Circumferential ablation device assembly

A tissue ablation device system for ablating multiple circumferential regions of tissue with different inner diameters and which are each located where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongate body with a proximal end portion and a distal end portion and a longitudinal axis;
• an expandable member located along the distal end portion and having a working length along the longitudinal axis which is adjustable between a radially collapsed position and a plurality of radially expanded positions which correspond to a range of outer diameters wherein the working length is adapted to engage each of the multiple circumferential regions of tissue;
• and
• a circumferential ablation element which is coupled to the distal end portion in a fixed position relative to the working length and is adapted in each of the radially expanded positions to ablatively couple to a circumferential area surrounding the working length and to ablate a substantially continuous, transmural circumferential pattern in each of the multiple circumferential regions of tissue, respectively, when engaged by the working length.

A tissue ablation device system that ablates a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongate body with a proximal end portion and a distal end portion and a longitudinal axis;
• an expandable member located along the distal end portion and having a working length with a longitudinal dimension defined between ends of the working length along the longitudinal axis and which is adjustable between a radially collapsed position and a radially expanded position with an expanded outer diameter that is larger than a radially collapsed diameter, the working length also being positionable within the pulmonary vein and being adapted to engage the circumferential region of tissue when in the radially expanded position;
• and
• a circumferential ablation element which is coupled to the working length of the expandable member such that movement of the elongated body moves the expandable member and the circumferential ablation element together, the circumferential ablation element being substantially spaced from the ends of the working length and being adapted to ablate the circumferential region of tissue when the working length is engaged to the circumferential region of tissue in the radially expanded position and also when the ablation element is actuated.

A tissue ablation device system that ablates a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongated body with a proximal end portion and a distal end portion and a longitudinal axis;
• an expandable member located along the distal end portion and having a working length along the longitudinal axis which is adjustable between a radially collapsed position and a radially expanded position which has an outer diameter which is larger when in the radially expanded position than when in the radially collapsed position, the working length also being adapted to engage the pulmonary vein ostium when in the radially expanded position;
• a circumferential ablation element which is coupled to the working length of the expandable member, which is adapted to couple to and ablate the circumferential region of tissue when the expandable member is engaged to the circumferential region of tissue in the radially expanded position;
• a linear ablation member coupled to the distal end portion of the elongate member with first and second linear ablation element ends and a linear ablation element therebetween which is adapted to ablate a continuous linear lesion in tissue adjacent thereto when the linear ablation element is coupled to and actuated by an ablation actuator, the first linear ablation member end being coupled to the expandable member which forms at least in part a first anchor adapted to secure the first linear ablation member end within the pulmonary vein ostium;
• and
• a second anchor coupled to the second linear ablation member end which is adapted to secure the second linear ablation member end to a second location along the left atrium wall.

A tissue ablation device system for ablating a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongated body with a proximal end portion, a distal end portion and a longitudinal axis;
• an expandable member located along the distal end portion with a working length along the longitudinal axis which is adjustable between a radially collapsed position and a radially expanded position, the working length having a first portion, a second portion, and an intermediate portion between the first and second portions along the longitudinal axis, and the working length at least along the intermediate portion being further constructed to define an interior space when in the radially expanded position;
• and
• a circumferential ablation element having a circumferential band which is comprised of a porous membrane and which circumscribes the interior space at a location along the intermediate portion of the working length of the expandable member, the circumferential band in the radially expanded position having a band width along the longitudinal axis which is shorter than the working length and also having an expanded outer diameter which is adapted to engage the circumferential region of tissue, the porous membrane having an inner surface which is adapted to fluidly couple to a pressurizeable source of electrically conductive fluid, and the porous membrane further being adapted to pass a volume of electrically conductive fluid from the inner surface, externally through the porous membrane, and into the circumferential region of tissue when engaged by the circumferential band in the radially expanded position, the circumferential ablation element further including an ablation electrode which is adapted to electrically couple to an electrical current source and also to the volume of electrically conductive fluid which passes through the porous membrane.

A tissue ablation device system that ablates a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongated body with a proximal end portion, a distal end portion and a longitudinal axis;
• an expandable member located along the distal end portion with a working length along the longitudinal axis which is adjustable between a radially collapsed position and a radially expanded position;
• and
• a circumferential ablation element having a circumferential band that is comprised of a thermal conductor and that is located along the distal end portion at a position relative to the longitudinal axis that generally coincides with the working length of the expandable member, the circumferential band further having a band width along the longitudinal axis which is shorter than the working length,
• wherein the radially expanded position the working length at least at the location coinciding with the circumferential band has an outer diameter that is sufficient to engage the circumferential region of tissue, and wherein the circumferential band is adapted to emit a circumferential pattern of thermal energy into the circumferential region of tissue when the circumferential region of tissue is engaged by the working length in the radially expanded position and when the thermal conductor is coupled to and actuated by a thermal ablation actuator.

A tissue ablation device system that ablates a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongated body with a proximal end portion and a distal end portion and a longitudinal axis;
• an inflatable balloon located along the distal end portion which is coupled to a fluid passageway that extends between the inflatable balloon and a proximal inflation port that is adapted to couple to a pressurizeable fluid source, the inflatable balloon also being comprised of a substantially compliant balloon material and having a working length along the longitudinal axis which is adjustable between a radially collapsed position and a radially expanded position which has an expanded outer diameter that is sufficient to engage the circumferential region of tissue;
• and
• an ablation element coupled to the elongate body and adapted to couple to an ablation actuator, and also when actuated, to ablatively couple to a circumferential area surrounding the working length,
• whereby adjusting the inflatable balloon to the radially expanded position in the left atrium and thereafter forcing the inflatable balloon retrogradedly against the pulmonary vein ostium, the working length is adapted to engage a pulmonary vein ostium of the pulmonary vein along the posterior left atrial wall such that the circumferential area is positioned along the circumferential region of tissue and wherein the ablation element is adapted to couple to and ablate the circumferential region of tissue.

A tissue ablation device assembly that ablates a circumferential region of tissue at a location where a pulmonary vein extends from a posterior left atrial wall of a left atrium in a patient, comprising:

• an elongate body with a proximal end portion, a distal end portion and a longitudinal axis;
• and
• a circumferential ablation member with an inflatable balloon located along the distal end portion and having a working length along the longitudinal axis which is adjustable between a radially collapsed position and a radially expanded position, the working length having an expanded outer diameter in the radially expanded position that is larger than when in the radially collapsed position and that is sufficient to engage the circumferential region of tissue, and
• a circumferential ablation element having a single circumferential band also located along the distal end portion at a position relative to the longitudinal axis generally coinciding with the working length of the inflatable balloon such that movement of the elongate body moves the inflatable balloon and the circumferential ablation element together, the circumferential band being adapted to couple to and be actuated by an ablation actuator such that the circumferential ablation element ablatively couples to only a circumferential area that surrounds the circumferential bond wherein the circumferential ablation element is adapted to ablate only the circumferential region of tissue in a circumferential pattern when the working length is engaged to the circumferential region of tissue in the radially expanded position.