and the first pulse current.

[0015] Example 14 is the method of Example 13, further including determining a first tissue impedance based on the first pulse voltage and the first pulse current, and wherein determining the charging voltage includes determining the charging voltage based on the first tissue impedance.

[0016] Example 15 is the method of any one of Examples 12-14, further including delivering a scan electrical pulse sequence during a scan section, receiving an initial pulse voltage of the scan electrical pulse sequence measured during the scan section, receiving an initial pulse current of the scan electrical pulse sequence measured during the scan section, and determining an initial tissue impedance based on the measured initial pulse voltage and initial pulse current, wherein the scan section is before a first treatment section, and the scan electrical pulse sequence has a scan pulse voltage that is lower than the controlled pulse voltage.

[0017] Example 16 is an electroporation ablation system for treating target tissue of a patient. The electroporation ablation system includes an ablation catheter including a catheter electrode configured to generate an electric field at the target tissue in response to multiple electrical pulse sequences delivered in multiple treatment sections, a controller configured to receive a first pulse voltage of the first electrical pulse sequence measured during a first treatment section of the multiple treatment sections and determine a charging voltage based on the first pulse voltage, and an electroporation generator. The electroporation generator is operably coupled to the catheter electrode and the controller and configured to deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the multiple treatment sections, the second treatment section being after the first treatment section, and the controlled pulse voltage being related to the charging voltage.

[0018] Example 17 is the electroporation ablation system of Example 16, wherein the electroporation generator includes a capacitor bank, and the electroporation generator is configured to charge the capacitor bank to a voltage level of the charging voltage before initiation of the second treatment section.

[0019] Example 18 is the electroporation ablation system of Example 16, wherein the first electrical pulse sequence includes a plurality of first electrical pulses. Example 19 is the electroporation ablation system of Example 18, wherein the first pulse voltage comprises one or more pulse voltages of the plurality of first electrical pulses measured during the first treatment section.

[0020] Example 20 is the electroporation ablation system of Example 16, wherein the controller is further configured to receive a first pulse current of a first electrical pulse sequence delivered during the first treatment section, and the controller is further configured to determine a charging voltage based on the first pulse voltage and the first pulse current.

[0021] Example 21 is the electroporation ablation system of Example 20, wherein the controller is further configured to determine a first tissue impedance based on the first pulse voltage and the first pulse current.

[0022] Example 22 is the electroporation ablation system of Example 21, wherein the controlled pulse voltage is a portion of the charging voltage. Example 23 is the electroporation ablation system of Example 22, wherein the ratio of the controlled pulse voltage to the charging voltage is related to the first tissue impedance.

[0023] Example 24 is the electroporation ablation system of Example 16, wherein the electroporation generator is further configured to deliver a scan electrical pulse sequence at a scan voltage during a scan section before the plurality of treatment sections, the controller is further configured to determine an initial tissue impedance based on an initial pulse voltage of the scan electrical pulse sequence and an initial pulse current of the scan electrical pulse sequence measured during the scan section, and the controller is further configured to determine an initial charging voltage based on the initial tissue impedance.

[0024] Example 25 is the electroporation ablation system described in Example 24, wherein the scan voltage is less than the controlled pulse voltage. Example 26 is the electroporation ablation system of Example 24, wherein the scanning electrical pulse sequence includes a single non-ablative electrical pulse.

[0025] Example 27 is an electroporation ablation system described in Example 16, wherein the electroporation generator includes a plurality of capacitor banks, and the electroporation generator is configured to individually charge at least one of the plurality of capacitor banks to a voltage level.

[0026] Example 28 is an electroporation ablation system described in Example 27, wherein the electroporation generator is configured to deliver a pulse sequence for a particular treatment section of the plurality of treatment sections using a first capacitor bank of the plurality of capacitor banks, and to charge a second capacitor bank of the plurality of capacitor banks to a voltage level of the determined charging voltage prior to the start of a treatment section immediately following the particular treatment section of the plurality of treatment sections.

[0027] Example 29 is an electroporation ablation system as described in Example 27, wherein the catheter electrode comprises a plurality of electrode pairs, and each capacitor bank of the plurality of capacitor banks is operably coupled to one or more electrode pairs of the plurality of electrode pairs.

[0028] Example 30 is the electroporation ablation system of Example 29, wherein the controller is configured to determine a bank charging voltage for each capacitor bank of the plurality of capacitor banks.

[0029] Example 31 is a method of using an electroporation ablation device, the method including: positioning a catheter of the electroporation ablation device anatomically proximate to a target ablation location, the catheter including one or more catheter electrodes and configured to generate an electric field in response to multiple electrical pulse sequences delivered in multiple treatment sections; receiving a first pulse voltage of the first electrical pulse sequence measured during a first treatment section of the multiple treatment sections; determining a charging voltage based on the first pulse voltage; and delivering a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the multiple treatment sections, the second treatment section being after the first treatment section, the controlled pulse voltage being related to the charging voltage.

[0030] Example 32 is the method of Example 31, further including receiving a first pulse current of the first electrical pulse sequence measured during the first treatment section, and determining the charging voltage includes determining the charging voltage based on the first pulse voltage and the first pulse current.

[0031] Example 33 is the method of Example 32, further including determining a first tissue impedance based on the first pulse voltage and the first pulse current, and wherein determining the charging voltage includes determining the charging voltage based on the first tissue impedance.

[0032] Example 34 is the method of Example 30, further including delivering a scan electrical pulse sequence during a scan section, receiving an initial pulse voltage of the scan electrical pulse sequence measured during the scan section, receiving an initial pulse current of the scan electrical pulse sequence measured during the scan section, and determining an initial tissue impedance based on the measured initial pulse voltage and initial pulse current, wherein the scan section is before a first treatment section, and the scan electrical pulse sequence has a scan pulse voltage that is lower than the controlled pulse voltage.

