Granted Patent B2

US 7,824,402 · App. 11/401,345 · Granted Nov 2, 2010

Assignee: St. Jude Medical, Atrial Fibrillation Division, Inc.

Abstract

Claims (83)

1. A method of sizing an area around pulmonary veins along an epicardial surface, the method comprising

providing a sizing device having i) an elongated body with a distal end and a proximal end, the elongated body being configured to form a partial loop when in a resting, unbiased shape, and ii) a plurality of sizing indicators along a length of the elongated body;

wrapping the sizing device around the pulmonary veins;

determining a size of an ablating device using the plurality of sizing indicators on the sizing device; and

selecting an ablating device based on the determining step.

2. The method of claim 1 , further comprising

attaching the selected ablating device to the proximal end of the sizing device; and

manipulating the sizing element to wrap the ablating device around the pulmonary veins.

3. The method of claim 2 , further comprising

attaching a first end of the ablating device to a second end of the ablating device so as to secure the ablating device to an epicardial surface encircling the pulmonary veins; and

decoupling the ablating device from the introducer device.

4. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

passing an introducer device through a first incision in the pericardial reflection of a patient's body near the right superior pulmonary vein, the introducer device having an elongated body with a proximal end and a distal end, the elongated body being configured to form a partial loop when in a resting, unbiased shape;

advancing the introducer device through the transverse pericardial sinus and around the left superior and inferior pulmonary veins;

coupling an ablating device to the proximal end of the introducer device; and

manipulating the introducer device to wrap the ablating device around the pulmonary veins.

5. The method of claim 4 , further comprising

removing the introducer device from the patient's body through an incision in the pericardial reflection near the right inferior pulmonary vein.

6. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

passing an introducer device through a first incision in the pericardial reflection of a patient's body near the right superior pulmonary vein, the introducer device having an elongated body with a proximal end and a distal end, the elongated body being configured to form a partial loop when in a resting, unbiased shape, and a plurality of sizing indicators along a length of the elongated body;

advancing the introducer device through the transverse pericardial sinus and around the left superior and inferior pulmonary veins;

determining a size of an ablating device using the plurality of sizing indicators on the introducer device;

selecting an ablating device based on the determining step;

coupling the ablating device to the proximal end of the introducer device; and

manipulating the introducer device to wrap the ablating device around the pulmonary veins.

7. A method of sizing an area around pulmonary veins along an epicardial surface, the method comprising

providing a sizing device having i) an elongated body with a distal end and a proximal end, wherein the distal end of the elongated body is preformed in a shape of at least a partial helix, and ii) a plurality of sizing indicators along a length of the elongated body;

wrapping the sizing device around the pulmonary veins;

determining a size of an ablating device using the plurality of sizing indicators on the sizing device; and

selecting an ablating device based on the determining step.

8. The method of claim 7 , further comprising

attaching the selected ablating device to the proximal end of the sizing device; and

manipulating the sizing element to wrap the ablating device around the pulmonary veins.

9. The method of claim 7 , further comprising

attaching a first end of the ablating device to a second end of the ablating device so as to secure the ablating device to an epicardial surface encircling the pulmonary veins; and

decoupling the ablating device from the introducer device.

10. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

passing an introducer device through a first incision in the pericardial reflection of a patient's body near the right superior pulmonary vein, the introducer device having an elongated body with a proximal end and a distal end, wherein the distal end of the elongated body is preformed in a shape of at least a partial helix;

advancing the introducer device through the transverse pericardial sinus and around the left superior and inferior pulmonary veins;

coupling an ablating device to the proximal end of the introducer device; and

manipulating the introducer device to wrap the ablating device around the pulmonary veins.

11. The method of claim 10 , further comprising

removing the introducer device from the patient's body through an incision in the pericardial reflection near the right inferior pulmonary vein.

12. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

passing an introducer device through a first incision in the pericardial reflection of a patient's body near the right superior pulmonary vein, the introducer device having an elongated body with a proximal end and a distal end, wherein the distal end of the elongated body is preformed in a shape of at least a partial helix, and a plurality of sizing indicators along a length of the elongated body;

advancing the introducer device through the transverse pericardial sinus and around the left superior and inferior pulmonary veins;

determining a size of an ablating device using the plurality of sizing indicators on the introducer device;

selecting an ablating device based on the determining step;

coupling the ablating device to the proximal end of the introducer device; and

manipulating the introducer device to wrap the ablating device around the pulmonary veins.

13. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

passing an introducer device through a first incision in the pericardial reflection of a patient's body near the right superior pulmonary vein, the introducer device having an elongated body with a proximal end and a distal end;

advancing the introducer device through the transverse pericardial sinus and around the left superior and inferior pulmonary veins;

coupling an ablating device to the proximal end of the introducer device; and

manipulating the introducer device to wrap the ablating device around the pulmonary veins.

14. The method of claim 13 , further comprising removing the introducer device from the patient's body through a second incision in the pericardial reflection near the right inferior pulmonary vein.

15. The method of claim 13 , wherein the introducer device has a plurality of sizing indicators;

and wherein the method further comprises determining a size of an ablating device using the plurality of sizing indicators on the introducer device and selecting an ablating device based on the determined size;

and wherein the coupling step comprises coupling the selected ablating device to the proximal end of the introducer device.

16. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

advancing an introducer device through an opening in the right chest of a patient;

dissecting the patient's pericardium to provide access to a transverse pericardial sinus;

advancing the introducer device through the pericardium and the transverse pericardial sinus and into an oblique pericardial sinus of the patient;

dissecting the patient's pericardium to provide access to the oblique pericardial sinus;

coupling an ablating device to a proximal end of the introducer device; and

pulling the introducer out of the body.

17. The method of claim 16 , wherein dissecting the patient's pericardium to provide access to the oblique pericardial sinus comprises making an incision in the pericardial reflection near the right inferior pulmonary vein;

and wherein the introducer device is pulled out of the body through the incision in the pericardial reflection near the right inferior pulmonary vein.

18. A method of wrapping an ablating device around pulmonary veins at an epicardial location, the method comprising

providing an introducer device comprising

an elongated body having a length and a distal segment that forms at least a partial loop when in a resting, unbiased state; and

a plurality of sizing indicators along the length of the elongated body introducing the introducer device into a patient via an incision in the patient's chest;

passing the introducer device around the patient's pulmonary veins;

determining an appropriately-sized ablating device with reference to the plurality of sizing indicators along the length of the elongated body;

attaching the appropriately-sized ablating device to the introducer device; and

using the introducer device to pass the appropriately-sized ablating device around the patient's pulmonary veins.

19. The method of claim 18 , further comprising

securing the appropriately-sized ablating device to an epicardial surface encircling the pulmonary veins by attaching a first end of the ablating device to a second end of the ablating device;

decoupling the appropriately-sized ablating device from the introducer device; and

removing the introducer device from the patient.

20. The method of claim 18 , wherein the plurality of sizing indicators comprise a plurality of numerical indicators, and wherein the step of determining an appropriately-sized ablating device with reference to the plurality of sizing indicators along the length of the elongated body comprises

noting which of the plurality of numerical indicators is closest to a distal end of the introducer device when the introducer device is passed around the patient's pulmonary veins; and

selecting an ablating device having a number of ablating elements, wherein the number of ablating elements corresponds to the numerical indicator closest to the distal end of the introducer device when the introducer device is passed around the patient's pulmonary veins.

Assignments (2)

Continuity (10)