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.

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 catheter has a two-piece tip electrode with a shell and a support structure that are secured to each other by multiple redundant mechanisms in order to reduce the risk of tip detachment during a procedure. The tip electrode includes at least two different welds attaching the shell to the support structure to provide a dual failure mode. One weld includes a seam weld and another weld includes a penetration weld.

Abstract: A method includes receiving a first representation of an internal surface of at least a portion of a wall of an organ of a patient, and a second representation of an external surface of at least the portion of the wall of the organ. The first and second representations are registered with one another. An exploded representation is generated from the first and second representations, that shows both the internal surface and the external surface. The exploded representation is presented to a user.

Abstract: An aspiration catheter for assisting in the retrieval of a clot from a vessel of a patient including at least one electrode pair and a first pressure sensor positioned within an inner lumen of the aspiration catheter and a second and third pressure sensor positioned on an exterior surface of the aspiration catheter. The electrode pair and pressure sensors are in electrical communication with a control console. The control console is configured to modulate an aspiration vacuum pressure waveform pattern applied through the aspiration catheter based on electrical and pressure inputs from the one or more sensors, and optionally based on a blood pressure waveform pattern of the patient.

Abstract: Systems and methods are disclosed for generating an electro-anatomical map of the heart. Techniques disclosed include measuring groups of activation signals. The activation signals of each group are measured by respective electrodes of a mapping catheter that is placed at a respective position in the heart. Where at least one electrode of the mapping catheter that measured an activation signal of one group spatially overlapped with a respective electrode of the mapping catheter that measured an activation signal of another group. Techniques disclosed further include obtaining, based on the groups of activation signals, respective sets of time measurements, utilizing the overlapping electrodes. And, constructing the electro-anatomical map based on the obtained sets of time measurements.

Abstract: A method for electrophysiological assessment, including acquiring electrical signals from locations of a region of ablated tissue in a heart chamber, and deriving from the signals respective annotations, which are indicative of times within a heart cycle at which a conduction wave traversed the locations. The method includes identifying a first location, at a first distance from the region, where the electrical signals include a double-potential signal, having first and second annotations at different times within the heart cycle, and identifying, in proximity to the first location, a second location, at a second distance from the region, greater than the first distance, where the electrical signals have a third annotation. The method further includes selecting one of the first and second annotations that is closest to the third annotation as a valid annotation for the first location, and displaying the valid annotation on an electroanatomical map of the heart.

Abstract: An apparatus, including a flexible insertion tube having a distal end for insertion into a body cavity, and first and second conduits configured to deliver first and second fluids, respectively, to the distal end. The distal end includes a first balloon coupled to the first conduit so that the first fluid inflates the first balloon and is delivered, via one or more spray ports in the first balloon, to tissue in the body cavity, a second balloon contained within the first balloon and coupled to the second conduit so that the second fluid inflates the second balloon, and multiple splines including a flexible, resilient material and extending along a longitudinal axis of the distal end, and configured to constrain the second balloon so that inflation of the second balloon creates lobes that form, along the longitudinal axis between the lobes, channels that direct the first fluid to the spray ports.

Abstract: A system includes a processor and an output device. The processor is configured to: (a) receive electrical signals indicative of measured positions of (i) one or more chest position sensors attached externally to a chest of a patient, and (ii) one or more back position sensors attached externally to a back of the patient; (b) compare between (i) a first shift between the measured positions and respective predefined positions of the one or more chest position sensors, and (ii) a second shift between the measured positions and respective predefined positions of the one or more back position sensors; and (c) produce an alert in response to detecting a discrepancy between the first and second shifts. The output device is configured to output the alert to a user.

Abstract: A catheter may be adapted to map a chamber of the heart. The catheter may include a magnetic and/or ultrasound sensor for navigation. The body of the catheter may be pliable and configured to form a predetermined shape upon exiting a catheter sheath. Upon exiting the catheter sheath, the catheter body may be configured to form one or more loops, and the loops may be non-overlapping loops. In some examples, the non-overlapping loops may be concentric loops. Alternatively, the catheter body may be configured to form one or more splines. The catheter body may include an embedded electrode assembly. The electrodes of the electrode assembly may be may be arranged in one or more rows and configured to detect a wave front. The electrode assembly may also be configured to generate and activation sequence and determine a direction of an activation source.

Abstract: Methods, apparatus and computer software products implement embodiments of the present invention that include applying energy to a probe that is in contact with tissue in a body cavity so as to ablate the tissue. While applying the energy, signals are received from a location transducer in the probe, which are indicative of a location of the probe in the cavity. The signals are processed so as to derive 3D location coordinate points corresponding to the location of the probe at a sequence of times during which the energy was applied. While applying the energy, a 3D representation of the body cavity is rendered to a display, and visual indicators are superimposed on the 3D representation, the visual indicators corresponding to the 3D location coordinate points at the sequence of times. Finally, a linear trace connecting the coordinate points in accordance with the sequence is superimposed on the 3D representation.