公开(公告)号：WO2007140331A3

公开(公告)日：2008-01-17

申请号：PCT/US2007069789

申请日：2007-05-25

Applicant: MEDTRONIC INC ,  STEWART MARK T ,  FRANCISCHELLI DAVID E ,  KEOGH JAMES R ,  HISSONG JAMES B ,  SKARDA JAMES R ,  LEE HOTAIK ,  SMITH NADINE B

Inventor： STEWART MARK T ,  FRANCISCHELLI DAVID E ,  KEOGH JAMES R ,  HISSONG JAMES B ,  SKARDA JAMES R ,  LEE HOTAIK ,  SMITH NADINE B

IPC: A61N7/02

CPC classification number: A61B17/320068 ,  A61B8/4281 ,  A61B34/20 ,  A61B2017/320076 ,  A61B2017/320078 ,  A61B2018/00291 ,  A61B2034/2051 ,  A61B2090/378 ,  A61B2090/3782 ,  A61N7/02 ,  A61N7/022 ,  A61N2007/0078

Abstract: A device and method for ablating tissue is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding an ablating member within the patient while tracking the position of the ablating member in the patient, positioning the ablating member in a desired position to ablate tissue, emitting ablating energy from the ablating member to form an ablated tissue area and removing the ablating member from the patient.

Abstract translation: 公开了一种用于消融组织的装置和方法，包括以下步骤：获取患者的解剖图像，将图像与患者相关联，在跟踪患者内的消融部件的位置的同时引导患者内的消融部件，定位消融 成员在消融组织的期望位置，从烧蚀构件发出消融能量以形成消融的组织区域，并从患者身上移除消融部件。

公开(公告)号：WO2004034899A3

公开(公告)日：2004-08-12

申请号：PCT/US0332677

申请日：2003-10-11

Applicant: MEDTRONIC INC

Inventor： STEWART MARK T ,  PURYEAR HARRY A

IPC: A61B5/107 ,  A61B8/12 ,  A61B18/14 ,  A61B19/00 ,  A61B5/00

CPC classification number: A61B8/0883 ,  A61B5/1076 ,  A61B8/12 ,  A61B8/445 ,  A61B8/4472 ,  A61B18/1492 ,  A61B2017/00106 ,  A61B2018/00375 ,  A61B2090/062

Abstract: The present invention relates to medical devices; in particular, the present invention provides devices and methods for sensing thickness of cardiac tissue and the like so that medical procedures may be efficiently performed through and/or upon a discrete location having suitable tissue thickness. The invention includes an elongated resilient dilator apparatus having an ultrasound transceiver coupled thereto. When the ultrasound transceiver is disposed proximate a region of relatively thin tissue, such as a latent Fossa Ovalis valve, a clinician receives a signal. The clinician may then proceed with enhanced confidence to pierce the relatively thin tissue. Thus, in the case of a transseptal procedure, the clinician gains access to the left atrial chamber from the right atrial chamber.

Abstract translation: 本发明涉及医疗器械; 特别地，本发明提供用于感测心脏组织等的厚度的装置和方法，使得可以通过和/或在具有适当组织厚度的离散位置上有效地执行医学过程。 本发明包括具有耦合到其上的超声波收发器的细长弹性扩张器装置。 当超声收发器设置在相对薄的组织的区域附近时，例如潜在的Fossa Ovalis瓣膜时，临床医生接收信号。 然后，临床医生可以进一步增强信心以刺穿相对薄的组织。 因此，在经常手术的情况下，临床医生从右心房获得进入左心房。

公开(公告)号：EP1768575A4

公开(公告)日：2009-04-22

申请号：EP05761687

申请日：2005-06-16

Applicant: MEDTRONIC INC

Inventor： LUTTERMAN ALISON ,  ROTHSTEIN PAUL T ,  FRANCISCHELLI DAVID E ,  BRISCOE RODERICK E ,  LEUER LEONARD H ,  HAEG DANIEL C ,  DAIGLE TOMAS P ,  FALKNER PHILIP C ,  WARMAN EDUARDO N ,  HETTRICK DOUGLAS A ,  STEINBRINK MARIE T ,  KIM DAVID J S ,  STEWART MARK T ,  CHRISTIAN STEVEN C ,  OLIG CHRISTOPHER P

IPC: A61B17/10 ,  A61B17/08

CPC classification number: A61B17/0057 ,  A61B17/12013 ,  A61B17/122 ,  A61B17/1285 ,  A61B90/39 ,  A61B2017/00243 ,  A61B2017/00575 ,  A61B2017/12018 ,  A61B2017/306

Abstract: Some embodiments of the invention provide a system for occluding a left atrial appendage of a patient. Some embodiments of the system can include a ring occluder that can be positioned around the left atrial appendage and a ring applicator to position the ring occluder with respect to the left atrial appendage. One embodiment discloses a method of accessing endocardial surfaces of the heart through the atrial appendage. Additional embodiments of the invention provide a clip occluder that can be positioned around the left atrial appendage. A clip applicator can position the clip occluder with respect to the left atrial appendage.

