Abstract:
A catheter for use in an electrophysiological procedure to ablate a site includes a metallic tip having a first work function and energized by a source of RF energy. The RF energy return path is through a relatively large plate of a metallic material having a second work function and disposed at a location removed from the ablation site. The difference in work functions of the tip and the plate, operating in the presence of an electrolyte represented by the intermediate tissue, produces an exchange of electrical charges through chemical reaction to create a galvanic cell. By loading the galvanic cell with a shunt resistor, it becomes a current source providing a current linear with and highly dependent on the tissue temperature at the ablation site. This accurate representation of the tissue temperature at the ablation site is used to regulate the RF energy applied to maintain the tissue at the ablation site at a predetermined temperature during the ablation procedure.

Description:
This is a division of application Ser. No. 08/990,877 filed on Dec. 15, 1997 now U.S. Pat. No. 6,013,074 E. Taylor for “APPARATUS AND METHOD FOR THERMAL ABLATION”, which is continuation application of Ser. No. 08/488,887 filed Jun. 9, 1995 entitled “APPARATUS AND METHOD FOR THERMAL ABALATION”, now U.S. Pat. No. 5,697,925. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to catheters and, more particularly, temperature controlled catheter probes for ablating tissue. 
     2. Background of the Invention 
     The heart is a four chamber muscular organ (myocardium) that pumps blood through various conduits to and from all parts of the body. In order that the blood be moved in the cardiovascular system in an orderly manner, it is necessary that the heart muscles contract and relax in an orderly sequence and that the valves of the system open and close at proper times during the cycle. Specialized conduction pathways convey electrical impulses swiftly to the entire cardiac muscle. In response to the impulses, the muscle contracts first at the top of the heart and follows thereafter to the bottom of the heart. As contraction begins, oxygen depleted venous blood is squeezed out of the right atrium (one of two small upper chambers) and into the larger right ventricle below. The right ventricle ejects the blood into the pulmonary circulation, which resupplies oxygen and delivers the blood to the left side of the heart. In parallel with the events on the right side, the heart muscle pumps newly oxygenated blood from the left atrium into the left ventricle and from there out to the aorta which distributes the blood to every part of the body. The signals giving rise to these machinations emanates from a cluster of conduction tissue cells collectively known as the sinoatrial (SA) node. The sinoatrial node, located at the top of the atrium, establishes the tempo of the heartbeat. Hence, it is often referred to as the cardiac pacemaker. It sets the tempo simply because it issues impulses more frequently than do other cardiac regions. Although the sinoatrial node can respond to signals from outside the heart, it usually becomes active spontaneously. From the sinoatrial node impulses race to the atrioventricular (AV) node above the ventricles and speed along the septum to the bottom of the heart and up along its sides. The impulses also migrate from conduction fibers across the overlying muscle from the endocardium to the epicardium to trigger contractions that force blood through the heart and into the arterial circulation. The spread of electricity through a healthy heart gives rise to the familiar electrocardiogram. Defective or diseased cells are abnormal electrically. That is, they may conduct impulses unusually slowly or fire when they would typically be silent. These diseased cells or areas might perturb smooth signalling by forming a reentrant circuit in the muscle. Such a circuit is a pathway of electrical conduction through which impulses can cycle repeatedly without dying out. The resulting impulses can provoke sustained ventricular tachycardia: excessively rapid pumping by the ventricles. Tachycardia dysrhythmia may impose substantial risk to a patient because a diseased heart cannot usually tolerate rapid rates for extensive periods. Such rapid rates may cause hypotension and heart failure. Where there is an underlying cardiac disease, tachycardia can degenerate into a more serious ventricular dysrhythmia, such as fibrillation. By eliminating a reentrant circuit or signal pathway contributing to tachycardia, the source of errant electrical impulses will be eliminated. Ablation of the site attendant such a pathway will eliminate the source of errant impulses and the resulting arrhythmia. Mapping techniques for locating each of such sites that may be present are well known and are presently used. 
