Vacuum coagulation probe for atrial fibrillation treatment
View Patent ↗An embodiment of the invention includes a surgical device for coagulating soft tissue such as atrial tissue in the treatment of atrial fibrillation, atrial flutter, and atrial tachycardia. The surgical device can include at least one elongate member comprising conductive elements adapted to coagulate soft tissue when radiofrequency or direct current energy is transmitted to the conductive elements. Openings through said conductive elements are routed through lumens in the elongate member to a vacuum source to actively engage the soft tissue surface intended to coagulate into intimate contact with the conductive elements to facilitate the coagulation process and ensure the lesions created are consistent, contiguous, and transmural. The embodiments of the invention can also incorporate cooling openings positioned near the conductive elements and coupled with a vacuum source or an injection source to transport fluid through the cooling openings causing the soft tissue surface to cool thus pushing the maximum temperature deeper into tissue. The embodiments of the invention can also incorporate features to tunnel between anatomic structures or dissect around the desired tissue surface to coagulate thereby enabling less invasive positioning of the soft tissue coagulating device and ensuring reliable and consistent heating of the soft tissue.
1. A surgical device for coagulating soft tissue, comprising:
a first elongate member comprising a non-conductive material and defining at least first and second lumens and comprising at least one electrode at a first end;
at least one opening through said electrode, said opening coupled to said first lumen; and
at least one electrical conduit associated with said electrode; and
at least one cooling opening through said first elongate member,
wherein said first lumen is adapted to be connected to a vacuum source;
wherein said cooling opening is coupled to said second lumen;
wherein said electrical conduit is adapted to be connected to an energy transmission source;
wherein said at least one opening is formed through said electrode to cause soft tissue to contact said electrode, and
wherein said electrical conduit transmits energy from said source through said electrode to cause contacted tissue to heat.
2. The device of claim 1 wherein said first elongate member is malleable.
3. The device of claim 1 wherein said electrode is malleable.
4. The device of claim 1 further comprising multiple electrodes coupled to said first elongate member and individually connected to electrical conduits that are routed to at least one energy transmission source.
5. The device of claim 1 further comprising a sheath of a non-conductive material adapted to cover a length of said electrode, wherein said sheath is axially movable relative to said electrode.
6. A surgical device for coagulating soft tissue, comprising:
a first elongate member defining a first lumen and a second lumen and comprising at least one electrode;
at least one vacuum opening through said electrode and along an active length of said electrode, said vacuum opening coupled to said first lumen;
at least one cooling opening through said first elongate member, said cooling opening coupled to said second lumen;
at least one electrical conduit associated with said electrode;
wherein said first lumen is adapted to be connected to a vacuum source to provide intimate contact between said at least one electrode throughout its length by said at least one vacuum opening;
wherein said second lumen is adapted to be connected to a fluid injection or suction source; and
wherein said electrical conduit is adapted to be connected to an energy transmission source.
7. The device of claim 6 wherein said first lumen is coupled to said second lumen and said lumens are connected to a single suction source to simultaneously apply suction through said vacuum opening causing said soft tissue surface to contact said conductive element and cool said soft tissue surface as energy is transmitted to said electrode causing said soft tissue to heat.
8. The device of claim 6 further comprising a sheath of a non-conductive material adapted to cover a length of said electrode, wherein said sheath is axially movable relative to said electrode.
9. A surgical device for coagulating soft tissue, and dissecting or tunneling through anatomic structures comprising:
a first elongate member defining a first lumen, a second lumen, and a distal end cap, and comprising at least one conductive element;
at least one vacuum opening through said conductive element, said vacuum opening coupled to said first lumen;
at least one injection opening through said distal end cap, said injection opening coupled to said second lumen;
at least one electrical conduit associated with said conductive element;
a vacuum source adapted to be connected to said first lumen;
a fluid injection source adapted to be connected to said second lumen; and
an energy transmission source adapted to be connected to said electrical conduit;
wherein fluid is adapted to be transported at a sufficiently high velocity through said injection opening to dissect or separate soft tissue.
10. The device of claim 9 further comprising at least one cooling opening coupled to said first lumen, wherein said cooling opening is adapted to cool the soft tissue surface by suctioning fluid through said cooling opening as energy is transmitted to said conductive element causing said soft tissue to heat.
11. The device of claim 9 further comprising at least one cooling opening coupled to said second lumen, wherein said cooling opening is adapted to cool the soft tissue surface by injecting fluid through said cooling opening as energy is transmitted to said conductive element causing said soft tissue to heat.
12. The device of claim 9 further comprising a sheath of a non-conductive material adapted to cover a length of said conductive element, wherein said sheath is axially movable relative to said conductive element.
