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1. WO1997017892 - ENDOCARDIAL MAPPING AND/OR ABLATION CATHETER PROBE AND METHOD

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WHAT IS CLAIMFD IS

1. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities, a lumen extending along a longitudinal axis between the proximal and distal extremities, a plurality of longitudinally-extending spaced apart arms having proximal and distal extremities, means interconnecting the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member, means interconnecting the distal extremities of the arms, the arms movable between a contracted position and an expanded position in which they bow outwardly from the longitudinal axis, the arms subtending an angle of approximately 180° or less about the longitudinal axis when in the expanded position, a plurality of longitudinally spaced apart electrodes carried by each of the arms, electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes, a wire slidably carried within the lumen having proximal and distal end portions, the means interconnecting the distal extremities of the arms securing the distal end portion of the wire to the distal extremities of the arms, means carried by the proximal extremity of the flexible elongate tubular member for pulling the proximal end portion of the wire to cause the arms to move to the expanded position whereby the electrodes carried by the arms can be urged against a portion of the wall of the heart when the arms are in the expanded position to map said portion of the wall.

2. A probe as in Claim 1 wherein the arms constitute five in number.

3. A probe as in Claim 1 wherein at least ten electrodes are carried by each of the arms.

4. A probe as in Claim 1 wherein the arms each include a spring-like member extending thereamong which has a predetermined bowed shape.

5. A probe as in Claim 1 further comprising means carried by the proximal extremity of the flexible elongate tubular member for pushing the wire distally within the lumen to move the arms toward the contracted position, the wire having a column strength sufficient to prevent buckling of the wire when a compressive force is exerted thereon.

6. A probe as in Claim 1 further comprising means carried by the flexible elongate tubular member for bending the distal extremity of the flexible elongate tubular member to move the electrodes carried by the arms toward said portion of the wall.

7. A probe as in Claim 6 wherein the distal extremity of the flexible elongate tubular member includes a highly flexible portion for facilitating bending at the highly flexible portion.

8. A probe as in Claim 6 wherein the bending means includes a pull wire extending between the proximal and distal extremities of the flexible elongate tubular member.

9. A probe as in Claim 1 wherein the flexible elongate tubular member is provided with a tubular braided element for enhancing one-to-one rotational movement between the proximal and distal extremities of the flexible elongate tubular member.

10. A probe as in Claim 1 wherein the lumen extends to an opening adjacent the proximal extremities of the arms, a fitting carried by the proximal extremity of the flexible elongate tubular member in communication with the lumen for permitting a liquid to be introduced through the opening into the heart for inhibiting the formation of thrombus at the proximal extremities of the arms.

11. A probe as in Claim 1 wherein the arms subtend an angle of approximately 120° about the longitudinal axis.

12. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate member having proximal and distal extremities, a plurality of longitudinally-extending spaced-apart arms carried by the distal extremity of the flexible elongate member, means interconnecting the distal extremities of the arms, the arms movable between a contracted position and an expanded position in which they bow outwardly from the longitudinal axis, the arms being asymmetrically spaced about the longitudinal axis when in the expanded position to as to be spaced relatively closely together in a group, a plurality of longitudinally spaced-apart electrodes carried by each of the arms, electrical means extending through the flexible elongate member and connected to the electrodes for performing electrical functions with respect to the electrodes and means carried by the flexible elongate member for bending the distal extremity of the flexible elongate member so as to move the arms toward a portion of the wall whereby the electrodes carried by the arms engage said portion of the wall of the heart when the arms are in the expanded position to map said portion of the wall.

13. A probe as in Claim 12 wherein the flexible elongate member is provided with a lumen extending between the proximal and distal extremities, the bending means including a pull wire extending through the lumen and having a distal end portion, means for securing the distal end portion of the pull wire to the distal extremity of the flexible elongate member.

14. A probe as in Claim 12 further comprising a handle carried by the proximal extremity of the flexible elongate member, finger actuatable means carried by the handle for moving the pull wire longitudinally within the lumen.

15. A probe as in Claim 12 wherein the distal extremity of the flexible elongate member includes first and second sections, the second section being more flexible than the first section for facilitating bending at the second section.

16. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, a plurality of longitudinally-extending spaced-apart arms, means interconnecting the proximal extremities of the plurality of arms to the distal extremity of the flexible elongate tubular member, means interconnecting the distal extremities of the plurality of arms, the plurality of arms being movable between a contracted position and an expanded position and being spaced closely together in a group extending along the first side of the longitudinal axis when in the expanded position, a plurality of longitudinally spaced-apart electrodes carried by each of the plurality of arms for engaging the wall of the heart when the plurality of arms are in the expanded position and electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes, the flexible elongate tubular member having at least one lumen extending between the proximal and distal extremities, at least one additional arm slidably carried within the lumen and having a distal extremity, means for securing the distal extremity of the additional arm to the interconnected distal extremities ofthe plurality of arms, the additional arm being bowable outwardly from a second side of the longitudinal axis generally opposite the first side for engaging the wall of the heart whereby movement of the additional arm distally in the lumen causes the distal extremity of the additional arm to engage a portion of the wall of the heart and thus urge the electrodes carried by the plurality of arms against a second portion of the wall generally opposing the first-named portion of the wall .

17. A probe as in Claim 16 wherein at least two additional arms are slidably disposed in the flexible elongate tubular member and bow outwardly from the second side of the longitudinal axis for urging the electrodes against the second portion of the wall.

18. A probe as in Claim 16 wherein the distal extremity of the additional arm is forned with a spring-like member having a predetermined bowed shape.

19. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities, a lumen extending along a longitudinal axis between the proximal and distal extremities, a plurality of at least four longitudinally-extending spaced-apart arms, means interconnecting the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member, means interconnecting the distal extremities of the arms, the arms movable between a contracted position and an expanded position in which they bow outwardly from the longitudinal axis, the arms subtending an angle of approximately 120° or less about the longitudinal axis when in the expanded position, a plurality of longitudinally spaced-apart electrodes carried by each of the arms, electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes, a wire slidably carried within the lumen having proximal and distal end portions, the means interconnecting the distal extremities of the arms securing the distal end portion of the wire to the distal extremities of the arms, means carried by the proximal extremity of the flexible elongate tubular member for pulling the proximal end portion of the wire to cause the arms to move to the expanded position, the flexible elongate tubular member having a proximal section and a highly flexible section which is more flexible than the proximal section, means carried by the flexible elongate tubular member for bending the distal extremity of the flexible elongate tubular member at the highly flexible section to move the electrodes carried by the arms toward a portion of the wall whereby the electrodes carried by the arms can be urged against said portion of the wall of the heart when the arms are in the expanded position to map said portion of the wall.

20. A probe as in Claim 19 wherein a plurality of at least eight electrodes are carried by each of the arms .

21. In an apparatus for mapping the wall of a chamber of a heart having blood therein, a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending between the proximal and distal extremities, expandable means carried by the distal extremity of the flexible elongate tubular member and being movable between contracted and expanded positions, a plurality of spaced-apart electrodes carried by the expandable means for engaging the wall of the heart and arranged in a pattern, the expandable means having spaces between electrodes when the expandable means is in the expanded position and a plurality of radiopaque markers carried by the expandable means and arranged in the pattern whereby the plurality of radiopaque markers arranged in the pattern facilitate location of the plurality of electrodes within the heart.

22. The apparatus of Claim 21 wherein the expandable means includes a plurality of longitudinally extending arms having interconnected distal extremities, the plurality of electrodes carried by the arms in longitudinally spaced-apart positions.

23. The apparatus of Claim 22 wherein the arms are circumferentially spaced-apart to form a basket-like assembly.

24. The apparatus of Claim 21 wherein the electrodes each have an outer surface formed from platinum black for reducing the impedance of the electrodes.

25. A method for mapping an apex of chamber of a heart formed by a wall with a catheter probe having a flexible elongate tubular member extending along a longitudinal axis and having proximal and distal extremities, a plurality of longitudinally-extending spaced-apart arms having proximal extremities and interconnected distal extremities carried by the distal extremity of the flexible elongate tubular member and movable between a contracted position and an expanded position in which the arms bow outwardly from the longitudinal axis, a plurality of longitudinally spaced-apart electrodes mounted on each of the arms, comprising the steps of introducing the arms into the chamber, extending the arms across the apex of the chamber and moving the interconnected distal extremities of the arms distally to facilitate engagement of the electrodes mounted on the arms with the apex of the chamber whereby the electrodes sense electrical signals from wall to permit mapping about the apex.