[0033] Example 35 is the method of example 34, wherein the scan pulse voltage is a non-ablation voltage level. While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive. [Brief explanation of the drawings]

[0034] [Figure 1] FIG. 1 is an exemplary system diagram for an electroporation ablation system according to an embodiment of the presently disclosed subject matter. [Figure 2A] FIG. 2A is an exemplary graph of pulse voltage varying across multiple treatment sections without adjusting charging voltage. [Figure 2B] FIG. 2B is an exemplary graph of pulse current varying across multiple treatment sections without adjusting the charging voltage. [Figure 2C] FIG. 2C is an exemplary graph of tissue impedance varying across multiple treatment sections. [Figure 3] FIG. 3 is an illustrative example of multiple scan and treatment sections associated with a heartbeat. [Figure 4]FIG. 4 is an exemplary schematic circuit diagram of an electroporation generator used for the electroporation ablation section, according to certain embodiments of the present disclosure. [Figure 5A] 5A and 5B illustrate an exemplary embodiment of a catheter that can be used for electroporation, including irreversible electroporation ablation, in accordance with an embodiment of the presently disclosed subject matter. [Figure 5B] 5A and 5B illustrate an exemplary embodiment of a catheter that can be used for electroporation, including irreversible electroporation ablation, in accordance with an embodiment of the presently disclosed subject matter. [Figure 6] FIG. 6 is an exemplary flow diagram illustrating an exemplary method of using an electroporation ablation device according to some embodiments of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0035] While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.

[0036] As used herein with respect to measurements (e.g., dimensions, characteristics, attributes, components, etc.) and ranges thereof of tangible (e.g., products, inventory, etc.) and / or intangible (e.g., data, electronic representations of currency, accounts, information, parts of things (e.g., percentages, fractions), calculations, data models, dynamic system models, algorithms, parameters, etc.), "about" and "approximately" mean a measurement that is inclusive of the stated measurement and reasonably close to the stated measurement, but which may be subject to measurement error, differences in calibration of measuring and / or manufacturing equipment, human error in reading and / or setting measurements, other measurements (e.g., other related to "measurements" may be used interchangeably to refer to measurements that also include any measurements that may differ by reasonably small amounts as understood and readily identified by those skilled in the art due to adjustments made to optimize performance and / or structural parameters taking into account related measurements, imprecise adjustment and / or manipulation of objects, settings, and / or measurements by a particular implementation scenario, humans, computing devices, and / or machines, system tolerances, control loops, machine learning, predictable variations (e.g., statistically insignificant variations, chaotic variations, system and / or model instability, etc.), preferences, and / or the like.

[0037] Although an example method may be represented by one or more drawings (e.g., flow diagrams, communication flows, etc.), the drawings should not be construed as implying any requirement of, or a particular order between, the various steps disclosed herein. However, certain embodiments may require certain steps and / or a particular order between certain steps (e.g., the operation of some steps may depend on the results of previous steps), as may be explicitly described herein and / or understood from the nature of the steps themselves. Additionally, a "set," "subset," or "group" of items (e.g., inputs, algorithms, data values, etc.) may include one or more items, and similarly, a subset or subgroup of items may include one or more items. "Plurality" means more than one.

[0038] As used herein, the term "based on" is not meant to be limiting, but rather indicates that a determination, identification, prediction, calculation, and / or the like is performed by using at least the term preceding "based on" as an input. For example, predicting an outcome based on particular information may additionally or alternatively base the same determination on other information.

[0039] Cryogenic and radiofrequency (RF) energy indiscriminately destroy tissue through cell necrosis, which can damage the esophagus, phrenic nerve, and coronary arteries, among other undesirable effects. Irreversible electroporation (IRE) uses short (e.g., 100 microseconds or less) pulses of high voltage to kill cells through apoptosis. IRE can be targeted to destroy myocardium while sparing other adjacent tissues, including esophageal vascular smooth muscle and endothelium. After IRE ablation begins, pores are induced in cell membranes, releasing intracellular fluid into the extracellular matrix, resulting in increased tissue conductivity and decreased tissue impedance. Changes in tissue impedance occur rapidly over the course of multiple IRE treatment sections, also referred to as treatment bursts or treatment sections. A treatment section (e.g., 10 milliseconds in duration) may include multiple electrical pulses (e.g., 20 pulses, 30 pulses, etc.) generated and delivered by an electroporation generator. If the electroporation generator does not regulate its charging voltage provided by the power supply component, the treatment pulse voltage will drop by as much as 40% over the course of IRE ablation. Because IRE treatment relies on an electric field, a drop in pulse voltage can potentially affect the effectiveness of the IRE treatment.

[0040] The present disclosure describes systems, devices, and methods for performing ablation using voltage-controlled electrical pulse sequences. In some embodiments, the pulse voltage and / or pulse current are measured during a treatment section and used to determine a charge voltage for the next treatment section so that each electrical pulse has a voltage that approaches a target pulse voltage during the next treatment section. As used herein, charge voltage refers to the voltage generated by an electroporation generator, which may be the voltage of one or more capacitor banks or other power sources. In some embodiments, tissue impedance is calculated based on the pulse voltage and pulse current. In some examples, tissue impedance is used to determine the charge voltage.

[0041] 1 shows an exemplary system diagram of an electroporation ablation system 100 according to an embodiment of the presently disclosed subject matter. Electroporation ablation system 100 includes one or more electroporation ablation catheters 110, a controller 120, one or more sensors 130, an electroporation generator 140, and a memory 160. In an embodiment, electroporation ablation system 100 is configured to deliver electric field energy to target tissue within a patient's heart to cause apoptosis of the tissue, rendering the tissue unable to conduct electrical signals. In some examples, electroporation ablation system 100 can be connected to other system(s) 170, such as a mapping system, an electrophysiology system, and / or the like.

[0042] In some embodiments, catheter 110(s) may be various types and forms of electroporation catheters, such as, for example, linear ablation catheters, regional ablation catheters, circumferential catheters, and / or the like. In embodiments, electroporation ablation system 100 includes an introducer sheath (not shown) operable to provide a delivery conduit that enables electroporation ablation catheter 110 to be deployed to a specific target site within a patient's cardiac chamber. In some examples, electroporation ablation catheter 110 includes a shaft having a distal end and a catheter electrode located at the distal end of the shaft and spatially arranged to generate an electric field at the target tissue in response to multiple electrical pulse sequences delivered in multiple treatment sections. In some examples, catheter 110(s) includes deflectable catheter(s).

