Mesh-overlayed ablation and mapping device
A medical system, including a catheter body, an elongate body disposed in the catheter body; an expandable element having a proximal portion coupled to the catheter body and a distal portion coupled to the elongate body, the distal portion of the expandable element defining the distal-most portion of the medical device; a mesh or array of longitudinal splines substantially surrounding the expandable element, at least a portion of the mesh or splines being electrically conductive; and a coolant source in fluid communication with the expandable element.
1. A method of treating a substantially continuous tissue region, the method comprising:
positioning a medical device adjacent the tissue region, the medical device including:
a catheter body;
an expandable element; and
an electrically conductive mesh substantially enclosing the expandable element, the mesh having;
a proximal portion coupled to the catheter body, the proximal portion being electrically insulated;
a distal portion coupled to the elongate body, the distal portion of the mesh being electrically conductive and defining a distal face configured to be in contact with the tissue region and the entirety of the distal face configured to deliver ablation energy to the tissue;
a first circumferential portion located between the proximal portion and the distal portion, the first circumferential portion being electrically conductive; and
a second circumferential portion located between the first circumferential portion and the distal portion, the second circumferential portion being electrically insulted;
contacting the substantially continuous tissue region with the distal face of the expandable element;
measuring an electrical signal from the tissue region with the mesh; and
ablating at least a portion of the tissue region with at least one of the expandable element and the mesh.
2. The method of claim 1 , wherein ablating at least a portion of the tissue region includes cryogenically ablating the tissue region with the expandable element.
3. The method of claim 1 , wherein ablating at least a portion of the tissue region includes delivering radiofrequency ablation energy through the mesh.
4. The method of claim 1 , wherein ablating at least a portion of the tissue region includes delivering electroporating pulsed energy through the mesh.
5. The method of claim 1 , further comprising assessing contact between at least a portion of the mesh and the tissue region.
6. The method of claim 5 , wherein ablating at least a portion of the tissue region includes dispersing a coolant inside the expandable element, and the method further comprises manipulating a direction of the coolant dispersion based at least in part on the assessed contact.
7. The method of claim 1 , wherein positioning a medical device adjacent the tissue region includes advancing the medical device along a guide wire.
8. The method of claim 1 , wherein the substantially continuous tissue region is an atrial wall.
9. The method of claim 1 , wherein the medical device further includes a sheath slidably coupled to at least a portion of the catheter body.
10. A method of treating a tissue region, the method comprising:
positioning a medical device adjacent the tissue region, the medical device including:
a catheter body;
an elongate body disposed in the catheter body;
an expandable element having a proximal portion coupled to the catheter body and a distal portion coupled to the elongate body;
a mesh surrounding the expandable element, the mesh having:
a proximal portion coupled to the catheter body, the proximal portion being electrically insulated;
a distal portion coupled to the elongate body, the distal portion of the mesh being electrically conductive and defining a distal face configured to be in contact with the tissue region and the entirety of the distal face configured to deliver ablation energy to the tissue region;
a first circumferential portion located between the proximal portion and the distal portion, the first circumferential portion being electrically conductive; and
a second circumferential portion located between the first circumferential portion and the distal portion, the second circumferential portion being electrically insulated; and
a coolant source in fluid communication with the expandable element;
contacting the tissue region with the distal face of the mesh;
measuring an electrical signal from the tissue region with the mesh; and
ablating at least a portion of the tissue region with at least one of the expandable element and the mesh.
11. The method of claim 10 , wherein ablating at least a portion of the tissue region includes cryogenically ablating the tissue region with the expandable element.
12. The method of claim 10 , wherein ablating at least a portion of the tissue region includes delivering radiofrequency ablation energy through the mesh.
13. The method of claim 10 , wherein ablating at least a portion of the tissue region includes delivering electroporating pulsed energy through the mesh.
14. The method of claim 10 , further comprising assessing contact between at least a portion of the mesh and the tissue region.
15. The method of claim 14 , wherein ablating at least a portion of the tissue region includes dispersing a coolant inside the expandable element, and the method further comprises manipulating a direction of the coolant dispersion based at least in part on the assessed contact.
16. The method of claim 10 , wherein the mesh includes at least one of a plurality of thermistors and plurality of thermocouples.