Energy based devices and methods for treatment of anatomic tissue defects
Methods and apparatus for treatment of anatomic defects in human tissues, such as patent foramen ovale (PFO), atrial or ventricular septal defects, left atrial appendage, patent ductus arteriosis, blood vessel wall defects and certain electrophysiological defects, involve positioning a distal end of an elongate catheter device at the site of the anatomic defect, engaging tissues at the site of the anatomic defect to bring the tissues together, and applying energy to the tissues with the catheter device to substantially close the anatomic defect acutely. Apparatus generally includes an elongate catheter having a proximal end and a distal end, a vacuum application member coupled with the distal end for engaging tissues at the site of the anatomic defect and applying vacuum to the tissues to bring them together, and at least one energy transmission member coupled with the vacuum application member for applying energy to tissues at the site of the anatomic defect to substantially close the defect acutely.
1. A method for treating an electrophysiological defect in human tissue, the method comprising:
positioning a tip end of a distal end of an elongate catheter device at a site of the electrophysiological defect, the positioning the tip end of the distal end including
advancing the catheter device intravascularly over a guidewire extending adjacent to the electrophysiological defect, and
engaging tissues by forming a seal between an opening of the tip end of the distal end of the elongate catheter device and the tissues at the site of the electrophysiological defect with the catheter device;
applying energy to the tissues with the catheter device to substantially reduce the electrophysiological defect; and
retracting an energy transmission member of the catheter device within the tip end of the distal end of the elongate catheter device.
2. The method as in claim 1 , wherein the electrophysiological defect comprises one of atrial fibrillation, supraventricular tachycardia, atrial flutter, A-V node re-entry and Wolf Parkinson White Syndrome.
3. The method as in claim 1 , wherein the tissues are in a vicinity of a pulmonary vein.
4. The method as in claim 1 , wherein advancing the catheter device over the guidewire positions the tip end of the distal end in a centered position over the electrophysiological defect.
5. The method as in claim 1 , further comprising removing the guidewire from the site of the electrophysiological defect after applying energy thereto.
6. The method as in claim 1 , wherein positioning the tip end of the distal end further includes extending the guidewire asymmetrically through the site of the electrophysiological defect.
7. The method as in claim 1 , wherein positioning the tip end of the distal end further comprises expanding an expandable member on the guidewire to adjust a position of the guidewire relative to the site of the electrophysiological defect.
8. The method as in claim 1 , wherein positioning further comprises actively steering the distal end of the catheter device.
9. The method as in claim 1 , further comprising visualizing the distal end during the step of positioning.
10. The method as in claim 9 , wherein visualizing comprises viewing at least one radiopaque marker of material on the distal end, using a radiographic visualization device.
11. The method as in claim 9 , wherein visualizing comprises using a technique selected from the group consisting of transesophageal echocardiogram, intracardiac echocardiography, MRI, fluoroscopy, ultrasound and direct vision.
12. The method as in claim 1 , wherein engaging the tissues comprises applying a vacuum force.
13. The method as in claim 12 , wherein applying the vacuum force comprises:
collecting vacuum force in a reservoir coupled with the catheter; and
applying the collected vacuum force as an impulse to the tissues.
14. The method as in claim 12 , further comprising:
passing fluid out of the tip end of the distal end of the catheter device to provide irrigation; and
suctioning the fluid back into the catheter device using the applied vacuum.
15. The method as in claim 14 , further comprising monitoring the suctioned fluid to determine the blood content of the fluid.
16. The method as in claim 14 , further comprising monitoring a flow rate of fluid from a fluid supply reservoir into the catheter to determine whether a seal has been formed.
17. The method as in claim 1 , wherein the positioning the tip end of the distal end further includes widening a braided mesh portion of the distal end.
18. The method as in claim 1 , wherein the energy is applied to the tissues via an energy transmission member of the catheter device after retraction of the energy transmission member.