公开(公告)号：US20070156114A1

公开(公告)日：2007-07-05

申请号：US11323908

申请日：2005-12-29

申请人： Seth Worley ,  Shiva Sharareh

发明人： Seth Worley ,  Shiva Sharareh

IPC分类号： A61M25/00 ,  A61M25/16 ,  A61M25/18

CPC分类号： A61M25/0152 ,  A61B18/1492 ,  A61B2017/00867 ,  A61M25/0141 ,  A61M25/0147 ,  C08L2201/12

摘要： A catheter for mapping and/or ablating a region of the heart, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible preshaped section. The highly flexible section presets the tip assembly at an off-axis and/or off-plane angles from the intermediate section, to provide the following: a) The intermediate section when deflected approximates the generally convex region of the cavo-tricuspid isthmus and the preset angle of the flexible section is off axis in the same plane and same direction as deflection of the intermediate section to enable the tip assembly to contact the cavo-tricuspid isthmus for ablation and/or mapping. b) The intermediate section when deflected approximates the generally concave region of the VA/RV/LA/LV and the preset angle in the same plane and opposite direction of deflection enables the tip assembly to contact the walls of the cavity for ablation and/or mapping. c) The intermediate section when deflected approximates the generally convex region of the His area and the preset off plane angle of the flexible section enable the tip assembly to contact the Bundle of His region. A high bending modulus of the flexible section enables the flexible section to absorb displacement force applied to the tip assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the intermediate section. The flexible section prevents excessive force from being applied to the tip assembly, reducing the risk of any of the following: a) mechanical perforation, b) steam pop, c) burying the tip assembly in the myocardium resulting in high temperatures, low energy delivery, thrombus formation and char formation.

摘要翻译： 用于映射和/或消融心脏区域的导管包括具有中间部分的导管主体，所述中间部分通过高柔性预成形部分连接到尖端组件。 高度灵活的部分将尖端组件预设在与中间部分的离轴和/或离平面角度处，以提供以下内容：a）当偏转时的中间部分接近于三尖瓣峡部的大致凸起的区域，并且 柔性部分的预设角度在与中间部分的偏转相同的平面和相同方向上偏离轴线，以使尖端组件能够接触三尖瓣峡部以进行消融和/或测绘。 b）当偏转近似于VA / RV / LA / LV的大致凹陷区域并且在同一平面和相反的偏转方向上的预设角度的中间部分使得尖端组件能够接触腔体的壁以进行消融和/或 映射。 c）当偏转的中间部分接近于His区域的大致凸起区域并且柔性部分的预设离开平面角度使得尖端组件能够接触His区域的束。 柔性部分的高弯曲模量使得柔性部分能够吸收施加到尖端组件的位移力，例如当尖端组件遇到不均匀的组织表面时，而不会使中间部分移位。 柔性部分防止过大的力施加到尖端组件，降低以下任何风险：a）机械穿孔，b）蒸汽流动，c）将尖端组件埋入心肌中，导致高温，低能量传递 ，血栓形成和形成。

公开(公告)号：US20070066878A1

公开(公告)日：2007-03-22

申请号：US11228633

申请日：2005-09-16

申请人： Seth Worley ,  Shiva Sharareh

发明人： Seth Worley ,  Shiva Sharareh

IPC分类号： A61B5/04 ,  A61B18/14

CPC分类号： A61M25/0068 ,  A61B18/1492 ,  A61B2017/00867 ,  A61B2018/00375 ,  A61B2018/1435 ,  A61M25/003 ,  A61M25/007 ,  A61M25/0071 ,  A61M25/008 ,  A61M25/0082 ,  A61M25/0147 ,  A61M2025/004 ,  A61M2025/0161 ,  C08L2201/12

摘要： A catheter for mapping and/or ablating continuous linear or circumferential lesions at the intersection of a generally flat structure, such as the left atrium, and the ostium of generally cavernous regions of the heart, including pulmonary vein and the pulmonary venous antrum, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible section. The intermediate section has at its distal end a preformed section, e.g., a curve, the intermediate section being deflectable in a direction opposite to the curve. The highly flexible section presets the tip assembly at an off-axis and/or off-plane angles from the preformed section. Accordingly, the preformed section is adapted to sit in the region and the preset angles of the ablation assembly enable contact with surrounding tissue. A high bending modulus enables the flexible section absorb displacement force applied to the ablation assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the curve from the region. The tip assembly can be irrigated as enabled by a plurality of irrigation ports, a coil electrode, and a porous covering to disperse fluid over the outer surface of the tip assembly.