26. A method as in Claim 25 wherein the catheter probe includes a wire slidably carried by the flexible elongate tubular member, the wire having a distal end portion joined to the interconnected distal extremities of the arms, wherein the moving step includes pushing the interconnected distal extremities of the arms with the wire.

27. A method as in Claim 25 wherein the arms subtend an angle of approximately 180° or less about the longitudinal axis when in the expanded position.

28. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities, expandable means capable of moving from a contracted position to an expanded position secured to the distal extremity of the flexible elongate tubular member and formed from at least two elongate members movable between contracted and expanded positions, the elongate members having extremities which are joined so that the elongate members extend at an angle relative to each other to form a vee therebetween, a plurality of longitudinally and radially spaced-apart electrodes carried by the expandable means so that they can be moved into engagement with the wall of the heart when the expandable means is expanded into the expanded position, electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes and an elastomeric material adhered to the joined extremities of the elongate members and disposed within the vee for inhibiting the formation of thrombus on the elongate members while the expandable means is disposed within the blood of the heart.

29. A probe as in Claim 28 wherein the elastomeric material forms a web in the vee.

30. A probe as in Claim 29 wherein the elastomeric material consists of polyurethane.

31. A probe as in Claim 28 wherein the elongate members consist of arms and wherein the extremities consist of the distal extremities of the arms.

32. A probe as in Claim 31 wherein the arms extend at an acute angle relative to each other.

33. A probe as in Claim 28 wherein the expandable means consists of a basket assembly having a plurality of longitudinally-extending radially spaced-apart elongate arms having joined proximal and distal extremities, the joined distal extremities of an adjacent pair of arms forming the vee.

34. A probe as in Claim 33 wherein the elongate arms include a group of arms which are spaced relatively closely together and at least one support arm aligned generally opposite the group of arms, the plurality of electrodes being carried in longitudinally spaced-apart positions on the group of arms and the at least one support arm serving to urge the group of arms against the wall of heart so as to permit high density mapping of the wall of the heart from electrical signals sensed from the wall by the electrodes.

35. A probe as in Claim 28 together with an antithrombogenic agent carried by the expandable means for inhibiting the formation of thrombus on the expandable means while the expandable means is disposed within the blood of the heart.

36. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending therethrough, a basket assembly movable between contracted and expanded positions, the basket assembly having a plurality of longitudinally-extending circumferentially spaced-apart arms with proximal and distal extremities, means for joining the proximal extremities of the arms to the distal extremity of the flexible elongate tubular member means for joining together the distal extremities of the arms, a plurality of longitudinally spaced-apart electrodes carried by each arm for engaging the wall of the heart when the basket assembly is expanded into the expanded position electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes and an elastomeric material disposed between the joined distal extremities of the arms for eliminating acute angles and inhibiting the formation of thrombus on the basket assembly while the basket assembly is disposed within the blood of the heart.

37. A catheter probe as in Claim 36 further comprising additional elastomeric material disposed between the proximal extremities of adjacent arms for eliminating acute angles therebetween.

38. A probe as in Claim 37 together with an antithrombogenic agent carried by the basket assembly .

39. A probe as in Claim 36 wherein the elastomeric material includes a web extending between the joined distal extremities of each adjacent pair of arms .

40. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, a basket assembly carried by the distal extremity of the flexible elongate tubular member and having first and second generally opposite sides relative to the longitudinal axis, the basket assembly movable between contracted and expanded positions and having a plurality of longitudinally extending spaced apart arms with proximal and distal extremities, the plurality of arms being spaced closely together in a group extending along the first side of the basket assembly, the basket assembly having at least one additional arm extending along the second side of the basket assembly, means for joining together the distal extremities of the arms, a plurality of longitudinally spaced-apart electrodes carried by each of the plurality of arms for engaging the wall of the heart when the basket assembly is expanded into the expanded position and electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes whereby the at least one additional arm urges the electrodes carried by the plurality of arms against the wall of the heart when the basket assembly is expanded into the expanded position.

41. A probe as in Claim 40 wherein the plurality of arms range between three and six in number.

42. A probe as in Claim 40 wherein the plurality of arms subtend an angle of less than 180° about the longitudinal axis.

43. A probe as in Claim 42 wherein the plurality of arms subtend an angle of approximately 90° about the longitudinal axis .

44. A probe as in Claim 40 wherein the basket assembly has a longitudinal dimension which approximates the longitudinal dimension of the chamber of the heart.

