Apparatus and method for guided ablation treatment

A - Human Necessities – 61 – B

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A61B 18/14 (2006.01) A61B 17/32 (2006.01) A61B 18/18 (2006.01) A61N 5/06 (2006.01)

Patent

CA 2586022

A method and apparatus for treating a body tissue in situ (e.g., an atrial tissue of a heart to treat) atrial fibrillation include a lesion formation tool is positioned against the heart surface. The lesion formation tool includes a guide member having a tissue-opposing surface for placement against a heart surface. An ablation member is coupled to the guide member to move in a longitudinal path relative to the guide member. The ablation member has an ablation element for directing ablation energy in an emitting direction away from the tissue-opposing surface. The guide member may be flexible to adjust a shape of the guide member for the longitudinal path to approximate the desired ablation path while maintaining the tissue-opposing surface against the heart surface. In one embodiment, the ablation member includes at least one radiation-emitting member disposed to travel in the longitudinal pathway. In another embodiment, the guide member has a plurality of longitudinally spaced apart tissue attachment locations with at least two being separately activated at the selection of an operator to be attached and unattached to an opposing tissue surface. Various means are described for the attachment including vacuum and mechanical attachment. The guide member may have a steering mechanism to remotely manipulate the shape of the guide member.

L'invention concerne un procédé et un appareil permettant de traiter la fibrillation auriculaire d'un tissu corporel in situ (par exemple un tissu atrial d'un coeur à traiter), qui consistent en un outil de formation de lésion placé contre la surface du coeur. Ledit outil de formation de lésion comporte un élément de guidage ayant une surface opposée au tissu à placer contre une surface d'un coeur. Un élément d'ablation est couplé à l'élément de guidage de façon à se déplacer longitudinalement par rapport à l'élément de guidage. L'élément d'ablation est équipé d'une unité d'ablation qui dirige l'énergie d'ablation dans une direction d'émission s'éloignant de la surface opposée au tissu. L'élément de guidage peut être souple pour adapter sa forme longitudinalement afin de s'approcher du chemin d'ablation recherché tout en maintenant la surface opposée au tissu contre la surface du coeur. Dans un mode de réalisation, l'élément d'ablation comporte au moins un élément émettant des rayonnements placé de manière à se déplacer longitudinalement. Dans un autre mode de réalisation, l'élément de guidage présente plusieurs emplacements de fixation tissulaire, deux au moins étant activés séparément selon la sélection d'un opérateur de façon à être fixés à une surface tissulaire opposée ou détachés de celle-ci. L'invention concerne divers moyens de fixation comprenant la fixation par aspiration et la fixation mécanique. L'élément de guidage peut être doté d'un mécanisme de direction qui permet de manipuler sa forme à distance.

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