     Interruption of the errant electrical impulses is generally achieved by ablating the appropriate site. Such ablation has been formed by lasers. The most common technique for use at an ablation site involves the use of a probe energized by radio frequency radiation (RF). Regulation and control of the applied RF energy is through a thermistor located proximate the RF element at the tip of a catheter probe. While such a thermistor may be sufficiently accurate to reflect the temperature of the thermistor, it inherently is inaccurate in determining the temperature of the tissue at the ablation site. This results from several reasons. First, there is a temperature loss across the interface between the ablation site and the surface of the RF tip. Second, the flow of blood about a portion of the RF tip draws off heat from the ablation site which must be replenished by increasing the temperature of the tissue under ablation. However, temperatures above 100° C. result in coagulum formation on the RF tip, a rapid rise in electrical impedance of the RF tip, and loss of effective tissue heating. Third, there is a lag in thermal conduction between the RF tip and the thermistor, which lag is a function of materials, distance, and temperature differential. Each of these variables changes constantly during an ablation procedure. To ensure that the ablation site tissue is subjected to heat sufficient to raise its temperature to perform irreversible tissue damage, the power transmitted to the RF tip must be increased significantly greater than that desired for the ablation site in view of the variable losses. Due to the errors of the catheter/thermistor temperature sensing systems, there is a propensity to overheat the ablation site tissue needlessly. This creates three potentially injurious conditions. First, the RF tip may become coagulated. Second, tissue at the ablation site may “stick to” the RF tip and result in tearing of the tissue upon removal of the probe. This condition is particularly dangerous when the ablation site is on a thin wall of tissue. Third, inadequate tissue temperature control can result in unnecessary injury to the heart including immediate or subsequent perforation. 
     When radio frequency current is conducted through tissue, as might occur during a procedure of ablating a tissue site on the interior wall (endocardium) of the heart with a radio frequency energized catheter, heating occurs preliminarily at the interface of the tip of the catheter and the myocardial tissue. Given a fixed power level and geometry of the catheter probe, the temperature gradient from the probe interface and a distance, r, into the tissue is proportional to 1/r 4 . Heating is caused by the resistive (OHMIC) property of the myocardial tissue and it is directly proportional to the current density. As may be expected, the highest temperature occurs at the ablation site which is at the interface of the RF tip and the tissue. 
     When the temperature of the tissue at the ablation site approaches 100° C., a deposit is formed on the RF tip that will restrict the electrical conducting surface of the RF tip. The input impedance to the RF tip will increase. Were the power level retained constant, the interface current density would increase and eventually arcing and carbonization would occur. At these relatively extreme temperatures, the RF tip will often stick to the surface of the tissue and may tear the tissue when the RF tip is removed from the ablation site. 
     To effect ablation, or render the tissue nonviable, the tissue temperature must exceed 50° C. If the parameters of the RF tip of a catheter are held constant, the size and depth of the lesion caused by ablation is directly proportional to the temperature at the interface (assuming a time constant sufficient for thermal equilibrium). In order to produce lesions of greatest depth without overheating of the tissues at the interface, critical temperature measurement techniques of the RF tip are required. 
     The current technology for measuring the temperature of an RF tip embodies a miniature thermistor(s) located in the RF tip of the probe. The present state of the art provides inadequate compensation for the thermal resistance that exists between the thermistor and the outer surface of the RF tip or between the outer surface of the RF tip and the surface of the adjacent tissue. Because of these uncertainties contributing to a determination of the specific temperature of the tissue at the interface, apparatus for accurately measuring the interface temperature would be of great advantage in performing an electrophysiological procedure to ablate a specific site(s) of the myocardial tissue. 
