Abstract: An irreversible electroporation and radio frequency ablation (IRE/RFA) generator incudes an IRE pulse generator, harmonic filtration circuitry, and a waveform interleaver. The IRE pulse generator is configured to generate biphasic IRE pulses. The harmonic filtration circuitry is configured to convert the IRE pulses into an RF signal. The waveform interleaver, which is configured to receive the IRE pulses and the RF signal and generate an IRE/RFA output signal by interleaving in alternation one or more of the IRE pulses with one or more periods of the RF signal.

Abstract: In one embodiment, a medical system includes a catheter configured to be inserted into a chamber of a heart of a living subject, and including a distal end including catheter electrodes configured to contact tissue at respective locations within the chamber of the heart, at least one position sensor configured to provide at least one position signal indicative of a position of the distal end, a display, and processing circuitry configured to compute the position of the distal end of the catheter responsively to the at least one position signal, render to the display a 3D anatomical map of the chamber of the heart and a 3D representation of the distal end of the catheter, and render to the display over at least part of the map, at least one intracardiac electrogram trace representing electrical activity in the tissue that is sensed by at least one of the catheter electrodes.

Abstract: A medical procedure system, including a medical instrument to be inserted into a body part, and including position-tracking transducers to provide position signals, a distal end, and at least one radiopaque marker, a position tracking sub-system to compute a position including at least one location and orientation of the distal end in a position-tracking sub-system coordinate frame responsively to the position signals, a fluoroscope to capture fluoroscopic images of an interior of the body part and the radiopaque marker(s), and a registration sub-system to render, to a display, the captured fluoroscopic images including at least one marker-image of the radiopaque marker(s), and at least one graphical representation indicative of the computed position of the distal end, receive user-alignment input aligning the graphical representation(s) with the marker-image(s), and register the position-tracking sub-system coordinate frame with a coordinate frame of the fluoroscope responsively to the received user-alignmen

Abstract: Described embodiments include a system that includes a display and a processor. The processor is configured to modify an image that includes a representation of a wall of an anatomical cavity, by overlaying an icon that represents an intrabody tool on a portion of the image that corresponds to a location of the intrabody tool within the anatomical cavity, and overlaying a marker on a portion of the representation of the wall that corresponds to a location at which the intrabody tool would meet the wall, were the intrabody tool to continue moving toward the wall in a direction in which the intrabody tool is pointing. The processor is further configured to display the modified image on the display. Other embodiments are also described.

Abstract: A catheter includes an insertion tube, a flexible substrate and one or more electrical devices. The insertion tube is configured for insertion into a patient body. The flexible substrate is configured to wrap around a distal end of the insertion tube and includes electrical interconnections. The electrical devices are coupled to the flexible substrate and are connected to the electrical interconnections.

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: A system includes a catheter and a processor. The catheter includes an expandable distal-end assembly (EDEA) having: (i) a transmitter, which is coupled to the EDEA and is configured to transmit a first signal, and (ii) one or more receivers, which are coupled to an elastic component of the EDEA, and are configured to produce one or more respective second signals in response to receiving the first signal. The processor is configured to estimate, based on the one or more respective second signals, a force applied to the elastic component.

Abstract: Catheterization is carried out by inserting a probe into a cavity in a body of a subject. The probe has a contact force, a transmitter, a receiver, and an ultrasound transducer in its distal segment. After navigating the probe into contact with a target in a wall of the cavity using the contact force sensor, a desired contact force is established and maintained between the probe and the target. Responsively to readings by the receiver of signals from the transmitter, the distal end of the probe is oriented orthogonally to the target.

Abstract: Methods and systems are provided for training machine learning (e.g., NN) or other artificial intelligence (AI) models to control a robot arm to manipulate a catheter to robotically perform an invasive clinical catheter-based procedure.

Abstract: An electroporation ablation system includes a probe to be inserted into a body part of a living subject, and including a distal end including at least one electrode, body-surface patches to be applied to a skin surface, an ablation power generator to apply at least one first electrical pulse train between the electrode(s) and first one(s) of the body-surface patches, and a processor to provide a measurement of movement of the living subject responsively to applying the first electrical pulse train(s) between the electrode(s) and the first one(s) of the body-surface patches, and select second one(s) of the body-surface patches responsively to the measurement of movement, and wherein the ablation power generator is configured to apply at least one second electrical pulse train between the electrode(s) and the second one(s) of the body-surface patches.

Abstract: An apparatus includes an interface and a processor. The interface is configured to receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches attached to a body of a patient, the magnetic-positioning signals indicative of respective positions of the position sensors. The processor is configured to (i) detect an inadvertent stimulation of a phrenic nerve of the patient, which occurs due to cardiac pacing applied by an intra-cardiac electrode in a heart of the patient, (ii) estimate, based on the magnetic-positioning signals, a motion of one or more of the body-surface patches occurring during the detected stimulation of the phrenic nerve, (iii) estimate, based on the estimated motion of the body-surface patches, a distance between the pacing electrode and the phrenic nerve, and (iv) send an output derived from the estimated distance to the output device.

