Source: https://patents.google.com/patent/US8287533B2/en
Timestamp: 2019-08-20 05:52:03
Document Index: 709148163

Matched Legal Cases: ['application no. 1024658', 'art 22', 'art 22', 'art 22', 'art 22', 'art 22']

US8287533B2 - Irrigated catheter and method, in particular for ablation and like techniques - Google Patents
Irrigated catheter and method, in particular for ablation and like techniques Download PDF
US8287533B2
US8287533B2 US13/210,090 US201113210090A US8287533B2 US 8287533 B2 US8287533 B2 US 8287533B2 US 201113210090 A US201113210090 A US 201113210090A US 8287533 B2 US8287533 B2 US 8287533B2
US13/210,090
US20110301596A1 (en
2007-04-05 Priority to US59560807A priority
2010-10-08 Priority to US12/900,983 priority patent/US7998141B2/en
2011-08-15 Priority to US13/210,090 priority patent/US8287533B2/en
2011-08-15 Application filed by University Medical Center Utrecht, University of Oklahoma filed Critical University Medical Center Utrecht
2011-12-08 Publication of US20110301596A1 publication Critical patent/US20110301596A1/en
2012-05-21 Assigned to UNIVERSITY MEDICAL CENTER UTRECHT reassignment UNIVERSITY MEDICAL CENTER UTRECHT ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: WITTKAMPF, FREDERIK
2012-05-21 Assigned to UNIVERSITY OF OKLAHOMA reassignment UNIVERSITY OF OKLAHOMA ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: NAKAGAWA, HIROSHI
2012-10-16 Publication of US8287533B2 publication Critical patent/US8287533B2/en
This is a continuation of U.S. application Ser. No. 12/900,983, filed 8 Oct. 2010, now pending (the '983 application), which is a continuation of U.S. application Ser. No. 10/595,608, filed Apr. 5, 2006, which issued as U.S. Pat. No. 7,815,635 (the '608 application), which is a national stage filing based upon international application no. PCT/NL2004/000741, filed 20 Oct. 2004 and published in English on 2 Jun. 2005 under international publication no. WO 2005/048858 (the '741 application), which claims priority to Dutch application no. 1024658, filed 29 Oct. 2003 (the '658 application). The '983 application, the '608 application, the '741 application, and the '658 application are all hereby incorporated by reference as though fully set forth herein.
The first end can be manufactured from a thermally and electrically conductive material such as metal. Also, only an outer casing can be provided with metal, on, for instance, aplastic, ceramic or glass core, whereby already a part of the desired thermal insulation can be obtained.
With this method, a cooling fluid such as a physiological saline solution is supplied, preferably in a known manner, through a channel extending through the catheter, which cooling fluid is directly introduced into the respective body cavity. In a method according to the invention, said cooling fluid is preferably thermally insulated to a high extent from the material of the leading first end of the catheter during use, so that the blood around this first end is cooled more intensively than the first end itself. Preferably, the temperature of the first end is measured accurately thereby, the temperature of the wall, against which or at which the catheter is held can be accurately controlled.
In the first end 4, in particular in the tip 9, a channel part 22 is provided extending in line with the axis A-A and is connected to the channel 13, for instance because a sleeve 23 extends from said end surface 21 in the channel 13 and is fitted therein. From an exterior 41 of the tip 9, first bores 24 are provided reaching into the channel part 22 and extending substantially radially. These first bores 24 all have a longitudinal axis 25 forming an angle α with the longitudinal axis A-A of the body 7, for instance approximately 90°. A second bore 26 is provided in line with the channel 13, at least with the axis A-A, which bore 26 terminates in the apex 36 of the tip 9. In each bore 24, 26, as well as around the channel part 22, a thermal insulating casing 27 is provided, such that during use a cooling fluid, in particular a physiological saline solution, can be passed through the channel 13, the channel part 22 and the bores 24, 26 without direct contact occurring between the cooling fluid and (the inside of) the tip 9. Direct cooling of the tip 9 by the cooling fluid is thereby prevented in large part. In the embodiment of FIG. 3, the sleeve 23 is not thermally insulated.
In FIGS. 5 and 5A, a further alternative embodiment is shown, with only tip 9 shown in cross-section, which largely corresponds in a constructional sense to the embodiments of FIGS. 3 and 4. However, a tip 9 is provided herein that has a core 28, which is manufactured from a material having a low thermal and/or electrical conductivity, for instance glass, ceramics or plastic, and a casing 29 having good heat conductivity and/or electrical conductivity relative thereto. Herein, the bores 24, 26 have been provided with a thermal inner casing from the casing 29, at least being formed as part of the core 28, whereby the desired thermal insulation is obtained in a simple manner. In this embodiment, the longitudinal axes 25 extend approximately tangentially relative to the channel part 22 (FIG. 5A) and form an angle α with the longitudinal axis A-A, which angle deviates from 90°, for instance approximately 75° to 80°, such that the outflow direction is somewhat in the direction of the apex 36, at least in the direction of the wall 11. Thereby, the cooling of the blood around the tip 9 and adjacent the wall 11 can be improved even more. A thermocouple 16 is attached to the casing 29.
