Catheter electrodes for energy management

Abstract

Methods, systems, and devices for enhancing the efficiency and efficacy of energy delivery and tissue mapping. One system includes a treatment element having a plurality of electrodes and an energy generator that is configured to deliver electric energy pulses to the electrodes in a variety of patterns. For example, electrodes may be arranged in closely spaced pairs. The energy generator may deliver mapping energy to each electrode in each pair individually to map tissue and may deliver ablation energy to the electrodes in each pair together, such that each pair is treated like a single electrode, to deliver ablation energy, such as bipolar ablation energy between adjacent pairs. One system includes at least one concave electrode, the configuration of which concentrates the energy and drives it deeper into the tissue. One system includes neutral electrodes between active electrodes, the energy generator selectively coupling the neutral electrodes to alter the ablation pattern.

What is claimed is: 
     
         1 . A system for the delivery of ablation energy, the system comprising:
 a medical device including a treatment element having a plurality of electrodes, the electrodes being arranged in a plurality of sets of a first electrode, a second electrode, and a third electrode; and   an energy generator in communication with the treatment element, the energy generator being configured to:
 electrically connect the first electrode and the second electrode of each electrode set to each other; 
 electrically connect the first electrode and the second electrode of every other electrode set to a first polarity of the energy generator; 
 electrically connect the first electrode and the second electrode of each of a plurality of remaining electrode sets to a second polarity of the energy generator; 
 electrically disconnect the third electrode of each electrode set from the energy generator; and 
 transmit ablation energy to the plurality of electrodes such that adjacent electrode sets deliver bipolar energy therebetween. 
   
     
     
         2 . The system of  claim 1 , wherein the energy generator is further configured to:
 electrically connect the second electrode and the third electrode of each electrode set to each other;   electrically connect the second electrode and the third electrode of every other electrode set to a first polarity of the energy generator;   electrically connect the second electrode and the third electrode of each of a plurality of remaining electrode sets to a second polarity of the energy generator;   electrically disconnect the first electrode of each electrode set from the energy generator; and   transmit ablation energy to the plurality of electrodes such that adjacent electrode sets deliver bipolar energy therebetween.   
     
     
         3 . The system of  claim 1 , wherein the medical device further includes an elongate body having a distal portion and a proximal portion, and
 wherein the treatment element is positioned at the distal portion of the elongate body, the treatment element including at least one concave electrode, the at least one concave electrode having at least one of a concave cylindrical configuration and a hemispherical configuration.   
     
     
         4 . The system of  claim 3 , wherein the treatment element has a linear configuration, the at least one concave electrode being a plurality of concave electrodes, each of the plurality of concave electrodes having a concave cylindrical configuration. 
     
     
         5 . The system of  claim 3 , wherein the at least one concave electrode includes a concave distal tip electrode having a hemispherical configuration, the elongate body further including a distalmost tip and the treatment element having a linear configuration. 
     
     
         6 . The system of  claim 5 , wherein the concave distal tip electrode is recessed within the elongate body a distance from the distalmost tip of the elongate body. 
     
     
         7 . The system of  claim 3 , wherein the at least one concave electrode includes a plurality of concave electrodes each having a concave cylindrical configuration, the treatment element including a flexible carrier element bearing the plurality of concave electrodes. 
     
     
         8 . The system of  claim 1 , wherein the treatment element includes at least one insulated protuberant segment, the at least one protuberant segment being immediately adjacent to the at least one electrode, the at least one insulated protuberant segment having at least one protrusion with a diameter that is greater than a greatest diameter of the at least one electrode. 
     
     
         9 . The system of  claim 8 , wherein the treatment element further includes a carrier element, each of the at least one electrode and the at least one insulated protuberant segment being on the carrier element, the greatest diameter of the at least one electrode being greater than a diameter of the carrier element. 
     
     
         10 . The system of  claim 8 , wherein the at least one insulated protuberant segment has a first end and a second end, the at least one insulated protuberant segment having a first protrusion at the first end having a first diameter and a second protrusion at the second end having the first diameter, and a length therebetween having a second diameter, the first diameter being greater than the second diameter. 
     
     
         11 . The system of  claim 8 , wherein the treatment element includes an insulated carrier element, the insulated carrier element defining the at least one insulated protuberant segment. 
     
     
         12 . A system for the delivery of ablation energy, the system comprising:
 a treatment element including at least two active electrodes and at least two neutral electrodes, two of the at least two neutral electrodes being between two of the at least two active electrodes; and   an energy generator in communication with the treatment element, the energy generator being configured to:
 deliver ablation energy to the at least two active electrodes; and 
 selectively electrically couple and decouple the at least two neutral electrodes from each other during the delivery of ablation energy to the at least two active electrodes. 
   
     
     
         13 . A system for the delivery of ablation energy, the system comprising:
 an energy generator having a first polarity and a second polarity; and   a treatment element including:
 at least one active electrode in electrical communication with one of the first polarity and the second polarity; and 
 a plurality of active electrodes in electrical communication with an other of the first polarity and the second polarity. 
   
     
     
         14 . The system of  claim 13 , wherein the at least one active electrode includes one active electrode. 
     
     
         15 . The system of  claim 14 , wherein the plurality of active electrodes includes at least two electrodes. 
     
     
         16 . The system of  claim 13 , the system further comprising:
 a first medical device including the treatment element having a plurality of electrodes, the plurality of electrodes having a first at least one electrode and a second at least one electrode, the first and second at least one electrode being different, the second at least one electrode including a greater number of the plurality of electrodes than the first at least one electrode, the plurality of electrodes having a first area, wherein the first at least one electrode includes the at least one active electrode in electrical communication with the one of the first polarity and the second polarity, wherein the second at least one electrode includes the plurality of active electrodes in electrical communication with the other of the first polarity and the second polarity; and   a second medical device including an electrode having a second area that is greater than the first area,   wherein the energy generator is in communication with the treatment element, the energy generator being configured to selectively:
 deliver bipolar energy through the plurality of electrodes; and 
 deliver unipolar energy through the plurality of electrodes and the ground electrode, 
   the energy generator being further configured to deliver energy having the first polarity through the first at least one electrode and to deliver energy having the second polarity through the second at least one electrode such that a greater amount of energy is delivered through the first at least one electrode than the second at least one electrode.   
     
     
         17 . The system of  claim 16 , wherein the plurality of electrodes includes a third at least one electrode that is electrically disconnected from the energy generator. 
     
     
         18 . The system of  claim 16 , wherein the plurality of electrodes includes nine electrodes, the first plurality of electrodes including two electrodes and the second plurality of electrodes including five electrodes. 
     
     
         19 . The system of  claim 18 , wherein the first at least one electrode and the second at least one electrode include the same number of electrodes. 
     
     
         20 . The system of  claim 16 , wherein the treatment element includes a carrier element having an at least substantially circular shape, the plurality of electrodes being radially distributed on the carrier element, the first at least one electrode being at a first position on the carrier element and the second at least one electrode being at a second location on the carrier element that is approximately 180° from the first location.