公开(公告)号：WO2016130234A1

公开(公告)日：2016-08-18

申请号：PCT/US2016/012031

申请日：2016-01-04

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  MA, Zhenyi

IPC: A61B8/08 ,  A61B8/12

CPC classification number: A61B8/085 ,  A61B8/0883 ,  A61B8/12 ,  A61B8/445 ,  A61B8/485 ,  A61B8/5223 ,  A61B8/543

Abstract: Apparatuses, systems, and methods of monitoring lesion formation using one-dimensional echograms are disclosed. In certain aspects, lesion formation progress is monitored using the intensity of reflectors in successive echograms during ablation. In another aspect, lesion formation progress is monitored based upon actual or apparent movement of acoustic reflectors before and after ablation. In still another aspect, the presence or absence of resonant microbubbles known to populate forming lesions are used to provide feedback on lesion formation. A lesion analysis processor can be programmed to determine lesion formation progress using any of the foregoing approaches, either alone or in various combinations.

Abstract translation: 公开了使用一维回波图监测病变形成的装置，系统和方法。 在某些方面，使用消融期间的连续回波图中反射器的强度来监测损伤形成进展。 在另一方面，基于消融之前和之后的声反射器的实际或明显移动来监测病变形成进展。 在另一方面，使用已知填充形成损伤的共振微泡的存在或不存在来提供病变形成的反馈。 病变分析处理器可以被编程以使用任何前述方法单独地或以各种组合来确定病变形成进展。

公开(公告)号：WO2015069887A1

公开(公告)日：2015-05-14

申请号：PCT/US2014/064335

申请日：2014-11-06

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  IZMIRLI, Alon ,  MA, Zhenyi ,  TEGG, Troy T.

IPC: A61B18/14 ,  A61B5/00 ,  A61B17/00 ,  A61B19/00

CPC classification number: A61B18/1492 ,  A61B5/042 ,  A61B5/0422 ,  A61B5/6885 ,  A61B8/12 ,  A61B18/1206 ,  A61B2090/064 ,  A61B2090/065 ,  A61B2562/0223 ,  A61B2562/0261

Abstract: Medical devices for diagnosis or treatment of tissue in a body. Representative devices include an elongate shaft having a proximal portion and a distal portion configured for movement relative to the proximal portion. A flexible member having a predetermined stiffness is disposed between the proximal and distal portions. One or more coils and an electrically passive element are disposed within the shaft with either the coils or element configured for movement with the distal portion. The element comprises a material effecting an electrical characteristic of the coils. Movement of the distal portion in response to its contact with the tissue and relative movement of the coils and element causes a change in the electrical characteristic in at least one of the coils indicative of at least a contact force magnitude between the distal portion and the tissue. Several embodiments allow determination of both force magnitude and force vector direction.

Abstract translation: 用于诊断或治疗身体组织的医疗装置。 代表性的装置包括细长轴，其具有被配置为相对于近端部分移动的近端部分和远侧部分。 具有预定刚度的柔性构件设置在近端部分和远端部分之间。 一个或多个线圈和电动无源元件设置在轴内，线圈或元件被构造成与远端部分一起移动。 元件包括影响线圈的电特性的材料。 远端部分响应于其与组织的接触和线圈和元件的相对运动的运动导致至少一个线圈中的电特性的变化，其指示远端部分和组织之间的至少接触力大小 。 几个实施例允许确定力量级和力矢量方向。

公开(公告)号：WO2017087740A1

公开(公告)日：2017-05-26

申请号：PCT/US2016/062662

申请日：2016-11-18

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  MA, Zhenyi ,  MORSE, Stephen A. ,  HAUCK, John A. ,  DENO, Don Curtis

IPC: A61B18/14 ,  A61B18/00

CPC classification number: A61B18/1492 ,  A61B2018/00083 ,  A61B2018/00351 ,  A61B2018/00577 ,  A61B2018/00797 ,  A61B2018/00839 ,  A61B2018/00869 ,  A61B2018/00875 ,  A61B2018/00892 ,  A61B2018/1417 ,  A61B2018/1467 ,  A61B2018/1497 ,  A61B2218/002