摘要翻译： 用于在大致平坦的结构（例如左心房）和心脏的大致海绵状区域的口（包括肺静脉和肺静脉窦）的交叉点处的连续线性或周边损伤的图形和/或消融导管包括 导管体，其具有通过高度柔性部分连接到尖端组件的中间部分。 中间部分在其远端处具有预成型部分，例如曲线，中间部分可沿与曲线相反的方向偏转。 高度灵活的部分将尖端组件预设在与预成型部分的离轴和/或离平面角度处。 因此，预成形部分适于位于该区域中，并且消融组件的预设角度能够与周围组织接触。 高弯曲模量使得柔性部分能够吸收施加到消融组件的位移力，例如当尖端组件遇到不均匀的组织表面时，而不使曲线从该区域移位。 尖端组件可以通过多个冲洗口，线圈电极和多孔覆盖物来灌溉，以将流体分散在尖端组件的外表面上。

公开(公告)号：US20100069734A1

公开(公告)日：2010-03-18

申请号：US12625470

申请日：2009-11-24

申请人： Seth J. Worley ,  Shiva Sharareh

发明人： Seth J. Worley ,  Shiva Sharareh

IPC分类号： A61B5/042 ,  A61M25/00 ,  A61B18/18

CPC分类号： A61M25/0068 ,  A61B18/1492 ,  A61B2017/00867 ,  A61B2018/00375 ,  A61B2018/1435 ,  A61M25/003 ,  A61M25/007 ,  A61M25/0071 ,  A61M25/008 ,  A61M25/0082 ,  A61M25/0147 ,  A61M2025/004 ,  A61M2025/0161 ,  C08L2201/12

摘要： A catheter for mapping and/or ablating continuous linear or circumferential lesions at the intersection of a generally flat structure, such as the left atrium, and the ostium of generally cavernous regions of the heart, including pulmonary vein and the pulmonary venous antrum, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible section. The intermediate section has at its distal end a preformed section, e.g., a curve, the intermediate section being deflectable in a direction opposite to the curve. The highly flexible section presets the tip assembly at an off-axis and/or off-plane angles from the preformed section. Accordingly, the preformed section is adapted to sit in the region and the preset angles of the ablation assembly enable contact with surrounding tissue. A high bending modulus enables the flexible section absorb displacement force applied to the ablation assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the curve from the region. The tip assembly can be irrigated as enabled by a plurality of irrigation ports, a coil electrode, and a porous covering to disperse fluid over the outer surface of the tip assembly.

摘要翻译： 用于在大致平坦的结构（例如左心房）和心脏的大致海绵状区域的口（包括肺静脉和肺静脉窦）的交叉点处的连续线性或周边损伤的图形和/或消融导管包括 导管体，其具有通过高度柔性部分连接到尖端组件的中间部分。 中间部分在其远端处具有预成型部分，例如曲线，中间部分可沿与曲线相反的方向偏转。 高度灵活的部分将尖端组件预设在与预成型部分的离轴和/或离平面角度处。 因此，预成形部分适于位于该区域中，并且消融组件的预设角度能够与周围组织接触。 高弯曲模量使得柔性部分能够吸收施加到消融组件的位移力，例如当尖端组件遇到不均匀的组织表面时，而不使曲线从该区域移位。 尖端组件可以通过多个冲洗口，线圈电极和多孔覆盖物来灌溉，以将流体分散在尖端组件的外表面上。

公开(公告)号：US20090005773A1

公开(公告)日：2009-01-01

申请号：US11824038

申请日：2007-06-29

申请人： Christopher Beeckler ,  Chad Allen Lieber ,  Shiva Sharareh

发明人： Christopher Beeckler ,  Chad Allen Lieber ,  Shiva Sharareh

IPC分类号： A61B18/14

CPC分类号： A61B5/14542 ,  A61B5/1459 ,  A61B18/1492 ,  A61B2017/0088 ,  A61B2018/00107 ,  A61B2018/00125 ,  A61B2018/00351 ,  A61B2018/00815 ,  A61B2018/00821 ,  A61B2090/306 ,  A61B2090/3614 ,  A61B2090/373 ,  A61B2090/378 ,  B82Y5/00 ,  B82Y30/00

