Diagnostic guidewire for cryoablation sensing and pressure monitoring

摘要

A method and system for performing pulmonary vein isolation, mapping, and assessing pulmonary vein occlusion using a single device. The device may generally include an ablation element, such as a cryoballoon, and a sensing component slidably disposed within a lumen of the device and bearing one or more mapping electrodes and one or more pressure sensors. The method may generally include mapping cardiac electrical signals within a heart and/or pulmonary vein, positioning a distal portion of the sensing component within a pulmonary vein, advancing the ablation element until it is in contact with the pulmonary vein ostium, recording blood pressure measurements within the pulmonary vein with the one or more pressure sensors to assess pulmonary vein occlusion, and activating the treatment element when the pulmonary vein is completely occluded. The sensing component may have a straight or hooped configuration, or a configuration therebetween.

主权项

1. A method of occluding a pulmonary vein within a patient's body, the method comprising:
providing a medical device including a treatment element, a longitudinal axis, and an elongate body defining a distal portion, a proximal portion, and a lumen therebetween, the treatment element being coupled to the distal portion of the elongate body; providing a sensing component having a pressure sensor and one or more mapping elements, the sensing component being longitudinally movable within the elongate body lumen, the sensing component having a hooped portion that is substantially orthogonal to the longitudinal axis of the medical device and a distal tip portion having a J-shape, the J-shaped distal portion including a linear portion located distal to the hooped portion and lying along an axis that is parallel to the longitudinal axis of the elongate body; providing a console processor in communication with the one or more mapping elements and the pressure sensor; recording a first blood pressure measurement within the pulmonary vein with the pressure sensor, the pressure sensor transmitting the first blood pressure measurement to the console processor; then positioning the treatment element in contact with a cardiac tissue and positioning a distal portion of the sensing component within the pulmonary vein; then recording a second blood pressure measurement within the pulmonary vein using the pressure sensor after positioning the treatment element in contact with the cardiac tissue, the pressure sensor transmitting the second blood pressure measurement to the console processor; comparing the first blood pressure measurement to the second blood pressure measurement, the console processor using the first blood pressure measurement and the second blood pressure measurements to determine substantial occlusion of the pulmonary vein by the treatment element when the second blood pressure measurement is within a first range and to determine partial occlusion of the pulmonary vein by the treatment element when the second blood pressure measurement is within a second range, the first range being higher than the second range.