Method and apparatus for transvascular treatment of tachycardia and fibrillation

A method of regulating the heart rate of a patient comprising:

• providing an electrophysiological catheter comprising:
• an elongated catheter body having proximal and distal ends and at least one lumen therethrough;
• a tip section comprising a section of flexible tubing having proximal and distal ends and at least one lumen therethrough, the proximal end of said tubing being fixedly attached to the distal end of the catheter body, said tip section further comprising a basket assembly at the distal end of the flexible tubing, said basket assembly comprising a plurality of arms connected at their proximal and distal ends, each arm comprising at least one electrode, said basket assembly having an expanded arrangement wherein the arms bow radially outwardly and a collapsed arrangement wherein the arms are arranged generally along the axis of the catheter tip section;
• inserting the catheter into a blood vessel and directing the catheter to an intravascular location, wherein the at least one electrode of basket assembly is adjacent a selected cardiac sympathetic or parasympathetic nerve;
• expanding the basket assembly to stabilize the at least one electrode adjacent the selected cardiac sympathetic or parasympathetic nerve;
• and
• delivering a stimulus through the at least one adjacent electrode, said stimulus selected to stimulate the adjacent sympathetic or parasympathetic nerve to thereby cause a regulation of the patient's heart rate.

A system to regulate the heart rate of a patient comprising:

• a) a catheter having:
• an elongated catheter body, the body having proximal and distal ends and at least one lumen therethrough;
• a tip section comprising a section of flexible tubing having proximal and distal ends and at least one lumen therethrough, the proximal end of said tubing being fixedly attached to the distal end of the catheter body, said tip section further comprising a basket assembly at the distal end of the flexible tubing, said basket assembly comprising a plurality of arms connected at their proximal and distal ends, each arm comprising at least one electrode, said basket assembly having an expanded arrangement wherein the arms bow radially outwardly and a collapsed arrangement wherein the arms are arranged generally along the axis of the catheter tip section, the length of the basket assembly in its expanded arrangement being from about 20 to about 60 mm;
• and
• b) a pulse generator electrically connected to the at least one electrode in each arm of the basket assembly, said pulse generator capable of generating stimulating pulses having a frequency of from about 1 Hz to about 200 Hz, an intensity of from about 1V to about 200 V and a duration of from about 0.01 msec to about 10 msec.

A catheter for use in regulating the heart rate of a patient comprising:

• an elongated catheter body, the body having proximal and distal ends and at least one lumen therethrough;
• a tip section comprising a section of flexible tubing having proximal and distal ends and at least two lumens therethrough, at least one such lumen being off-axis, the proximal end of said tubing being fixedly attached to the distal end of the catheter body, said tip section further comprising a basket assembly at the distal end of the flexible tubing, said basket assembly comprising a plurality of arms connected at their proximal ends by a proximal fitting and at their distal ends by a distal fitting, each arm comprising at least one electrode, said basket assembly having an expanded arrangement wherein the arms bow radially outwardly and a collapsed arrangement wherein the arms are generally straight and are arranged generally along the axis of the catheter tip section;
• the length of the basket assembly in its expanded arrangement being from about 20 mm to about 60 mm and the diameter of the basket assembly in its expanded arrangement being from about 10 mm to about 30 mm;
• a control handle at the proximal end of the catheter body, said control handle having first and second movable members, each being movable between first and second positions;
• a first puller wire comprising a proximal end attached to the first movable member of the handle, and extending through the catheter body and into an off-axis lumen in the tip section, the distal end of the first puller wire being anchored to the tip section so that movement of the first movable member from a first to a second position results in longitudinal movement of the first puller wire relative to the catheter body and deflection of the tip section,
• a second puller wire comprising a proximal end attached to the second movable member of the handle and extending through a lumen in the catheter body and a lumen of the tip section and the proximal fitting, the distal end of the second puller wire being attached to the distal fitting of the basket assembly such that movement of the second movable member from a first to a second position results in longitudinal movement of the second puller wire relative to the catheter body and expansion of the basket assembly;
• and
• a plurality of electrode lead wires extending through the handle and catheter body, each lead wire attached to a corresponding electrode of the basket assembly.