Cardiac ablation systems and methods

Abstract

Cardiac ablation systems and methods of their use and manufacture involve an ablation mechanism, a stabilizer mechanism, and a cinching mechanism that urges the ablation mechanism toward a patient tissue. Embodiments encompass methods for administering epicardial and endocardial lesions, including box lesions and connecting lesions, to patient tissue.

1 .- 20 . (canceled) 
     
     
         21 . A system for administering an ablation treatment to a patient, comprising:
 an ablation assembly having a flexible ablation mechanism configured to ablate a tissue of the patient;   a cinching mechanism configured to constrict the ablation member about the patient tissue; and   an introducer coupleable with the ablation assembly of the introducer and having a distal grasping element to facilitate placement of and/or cinching of the flexible ablation mechanism about the tissue.   
     
     
         22 . A system as in  claim 21 , wherein the introducer is coupleable with the ablation assembly of the introducer along a length of the introducer proximal of the distal grasping portion. 
     
     
         23 . A system as in  claim 21 , wherein the distal grasping element comprises a string or tape accessible for grasping by an operator with a minimally invasive tool. 
     
     
         24 . A system as in  claim 21 , wherein the distal grasping element comprises a tape or ribbon shape to facilitate maneuvering and/or positioning of the ablation assembly coupled to the introducer. 
     
     
         25 . A system as in  claim 24 , wherein the introducer is configured such that a width of the tape or ribbon shaped distal grasping element is aligned with a width of the introducer so as to facilitate maneuvering and/or positioning of the ablation assembly through the introducer coupled to the ablation assembly by manipulation of the distal grasping element. 
     
     
         26 . A system as in  claim 21 , further comprising:
 a tool insertable through a trocar, the tool being configured for snagging the distal grasping portion.   
     
     
         27 . A system as in  claim 26 , wherein the distal grasping portion comprises a ribbon or tape and the tool comprises a tape hook. 
     
     
         28 . A system as in  claim 26 , wherein the tool comprises a distal fin or wedge configured to snag the distal grasping element when twisted adjacent the distal grasping element. 
     
     
         29 . A system as in  claim 26 , wherein the tool comprises a moveable jaw configured for grasping and releasing of the distal grasping element. 
     
     
         30 . A system as in  claim 26 , wherein the tool further comprises a scope for visualizing one or both of the distal grasping element and the flexible ablation member so as to facilitate placement and/or cinching of the flexible ablation member by manipulation of the distal grasping member. 
     
     
         31 . A system as in  claim 23 , wherein a portion of the introducer comprises a bias towards a curve or arc shape comprises a ribbon or tape and the tool comprises a tape hook. 
     
     
         32 . A system as in  claim 21 , further comprising a stabilizer mechanism coupled to the flexible ablation member, wherein the distal grasping element is attached to a distal portion of the stabilizer mechanism 
     
     
         33 . A system as in  claim 32 , wherein the distal grasping element extends within the introducer and through a distal aperture in the introducer 
     
     
         34 . A system as in  claim 33 , wherein the distal grasping element extends alongside a moveable urging element disposed within the introducer such that tension on the distal grasping element moves or maintains the urging element at least partially within the stabilizing member to force the introducer and stabilize together, while releasing tension on the distal grasping element allows the introducer and stabilizer to be separated. 
     
     
         35 . A system as in  claim 34 , wherein the distal grasping element comprises a tape-shaped element and the urging member comprises a pin. 
     
     
         36 . A system as in  claim 32 , wherein the stabilizer mechanism that forms a seal with the tissue of the patient, wherein the ablation mechanism is at least partially disposed within a recess of the stabilizer member. 
     
     
         37 . A method for ablating a cardiac tissue of a patient, comprising:
 inserting an ablation assembly through a minimally invasive aperture in the patient so as to position a flexible ablation member tissue near the tissue;   urging the flexible ablation member bout the tissue by guiding a distal introducer coupled to the flexible ablation member about the tissue;   grasping a distal grasping element extending from the introducer; and   maneuvering the flexible ablation member to a desired placement or position about the tissue by manipulating the distal grasping element; and   administering an ablation to the cardiac tissue via the ablation mechanism to create a lesion in the cardiac tissue.   
     
     
         38 . A method as in  claim 37 , wherein grasping the distal grasping element comprises snagging the distal grasping element with a tool inserted through the minimally invasive aperture or through another minimally invasive aperture. 
     
     
         39 . A method as in  claim 38 , wherein grasping the distal grasping element comprises twisting the tool such that a fin, curved portion or hook of the tool snags the distal grasping element. 
     
     
         40 . A method as in  claim 38 , wherein grasping the distal grasping element comprises visualizing the distal grasping element with a scope incorporate into a shaft of the grasping tool. 
     
     
         41 . A method as in  claim 37 , wherein the distal grasping element comprises a tape or ribbon and manipulating the distal grasping element comprises any of pulling, releasing and twisting the distal grasping element or any combination thereof so as to provide the desired placement or position of the flexible ablation member about the tissue. 
     
     
         42 . A method as in  claim 37 , wherein grasping the distal grasping element comprises snagging the ribbon or tape by twisting a tool such that a fin or curved portion snags the ribbon or tape and wraps around a sheath of the tool so as to facilitate manipulation of the ribbon or tape with the tool. 
     
     
         43 . A method as in  claim 37 , wherein the ablation assembly is disposed at least partially within a stabilizer member, the method further comprising:
 forming a seal between the stabilizer assembly and the cardiac tissue.   
     
     
         44 . A method as in  claim 43  wherein the introducer includes an urging member that couples the introducer and stabilizer member when the distal grasping element is tensioned, the method further comprising:
 tensioning the distal grasping element during manipulating of the distal grasping element so that the stabilizer member and introducer remain coupled during maneuvering of the flexible ablation member. 
 
     
     
         45 . A method as in  claim 43  further comprising:
 releasing the distal grasping element so as to decouple the introducer and a stabilizing member of the flexible ablation assembly after maneuvering of the flexible ablation member; and 
 removing the introducer through the minimally invasive aperture.