Abstract: A catheter is described with an end effector having densely arrayed electrodes on three loops which are arrayed in various planar configurations when the end effector is unconstrained. The end effector has first, second and third loop members, each loop member includes two spines and a connector that connects the two spines to define a loop extending away from a tubular member of the catheter such that the first, second and third loop members are configured so that each connector of each of the first, second and third loop members is in contact with only one connector of the adjacent loop member.

Abstract: A method is provided. The method includes pacing, by electrodes of a catheter, a heart tissue with pulses. The method includes observing, by the electrodes, a period of electrophysiological repolarization for the heart tissue. The period of electrophysiological repolarization is caused by the pacing. The method also includes measuring, by the electrodes, an electrical signal within the heart tissue after the period of electrophysiological repolarization.

Abstract: A system includes signal acquisition circuitry and a processor. The signal acquisition circuitry is configured to receive multiple intra-cardiac signals acquired by multiple electrodes of an intra-cardiac probe in a heart of a patient. The processor is configured to perform a sequence of annotation-visualization operations at subsequent times, by performing, in each operation: extracting multiple annotation values from the intra-cardiac signals, selecting a group of the intra-cardiac signals, identifying in the group one or more annotation values that are statistically deviant by more than a predefined measure of deviation, and visualizing the annotation values to a user, while omitting and refraining from visualizing the statistically deviant annotation values.

Abstract: Methods, apparatus, and systems for medical procedures are disclosed herein and include sensing a plurality of tissue electrical potentials at an organ area of an organ, by one or more electrodes on a catheter, determining a number of peak electrical potentials from the plurality of first tissue electrical potentials such that the a peak electrical potential exceeds a potential threshold, determining a first visual characteristic based on the number of peak electrical potential and displaying a rendering of the organ comprising the organ area such that the rendering of the first organ area comprises the first visual characteristic.

Abstract: A method includes, using anatomical data, calculating multiple cross-sectional shapes of a lumen of an organ in a body of a patient at multiple respective positions on a medial axis of the lumen. One or more of the positions on the medial axis are identified, at which a given expandable frame of a catheter would fit the cross-sectional shapes. The one or more identified positions are presented to a user.

Abstract: A method includes assigning, to first voxels in a model of tissue of a chamber of a heart, respective first values of a parameter at respective locations on the tissue, the first voxels representing the locations, respectively. Some of the locations are on an endocardial surface of the tissue, and others of the locations are on an epicardial surface of the tissue. The method further includes assigning respective second values to second voxels in the model, a subset of which represent a portion of the tissue between the endocardial surface and the epicardial surface, by interpolating the first values. Other embodiments are also described.

Abstract: A system and method for Brugada syndrome epicardial ablation comprising preparing an endocardial duration map; preparing a baseline epicardial duration map comprising at least one or more areas of delimination; and when some of the areas of delimination are greater than 200 ms, performing epicardial ablation of the areas of delimination greater than 200 ms. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not a BrS pattern appears in the updated epicardial duration map; and when the BrS pattern appears, performing epicardial ablation. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not an abnormal EGM exists in the updated epicardial duration map; and when the abnormal EGM exists, performing epicardial ablation.

Abstract: A method includes, in a medical procedure carried out during a time interval including at least first and second time periods, receiving, for the first time period, a first electrical signal indicative of at least a first position and a first orientation of a hand-held device directing energy to one or more volumetric portions of an organ. A second electrical signal indicative of at least a second position and a second orientation of the hand-held device is received for the second time period. Based on the first and second electrical signals, a cumulative energy applied to at least one of the one or more volumetric portions is estimated. The estimated cumulative energy, of at least one of the one or more volumetric portions, is overlaid on an anatomical image of the organ.

Abstract: A method and system for visualization of electrophysiology information sensed by electrodes on a catheter, includes recording times of electrode signal acquisition, designating a reference electrode signal acquisition, assigning a relative time to each recorded time of electrode signal acquisition relative to the reference electrode signal acquisition, identifying the electrodes with signal acquisition, correlating assigned relative times to identified electrodes to generate a sequence of electrode signal acquisitions, and generating a visual representation of the sequence of electrode signal acquisitions generating a visual representation with a graphical image of the electrodes, wherein individual electrodes are visually marked to represent the sequence of electrode signal acquisitions.

Abstract: Medical apparatus includes a probe configured for insertion into a chamber of a heart of a patient and including one or more intracardiac electrodes. Interface circuitry acquires intracardiac electrogram signals from the intracardiac electrodes and electrocardiogram (ECG) signals from body-surface electrodes that are fixed to a body surface of the patient. A processor detects, in each of the heartbeats in the sequence, a P wave in the acquired ECG signals and identifies one or more of the heartbeats in the sequence as ectopic beats responsively to a morphology of the detected P wave in the heartbeats. The processor extracts electrophysiological parameters from the intracardiac electrogram signals acquired during the sequence of the heartbeats and generates a map of the extracted electrophysiological parameters while excluding from the map the intracardiac electrogram signals that were received during the ectopic beats.

