Intracardiac tools and methods for delivery of electroporation therapies
A medical system, including a medical device having a plurality of deployable arms, and at least one electrode on at least one of the plurality of arms; and an electric signal generator in communication with the medical device, the electric signal generator programmed to deliver pulsed energy to the medical device sufficient to induce irreversible electroporation ablation.
1. A method for treating tissue, comprising:
providing a medical device coupled to a power source, the medical device having an expandable structure having at least three arms, each arm having a proximal portion, a distal portion, and a plurality of conductive elements, the plurality of conductive elements being distal facing on the distal portion of each arm;
inserting the medical device into the tissue;
positioning the distally facing conductive elements proximate the tissue;
activating the plurality of conductive elements to deliver at least one train of biphasic electroporation pulses to the tissue, and delivery of the electroporation at an output voltage that is between 800 and 2000 volts; and
removing the medical device from the tissue,
wherein each pulse of the at least one train of biphasic electroporation pulses has a pulse width of between 0.005 μs and 5 μs.
2. The method of claim 1 , wherein the output voltage is between 800 and 1500 volts at a current in a range of between 8 and 25 Amps.
3. The method of claim 1 , wherein the at least one train of biphasic electroporation pulses is 40 biphasic electroporation pulses and the 40 biphasic electroporation pulses last for 8 milliseconds.
4. The method of claim 1 , wherein each of the biphasic electroporation pulses has an inter-pulse interval of 20 μs.
5. The method of claim 1 , wherein each of the at least one train of biphasic electroporation pulses has a pulse cycle length, the pulse cycle length is approximately 800 μs.
6. The method of claim 1 , wherein inserting the medical device into the tissue further comprises inserting the medical device into a myocardium tissue, the plurality of conductive elements being configured to detect an electrical activity of the myocardium tissue, the delivery of the at least one train of biphasic electroporation pulses is timed to correspond with an onset of depolarization of the myocardium tissue.
7. The method of claim 1 , wherein inserting the medical device into the tissue further comprises inserting the medical device into a myocardium tissue, the plurality of conductive elements being configured to detect an electrical activity of the myocardium tissue, the delivery of the at least one train of biphasic electroporation pulses is timed to correspond with when the myocardium tissue is fully polarized just before a normal sinus rhythm activation.
8. A method of ablating cardiac tissue, comprising:
providing a medical device coupled to a power source, the medical device having an expandable structure with at least three arms, each arm having a proximal portion, a distal portion, and a plurality of conductive elements, the plurality of conductive elements being distal facing on the distal portion of each arm;
positioning the plurality of conductive elements adjacent an endocardial surface of a heart; and
conducting pulsed energy to the plurality of conductive elements to induce irreversible electroporation ablation of tissue therebetween, the pulsed energy including a plurality of biphasic electroporation pulses each having a pulse width of between 0.005 μs and 5 μs.
9. The method of claim 8 , wherein the plurality of conductive elements includes a plurality of electrodes.
10. The method of claim 9 , wherein each arm has three or more electrodes.
11. The method of claim 8 , wherein the pulsed energy includes a plurality of pulse trains, each pulse train lasting less than 50 millisecond.
12. The method of claim 11 , wherein each pulse train includes 10 to 60 biphasic electroporation pulses.
13. The method of claim 12 , wherein the pulsed energy has an output voltage of between approximately 500 volts and approximately 1000 volts.
14. The method of claim 8 , wherein the delivery of the energy is at an output voltage that is between 800 and 2000 volts.
15. The method of claim 8 , wherein each of the plurality of biphasic electroporation pulses has an inter-pulse interval of 20 μs.
16. The method of claim 8 , wherein the method further comprises expanding the at least three arms before pulsed energy is conducted to the plurality of conductive elements.
17. The method of claim 8 , wherein the at least three arms are movable from a first configuration to a second configuration, the method further comprising positioning the medical device adjacent the endocardial surface of the heart when the at least three arms are in the first configuration.
18. The method of claim 17 , wherein the method further comprises transitioning the at least three arms from the first configuration to the second configuration.
19. The method of claim 17 , wherein the at least three arms are in the second configuration when the at least three arms are in contact with the endocardial surface of the heart.
20. The method of claim 19 , wherein the first configuration is a collapsed configuration and the second configuration is an expanded configuration.
21. The method of claim 20 , where the distal portion of the medical device further includes a distal tip, the distal tip extending distally beyond the at least three arms when the at least three arms are in the second configuration.
22. The method of claim 19 , wherein when in the second configuration, the at least three arms are co-planar.
23. The method of claim 22 , where the at least three arms are flexible and transitionable to a third configuration when in contact with the endocardial surface of the heart.
24. The method of claim 23 , wherein the medical device has an elongate body having a proximal portion and a distal portion, the at least three arms extending toward the proximal portion of the elongate body when in the third configuration.
25. The method of claim 8 , wherein each arm has at least three conductive elements.
26. A method of ablating cardiac tissue, comprising:
providing a medical device coupled to a power source, the medical device having an expandable structure with five arms, each arm having a proximal portion, a distal portion, and a plurality of conductive elements, the plurality of conductive elements being distal facing on the distal portion of each arm;
positioning the plurality of conductive elements adjacent an endocardial surface of a heart; and
conducting pulsed energy to the plurality of conductive elements to induce irreversible electroporation ablation of tissue therebetween, the pulsed energy including at least one train of biphasic electroporation pulses, and delivery of the energy at an output voltage that is between 800 and 2000 volts,
wherein each pulse of the at least one train of biphasic electroporation pulses has a pulse width of between 0.005 μs and 5 μs.