Contact assessment based on phase measurement
Methods and systems achieve tissue ablation, which is carried out by inserting a probe having an ablation electrode into a body of a living subject, and while the ablation electrode is in a non-contacting relationship to a target tissue, making a pre-contact determination of a phase of an electrical current passing between the ablation electrode and another electrode. The ablation electrode is placed in contact with the target tissue, and while the ablation electrode is in the contacting relationship, a dosage of energy is applied via the ablation electrode to the target tissue for ablation thereof. Iterative intra-operative determinations of the phase of the electrical current are made. When one of the intra-operative determinations satisfies a termination criterion, the energy application is terminated.
1. A method of ablation using a body-surface electrode and a probe, comprising the steps of:
inserting the probe into a body of a living subject, the probe having a proximal end and a distal end terminating in a distal tip, with an ablation electrode affixed to the distal tip, and a reference electrode affixed along the distal end proximal to the ablation electrode;
passing a current at a known frequency between the reference electrode and the body-surface electrode and reading a reference waveform having a reference phase from the reference electrode;
while the ablation electrode is in a non-contacting relationship to a target tissue, passing the current at the known frequency between the ablation electrode and the body-surface electrode and reading a non-contact waveform having a non-contact phase from the ablation electrode;
making a pre-contact determination by comparing the reference phase to the non-contact phase;
urging the ablation electrode into a contacting relationship with the target tissue;
while the ablation electrode is in the contacting relationship applying a dosage of energy via the ablation electrode to the target tissue for ablation thereof;
while the ablation electrode is in the contacting relationship with target tissue, iteratively passing the current at the known frequency between the ablation electrode and the body-surface electrode and intra-operatively reading a contact waveform having a contact phase from the ablation electrode;
iteratively making intra-operative determinations by comparing the contact phase to the reference phase; and
establishing that one of the intra-operative determinations satisfies a termination criterion for completion of the ablation, and responsively thereto, terminating the step of applying a dosage of energy.
2. The method according to claim 1 , further comprising the steps of displaying a visual indication of the intra-operative determinations of the phase of the electrical current.
3. The method according to claim 2 , wherein the visual indication comprises a progress of the ablation with respect to an intended lesion in the target tissue.
4. The method according to claim 2 , wherein the termination criterion comprises a difference between one of the intra-operative determinations and the pre-contact determination that is less than a predetermined value.
5. The method according to claim 2 , wherein the termination criterion comprises a failure of one of the intra-operative determinations to vary from a preceding one of the intra-operative determinations by more than a threshold value.
6. The method according to claim 1 , wherein the step of making intra-operative determinations is performed every 2-5 seconds.
7. The method according to claim 1 , wherein the steps of making intra-operative determinations and applying the dosage of energy are performed concurrently.
8. The method according to claim 1 , wherein making a pre-contact determination is performed at a power of less than 10 milliwatts.
9. The method according to claim 1 , wherein making intra-operative determinations is performed at a power of 5-50 watts.