45. A probe as in Claim 40 wherein the electrodes create a pattern of closely-spaced electrodes for permitting high density mapping of a region of the wall.

46. A probe as in Claim 45 wherein the basket assembly has a longitudinal dimension significantly less than the longitudinal dimension of the chamber of the heart so as to permit the closely-spaced electrodes to be moved longitudinally within the chamber to another region of the wall.

47. A probe as in Claim 40 together with an elastomeric material disposed between the joined distal extremities of the plurality of arms for inhibiting the formation of thrombus on the basket assembly while the basket assembly is disposed within the blood of the heart.

48. A probe as in Claim 40 wherein the electrodes on adjacent arms are longitudinally offset relative to each other.

49. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber, a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, a plurality of longitudinally-extending spaced-apart arms with interconnected proximal extremities and interconnected distal extremities carried by the distal extremity of the flexible elongate tubular member, the arms movable between a contracted position and an expanded position in which they bow outwardly from the longitudinal axis, the arms subtending an angle of approximately 180° or less about the longitudinal axis when m the expanded position, a plurality of longitudinally spaced apart electrodes carried by each of the arms for engaging the wall of the heart when the arms are moved into the expanded position and electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes whereby the electrodes carried by the arms can be urged against a portion of the wall of the heart when the arms are in the expanded position for performing high density mapping of said portion of the wall.

50. A probe as in Claim 49 wherein the arms subtend an angle of approximately 90° or less about the longitudinal axis when in the expanded position.

51. A probe as in Claim 50 wherein the arms range between three and six in number.

52. A probe as in Claim 49 together with an elongate member having a proximal extremity carried by the distal extremity of the flexible elongate tubular member and a distal extremity, means for securing the distal extremity of the elongate member to the distal extremities of the arms.

53. A probe as in Claim 52 wherein the elongate member consists of an additional arm which is disposed generally opposite the arms and is movable between a contracted position and an expanded position in which the additional arm bows outwardly from the longitudinal axis.

54. A probe as in Claim 49 wherein the arms each include a spring-like member extending therealong which has a predetermined shape corresponding substantially to the expanded position of the arm.

55. In a catheter probe for introduction into a chamber of the heart having blood therein and formed by a wall through a lumen leading to the chamber a flexible elongate tubular member having proximal and distal extremities and extending along a longitudinal axis, a plurality of longitudinally-extending spaced-apart arms carried by the distal extremity of the flexible elongate tubular member, the arms movable between a contracted position and an expanded position in which they bow outwardly from the longitudinal axis, each of the arms including a spring-like strip extending therealong which has a predetermined shape corresponding generally to the expanded position of the arm, the arms subtending an angle of approximately 180° or less about the longitudinal axis when in the expanded position a plurality of longitudinally spaced-apart electrodes carried by each of the arms for engaging the wall of the heart when the arms are moved into the expanded position and electrical means extending through the elongate tubular member and connected to the electrodes for performing electrical functions with respect to the electrodes whereby the electrodes carried by the arms can be urged against a portion of the wall of the heart when the arms are m the expanded position for performing high density mapping of said portion of the wall.

56. A probe as in Claim 55 wherein the strip is made from a shape memory alloy.

57. In an apparatus for mapping a wall of a chamber of the heart, a flexible elongate member having proximal and distal extremities, expandable means carried by the distal extremity of the flexible elongate member for moving between contracted and expanded positions, the expandable means having a plurality of elongate flexible spaced-apart arms with distal extremities and means for joining together the distal extremities of the arms, a plurality of spaced-apart electrodes carried by the expandable means for engaging the wall of the heart when the expandable means is moved to its expanded position, the means for joining together the distal extremities of the arms including a rounded distal tip formed from a soft material for inhibiting the formation of trauma in the wall of the heart upon engagement of the tip with said wall.

58. An apparatus as in Claim 57 wherein the soft material is an elastomeric material.

59. An apparatus as in Claim 57 wherein the soft material is silicone.

60. An apparatus as in Claim 57 wherein the expandable means is a basket assembly having a plurality of spaced-apart arms, a plurality of longitudinally spaced-apart electrodes carried by each of the arms for mapping the wall of the heart.

61. An apparatus as in Claim 60 wherein the plurality of arms are circumferentially spaced apart.

62. An apparatus as in Claim 60 wherein the plurality of arms are relatively closed spaced apart for permitting high density mapping of a portion of the wall of the heart.