公开(公告)号：WO2004100813A3

公开(公告)日：2005-01-06

申请号：PCT/US2004014224

申请日：2004-05-07

Applicant: MEDTRONIC INC ,  STEWART MARK T ,  FIEDLER GARY R ,  SANDSTONE JEFFREY D

Inventor： STEWART MARK T ,  FIEDLER GARY R ,  SANDSTONE JEFFREY D

IPC: A61B10/00 ,  A61B10/02 ,  A61B18/00 ,  A61B18/14

CPC classification number: A61B18/1492 ,  A61B10/0233 ,  A61B2018/00011 ,  A61B2018/1407 ,  A61B2018/1435 ,  A61B2218/002

Abstract: According to the present invention, a catheter having at least one multi-purpose lumen formed through the catheter terminates proximal a relatively complex-shaped distal portion thereof. In one form of this embodiment, the relatively complex-shaped distal portion comprises a looped portion having diagnostic- and/or ablation-type electrodes coupled thereto and an elongated diameter-adjusting member coupled proximal the distal end of the looped portion. The multi-purpose lumen may be used to alternately accommodate a variety of dedicated materials; such as, (i) a guide wire for initial deployment or later repositioning of the catheter, (ii) a volume or flow of a contrast media and the like, (iii) a deployable hollow needle or tube and the like used to biopsy adjacent tissue or dispense a therapeutic agent into a volume of tissue, and (iv) a cooling fluid, such as saline solution and the like dispensed at least during therapeutic tissue ablation procedures.

Abstract translation: 根据本发明，具有通过导管形成的至少一个多用途腔的导管终止于其相对复杂形状的远端部分的近端。 在该实施例的一种形式中，相对复杂形状的远侧部分包括具有耦合到其上的诊断和/或消融型电极的环形部分和在环形部分的远端附近耦合的细长直径调节构件。 多用途腔可用于交替容纳各种专用材料; 例如，（i）用于初始部署或稍后重新定位导管的导丝，（ii）造影剂等的体积或流动，（iii）用于活检相邻的可展开的空心针或管等 组织或将治疗剂分配到一定体积的组织中，和（iv）至少在治疗性组织消融过程期间分配的冷却液，例如盐水溶液等。

公开(公告)号：WO0245608A9

公开(公告)日：2003-12-18

申请号：PCT/US0144977

申请日：2001-11-30

Applicant: MEDTRONIC INC

Inventor： STEWART MARK T ,  SKARDA JAMES R ,  FLICKINGER WILLIAM J ,  FRANCISCHELLI DAVID E

IPC: A61B17/00 ,  A61B18/14

CPC classification number: A61B18/1492 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2018/00214 ,  A61B2018/00267 ,  A61B2018/00351 ,  A61B2018/00375 ,  A61B2018/1407 ,  A61B2018/1435

Abstract: A catheter assembly and method for treatment of cardiac arrhythmia. In one preferred embodiment, the catheter assembly includes a cetheter body, at least one electrode, and a fluid source. The catheter body includes a proximal portion, an intermediate portion, a distal portion, a first lumen, and an ablation section. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a helix or coil. The first lumen extends from the proximal portion to the distal portion. Finally, the ablation section is formed along the helix of the distal portion and defines a loop transverse to the longitudinal axis. The ablation section is, in one preferred embodiment, comprised of a microporous material in fluid communication with the first lumen so as to irrigate fluid from the first lumen to an exterior surface of the ablation section. The electrode is associated with the ablation section. Finally, the fluid source is provided to supply a conductive fluid to the first lumen. With the configuration, upon activation, the electrode supplies an ablation energy to fluid irrigated to the exterior surface of the ablation section, thereby ablating a continuous, closed lesion pattern. During use, for example, the catheter assembly can ablate a closed lesion pattern corresponding with the loop defined by the ablation section on a chamber wall about a pulmonary vein ostium to electrically isolate the pulmonary vein from the left atrium. In one preferred embodiment, the ablation section is comprised of a high density, expanded PTFE material. In another preferred embodiment, a shaping wire is slidably disposed within the catheter body to selectively dictate the desired helical shape of the distal portion.