13. A method for coagulating a length of soft tissue comprising:
placing an elongate member comprising at least one lumen, at least one electrode, and at least one opening through said electrode and associated with said lumen against a soft tissue surface;
applying a vacuum source to said lumen causing said soft tissue to contact said electrode at said opening throughout an active length of said electrode; and
transmitting radiofrequency energy through said electrode to heat said soft tissue.
14. The method of claim 13 wherein at least one of said elongate member and said electrode are malleable and the act of placing said elongate member against said soft tissue surface comprises deforming at least one of said elongate member and said electrode before or after advancing said electrode against said soft tissue surface.
15. The method of claim 13 wherein said elongate member further comprises a non-conductive sheath covering a length of said conductive member and movable relative to said conductive member, and said act of placing said elongate member against said soft tissue surface comprises advancing or retracting said sheath relative to said conductive member until the active length of exposed electrode equals the desired lesion length before or after advancing said electrode against said soft tissue surface.
16. The method of claim 13 wherein said elongate member further comprises at least one fluid injection opening and said act of placing said elongate member against soft tissue surface comprises tunneling between or dissecting around anatomic structures to expose said soft tissue surface before advancing said electrode against said soft tissue surface.
17. The method of claim 13 wherein said act of placing said elongate member against a soft tissue surface comprises tunneling or dissecting around pulmonary veins to engage said electrode against a left atrial surface associated with the pulmonary veins.
18. The method of claim 13 wherein said act of heating said soft tissue comprises coagulating a contiguous, transmural lesion in atrial tissue by transmitting radiofrequency energy through said electrode and into the contacting atrial epicardium.
19. The method of claim 13 wherein said of heating said soft tissue comprises coagulating a contiguous, transmural lesion in atrial tissue by resistive heating said electrode contacting atrial epicardium.
20. A surgical device for coagulating soft tissue comprising:
a first elongate member defining at least one lumen and comprising at least one conductive element at a first end;
at least one opening through said conductive element, said opening coupled to said lumen;
at least one electrical conduit associated with said conductive element; and
a sheath of a non-conductive material adapted to cover a length of said conductive element;
wherein said sheath is axially movable relative to said conductive element;
wherein said lumen is adapted to be connected to a vacuum source; and
wherein said electrical conduit is adapted to be connected to an energy transmission source.
21. A surgical device for coagulating soft tissue comprising:
a first elongate member defining a first lumen and a second lumen and comprising at least one conductive element;
at least one vacuum opening through said conductive element, said vacuum opening coupled to said first lumen;
at least one cooling opening through said first elongate member, said cooling opening coupled to said second lumen;
at least one electrical conduit associated with said conductive element;
wherein said first lumen is adapted to be connected to a vacuum source;
wherein said second lumen is adapted to be connected to a fluid injection or suction source;
wherein said electrical conduit is adapted to be connected to an energy transmission source; and
wherein said first lumen is coupled to said second lumen and said lumens are connected to a single suction source to simultaneously apply suction through said vacuum opening causing said soft tissue surface to contact said conductive clement and cool said soft tissue surface as energy is transmitted to said conductive element causing said soft tissue to heat.
22. A surgical device for coagulating soft tissue, comprising:
a first elongate member defining a first lumen and a second lumen and comprising at least one conductive element;
at least one vacuum opening through said conductive element, said vacuum opening coupled to said first lumen;
at least one cooling opening through said first elongate member, said cooling opening coupled to said second lumen;
at least one electrical conduit associated with said conductive element; and
a sheath of a non-conductive material adapted to cover a length of said conductive element;
wherein said sheath is axially movable relative to said conductive element;
wherein said first lumen is adapted to be connected to a vacuum source;
wherein said second lumen is adapted to be connected to a fluid injection or suction source; and
wherein said electrical conduit is adapted to be connected to an energy transmission source.
23. A method for coagulating a length of soft tissue comprising:
placing an elongate member comprising at least one lumen, at least one conductive element, and at least one opening through said conductive element and associated with said lumen against a soft tissue surface;
applying a vacuum source to said lumen causing said soft tissue to contact said conductive element at said opening; and
transmitting radiofrequency energy through said conductive element to heat said soft tissue;
wherein said elongate member comprising a non-conductive sheath covering a length of said conductive member and movable relative to said conductive member, and
wherein said act of placing said elongate member against said soft tissue surface comprises advancing or retracting said sheath relative to said conductive member until the length of exposed conductive element equals the desired lesion length before or after advancing said conductive element against said soft tissue surface.
24. A method for coagulating a length of soft tissue comprising:
placing an elongate member comprising at least one lumen, at least one conductive element, and at least one opening through said conductive element and associated with said lumen against a soft tissue surface;
applying a vacuum source to said lumen causing said soft tissue to contact said conductive element at said opening; and
transmitting radiofrequency energy through said conductive element to heat said soft tissue;
wherein said act of placing said elongate member against a sot tissue surface comprises tunneling or dissecting around pulmonary veins to engage said conductive element against a left atrial surface associated with the pulmonary veins.