     SUMMARY OF THE INVENTION 
     A catheter probe having a tip energized by an RF generator radiates RF energy as a function of the RF energy applied. When the tip is placed adjacent tissue at an ablation site, the irradiating RF energy heats the tissue due to the ohmically resistive property of the tissue. The catheter tip placed adjacent the ablation site on tissue in combination with an electrically conducting plate in contact with tissue at a location remote from the ablation site and an electrolyte defined by the intervening tissue create a galvanic cell when the tip and plate have different work functions because of migration of electrical charges therebetween. By loading the galvanic cell, the DC output current is a linear function of the temperature of the ablation site heated by the RF energy. The DC output current of the galvanic cell is used to regulate the output of the RF generator applied to the catheter tip to control the current density at the ablation site and hence maintain the ablation site tissue at a predetermined temperature. 
     It is therefore a primary object of the present invention to provide regulation of RF energy radiated from a catheter tip during an ablation procedure. 
     Another object of the present invention is to provide an output signal representative of the tissue temperature at an ablation site for regulating the RF radiation power level of a probe performing an ablation procedure. 
     Yet another object of the present invention is to generate a signal representative of the actual tissue temperature at an ablation site to control heating of the ablation site by regulating irradiating RF energy from an ablating RF tip despite heat dissipating variables that may be present. 
     Still another object of the present invention is to provide a catheter for ablating cardiac impulse pathways at a predetermined temperature. 
     A further object of the present invention is to provide a self-regulating catheter mounted RF radiating element controlled by the tissue temperature at an ablation site for ablating a site on the endocardium of a heart suffering tachycardia dysrhythmia to destroy a pathway of errant electrical impulses at least partly contributing to the tachycardia dysrhythmia. 
     A still further object of the present invention is to provide a method for heating and ablating an ablation site at a predetermined and controllable temperature. 
     These and other objects of the present invention will become apparent to those skilled in the art as the description thereof proceeds. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The present invention may be described with greater specificity and clarity with reference to the following drawings, in which: 
     FIG. 1 illustrates a simplified representation of the present invention; 
     FIG. 2 illustrates the current density at an ablation site during an ablation procedure; 
     FIG. 3 illustrates a representation of a catheter probe embodying a thermistor useful in the present invention; 
     FIG. 4 illustrates representatives curves for calibrating the temperature of an ablation site through use of a probe embodying a thermistor; 
     FIG. 5 is a block diagram illustrating the circuitry attendant the present invention; and 
     FIG. 6 illustrates a catheter probe for sequentially mapping the endocardium, identifying a site to be ablated and ablating the site without relocating the probe. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Two electrodes of different metals having different work functions in the presence of an electrolyte, such as blood, a saline solution or living tissue, will produce an exchange of electrical charges and an electromotive force (emf) is generated. This emf generator is known as a galvanic cell. A technical discussion of the history of galvanic cells is set forth in Chapter 1.3, entitled “Basic Electrochemistry” (pages 12-31) in a textbook entitled  Modern Electrochemistry , authored by John O&#39;M. Bockris, published by Plenum Press., New York, dated 1970. Detailed technical discussions of galvanic cells can be found in: Chapter 4, entitled “Reversible Electrode Potentials” (pages 73-100) of a textbook entitled  Electrochemistry Principles and Applications , authored by Edmund C. Potter, published by Cleaver-Hume Press, Ltd., dated 1956; Chapter 4 entitled “Electrodes and Electrochemical Cells” (pages 59-89) of a textbook entitled  Introduction to Electrochemistry , authored by D. Bryan Hibbert, published by MacMillan Press Ltd., dated 1993; and Chapter 12 entitled “Reversible Cells” (pages 282-311) of a textbook entitled  Electrochemistry of Solutions , authored by S. Glasstone, published by Methuen &amp; Co. Ltd., London, dated 1937 (Second Edition). These technical discussions are incorporated herein by reference. 
     The magnitude of the potential of a galvanic cell is a function of the electrolyte concentrates and the metals&#39; work functions. The open circuit voltage of the galvanic cell is essentially constant despite temperature changes at the interface between the electrodes and the electrolyte. However, by loading the galvanic cell with a fixed value shunt resistance it simulates a current generator which has an output signal directly proportional to the temperature of the metal and electrolyte interface. The output signal of the current generator can be calibrated as a function of the temperature at the interface. A simple method for calibration is that of referencing the output of the current generator with the output of a thermistor embedded in the electrode at steady state power and temperature conditions at an initial or first temperature and at a second temperature. This will provide two data points for the power/temperature curve of the current generator. Since the output of the current generator is linear, the curve can be extended to include all temperatures of interest. 