摘要： A catheter enables real-time light measurements, for example, without limitation, diffuse reflectance, fluorescence, etc., from biological materials, such as tissue (including blood), while performing RF ablation. The catheter tip design isolates illumination and collection paths such that light exits the catheter tip and travels through the tissue of interest (e.g., cardiac tissue or blood) before returning to the catheter tip. Such a design advantageously avoids saturation of the optical detector, and ensures diffusion of the illumination light within the medium of interest. The catheter has a catheter body and a tip electrode. The tip electrode has an exterior shell, an inner layer of diffuse material and a hollow cavity, wherein the inner layer is configured to transmit light outside the tip electrode to a tissue via a set of illumination openings in the shell wall and the hollow cavity is configured to receive light from the tissue via a set of collection openings in the shell wall and the inner layer. An inner surface of the inner layer has a reflective coating to isolate light injected into the inner layer from light collected in the hollow cavity. There are a first optical waveguide extending between the catheter body and the tip electrode to inject light into the inner layer and illuminate the tissue, and a second optical waveguide extending between the catheter body and the tip electrode to collect the recaptured light in the hollow cavity.

摘要翻译： 导管能够进行实时光测量，例如但不限于来自生物材料（例如组织（包括血液））的漫反射，荧光等，同时进行RF消融。 导管尖端设计隔离照明和收集路径，使得光返回到导管尖端之前光离开导管尖端并穿过感兴趣的组织（例如，心脏组织或血液）。 这种设计有利地避免了光学检测器的饱和，并且确保照明光在感兴趣的介质内的扩散。 导管具有导管主体和尖端电极。 尖端电极具有外壳，扩散材料的内层和中空腔，其中内层被配置为通过壳壁中的一组照明开口将尖端电极外部的光透射到组织，并且中空腔是 被配置为经由所述壳壁和所述内层中的一组收集开口从所述组织接收光。 内层的内表面具有反射涂层以将注入内层的光与收集在中空腔中的光隔离。 在导管主体和尖端电极之间延伸有第一光波导，以将光注入内层并照亮组织;以及第二光波导，其在导管主体和尖端电极之间延伸以收集中空腔中的重新捕获的光 。

公开(公告)号：US20090005768A1

公开(公告)日：2009-01-01

申请号：US11417092

申请日：2006-05-02

申请人： Shiva Sharareh ,  Chad Allen Lieber ,  Jeffrey William Schultz

发明人： Shiva Sharareh ,  Chad Allen Lieber ,  Jeffrey William Schultz

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B34/20 ,  A61B2017/00057 ,  A61B2017/00084 ,  A61B2017/003 ,  A61B2018/00577 ,  A61B2018/00589 ,  A61B2018/00791 ,  A61B2090/397 ,  A61B2218/002

摘要： A catheter is adapted to ablate tissue and provide lesion qualitative information on a real time basis, having an ablation tip section with a generally omni-directional light diffusion chamber with one openings to allow light energy in the chamber to radiate the tissue and return to the chamber. The chamber is irrigated at a positive pressure differential to continuously flush the opening with fluid. The light energy returning to the chamber from the tissue conveys a tissue parameter, including without limitation, lesion formation, depth of penetration of lesion, cross-sectional area of lesion, formation of char during ablation, recognition of char during ablation, recognition of char from non-charred tissue, formation of coagulum around the ablation site, differentiation of coagulated from non-coagulated blood, differentiation of ablated from healthy tissue, tissue proximity, and recognition of steam formation in the tissue for prevention of steam pop.

摘要翻译： 导管适于消融组织并实时提供损伤定性信息，其具有消融尖端部分，该消融尖端部分具有一个具有一个开口的全向光扩散室，以允许腔室内的光能辐射组织并返回到 房间。 腔室以正压差灌溉，以连续冲洗开口。 从组织返回到腔室的光能传递组织参数，包括但不限于病变形成，损伤的穿透深度，损伤的横截面积，消融期间形成焦炭，消融期间识别焦炭，识别焦炭 来自非烧焦组织，消融部位周围形成凝固物，从非凝固血液凝结的分化，从健康组织中消融的分化，组织接近以及组织中蒸汽形成的识别以防止蒸汽流出。

公开(公告)号：US07623899B2

公开(公告)日：2009-11-24

申请号：US11228633

申请日：2005-09-16

申请人： Seth J. Worley ,  Shiva Sharareh

发明人： Seth J. Worley ,  Shiva Sharareh

IPC分类号： A61B5/04 ,  A61B18/14

CPC分类号： A61M25/0068 ,  A61B18/1492 ,  A61B2017/00867 ,  A61B2018/00375 ,  A61B2018/1435 ,  A61M25/003 ,  A61M25/007 ,  A61M25/0071 ,  A61M25/008 ,  A61M25/0082 ,  A61M25/0147 ,  A61M2025/004 ,  A61M2025/0161 ,  C08L2201/12

