Abstract: A catheter including a distal end assembly having an external surface coating. Where the distal end assembly includes electrodes or other electrical components, the coating is preferably electrically conductive. Such an electrically conductive coating is formed from a material comprising regenerated cellulose, although other materials such as a hydrogel or a plastic having an electrically conductive component are utilizable. Where the distal end assembly includes optical or ultrasonic components, the regenerated cellulose coating is suitable. The robustness of the surface coating permits the manufacture and utilization of electrode configurations that are formed on a non-conductive base member by processes such as pad printing, vapor deposition, ion beam assisted deposition, electroplating and other printed circuit manufacturing processes.

Abstract: A catheter device for inserting a tightened lasso of material into a body by remote control includes a removable end component which provides ratchet-like tightening but prevents loosening of the lasso.

Abstract: A sleeve assembly for use in the transition region of a catheter between a relatively stiff catheter body and a less stiff distal catheter region mediates the difference in stiffness between these two catheter regions.

Abstract: Systems and methods support arrays of multiple electrodes in asymmetric pattern, either radially, or axially, or both. Radial asymmetry makes it possible provide localized density of electrodes. Axial asymmetry makes it possible to locate electrodes in a pattern that closely conforms to the irregular contours of an interior body cavity, like the heart. In a preferred embodiment, the systems and methods operate the multiple electrode arrays to form continuous lesion patterns.

Abstract: A probe for cardiac diagnosis and/or treatment has a catheter tube. The distal end of the catheter tube carries first and second electrode elements. The probe includes a mechanism for steering the first electrode element relative to the second electrode element so that the user can move the first electrode element into and out of contact with endocardial tissue without disturbing the contact of the second electrode element with endocardial tissue, even through the two electrode elements are carried on a common catheter tube. The distal end can carry a three dimensional structure having an open interior area. One of electrode elements can be steered through the open interior area of the structure. Electrode elements on the exterior of the structure can be used for surface mapping, while the electrode element inside the structure is steered to ablate tissue.

Abstract: Porous electrode assemblies for tissue heating and ablation systems and methods enable ionic transport of electrical energy to occur substantially free of liquid perfusion.

Abstract: Systems and methods acquire electrocardiograms using a first electrode associated with a region of heart tissue and a second body surface electrode. An analog or digital processing element is coupled to the first and second electrodes for conditioning the first electrode to emit a pacing signal and for conditioning the second electrode to sense paced electrocardiograms occurring as a result of the pacing signal. The systems and methods also employ a template of an electrocardiogram of a cardiac event of known diagnosis; for example an arrhythmia that the physician seeks to treat. The systems and methods compare this event-specific template to a sample of a paced electrocardiogram. The comparison yields a matching coefficient indicating how alike the input sample is to the input template. The matching coefficient can be used by the physician, for example, to aid in the location of sites that are potentially appropriate for ablation.

Abstract: Systems and methods for locating an operative element within an interior body space use a locating probe, which includes at least one transmitting element to transmit an electric waveform output within at least a portion of the space. The systems and methods also use a sensing element, which is adapted to be carried by the operative element to sense a local electric waveform within the space. A processing element coupled to the sensing element generates a processed output that locates the sensing element relative to the locating probe based, at least in part, upon a differential comparison of the waveform output and the sensed local waveform.

Abstract: Systems and methods evaluate electrical contact between the myocardium and one or more electrodes inside the heart. The systems and methods electrically sense electrical contact between the myocardium and electrodes and generate unitary contact-indicating outputs indicating the presence or absence of electrical contact between the myocardium and each particular electrode. The systems and methods also correlate the electrode-specific unitary outputs to generate a compound contact-indicating output. The compound output represents the aggregate of the electrical contact between the myocardium and multiple electrodes on a multiple electrode array.

Abstract: An electrode circuit has a distal region for carrying at least one electrode, a proximal region for connection to external apparatus, and an intermediate region electrically coupling the distal region with the proximal region. At least one, and preferably all, of the regions comprises flexible ribbon cable having two or more adjacent tracks of electrical conduction material and adjoining electrical insulating material. Use of ribbon cable make possible highly dense, extremely reliable electrical connections. Its reliability and density obviate the need for complicated multiplexing schemes at the distal region. Instead, less complicated, proximal multiplexing schemes can be used.

Abstract: Electrode assemblies and associated systems employ a nonporous wall having an exterior for contacting tissue. The exterior peripherally surrounds an interior area. The wall is essentially free of electrically conductive material. The wall is adapted to assume an expanded geometry having a first maximum diameter and a collapsed geometry having a second maximum diameter less than the first maximum diameter. The assemblies and systems include a lumen that conveys a medium containing ions into the interior area. An element free of physical contact with the wall couples the medium within the interior area to a source of electrical energy to enable ionic transport of electrical energy from the source through the medium to the wall for capacitive coupling to tissue contacting the exterior of the wall.

