U.S. patent application number 11/975822 was filed with the patent office on 2008-07-24 for non-contact tissue ablation device and methods thereof.
This patent application is currently assigned to Irvine Biomedical Inc. Invention is credited to Peter C. Chen, Cary K. Hata, Tho Hoang Nguyen, Alan de la Rama, Vivian Tran.
Application Number | 20080177205 11/975822 |
Document ID | / |
Family ID | 34936340 |
Filed Date | 2008-07-24 |
United States Patent
Application |
20080177205 |
Kind Code |
A1 |
Rama; Alan de la ; et
al. |
July 24, 2008 |
Non-contact tissue ablation device and methods thereof
Abstract
A catheter for ablating body tissue of the interior regions of
the heart includes a handle assembly, a shaft, and a distal tip
section coupled to the distal end of the shaft. The distal tip
section has a non-compliant and non-porous cap that has a tubular
wall that defines a bore, and an ablation element that is housed
inside the bore and spaced apart from the wall of the cap.
Inventors: |
Rama; Alan de la; (Cerritos,
CA) ; Nguyen; Tho Hoang; (Huntington Beach, CA)
; Tran; Vivian; (Santa Ana, CA) ; Hata; Cary
K.; (Tustin, CA) ; Chen; Peter C.; (Irvine,
CA) |
Correspondence
Address: |
Raymond Sun;Law Offices of Raymond Sun
12420 Woodhall Way
Tustin
CA
92782
US
|
Assignee: |
Irvine Biomedical Inc
|
Family ID: |
34936340 |
Appl. No.: |
11/975822 |
Filed: |
October 22, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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10845798 |
May 15, 2004 |
7285116 |
|
|
11975822 |
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Current U.S.
Class: |
601/3 |
Current CPC
Class: |
A61N 7/022 20130101;
A61B 2017/00247 20130101; A61B 2018/00392 20130101; A61B 5/01
20130101; A61B 2017/00243 20130101; A61B 17/2202 20130101; A61B
5/24 20210101; A61B 2017/320084 20130101; A61B 5/0245 20130101 |
Class at
Publication: |
601/3 |
International
Class: |
A61N 7/02 20060101
A61N007/02 |
Claims
1. A catheter for ablating body tissue of the interior regions of
the heart, comprising: a handle assembly; a shaft having a main
lumen, a proximal end coupled to the handle assembly, and a distal
end; and a distal tip section coupled to the distal end of the
shaft, the distal tip section having: a non-compliant and
non-porous cap that has a tubular wall that defines a bore; and an
ablation element that is housed inside the bore and spaced apart
from the wall of the cap.
2. The catheter of claim 1, wherein the ablation element is a
transducer.
3. The catheter of claim 1, further including irrigation fluid in
the bore between the tubular wall and the ablation element.
4. The catheter of claim 1, wherein the cap has a closed distal tip
that has an opening provided thereat.
5. The catheter of claim 1, further including an irrigation tube
extending through the lumen and having a distal end that terminates
in the bore.
6. The catheter of claim 1, further including a plurality of ring
electrodes provided in spaced-apart manner about the outer surface
of the shaft adjacent the distal tip section.
7. The catheter of claim 1, further including an inner sleeve
secured in the main lumen at the distal end of the shaft.
8. The catheter of claim 1, further including an inner supporting
member that extends through the main lumen of the shaft and the
bore of the cap.
9. The catheter of claim 8, wherein the inner supporting member is
provided in the form of a coil, a flat wire, or a rod composed of
metal, alloy or a polymer.
10. The catheter of claim 8, further including an outer supporting
member that extends through the inner sleeve and into the bore,
with the inner supporting member housed in the outer supporting
member.
11. The catheter of claim 1, further including a plurality of
thermocouple wires that are connected to the cap.
12. The catheter of claim 1, further including a steering mechanism
that extends in the main lumen of the shaft and which terminates at
the distal end of the shaft before the location of the distal tip
section.
13. A method of ablating tissue at a selected treatment site,
comprising: a. providing a catheter comprising: a shaft having a
distal end; and a distal tip section coupled to the distal end of
the shaft, the distal tip section having a non-compliant and
non-porous cap that has a tubular wall that defines a bore, and an
ablation element that is housed inside the bore and spaced apart
from the wall of the cap; b. positioning the distal tip section of
the catheter at a desired treatment site; c. flowing irrigation
fluid to the bore between the ablation element and the cap; d.
delivering ultrasound energy to the ablation element; and e.
radiating acoustic energy in a radial manner from the ablation
element, and through the irrigation fluid and the cap towards the
tissue at the treatment site.
