Methods and apparatus for multi-catheter tissue ablation

Abstract

Catheter systems, tools and methods are disclosed for the selective and rapid application of DC voltage to drive irreversible electroporation, with the system controller configurable to apply voltages to an independently selected subsets of electrodes, such that voltages of one polarity are applied to a multiplicity of electrodes on a first medical device and voltages of the opposite polarity to a multiplicity of electrodes on a second medical device. The first and second medical devices can be epicardial catheters positioned such that their opposing distal tips are approximately aligned and whose segments with electrodes collectively wrap around the pulmonary veins.

1 - 16 . (canceled) 
     
     
         17 . A method, comprising:
 identifying, via a selection module of an electrode controller, a plurality of anode/cathode pairs, each anode selected in the plurality of anode/cathode pairs being only in a first plurality of electrodes of a first multi-electrode catheter, each cathode selected in the plurality of anode/cathode pairs being only in a second plurality of electrodes of a second multi-electrode catheter, the first multi-electrode catheter and the second multi-electrode catheter configured to collectively surround a portion of a heart;   conveying a pacing signal to a pacing lead configured to be operatively coupled to the heart;   delivering, via a pulse delivery module of the electrode controller, a first output signal having a first polarity to each anode selected; and   delivering, via the pulse delivery module, a second output signal having a second polarity opposite the first polarity to each cathode selected, the first output signal and the second output signal being delivered according to a sequential pattern.   
     
     
         18 . The method of  claim 17 , wherein the identifying is based on an input received from an input/output module of the electrode controller. 
     
     
         19 . The method of  claim 17 , further comprising:
 computing an impedance between at least one anode electrode in the first plurality of electrodes and at least one cathode electrode in the second plurality of electrodes,   the identifying being performed automatically by the selection module based at least in part on the impedance.   
     
     
         20 . The method of  claim 17 , further comprising:
 generating the sequential pattern based on at least one of an impedance associated with the plurality of anode/cathode pairs, a distance between the plurality of anode/cathode pairs, and a characteristic associated with the heart.   
     
     
         21 . The method of  claim 17 , wherein the first multi-electrode catheter is electrically isolated from the second multi-electrode catheter. 
     
     
         22 . The method of  claim 17 , wherein the portion of the heart includes one or more of the pulmonary veins. 
     
     
         23 . A non-transitory processor readable medium storing code representing instructions to be executed by a processor, the code comprising code to cause the processor to:
 identify a plurality of anode/cathode pairs, each anode in the plurality of anode/cathode pairs being only in a first plurality of electrodes of a first multi-electrode catheter, each cathode in the plurality of anode/cathode pairs being only in a second plurality of electrodes of a second multi-electrode catheter, the first multi-electrode catheter and the second multi-electrode catheter configured to collectively surround a portion of a heart;   convey a pacing signal to a pacing lead configured to be operatively coupled to the heart;   and   deliver, according to a sequential pattern, a first output signal having a first polarity to each anode selected and a second output signal having a second polarity opposite the first polarity to each cathode selected.   
     
     
         24 - 28 . (canceled) 
     
     
         29 . The method of  claim 17 , further comprising:
 receiving, at a feedback module, an electrocardiograph signal associated with the heart.   
     
     
         30 . The non-transitory processor readable medium of  claim 23 , further comprising:
 computing an impedance between at least one electrode in the first plurality of electrodes and at least one electrode in the second plurality of electrodes,   the identifying being performed automatically based on the impedance.   
     
     
         31 . The non-transitory processor readable medium of  claim 23 , further comprising:
 generating the sequential pattern based on at least one of an impedance associated with the plurality of anode/cathode pairs, a distance between the plurality of anode/cathode pairs, and a characteristic associated with the heart.   
     
     
         32 . The non-transitory processor readable medium of  claim 23 , further comprising:
 receiving an electrocardiograph signal associated with the heart.   
     
     
         33 . The non-transitory processor readable medium of  claim 23 , wherein the portion of the heart includes one or more of the pulmonary veins.