CATHETER WITH ABLATION ELECTRODE

Ablation systems and methods of the present disclosure control lesion depth and width such that, for example, wide and shallow lesions can be formed in target tissue in an anatomic structure of a patient during a medical procedure. Such wide and shallow lesions can be useful for treating, for example, thin tissue such as atrial tissue in atria of the heart of the patient. 1. A catheter , comprising:an elongated shaft including a distal end portion; andan expandable ablation electrode having (i) a proximal region coupled to the distal end portion of the elongated shaft and (ii) a distalmost region opposite the proximal region,wherein the ablation electrode is transformable between a low-profile delivery state and an expanded treatment state for delivery of therapeutic energy to target tissue, and the ablation electrode has a maximum radial dimension greater than a maximum radial dimension of the distal end portion of the elongated shaft in an absence of external force applied to the ablation electrode,', 'the ablation electrode is configured such that blood or another fluid can flow therethrough, and', 'the ablation electrode is configured such that the therapeutic energy can be delivered to the target tissue through an outer portion of the ablation electrode, including through the distalmost region of the ablation electrode, and independent of orientation of contact between the outer portion of the ablation electrode and the target tissue., 'wherein, when in the expanded treatment state'}2. The catheter of wherein:when in the expanded treatment state in the absence of the external force, the ablation electrode is positionable at multiple different angles relative to the target tissue; andfor a same amount of the therapeutic energy delivered through the outer portion of the ablation electrode to the target tissue, the ablation electrode is configured such that lesions of similar sizes can be generated at each of the multiple different angles.3. The catheter of ...

MULTIPLE ZONE PAD CONDITIONING DISK

A pad conditioning disk configured to condition a polishing pad of a chemical mechanical polishing tool including a plurality of zones comprising cutting elements that selectively engage the polishing pad based on a positioning of the plurality of zones, is provided. An associated chemical mechanical polishing (CMP) tool and method for conditioning a polishing pad during a chemical mechanical polishing process is also provided. 1. A pad conditioning disk configured to condition a polishing pad of a chemical mechanical polishing tool , comprising:a plurality of zones comprising cutting elements that selectively engage the polishing pad based on a positioning of the plurality of zones.2. The pad condition disk of claim 1 , wherein the plurality of zones are moveable with respect to each other.3. The pad condition disk of claim 1 , wherein the plurality of zones are moveable with respect to each other so that cutting elements of a first zone of the plurality of zones engage the polishing pad during a chemical mechanical polishing process while cutting elements of a second zone of the plurality of zones do not engage the polishing pad.4. The pad conditioning disk of claim 1 , wherein the cutting elements are diamonds or diamond-like films of a same or a different shape claim 1 , size claim 1 , distribution claim 1 , density claim 1 , and/or configuration.5. The pad conditioning disk of claim 1 , wherein at least one cutting element is a brush.6. The pad conditioning disk of claim 1 , wherein a first zone of the plurality of zones comprise grit diamonds of a certain shape claim 1 , size claim 1 , distribution and density claim 1 , and a second zone of the plurality of zones comprises chemical vapor deposition (CVD) diamond film coated on a textured surface.7. The pad conditioning disk of claim 1 , wherein the pad conditioning disk is connected to a pad conditioner arm of the chemical mechanical polishing tool by a moveable connector claim 1 , and an actuator facilitates ...

LESION FORMATION

Ablation systems and methods of the present disclosure control lesion depth and width such that, for example, wide and shallow lesions can be formed in target tissue in an anatomic structure of a patient during a medical procedure. Such wide and shallow lesions can be useful for treating, for example, thin tissue such as atrial tissue in atria of the heart of the patient. 120-. (canceled)21. A method comprising:positioning a distal portion of a shaft of a catheter in an anatomic structure of a patient;expanding an expandable tip, wherein the expandable tip has (i) a proximal region coupled to the distal portion of the shaft and (ii) a distal region opposite the proximal region, and wherein the expandable tip has a maximum radial dimension greater than a maximum radial dimension of the distal portion of the shaft, and further wherein blood flows through the expandable tip at a treatment site in the anatomic structure;delivering energy through the expandable tip to tissue at the treatment site, wherein the expandable tip is configured such that ablative energy can be delivered through an outer portion of the expandable tip, including through the distal region of the expandable tip, and independent of orientation of contact between the outer portion of the expandable tip and the tissue at the treatment site; andcontrolling the energy delivered to the treatment site to form, in the tissue, a lesion having a maximum depth less than about one-half of a maximum width.22. The method of wherein controlling the energy delivered to the treatment site to form the lesion is based upon a predetermined relationship between size of the lesion and amount and duration of energy delivery.23. The method of wherein controlling the energy delivered to the treatment site to form the lesion includes controlling the energy delivered to the treatment site such that the maximum depth of the lesion is about 5 mm or less.24. The method of wherein controlling the energy delivered to the ...