Abstract: A catheter including fluoroscopic marker components disposed in the catheter distal end portion to provide enhanced fluoroscopic visibility of the catheter end portion. Various embodiments of the marker include a cylindrical plug disposed within the catheter tip, a half section catheter tip, a longitudinal stripe along a sidewall of the catheter end portion, and multiple combinations of marker plugs and marker stripes to provide enhanced in vivo fluoroscopically visible catheter disposition information to the physician. An enhanced embodiment of the present invention includes an orientation marker that is disposed on the steering handle, particularly on the control knob, to provide visual and tactile information to the catheter user regarding the direction to manipulate the control knob in order to maneuver the catheter distal end portion.

Abstract: A multiple electrode array senses electrical events in heart tissue at different orientations in a localized region. First, second, and third electrode elements are spaced apart along different axes. The electrodes are electrically isolated from each other. The spaced apart and electrically isolated electrodes sense multiple bipolar signals measured along the different axes. The electrode array can, without changing position, continuously record multiple electrical events at different relative orientations within a localized area. The spacing and orientation of electrodes on the array permit the physician to detect a small volume signal (like one associated with an accessory pathway) and to differentiate it from nearby large volume signals (like those associated with atrial and ventricular potentials).

Abstract: A graphical user interface (GUI) is provided for assisting medical personnel in interpreting data collected by a multiple electrode catheter deployed within the body. The GUI generates and displays an image of the multiple electrode catheter. By manipulating appropriate controls, the medical personnel are able to change the orientation of the displayed image until it matches the orientation of the actual multiple electrode catheter as seen on a fluoroscope. Afterwards, the medical personnel can determine the relative position and orientation of the catheter by reference to the GUI generated image. To aid in interpreting data recovered by the catheter, the individual electrodes and splines are highlighted and labeled. Electrodes recovering particular types of physiological waveforms can be automatically identified and highlighted. Comments and anatomic landmarks can be inserted where desired to further assist in interpreting data.

Abstract: Elongated spline members are threaded through a hub to form depending spline legs. In one embodiment, the spline members are threaded through a puncturable material on the hub. In another embodiment, the spline members are threaded through a slotted hub, which is then encapsulated by a sealing, elastomeric material. In another embodiment, multiple spline members are looped and woven together beyond a distal end of the hub, and the distal end of the hub serves to exert a force that maintains the woven relationship of the spline members. The spline legs, which radiate from the hub, preferable carry one or more diagnostic or therapeutic elements, such as electrodes. Preferably, a base constrains the terminal ends of the spline legs in a normally expanded geometry between the hub and base.

Abstract: An ablation catheter having self assembling large surface area distal component provided with one or more energy emitting surfaces for thermally destroying tissue. The distal component is oriented to present a compact, low profile for introduction into the heart, and after introduction is reconfigured to present a large surface area distal ablation tip assembly. The distal tip component is subsequently returned to the low profile configuration for removal from the heart. Once introduced, the energy emitting surfaces are thus carried by a distal component having significantly enlarged surface area. The enlargable distal component is produced using a plurality of pivoting sections capable of alignment into a compact profile for introduction into and removal from a living body. When reconfigured by pivoting of the sections into contact with each other, the distal component has an significantly enlarged dimension.

Abstract: A catheter assembly having a sheath, which includes a side wall enclosing an interior bore, and a distal region. The assembly also has a bendable catheter tube, which is carried for sliding movement in the interior bore. A pull wire also runs through the interior bore of the sheath, preferably within a lumen. The catheter tube has a distal portion with a coupling which joins the distal portion of the catheter tube and the distal portion of the pull wire. Relative movement of the pull wire and the sheath causes bending of the catheter tube outwardly through the opening, in response to sliding movement of the catheter tube within the interior bore toward the distal region of the sheath.

Abstract: An imaging element characterizes tissue morphology by analyzing perfusion patterns of a contrast media in tissue visualized by the imaging element, to identify infarcted tissue. In a preferred implementation, a catheter tube introduced into a heart region carries the imaging element, as well as a support structure spaced from the imaging element, which contacts endocardial tissue. The imaging element is moved as the imaging element visualizes tissue. A selected electrical event is sensed in surrounding myocardial tissue, which regulates movement of the imaging element. The support element stabilizes the moving imaging element as it visualizes tissue, providing resistance to dislodgment or disorientation despite the presence of dynamic forces.

Abstract: Systems and methods employ an energy emitting electrode to heat tissue. The systems and methods derive a temperature prediction for a future time period. The systems and methods control the application of energy to the energy emitting electrode based, at least in part, upon the temperature prediction.

Abstract: A bidirectional catheter with a deflectable tip at a distal end includes a handle at a proximal end and a tubular member extending between the tip and the handle. The handle includes a first piston member slidably mounted in a handle base with proximal ends of steering wires secured in the handle. The steering wires extend through the tubular member with respective distal ends thereof secured to circumferentially spaced portions of the distal end tip. Axial displacement of the piston member in a second direction conversely urges deflection of the distal end tip in a second direction by tensioning the other wire relative to the first wire. The piston member can include another piston member slidable in the first piston member with the proximal ends of the steering wires secured in the first mentioned piston member and the handle member, respectively, and with the other piston member supporting a proximal end of the tubular member.