14. The method of claim 13, wherein step (c) further includes:
varying the flow rate of the irrigation fluid.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] The present invention is directed to systems and methods for
mapping and ablating body tissue of the interior regions of the
heart. More particularly, this invention relates to catheters and
methods for ablating cardiac tissues using a deflectable catheter
having an irrigated ablation element for the treatment of cardiac
arrhythmia, for example atrial fibrillation and ventricular
tachycardia.
[0003] 2. Description of the Prior Art
[0004] Abnormal heart rhythms are generally referred to as cardiac
arrhythmias, with an abnormally rapid rhythm being referred to as a
tachycardia. The present invention is concerned with the treatment
of tachycardias which are frequently caused by the presence of an
"arrhythmogenic site" or "accessory atrioventricular pathway" close
to the endocardial surface of the chambers of the heart. The heart
includes a number of normal pathways which are responsible for the
propagation of electrical signals from the upper to the lower
chambers necessary for performing normal systole and diastole
function. The presence of an arrhythmogenic site or an accessory
pathway can bypass or short circuit the normal pathway, potentially
resulting in very rapid heart contractions or tachycardias.
[0005] Treatment of tachycardias may be accomplished by a variety
of approaches, including medications, implantable
pacemakers/defibrillators, surgery and catheter ablation. While
drugs may be the treatment of choice for many patients, they only
mask the symptoms and do not cure the underlying causes.
Implantable devices only correct the arrhythmia after it occurs.
Surgical and catheter-based treatments, in contrast, will actually
cure the problem, usually by blocking or ablating the abnormal
arrhythmogenic tissue or accessory pathway responsible for the
tachycardia.
[0006] Of particular interest to the present invention is
radiofrequency (RF) ablation technique which has been proven to be
highly effective in tachycardia treatment while exposing a patient
to minimal side effects and risks. RF catheter ablation is
generally performed after conducting an initial mapping study where
the locations of the arrhythmogenic site and/or accessory pathway
are determined by diagnostic electrophysiology catheters which are
connected to commercially available EP monitoring systems. After a
mapping study, an ablation catheter is usually introduced to the
target region inside the heart and is manipulated so that the
ablation tip electrode lies exactly at the target tissue site. RF
energy or other suitable energy is then applied through the tip
electrode to the cardiac tissue in order to ablate the tissue of
the arrhythmogenic site or the accessory pathway. By successfully
destroying that tissue, the abnormal signal patterns responsible
for the tachycardia may be eliminated.
[0007] Atrial fibrillation (AF) is one type of cardiac arrhythmia
believed to be the result of the simultaneous occurrence of
multiple wavelets of functional re-entry of electrical impulses
within the atria, resulting in a condition in which the
transmission of electrical activity becomes so disorganized that
the atria contracts irregularly. AF is a common arrhythmia
associated with significant morbidity and mortality. A number of
clinical conditions may arise from irregular cardiac functions and
the resulting hemodynamic abnormalities associated with AF,
including stroke, heart failure and other thromboembolic events. AF
is a significant cause of cerebral stroke, wherein the fibrillating
motion in the left atrium induces the formation of thrombus. A
thromboembolism is subsequently dislodged into the left ventricle
and enters the cerebral circulation where stroke may occur.
[0008] For many years, the only curative treatment for AF has been
surgical, with extensive atrial incisions used to compartmentalize
the atrial mass below that critical for perpetuating AF. The
surgical "maze" procedure, as it is commonly known, includes, in
the left atrium creating vertical incisions from the superior
pulmonary veins, to the inferior pulmonary veins and ending in the
mitral valve annulus, with an additional horizontal incision
linking the upper ends of the vertical lines. It is believed that
ectopic beats originating within or at the ostium of the pulmonary
veins (PV) may be the source of paroxysmal and even persistent AF.
As a result, a series of multiple point RF ablations to create
linear patterns in the left atrium has been used to replicate
surgical procedures in patients with paroxysmal or chronic AF.