     The present invention is directed to apparatus for ablating an errant cardiac conduction pathway responsible for or contributing to arrhythmia of the heart. The ablation process is performed by heating the ablation site tissue to a temperature typically exceeding 50° C., sufficient to cause ablation of the cells contributing to the errant impulse pathway. The ablation is effected by irradiating the ablation site tissue with radio frequency (RF) energy. For this purpose, a catheter probe tip is positioned adjacent the ablation site, which site has been previously determined by mapping procedures well known to physicians and those skilled in the art. Upon positioning of the probe tip at the ablation site, a source of RF energy is actuated to transmit RF energy through a conductor to the tip of the probe. The RF energy radiates from the tip into the ablation site tissue. The current density at the ablation site is a function of the power of the RF energy irradiating the ablation site and the surface area defining the interface between the tip and the ablation site tissue. Control of the tissue temperature at the interface is of significant importance to control the area and depth of ablation in order to perform the degree of ablation necessary, to prevent coagulation on the tip, to prevent the tip from sticking to the tissue, to prevent avoidable injury to adjacent tissue, to prevent perforation of the tissue, and to avoid unnecessary heating of the blood flowing in and about the tip. 
     Catheter probes having a thermistor embedded at the tip have been used to perform an ablation procedure and the amount of RF energy applied has been regulated as a function of the temperature sensed by the thermistor. Such temperature sensing is inherently inaccurate in determining the temperature at the ablation site due to the numerous variables present. First, there exists a temperature loss through the interface between the ablation site and the surface area of the tip in contact with tissue. Second, there exists a thermal conductivity lag between the surface area of the tip in contact with the ablation site and the thermistor. Third, the orientation of the tip with respect to the ablation site will vary with a consequent variation of heating of the ablation site. Finally, the blood flowing about the tip area not in tissue contact will draw off heat as a function of both flow rate and orientation of the tip with respect thereto. By experiment, it has been learned that the differences between the tissue temperature at the ablation site and the temperature registered by a thermistor may range from 10° C. to 35° C. Such temperature excursion may result in unnecessary injury without a physician being aware of the injury caused at the time of the ablation procedure. Where ablation is being performed upon a thin wall myocardium, puncturing can and does occur with potentially disastrous results. 
     The present invention is shown in simplified format in FIG.  1 . An RF generator  10  serves as a source of RF energy. The output of the RF generator is controlled by an input signal identified as J 1 . The RF energy, as controlled by J 1 , is transmitted through a conductor  12  to a catheter probe  14 . This probe is depicted as being lodged within a blood filled chamber  16  of a heart. The chamber may be the right or left atrium or the right or left ventricle. Probe  14  is lodged adjacent, for instance, tissue  18  at an ablation site  20  representing a reentrant circuit to be ablated. As represented, blood continually flows through chamber  16  about and around probe  14 . 
     Probe  14  includes a tip  30  electrically connected to conductor  12  to irradiate ablation site  20  with RF energy. Typically, the frequency may be in the 350 kHz to 1200 kHz range. Such irradiation of the ablation site will result in heating of the ablation site as a function of the current density at the ablation site. The current density is determined by the energy level of the irradiating RF energy and the surface area of the ablation site. More specifically, the heat generated is proportional to the current density squared. This may be expressed as: T(r)=kPd=kI 2 R=(J O   2 /r 4 ) R, where T=temperature, r=distance from the interface, J 0 =current density at the interface, Pd=power dissipated, I=current at the interface, and R=resistance at the interface. The return path to RF generator  10  is represented by conductor  32 . Conductor  32  is electrically connected to a relatively large sized plate  34  placed adjacent the patient&#39;s skin, preferably a large surface area of the patient&#39;s back. To ensure good electrical contact, an electrically conducting salve may be disposed intermediate plate  34  and patient&#39;s back  36 . The fluid and tissues of the patient intermediate tip  30  and plate  34 , represented by numeral  38 , constitutes, in combination, an electrolyte and therefore an electrically conductive path between the tip and the plate. The DC current flow is represented by i, and the DC voltage is represented by V s . 