Abstract translation: 一种用于治疗心律失常的导管组件和方法。 在一个优选实施例中，导管组件包括绦虫体，至少一个电极和流体源。 导管主体包括近端部分，中间部分，远端部分，第一内腔和消融部分。 中间部分从近侧部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并形成螺旋或线圈。 第一管腔从近端部分延伸到远端部分。 最后，消融部分沿着远侧部分的螺旋形成，并且限定了一个横向于纵轴的环。 在一个优选实施例中，消融部分包括与第一内腔流体连通的微孔材料，以便将流体从第一内腔冲洗到消融部分的外表面。 电极与消融部分相关联。 最后，提供流体源以向第一管腔提供导电流体。 利用该配置，在激活时，电极将消融能量提供给冲洗到消融部分的外表面的流体，从而消除连续的闭合病变图案。 在使用期间，例如，导管组件可以消除对应于围绕肺静脉口的腔室壁上的消融部分限定的环的封闭病变图案，以将肺静脉与左心房电隔离。 在一个优选实施例中，消融部分由高密度，膨胀的PTFE材料组成。 在另一优选实施例中，成形线可滑动地设置在导管主体内，以选择性地决定远侧部分的期望的螺旋形状。

公开(公告)号：WO02087452A2

公开(公告)日：2002-11-07

申请号：PCT/US0213166

申请日：2002-04-25

Applicant: MEDTRONIC INC

Inventor： FRANSISCHELLI DAVID E ,  SKARDA JAMES R ,  STEWART MARK T ,  MEHR RAHUL

IPC: A61B18/12 ,  A61B18/00

CPC classification number: A61B18/1206 ,  A61B18/1445 ,  A61B2018/0016 ,  A61B2018/00351 ,  A61B2018/00363 ,  A61B2018/00577 ,  A61B2018/00702 ,  A61B2018/00761 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61B2018/00886 ,  A61B2018/1467 ,  A61B2218/002

Abstract: A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.

Abstract translation: 用于创建病变并评估其完整性或透视性的系统和方法。 通过监测要消融的组织的阻抗来评估病变的透壁性。 不是试图检测到期望的下降或期望的增加阻抗，而是响应于被测量的阻抗保持在稳定的电平，在期望的时间段（被称为阻抗平台）来检测损伤的完整性。 当邻近这些单个电极或电极对的组织中的损伤完整时，用于确定相邻个体电极或对的损伤的透壁性的机制可用于使单个电极或电极对失活，以产生沿着电极线的基本均匀的损伤或 电极对，而不管邻近各个电极或电极对的组织厚度的差异。

公开(公告)号：WO2011094073A3

公开(公告)日：2011-11-24

申请号：PCT/US2011021227

申请日：2011-01-14

Applicant: MEDTRONIC INC ,  URBAN JON F ,  SHARMA VINOD ,  STEWART MARK T

Inventor： URBAN JON F ,  SHARMA VINOD ,  STEWART MARK T

IPC: A61N1/05 ,  A61B17/00 ,  A61M25/00

CPC classification number: A61N1/0575 ,  A61B5/042 ,  A61B5/6848 ,  A61B5/6852 ,  A61B2017/00053 ,  A61M25/0084 ,  A61M2025/0089 ,  A61M2025/0091

Abstract: A system and associated method measure monophasic action potential signals for identifying a targeted tissue location and delivering a therapy to the targeted tissue location. The system includes a hollow needle having a sharpened distal tip, a first electrode at the distal tip and a fluid delivery lumen extending through the needle from a proximal needle end to an opening in the sharpened distal tip.

Abstract translation: 系统和相关方法测量单相动作电位信号，用于识别目标组织位置并向目标组织位置递送治疗。 该系统包括具有尖锐远侧尖端的中空针头，位于远侧尖端处的第一电极以及从近侧针头延伸穿过针头到达尖锐远侧尖端中的开口的流体递送内腔。

公开(公告)号：WO2009140359A2

公开(公告)日：2009-11-19

申请号：PCT/US2009043751

申请日：2009-05-13

Applicant: MEDTRONIC INC ,  STEWART MARK T ,  FRANCISCHELLI DAVID E ,  HONG JINBACK

Inventor： STEWART MARK T ,  FRANCISCHELLI DAVID E ,  HONG JINBACK

IPC: A61B18/14

CPC classification number: A61B18/1445 ,  A61B2018/00029 ,  A61B2018/00065 ,  A61B2018/00113 ,  A61B2018/0016 ,  A61B2018/00357 ,  A61B2018/00363 ,  A61B2018/00577 ,  A61B2018/00839 ,  A61B2018/1472 ,  A61B2090/064 ,  A61B2218/002

Abstract: Device, system and method for ablating tissue of a heart of a patient. The tissue is clamped between a pair of opposing jaws. A portion of the tissue is ablated at a first generally linear position on the tissue by applying ablative energy to two of a plurality of elongate electrodes, each of the two of the plurality of elongate electrodes being coupled in opposing relationship to each other and the pair of opposing jaws, respectively. An effectiveness of the ablation is sensed at a second generally linear position on the tissue with at least one of the plurality of elongate electrodes positioned on one of the pair of opposing jaws. The second linear position on the tissue is laterally distal to the first linear position on the tissue with respect to the atrium of the heart.

