Arrhythmia Diagnostic and/or Therapy Delivery Methods and Devices, and Robotic Systems for Other Uses

Abstract

Improved systems for diagnosing and/or treating arrhythmia of a heart makes use of an array of articulation balloons to control movement of a distal portion of a catheter inside the heart, and may be used to align a diagnostic or treatment tool with a target tissue surface region along or adjacent an inner surface of one of the chambers of the heart. The articulation balloons can generate articulation forces at the site of articulation, and the movement may provide greater dexterity than movements induced by transmitting articulation forces proximally along a catheter body that winds through a tortuous vascular pathway. One or more fluid channels may transmit pressure signals that can be used to determine engagement forces between an electrode or other surface near the distal and of an elongate flexible structure and a tissue or other surface, and those same channels may also be used to control inflation of a balloon articulation array, with the pressure signals optionally providing both force and engagement orientation information.

What is claimed is: 
     
         1 . An arrhythmia catheter system for diagnosing and/or treating an arrhythmia of a heart of a patient, the system comprising:
 an elongate flexible cardiac catheter body having a proximal end and a distal end with an axis therebetween;   an arrhythmia tool mounted near the distal end of the catheter body, the tool having an axis;   the catheter body having an articulated portion adjacent the distal end, the articulated portion having an array of articulation balloons.   
     
     
         2 . The system of  claim 1 , the heart including a tissue, wherein the system further comprises:
 a fluid source in fluid communication with the balloons, the fluid source having an inflation fluid; and   a processor coupled with the fluid source and with the balloons, wherein the processor is configured to determine an engagement force between the tool and the tissue using a pressure of the inflation fluid.   
     
     
         3 . The system of  claim 2 , wherein the processor is configured to control articulation of the articulated portion, the engagement force being induced by the articulation. 
     
     
         4 . The system of  claim 2 , wherein a plurality of valves couple the balloons with the fluid source, wherein the processor comprises a feedback system configured to control articulation of the articulated portion by actuating the valves. 
     
     
         5 . The system of  claim 1 , wherein the tool comprises an ablation electrode or a diagnostic electrode array. 
     
     
         6 . The system of  claim 5 , further comprising a pressure sensor coupled to the balloons, an output, and a processor coupling the output to pressure sensor so that the output can provide, to a system user, an indication of an engagement force between the electrode and the heart in response to balloon pressure signals. 
     
     
         7 . The system of  claim 1 , wherein the indication identifies an orientation of the engagement force. 
     
     
         8 . The system of  claim 1 , wherein the catheter body is included in a transseptal access system. 
     
     
         9 . The system of  claim 1 , wherein the articulated portion includes a first articulated segment and a second articulated segment, wherein the first segment is configured to be articulated along first and second lateral orientations, and wherein the second segment is configured to be articulated along third and fourth lateral orientations. 
     
     
         10 . The system of  claim 9 , wherein inflation of a third subset of balloons axially elongates the articulated portion. 
     
     
         11 . A catheter system for diagnosing and/or treating a tissue of a patient, the tissue having a tissue surface, the system comprising:
 an elongate flexible catheter body having a proximal end and a distal end with an axis therebetween;   a diagnostic and/or treatment tool mounted near the distal end of the catheter body;   a fluid channel extending along the axis between the proximal end and the tool, wherein an engagement between the tool and the tissue surface induces pressure within the channel; and   an output coupled with the channel and indicating a force of the engagement.   
     
     
         12 . The catheter system of  claim 11 , further comprising an array of articulation balloons coupled to the proximal end by a plurality of channels, the engagement inducing a plurality of differing pressures in the balloons in response to an orientation of the engagement force, wherein the output indicates the engagement orientation. 
     
     
         13 . The catheter system of  claim 11 , further comprising a processor, a sensor, and a plurality of valves coupling the processor to a plurality of channels extending along the axis, wherein the processor is configured to articulate the catheter body by actuating the valves, wherein the sensor transmits signals to the processor, the signals comprising feedback signals indicating an articulation state of the catheter body, and wherein the processor is configured to actuate the valves using the feedback signals. 
     
     
         14 . An articulation system comprising:
 an elongate flexible body having a proximal end and a distal end with an axis therebetween;   a surface near the distal end of the body;   an articulation balloon array proximal of the surface;   a fluid channel extending along the axis between the proximal end and the balloon array,   wherein an engagement between the surface and a target structure induces pressure within the channel;   a pressure sensor coupled with the channel; and   a processor coupled with the pressure sensor so as to determine a force of the engagement.   
     
     
         15 . The articulation system of  claim 14 , wherein the processor is configured to determine a mass of inflation fluid present in the channel and/or a subset of balloons in the articulation array, and to use the mass of inflation fluid and a stiffness of the body to determine the force of engagement.