Systems, devices and methods for generating patterns of voltage pulses and electrical arcs between spaced-apart electrode pairs in intravascular lithotripsy

1 . A pressure wave generating catheter system comprising:

a catheter;

a plurality of electrodes disposed within in the catheter;

a fluid-fillable balloon enclosing the plurality of electrodes;

a pulse generator in electrical communication with the plurality of electrodes in the catheter, wherein the pulse generator is configured to:

for a given cycle, cause a first voltage pulse to be applied to at least a portion of the plurality of electrodes in the catheter, after which a second voltage pulse is applied to at least a portion of the plurality of electrodes in the catheter, the first voltage pulse causing an initial pressure wave, and wherein the second voltage pulse occurs prior to the initial pressure wave resulting from the first voltage pulse dissipating;

a processor coupled to the pulse generator, the processor executing pre-programmed instructions comprising various timing sequences of pulses and delays resulting in a plurality of arcs that cause pressure waves to occur together but with at least one pressure wave delayed from another pressure wave.

2 . The pressure wave generating catheter system of claim 1 , wherein the second voltage pulse, in combination with the first voltage pulse, causes a combined pressure wave.

3 . The pressure wave generating catheter system of claim 2 , wherein each of the first voltage pulse and the second voltage pulse causes its own pressure wave, which combine to form the combined pressure wave.

4 . The pressure wave generating catheter system of claim 1 , wherein the second voltage pulse causes a change in the initial pressure wave.

5 . The pressure wave generating catheter system of claim 1 , wherein the first voltage pulse and the second voltage pulse have different magnitudes.

6 . The pressure wave generating catheter system of claim 1 , wherein the first voltage pulse and the second voltage pulse have different time durations.

7 . A method of generating pressure waves within a fluid-filled balloon of a catheter system, the method comprising:

inserting a catheter having a plurality of electrodes into a vessel;

filling a balloon enclosing the plurality of electrodes with a fluid; and

operating a pulse generator in electrical communication with the plurality of electrodes to:

for a given cycle, apply a first voltage pulse to at least a portion of the plurality of electrodes in the catheter, after which a second voltage pulse is applied to at least a portion of the plurality of electrodes in the catheter, wherein the first voltage pulse causes an initial pressure wave in the fluid, and the second voltage pulse occurs prior to the initial pressure wave resulting from the first voltage pulse dissipating.

8 . The method of claim 7 , further comprising executing, by a processor coupled to the pulse generator, pre-programmed instructions including a plurality of timing sequences of pulses and delays resulting in a plurality of arcs that cause pressure waves to occur together with at least one pressure wave delayed from another pressure wave.

9 . The method of claim 7 , wherein the second voltage pulse, in combination with the first voltage pulse, produces a combined pressure wave.

10 . The method of claim 9 , wherein each of the first voltage pulse and the second voltage pulse produces its own pressure wave, and the two pressure waves combine to form the combined pressure wave.

11 . The method of claim 7 , wherein the second voltage pulse alters or modifies the initial pressure wave.

12 . The method of claim 7 , wherein the first voltage pulse and the second voltage pulse have different magnitudes.

13 . The method of claim 7 , wherein the first voltage pulse and the second voltage pulse have different time durations.

14 . A pressure wave generating system comprising:

a catheter having a plurality of electrodes;

a fluid-fillable balloon enclosing the plurality of electrodes;

a pulse generator in electrical communication with the plurality of electrodes; and

a processor coupled to the pulse generator, the processor executing computer-executable instructions that cause the pulse generator to:

for a given cycle, cause a first voltage pulse to be applied to at least a portion of the plurality of electrodes in the catheter, after which a second voltage pulse is applied to at least a portion of the plurality of electrodes in the catheter, the first voltage pulse causing an initial pressure wave, and wherein the second voltage pulse occurs prior to the initial pressure wave resulting from the first voltage pulse dissipating.

15 . The pressure wave generating system of claim 14 , wherein the second voltage pulse, in combination with the first voltage pulse, causes a combined pressure wave.

16 . The pressure wave generating system of claim 15 , wherein each of the first voltage pulse and the second voltage pulse causes its own pressure wave, which combine to form the combined pressure wave.

17 . The pressure wave generating system of claim 14 , wherein the second voltage pulse causes a change in the initial pressure wave.

18 . The pressure wave generating system of claim 14 , wherein the processor executes computer-executable instructions that cause the pulse generator to generate the first voltage pulse and the second voltage pulse to have different magnitudes.