[0043] In some examples, catheter(s) 110 include one or more electrodes for generating an electric field for ablation. Electroporation generator 140, also referred to as a pulse generator, is configured to generate ablation pulses / energies, or pulses / energies referred to as electroporation pulses / energies, that are delivered to the electrodes of catheter(s) 110. Electroporation pulses are typically high voltage and short pulses. Controller 120 is configured to control functional aspects of electroporation ablation system 100. In embodiments, electroporation controller 120 is configured to control electroporation generator 140 for generating and delivering ablation energy to electrodes of catheter 110 that are individually addressable, in some examples, for each of one or more electrodes of catheter(s) 110. In such examples, controller 120 may control the delivery of ablation energy to each electrode.

[0044] In some embodiments, the electroporation controller 120 can control the output voltage (i.e., the pulse voltage of the pulse sequence) generated by the electroporation generator 140. In some embodiments, the electroporation generator 140 includes a capacitor bank 145 that can be charged and discharged to generate a charge voltage for generating the electrical pulses. In some examples, the electroporation controller 120 can determine the charge voltage of the capacitor bank 145 in response to sensed data. In some implementations, the charge voltage is a voltage generated by a power supply component (e.g., the capacitor bank 145) of the electroporation generator 140. In some examples, the capacitor bank 145 includes one or more capacitor banks, such that at least one capacitor bank provides a charge voltage for a current treatment section of the electrical pulse (e.g., a current treatment burst) and at least one capacitor bank is charged to provide a charge voltage for a next treatment section of the electrical pulse (e.g., a next treatment burst). In some embodiments, the electroporation generator 140 has an impedance referred to as an internal impedance, or generator impedance. In some examples, the electroporation generator 140 can generate electrical pulses at a pulse voltage, or voltage referred to as output voltage, that is lower than the charge voltage due to generator impedance. In some examples, the pulse voltage is a fraction of the charge voltage. In some examples, a user can set a target pulse voltage via an interface (e.g., a user interface, a software interface, a system interface) to the controller.

[0045] In some embodiments, electroporation controller 120 receives sensor data collected by sensor(s) and / or sensor 130 of catheter(s) positioned proximate the ablation location. In some examples, controller 120 is configured to determine tissue impedance near the electroporation location based on measured pulse voltage and / or pulse current. In some examples, controller 120 is configured to determine a charging voltage based on the measured pulse voltage and / or tissue impedance. In some examples, controller 120 is configured to determine the charging voltage based on a target pulse voltage, generator impedance, and / or tissue impedance. In some examples, controller 120 is configured to control capacitor bank 145 based on the determined charging voltage.

[0046] In some embodiments, the controller 120 is configured to receive a first pulse voltage and / or a first pulse current of a first electrical pulse sequence to be delivered during a first treatment section of the multiple treatment sections. In some implementations, the electrical pulse sequence includes multiple electrical / electroporation pulses for the treatment section. In some examples, the first pulse voltage and / or the first pulse current are measured for the last electrical pulse of the treatment section. In some examples, the first pulse voltage and / or the first pulse current are measured for the first electrical pulse of the treatment section. In some examples, the first pulse voltage and / or the first pulse current are determined based on measurements of multiple electrical pulses of the treatment section. In one example, the first pulse voltage and / or the first pulse current are average voltages and / or currents, respectively, measured for the multiple electrical pulses of the treatment section. In one example, the first pulse voltage and / or the first pulse current are average voltages and / or currents, respectively, measured for all electrical pulses of the treatment section.

[0047] In some embodiments, the controller 120 determines the charge voltage based on the first pulse voltage. In some examples, the controller 120 determines a charge voltage difference between the determined charge voltage and a current charge level of the capacitor bank 145. In some examples, the controller 120 determines the charge voltage difference based on a percentage difference between the measured pulse voltage and a target pulse voltage. For example, the charge voltage difference is determined by multiplying the current charge voltage by the percentage difference between the measured pulse voltage and the target pulse voltage. In some examples, the controller 120 controls or sets the capacitor bank 145 based on the determined charge voltage and / or charge voltage difference. In some embodiments, the electroporation generator 140 is operably coupled to the catheter electrode and the controller 120 and configured to deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the multiple treatment sections, the second treatment section being after the first treatment section. In some examples, the controlled pulse voltage is based at least in part on the determined charge voltage. In some examples, the capacitor bank 145 is set to the determined charge voltage level.

[0048] In some embodiments, the controller 120 is configured to determine a charge voltage for the second treatment section based on the first pulse voltage and the first pulse current. In some examples, the controller 120 is configured to determine a first tissue impedance based on the first pulse voltage and the first pulse current. In some examples, the controller 120 is configured to determine a charge voltage based on the first tissue impedance and a target pulse voltage. In some examples, the controller 120 is configured to determine a charge voltage based on the first tissue impedance, the target pulse voltage, and the generator impedance. In some embodiments, the electroporation generator 140 is configured to receive a signal indicative of the determined charge voltage and charge the capacitor bank 145 to the determined charge voltage level before the start of the next treatment section. In some examples, the controlled pulse voltage is a fraction of the determined charge voltage. In some examples, the ratio of the controlled pulse voltage to the determined charge voltage is associated with the first tissue impedance.

[0049] In embodiments, controller 120 is configured to measure pulse voltage and / or pulse current during each or some of the treatment sections to determine a charge voltage for the subsequent treatment section. In some embodiments, controller 120 is configured to store the pulse voltage, pulse current, charge voltage, generator impedance, and / or tissue impedance in data repository 165. FIG. 2A is an exemplary graph of pulse voltage varying over multiple treatment sections without adjusting charge voltage. As shown, the pulse voltage decreases over the series of treatment sections. FIG. 2B is an exemplary graph of pulse current varying over several treatment sections without adjusting charge voltage. As shown, the pulse current increases over the series of treatment sections. FIG. 2C is an exemplary graph of tissue impedance varying over multiple treatment sections. As shown, the tissue impedance decreases over the series of treatment sections.

