Devices and methods for ablation of tissue
This document provides devices and methods for the treatment of heart conditions, hypertension, and other medical disorders. For example, this document provides devices and methods for treating atrial fibrillation by performing thoracic vein ablation procedures, including pulmonary vein myocardium ablation. In some embodiments, the ablation is performed in coordination with the delivery a pharmacological agent that can abate the formation of tissue stenosis or neointimal hyperplasia caused by the ablation.
1. A method for ablating a tissue of a patient, said method comprising:
inserting a catheter-based medical device into said patient, said medical device comprising:
an elongate catheter shaft including a liquid delivery lumen therethrough;
a balloon device disposed at a distal end of said catheter shaft, said balloon device comprising a bulbous-shaped proximal portion and a cylindrical-shaped distal portion when said balloon is inflated, said bulbous-shaped proximal portion in fluid communication with said cylindrical-shaped distal portion, said balloon device comprising an outer surface and an inner surface, said inner surface defining an interior space of said balloon device, said balloon device in fluid communication with said liquid delivery lumen, said balloon device comprising a porous or microporous material that is arranged to exude a liquid through said porous or microporous material;
one or more electrodes that are disposed on or within said balloon device and are arranged to deliver energy to said tissue; and
a filter device disposed proximal to the balloon device, the filter device being self-expandable from a low-profile delivery configuration to an expanded configuration;
deploying said balloon device near said tissue;
deploying said filter device from the low-profile delivery configuration to the expanded configuration, wherein said bulbous-shaped proximal portion of said balloon device is inside said filter device while said filter device is configured in said expanded configuration;
supplying a pharmacological agent through said liquid delivery lumen to said interior space thereby causing inflation of said balloon device and causing said pharmacological agent to exude from said interior space to said outer surface; and
energizing at least a first one of said one or more electrodes, wherein said energizing provides an energy sufficient for ablation of at least a portion of said tissue.
2. The method of claim 1 , wherein at least a portion of said energizing at least a first one of said one or more electrodes takes place while said pharmacological agent is exuding from said interior space to said outer surface.
3. The method of claim 1 , wherein said pharmacological agent transmits at least a portion of said energy sufficient for ablation of at least a portion of said tissue.
4. The method of claim 1 , further comprising energizing at least a second one of said one or more electrodes, wherein said energizing at least a second one of said one or more electrodes comprises supplying direct current electricity energy sufficient for enhancing an uptake of said pharmacological agent by said tissue.
5. The method of claim 1 , wherein said tissue is a pulmonary vein.
6. The method of claim 1 , wherein said pharmacological agent is an antimitotic pharmacological agent.
7. The method of claim 1 , wherein said tissue is a left atrial appendage.
8. The method of claim 1 , wherein said tissue is a renal artery.
9. The method of claim 1 , wherein said filter device is attached to said catheter shaft.
10. The method of claim 1 , wherein said filter device defines a central aperture through which the elongate catheter shaft and the balloon device extend.
11. The method of claim 1 , wherein a maximum diameter of the filter device in the expanded configuration is larger than a maximum diameter of the balloon device in its inflated configuration.
12. The method of claim 1 , wherein the filter device is conical when in the expanded configuration.
13. The method of claim 1 , further comprising capturing emboli by the filter device.
14. The method of claim 1 , wherein the filter device comprises a mesh material.
15. The method of claim 14 , wherein the filter device further comprises a Nitinol framework on which the mesh material is disposed.
16. The method of claim 1 , wherein said one or more electrodes comprises: (i) at least one electrode that is arranged to transmit radio frequency energy for the ablation and (ii) the at least a first one of said one or more electrodes being arranged to transmit direct current electrical energy.