     As more particularly illustrated in FIG. 2, ablation site  20  has a relatively high concentration of current paths, representatively depicted by diverging lines identified with numerals  42 ,  44 ,  46 ,  48 ,  50 , and  52 . These current paths are in close proximity with one another at the ablation site. The resulting high current density will produce heating of the ablation site as a function of the current density. The depth of the ablated tissue is representatively illustrated by line  54 . The current density proximate back  36  of the patient adjacent plate  34  is relatively low. With such low current density, essentially no heating of the skin adjacent plate  34  will occur. It is to be appreciated that FIG. 2 is not drawn to scale and is intended to be solely representative of relative current densities resulting from irradiation of an ablation site by tip  30 . 
     Ablation with tissue temperature control permits the physician to optimize the ablation process by allowing the ablation to occur at maximum temperature that is below a temperature conducive to formation of coagulation on the tip. Since such temperature is a function of the RF energy irradiating the ablation site tissue, control of the amount of RF energy transmitted via conductor  12  to the tip is necessary. A presently available type of catheter probe  60  is illustrated in FIG.  3 . This probe includes a tip  62  for radiating RF energy received through conductor  64  from a source of RF energy. A thermistor  66  is embedded in tip  62  or in sufficient proximity with the tip to be responsive to the temperature of the tip. A pair of conductors  68  and  70  interconnect thermistor  66  with a signal detection circuit to provide an output signal representative of the temperature sensed. Furthermore, probe  60  may include mapping electrodes  72 ,  74  and  76 . These electrodes may be used in conjunction with manipulation of probe  60  within the heart to detect and identify errant impulse pathways causing cardiac arrhythmia. Conductors  78 ,  80  and  82  connect electrodes  72 ,  74  and  76 , respectively, to circuitry associated with the mapping functions, as is well known. 
     As stated above, thermistor  66  is incapable of providing an accurate representation of the temperature at the ablation site. In summary, these causes are due to heat loss through the interface between tip  30  and ablation site  20  (see FIG.  2 ), thermal lag between the area of tissue in contact with the tip and the sensing element of the thermistor, and heat loss resulting from flow of blood about the tip area not in contact with the tissue. 
     By experimentation, it has been learned that the combination of tip  30 , plate  34  and body  38  perform in the manner of a galvanic cell provided that the tip and the plate are metallic and of different work functions since body  38  acts as an electrolyte; the body is permeated by fluids having electrical properties similar to a saline solution. Experiments indicate that a preferable material for tip  30  is platinum and a preferable material for plate  34  is copper. The open circuit voltage (v s ) of this galvanic cell is essentially independent of the temperature of ablation site  20 . However, if the galvanic cell is heavily loaded with a shunt resistor, the galvanic cell serves as a current source and the magnitude of the current (i s ) is linear as a function of the tissue temperature at the ablation site through the 37° C. to 100° C. temperature range of interest. The temperature of the tissue adjacent plate  34  is the body temperature since the current density is insufficient to generate heat of any consequence. Thus, the galvanic cell created by the apparatus illustrated in FIG. 2 provides an output signal representative of the tissue temperature at ablation site  20  and irrespective of the temperature of tip  30 . 
