# US 11,298,184 B2 · Electrosurgical pericardial puncture

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- Number: US 11,298,184 B2
- Document ID: US11298184B2
- Status: Granted
- Kind: B2
- Application number: 16/124,684
- Filed: 2018-09-07
- Published: 2019-01-10
- Granted: 2022-04-12
- Earliest claimed: 2007-01-02
- Assignees: Baylis Medical Company Inc.
- Applicants: Baylis Medical Company Inc.
- Inventors: Gareth Davies
- Web page: https://patentgrep.com/patent/US11298184B2

## CPC

- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 8/0841: {for locating instruments}
- A61B 8/0883: {for diagnosis of the heart}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 8/445: {Details of catheter construction}
- A61B 8/4494: {characterised by the arrangement of the transducer elements}
- A61B 8/481: {involving the use of contrast agents, e.g. microbubbles introduced into the bloodstream}
- A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 17/2202: {the ultrasound transducer being inside patient's body at the distal end of the catheter}
- A61B 2017/00026: {Conductivity or impedance, e.g. of tissue}
- A61B 2017/00154: {pulsed}
- A61B 2017/00243: {cardiac}
- A61B 2017/00247: {Making holes in the wall of the heart, e.g. laser Myocardial revascularization}
- A61B 2017/00353: {one mechanical instrument performing multiple functions, e.g. cutting and grasping}
- A61B 2017/22014: {the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire}
- A61B 2018/00083: {low, i.e. electrically insulating}
- A61B 2018/00291: {using suction}
- A61B 2018/00363: {Epicardium}
- A61B 2018/00601: {Cutting}
- A61B 2018/00702: {Power or energy}
- A61B 2018/00839: {Bioelectrical parameters, e.g. ECG, EEG}
- A61B 2018/00875: {Resistance or impedance}
- A61B 2018/1861: {with an instrument inserted into a body lumen or cavity, e.g. a catheter}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/378: {using ultrasound}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes using an apparatus to apply pressure to a parietal pericardium, retracting the apparatus, and puncturing the parietal pericardium by delivering electrical energy using a puncture device. Another method includes moving a portion of parietal pericardium away from a surface of myocardium of the heart and puncturing the parietal pericardium by delivering electrical energy using a puncture device. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device.

## Claims

### Claim 1

A method of accessing a pericardial cavity of a heart comprising:
a. moving a portion of a parietal pericardium away from a surface of a myocardium of the heart using suction; and
b. puncturing the parietal pericardium by delivering electrical energy using a puncture device while maintaining a distal end of the puncture device in a substantially stationary position relative to the portion of the parietal pericardium.

### Claim 2 (depends on 1)

The method of claim 1, further comprising a step of confirming that the puncture device is at least partially within the pericardial cavity.

### Claim 3 (depends on 2)

The method of claim 2, wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises injecting a contrast fluid into the pericardial cavity through a lumen of the puncture device.

### Claim 4 (depends on 2)

The method of claim 2, wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises aspirating fluid from the pericardial cavity through a lumen of the puncture device.

### Claim 5 (depends on 2)

The method of claim 2, wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises measuring electrical impedance at a distal end of the puncture device.

### Claim 6 (depends on 2)

The method of claim 2, wherein the step of confirming that the puncture device is at least partially within the pericardial cavity comprises measuring pressure at a distal end of the puncture device.

### Claim 7 (depends on 1)

The method of claim 1, wherein the electrical energy is in the radiofrequency range.

### Claim 8 (depends on 1)

The method of claim 1, wherein a distal tip of the puncture device comprises an energy delivery device and wherein the electrical energy delivered to the parietal pericardium is delivered through the energy delivery device.

### Claim 9 (depends on 1)

The method of claim 1, wherein the portion of the parietal pericardium is moved away from the myocardium such that a space of the pericardial cavity is enlarged, thereby reducing a risk of accidental myocardial damage.

### Claim 10 (depends on 1)

The method of claim 1, wherein the step of moving the portion of the parietal pericardium is accomplished through a mechanical means.

### Claim 11 (depends on 1)

The method of claim 1, further comprising a step of advancing a guidewire into the pericardial cavity.

### Claim 12 (depends on 1)

The method of claim 1, further comprising a step of enlarging the puncture by advancing a dilator over the puncture device and into the pericardial cavity.