Abstract: Ultrasound energy originating from an emitter at a number of predetermined positions is sensed by a plurality of duplex transducers in a predefined arrangement. Each transducer produces a sensor signal representing ultrasound energy sensed by it, and the sensor signals of each transducer are stored in association with the predetermined position producing the sensor signal. Thereafter, an ablation pattern corresponding to a group of the predetermined positions may be generated by actuating each transducer with a time-reversed version of the sensor signals stored in association with the group of positions. By placing the transducers in a predetermined spatial relationship to the heart, the ablation pattern may be formed on the ostium of a pulmonary artery. Preferably the predetermined positions correspond to a grid of dots that may be used to approximate virtually any shape.

Abstract: A cardiac ablation device treats atrial fibrillation by directing and focusing ultrasonic waves into a ring-like ablation region (A). The device desirably is steerable and can be moved between a normal disposition, in which the ablation region lies parallel to the wall of the heart for ablating a loop-like lesion, and a canted disposition, in which the ring-like focal region is tilted relative to the wall of the heart, to ablate only a short, substantially linear lesion. The ablation device desirably includes a balloon reflector structure (18, 1310) and an ultrasonic emitter assembly (23, 1326), and can be steered and positioned without reference to engagement between the device and the pulmonary vein or ostium. A contrast medium (C) can be injected through the ablation device to facilitate imaging, so that the device can be positioned based on observation of the images.