摘要： A catheter for mapping and/or ablating continuous linear or circumferential lesions at the intersection of a generally flat structure, such as the left atrium, and the ostium of generally cavernous regions of the heart, including pulmonary vein and the pulmonary venous antrum, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible section. The intermediate section has at its distal end a preformed section, e.g., a curve, the intermediate section being deflectable in a direction opposite to the curve. The highly flexible section presets the tip assembly at an off-axis and/or off-plane angles from the preformed section. Accordingly, the preformed section is adapted to sit in the region and the preset angles of the ablation assembly enable contact with surrounding tissue. A high bending modulus enables the flexible section absorb displacement force applied to the ablation assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the curve from the region. The tip assembly can be irrigated as enabled by a plurality of irrigation ports, a coil electrode, and a porous covering to disperse fluid over the outer surface of the tip assembly.

摘要翻译： 用于在大致平坦的结构（例如左心房）和心脏的大致海绵状区域的口（包括肺静脉和肺静脉窦）的交叉点处的连续线性或周边损伤的图形和/或消融导管包括 导管体，其具有通过高度柔性部分连接到尖端组件的中间部分。 中间部分在其远端处具有预成型部分，例如曲线，中间部分可沿与曲线相反的方向偏转。 高度灵活的部分将尖端组件预设在与预成型部分的离轴和/或离平面角度处。 因此，预成形部分适于位于该区域中，并且消融组件的预设角度能够与周围组织接触。 高弯曲模量使得柔性部分能够吸收施加到消融组件的位移力，例如当尖端组件遇到不均匀的组织表面时，而不使曲线从该区域移位。 尖端组件可以通过多个冲洗口，线圈电极和多孔覆盖物来灌溉，以将流体分散在尖端组件的外表面上。

公开(公告)号：US20090163850A1

公开(公告)日：2009-06-25

申请号：US12359204

申请日：2009-01-23

申请人： Andres Betts ,  Shiva Sharareh

发明人： Andres Betts ,  Shiva Sharareh

IPC分类号： A61N1/05

CPC分类号： A61B18/1492 ,  A61B2017/22038 ,  A61B2018/00083 ,  A61B2018/00196 ,  A61B2018/00434 ,  A61B2018/0044 ,  A61B2018/00791 ,  A61B2018/1405 ,  A61B2018/1475 ,  A61B2218/002

摘要： An integrated catheter shaft with a guidewire and a radio frequency wire is used in a catheter to deliver radio frequency energy to a treatment site. The small entry wound and the long integrated catheter shaft allows a user to thread the shaft along a tortuous route along a spinal canal to reach a treatment site while causing a minimal amount of trauma to the patient.

摘要翻译： 在导管中使用具有导丝和射频线的集成导管轴将射频能量传送到治疗部位。 小入口伤口和长整合的导管轴允许使用者沿着沿着脊柱的曲折路线螺纹连接到达治疗部位，同时对患者造成最小的创伤。

公开(公告)号：US20090005771A1

公开(公告)日：2009-01-01

申请号：US11770604

申请日：2007-06-28

申请人： Chad Allen Lieber ,  Shiva Sharareh

发明人： Chad Allen Lieber ,  Shiva Sharareh

IPC分类号： A61B18/14 ,  A61B5/01

CPC分类号： A61B18/1492 ,  A61B18/02 ,  A61B18/18 ,  A61B18/24 ,  A61B2017/0007 ,  A61B2017/00243 ,  A61B2017/003 ,  A61B2090/397

摘要： A system for opto-pyrometric tissue temperature monitoring in real time. The system is adapted for cardiac ablation and tissue temperature measurement, having a catheter having a tip electrode adapted for RF ablation of cardiac tissue and an optical collector whose distal end is received in an opening formed in the tip electrode to detect black body radiation from the cardiac tissue. The system includes an optical detection system in communication with the optical collector, the optical processing system processing signals representative of a wavelength of at least a portion of the black body radiation to determine a tissue temperature. The incorporation of an optical collector within a catheter tip permits real time monitoring of tissue temperature during ablation and lesion formation to prevent critical thresholds in temperature associated with events that can damage tissue, including steam pop, thrombus, char, etc.

