Current control methods and systems
Apparatus, systems, and methods of controlling energy delivered to electrodes used in electrically and/or thermally induced neuromodulation are provided to improve neuromodulation. In particular, a catheter treatment device having a control algorithm that regulates current or current density delivered to an electrode is provided. The electrode may maintain a known and consistent electrode contact surface area with the vessel. The control algorithm controls energy delivery to provide consistent current or current density to the treatment site, even though the tissue impedance Z may vary from patient to patient and vessel to vessel, and despite changes in impedance of the treatment site during the course of the treatment. The controlled delivery of energy can be used to control and maintain placement of the zone of thermal treatment and reduce undesirable energy delivery to unwanted locations near the treatment site.
1. A method of controlling current delivered to a therapeutic assembly for ablating target tissue adjacent a vessel intima in a patient, the therapeutic assembly being configured for receiving energy via only a single wire and comprising an electrode having a total surface area (TSA), a portion of the TSA being in contact with the vessel intima of the patient and defining an electrode active surface area (ASA), the method comprising:
determining a desired current density for ablating the target tissue;
determining a surface area size of the ASA;
delivering an amount of energy to the therapeutic assembly via the single wire to achieve the desired current density through the ASA;
during delivery of energy thereto, measuring at the therapeutic assembly one or more treatment parameters selected from temperature, voltage, and current through the electrode; and
based on at least one of the measured treatment parameters, adjusting the amount of energy delivered to the therapeutic assembly via the single wire as necessary to achieve or maintain the desired current density through the ASA.
2. The method of claim 1 , further comprising calculating a power level of the electrode based on the measured parameters of voltage and current, and wherein adjusting the amount of energy delivered to the therapeutic assembly is based on at least one of the measured parameters and the calculated power level.
3. The method of claim 2 , wherein adjusting the amount of energy delivered to the therapeutic assembly further comprises increasing or decreasing the amount of energy delivered to the therapeutic assembly to achieve a determined current level through the electrode, wherein the determined current level is determined based on at least one of a change in the temperature of the electrode, a change in impedance of the tissue, and the calculated power of the electrode.
4. The method of claim 3 , further comprising determining a maximum increase in current through the electrode by at least one of a maximum current level, a maximum temperature, a maximum power, and a maximum change in impedance of the tissue.
5. The method of claim 4 , wherein the step of adjusting the amount of energy delivered to the therapeutic assembly comprises overriding the maximum increase in current through the electrode based on at least one of the temperature, the power, and the impedance measured.
6. The method of claim 1 , wherein determining a desired current density for ablating tissue comprises determining a desired current density for a neuromodulation treatment.
7. The method of claim 1 , wherein the step of adjusting the amount of energy delivered to the therapeutic assembly comprises limiting the resulting amount of current change to a maximum change in current through the ASA.
8. The method of claim 1 , further comprising terminating the energy delivered to the therapeutic assembly based on at least one of a set amount of time, a predetermined temperature value, a predetermined current value, a predetermined integral of current over time value, and a predetermined impedance change value.
9. The method of claim 1 , wherein the step of adjusting the amount of energy delivered to the therapeutic assembly comprises monitoring a rate of change in temperature of tissue at the electrode, and if temperature increases faster than a predetermined rate, reducing energy delivered to the therapeutic assembly.
10. The method of claim 1 , wherein the step of adjusting the amount of energy delivered to the therapeutic assembly comprises monitoring a rate of change in tissue impedance through a return path of the delivered energy, and if the impedance increases faster than a predetermined rate, reducing the amount of energy delivered to the therapeutic assembly.
11. The method of claim 1 , further comprising monitoring patient stability and generating an alert in the event that sudden patient instability is detected.
12. The method of claim 1 , further comprising monitoring a treatment criterion and if the criterion is unmet after a predetermined period of time, changing the amount of energy delivered to the therapeutic assembly.
13. The method of claim 1 , further comprising monitoring a temperature at the intima and cooling the electrode when the temperature reaches a predetermined threshold.