Protective systems and methods for use during ablation procedures
Systems and methods provide protection for patient tissue during radiofrequency ablation treatments. Exemplary techniques involve placing a conductive or semiconductive pad assembly near a target tissue, and administering electrical current through the target tissue while protecting adjacent tissue with the pad assembly. The pad assembly may include a material having an electrical conductivity value that is equal to or greater than the electrical conductivity value of the target tissue.
1. A system for administering ablative radiofrequency electric current therapy to a human patient, comprising:
an electrosurgical unit assembly having an ablation probe carrying an electrode configured for placement within the patient's left atrial chamber, the electrode configured to transmit an ablative radiofrequency electric current, the electrosurgical unit controlling the temperature at the ablation probe;
a pad assembly having a thickness sufficiently thin to facilitate insertion between the patient's esophagus and the posterior wall of the patient's left atrium, the pad assembly having a proximal portion, a distal portion, and a tether transition portion, the proximal portion being wider than the distal portion and the tether transition portion, the tether transition portion contacting a tether assembly, the pad assembly having a rounded border, where an entirety of the thickness of the pad assembly has an electrical pad conductivity greater than or equal to an electrical conductivity of the posterior wall of the left atrium to receive the ablative radiofrequency electric current transmitted by the electrode such that thermal damage of the esophagus is inhibited during therapy, where the ablation probe is moveable independent of the pad assembly such that increasing a distance between the ablation probe and the pad assembly spreads the current throughout the patient's left atrial chamber; and
a return pad configured for placement on the patient's skin, the return pad in operative association with the electrosurgical unit assembly and configured to receive the ablative radiofrequency electric current delivered from the pad assembly.
2. The system according to claim 1 , wherein the pad assembly comprises a material having a thermal conductivity value that is within a range from about 0.05 W/m° C. to about 1.0 W/m° C.
3. The system according to claim 1 , wherein the pad assembly comprises a pad having an anterior portion and posterior portion on opposing sides of the pad, the posterior portion comprising a posterior portion material with a thermal conductivity value that is within a range from about 0.05 W/m° C. to about 1.0 W/m° C.
4. The system according to claim 1 , wherein the pad assembly is positionable between epicardial tissue and pericardial tissue of the patient's heart.
5. The system according to claim 1 , wherein the pad assembly comprises an anterior portion and a posterior portion, and the pad assembly is positionable between the patient's atrial wall and esophagus so that the anterior portion faces toward the atrial wall and the posterior portion faces toward the esophagus.
6. A system for administering ablative radiofrequency electric current therapy to a human patient, comprising:
an electrosurgical unit assembly having an electrode configured for placement at or near a target tissue of the patient, the electrode configured to transmit an ablative radiofrequency electric current, the electrosurgical unit controlling the temperature of the electrode;
a pad assembly having a thickness suitable for insertion between the patient's target tissue and a protected tissue of the patient, the pad assembly having a proximal portion, a distal portion, and a tether transition portion, the proximal portion being wider than the distal portion and the tether transition portion, the tether transition portion contacting a tether assembly, the protected tissue being adjacent to the target tissue, an entirety of the pad assembly being configured with an electrical pad conductivity greater than or equal to an electrical conductivity of patient's target tissue to receive the ablative radiofrequency electric current transmitted by the electrode during therapy such that thermal damage of the protected tissue is inhibited, the pad assembly having a rounded border; and
a return pad configured for placement on the patient's skin, the return pad in operative association with the electrosurgical unit assembly and configured to receive the ablative radiofrequency electric current delivered from the pad assembly.
7. A system as in claim 1 , wherein the pad assembly comprises a thin pad having a thickness within a range from about 1 mm to 8 mm to facilitate insertion of the thin pad between pulmonary veins or between atrial tissues and the esophagus of the patient.
8. A system as in claim 7 wherein the thin pad varies in thickness such that a thickness at a center is about twice that of a thickness near an edge of the thin pad so as to facilitate placement of the thin pad between pulmonary veins or between atrial tissues and the esophagus of the patient.
9. A system as in claim 7 , wherein the thin pad comprises a rounded or curved leading edge so as to facilitate placement of the thin pad between pulmonary veins or between atrial tissues and the esophagus of the patient.
10. A pad assembly for use with a return pad and in an ablative radiofrequency electric current therapy applied to a target tissue of a patient, comprising:
a pad having a planar thickness sufficiently thin to facilitate insertion between the target tissue and a protected tissue in the patient, the pad having a proximal portion, a distal portion, and a tether transition portion, the proximal portion being wider than the distal portion and the tether transition portion, the tether transition portion contacting a tether assembly, the pad having a rounded border, the pad assembly configured with a first side of the pad assembly having a first electrical conductivity greater than or equal to an electrical conductivity of the target tissue, and where a second side of the pad assembly is thermally insulative and at least semi electrically conductive, such that an entire thickness of the pad assembly is electrically conductive; and
where the first side of the pad assembly receives the ablative radiofrequency electric current transmitted by an electrode of an electrosurgical unit assembly during therapy so that thermal damage of the protected tissue is inhibited when the ablative radiofrequency current is transmitted from within the patient to the target tissue while the return pad is on the patient's skin.
11. The pad assembly according to claim 10 , wherein the pad comprises a material having a thermal conductivity value that is within a range from about 0.05 W/m° C. to about 1.0 W/m° C.
12. The pad assembly according to claim 10 , wherein the pad assembly is positionable between epicardial tissue and pericardial tissue of the patient's heart.
13. The pad assembly according to claim 10 , wherein the rounded border surrounds the proximal portion and the distal portion, and wherein the rounded border does not surround the tether transition portion.
14. The pad assembly according to claim 10 , wherein the pad comprises an anterior portion and a posterior portion on opposite facing surfaces of the pad such that, when the pad is positioned between the target tissue and the protected tissue in the patient, the anterior portion faces toward the target tissue and the posterior portion faces toward the protected tissue.
15. The pad assembly according to claim 14 , wherein the posterior portion comprises a posterior portion material with a thermal conductivity value that is within a range from about 0.05 W/m° C. to about 1.0 W/m° C.
16. The pad assembly according to claim 10 , wherein the pad assembly comprises a thin pad having a thickness within a range from about 1 mm to 8 mm to facilitate insertion of the thin pad between the target tissue and the protected tissue in the patient.
17. The pad assembly according to claim 16 , wherein the pad varies in thickness such that a thickness at a center is about twice that of a thickness near an edge of the thin pad so as to facilitate placement of the thin pad between the target tissue and the protected tissue in the patient.
18. The pad assembly according to claim 16 , wherein the pad comprises a rounded or curved leading edge so as to facilitate placement of the thin pad between the target tissue and the protected tissue in the patient.
19. The pad assembly according to claim 10 , wherein the pad is sufficiently hard to inhibit buckling of the pad assembly during insertion between the target tissue and the protected tissue in the patient.