[0050] In some embodiments, the electroporation generator 140 is configured to deliver a scan electrical pulse sequence at a scan voltage during a scan section prior to the multiple treatment sections, the scan voltage being lower than a treatment voltage (e.g., a target pulse voltage). In some examples, the scan voltage is a non-ablative voltage level. In some examples, the scan electrical pulse sequence is a single non-ablative electrical pulse. In some examples, the controller 120 is configured to determine an initial tissue impedance based on an initial pulse voltage of the scan electrical pulse sequence and an initial pulse current of the scan electrical pulse sequence measured during the scan section. In some examples, the controller 120 is configured to determine an initial charging voltage based on the initial tissue impedance. In some examples, the controller 120 is configured to determine the initial charging voltage based on the initial tissue impedance and the target pulse voltage. In some examples, the controller 120 is configured to determine the initial charging voltage based on the initial tissue impedance, the target pulse voltage, and the generator impedance.

[0051] FIG. 3 is an illustrative example of multiple scan and treatment sections associated with a heartbeat. As shown, a treatment section 330 is provided during the heartbeat depicted in waveform 310. In this example, scan section 320 precedes treatment section 330. In some embodiments, electroporation generator 140 is configured to charge capacitor bank 145 to a determined charging voltage before the start of each treatment section. For example, at a heart rate of 90 BPM (beats per minute), electroporation generator 140 is configured to charge capacitor bank 145 to the determined charging voltage level within 667 milliseconds. In some examples, electroporation controller 120 is configured to model the electric field that may be generated by catheter 110, which often includes consideration of the physical characteristics of electroporation ablation catheter 110, including the electrodes, and the spatial relationship of the electrodes on electroporation ablation catheter 110. In embodiments, electroporation controller 120 is configured to control the field strength of the electric field formed by the electrodes of catheter 110 to 1500 volts per centimeter or less.

[0052] In some embodiments, catheter 110 includes two or more electrode pairs, and capacitor bank 145 includes two or more capacitor banks, with each capacitor bank of capacitor bank 145 (e.g., a group of capacitor banks) configured to charge one or more electrode pairs. In some examples, electroporation controller 120 is configured to receive measured pulse voltages from the electrode pairs and determine a charging voltage for each respective capacitor bank for charging the electrode pairs. As an example, capacitor bank 145 includes two capacitor banks (e.g., Bank A, Bank B), with each capacitor bank configured to charge two electrode pairs (e.g., Bank A for charging electrode pairs 1 and 2, and Bank B for charging electrode pairs 3 and 4). In this example, electroporation controller 120 is configured to determine the charging voltage for Bank A based on the measured pulse voltages of electrode pairs 1 and 2, and to determine the charging voltage for Bank B based on the measured pulse voltages of electrode pairs 3 and 4.

[0053] In embodiments, electroporation controller 120 includes one or more controllers, microprocessors, and / or computers that execute code from memory 160, e.g., non-transitory machine-readable media, to control and / or execute functional aspects of electroporation ablation system 100. In embodiments, memory 160 may be part of one or more controllers, microprocessors, and / or computers, and / or part of a memory capacity accessible through a network, such as the World Wide Web. In embodiments, memory 160 comprises a data repository 165 configured to store ablation data (e.g., position, energy, etc.), measured pulse voltage, measured pulse current, tissue impedance, generator impedance, sensing data, treatment planning data, charging voltage, and / or the like.

[0054] In embodiments, other system 170 includes an electroanatomical mapping (EAM) system. In some examples, the EAM system is operable to track the positions of various functional components of electroporation ablation system 100 and generate high-fidelity three-dimensional anatomical and electroanatomical maps of a target cardiac chamber. In embodiments, the EAM system may be the RHYTHMIA™ HDx mapping system sold by Boston Scientific. Also, in embodiments, the mapping and navigation controller of the EAM system includes one or more controllers, microprocessors, and / or computers that execute code from memory to control and / or perform functional aspects of the EAM system.

[0055] The EAM system generates a localization field via a field generator to define a localization volume around the heart, and one or more position sensors or sensing elements on the tracked device(s), e.g., electroporation ablation catheter 110, generate outputs that can be processed by the mapping and navigation controller to track the position of the sensor, and therefore the corresponding device, within the localization volume. In one embodiment, device tracking is achieved using magnetic tracking techniques, whereby the field generator is a magnetic field generator that generates a magnetic field that defines the localization volume, and the position sensor on the tracked device is a magnetic field sensor.

[0056] In some embodiments, impedance tracking methods may be employed to track the positions of various devices. In such embodiments, the localization fields are electric fields generated, for example, by external field generator configurations, e.g., surface electrodes, by internal or intracardiac devices, e.g., intracardiac catheters, or both. In these embodiments, the position sensing elements may comprise electrodes on the tracked devices that generate outputs that are received and processed by the mapping and navigation controller to track the positions of the various position sensing electrodes within the localization volume.

[0057] In embodiments, the EAM system includes both magnetic and impedance tracking capabilities. In such embodiments, impedance tracking accuracy can be improved in some instances by first creating a map of the electric field induced by the field generator within the subject's cardiac chamber using a probe with a magnetic position sensor, as is possible with the aforementioned RHYTHMIA HDx™ mapping system. One exemplary probe is the INTELLAMAP ORION™ mapping catheter sold by Boston Scientific.

[0058] Regardless of the tracking method used, the EAM system utilizes the positional information of the various tracked devices, along with cardiac electrical activity acquired, for example, by the electroporation ablation catheter 110 or another catheter or probe equipped with sensing electrodes, to generate and display via a display a detailed three-dimensional geometrical anatomical map or representation of the heart chambers, as well as an electroanatomical map in which the cardiac electrical activity of interest is superimposed on the geometrical anatomical map. Additionally, the EAM system can generate graphical representations of the various tracked devices within the geometrical anatomical map and / or the electroanatomical map.

[0059] According to embodiments, various components of electroporation ablation system 100 (e.g., controller 120) may be implemented on one or more computing devices. The computing devices may include any type of computing device suitable for implementing embodiments of the present disclosure. Examples of computing devices include dedicated or general-purpose computing devices such as workstations, servers, laptops, portable devices, desktops, tablet computers, handheld devices, general-purpose graphics processing units (GPGPUs), and the like, all of which are contemplated within the scope of FIG. 1 with respect to the various components of system 100.

