Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation employing tissue protection
View Patent ↗An enhanced method and device are provided to treat atrial fibrillation or inhibit or reduce restenosis following angioplasty or stent placement. A balloon-tipped catheter is disposed in the area treated or opened through balloon angioplasty immediately following angioplasty. The balloon, which can have a dual balloon structure, may be delivered through a guiding catheter and over a guidewire already in place. A fluid such as a perfluorocarbon flows into the balloon to freeze the tissue adjacent the balloon, this cooling being associated with reduction of restenosis. A similar catheter may be used to reduce atrial fibrillation by inserting and inflating the balloon such that an exterior surface of the balloon contacts at least a partial circumference of the portion of the pulmonary vein adjacent the left atrium. In another embodiment, blood perfusion is performed simultaneously. In another embodiment, tissue contacted by the cryoablation catheter, undesired to be ablated, is protected against damage by a separate heating step.
1. A method of treating atrial fibrillation while preventing tissue damage to the atrial septum, comprising:
inserting a trocar wire capable of rupturing the atrial septum from the femoral vein into the right atrium;
forming a hole using the trocar wire in the atrial septum between the right atrium and the left atrium;
inserting an introducer sheath into the hole, the introducer sheath at least partially contacting the atrial septum;
inserting a guide wire through the introducer sheath into the right atrium and left atrium and further into a pulmonary vein;
disposing an ablation catheter over the guidewire into a volume defined by the joint of the left atrium and the pulmonary vein;
flowing a cryofluid into a balloon disposed within the ablation catheter to ablate tissue adjacent the joint of the left atrium and the pulmonary vein; and
operating and controlling a heater disposed adjacent or within the introducer sheath, the heater thermally coupled to the atrial septum.
2. The method of claim 1 , wherein the operating and controlling a heater including providing power to a resistive heater.
3. The method of claim 1 , wherein the operating and controlling a heater includes flowing a warming fluid into an inlet tube fluidically coupled to an interior of the introducer sheath, and flowing the warming fluid out of at least one outlet orifice disposed in the introducer sheath.
4. The method of claim 1 , wherein the operating and controlling a heater includes allowing a body fluid to flow in an inlet sleeve having an input for the body fluid at a distal end of the introducer sheath, wherein the inlet sleeve is fluidically coupled to an interior of the introducer, and allowing the body fluid to flow out of the at least one outlet orifice disposed in the introducer.
5. The method of claim 1 , wherein the cryofluid is selected from the group consisting essentially of Galden® fluid, DMSO, and d-limonene.
6. The method of claim 1 , further comprising circulating the cryofluid with a gear pump.
7. The method of claim 6 , wherein the gear pump is one selected from the group consisting of a radial spur gear pump and a helical tooth gear pump.