Abstract: Electrode assemblies include segmented electrodes disposed on a catheter. The segmented electrodes can be constructed at the tip of the catheter. Tip electrode (501) can be constructed from an electrically insulative substrate (505) comprising an inner lumen (533), an external tip surface, and a plurality of channels extending from the inner lumen to the external tip surface, a plurality of segmented electrodes, and a plurality of spot electrodes. Each of the plurality of segmented electrodes and each of the plurality of spot electrodes can be laterally separated from each other by an electrically non-conductive substrate portion and each of the spot electrodes and each of the segmented electrodes can be electrically coupled to at least one wire or conductor trace.

Abstract translation: 电极组件包括设置在导管上的分段电极。 分段电极可以构造在导管的尖端。 尖端电极（501）可由包括内腔（533），外部尖端表面和从内腔延伸到外部尖端表面的多个通道的电绝缘基板（505）构造，多个分段电极 和多个点电极。 多个分段电极中的每一个和多个点电极中的每一个可以通过非导电衬底部分彼此横向分离，并且每个点电极和每个分段电极可以电耦合到至少一个 电线或导体迹线。

公开(公告)号：WO2017074726A1

公开(公告)日：2017-05-04

申请号：PCT/US2016/057263

申请日：2016-10-17

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： LUPOTTI, Fermin A. ,  ROSENBERG, Stuart ,  SLIWA, John W. ,  SHAH, Riddhi

IPC: A61B8/00 ,  A61B18/14 ,  A61M25/00

CPC classification number: A61B8/12 ,  A61B8/4254 ,  A61B8/445 ,  A61B8/4461 ,  A61B8/4477 ,  A61B8/4494 ,  A61B8/483 ,  A61B18/1492 ,  A61B2018/00577 ,  A61B2090/3925 ,  A61M25/0023

Abstract: An ablation catheter (10) includes a body (12) having a distal end (16), a hollow tip (22) attached to the distal end and an ultrasound transducer assembly positioned within the hollow tip and mounted to rotate about a longitudinal axis of the catheter body. The hollow tip includes an acoustically transparent shell, which allows acoustic energy to pass to and from the ultrasound transducer assembly, and an electrically-conductive coating on its exterior surface, which allows ablating energy to be delivered to an adjacent tissue. A plurality of ribs extend inwardly from an inner surface of the shell. A system (100) incorporating the ablation catheter and methods of using the same to ablate, image and/or monitor tissue are also disclosed.

Abstract translation: 消融导管（10）包括具有远端（16），附接到远端的中空尖端（22）和定位在中空尖端内的超声换能器组件的主体（12），以及 安装成围绕导管主体的纵向轴线旋转。 中空尖端包括允许声能传递到超声换能器组件以及从超声换能器组件传递的声学透明外壳和其外表面上的导电涂层，其允许消融能量传递到相邻组织。 多个肋从壳体的内表面向内延伸。 还公开了包含消融导管的系统（100）以及使用消融导管消融，成像和/或监测组织的方法。

公开(公告)号：WO2015108666A2

公开(公告)日：2015-07-23

申请号：PCT/US2014/071434

申请日：2014-12-19

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  MA, Zhenyi ,  MORSE, Stephen A.

IPC: A61B1/00

CPC classification number: A61M25/007 ,  A61B1/00096 ,  A61B1/00177 ,  A61B1/015 ,  A61B5/0084 ,  A61B5/4836 ,  A61B5/4848 ,  A61B5/6853 ,  A61B8/12 ,  A61B8/445 ,  A61B18/1492 ,  A61B2017/00106 ,  A61B2018/00029 ,  A61B2018/00285 ,  A61B2018/00577 ,  A61B2090/065 ,  A61B2217/007 ,  A61B2218/002 ,  A61B2560/0443 ,  A61B2562/16

Abstract: A tip for a medical device includes a hollow body having a window, a sensor positioned within the hollow body and oriented such that its active surface is pointed towards the window, and a membrane positioned within a beam path of the sensor. The membrane passes energy without preventing an outer surface of the hollow body of the tip from coming in contact with tissue, thus allowing the hollow body to deliver therapy to an adjacent tissue and/or diagnose adjacent tissue. The membrane can cover the window or the sensor. The membrane is desirably permeable to an irrigant, such that a suitable level of irrigant outflow from the window is maintained, and thin enough that it minimizes attenuation of energy passing to and/or from the sensor.

