Cryogenic balloon device with electroporation treatment region

1. A medical device, comprising:

an elongate catheter body including a proximal portion coupled to a handle and a distal portion;

a cryogenic treatment region coupled to the distal portion of the catheter body; and

an electroporation treatment region defining an outer surface of and a distal tip of the medical device, an entirety of the electroporation treatment region coupled to the distal portion of the catheter body at a location that is distal to the cryogenic treatment region.

2. The medical device of claim 1 , wherein the cryogenic treatment region includes an expandable element.

3. The medical device of claim 1 , wherein the cryogenic treatment region includes a first expandable element and a second expandable element within the first expandable element.

4. The medical device of claim 2 , wherein the electroporation treatment region includes a substantially linear segment.

5. The medical device of claim 1 , wherein the cryogenic treatment region is operable independently from the electroporation treatment region.

6. The medical device of claim 1 , further comprising a fluid flow path in fluid communication with the cryogenic treatment region and a cryogenic fluid source in fluid communication with the fluid flow path.

7. The medical device of claim 6 , further comprising a power source coupled to the electroporation treatment region, the power source being configured to deliver electrical pulses.

8. The medical device of claim 1 , further comprising a sensor coupled to at least one of the cryogenic treatment region and the electroporation treatment region.

9. The medical device of claim 1 , wherein the electroporation treatment region is deflectable independently of the cryogenic treatment region.

10. An intravascular ablation device, comprising:

a flexible elongate body including a proximal portion coupled to a handle and a distal portion;

an expandable element coupled to the distal portion of the elongate body;

a substantially linear, elongated electroporation segment coupled to the distal portion of the elongate body and extending distally beyond the expandable element when the expandable element is fully expanded;

a cryogenic coolant source in direct fluid communication with an interior of the expandable element; and

a power source in communication with the electroporation segment, the power source being configured to transmit electrical pulses to the electroporation segment.

11. The device of claim 10 , wherein the elongate body includes a deflectable segment between the expandable element and the electroporation segment.

12. The device of claim 11 , wherein the deflectable segment includes a bellows.

13. The device of claim 10 , wherein the expandable element includes a first balloon and a second balloon, the second balloon being within the first balloon.

14. A method of treating cardiac tissue, comprising:

positioning an expandable cryogenic treatment region proximate a pulmonary vein, the expandable cryogenic treatment region having an interior chamber and being coupled to a distal portion of a medical device;

delivering cryogenic coolant to the interior chamber of the cryogenic treatment region;

ablating tissue proximate the pulmonary vein with the expandable cryogenic treatment region;

positioning an electroporation treatment region proximate the pulmonary vein, the electroporation treatment region including an electrode coupled to distal portion of the medical device at a location distal to the cryogenic treatment region and extending distally beyond the cryogenic treatment region when the cryogenic treatment region is fully expanded; and

one of irreversibly and reversibly electroporating tissue proximate the pulmonary vein with the electroporation treatment region.

15. The method of Claim 14 , wherein positioning the expandable cryogenic treatment region includes expanding the expandable cryogenic treatment region in the pulmonary vein to substantially occlude the pulmonary vein.

16. The method of claim 14 , wherein ablating tissue proximate the pulmonary vein with the expandable cryogenic treatment region includes circulating a cryogenic fluid through the expandable cryogenic treatment region.

17. The method of claim 14 , wherein ablating tissue proximate the pulmonary vein with the expandable cryogenic treatment region includes creating a first ablative treatment pattern, and wherein electroporating tissue proximate the pulmonary vein with the electroporation treatment region includes creating a second ablative treatment pattern by irreversibly electroporating the tissue proximate the pulmonary vein.

18. The method of Claim 17 , wherein the first ablative treatment pattern includes a substantially arcuate shape.

19. The method of claim 17 , wherein the second ablative treatment pattern includes a substantially focal shape.

20. The method of claim 18 , wherein the first and second ablative treatment patterns are substantially continuous.