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WO1995020361B1 - Method of determining sites for arrhythmia ablation - Google Patents

Method of determining sites for arrhythmia ablation

Info

Publication number
WO1995020361B1
WO1995020361B1 PCT/US1994/014378 US9414378W WO9520361B1 WO 1995020361 B1 WO1995020361 B1 WO 1995020361B1 US 9414378 W US9414378 W US 9414378W WO 9520361 B1 WO9520361 B1 WO 9520361B1
Authority
WO
WIPO (PCT)
Prior art keywords
impedance
measuring
electrode
catheter
endocardium
Prior art date
Application number
PCT/US1994/014378
Other languages
French (fr)
Other versions
WO1995020361A1 (en
Filing date
Publication date
Priority claimed from US08/188,514 external-priority patent/US5447529A/en
Application filed filed Critical
Priority to AU14358/95A priority Critical patent/AU1435895A/en
Publication of WO1995020361A1 publication Critical patent/WO1995020361A1/en
Publication of WO1995020361B1 publication Critical patent/WO1995020361B1/en

Links

Abstract

A method of locating infarcted myocardial tissue in a beating heart includes the step of inserting an impedance measuring tip (10) of a catheter (14) into the chamber of the beating heart and measuring the impedance of the endocardium at various locations within the beating heart. The values measured are compared to impedance values with a predetermined range of values (22) to identify an infarcted area of myocardium and distinguish such area from normal myocardium (20). The measurements are also compared to a range of values for an infarction border zone. The infarction border zone is a significant source of arrhythmia, and particularly of ventricular tachycardia. In accordance with the methods of the present invention, the risk of arrhythmia in a beating heart may be substantially reduced or eliminated by ablating endocardium within the infarction border zone utilizing the same catheter tip.

