The CardioFocus Catheter positioned at the ostium of a pulmonary vein. Laser energy is delivered in a series of continuous arcs upon the atrial wall surrounding the vein.
Using Endoscopically Guided Light Energy for Ablation of Atrial Fibrillation
Companies have been exploring technological options to treat Atrial Fibrillation from the time physicians began to concentrate on explaining its etiology. As a result, there is a long history of tools that have been created to support therapeutic intervention. Inevitably, many have missed the mark. Invisible signals buried in a confoundingly irregular anatomy present a serious challenge for all but the most flexible devices and their highly trained physician operators.
No matter how much pre- procedure imaging is obtained, omniscience is generally in very short supply when approaching an individual patient. As a result, it is now painfully clear that a superior tool for AF ablation must able to accommodate the high degree of inter patient variation and anatomically based procedural surprises. Components of this flexibility include the capacity to visualize the anatomy, precisely select the site where therapy will be rendered, have the capacity to easily project energy to that location and ultimately to see the results of that intervention in detail and in real time.
The Endoscopic Ablation System from CardioFocus promises minimally invasive therapy in an easy to learn, two to three hour, procedure. The catheter system includes a deflectable sheath to provide efficient transseptal access to all four pulmonary veins. The physician uses the sheath to transport the catheter to the vicinity of the vein using fluoroscopy whereupon the compliant balloon is inflated. Once tissue contact is achieved, an integral micro-endoscope is used to visualize the placement of the balloon relative to the mouth, (ostium), of the vein. The physician can then use the endoscopic image acquired by direct visualization to determine the placement of each arc of laser light on the target cardiac tissue. The endoscope also provides unique feedback regarding progress obtained in achieving isolation of the vein via a dynamic view of the developing lesions. This major advance in the guidance and visual targeting of the therapy reduces fluoroscopy time dramatically and facilitates the use of the catheter by less practiced users.
The continuous near infrared laser light projected by the catheter heats the atrial tissue around the vein; scar tissue is formed and electrical isolation results acutely. The catheter works to create "conduction block" by allowing the physician operator to place overlapping arcs of laser light into the atrial wall around each vein. Complete isolation is often obtained with several 20-30 second energy deliveries promising a great advantage in accuracy, speed and effectiveness vs. other catheter methodologies.