Systems and Methods for Transmural Ablation

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments. 1. A method of applying ablation energy to a tissue site , the method comprising:applying ablation energy at a first power level to the tissue site;monitoring impedance of the tissue site;identifying a rising impedance;determining a rate of increase of the identified rising impedance; andperforming a first control operation of reducing the ablation energy applied to the tissue site from the first power level to a second power level only if the determined rate of increase exceeds a preset minimum.2. The method of claim 1 , wherein the second power level is non-zero.3. The method of claim 1 , wherein the step of performing a first control operation of reducing the ablation energy further includes reducing the ablation energy applied to the tissue site only if the first power level exceeds a preset value.4. The method of claim 1 , wherein after the step determining a rate of increase of the identified rising impedance claim 1 , the method further comprising:performing a second control operation of increasing the ablation energy applied to the tissue site from the first power level to a third power level.5. The method of claim 1 , further comprising:performing a second control operation of terminating application of ablation energy to the tissue site in response to a detected parameter exceeding a corresponding preset maximum value.6. The method of claim 5 , wherein the preset maximum value is selected from the group consisting of a maximum impedance claim 5 , a maximum total delivered energy and a maximum total ablation time.7. The method of claim 1 , wherein the first power level is an initial power level.8. The method of claim 1 , wherein prior to the step ...

Systems and methods for cardiac tissue electroporation ablation

Cardiac electroporation ablation systems and methods in which pulsed, high voltage energy is delivered to induce electroporation of cells of cardiac tissue followed by cell rupturing. In some embodiments, the delivered energy is biphasic, having a cycle time of not more than 500 microseconds.

METHODS AND DEVICES FOR CONTROLLING ENERGY DURING ABLATION

System and method for ablating tissue of a heart of a patient. The tissue is characterized, then a predetermined ablation procedure is selected based on the characterization, ablation energy is delivered according to procedure with the ablation device, and a temperature of the tissue and an impedance of the tissue are determined. Delivery of ablation energy is ceased at a time based, at least in part, on when at least one of an accumulated effective temperature of the tissue over time exceeds a thermal dose threshold and an accumulated effective energy of the tissue over time exceeds an effective energy threshold. Else, the ablation energy delivered is modified by adjusting the energy level based, at least in part, on at least one of the temperature being outside of a predetermined temperature range and the impedance being outside of an impedance range.

Transmural ablation systems and methods

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. The power applied to the tissue site can be increased in response to detection of a power plateau or application of a first power for a minimum time according to some embodiments. A power applied to the tissue site can be reduced in response to an increase in impedance according to some embodiments. Transmurality can be indicated in response to a transmurality plateau following a rise in impedance according to some embodiments.

Tissue Lesion Evaluation

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.

Tissue lesion evaluation

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.

Systems and methods for transmural ablation

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.

SYSTEMS AND METHODS FOR CARDIAC TISSUE ELECTROPORATION ABLATION

Cardiac electroporation ablation systems and methods in which pulsed, high voltage energy is delivered to induce electroporation of cells of cardiac tissue followed by cell rupturing. In some embodiments, the delivered energy is biphasic, having a cycle time of not more than 500 microseconds.

Systems and Methods for Transmural Ablation

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments. 118.-. (canceled)19. A method of applying ablation energy to achieve transmurality at a tissue site , the method comprising:applying ablation energy at a first power to the tissue site;monitoring impedance of the tissue site;reducing the ablation energy applied to the tissue site to a second power in response to a rise in impedance; andmonitoring total ablation energy delivered, and indicating transmurality if the total ablation energy delivered exceeds a preset minimum following the rise in impedance.20. The method of claim 19 , further comprising applying ablation energy at a first power for a start-up blanking period.21. The method of claim 20 , wherein the start-up blanking period is a programmable setting.22. The method of claim 19 , further comprising increasing the ablation energy applied to the tissue site to a third power only if the minimum time at the second power has been met.23. The method of claim 22 , further comprising increasing the ablation energy applied to the tissue site to a third power only if a minimum time at the second power has been met. This application is a continuation of U.S. Ser. No. 11/780,911, filed Jul. 20, 2007, that claims priority to U.S. Provisional Ser. No. 60/832,242 filed Jul. 20, 2006, and U.S. Provisional Ser. No. 60/923,365 filed Apr. 13, 2007, and which is continuation-in-part of U.S. Ser. No. 10/923,178, filed Aug. 20, 2004, now U.S. Pat. No. 7,250,048, which is a continuation-in-part of U.S. Ser. No. 10/364,553, filed Feb. 11, 2003, now U.S. Pat. No. 6,989,010, which is a continuation-in-part application of U.S. Ser. No. 10/132,379, filed Apr. 24, 2002, now U.S. Pat. No. 6,648,883, which claims priority to U. ...

Systems and methods for transmural ablation

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.

TRANSMURAL ABLATION SYSTEMS AND METHODS

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. The power applied to the tissue site can be increased in response to detection of a power plateau or application of a first power for a minimum time according to some embodiments. A power applied to the tissue site can be reduced in response to an increase in impedance according to some embodiments. Transmurality can be indicated in response to a transmurality plateau following a rise in impedance according to some embodiments.

SYSTEMS AND METHODS FOR TRANSMURAL ABLATION

A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.

Transmural ablation systems

Tissue lesion evaluation

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.

Tissue lesion evaluation

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.