摘要翻译： 实时光电组织温度监测系统。 该系统适用于心脏消融和组织温度测量，具有导管，其具有适于心脏组织的RF消融的尖端电极和光学收集器，其远端容纳在形成于尖端电极中的开口中，以检测来自 心脏组织。 该系统包括与光学收集器通信的光学检测系统，光学处理系统处理表示黑体辐射的至少一部分的波长的信号以确定组织温度。 导管尖端中的光学收集器的结合允许在消融和损伤形成期间实时监测组织温度，以防止与可能损伤组织的事件相关的温度的临界阈值，包括蒸汽流淌，血栓，焦炭等。

公开(公告)号：US20080097220A1

公开(公告)日：2008-04-24

申请号：US11552075

申请日：2006-10-23

申请人： Chad Allen Lieber ,  Ariel Garcia ,  Shiva Sharareh

发明人： Chad Allen Lieber ,  Ariel Garcia ,  Shiva Sharareh

IPC分类号： A61B6/00

CPC分类号： A61B18/1492 ,  A61B5/0084 ,  A61B18/1233 ,  A61B2017/00061 ,  A61B2017/00066 ,  A61B2017/00123 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61B2018/00666

摘要： A system and method that enable real-time optical measurements of tissue reflection spectral characteristics while performing ablation, involves the radiation of tissue and recapturing of light from the tissue to monitor changes in the reflected optical intensity as an indicator of steam formation in the tissue for prevention of steam pop. The system includes a catheter adapted to collect light reflected from tissue undergoing ablation, a detection component that identifies and separates constituent wavelengths of collected light, a quantification apparatus for generating measured light intensity data for the collected light, and a processor that analyses the measured light intensity data in relation to time. The system may include a graphical display and/or an audio output (e.g., speaker) that provide visual and/or audio alarm when the system infers formation of a steam pocket in the tissue. The method for monitoring formation of steam pocket during ablation, wherein a measured reflectance spectral intensity MRSI versus time is analyzed, includes delivering light to tissue, delivering energy for ablation at tissue and measuring the reflectance spectral intensity of the tissue, wherein observation is made as to whether the MRSI initially increases in a specified time period followed by a decrease at a specified rate in the MRSI. If there is no decrease in the MRSI, then delivery of ablation energy to tissue continues. However, if there is a decrease in the MRSI within a specified time and at a specified rate, then the method infers the formation of a steam pocket and decreases or discontinues the delivery of ablative energy to tissue.

摘要翻译： 能够在进行消融时实现组织反射光谱特征的实时光学测量的系统和方法涉及组织的辐射和来自组织的光的重新捕获，以监测反射光强度的变化，作为组织中蒸汽形成的指标 预防蒸汽流行。 所述系统包括适于收集经历消融的组织反射的光的导管，识别并分离所收集的光的组成波长的检测部件，用于产生所收集的光的测量光强度数据的量化装置，以及分析所测量的光的处理器 强度数据与时间有关。 该系统可以包括图形显示和/或音频输出（例如，扬声器），当系统推断组织中的蒸汽口袋的形成时，提供视觉和/或音频报警。 在消融期间监测蒸汽袋形成的方法，其中分析测量的反射光谱强度MRSI与时间的关系，包括将光传送到组织，在组织处输送消融能量并测量组织的反射光谱强度，其中观察为 MRSI是否在特定时间段内最初增加，之后MRSI中以指定的速率下降。 如果MRSI没有减少，那么消融能量传递给组织就会持续下去。 然而，如果MRSI在规定时间内以规定的速率下降，则该方法推测形成蒸汽口袋并减少或停止向组织输送烧蚀能量。

公开(公告)号：US20070287998A1

公开(公告)日：2007-12-13

申请号：US11453188

申请日：2006-06-13

申请人： Shiva Sharareh ,  Ariel Garcia

发明人： Shiva Sharareh ,  Ariel Garcia

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B2017/00057 ,  A61B2017/00084 ,  A61B2018/00642 ,  A61B2090/306 ,  A61B2218/002

摘要： A catheter is adapted to ablate tissue and provide optically-based lesion qualitative and quantitative monitoring, comprising a catheter body and a tip electrode distal the catheter body adapted for ablating tissue, the tip electrode having a shell and an alignment member defining a hollow distal portion therebetween. In accordance with the invention, the catheter further includes a plurality of optical waveguides adapted to transmit optical energy to and from the tip electrode. A distal portion of each waveguide extends through the hollow distal portion and terminates in openings formed in the shell. Advantageously, the alignment member fixedly secures the distal portion of each waveguide against movement relative to the alignment member and the shell.

摘要翻译： 导管适于消融组织并提供基于光学的病变定性和定量监测，包括导管主体和适于消融组织的导管主体远端的末端电极，尖端电极具有外壳和限定中空远端部分的对准构件 之间。 根据本发明，导管还包括适于将光能传递到尖端电极和从尖端电极传输光能的多个光波导。 每个波导的远端部分延伸穿过中空的远端部分并且终止于壳体中形成的开口。 有利地，对准构件固定地固定每个波导的远端部分，防止相对于对准构件和壳体移动。