Claims

AMENDED CLAIMS
[received by the International Bureau on 19 July 1995 (19.07.95); original claims 1-9 amended; new claims 17-30 added; remaining claims unchanged (8 pages)] 1. A method of locating a source of arrythmia in a beating heart, comprising: inserting an impedance measuring electrode of a catheter into a chamber of a beating heart; measuring the impedance of the endocardium at various locations within the chamber of the beating heart using said electrode of said catheter; and determining a border zone between normal and infarcted endocardium based upon measured impedance, said border zone being said source. 2. A method in accordance with Claim 1, wherein insert¬ ing step includes inserting said measuring electrode of said catheter into the left ventricle of a beating heart.
3. A method in accordance with Claim 1, wherein insert¬ ing step includes inserting said measuring electrode of said catheter into the right ventricle of a beating heart.
4. A method of locating a source of arrythmia and reducing the risk of future arrythmia in a beating heart, comprising: inserting an electrode of a catheter into a chamber of a beating heart, said electrode being adapted for impedance measuring and ablation; measuring the impedance of the endocardium at various locations within the chamber of the beating heart
23 using said electrode of said catheter; determining a border zone between normal and infarcted endocardium based upon measured impedance; and using said electrode of said catheter to ablate endocardium in said border zone.
5. A method in accordance with Claim 4, wherein insert¬ ing step includes inserting said electrode of said catheter into the left ventricle of a beating heart.
6. A method in accordance with Claim 4, wherein insert- ing step includes inserting said electrode of said catheter into the right ventricle of a beating heart.
7. A method of locating a source of arrythmia and infarcted myocardial tissue in a beating heart, comprising: inserting an impedance measuring electrode of a catheter into a chamber of a beating heart; measuring the impedance of the endocardium at various locations within the chamber of the beating heart using said electrode of said catheter; and comparing measured impedance values with a predetermined range of values to identify an infarcted area of myocardium and distinguishing such area from normal myocardi¬ um.
8. A method in accordance with Claim 7, wherein insert¬ ing step includes inserting said measuring electrode of said catheter into the left ventricle of a beating heart.
9. A method in accordance with Claim 7, wherein insert¬ ing step includes inserting said impedance measuring electrode of said catheter into the right ventricle of a beating heart. 10. A method for assessing adequacy of electrode-tissue contact in a fluid filled organ, comprising the steps of: inserting an impedance measuring electrode mounted on a catheter into a desired portion of a fluid filled organ; and determining whether the electrode is in contact with organ tissue based on the impedance value.
11. A method in accordance with Claim 10, including the steps of measuring the impedance value when the electrode is in fluid to establish a base line impedance value and detect¬ ing the change in impedance when the electrode comes in con¬ tact with organ tissue.
12. A method in accordance with Claim 10, wherein said inserting step comprises inserting the impedance measuring electrode into a chamber of a beating heart.
13. A method in accordance with Claim 12, wherein said method includes the steps of measuring the impedance in a blood vessel outside of the heart and measuring the impedance at least one stable catheter placement site as determined by fluoroscopy to determine values enabling the determination of whether the electrode is in contact with endocardium based on the impedance value.
1 . A method for assessing the effectiveness of tissue ablation, comprising the steps of: measuring the impedance of tissue at or around the area of tissue to be ablated at body temperature; and measuring the impedance of the tissue in the area being ablated during or immediately after the application
25 of ablation energy in order to assess the degree of heating of the tissue.
15. A method in accordance with Claim 14, wherein said impedance measuring steps are carried out utilizing an elec- trode mounted on the tip of a catheter.
16. A method in accordance with Claim 15, wherein said method is utilized within a beating heart to determine the adequacy of endocardial tissue ablation in a beating heart .
17. A method in accordance with Claim 1 wherein said step of determining a border zone between normal and infarcted endocardium includes the step of determining three predeter¬ mined ranges of impedance values, a highest range of impedance value being normal endocardium, a lowest range of impedance values representing infarcted endocardium and a middle range of impedance values representing said border zone and the source of arrythmia.
18. A method in accordance with Claim 4 wherein said step of determining a border zone between normal and infarcted endocardium includes the step of determining three predeter- mined ranges of impedance values, a highest range of impedance values being normal endocardium, a lowest range of impedance values representing infarcted endocardium and a middle range of impedance values representing said border zone.
19. A method in accordance with Claim 7, including the step of establishing predetermined ranges of values to identi¬ fy an infarcted area and an infarct border area of myocardium.
20. A method in accordance with Claim 19 wherein said step of establishing predetermined ranges of values includes
26 the step of measuring the impedance of normal endocardium of a patient being treated and deriving from the normal endocardium impedance values ranges of impedance values for infarcted areas and infarct border areas. 21. A method in accordance with Claim 19 wherein said step of establishing predetermined ranges of values to identi¬ fy the infarcted area and the infarct border area include the step of performing impedance measurements of the endocardium in a plurality of beating hearts and recording ranges of the impedance values for future use.
22. A method of locating infarcted myocardial tissue in a beating heart, comprising: inserting an impedance measuring electrode of a catheter into a chamber of a beating heart; measuring impedance of endocardium at various locations within the chamber of the beating heart using said electrode of said catheter; and comparing measured impedance values with a predetermined range of values to identify an infarcted area of myocardium and distinguishing such area from normal myocardi¬ um.
23. A method of locating a border zone separating normal and infarcted myocardium, comprising: inserting an impedance measuring electrode of a catheter into a chamber of a beating heart; measuring impedance of endocardium at various locations within the chamber of the beating heart using said electrode of said catheter; and
27 comparing measured impedance values with a predetermined range of values to identify a border zone sepa¬ rating normal and infarcted myocardium and to distinguish such area from normal and infarcted myocardium. 2 . A method of diagnosing the condition of living tissue comprising part of a fluid filled organ, comprising the steps of : inserting an impedance measuring electrode of a catheter into a chamber of the fluid filled organ; measuring impedance of tissue of the fluid filled organ at various locations within the chamber of the organ; and determining a condition of tissue by comparing impedance values. 25. A method of diagnosing the condition of living tissue comprising part of a fluid filled organ, comprising the steps of: inserting an impedance measuring electrode of a catheter into a chamber of the fluid filled organ; measuring impedance of tissue of the fluid filled organ at various locations within the chamber of the organ; and diagnosing a condition of tissue by comparing measured impedance values with predetermined ranges of values to determine the condition of the tissue of the fluid filled organ at various locations.
26. A method in accordance with Claim 25 including the step of establishing said predetermined ranges of values by
28 measuring the impedance of normal tissue of the patient being treated and deriving from the normal tissue impedance values ranges of impedance values for abnormal tissue.
27. A method in accordance with Claim 25 including the step of establishing said predetermined ranges of values by measuring the tissue impedance of a plurality of like organs and recording the ranges of the impedance values for future use.
28. A method for assessing the effectiveness of tissue ablation, comprising the steps of: inserting into a beating heart a catheter having an electrode with a design which comes directly into contact with the endocardium in such a manner as to minimize contact of the measuring electrode with blood in the beating heart; measuring the impedance of endocardium at or around the area of endocardium to be ablated at body tempera¬ ture using said catheter electrode; measuring the impedance of endocardium in the area being ablated during or immediately after the application of ablation energy using said catheter electrode in order to assess the degree of heating of the endocardium.
29. A method for assessing the effectiveness of tissue ablation in accordance with claim 28 wherein said catheter electrode is placed in it entirety directly in contact with the endocardium during said impedance measuring steps.
30. A method for assessing the effectiveness of tissue ablation in accordance with claim 28 wherein said steps of
29 measuring the impedance are performed using a sharp tipped catheter electrode to achieve exclusive tissue contact by piercing the endocardium.
30
PCT/US1994/014378 1994-01-28 1994-12-12 Method of determining sites for arrhythmia ablation WO1995020361A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU14358/95A AU1435895A (en) 1994-01-28 1994-12-12 Method of determining sites for arrhythmia ablation

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/188,514 1994-01-28
US08/188,514 US5447529A (en) 1994-01-28 1994-01-28 Method of using endocardial impedance for determining electrode-tissue contact, appropriate sites for arrhythmia ablation and tissue heating during ablation

Publications (2)

Publication Number Publication Date
WO1995020361A1 WO1995020361A1 (en) 1995-08-03
WO1995020361B1 true WO1995020361B1 (en) 1995-08-17

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/014378 WO1995020361A1 (en) 1994-01-28 1994-12-12 Method of determining sites for arrhythmia ablation

Country Status (4)

Country Link
US (3) US5447529A (en)
AU (1) AU1435895A (en)
CA (1) CA2179058A1 (en)
WO (1) WO1995020361A1 (en)

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