Guided ablation with motion control

1 . An apparatus for forming a lesion in tissue along a desired ablation path, said apparatus comprising:

a guide member having a tissue-opposing surface for placement against a heart surface, said guide member having interior surfaces and a longitudinal axis;

a guide carriage sized to be received within said guide member and moveable therein along said longitudinal axis;

a flexible tubular member extending from a proximal end of said carriage and through a length of said guide member with said tubular member adapted to move said carriage within said guide member upon application of a force to said tubular member;

a system for urging said carriage to move in a path along an axis of said guide member by amount substantially identical to a displacement of an application location of said force on said flexible tubular member.

2 . An apparatus according to claim 1 wherein system includes a spacer system for maintaining an axial positioning of said tubular member within said guide member.

3 . An apparatus according to claim 2 wherein said spacer system includes a plurality of spacers slidably surrounding said flexible tubular member within said guide member.

4 . An apparatus according to claim 3 wherein said spacers are resiliently connected to maintain a substantially even spacing between said spacers.

5 . An apparatus for forming a lesion in tissue along a desired ablation path, said apparatus comprising:

a guide member having a tissue-opposing surface for placement against a heart surface, said guide member having interior surfaces and a longitudinal axis;

a guide carriage sized to be received within said guide member and moveable therein along said longitudinal axis,

a flexible tubular member extending from a proximal end of said carriage and through a length of said guide member and out a proximal end of said guide member;

an ablation element carried in said carriage for movement therewith and connected to a source of ablation energy through said flexible tubular member;

a coupling on said guide member and positionable along a length of said guide member;

a distal end of said guide member adapted to be secured to said coupling.

6 . An apparatus for forming a lesion in tissue along a desired ablation path, said apparatus comprising:

a guide member having a tissue-opposing surface for placement against a heart surface, said guide member having interior surfaces and a longitudinal axis;

a guide carriage sized to be received within said guide member and moveable therein along said longitudinal axis,

a flexible tubular member extending from a proximal end of said carriage and through a length of said guide member and out a proximal end of said guide member;

an ablation element carried in said carriage for movement therewith and connected to a source of ablation energy through said flexible tubular member;

a flexible, elongated member releasable secured to a distal end of said guide member.

7 . An apparatus for forming a lesion in tissue along a desired ablation path, said apparatus comprising:

a guide member having a tissue-opposing surface for placement against a heart surface, said guide member having interior surfaces and a longitudinal axis;

a guide carriage sized to be received within said guide member and moveable therein along said longitudinal axis;

said guide member having a plurality of slits formed partially therethrough to permit controlled bending of said guide member;

a covering at least partially covering said slits;

said covering formed of compliant material selected to conform to a bending of said guide member.