Although successful, there are instances in which this technique
may leave gaps between lesions giving opportunities for reentrant
circuits to reappear. Another challenge with using this approach is
the high incidence of pulmonary vein (PV) stenosis.
[0009] Different energy sources have been utilized for electrically
isolating the pulmonary veins from the atrium. These include RF,
laser, microwave, cryoablation, light, and ultrasound energy. Each
energy source has its advantages and disadvantages and PV isolation
has been achieved to different degrees of success. Moreover several
researchers have recently suggested that catheter ablation using
ultrasound energy may reduce the incidence of PV stenosis.
[0010] Ventricular tachycardia (VT) is another abnormal heart
rhythm that can be treated by catheter-based mapping and ablation
systems. VT is an arrhythmia that results from electrical impulses
arising from the ventricles instead of the heart's natural
pacemaker known as the sinoatrial (SA) node. Due to the fact that
electrical impulses are not conducting from the SA node to the
ventricles, the ventricles contract abnormally very rapidly. As a
result, the four chambers of the heart are less able to fill
completely with blood between beats, and hence less blood is pumped
to the remaining circulatory pathways in the body. Over time, VT
can lead to heart failure or degenerate into ventricular
fibrillation, which can result in myocardial infarction. The most
common treatment for VT is antiarrhythmic medication, however if
drugs are not effective, cardioversion may be recommended. Patients
who still suffer from episodes of VT may require an implantable
cardioverter defibrillator. Although RF catheter ablation as a
treatment for VT has been performed, success has been limited
particularly to those VT's due to ischemic heart disease. This may
be due to the difficulty in achieving sufficient tissue penetration
of RF energy to ablate arrhythmia circuit lying beneath the
endocardial scar tissue. In addition, the ventricles are naturally
much thicker than atrial tissues and creating transmural lesions is
more challenging when utilizing conventional RF ablation
techniques.
[0011] Irrigated tip RF ablation catheters have recently been
introduced to create deeper and larger lesions and have achieved
the transmurality of the cardiac wall, however further improvements
in performance is desirable. This may be due to the irregular
endocardial surface of the ventricular trabeculum that may present
a technical challenge for ablating electrodes of RF ablation
catheters to make adequate tissue contact.
[0012] Cardiac ablation with ultrasound energy however, does not
require good contact with the underlying tissue. Ultrasound energy
propagates as a mechanical wave within the surrounding medium, and
in the tissue the vibrating motion is converted into heat.
Therefore the tissue does not need to be in intimate contact with
the ultrasound transducer unlike in the case of RF ablating
electrodes. At a designated zone within the tissue, the tissue at
the target area can be heated to a sufficiently high temperature
for ablation, while tissue surrounding the target area is subject
to a lower intensity ultrasound energy and not damaged.
[0013] In order to produce thermal effect in the tissue, the
ultrasound emitting member has a transducer. The piezoelectric
nature of ultrasound transducers creates limitations for these
materials. One major limitation is when the temperature of the
transducer is elevated, the performance decreases steadily until no
acoustic waves can be observed. One way to keep the operating
temperature of this material cool is to irrigate the transducer. A
cooling medium such as water is introduced or pumped through the
catheter in order to dissipate heat in the housing and effect
cooling of the transducer, including cooling of the external tissue
surface to avoid unwanted tissue damage. Schaer et al in U.S. Pat.
No. 6,522,930 describes a tissue ablation device in which the
ablation element is covered by a tubular porous membrane that
allows pressurized fluid to pass therethrough for ablatively
coupling the ablation element to a tissue site. McLaughlin et al in
U.S. Pat. No. 5,997,532 also describes an ablation catheter having
a porous, non-conductive buffer layer over the tip electrode. In
both the Schaer et al. and McLaughlin et al. catheters, the amount
of irrigation fluid permeating out from the porous membrane or
porous tip electrode to cool the tissue-ablation element interface
may not be consistent due to its contact with the underlying tissue
and therefore may produce a larger or smaller intended ablation
area. This phenomenon can be more pronounced in irregular
endocardial surfaces such as the ventricular trabeculae.
[0014] Thus, there still remains a need for a catheter-based system
and method that provides improved ablation performance at the
treatment location, especially in irregular endocardial
surfaces.
SUMMARY OF THE DISCLOSURE
[0015] It is an objective of the present invention to provide a
system and method that accurately positions a catheter at the
desired treatment location.