Abstract translation: 用于医疗装置的尖端包括具有窗口的中空主体，定位在中空主体内并定向成使得其主动表面指向窗口的传感器以及定位在光路中的膜片 的传感器。 膜通过能量而不会阻止尖端的中空体的外表面与组织接触，从而允许中空体将治疗递送至邻近的组织和/或诊断邻近的组织。 膜可以覆盖窗户或传感器。 该膜对于冲洗剂是理想的渗透性的，从而维持从窗口流出的适当水平的冲洗剂，并且足够薄以至于使传递至传感器和/或传感器的能量的衰减最小化。

公开(公告)号：WO2015089173A1

公开(公告)日：2015-06-18

申请号：PCT/US2014/069521

申请日：2014-12-10

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  IZMIRLI, Alon

IPC: A61B18/14 ,  A61B19/00 ,  A61B18/00

CPC classification number: A61B18/1492 ,  A61B2018/00577 ,  A61B2018/00839 ,  A61B2090/065 ,  A61B2218/002 ,  A61B2218/007 ,  A61B2562/0247

Abstract: A medical device for diagnosis or treatment of tissue in a body is provided. The device includes an elongate, tubular shaft configured to be received within the body. The shaft has a proximal portion and a distal portion configured for movement relative to the proximal portion. A flexible member having a predetermined stiffness is disposed between the proximal and distal portions. A plurality of coils are disposed within the shaft with one or more of the coils configured for movement with the distal portion. Electromagnetic fields generated from within or outside of the medical device induce currents in the coils from which movement of the distal portion in response to contact of the distal portion with the tissue may be determined. In one embodiment, several of the coils are connected in series to reduce the space required in the device for conductors.

Abstract translation: 提供了用于诊断或治疗身体中的组织的医疗装置。 该装置包括被配置为容纳在主体内的细长管状轴。 轴具有近端部分和远端部分，该远端部分构造成用于相对于近端部分移动。 具有预定刚度的柔性构件设置在近端部分和远端部分之间。 多个线圈设置在轴内，其中一个或多个线圈构造成与远端部分一起移动。 从医疗装置的内部或外部产生的电磁场引起线圈中的电流，可以确定远端部分响应远端部分与组织接触的运动。 在一个实施例中，若干线圈串联连接以减少用于导体的装置所需的空间。

公开(公告)号：WO2018226752A1

公开(公告)日：2018-12-13

申请号：PCT/US2018/036141

申请日：2018-06-05

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  MORSE, Stephen A.

IPC: A61B18/14 ,  A61B18/08 ,  A61B18/02 ,  A61M25/10 ,  A61B18/00

Abstract: Devices and methods for creating radial-linear lesions in pulmonary vein antral tissue are disclosed. In an embodiment, a device includes an elongate shaft structure with a distal tip ablation region including a spline and an ablation element slidably coupled to the spline. The ablation element includes at least one of an ultrasound emitter, a high frequency ultrasound emitter, a laser, a radiofrequency electrode, a virtual radiofrequency electrode, or a cryogenic source. A backing balloon may be configured to push or pull the spline and the ablation element toward or against the pulmonary vein antral tissue. In an embodiment, the distal tip ablation region includes a splineless cryoballoon with at least one thermally conductive region.

公开(公告)号：WO2018226751A1

公开(公告)日：2018-12-13

申请号：PCT/US2018/036140

申请日：2018-06-05

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： MORSE, Stephen A. ,  SLIWA, John W.