Abstract translation: 用于消除患者心脏的组织的装置，系统和方法。 将组织夹在一对相对的夹爪之间。 通过向多个细长电极中的两个施加烧蚀能量，组织的一部分在组织上的第一大致线性位置被消融，多个细长电极中的每一个彼此相对地相互耦合，并且该对 的对颚分别。 在组织上的第二大致直线位置处感测消融的有效性，其中多个细长电极中的至少一个位于一对相对的夹爪中的一个上。 组织上的第二线性位置相对于心脏的心房横向远离组织上的第一线性位置。

公开(公告)号：WO2006009729A2

公开(公告)日：2006-01-26

申请号：PCT/US2005021107

申请日：2005-06-16

Applicant: MEDTRONIC INC

Inventor： LUTTERMAN ALISON ,  ROTHSTEIN PAUL T ,  FRANCISCHELLI DAVID E ,  BRISCOE RODERICK E ,  LEUER LEONARD H ,  HAEG DANIEL C ,  DAIGLE TOMAS P ,  FALKNER PHILIP C ,  WARMAN EDUARDO N ,  HETTRICK DOUGLAS A ,  STEINBRINK MARIE T ,  KIM DAVID J S ,  STEWART MARK T ,  CHRISTIAN STEVEN C ,  OLIG CHRISTOPHER P

IPC: A61B17/10

CPC classification number: A61B17/0057 ,  A61B17/12013 ,  A61B17/122 ,  A61B17/1285 ,  A61B90/39 ,  A61B2017/00243 ,  A61B2017/00575 ,  A61B2017/12018 ,  A61B2017/306

Abstract: Some embodiments of the invention provide a system for occluding a left atrial appendage of a patient. Some embodiments of the system can include a ring occluder that can be positioned around the left atrial appendage and a ring applicator to position the ring occluder with respect to the left atrial appendage. Other embodiments of the invention provide a clip occluder that can be positioned around the left atrial appendage. A clip applicator can position the clip occluder with respect to the left atrial appendage.

Abstract translation: 本发明的一些实施例提供一种用于闭塞患者左心耳的系统。 该系统的一些实施例可以包括可以围绕左心耳定位的环封闭器和环施加器来相对于左心耳定位环封闭器。 本发明的其它实施例提供可围绕左心耳定位的夹子封堵器。 夹子施放器可以相对于左心耳定位夹子封堵器。

公开(公告)号：WO2004034899B1

公开(公告)日：2004-10-14

申请号：PCT/US0332677

申请日：2003-10-11

Applicant: MEDTRONIC INC

Inventor： STEWART MARK T ,  PURYEAR HARRY A

IPC: A61B5/107 ,  A61B8/12 ,  A61B18/14 ,  A61B19/00 ,  A61B5/00

CPC classification number: A61B8/0883 ,  A61B5/1076 ,  A61B8/12 ,  A61B8/445 ,  A61B8/4472 ,  A61B18/1492 ,  A61B2017/00106 ,  A61B2018/00375 ,  A61B2090/062

Abstract: The present invention relates to medical devices; in particular, the present invention provides devices and methods for sensing thickness of cardiac tissue and the like so that medical procedures may be efficiently performed through and/or upon a discrete location having suitable tissue thickness. The invention includes an elongated resilient dilator apparatus having an ultrasound transceiver coupled thereto. When the ultrasound transceiver is disposed proximate a region of relatively thin tissue, such as a latent Fossa Ovalis valve, a clinician receives a signal. The clinician may then proceed with enhanced confidence to pierce the relatively thin tissue. Thus, in the case of a transseptal procedure, the clinician gains access to the left atrial chamber from the right atrial chamber.

Abstract translation: 本发明涉及医疗装置; 具体而言，本发明提供了用于感测心脏组织等的厚度的装置和方法，使得医疗过程可以通过和/或在具有合适组织厚度的离散位置上被有效地执行。 本发明包括具有与其耦合的超声波收发器的细长弹性扩张器装置。 当超声波收发器设置在相对较薄的组织区域（例如潜伏卵圆孔阀）附近时，临床医生接收信号。 然后临床医生可以增强自信以刺穿相对较薄的组织。 因此，在经房间隔过程的情况下，临床医生从右心房进入左心房。