Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation. The methods may be performed using an ultrasound ablation catheter. The methods may also include imaging using at least one ultrasound imaging catheter.

Abstract: In a method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values, energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation. The methods may be performed using an ultrasound ablation catheter. The methods may also include imaging using at least one ultrasound imaging catheter.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation.

Abstract: A method of controlling electrosurgical power delivery is based on a comparison of sensed tissue impedance to various impedance threshold values. Energy is delivered to tissue in a sealing cycle as a series of pulses. A pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a limit.

Abstract: Embodiments of the disclosed technology provide systems, devices, and methods of creating an electrosurgical tissue seal that is augmented with a seal-enhancing composition. One embodiment of a device includes a set of opposing electrosurgical jaws configured to be able to close on a targeted tissue-sealing site; the jaws have a reservoir configured to hold a tissue seal-enhancing composition. The reservoir is in communication with a surface of the tissue-sealing site when the jaws are closed on the site, and the electrosurgical device is configured to deliver the tissue seal-enhancing composition to the site during an electrosurgical procedure. The device is further configured to deliver sufficient radiofrequency energy to the site such that the targeted tissue and the tissue seal-enhancing composition at the tissue-sealing site are processed to form a high integrity sealed tissue site.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation.

Abstract: In a method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values, energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

Abstract: A method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values is provided. Energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

Abstract: Methods and endovascular catheters for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via transmural carotid body ablation.

Abstract: A method of controlling electrosurgical power delivery is based on a comparison of sensed tissue impedance to various impedance threshold values. Energy is delivered to tissue in a sealing cycle as a series of pulses. A pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a limit.

Abstract: An adaptive algorithm monitors the rate of tissue impedance change during an electrosurgical procedure. Impedance levels are examined to determine an impedance ramp and/or slope rate, which indicates the rate at which a target tissue is undergoing a phase or state change. The level of electrosurgical energy applied to the target tissue is adjusted in real time. Energy is applied to the target tissue at levels that allow tissue phase or state change to occur in an optimum fashion. Undesired results such as thermal damage and defective sealing are mitigated. Another embodiment determines impedance achieved within a specific interval and adjusts the electrosurgical energy applied to the tissue after a threshold impedance has been maintained or exceeded for a predetermined interval. A further aspect of the invention provides mitigation during processing for partial tissue coverage of device electrodes or thin tissue.

Abstract: Embodiments of the disclosed technology provide systems, devices, and methods of creating an electrosurgical tissue seal that is augmented with a seal-enhancing composition. One embodiment of a device includes a set of opposing electrosurgical jaws configured to be able to close on a targeted tissue-sealing site; the jaws have a reservoir configured to hold a tissue seal-enhancing composition. The reservoir is in communication with a surface of the tissue-sealing site when the jaws are closed on the site, and the electrosurgical device is configured to deliver the tissue seal-enhancing composition to the site during an electrosurgical procedure. The device is further configured to deliver sufficient radiofrequency energy to the site such that the targeted tissue and the tissue seal-enhancing composition at the tissue-sealing site are processed to form a high integrity sealed tissue site.

Abstract: Methods for treating anatomic tissue defects such as a patent foramen ovale generally involve positioning a distal end of a catheter device at the site of the defect, exposing a housing and energy transmission member from the distal end of the catheter, engaging the housing with tissues at the site of the defect, applying suction or other approximating tool to the tissue via the housing to bring the tissue together, and applying energy to the tissue with the energy transmission member or to deliver a clip or fixation device to substantially close the defect. Apparatus generally include a catheter body, a housing extending from a distal end of the catheter body for engaging tissue at the site of the defect, and further adapted to house a fusing or fixation device such as an energy transmission member adjacent a distal end of the housing, or a clip or fixation delivery element.

Abstract: A single transducer element that is capable of oscillation at a plurality of natural resonant frequencies may be used in an ultrasonic imaging catheter assembly including a catheter body configured to be inserted and guided through the vascular system of a living being, a lumen and a rotatable imaging core adapted to pass through the lumen, the imaging core including a flexible drive-shaft. Because the transducer element is capable of oscillation at a plurality of natural resonant frequencies, a user can switch from one frequency to another in order to improve the depth of field or resolution without having to switch out the catheter or imaging core.

Abstract: An adaptive algorithm monitors, inter alia, the rate of tissue impedance change during an electrosurgical procedure. Impedance levels achieved within a specific timeframe are examined to determine an impedance ramp and/or slope rate, which indicates the rate at which a target tissue is undergoing a phase or state change and, thus, indicates a desired rate of tissue processing. The level of electrosurgical energy applied to the target tissue is adjusted in real time in accordance with such rate of impedance change and/or by predetermined values. Energy is thus applied to the target tissue at levels that allow tissue phase or state change to occur in an optimum fashion, for example allowing moisture to escape from the tissue slowly, and thus avoid thermal damage. As a result, such undesired results as thermal damage and defective sealing are mitigated.

Abstract: A method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values is provided. Energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

Abstract: Methods and apparatus for treatment of layered tissue defects having a majority of the surfaces of the defect layers in contact generally involve use of a catheter having at least one energy transmission member at its distal end. The distal end of the apparatus also typically has a force applying member which can apply a force to the tissue defect. Often this force is a lateral force or vacuum which helps the tissue to appose itself. An exemplary method of closing a patent foramen ovale (PFO) involves positioning a closure device between layers of the PFO. Energy is then applied to the layered tissue defect with the closure device so as to substantially close the tissue defect. The energy is often monopolar or bipolar radiofrequency energy. A force may also be applied by the closure device to the layered tissue defect so as to bring the layered tissue defect together.

Abstract: Methods and apparatus for treatment of layered tissue defects such as a patent foramen ovale provide for applying energy to tissues adjacent to the PFO with a closure device that substantially closes the PFO. Apparatus generally includes an elongate flexible member having a proximal end and a distal end and an energy transmission member deployable from the elongate flexible member. The energy transmission member applies energy to the layered tissue defect at a first position and a second position adjacent to the first position so as to substantially close the layered tissue defect along at least a portion of the defect. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating, direct heat energy, cryogenic or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.