Time multiplexed waveform for selective cell ablation
Methods and devices for performing ablation using time multiplexed waveforms are disclosed. The increased efficacy of monophasic waveforms is combined with the reduced side effects of biphasic waveforms by distributing components of the waveform across over a broader time interval than that typically used in a conventional biphasic waveform. Charge balancing occurs upon completion of therapy delivery within a time period that avoids muscle stimulation, while allowing unbalanced waveforms to be delivered during stimulation.
1. A method of delivering a multiphasic ablation waveform comprising:
generating a first output of a first polarity at a first amplitude for a first time period as a first phase;
generating a second output of a second polarity, opposite the first polarity, at a second amplitude for a second time period, the second time period being less than half the first time period; and
generating a third output using the second polarity at a third amplitude less than the second amplitude for a third time period, the third time period being greater than the first time period;
wherein the sum of the first, second and third outputs yields a balanced charge to limit muscle stimulation associated with the multiphasic ablation waveform; and
wherein the second output is delivered after the first output, and the third output is delivered after the second output.
2. The method of claim 1 wherein at least one of the first and second amplitudes exceeds an irreversible electroporation threshold, and the third amplitude is less than an irreversible electroporation threshold.
3. The method of claim 1 wherein the first time period is in the range of about 1 to 50 microseconds, and the second time period is in the range of about 0.5 to 10 microseconds.
4. The method of claim 1 wherein the first, second and third outputs are delivered in a sequence having a duration from a start of the first output to an end of the third output which has a duration of less than one millisecond to limit muscle stimulation.
5. A method of treating a patient comprising:
in a first iteration, each of:
performing the method of claim 1 to deliver the first, second and third outputs;
measuring one or more of impedance or current flow for each of the first, second and third outputs; and
determining that a residual charge imbalance remains after delivery of the first, second and third outputs; and
in a second iteration, again performing the method of claim 1 and adjusting at least one of the amplitude or pulse width of at least one of the first, second and third outputs to reduce the residual change imbalance;
wherein the first and second iterations are performed within a time period of less than 10 milliseconds.
6. The method of claim 1 , wherein the first and second amplitudes each exceed an irreversible electroporation threshold, and the third amplitude is less than an irreversible electroporation threshold.
7. A method of delivering a multiphasic ablation waveform comprising:
generating a first pulse of a first polarity having a first amplitude and a first pulse width;
generating a first pulse train having a plurality of second pulses of a second polarity opposite the first polarity, the second pulses having second amplitudes and second pulse widths, the second pulse widths being less than one-half of the first pulse width;
such that the first pulse yields a first charge imbalance, and the first pulse train yields a second charge imbalance that offsets the first charge imbalance to prevent muscle stimulation;
wherein the first pulse width is equal to a sum of the second pulse widths.
8. The method of claim 7 wherein the plurality of second pulses are each separated by an interpulse interval, the interpulse interval being between one-half and twice the second pulse width.
9. The method of claim 7 wherein the first amplitude and the second amplitude each exceed an irreversible electroporation threshold.
10. The method of claim 7 , wherein a duration from the start of the first pulse to the end of the first pulse train is less than one millisecond.