     One method for calibrating the galvanic cell will be described, but other methods may be used which do not require the presence of a thermistor at the tip. A thermistor is embedded in the tip of a catheter probe, such as probe  60 . For reasons set forth above, the output of the thermistor is inherently inaccurate with respect to the actual tissue temperature at the ablation site; moreover, the temperature sensed by the thermistor as a function of the power applied is generally nonlinear. However, within a temperature range from a quiescent standby state to a small temperature increase at the ablation site (small increase in power applied), the output signal of the thermistor is essentially linear. By matching the output curve of the thermistor with the generally linear response curve of the galvanic cell, two coincident reference points can be determined. Referring to FIG. 4, there is illustrated a thermistor response curve and a galvanic cell response curve manipulated to be coincident from a point  0  to a point  1 . By correlating the temperature indication of the thermistor at these two points, with the current output (i s ) of the galvanic cell, the temperature response can be linearly extrapolated to obtain a temperature reading correlated with the current output of the galvanic cell. That is, for any given current output of the galvanic cell, the tissue temperature of the ablation site can be determined. Thus, if probe  14  illustrated in FIGS. 1 and 2 is of the type shown in FIG. 3, calibration of the probe at the ablation site can be readily determined. Other methods for calibrating the current output with temperature can also be employed, as set forth above. 
     Referring to FIG. 5, there is illustrated a block diagram of the major components necessary to control the power applied to a catheter probe for ablating an errant impulse pathway at an ablation site. FIG. 5 shows a temperature input circuit  90  for setting a reference voltage equivalent to the tissue temperature sought for an ablation site at which an ablation procedure is to be performed. The resulting output signal is transmitted through conductor  92  to a servo amplifier  94 . The servo amplifier provides an output signal on conductor  96  to control the output power of RF generator  98 . A switch  100  controls operation of the RF generator. The RF energy output is impressed upon conductor  102 . A blocking capacitor  104  is representative of a high pass filter and blocks any DC component of the signal on conductor l 02 . Conductor  106  interconnects the blocking capacitor with tip  30  of probe  14  and transmits RF energy to the tip. Tip  30  irradiates ablation site  20  of an endocardium, wall, membrane, or other living tissue to be irradiated with RF energy. Tip  30  is of a substance, such as platinum or other metal, having a first work function. Plate  34  displaced from tip  30 , is of a substance, such as copper or other metal, having a second work function which is different from the first work function. Plate  34  is in electrical contact with a mass of tissue  38  intermediate tip  30  and the plate. This tissue, being essentially a liquid and having electrical characteristics of a saline solution, serves in the manner of an electrolyte interconnecting tip  30  and plate  34 . The resulting galvanic cell formed, as discussed above, provides a DC output voltage v s  across conductors  106  and  108 . Shunt impedance R 1  heavily loads the galvanic cell formed to convert the galvanic cell to a current source (i s ) to provide an output signal reflective of the tissue temperature at ablation site  20 . The output signal from the galvanic cell is transmitted through conductor  110  to a lowpass filter  112 . The output of the lowpass filter is conveyed via conductor  114  to an operational amplifier  120  of a calibration circuit  116 . Additionally, a signal measurement and processing circuit  118 , connected to conductor  102  through conductor  103  to provide sampling of the output load voltage (V 0 ). It is also connected to conductor  107  through conductor  105  to provide an input signal of the load output) current (I 0 ) sensed, processes the input signals to provide an indication of the impedance, power, and voltage and current levels. A readout  123 , connected through conductor  119  to signal measurement and processing circuit  118  provides each of a plurality of indications of impedance, power, voltage level, current level, etc. 
     Variable resistors R 3  and R 4 , in combination with operational amplifier  120 , are representative of adjustments to be made to correlate the output current (i s ) of the galvanic cell with the tissue temperature of ablation site  20 . Calibration circuit  116  can perform the above-described correlation of the thermistor indicated temperature with the current output signal of the galvanic cell to obtain a tissue temperature indication of the ablation site as a function of the current (i s ) generated by the galvanic cell. A readout  122 , connected via conductors  124 ,  126  with the calibration circuit, may be employed to provide an indication of the tissue temperature of the ablation site. An output signal from the calibration circuit is also conveyed via conductors  124  and  128  to servo amplifier  94 . This output signal is reflective of the tissue temperature at the ablation site. Thereby, the servo amplifier receives an input signal reflective of the tissue temperature at the ablation site. Circuitry of servo amplifier  94  will determine whether to raise or lower the tissue temperature of the ablation site or to maintain it at its preset temperature. A command signal to increase, to decrease, or to maintain the power output of the RF generator is transmitted from servo amplifier  94  through conductor  96  to the RF generator. 
