System and methods for locating and ablating arrhythomogenic tissues

Abstract

The disclosure relates to a variety of systems and methods for sensing electrical events about a selected annulus region of the heart and for treating tissue in the selected annulus region. Wherein the system includes a first catheter that has an expandable member, an ablation element, and a lumen configured to allow a second catheter therethrough. The second catheter includes a distal section in a ring shape and a plurality of electrodes coupled around the ring. Optionally a second lumen can be included through the first catheter that allows for contrast media to be delivered to the distal end of the system.

1 . A system for sensing electrical events about a selected annulus region of the heart and for treating tissue in the selected annulus region, comprising:
 a first catheter having:
 a first handle assembly; 
 a first shaft having a first proximal end coupled to the first handle assembly, and a first distal end, the first shaft extending along a first axis; 
 a first lumen extending through said first shaft along the first axis; 
 a second lumen extending through said first shaft along the first axis and terminating at the first distal end; 
 an ablation element provided adjacent the first distal end of the first shaft; 
 an expandable member coupled to the first distal end; and 
   an energy source coupled to the ablation element,
 wherein said first lumen is adapted to receive a second catheter therethrough; 
   the second catheter having:
 a second shaft having a second proximal end coupled to the second handle assembly of the second catheter, and a second distal end, the second shaft of the second catheter extending along a second axis; and 
 a distal ring provided at the second distal end of the second shaft of the second catheter and oriented substantially perpendicular to the second axis of the second shaft of the second catheter, the distal ring having a plurality of electrodes positioned in spaced-apart manner about the distal ring of the second catheter. 
   
     
     
         2 . A system according to  claim 1 , wherein:
 the expandable member comprises a first expandable member; and   the ablation element comprises a transducer housed inside a different second expandable member that is positioned proximal of the first expandable element.   
     
     
         3 . A system according to  claim 2 , wherein the transducer comprises one of a radiofrequency ablation element and an acoustic ablation element. 
     
     
         4 . A system according to  claim 3 , wherein the different second expandable member comprises an inflatable balloon. 
     
     
         5 . A system according to  claim 1 , wherein the distal ring has a first diameter that is less than a second diameter of the fully expanded expandable member. 
     
     
         6 . A system according to  claim 1 , wherein the ablation element comprises a transducer housed inside the expandable member. 
     
     
         7 . A system according to  claim 6 , wherein the expandable member comprises an inflatable balloon. 
     
     
         8 . A system according to  claim 1 , wherein the first handle assembly is configured to deflect the first distal end of the first catheter. 
     
     
         9 . A system according to  claim 1 , further comprising:
 a second handle assembly coupled to the second proximal end,   wherein the second handle assembly is configured to deflect the second distal end of the second catheter.   
     
     
         10 . A system according to  claim 1 , wherein the second handle assembly is configured to change a diameter of the distal ring. 
     
     
         11 . A system for sensing electrical events about a selected annulus region of the heart and for treating tissue in the selected annulus region, comprising:
 a first catheter having:
 a first handle assembly; 
 a first shaft having a first proximal end coupled to the first handle assembly, and a first distal end, the first shaft extending along a first axis; 
 a lumen extending through said first shaft along the first axis; 
 an ablation element provided adjacent the first distal end of the first shaft; and 
 an expandable member coupled to the first distal end; and 
   an energy source coupled to the ablation element,
 wherein said lumen is adapted to receive a second catheter therethrough; 
   the second catheter having:
 a second shaft having a second proximal end coupled to the second handle assembly of the second catheter, and a second distal end, the second shaft of the second catheter extending along a second axis; and 
 a distal ring provided at the second distal end of the second shaft of the second catheter and oriented substantially perpendicular to the second axis of the second shaft of the second catheter, the distal ring having a plurality of electrodes positioned in spaced-apart manner about the distal ring of the second catheter. 
   
     
     
         12 . A system according to  claim 11 , wherein:
 the expandable member comprises a first expandable member; and   the ablation element comprises a transducer housed inside a different second expandable member that is positioned proximal of the first expandable element.   
     
     
         13 . A system according to  claim 12 , wherein the transducer comprises one of a radiofrequency ablation element and an acoustic ablation element. 
     
     
         14 . A system according to  claim 11 , wherein the ablation element comprises a transducer housed inside the expandable member. 
     
     
         15 . A system according to  claim 11  further comprising:
 a second handle assembly coupled to the second proximal end, 
 wherein the second handle assembly is configured to deflect the second distal end of the second catheter. 
 
     
     
         16 . A system according to  claim 10 , wherein the distal ring has a first diameter that is less than a second diameter of the fully expanded expandable member. 
     
     
         17 . A method of sensing electrical events and ablating about a selected annulus region, comprising:
 providing a first catheter having a first proximal end, a first distal end, a first axis a first lumen extending through said first catheter along the first axis and a second lumen extending through said first catheter along the first axis, with an expandable member coupled to the first distal end and an ablation element housed within the expandable member;   providing a second catheter having a second proximal end, a second distal end, and a second axis, with a distal ring disposed at the second distal end and oriented perpendicular to the second axis, where the distal ring has a plurality of electrodes positioned in spaced-apart manner about the distal ring;   advancing the first catheter to a selected annulus region within a body;   advancing the second catheter through the lumen of the first catheter to the first distal end;   deploying the distal ring of the second catheter so that the plurality of electrodes can detect electrical signals from the selected annulus region;   activating the ablation element;   detecting signals from the selected annulus region with the plurality of electrodes.   
     
     
         18 . A method according to  claim 17 , further comprising using the plurality of electrodes to detect electrical signals from the selected annulus before activating the ablation element. 
     
     
         19 . A method according to  claim 17 , further comprising injecting a contrast medium through the second lumen after deploying the distal ring of the second catheter. 
     
     
         20 . A method according to  claim 18 , further comprising comparing the detected electrical signals from the selected annulus before and after activating the ablation element.