Epicardial myocardial revascularization and denervation methods and apparatus

1. A myocardial revascularization and denervation method, comprising the steps of:

positioning an electrode, including an electrode main portion and an electrode needle portion, on the epicardial surface such that the electrode main portion is on the epicardial surface of a ventricle;

piercing the epicardial surface with the electrode needle portion such that the electrode needle portion is located within the ventricular wall; and

transmitting energy from the electrode, through the epicardial surface and into the ventricular wall to create a lesion within the ventricular wall.

2. A method as claimed in claim 1 , wherein the step of transmitting energy from the electrode comprises transmitting energy from the electrode main portion and the electrode needle portion.

3. A myocardial revascularization and denervation method, comprising the steps of:

positioning an electrode on the epicardial surface of a ventricle shaped such that the lesion produced thereby will define a first region relatively close to the epicardial surface with a relatively large cross-sectional area and a second region relatively far from the epicardial surface with a relatively small cross-sectional area; and

transmitting energy from the electrode, through the epicardial surface and into the ventricular wall to create a lesion within the ventricular wall.

4. A method as claimed in claim 3 , wherein the step of positioning an electrode on the epicardial surface of a ventricle comprises the step of introducing the electrode thoracoscopically.

5. A method as claimed in claim 3 , wherein the step of positioning an electrode on the epicardial surface of a ventricle comprises positioning a plurality of electrodes on the epicardial surface of the ventricle.

6. A myocardial revascularization and denervation method for use on a wall of the heart defining an epicardial surface and an endocardial surface, the method comprising the steps of:

positioning a first lesion creation device on the epicardial surface;

positioning a second lesion creation device within the heart wall; and

forming a lesion with the first and second lesion creation devices.

7. A method as claimed in claim 6 , wherein the step of positioning a first lesion creation device on the epicardial surface comprises positioning an electrode on the epicardial surface.

8. A method as claimed in claim 6 , wherein the step of positioning a second lesion creation device within the heart wall comprises positioning an electrode within the heart wall.

9. A method as claimed in claim 6 , wherein the step of forming a lesion with the first and second lesion creation devices comprises forming a first lesion portion having a first cross-sectional area and a second lesion portion having a second cross-sectional area less than the first cross-sectional area.

10. A method as claimed in claim 9 , wherein the step of forming a first lesion portion comprises forming a first lesion portion that extends inwardly from the epicardial surface towards the endocardial surface and the step of forming a second lesion portion comprises forming a second lesion portion that extends inwardly from the first lesion portion.

11. A method as claimed in claim 9 , wherein the step of forming a lesion with the first and second lesion creation devices comprises forming a lesion which, when viewed in a cross-section taken in a plane perpendicular to the epicardial surface, includes a first area that defines a border having a relatively smooth slope, a second area that defines a border having a relatively smooth slope, and a abrupt change in slope therebetween.