     Referring to FIG. 6, there is illustrated a variant of probe  14  useable with the present invention. The combination of first mapping a site of interest and then ablating the site is a lengthy procedure. Were it possible to ablate a site identified during a mapping procedure without relocating the probe or without replacing the mapping probe with an ablating probe, significant time would be saved. FIG. 6 illustrates a catheter probe  130 , which may be sufficiently flexible to position all or some of its length in contacting relationship with the surface of the myocardial tissue to be mapped. A tip  132 , which may be similar to tip  30  of probe  14 , is disposed at the distal end. A plurality of mapping electrodes, such as rings  134 ,  136 ,  138 ,  140  and  142  are disposed proximally along the probe from tip  132 . These rings serve a function of mapping the tissue of interest to identify and locate a site to be ablated to destroy the circuit responsible for errant impulses. For these rings to work in the manner of tip  30 , as described with reference to FIGS. 1-5, the rings are preferably metallic and have a work function different from that of plate (or electrode)  34 . One of a plurality of conductors  144 ,  146 ,  148 ,  150 ,  152  and  154  interconnect the respective tip and rings with the output of a switching circuit(s)  160 . A data acquisition circuit  162  is selectively interconnected through switching circuit  160  to each of rings  132 - 142  and possibly tip  132 . The data acquisition circuit collects data sensed by the rings and/or tips to map the tissue surface traversed by the probe. Upon detection of a site to be ablated to destroy an impulse pathway (circuit), switch circuit  160  switches to interconnect the respective ring (or tip) with RF generator  164 . Upon such interconnection, the respective ring (or tip) will irradiate the identified site with RF energy and the ablation function, as described above along with the tissue temperature control function, will be performed. 
     From this description, it is evident that upon detection of a site located by performing a mapping function, ablation of the site can be performed immediately without further movement or manipulation of the catheter probe. Furthermore, the ablation function can be performed with the circuitry illustrated in FIG. 5 to heat and maintain the tissue at a predetermined temperature until ablation is completed. 
     Empirically, it has been determined that the circuit and apparatus for ablating tissue, as illustrated in FIG. 5, provides to a physician a very accurate indication of the tissue temperature at the ablation site. With such accuracy, ablation procedures are capable of being performed on thin wall tissue without fear of coagulation of the tip, adhesion of tissue to the tip or puncture, which fears exist with presently used ablation performing apparatus. Furthermore, accurate representation of the temperature at the ablation site is no longer critically dependent upon the orientation of the probe at the ablation site nor upon the extent of the depression of the tissue in response to the pressure exerted by the probe tip. Because of these very difficult to control variables, complete ablation of the errant impulse pathway was not always achieved if the physician were overly cautious. Tip coagulation, sticking tissue and sometimes excessive injury to and puncture of the tissue occurred if the physician were more aggressive. These results were primarily due to the inaccuracy of the information conveyed to the physician during the procedure and not so much due to poor technique. 
     As will become evident from the above description, tip  30  (and tip  132 ) does not need a thermistor or a thermocouple to set or determine the temperature of the ablation site. Therefore, the probe can be smaller and more versatile than existing probes. Moreover, the probe can be manufactured at a substantially reduced cost because it is more simple than existing devices. Rings (or other electrodes) located on the catheter can be used for mapping sites of errant impulses and any of the rings (or other electrodes) can be used to irradiate the tissue at such site after identification of the site and without repositioning of the catheter. 
     While the invention has been described with reference to several particular embodiments thereof, those skilled in the art will be able to make the various modifications to the described embodiments of the invention without departing from the true spirit and scope of the invention. It is intended that all combinations of elements and steps which perform substantially the same function in substantially the same way to achieve the same result are within the scope of the invention.