Impedance controlled tissue ablation apparatus and method
View Patent ↗A method and apparatus for carrying our thermal ablation of target tissue is disclosed. The apparatus includes an RF ablation device having a multi-electrode electrode assembly designed to be deployed in target tissue, defining a selected-volume tissue region to be ablated, and having infusion channels for infusing a liquid into the target tissue during the ablation process. A control unit in the apparatus is operably connected to an RF energy source, for controlling the RF power level supplied to the electrodes, and to an infusion device, for controlling the rate of infusion of a liquid through the device into the tissue. During both electrode deployment and tissue ablation, impedance and or temperature measurements made within the tissue are used to control the RF source and infusion device, for optimizing the time and extent of tissue ablation.
1. A cell necrosis apparatus for use in ablating target tissue, comprising, in operative condition:
an elongated delivery device including a lumen;
an energy delivery device including a plurality of electrodes, each electrode having a tissue piercing distal portion and being positionable in the elongated delivery device in a compacted state and preformed to assume a curved shape when deployed, the plurality of electrodes exhibiting a changing direction of travel when advanced from the elongated delivery device to a selected tissue site and defining an ablation volume when in said deployed state, said energy delivery device being operably connected to a source of energy;
at least two of the plurality of electrodes being adapted for fluid delivery therethrough to at least one infusion port, wherein said at least two electrodes adapted for fluid delivery are operably connected to a fluid delivery device
an energy control unit operably connected to (i) the source of energy, for controlling energy delivery to said energy delivery device, and to (ii) the energy delivery device for use in detecting impedance; and
a fluid control operatively connected the fluid delivery device by which the amount of fluid infused from the device into the target tissue can be controlled in response to said detected impedance, wherein said fluid control is operable to provide independent control of infusion through the separate infusion lumens.
2. The apparatus according to claim 1 , wherein said energy control unit is operably connected to at least one of the plurality of electrodes to determine tissue impedance.
3. The apparatus of claim 2 , wherein local impedance is determined directly by determining the impedance along conductive pathways between one or more sites on at least one of the plurality of electrodes.
4. The apparatus of claim 3 , wherein said one or more sites is at least two sites on the same electrode for determining local impedance across a fixed distance.
5. The apparatus according to claim 2 , wherein at least one of said plurality of electrodes is a passive electrode, and the energy control unit is operably connected to said passive electrode(s).
6. The apparatus according to claim 1 , further comprising:
a temperature sensor positioned on at least one of the plurality of electrodes and operably connected to the control unit.
7. The apparatus according to claim 1 , where said energy control unit is operably connected to said fluid delivery device for regulating the amount of fluid infused from the fluid delivery device in response to said detected impedance.
8. The apparatus according to claim 1 , where the energy control unit is manually adjustable for regulating the amount of energy delivered to said at least one electrode in response to said detected impedance.
9. The apparatus according to claim 1 , where the energy control is manually adjustable for regulating the amount of fluid infused from the fluid delivery device in response to said detected impedance.
10. The apparatus of claim 1 , said elongated delivery device being adapted for fluid delivery therethrough to at least one infusion port.
11. A method for use in ablating target tissue in a patient, comprising:
positioning in the patient an energy delivery device having (a) an elongated delivery device that includes a lumen, (b) a plurality of electrodes, with a tissue piercing distal end, that are positionable in the delivery device in a compact state and preformed to assume a curved shape when deployed, the plurality of electrodes exhibiting a changing direction of travel when advanced from the delivery device to a selected tissue site, at least two of the plurality of electrodes being adapted for fluid delivery therethrough to at least one infusion port; and wherein said positioning is effective to place the distal tip of the elongated delivery device in or adjacent a target tissue;
deploying said plurality of electrodes from said delivery device to define an ablation volume that includes at least a portion of the target tissue,
selectively infusing a fluid from a fluid delivery device operatively connected to said at least two electrodes and through the electrodes into the defined ablation volume to provide independent infusion through each of the electrodes;
applying an ablating current to the electrodes,
by said applying, ablating target tissue contained within the defined volume,
determining impedance; and
regulating the impedance by controlling the amount of fluid infused from the at least two electrodes.
12. The method of claim 11 , where said infusing step is performed at one or more of prior to, during, and after said ablating step.
13. The method of claim 11 , wherein said regulating step includes varying the fluid flow at different electrodes of the at least two of electrodes.
14. The method of claim 11 , wherein said ablating step is additionally performed during said deploying step.
15. The method of claim 11 , wherein the fluid infused is an infused electrolytic solution and the method further comprises varying the conductivity of the infused solution, by controlling the concentration of an electrolyte in the infused electrolytic solution.
16. The method of claim 15 , wherein said infused electrolytic solution is a saline solution and the conductivity of the infused electrolytic solution is controlled by varying the salinity of the solution.
17. The method of claim 15 , wherein said infusing step is effective to control a zone of infusion around individual electrodes of the plurality of electrodes.
18. The method of claim 11 , wherein said impedance is system or local impedance determined from the impedance between one or more electrodes of the plurality of electrodes and an exterior of the patient for system impedance, and between electrodes or between two or more sites on the same electrode for local impedance.
19. The method of claim 18 further comprising:
maximizing a power dissipation efficiency by controlling system and/or local impedance to an optimal value.
20. The method of claim 18 , wherein said controlling impedance is controlling impedance between a minimum value and maximum value.
21. The method of claim 18 , wherein said infusing step is performed at a preprogrammed flow rate profile to produce a time variable impedance profile.
22. The method of claim 18 , wherein determining said impedance is performed with a frequency selected from the group consisting of the same frequency as an energy source connected to the plurality of electrodes, a different frequency from the energy source and a range of frequencies.