[0060] In some embodiments, a computing device includes a bus that directly and / or indirectly couples the following devices: a processor, memory, input / output (I / O) ports, I / O components, and a power supply. Any number of additional components, different components, and / or combinations of components may be included in a computing device. A bus represents what may be one or more buses (e.g., an address bus, a data bus, or a combination thereof). Similarly, in some embodiments, a computing device may include multiple processors, multiple memory components, multiple I / O ports, multiple I / O components, and / or multiple power supplies. Additionally, any number of these components, or combinations thereof, may be distributed and / or replicated across multiple computing devices.

[0061] In some embodiments, memory 160 includes computer-readable media in the form of volatile and / or non-volatile memory, transient and / or non-transitory storage media, which may be removable, non-removable, or a combination thereof. Examples of media include random access memory (RAM), read-only memory (ROM), electronically erasable programmable read-only memory (EEPROM), flash memory, optical or holographic media, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, data transmission, and / or any other medium that can be used to store information and that can be accessed by a computing device, such as, for example, quantum state memory and / or the like. In some embodiments, memory 160 stores computer-executable instructions that cause a processor (e.g., controller 120) to implement aspects of embodiments of the system components described herein and / or perform aspects of embodiments of the methods and procedures described herein.

[0062] Computer-executable instructions may include, for example, computer code, machine-usable instructions, program components, and the like, executable by, for example, one or more processors associated with a computing device. The program components may be programmed using any number of different programming environments, including various languages, development kits, frameworks, and / or the like. Some or all of the functionality contemplated herein may additionally or alternatively be implemented in hardware and / or firmware.

[0063] The data repository 165 may be implemented using any one of the configurations described below. The data repository may include random access memory, flat files, XML files, and / or one or more database management systems (DBMS) running on one or more database servers or data centers. The database management system may be a relational (RDBMS), hierarchical (HDBMS), multidimensional (MDBMS), object-oriented (ODBMS or OODBMS), or object-relational (ORDBMS) database management system, etc. The data repository may be, for example, a single relational database. In some examples, the data repository may include multiple databases that can exchange and aggregate data through a data integration process or software application. In exemplary embodiments, at least a portion of the data repository 165 may be hosted in a cloud data center. In some examples, the data repository may be hosted on a single computer, server, storage device, cloud server, etc. In some other cases, the data repository may be hosted on a series of networked computers, servers, or devices. In some examples, the data repository may be hosted on tiers of data storage devices, including local, regional, and central.

[0064] The various components of the system 100 can communicate or be coupled via communication interfaces, e.g., wired or wireless interfaces. Communication interfaces include, but are not limited to, any wired or wireless short-range and long-range communication interfaces. Wired interfaces can use cables, umbilicals, etc. Short-range communication interfaces can be, for example, interfaces that comply with known communication standards such as a local area network (LAN), Bluetooth® standards, IEEE 802 standards (e.g., IEEE 802.11), ZigBee® or similar specifications, such as those based on the IEEE 802.15.4 standard, or other public or proprietary wireless protocols. Long-range communication interfaces can be, for example, wide area networks (WANs), cellular network interfaces, satellite communication interfaces, etc. Communication interfaces can be within a private computer network, such as an intranet, or on a public computer network, such as the Internet.

[0065] FIG. 4 is an exemplary schematic circuit diagram 400 of an electroporation generator 430 used for the electroporation ablation section, according to certain embodiments of the present disclosure. In some implementations, other components may be included in the circuit diagram 400. In the circuit diagram 400, the electroporation generator 430 delivers an electrical pulse sequence at pulse_voltage 420 to the target tissue. The target tissue has a tissue impedance 440 that varies during the electroporation ablation section. In the simplified schematic, the electroporation generator 430 includes a voltage source 432, a bulk capacitance 435 (e.g., a capacitor bank), and a generator impedance 437. In this example, the generator impedance 437 represents the overall impedance of the electroporation generator 430. In embodiments, the electroporation ablation section includes multiple treatment sections. In some embodiments, the voltage source 432 can charge the bulk capacitance 435 between treatment sections to adjust the charge_voltage 410, thereby adjusting the pulse_voltage 420 to reach a target pulse voltage.

[0066] In some embodiments, a pulse_voltage or multiple pulse voltages are measured during the treatment section. In one example, the pulse_voltage 420 is calculated according to the following equation (1):

[0067]

number

[0068] where the voltage パルス is the pulse voltage 420, and the voltage 充電 is the charge voltage 410 and the impedance 組織 represents the tissue impedance 440, and impedance 生成器 is the generator impedance 437. Additionally, in one example, the charge_voltage 410 is calculated according to the following equation (2):

[0069]

number

[0070] The pulse voltage 420 measured during the treatment section can be determined according to 充電 is the voltage generated from the voltage source 432 and the bulk capacitance 435, and the voltage パルス is the pulse voltage 420 and the impedance 組織 represents the tissue impedance 440, and impedance 生成器 is the generator impedance 437.

[0071] In some embodiments, the controller (e.g., controller 120 of FIG. 1 ) is configured to determine and control the electroporation generator 430 using equation (2) above. In some embodiments, the controller (e.g., controller 120 of FIG. 1 ) is configured to determine and control the electroporation generator 430 using other approaches for determining charge_voltage. In some implementations, the electroporation generator 430 is configured to generate an electrical pulse sequence having multiple electrical / electroporation pulses (e.g., 2 microsecond electrical pulses with a 500 microsecond interval between two adjacent pulses) during a treatment section during a heartbeat (e.g., a 10 millisecond treatment section, a 20 millisecond treatment section, etc.).

[0072] 5A and 5B illustrate exemplary embodiments of catheters 200 and 250 (e.g., catheter 110 of FIG. 1) that can be used for electroporation, including ablation by irreversible electroporation, according to embodiments of the presently disclosed subject matter. Catheters 200 and 250 include electrodes spaced apart from one another and configured to conduct electricity, as described below. Catheter properties are used to model the electric field that may be generated by the catheter. In embodiments, properties used to model the electric field may include the type of catheter, such as a basket catheter with a fixed profile after opening and a spline catheter with a variable profile that can open and close to a certain extent; the form factor of the catheter, such as a balloon catheter, a basket catheter, and a spline catheter; the number of electrodes; the spacing between electrodes on the catheter; the spatial relationship and orientation of the electrodes, particularly relative to other electrodes on the same catheter; the type of material from which the electrodes are made; and the shape of the electrodes. In embodiments, catheter types and / or catheter form factors include catheters such as linear ablation catheters and focal ablation catheters. In some examples, the catheter types and / or catheter form factors are not limited to those mentioned herein.