[0016] It is another objective of the present invention to provide
a system and method that provides improved ablation performance at
the treatment location, especially in irregular endocardial
surfaces.
[0017] In order to accomplish the objects of the present invention,
there is provided a catheter for ablating body tissue of the
interior regions of the heart. The catheter includes a handle
assembly, a shaft, and a distal tip section coupled to the distal
end of the shaft. The distal tip section has a non-compliant and
non-porous cap that has a tubular wall that defines a bore, and an
ablation element that is housed inside the bore and spaced apart
from the wall of the cap.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 illustrates a mapping and ablation system according
to one embodiment of the present invention.
[0019] FIG. 2 is a side plan view of the catheter of the system of
FIG. 1.
[0020] FIG. 3 is an enlarged cross-sectional view of the distal tip
section of the catheter of FIGS. 1 and 2.
[0021] FIG. 4 is an enlarged side plan view of the distal tip
section of the catheter of FIGS. 1 and 2.
[0022] FIG. 5 is a cross-sectional view of the distal tip section
of FIG. 4 taken along lines A-A thereof.
[0023] FIG. 6 is a cross-sectional view of the distal tip section
of FIG. 3 taken along lines B-B thereof.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0024] The following detailed description is of the best presently
contemplated modes of carrying out the invention. This description
is not to be taken in a limiting sense, but is made merely for the
purpose of illustrating general principles of embodiments of the
invention. The scope of the invention is best defined by the
appended claims. --In certain instances, detailed descriptions of
well-known devices, compositions, components, mechanisms and
methods are omitted so as to not obscure the description of the
present invention with unnecessary detail.
[0025] The present invention provides a catheter for ablating body
tissue of the interior regions of the heart. The catheter includes
a handle assembly, a shaft, and a distal tip section coupled to the
distal end of the shaft. The distal tip section has a non-compliant
and non-porous cap that has a tubular wall that defines a bore, and
an ablation element that is housed inside the bore and spaced apart
from the wall of the cap.
[0026] Even though the present invention will be described
hereinafter in connection with treating AF or VT, it is understood
that the principles of the present invention are not so limited,
but can be used in other applications (e.g., treatment of accessory
pathways, atrial flutter), and in other body pathways (e.g., right
atrium, left atrium, superior vena cava, right ventricle, left
ventricle, pulmonary veins).
[0027] FIGS. 1-6 illustrate a catheter system 20 according to one
embodiment of the present invention. The catheter system 20 has a
tubular shaft 22 having a distal end 26, a proximal end 28, and a
main lumen 30 extending through the shaft 22. A distal tip section
24 is secured to the distal end 26 of the shaft 22. A handle
assembly 32 is attached to the proximal end 28 of the shaft 22
using techniques that are well-known in the catheter art.
[0028] The distal tip section 24 has an ablation element 60 that is
housed inside a non-compliant and non-porous tubular cap 62. The
ablation element 60 is spaced from, and does not contact, the walls
of the cap 62. The cap 62 has a bore 64 extending therethrough. The
distal end 26 of the shaft 22 is slide-fitted into the bore 64 at
the proximal end 66 of the cap 62, and secured to the cap 62 by
adhesive bonding. An inner sleeve 68 is secured by adhesive bonding
in the main lumen 30 at the distal end 26 of the shaft 22. The
inner sleeve 68 is made of a plastic material such as PEEK and has
multiple channels 67 (see FIG. 6) separating the wires, an inner
supporting member 102, and a fluid lumen so they do not interfere
with each other inside the cap 62 when the catheter is subjected to
mechanical forces during use, including deflection of the distal
tip, torque, and advancement and withdrawal from the patient. The
cap 62 can be made from a non-compliant material such as
polyethylene, polyurethane, polyolefins, polymethylpentene, and the
like, that is capable of allowing ultrasound energy to be
transmitted therethrough. The cap 62 extends from its proximal end
66 and terminates at a closed distal tip 92 that has an opening 94
provided thereat.
[0029] The ablation element 60 can be embodied in the form of a
transducer or an electrode that includes a piezoelectric crystal
which converts electrical energy into ultrasound energy. The
transducer 60 is tubular, and O-rings 108 are positioned between
the transducer 60 and a tubular outer supporting member 104 to
create an air space between the supporting member 104 and the
transducer 60 to minimize transmission of ultrasound waves inside
the transducer 60. A silicone adhesive 110 seals the ends of the
transducer 60. Irrigation fluid fills the space between the
transducer 60 and the cap 62, so that the ultrasound energy can be
transmitted through the fluid and the cap 62 into the body tissue.
