Ablation equipment to treat target regions of tissue in organs

Ablation equipment (100) according to anyone of the claims from 1 to 14, wherein

• said ablation catheter (1) comprising an elongate shaft (13) having a longitudinal main direction (X-X), said elongate shaft (13) comprising at least shaft distal portion (17), said shaft distal portion (17) comprising a shaft distal portion distal end (19);
• said ablation catheter (1) comprising an inner lumen (118) arranged within the elongate shaft (13);
• said ablation catheter (1) comprising a shaft ablation assembly (20) fixedly disposed at said shaft distal portion (17), the shaft ablation assembly (20) being configured to deliver both thermal energy for ablating said tissue (41) and non-thermal energy for treating said tissue (41);
• at least a shape setting mandrel (26) disposed within the ablation catheter (1), the shape setting mandrel (26) being insertable within the inner lumen (118) and removable from the inner lumen (118),
• wherein the shape setting mandrel (26) is free to move in respect of the inner lumen (118) avoiding any constraint with said shaft distal portion (17) during the shape setting mandrel insertion,
• wherein the shape setting mandrel (26) comprises at least a pre-shaped configuration and the shape setting mandrel (26) is reversibly deformable between at least a straight loaded configuration and said pre-shaped configuration,
• wherein, when the shape setting mandrel (26) is fully inserted in the shaft distal portion (17), the shape setting mandrel (26) is configured to shape set said shaft distal portion (17) with said pre-shaped configuration.

Method for set shaping an ablation catheter, comprising the following steps:

• providing an ablation equipment (100) according to anyone of the claims from 15 to 17,
• inserting said shape setting mandrel (26) in said loaded straight configuration within said inner lumen (118) of said ablation catheter (1),
• moving said shape setting mandrel (26) within said inner lumen (118) towards the shaft distal portion distal end (19) until the shape setting mandrel (26) is fully inserted into said shaft distal portion (17), and
• conforming the shape of shaft distal portion (17) to the pre-shaped configuration of said shape setting mandrel (26) when the shape setting mandrel (26) is fully inserted into said shaft distal portion (17).

A method for the treatment of proximal, persistent or long-standing persistent atrial fibrillation in a patient comprising the following steps:

• providing an ablation equipment (100) according to anyone of the claims from 1 to 17;
• placing the ablation catheter (1) in the coronary sinus of the patient, such as to deliver both non-thermal energy for treating a tissue and thermal energy for ablating a tissue, and subsequently;
• place the ablation catheter (1) in the left or right atrium to deliver both non-thermal energy for treating a tissue and thermal energy for ablating a tissue,
• wherein the tissue locations include fasicals around a pulmonary vein, and/or the left atrial roof, and/or the mitral isthmus.

A method for the treatment of ventricular tachycardia in a patient comprising the following steps:

• providing an ablation equipment (100) according to anyone of the claims from 1 to 17;
• placing the ablation catheter (1) in the left or right ventricles of the heart (43);
• inducing ventricular tachycardia by delivering pacing energy, and
• ablating tissue to treat the patient by delivering both non-thermal energy for treating a tissue and thermal energy for ablating a tissue.

A method to ablate atrial tissues comprising the following steps:

• providing an ablation equipment (100) according to anyone of the claims from 1 to 17;
• wherein the shaft distal portion (17) comprises a first deflection geometry when the shape setting mandrel (26) is fully inserted in the elongate shaft (13), and the shaft distal portion (17) comprises a second deflection geometry when the shape setting mandrel (26) is removed from the shaft distal portion (17), wherein the first deflection geometry is larger than the second deflection geometry;
• placing the ablation catheter (1) exposed to an atrial tissue, with the shaft distal portion (17) in the second deflection geometry with said shape setting mandrel (26) outside said distal portion (17);
• ablating one or more of the following tissue locations:
• left atrial septum;
• tissue adjacent the left atrial septum;
• and tissue adjacent the left atrial posterior wall by delivering both non-thermal energy for treating a tissue and thermal energy for ablating a tissue;
• placing the ablation catheter (1) with the shaft distal portion (17) in the first deflection geometry by fully inserting the shape setting mandrel (26) within the elongate shaft (13),
• ablating at least the circumference around the pulmonary veins by delivering both non-thermal energy for treating a tissue and thermal energy for ablating a tissue.