Abstract: A method includes, receiving a first electrocardiogram (ECG) signal, which is acquired in a heart of a patient and is distorted by interference. One or more external signals that sense the interference concurrently with acquisition of the first ECG signal are received from one or more sources external to the heart. A second ECG signal, in which the interference is suppressed relative to the first ECG signal, is produced by applying a trained Neural Network (NN) to the first ECG signal and to the one or more external signals.

Abstract: A system includes a catheter and a processor. The catheter includes a distal-end assembly coupled to a distal end of a shaft for insertion into a cavity of an organ of a patient, the distal-end assembly including (i) one or more functional electrodes configured to be placed in contact with wall tissue of the cavity and (ii) a reference electrode configured to be placed in the cavity but not in contact with the wall tissue. The processor is configured to (i) estimate one or more impedances between one or more of the functional electrodes and the reference electrode, and (ii) based on the impedances, determine, for at least a functional electrode from among the one or more functional electrodes, whether the functional electrode is in physical contact with the wall tissue.

Abstract: A method includes emitting an ultrasound beam, having a predefined field of view (FOV), from an array of ultrasound transducers in a catheter in an organ of a patient. Echo signals are received in the array, in response to the ultrasound beam. A position of a target object is estimated within the FOV. When the estimated position of the target object violates a centering condition, the FOV of the ultrasound beam is automatically modified to re-meet the centering condition.

Abstract: An irreversible electroporation (IRE) system includes an IRE ablation power source configured to generate bipolar IRE pulses, a switching assembly, and a processor. The switching assembly is configured to short-circuit a first group and a second group of electrodes of a catheter, the groups of electrodes configured to be placed in contact with tissue of organ, so as to create respective combined electrodes of a first size and a second size smaller than the first size, and to connect the IRE ablation power source to the groups of electrodes. The processor is configured to receive target tissue depth of ablation, select the groups of the electrodes, to control the switching assembly to create the combined electrodes and to ablate the tissue by controlling the switching assembly to apply the bipolar IRE pulses to the groups of electrodes to ablate tissue location in contact with a combined electrode to target depth.

Abstract: A method includes receiving a set of data points including positions and respective velocities of an activation wave in a tissue region of a cardiac chamber. The set is partitioned into at least two velocity clusters, each velocity cluster characterized by a respective velocity of the activation wave. One or more border curves are estimated, between the at least two clusters. The one or more border curves are indicated to a user as possible lines of block of the activation wave.

Abstract: A medical probe includes a shaft and a distal-end assembly. The shaft is configured for insertion into an organ of a body. The distal-end assembly is fitted at a distal end of the shaft. The distal-end assembly includes (a) a substrate, (b) a two-dimensional (2D) ultrasound transducer array located on the substrate, and (c) a sensor, which is also located on the substrate, the sensor configured to output signals indicative of a position and an orientation of the 2D ultrasound transducer array inside the organ.

Abstract: A method includes emitting an ultrasound beam from an array of ultrasound transducers in a catheter placed in a blood pool in an organ. Echo signals reflected in response to the ultrasound beam are received in the array. Distinction is made in the echo signals between (i) first spectral signal components having Doppler shifts characteristic of blood and (ii) second spectral signal components having Doppler shifts characteristic of tissue of the organ. The first spectral signal components are suppressed relative to the second spectral signal components in the echo signals. An ultrasound image of at least a portion of the organ is reconstructed from the echo signals having the suppressed first spectral signal components. The reconstructed image is displayed to a user.

Abstract: A medical procedure system, including a medical instrument to be inserted into a body part, and including position-tracking transducers to provide position signals, a distal end, and at least one radiopaque marker, a position tracking sub-system to compute a position including at least one location and orientation of the distal end in a position-tracking sub-system coordinate frame responsively to the position signals, a fluoroscope to capture fluoroscopic images of an interior of the body part and the radiopaque marker(s), and a registration sub-system to render, to a display, the captured fluoroscopic images including at least one marker-image of the radiopaque marker(s), and at least one graphical representation indicative of the computed position of the distal end, receive user-alignment input aligning the graphical representation(s) with the marker-image(s), and register the position-tracking sub-system coordinate frame with a coordinate frame of the fluoroscope responsively to the received user-alignmen

Abstract: Medical apparatus includes an insertion tube configured for insertion into a body cavity of a patient and an expandable assembly connected distally to the insertion tube and comprising electrodes, which are configured to apply electrical energy to tissue within the body cavity. A flexible porous sheath is fitted over the expandable assembly and configured to contact the tissue within the body cavity so that the electrical energy is applied from the electrodes through the sheath to the tissue.