The fluid acts to cool the transducer 60, and functions as a medium
to transmit the ultrasound energy. Since the transducer 60 has a
diameter that is smaller than the inner diameter of the cap 62, the
transducer 60 does not contact the body tissue.
[0030] An irrigation tube 100 extends through the main lumen 30 of
the shaft 22, and has a distal end that terminates inside the
proximal end 66 of the cap 62, at a location proximal to the
transducer 60. Irrigation fluid is introduced from a pump 120 via a
standard infusion tube 35 and a luer fitting 34 through the
irrigation tube 100 to be delivered inside the bore 64 of the cap
62 for cooling the transducer 60.
[0031] The inner supporting member 102 extends through the main
lumen 30 of the shaft 22 and the bore 64 of the cap 62, terminating
adjacent the opening 94 in the distal tip 92. The inner supporting
member 102 functions to provide support to the catheter shaft 22
and the distal tip section 24, and is received inside the outer
supporting member 104 that extends through the inner sleeve 68 and
into the bore 64. The inner supporting member 102 can be provided
in the form of a coil, a flat wire, or a rod composed of metal,
alloy or a polymer.
[0032] A plurality of thermocouple wires 54 can have their distal
tips secured to the inner surface of the cap 62, and are used to
detect the temperature at the ablation site.
[0033] A plurality of ring electrodes 58 are provided in
spaced-apart manner about the outer surface of the shaft 22
adjacent the distal tip section 24. The ring electrodes 58 can be
made of a solid, electrically conducting material, like
platinum-iridium, stainless steel, or gold, that is attached about
the shaft 22. Alternatively, the ring electrodes 58 can be formed
by coating the exterior surface of the shaft 22 with an
electrically conducting material, such as platinum-iridium or gold.
The coating can be applied by sputtering, ion beam deposition or
similar known techniques. The number of ring electrodes 58 can vary
depending on the particular geometry of the region of use and the
functionality desired.
[0034] As will be explained in greater detail below, the ring
electrodes 58 function to map the region of the heart that is to be
treated. After the mapping has been completed, the transducer 60 is
positioned at the location where ablation is to be performed, and
the irrigation fluid through the lumen tube 100 is increased to the
desired flow rate set on the pump 120. The flow of the irrigation
fluid is software-controlled and its instructions are transmitted
from the generator 52 to the pump 120 through the cable 45. The
ablation is then carried out by energy that is emitted from the
transducer 60 through the irrigation media (e.g., fluid, saline,
contrast media or mixture) inside the cap 62.
[0035] A standard luer fitting 34 is connected to the proximal end
of the tubing 38 extending out from the proximal end 36 of the
handle assembly 32 using techniques that are well-known in the
catheter art. The luer fitting 34 provides a fluid line for
irrigation media to be introduced to cool the transducer 60 at the
distal tip section 24 of the shaft 22. The irrigation media is
delivered via the infusion tube 35 and into the irrigation tube 100
that extends from the luer fitting 34, and terminates in the bore
64 of the cap 62. The irrigation media exits from the holes 98
located distally of the transducer 60 at the distal end of the cap
62. In another embodiment, the cap 62 is completely closed without
the distally located holes 98, and the irrigation media entering
the bore 64 is withdrawn back out through another lumen tube (not
shown) towards the proximal end of the catheter.
[0036] A connector assembly 40 is also connected to the proximal
end 36 of the handle assembly 32 using techniques that are
well-known in the catheter art. The connector assembly 40 has a
proximal connector 42 that couples the handle assembly 32 to the
connector 44 of a cable 46 that leads to an ultrasound generator
52. An EP monitoring system 50 is coupled to the ultrasound
generator 52 via another cable 48. The EP monitoring system 50 can
be a conventional EP monitor which receives (via the ultrasound
generator 52) electrical signals detected by the electrodes 58, and
processes and displays these intracardiac signals to assist the
physician in locating the arrhythmogenic sites or pathways. The
ultrasound generator 52 can be a conventional ultrasound generator
that creates and transmits ablating energy to the transducer 60,
which emits the acoustic energy to ablate the tissue that extends
radially from the position of the cap 62.