PULSED RADIOFREQUENCY ABLATION

Ablation systems and methods of the present disclosure are directed toward delivering pulsed radiofrequency (RF) energy to target tissue. The pulsations of the RF energy, combined with cooling at a surface of the target tissue, can advantageously promote local heat transfer in the target tissue to form lesions having dimensions larger than those that can be safely formed in tissue using non-pulsed RF energy under similar conditions. 1. A method comprising:placing an ablation electrode at an interface between tissue and blood in an anatomic structure of a patient such that fluid in the anatomic structure moves through the ablation electrode placed at the interface;delivering RF energy to the ablation electrode at the interface during a period of lesion formation;delivering an irrigation fluid to the interface during at least a portion of the period of lesion formation such that the fluid moving through the ablation electrode includes the irrigation fluid; andmonitoring tissue at the interface, wherein monitoring tissue at the interface includes reducing the RF energy and reducing the volumetric flow rate of the irrigation fluid during a measurement phase of the period of lesion formation, receiving one or more signals indicative of temperature at the interface, and determining a temperature at the interface based on the one or more signals received during the measurement phase of the period of lesion formation.2. The method of claim 1 , wherein determining the temperature at the interface is further based on the one or more signals received during a portion of the period of lesion formation other than the measurement phase.3. The method of claim 1 , further comprising displaying the determined temperature on a graphical user interface.4. The method of claim 1 , further comprising claim 1 , based on the determined temperature claim 1 , titrating the RF energy delivered to the ablation electrode.5. The method of claim 1 , further comprising adjusting the volumetric ...

CATHETER INSERTION

Devices, systems, and methods of the present disclosure can overcome physical constraints associated with catheter introduction to facilitate the use of a catheter with a large distal portion as part of a medical procedure benefiting from such a large distal portion, such as, for example, cardiac ablation. More specifically, devices, systems, and methods of the present disclosure can compress an expandable tip of a catheter from an expanded state to a compressed state along a tapered surface of an insertion sleeve for advancement of the expandable tip into vasculature of a patient. The tapered surface of the insertion sleeve can, for example, apply compressive forces at an angle against the advancing expandable tip. As compared to other approaches to the application of compressive force to an expandable tip, compressing the expandable tip using an angled force can reduce the likelihood of unintended deformation of the expandable tip. 1. A method of inserting a catheter into vasculature of a patient , the method comprising:positioning a distal portion of a sheath in a blood vessel of the patient;moving an insertion sleeve proximally over an expandable tip supported by a catheter shaft, the proximal movement of the insertion sleeve compressing at least one portion of the expandable tip from an expanded state to a compressed state along a tapered surface of the insertion sleeve;mating the insertion sleeve with the sheath; andadvancing the expandable tip distally beyond the sheath and into the vasculature of the patient.2. The method of claim 1 , wherein the insertion sleeve is mated with the sheath with the expandable tip disposed in the insertion sleeve in the compressed state.3. The method of claim 1 , wherein the at least one portion of the expandable tip in the expanded state has a maximum radial dimension greater than a maximum inner radial dimension of the sheath.4. The method of claim 1 , wherein the at least one portion of the expandable tip is resiliently ...

LESION FORMATION

Ablation systems and methods of the present disclosure control lesion depth and width such that, for example, wide and shallow lesions can be formed in target tissue in an anatomic structure of a patient during a medical procedure. Such wide and shallow lesions can be useful for treating, for example, thin tissue such as atrial tissue in atria of the heart of the patient. 1. A method comprising:positioning a distal portion of a shaft of a catheter in an anatomic structure of a patient;expanding an ablation electrode coupled to the distal portion of the shaft, the expanded ablation electrode having a maximum radial dimension greater than a maximum radial dimension of the distal portion of the shaft;delivering energy through the expanded ablation electrode to tissue at a treatment site in the anatomic structure; andcontrolling the energy delivered to the treatment site to form, in the tissue, a lesion having a maximum depth less than about one-half of a maximum width.2. The method of claim 1 , wherein controlling the energy delivered to the treatment site to form the lesion is based upon a predetermined relationship between size of the lesion and amount and duration of energy delivery.3. The method of claim 1 , wherein controlling the energy delivered to the treatment site to form the lesion includes controlling the energy delivered to the treatment site such that the maximum depth of the lesion is about 5 mm or less.4. The method of claim 1 , wherein controlling the energy delivered to the treatment site to form the lesion includes controlling the energy delivered to the treatment site such that the maximum depth of the lesion is less than about one-third of the maximum width of the lesion.5. The method of claim 1 , wherein controlling delivery of energy through the expanded ablation electrode includes delivering energy to the tissue for greater than about 2 seconds and less than about 20 seconds.6. The method of any one of claim 1 , wherein controlling delivery of ...