IPC: A61B18/14 ,  A61B18/08 ,  A61B18/02 ,  A61M25/10 ,  A61B18/00

Abstract: A catheter comprises an expandable spline structure defining a distal tip portion of the catheter. The spline structure comprises a plurality of individual splines, and each spline is configured to support a plurality of energy transfer elements and/or temperature sensors. An expandable balloon configured to be associated with the spline structure is unattached to the spline structure along its length.

公开(公告)号：WO2017095689A1

公开(公告)日：2017-06-08

申请号：PCT/US2016/063250

申请日：2016-11-22

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： SLIWA, John W. ,  MORSE, Stephen A.

IPC: A61B18/14

CPC classification number: A61B18/14 ,  A61B2018/1405 ,  A61B2018/1407

Abstract: An ablation catheter includes a distal region, which may be disposed into or capable of being shaped into at least a partial loop, and a plurality of individually electrically addressable flexible ablation electrodes disposed within the distal region and separated by a plurality of electrically insulating gaps. The plurality of individually electrically addressable flexible ablation electrodes can include a plurality of pleated ablation electrodes. In embodiments, the pleated ablation electrodes are irrigated, for example via irrigation ports within the troughs of their pleats. The individually electrically addressable flexible ablation electrodes can also include a plurality of commonly electrically addressable rigid electrode segments separated by a plurality of flexible inter-electrode gaps. The plurality of individually electrically addressable flexible ablation electrodes cover at least 50%, and, in embodiments, at least 80%, of an overall length of the distal region.

Abstract translation: 消融导管包括远端区域和多个单独的可电寻址的柔性消融电极，所述远端区域可以布置成或能够成形为至少部分环路，所述多个单独的可电寻址的柔性消融电极设置在远端区域内并且分开 通过多个电绝缘间隙。 多个独立电寻址的柔性消融电极可以包括多个褶皱消融电极。 在实施例中，打褶的消融电极例如经由它们的褶的槽内的灌注端口被灌注。 独立电寻址的柔性消融电极还可以包括由多个柔性电极间间隙分开的多个通常可电寻址的刚性电极段。 多个独立电寻址的柔性消融电极覆盖远侧区域的总长度的至少50％，并且在一些实施例中至少80％。

公开(公告)号：WO2016111804A1

公开(公告)日：2016-07-14

申请号：PCT/US2015/064960

申请日：2015-12-10

Applicant: ST. JUDE MEDICAL, CARDIOLOGY DIVISION, INC.

Inventor： LUPOTTI, Fermin A. ,  SLIWA, John W. ,  MA, Zhenyi ,  MORSE, Stephen A.

IPC: A61B8/12 ,  A61B8/08

CPC classification number: A61B8/12 ,  A61B8/445 ,  A61B8/4461 ,  A61B8/4483 ,  A61B8/4488 ,  A61B8/483

Abstract: An apparatus for imaging tissue in three dimensions (e.g. ICE catheter) includes a shaft, a static imaging element (20) disposed within the shaft, an oscillating energy deflector (24) positioned within the beam path of the imaging element, and a drive assembly operable to oscillate the energy deflector. The imaging element can be acoustic or electromagnetic, and the energy deflector can be a prism, a lens or an acoustic mirror. By oscillating the energy deflector and/or by providing an asymmetric energy deflector, a plurality of two-dimensional image slices can be obtained. These image slices can then be assembled into a three-dimensional volumetric image.

Abstract translation: 用于在三维（例如ICE导管）中成像组织的装置包括轴，设置在轴内的静态成像元件（20），位于成像元件的光束路径内的振荡能量偏转器（24）和驱动组件 可操作地振荡能量偏转器。 成像元件可以是声学或电磁的，并且能量偏转器可以是棱镜，透镜或声镜。 通过振荡能量偏转器和/或通过提供不对称能量偏转器，可以获得多个二维图像切片。 然后可以将这些图像切片组装成三维体积图像。