Epicardial Ablation Catheter and Access Sheath and Methods of Use
Today most electrophysiologic ablations are done from the endocardium because many superventricular tachycardias originate there. However, two of the fastest growing areas of ablation atrial fibrillation ablation and ventricular tachycardia (VT) ablation have significant contributors in the epicardium.
In particular, endocardial VT ablation is only successful 50% of the time in the long-term. One reason is that 15-50% of VT is epicardial. Furthermore, endocardial VT ablations have a real risk of valve damage and stroke. Recently, electrophysiologists in a few centers introduced a way to do epicardial ablations from a subxiphoid stick. Epicardial ablation allows for cure of VT in many patients and does not have the stroke risk. However, a major barrier to epicardial ablations is that there are no catheters or sheaths designed to ablate the heart tissue from the pericardial space.
Dr. Srijoy Mahapatra, M.D., an electrical engineer, practicing clinician, and an expert in epicardial ablation in the Division of Cardiology and Dr. George Gillies, Research Professor of Mechanical and Biomedical Engineering at the University of Virginia, have combined their talents to develop a series of tools that can be used for epicardial ablation procedures. In the present invention, Dr. Mahapatra and Dr. Gillies have created a catheter and an access sheath for ablation of epicardial tissue. The use of this device outside the wall of the heart does not disrupt the internal mechanics of the heart or its cycles of operation. The newly designed ablation tool allows for epicardial treatment of atrial fibrillation and ventricular tachycardia, significantly minimizing risk from stroke. In addition, this ablation tool offers the following advantages
• Limit awkward and unsafe movement of long endocardial sheaths and catheters
• Optimize movement in the pericardium
• Minimize the risk of tamponade
• Minimize damage to esophagus, phrenic nerve and other adjacent structures
• Optimize energy delivery for deeper epicardial lesions
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