[0073] 5A is a diagram illustrating a catheter 200 according to an embodiment of the presently disclosed subject matter. The catheter 200 includes a catheter shaft 202 and a catheter basket 204 connected to the catheter shaft 202 at a distal end 206 of the catheter shaft 202. The catheter basket 204 includes a first group of electrodes 208 disposed on the outer periphery of the catheter basket 204 and a second group of electrodes 210 disposed adjacent to a distal end 212 of the catheter basket 204. Each electrode of the first group of electrodes 208 and each electrode of the second group of electrodes 210 is configured to conduct electricity and to be operably connected to a controller (e.g., controller 120 of FIG. 1 ) and an ablation energy generator (e.g., electroporation generator 140 of FIG. 1 ). In an embodiment, one or more of the electrodes of the first group of electrodes 208 and the second group of electrodes 210 include a metal.

[0074] The electrodes of the first electrode group 208 are spaced apart from the electrodes of the second electrode group 210. The first electrode group 208 includes electrodes 208a-208f, and the second electrode group 210 includes electrodes 210a-210f. Furthermore, the electrodes of the first electrode group 208, such as electrodes 208a-208f, are spaced apart from one another, and the electrodes of the second electrode group 210, such as electrodes 210a-210f, are spaced apart from one another.

[0075] The spatial relationship and orientation of the electrodes of the first electrode group 208 and the second electrode group 210 relative to other electrodes on the same catheter 200 is known or can be determined. In embodiments, the spatial relationship and orientation of the electrodes of the first electrode group 208 and the second electrode group 210 relative to other electrodes on the same catheter 200 are constant once the catheter is deployed.

[0076] With respect to the electric field, in embodiments, each electrode in the first electrode group 208 and each electrode in the second electrode group 210 may be selected to be an anode or a cathode, thereby establishing an electric field between any two or more electrodes in the first electrode group 208 and the second electrode group 210. Also, in embodiments, each electrode in the first electrode group 208 and each electrode in the second electrode group 210 may be selected to be biphasic, thereby causing the electrodes to switch or alternate between an anode and a cathode. Also, in embodiments, groups of electrodes in the first electrode group 208 and groups of electrodes in the second electrode group 210 may be selected to be anodic or cathodic or biphasic, thereby establishing an electric field between any two or more groups of electrodes in the first electrode group 208 and the second electrode group 210.

[0077] In embodiments, the electrodes of the first electrode group 208 and the second electrode group 210 may be selected to be biphasic electrodes, such that during pulse trains, including biphasic pulse trains, the selected electrodes switch or alternate between anode and cathode, rather than being monophasic, with one electrode always being the anode and the other always being the cathode. In some examples, the electrodes of the first electrode group 208 and the second electrode group 210 may form an electric field with an electrode(s) of another catheter. In such cases, the electrodes of the first electrode group 208 and the second electrode group 210 may be the anode of the electric field or the cathode of the electric field.

[0078] Additionally, while, as described herein, electrodes are selected to be one of anodes and cathodes, it should be understood without further elaboration that throughout this disclosure, electrodes may be selected to be biphasic, such that they switch or alternate between anodes and cathodes. In some examples, one or more of the electrodes in the first electrode group 208 are selected to be cathodes, and one or more of the electrodes in the second electrode group 210 are selected to be anodes. Also, in embodiments, one or more of the electrodes in the first electrode group 208 may be selected as cathodes, and another one or more of the electrodes in the first electrode group 208 may be selected as anodes. In embodiments, one or more of the electrodes in the second electrode group 210 may be selected as cathodes, and another one or more of the electrodes in the second electrode group 210 may be selected as anodes.

[0079] 5B illustrates a catheter 250 according to an embodiment of the presently disclosed subject matter. The catheter 250 includes a catheter shaft 252 and a catheter spline 254 connected to the catheter shaft 252 at a distal end 256 of the catheter shaft 252. The catheter spline 254 includes a first group of electrodes 258 disposed proximal to a maximum circumference of the catheter spline 254 and a second group of electrodes 260 disposed distal to the maximum circumference of the catheter spline 254. Each electrode in the first group of electrodes 258 and each electrode in the second group of electrodes 260 are configured to conduct electricity and to be operably connected to an electroporation console (not shown). In an embodiment, one or more of the electrodes in the first group of electrodes 258 and the second group of electrodes 260 include a metal.

[0080] The electrodes of the first electrode group 258 are spaced apart from the electrodes of the second electrode group 260. The first electrode group 258 includes electrodes 258a-258f, and the second electrode group 260 includes electrodes 260a-260f. Furthermore, the electrodes of the first electrode group 258, such as electrodes 258a-258f, are spaced apart from one another, and the electrodes of the second electrode group 260, such as electrodes 260a-260f, are spaced apart from one another.

[0081] The spatial relationship and orientation of the electrodes of the first electrode group 258 and the second electrode group 260 relative to other electrodes on the same catheter 250 is known or can be determined. In embodiments, the spatial relationship and orientation of the electrodes of the first electrode group 258 and the second electrode group 260 relative to other electrodes on the same catheter 250 is variable, and the distal end 262 of the catheter 250 can be extended and retracted, which changes the spatial relationship and orientation of the electrodes 258 and 260. In some embodiments, the spatial relationship and orientation of the electrodes of the first electrode group 258 and the second electrode group 260 on the same catheter 250 remains constant once the catheter 250 is deployed.

[0082] With respect to the electric field, in embodiments, each electrode in the first electrode group 258 and each electrode in the second electrode group 260 may be selected to be an anode or a cathode, thereby establishing an electric field between any two or more electrodes in the first electrode group 258 and the second electrode group 260. Also, in embodiments, groups of electrodes in the first electrode group 258 and groups of electrodes in the second electrode group 260 may be selected to be an anode or a cathode, thereby establishing an electric field between any two or more groups of electrodes in the first electrode group 258 and the second electrode group 260. In some examples, the electrodes in the first electrode group 258 and the second electrode group 260 may form an electric field with an electrode(s) of another catheter. In such cases, the electrodes in the first electrode group 258 and the second electrode group 260 may be an anode of the electric field or a cathode of the electric field.