PULSED RADIOFREQUENCY ABLATION

Ablation systems and methods of the present disclosure are directed toward delivering pulsed radiofrequency (RF) energy to target tissue. The pulsations of the RF energy, combined with cooling at a surface of the target tissue, can advantageously promote local heat transfer in the target tissue to form lesions having dimensions larger than those that can be safely formed in tissue using non-pulsed RF energy under similar conditions. 1. A method comprising:placing an ablation electrode at an interface between tissue and blood in an anatomic structure of a patient;delivering RF energy to the ablation electrode at the interface during a period of lesion formation; anddelivering an irrigation fluid to the interface during at least a portion of the period of lesion formation, wherein the RF energy delivered to the ablation electrode at the interface is pulsed to cycle between a first energy phase and a second energy phase during the period of lesion formation, the RF energy in the first energy phase being greater than the RF energy in the second energy phase, and a combination of irrigation fluid and blood moves through the ablation electrode to cool the ablation electrode at the interface during the period of lesion formation.2. The method of claim 1 , wherein a rate of cooling of the interface by the combination of blood and irrigation fluid moving through the ablation electrode at the interface is greater than a rate of heating of the interface by the RF energy during the second energy phase.3. The method of claim 1 , wherein the second energy phase is an off phase.4. The method of claim 1 , wherein claim 1 , during the period of lesion formation claim 1 , the RF energy is cycled between at least two cycles claim 1 , with each cycle including a second energy phase and a first energy phase.5. The method of claim 1 , wherein each second energy phase has a duration greater than 0 seconds and less than about 6 seconds.6. The method of claim 1 , wherein each second energy ...

CATHETER SENSING AND IRRIGATING

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site. 1. A catheter comprising:a catheter shaft having a proximal end portion and a distal end portion; andan ablation electrode coupled to the distal end portion of the catheter shaft and in electrical communication with an electrical power source, the ablation electrode including a deformable portion resiliently flexible between a compressed state and an uncompressed state, the deformable portion having less than about ±10 percent variation in current density at 1 mm away in a medium of uniform conductivity from an outer portion of the deformable portion in the uncompressed state as current from the electrical power source moves through the deformable portion of the ablation electrode.2. The catheter of claim 1 , wherein claim 1 , in the uncompressed state claim 1 , the maximum radial dimension of the deformable portion is at least 20 percent greater than a maximum radial dimension of the catheter shaft.3. The catheter of claim 2 , wherein claim 2 , in the compressed state claim 2 , the deformable portion is deliverable through an 8 Fr sheath.4. The catheter of claim 1 , wherein the deformable portion is substantially spherical in the uncompressed state.5. The catheter of claim 1 , wherein the ablation electrode is nitinol.6. The ...

Catheter sensing and irrigating

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site.

Catheter with ablation electrode

Uni-stage delay speculative address decoder

Uni-stage delay speculative address decoder

An address decoder. The address decoder includes a plurality of decoder circuits. Each decoder circuit includes a first stage including a first logic circuit having n−1 inputs, the n−1 inputs being a subset of n inputs conveyed to each decoder circuit. Each decoder circuit further includes a second stage having a second and third logic circuits. Both the second and third logic circuits receive an output provided by the first logic circuit. The second logic circuit also receives the other one of the n bits, while the third logic circuit receives its complement. The second and third logic circuits provide second and third outputs, respectively. The address decoder is configured to assert one of a plurality of address selection outputs by asserting one of the second or third outputs of one of the decoder circuits, while de-asserting both the second or third outputs of the other decoder circuits.

A system comprising a catheter, a sheath and an insertion sleeve

Catheter insertion

Devices, systems, and methods of the present disclosure can overcome physical constraints associated with catheter introduction to facilitate the use of a catheter with a large distal portion as part of a medical procedure benefitting from such a large distal portion, such as, for example, cardiac ablation. More specifically, devices, systems, and methods of the present disclosure can compress an expandable tip of a catheter from an expanded state to a compressed state along a tapered surface of an insertion sleeve for advancement of the expandable tip into vasculature of a patient. The tapered surface of the insertion sleeve can, for example, apply compressive forces at an angle against the advancing expandable tip. As compared to other approaches to the application of compressive force to an expandable tip, compressing the expandable tip using an angled force can reduce the likelihood of unintended deformation of the expandable tip.

Catheter insertion

Devices, systems, and methods of the present disclosure can overcome physical constraints associated with catheter introduction to facilitate the use of a catheter with a large distal portion as part of a medical procedure benefitting from such a large distal portion, such as, for example, cardiac ablation. More specifically, devices, systems, and methods of the present disclosure can compress an expandable tip of a catheter from an expanded state to a compressed state along a tapered surface of an insertion sleeve for advancement of the expandable tip into vasculature of a patient. The tapered surface of the insertion sleeve can, for example, apply compressive forces at an angle against the advancing expandable tip. As compared to other approaches to the application of compressive force to an expandable tip, compressing the expandable tip using an angled force can reduce the likelihood of unintended deformation of the expandable tip.

Catheter with ablation electrode

Ablation systems and methods of the present disclosure control lesion depth and width such that, for example, wide and shallow lesions can be formed in target tissue in an anatomic structure of a patient during a medical procedure. Such wide and shallow lesions can be useful for treating, for example, thin tissue such as atrial tissue in atria of the heart of the patient.