Abstract: A medical instrument includes a shaft, a distal-end assembly and a puller-wire. The shaft is configured for insertion into a body of a patient. The distal-end assembly, which is coupled to the shaft, includes a telescopic assembly, configured to elongate so as to collapse the distal-end assembly, and to compress so as to expand the distal-end assembly. The distal-end assembly further includes an elastic element, coupled to self-elongate and thus elongate the telescopic assembly. The distal-end assembly also includes an inflatable balloon, which is coupled to the telescopic assembly and is configured to collapse by the telescopic assembly elongating, and to expand by the telescopic assembly compressing. The puller-wire runs through the shaft and is connected to a distal end of the telescopic assembly, and is configured, when pulled, to compress the telescopic assembly.

Abstract: A radio frequency ablation system, includes a single frequency RF signal generator, control circuitry configured to set phases and amplitudes of a plurality of replicas of the RF signal, a plurality of non-linear amplifiers, configured to amplify the plurality of replicas of the RF signal, and to drive a respective plurality of ablation electrodes in a patient body with the amplified replicas. A processor is configured to receive a superposition of the plurality of replicas as a return signal from a body surface patch electrode, and to adaptively adjust phases and amplitudes of the amplified replicas in response to the return signal with the control circuitry to zero crosstalk currents. In a tissue contact check mode of operation the phases of the amplified replicas are identical, and in an ablation mode of operation the phases of the amplified replicas differ from one another.

Abstract: A pump for use with a tube, having a rotor having an axis of rotation and a plurality of rollers configured to define an orbital path about the axis of rotation, the orbital path defined by a radius, and a roller bed having a surface adapted to support the tube for peristaltic compression by one or more rollers, wherein the surface has a predetermined profile comprising a circular arc segment and at least one side segment, the arc segment having a first curvature defined by the radius, and the at least one side segment having a second curvature lesser than the first curvature.

Abstract: An irreversible electroporation (IRE) includes setting an initial IRE protocol for applying IRE pulses by electrodes of a catheter placed in contact with tissue in an organ. A notification is issued to a user upon determining that the initial IRE protocol is expected to cause bubbles in blood. In response to the notification, user input is received from the user, that selects between the initial IRE protocol and an alternative protocol that is not expected to cause the bubbles. The IRE pulses are applied according to the initial IRE protocol or the alternative IRE protocol, depending on the user input.

Abstract: A trocar for insertion into an organ of a patient includes a cannula, a channel inside the cannula, and a camera. The cannula has a longitudinal axis, and the channel inside the cannula is fitted parallel to the longitudinal axis. The camera is disposed at a distal end of the channel and is configured to provide images in a direction of a distal opening of the cannula.

Abstract: A jig for inspecting a tip of a catheter at a first facility of at least two facilities at which the catheter is processed during manufacturing. The jig includes a housing, at least one clamp, a plurality of cameras mounted in the housing, a plurality of illuminators mounted in the housing and a processor. The processor operates the plurality of cameras and the plurality of illuminators for capturing a plurality of images, and transfers respective copies of the plurality of images to a second facility, separate from the first facility. The processor is additionally configured to generated a report generate a report of the inspection from the first facility and the second facility based on annotations received from the first facility and the second facility.

Abstract: Apparatus, consisting of a probe configured to be inserted into contact with a myocardium, and an electrode attached to the probe. A temperature sensor, incorporated in the probe, is configured to output a temperature signal. A pump irrigates the myocardium, via the probe, with an irrigation fluid at a controllable rate, and a radiofrequency (RF) signal generator applies RF power via the electrode to the myocardium, so as to ablate the myocardium. The apparatus also has processing circuitry that measures a temperature of the probe, based on the temperature signal, while the RF power is applied and, when the measured temperature exceeds a preset target temperature, iteratively reduces the RF power applied by the signal generator and concurrently iteratively varies a rate of irrigation of the irrigation fluid provided by the pump, until the measured temperature is reduced to the preset target temperature.

Abstract: Apparatus for controlling motion of an invasive probe relative to a sheath enclosing the probe. The apparatus includes an outer casing, configured for connection to the sheath. The apparatus further includes a drive mechanism, fixedly connected to the outer casing. The drive mechanism has a first set of components, configured to translate the probe along a direction parallel to as axis of the probe, in order to advance and retract the probe with respect to the sheath in a translational stepwise manner. The drive mechanism also includes a second set of components, configured to rotate the probe around the axis of the probe, in order to rotate the probe clockwise and counter-clockwise, with respect to the sheath, in a rotational stepwise manner.

Abstract: A catheter has a two-piece tip electrode with a shell and a support structure defining a chamber, and a fluid distribution tube that extends longitudinally into the chamber, the fluid tube having fluid apertures along its length for distributing fluid more uniformly distributed throughout the chamber for improved cooling and thus minimizing the risk of char formation on regions of the tip electrode more prone to overheating.