[0083] In some embodiments, one or more of the electrodes in the first electrode group 258 are selected to be cathodes, and one or more of the electrodes in the second electrode group 260 are selected to be anodes. Also, in embodiments, one or more of the electrodes in the first electrode group 258 may be selected as cathodes, and another one or more of the electrodes in the first electrode group 258 may be selected as anodes. Additionally, one or more of the electrodes in the second electrode group 260 may be selected as cathodes, and another one or more of the electrodes in the second electrode group 260 may be selected as anodes. Using the properties of the catheter 250 and the surrounding tissue, the electroporation controller (e.g., controller 120 of FIG. 1 ) can determine models of various electric fields that may be generated by the catheter 250.

[0084] 6 is an exemplary flow diagram illustrating an exemplary method 600 of using an electroporation ablation device according to some embodiments of the present disclosure. Aspects of the embodiment of method 600 may be performed, for example, by an electroporation ablation system (e.g., system 100 shown in FIG. 1). One or more steps of method 600 are optional and / or may be modified by one or more steps of other embodiments described herein. In addition, one or more steps of other embodiments described herein may be added to method 600. Initially, the electroporation ablation system deploys (605) electroporation ablation catheter(s) in proximity to the target tissue.

[0085] In some examples, the electroporation ablation system is configured to perform a scan section to determine initial tissue impedance (610). In some examples, the scan section is performed before the treatment section. In some examples, the scan section includes a scan electrical pulse sequence at a scan voltage lower than the treatment pulse voltage. In one embodiment, the scan electrical pulse sequence includes a single non-ablative electrical pulse during the scan section. In some embodiments, an initial pulse voltage of the scan electrical pulse sequence and an initial pulse current of the scan electrical pulse sequence are measured during the scan section. In some examples, the initial pulse voltage and the initial pulse current are measured for the last electrical pulse of the scan electrical pulse sequence. In some examples, the initial pulse voltage and / or the initial first pulse current are measured for the first electrical pulse of the scan electrical pulse sequence. In some examples, the initial pulse voltage and / or the initial pulse current are determined based on measurements of multiple electrical pulses of the scan electrical pulse sequence.

[0086] In one example, the initial pulse voltage and / or initial pulse current are the average voltage and / or current, respectively, measured for multiple electrical pulses in the scan section. In one example, the initial pulse voltage and / or initial pulse current are the average voltage and / or current, respectively, measured for all electrical pulses in the scan section. In some embodiments, the initial tissue impedance is determined as the initial pulse voltage divided by the initial pulse current. In some examples, the generator impedance can be determined by the charge voltage output from a capacitor bank (e.g., capacitor bank 145 of FIG. 1 ) and the measured pulse voltage, for example, using equation (1).

[0087] In some embodiments, the electroporation ablation system is configured to measure one or more pulse voltages (615), e.g., during a treatment section. In some embodiments, the electroporation ablation system is configured to measure one or more pulse currents (620), e.g., corresponding to the one or more pulse voltages. In some examples, a controller of the electroporation ablation system (e.g., controller 120 of FIG. 1 ) is configured to determine a current tissue impedance using the one or more measured pulse voltages and / or the one or more measured pulse currents. In one implementation, the current tissue impedance is determined as the pulse voltage divided by the pulse current. In one implementation, the current tissue impedance is determined as the pulse voltage divided by the pulse current measured in the first electrical pulse during the treatment section.

[0088] In one implementation, the current tissue impedance is determined as the pulse voltage divided by the pulse current measured at the last electrical pulse during the treatment section. In one implementation, the current tissue impedance is determined as the pulse voltage divided by the pulse current. In one implementation, the current tissue impedance is determined based on multiple pulse voltages and multiple pulse currents measured during the treatment section. In some examples, the current tissue impedance is used to determine the charging voltage of the electroporation generator (i.e., the voltage generated by the electroporation generator). In some examples, the pulse voltage and / or pulse current are measured by a sensor (e.g., sensor 130 of FIG. 1 ) deployed in proximity to the target tissue. In some examples, the pulse voltage and / or pulse current are measured by a sensor deployed with the catheter(s).

[0089] In some embodiments, the electroporation ablation system is configured to determine (625) a charging voltage for the electroporation generator (e.g., electroporation generator 140 of FIG. 4). In one example, the charging voltage is calculated using equation (2). For example, if the measured pulse voltage of the previous treatment section is 100 volts below the target pulse voltage and assuming the generator impedance is equal to the tissue impedance, the charging voltage should be increased by 200 volts. In one implementation, the electroporation ablation system can set the capacitor bank (e.g., capacitor bank 145 of FIG. 4) by increasing the setting by 200 volts, so that the electrical pulse sequence is delivered in the next treatment section at a voltage close to the target pulse voltage.

[0090] In one embodiment, the electric field generated by the electrodes of the deployed catheter(s) has a field strength of 1500 volts per centimeter or less. In one embodiment, the electric field generated by the electrodes of the deployed catheter(s) has a field strength of greater than 500 volts per centimeter. In some embodiments, the electroporation ablation system is configured to control the power source based on the determined charging voltage (630), for example, by charging a capacitor bank based on the determined charging voltage. In some embodiments, the electroporation ablation system is configured to set the capacitor bank based on a voltage difference between the determined charging voltage and the current charging voltage of the power source.

[0091] In some embodiments, the electroporation ablation system is configured to deliver an electrical pulse sequence for the next treatment section (635), e.g., using a power source. In some examples, if the ablation treatment section is not finished, the electroporation ablation system returns to step 615 to measure one or more pulse voltages while the electrical pulse sequence (e.g., multiple electrical pulses delivered during a burst period) is being delivered. In embodiments, the electroporation ablation system is configured to measure pulse voltage and / or pulse current during each or some of the treatment sections to determine the charging voltage for the subsequent treatment section.

