Combination monophasic action potential/ablation catheter and high-performance filter system

A method for detecting monophasic action potentials and ablating surface tissue in an in vivo heart of a patient using a catheter having a proximal end and a distal end, with a first electrode, carried at the distal end, a second electrode carried on a surface of the catheter and spaced from the first electrode, and a third electrode adjacent to but electrically insulated by a skirt member having a thickness of 0.001 to 0.200 inches from the first electrode, including the steps of:

• inserting the distal end into the heart;
• positioning the distal end in a substantially perpendicular configuration against endocardium of the heart such that the first electrode contacts said endocardium with a force sufficient to depolarize myocardial cells in the vicinity of the first electrode and such that the second electrode does not contact said endocardium;
• detecting first signals by means of said first and second electrodes, said first signals relating to the monophasic action potentials of the heart;
• at about the same time as said detecting step is performed, delivering radiofrequency energy to the heart by means of said third electrode, said energy sufficient to ablate the heart tissue;
• and
• repeating said detecting and delivering steps until no monophasic action potential signals are detected.

A method for detecting monophasic action potentials and for supplying energy to ablate tissue within the heart comprising:

• introducing a catheter having a distal end in a region of the heart, the distal end of the catheter carrying
• first electrode means for contacting a tissue region for detecting monophasic action potentials in the contacted tissue region,
• indifferent second electrode means for supplying a reference potential for the first electrode means and being carried on the catheter spaced from the first electrode means,
• third electrode means between the first and second electrode means, the third electrode means being positioned close to the first electrode means, the third electrode means being operative for emitting energy to ablate the contacted tissue region, and
• means for electrically insulating the third electrode means from the first and second electrode means,
• bringing the first and third electrodes into contact with a tissue region within the heart,
• operating the first electrode means to detect monophasic action potentials in the contacted tissue region,
• operating the third electrode means to emit ablating energy to the contacted tissue region simultaneously with like operation of the first electrode means.

A method for detecting monophasic action potentials and ablating tissue in the heart using a catheter having a distal end, with a first electrode carried at the distal end, a second electrode carried on a surface of the catheter and spaced from the first electrode, and a third electrode adjacent to but electrically insulated from the first electrode, including the steps of:

• inserting the distal end into the heart;
• positioning the distal end in a substantially perpendicular configuration against the endocardium of the heart such that the first electrode contacts the endocardium with a force sufficient to depolarize myocardial cells in the vicinity of the first electrode and such that the second electrode does not contact said endocardium;
• detecting first signals by means of the first and second electrodes, said first signals relating to the monophasic action potentials of the heart;
• at about the same time as the detecting step is performed, delivering ablating energy to the heart by means of the third electrode, and
• repeating the detecting and delivering steps until no monophasic action potential signals are detected.