Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

Fluid-assisted medical devices, systems and methods

An ablation apparatus including a maneuvering mechanism, a conductive element attached to the apparatus, a sensor attached to the apparatus and an output device in communication with the sensor is provided. The sensor senses vibration during the ablation procedure and sends a signal to the output device to reduce power to the conductive element.

Vibration sensitive ablation device and method

The present invention provides an apparatus and a method for producing a virtual electrode within or upon a tissue to be treated with radio frequency alternating electric current, such tissues including but not limited to liver, lung, cardiac, prostate, breast, and vascular tissues and neoplasms. An apparatus in accord with the present invention includes a supply of a conductive or electrolytic fluid to be provided to the patient, an alternating current generator, and a processor for creating, maintaining, and controlling the ablation process by the interstitial or surficial delivery of the fluid to a tissue and the delivery of electric power to the tissue via the virtual electrode. A method in accord with the present invention includes delivering a conductive fluid to a predetermined tissue ablation site for a predetermined time period, applying a predetermined power level of radio frequency current to the tissue, monitoring at least one of several parameters, and adjusting either the applied power and/or the fluid flow in response to the measured parameters.

Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue

Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.

Apparatus and methods for treating tissue

Devices, systems and methods are disclosed for the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be constrained within the lumen of a catheter, and deployed to take on an expanded condition. The carrier assembly includes multiple electrodes that are configured to ablate tissue at low power. Systems include an interface unit with a visual display that provides a visual representation of the geometry of the ablation elements and/or provides selection means for selecting an icon provided on the display.

User interface for tissue ablation system

This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. The equatorial band has a length relative to the longitudinal axis of the expandable member that is narrow relative to the working length, and is also substantially shorter than its circumference when the working length is in the radially expanded position. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described. The expandable member is also adapted to conform to the pulmonary vein in the region of its ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length which has a distally reducing outer diameter. A linear ablation element is provided adjacent to the circumferential ablation element in a combination assembly which is adapted for use in a less-invasive “maze”-type procedure in the region of the pulmonary vein ostia in the left ventricle.

Circumferential ablation device assembly

A circumferential ablation device assembly includes a circumferential ablation member with an ablation element that is adapted to ablate a circumferential region of tissue in the region of a pulmonary vein ostium. The ablation element couples to a middle portion of the circumferential ablation member and which is bordered on either side by two end portions. The end portions are adapted to shield and thereby isolate ablative energy from the ablation element to the circumferential region of tissue adjacent the middle region. The ablation element is coupled to an expandable member with a working length that is adjustable to a radially expanded position which engages the circumferential region of tissue, and may be coupled only to a narrow circumferential band that circumscribes the outer surface of the working length to form the middle region adapted to ablate tissue adjacent thereto. The ablation element may couple to the entire working length of the expandable member, and insulators may be provided over both end portions to leave the circumferential band as the only ablative middle region. The expandable member conforms to the pulmonary vein ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length with a distally reducing outer diameter. The ablation element may be any energy sink adapted to couple to and ablate the circumferential region, although in one mode an ultrasound transducer is ultrasonically coupled to the circumferential band to either heat the band or pass through the band in order to ablate the circumferential region of tissue. A linear ablation element is provided adjacent to the ablation element in a combination assembly which is adapted for use in a less-invasive 'maze'-type procedure in the region of the pulmonary vein ostia in the left atrium.

Circumferential ablation device assembly and method

A deflectable tip catheter that is used in combination with a guidewire for delivery of an ablation element to target areas of a patient's vasculature. The deflectable tip catheter has a handle portion, an elongated shaft and a deflectable tip portion. A guidewire lumen extends through the elongated shaft and deflectable tip portion. A guidewire passes through the guidewire lumen and exits from a port in the distal end of the deflectable tip portion. The deflectable tip of the catheter is deflected by manipulation of the handle portion to direct the advancement of the guidewire as the guidewire is advanced out of the distal port. By using the deflectable tip portion to direct the advancement of the guidewire, the physician's ability to navigate sharp angles is greatly improved. The deflectable tip catheter is particularly suitable for delivering an ablation element to a pulmonary vein or pulmonary vein branch for performing circumferential ultrasound vein ablation to treat atrial fibrillation.

Michael Ronald Ross

Papers

Circumferential ablation device assembly

Circumferential ablation device assembly and method

Deflectable tip catheter with guidewire tracking mechanism

Katheter mit lenkbarer spitze und spurausrichtungsmechanismus eines führungsdrahts