[0092] Various modifications and additions can be made to the exemplary embodiments described without departing from the scope of the present disclosure. For example, while the above embodiments refer to particular features, the scope of the present disclosure also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations that fall within the scope of the claims, together with all equivalents thereof. The technical ideas included in this disclosure are described below as appendices. (Appendix 1) 1. An electroporation ablation system for treating target tissue in a patient, comprising: an ablation catheter including a catheter electrode configured to generate an electric field at the target tissue in response to a plurality of electrical pulse sequences delivered at a plurality of treatment sections; a controller configured to receive a first pulse voltage of a first electrical pulse sequence measured during a first treatment section of the plurality of treatment sections and to determine a charging voltage based on the first pulse voltage; an electroporation generator operably coupled to the catheter electrode and the controller; the electroporation generator is configured to deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the plurality of treatment sections, the second treatment section being after the first treatment section, and the controlled pulse voltage being related to the charging voltage. (Appendix 2) 2. The electroporation ablation system of claim 1, wherein the electroporation generator includes a capacitor bank, and the electroporation generator is configured to charge the capacitor bank to a voltage level of the charging voltage before initiation of the second treatment section. (Appendix 3) 3. The electroporation ablation system of claim 1 or 2, wherein the first electrical pulse sequence includes a plurality of first electrical pulses. (Appendix 4) 4. The electroporation ablation system of claim 3, wherein the first pulse voltage comprises one or more pulse voltages of the plurality of first electrical pulses measured during the first treatment section. (Appendix 5) 5. The electroporation ablation system of claim 1, wherein the controller is further configured to receive a first pulse current of the first electrical pulse sequence delivered during the first treatment section, and the controller is further configured to determine the charging voltage based on the first pulse voltage and the first pulse current. (Appendix 6) 6. The electroporation ablation system of claim 5, wherein the controller is further configured to determine a first tissue impedance based on the first pulse voltage and the first pulse current. (Appendix 7) 7. The electroporation ablation system of claim 6, wherein the controlled pulse voltage is a portion of the charging voltage. (Appendix 8) 8. The electroporation ablation system of claim 7, wherein the ratio of the controlled pulse voltage to the charging voltage is related to the first tissue impedance. (Appendix 9) 9. The electroporation ablation system of any one of claims 1 to 8, wherein the electroporation generator is further configured to deliver a scan electrical pulse sequence at a scan voltage during a scan section preceding the plurality of treatment sections, the controller is further configured to determine an initial tissue impedance based on an initial pulse voltage of the scan electrical pulse sequence and an initial pulse current of the scan electrical pulse sequence measured during the scan section, and the controller is further configured to determine an initial charging voltage based on the initial tissue impedance. (Appendix 10) 10. The electroporation ablation system of claim 9, wherein the scan voltage is less than the controlled pulse voltage. (Appendix 11) 10. The electroporation ablation system of claim 9, wherein the scanning electrical pulse sequence includes a single non-ablative electrical pulse. (Appendix 12) The electroporation ablation system of any one of appendixes 1 to 11, wherein the ablation catheter includes a catheter basket, and the catheter electrodes include a first group of electrodes arranged on the outer periphery of the catheter basket and a second group of electrodes arranged adjacent to the distal end of the catheter basket. (Appendix 13) 13. The electroporation ablation system of claim 12, wherein the electrodes of the first electrode group are spaced apart from one another and the electrodes of the second electrode group are spaced apart from one another. (Appendix 14) 14. The electroporation ablation system of claim 13, wherein each electrode in the first group of electrodes can be configured as an anode or a cathode, and each electrode in the second group of electrodes can be configured to have an opposite polarity to the electrodes in the first group of electrodes. (Appendix 15) The electroporation ablation system of any one of appendixes 12 to 14, wherein the catheter basket has a plurality of splines, each spline including at least one of the electrodes of the first electrode group and at least one of the electrodes of the second electrode group.

Claims

1. 1. An electroporation ablation system for treating target tissue in a patient, comprising: an electroporation generator having a generator impedance; an ablation catheter including a catheter electrode configured to generate an electric field at the target tissue in response to a plurality of electrical pulse sequences delivered at a plurality of treatment sections; a controller configured to receive a first pulse voltage of a first electrical pulse sequence measured during a first treatment section of the plurality of treatment sections, and to determine a charging voltage of a capacitor bank based on the first pulse voltage, the generator impedance, and the target tissue impedance; Equipped with the electroporation generator is operably coupled to the catheter electrode and the controller, the electroporation generator configured to charge the capacitor bank to the charging voltage and then deliver a second electrical pulse sequence at a controlled pulse voltage to a second treatment section of the plurality of treatment sections.

2. 10. The electroporation ablation system of claim 1, wherein the controller is further configured to receive a first pulse current of the first electrical pulse sequence delivered during the first treatment section.

3. 3. The electroporation ablation system of claim 2, wherein the controller is further configured to determine an impedance of the target tissue based on the first pulse voltage and the first pulse current.

4. The controller calculates the charging voltage of the capacitor bank according to the formula: [Equation 1] 2. The electroporation ablation system of claim 1, further configured to determine a target tissue impedance using: where Voltage charge is the charging voltage, Voltage pulse is the first pulse voltage, Impedance generator is the generator impedance, and Impedance tissue is the impedance of the target tissue.

5. 5. The electroporation ablation system of claim 1, wherein the electroporation generator is further configured to deliver a scanning electrical pulse sequence at a scanning voltage during a scan section before the plurality of treatment sections.

6. The electroporation ablation system of claim 5 , wherein the scan voltage is less than the controlled pulse voltage.

7. The electroporation ablation system of claim 5 , wherein the scanning electrical pulse sequence includes a single non-ablative electrical pulse.

8. 8. The electroporation ablation system according to claim 1, wherein the ablation catheter includes a catheter basket, and the catheter electrodes include a first group of electrodes arranged on an outer periphery of the catheter basket and a second group of electrodes arranged adjacent to a distal end of the catheter basket.

9. 9. The electroporation ablation system of claim 8, wherein the electrodes of the first group of electrodes are spaced apart from one another and the electrodes of the second group of electrodes are spaced apart from one another.

10. 10. The electroporation ablation system of claim 9, wherein each electrode in the first group of electrodes can be configured as an anode or a cathode, and each electrode in the second group of electrodes can be configured to have an opposite polarity to the electrodes in the first group of electrodes.

11. 11. The electroporation ablation system of claim 8, wherein the catheter basket comprises a plurality of splines, each spline including at least one of the electrodes of the first group of electrodes and at least one of the electrodes of the second group of electrodes.

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