[0037] Conductor wires 51 extend from the ultrasound generator 52
along the cables 46 and 48 (through the connector assembly 40, the
handle assembly 32 and the lumen 30 of the shaft 22) to the distal
tip section 24, where the conductor wires 51 couple the ring
electrodes 58. The thermocouple wires 54 couple the cap 62, and the
ultrasound wires 55 couple the transducer 60. The thermocouple
wires 54 and ultrasound wires 55 can extend from the cap 62 and
transducer 60 through the channels 67 of the inner sleeve 68 and
through the lumen 30 of the shaft 22 and the handle assembly 32 to
the proximal connector 42, where they can be electrically coupled
by the internal thermocouple wires in the cable 46 to the
ultrasound generator 52 where the temperature can be displayed.
[0038] The handle assembly 32 also includes a steering mechanism 70
that functions to deflect the distal tip section 24 of the shaft 22
for maneuvering and positioning the distal tip section 24 at the
desired location in the heart. Referring to FIG. 3, the steering
mechanism 70 includes a steering wire 72 that extends in the main
lumen 30 of the shaft 22 from its proximal end at the handle
assembly 32 to its distal end which terminates at the distal end 26
of the shaft 22 before the location of the distal tip section 24.
The distal end of the steering wire 72 is secured to a flat wire 75
that is fixedly positioned inside the handle assembly 32. The flat
wire 75 extends in the lumen 30 from the anchor to its distal end
at a location slightly proximal to the inner sleeve 68. The flat
wire 75 is attached to the steering wire 72 at the distal ends of
the flat wire 75 and the steering wire 72 so as to be controlled by
the steering wire 72. Specifically, by pushing the steering
mechanism 70 forward in a distal direction, the steering mechanism
70 will pull the steering wire 72 in a proximal direction, causing
the distal tip section 24 to deflect to one direction. By pulling
back the steering mechanism 70 in a proximal direction, the
steering wire 72 is deactivated and the distal tip section 24
returns to its neutral position or deflects to the opposite
direction for bi-directionality.
[0039] The operation and use of the catheter system 20 will now be
described. To introduce and deploy the distal tip section 24 within
the heart, the physician uses a conventional introducer sheath to
establish access to a selected artery or vein. The physician
introduces the shaft 22 through a conventional hemostasis valve on
the introducer and progressively advances the catheter through the
access vein or artery into the desired location within the heart.
The physician observes the progress of the catheter using
fluoroscopic or ultrasound imaging. The catheter can include a
radio-opaque compound, such as barium sulfate, for this purpose.
Alternatively, radio-opaque markers can be placed at the distal end
of the introducer sheath.
[0040] The shaft 22 and the introducer sheath can be maneuvered to
the right atrium by the steering mechanism 70. Once located in the
right atrium or ventricle, good contact is established when the
ring electrodes 58 contact the target endocardial tissue, and the
intracardiac signals of the selected region are recorded through
the ring electrodes 58. The results of the mapping operation are
processed and displayed at the EP monitoring system 50. A
differential input amplifier (not shown) in the EP monitoring
system 50 processes the electrical signals received from the ring
electrodes 58 via the wires 51, and converts them to graphic images
that can be displayed. The thermocouple wires 54 can also function
to monitor the temperature of the surrounding tissue, and provide
temperature information to the ultrasound generator 52.
[0041] Once the desired position of the transducer 60 has been
confirmed by mapping through the ring electrodes 58, and visually
through fluoroscopy, the physician can then increase the irrigation
fluid flow rate by turning the power of the ultrasound generator 52
on which controls the fluid flow rate prior to the start of
ablation. The ultrasound generator 52 delivers high frequency
energy that is propagated through the wires 55 to the ultrasound
transducer 60 that is positioned inside the cap 62. The acoustic
energy radiates in a radial manner from the transducer 60,
propagates through the irrigation media (which acts as an energy
transmitting medium), exits the cap 62 and then reaches the
selected tissue (typically in a pressure waveform) to ablate the
tissue.
[0042] While the description above refers to particular embodiments
of the present invention, it will be understood that many
modifications may be made without departing from the spirit
thereof. The accompanying claims are intended to cover such
modifications as would fall within the true scope and spirit of the
present invention.
* * * * *