Devices and methods for creating continuous lesions
The present invention discloses devices and methods for creating multiple lesions using ablation devices in anatomical regions such as the heart, for example to treat cardiac arrhythmias. The present invention discloses methods and devices to create continuous lesions using area ablation devices. The present invention discloses various embodiments of reference assemblies for accurately positioning ablation devices having ablating portions, especially deployable ablation portions adapted for area ablation. The ablation devices are positioned using the reference assemblies in the anatomy to create one or more lesions. The present invention also discloses several method embodiments for creating continuous lesions using deployable ablating portions to produce two or more overlapping lesions.
1. A method of treating tissue at an anatomical site, the method comprising:
positioning a treatment system adjacent to the anatomical site, where the treatment system includes a closed loop assembly comprising a first elongate arm, a second elongate arm, and an ablation device that advanceable through the first elongate arm and coupled to a distal portion of the second elongate arm by a flexible member;
stabilizing the closed loop assembly within the anatomical site by manipulating either the first elongate arm or the second elongate arm to force the closed loop assembly against tissue;
advancing the ablation device through the first elongate arm and positioning the ablation device using the flexible member such that after being stabilized the closed loop assembly stabilizes the ablation device;
treating the tissue with the ablation device at a first region; and
placing at least one electrode against the tissue to transmit and receive electrophysiological signals from the tissue where the at least one electrode is located on the flexible member.
2. The method of claim 1 , where the closed loop assembly comprises a steering system.
3. The method of claim 2 , where the steering system comprises at least one steering wire.
4. The method of claim 2 , where the steering system enables deflection in more than one plane.
5. The method of claim 1 , where a portion of the closed loop assembly comprises materials adapted to fluoresce and where the method further comprises determining an orientation of the closed loop assembly by a fluorescence of the materials.
6. The method of claim 1 , further comprising repositioning the ablation device to a second region of tissue adjacent to the flexible member and ablating the second region of tissue.
7. The method of claim 6 , where the first region and the second region are continuous.
8. The method of claim 6 , further comprising manipulating either or both of the first elongate arm and the second elongate arm to reposition the flexible member, which repositions the ablation device to the second region of tissue along the repositioned flexible member and ablating the second region of tissue.
9. The method of claim 8 , where ablating the second region of tissue forms an area ablation pattern between the first region and the second region.
10. The method of claim 1 , where the at least a second electrode located on one of the first elongate arm or the second elongate arm.
11. The method of claim 1 , where stabilizing the closed loop assembly comprises stabilizing the closed loop assembly by applying contact forces against anatomical structures.
12. The method of claim 1 , further comprising advancing at least one of the first elongate arm or the second elongate arm into a pulmonary vein.
13. The method of claim 1 , where the ablation device is steerable, where the method comprises steering the ablation device during positioning of the treatment system.
14. The method of claim 1 , where the ablation device is configured to ablate a tissue region that is not directly adjacent to the flexible member.
15. The method of claim 1 , where the ablation device applies an ablation energy selected from a group consisting of radiofrequency energy, microwave energy, infrared energy; thermal energy, photonic energy, laser energy, high energy particles, ultrasonic energy, cryoablation, and chemical.
16. The method of claim 1 , where the first elongate arm and/or the second elongate arm is stiffer than the flexible member.