When using a catheter 1 according to the invention in a treatment of, for instance, cardiac arrhythmias or the like, wherein an ablation technique is used in a body cavity, in which blood is flowing through, such as a ventricle or atrium of a heart or an artery or a vein, the current intensity and the supply of cooling fluid are preferably regulated such that the temperature of the blood around the tip 9 is kept below the coagulation temperature. In practice, this means below approximately 55° C., so that no coagulation occurs. Preferably, the temperature of the tip 9 is regulated such that it does not exceed 65° C. In practice, this has appeared to be a reasonably safe limit. With larger electrodes (of a length of, for instance, 8 mm instead of 4 mm), the flowing blood will provide proportionally more cooling so that there is a greater difference between the tissue and electrode temperature. With an 8 mm tip, 50 to 55° is a good target value, at least with existing electrodes. The electrode will clearly remain cooler than the heated tissue of the wall, which is kept below 100° C. in order to prevent the earlier-mentioned explosions. In FIG. 3, an area 40 is schematically indicated in the wall 11 wherein heat development occurs as a result of the current passed through the wall 11, as described earlier. Naturally, as to dimension and shape, this influenced area 40 depends on the current intensity used and the duration of the treatment and is only given as an indication.
an irrigation channel or an irrigation tube extending through said elongate body and having a distal end;
at least one outlet opening extending radially from the longitudinal axis, and fluidly coupled to, the distal end of the irrigation channel or the irrigation tube; and
means for providing thermal separation such that a fluid flowing through the channel during use substantially does not come into thermal contact with the electrode surface before flowing out of the at least one outlet opening.
3. A catheter according to claim 1, wherein the at least one outlet opening couples to the longitudinal axis of said irrigation channel or said irrigation tube at an angle of between about 30 and about 90 degrees.
8. A catheter according to claim 7, wherein the temperature sensor comprises at least one of a thermocouple and a thermistor.
9. A catheter according to claim 1, further comprising a temperature sensor coupled to said electrode.
an irrigation channel or an irrigation duct extending through said elongate body; and
at least one outlet opening, having a first end and a second end, extending radially from a distal end of the irrigation channel or the irrigation duct having a first end and a second end;
wherein said first end is fluidly coupled to a distal end of the irrigation channel or the irrigation duct;
wherein said second end comprises means for creating a somewhat turbulent flow at a distal end of the electrode;
wherein the at least one outlet opening includes a thermally insulating material coupled to a portion of an interior casing disposed therein.
11. A catheter according to claim 10, wherein said irrigation channel or said irrigation duct is configured to couple a fluid from a remote source of fluid through said elongate body and egress from said at least one outlet opening.
12. A catheter according to claim 11, wherein said at least one outlet opening is adapted to deliver said fluid to an outer surface of said elongate body in an outflow direction, and wherein said outflow direction comprises an angle relative to said longitudinal axis.
13. A catheter according to claim 10, further comprising a temperature sensor coupled to a portion of the electrode.
14. A catheter according to claim 10, wherein said second end couples to an outer portion of the elongate body.
and at least one outlet opening extending radially from the longitudinal axis, and fluidly coupled to, the distal end of the irrigation channel or the irrigation tube;
wherein said at least one outlet opening terminates proximally adjacent said electrode and comprises means for directing a fluid substantially along the outside surface of the electrode.
16. A catheter according to claim 15, further comprising a temperature sensor coupled to said electrode.
17. A catheter according to claim 16, wherein the temperature sensor comprises at least one of a thermocouple and a thermistor.
18. A catheter according to claim 15, wherein said irrigation channel or said irrigation duct is configured to couple a fluid from a remote source of fluid through said elongate body and egress from said at least one outlet opening.
19. A catheter according to claim 18, wherein said at least one outlet opening is adapted to deliver said fluid to an outer surface of said elongate body in an outflow direction, and wherein said outflow direction comprises an angle relative to said longitudinal axis.
20. A catheter according to claim 15, wherein said at least one outlet opening couples to a lateral exterior portion of the elongate body.
at least one outlet opening extending radially from the longitudinal axis, and fluidly coupled to, the distal end of the irrigation channel or the irrigation tube; and,
a thermally insulating material thermally separating said at least one outlet opening from said electrode;
wherein said at least one outlet opening terminates adjacent said electrode and comprises means for directing a fluid substantially along the outside surface of the electrode.
US13/210,090 2003-10-29 2011-08-15 Irrigated catheter and method, in particular for ablation and like techniques Active US8287533B2 (en)
US59560807A true 2007-04-05 2007-04-05
US12/900,983 Continuation US7998141B2 (en) 2003-10-29 2010-10-08 Irrigated catheter and method, in particular for ablation and like techniques
US20110301596A1 US20110301596A1 (en) 2011-12-08
US8287533B2 true US8287533B2 (en) 2012-10-16
Wittkampf, Fred H. , "Radiofrequency ablation with a cooled porous electrode catheter", JACC vol. II, No. 2 Feb. 1988; 17a.
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:NAKAGAWA, HIROSHI;REEL/FRAME:028240/0783
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:WITTKAMPF, FREDERIK;REEL/FRAME:028239/0819