Abstract: Described embodiments include an apparatus that includes an intrabody probe and an electrode coupled to a distal end of the intrabody probe. The electrode includes a flexible electrically-insulating substrate, comprising a substrate surface. The electrode further includes a layer of an electrically-conducting metal covering at least part of the substrate surface. The electrode further includes a metallic sheet, comprising an inner sheet surface, and an outer sheet surface shaped to define multiple depressions. The electrode further includes an adhesive, which fills the depressions and bonds the outer sheet surface to the layer of the electrically-conducting metal. Other embodiments are also described.

Abstract: A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter.

Abstract: A medical tool includes a rotatable hollow tube and one or more electrical wires. The rotatable hollow tube is defining a working channel therein for insertion of a medical instrument into a cavity of a patient body. The one or more electrical wires traverse the working channel for exchanging electrical signals with one or more electronic devices located at a distal end of the rotatable hollow tube. The working channel has a non-circular cross section for passing both the medical instrument and the one or more electrical wires, and for allowing rotation of the rotatable hollow tube relative to the medical instrument located inside the working channel in the presence of the one or more electrical wires.

Abstract: A method includes receiving multiple electrophysiological (EP) signals acquired by multiple electrodes of a multi-electrode catheter that are in contact with tissue in a region of a cardiac chamber, and respective tissue locations at which the electrodes acquired the EP signals. The region is divided into two sections. Using the EP signals acquired by the electrodes, local activation times (LAT) are calculated for the respective tissue locations, and found are: a first section of the two sections having a smaller average LAT value, and a second section of the two sections having a higher average value. Determined are a first representative location in the first section, and a second representative location in the second section. A propagation vector is calculated between the first and second representative locations, that is indicative of propagation of an EP wave that has generated the EP signals. The propagation vector is presented to a user.

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 dual-action pump includes a cylinder, a piston and a controller. The cylinder includes first and second inlet-outlet ports, each of the first and second inlet-outlet ports is configured to alternately intake a fluid to the cylinder and output the fluid from the cylinder. The piston is configured to be moved within the cylinder in a periodic cycle that alternately reverses a direction of movement of the piston, so as to pump the fluid through the first and second inlet-outlet ports. The controller is configured to control the movement of the piston within the cylinder, including setting to the piston: (a) a first speed, during a first predefined interval that precedes reversing the direction of movement, (b) a second speed, larger than the first speed, during a second predefined interval that follows reversing the direction, and (c) a baseline speed, smaller than the first speed, outside the first and second intervals.

Abstract: In one embodiment, a medical system includes respective electrodes for application to a body of a subject and to output a set of respective activation signals in response to electrical activity of a heart of the subject captured over a sequence of heartbeat intervals, and a processor to classify a first heartbeat interval of the set of activation signals as a first morphological template, compute a measure of similarity between a second heartbeat interval of the set of activation signals and the first morphological template, group the second heartbeat interval of the set of activation signals in a first morphological group with the first morphological template responsively to the measure exceeding a predefined threshold, and classify the second heartbeat interval of the set of activation signals as a second morphological template responsively to the measure not exceeding the predefined threshold, and repeat the above, mutatis mutandis, for subsequent heartbeat intervals.

Abstract: A catheter comprising an elongated catheter body, and an electrode assembly distal of the catheter body, the assembly comprising a plurality of spines, wherein each spine has a distal end that is connected to the distal end of at least one other spine, wherein each spine has an electrode-carrying portion, the electrode-carrying portions of all spines of the assembly being in a single common plane, and wherein all spines of the assembly have a uniform exposed total length.

Abstract: A medical apparatus includes a trocar, a control handle, a first electrical wire, and a second electrical wire. The trocar is used for insertion into an organ of a patient, and includes (i) a cannula having a longitudinal axis, (ii) a position sensor that is fitted inside the cannula, and (iii) a camera that is coupled to a movable element, which is fitted inside the cannula and configured to be moved along the longitudinal axis for moving the camera along the cannula. The control handle is coupled to a proximal end of the movable element and is configured to move the movable element and the camera. The first electrical wire is coupled between the control handle and the camera. The second electrical wire is coupled between the control handle and the position sensor, and has a slack configured to compensate for a motion of the camera.

Abstract: An irreversible electroporation and radio frequency ablation (IRE/RFA) generator includes 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 output signal having a composition of the adapted IRE pulses having a final shape and repetition rate, the converted RF sinusoidal signal, or a combined IRE/RFA output signal, by switching between the received IRE square pulses and the received converted RF sinusoidal signal.

Abstract: A method and system includes, using a probe, applying irreversible electroporation (IRE) pulses to tissue over a time period to form a lesion in the tissue. A contact force applied to the tissue by the probe is measured over the time period. An IRE index is calculated based on the measured contact force and on a power level of the IRE pulses. Whether a value of the calculated estimated IRE index values has reached the prespecified target IRE index value is determined. Application of the IRE pulses to the tissue is displayed as a graphic and/or alphanumeric data while the estimated IRE index values are being calculated.

Abstract: Shown and described is electrophysiology catheter end effector having a balloon with three expandable membranes attached to each other such that wiring (for the electrodes or other sensors on the membrane surfaces) no longer extend from inside the first membrane yet at the same time is captured between the first membrane and a second membrane.

Abstract: A pacing system includes a signal generator and an electromechanical switch. The signal generator is configured to generate a pacing signal. The electromechanical switch has a plurality of outputs that are configured to be coupled to a plurality of electrodes inserted into a heart of a patient, each output configured to deliver the pacing signal to a respective electrode. The electromechanical switch is configured to route the pacing signal to no more than a single selected one of the outputs at any given time, so as to pace the heart using no more than a single selected one of the electrodes.

Abstract: A medical probe includes a generally tubular member with a tip portion coupled to the tubular member. A puller wire is disposed in the tubular member and configured for movement along the longitudinal axis to bend the tip portion with respect to the longitudinal axis. An anchor is disposed within the tubular member and connected to the puller wire such that the anchor has a t-bar. The t-bar includes a generally transverse extension and a ferrule connected to the puller wire. The probe includes a fiber engaged to the generally transverse extension and extending distally into the probe to increase a strength of the anchor with respect to forces applied to the puller wire to deflect the tip of the medical probe.

Abstract: A medical probe, including a flexible insertion tube having a proximal segment and a deflectable distal segment, and containing first and second lumens running longitudinally through the insertion tube, wherein the first and second lumens are twisted around each other in the proximal segment, and run parallel to each other in the deflectable distal segment. The medical probe also includes first and second wires running respectively through the first and second lumens and having respective first and second distal ends, which are anchored within the deflectable distal segment of the insertion tube.

Abstract: A method of mapping includes receiving inputs measured by a probe at respective locations inside a body cavity of a subject. At each of the respective locations, a respective contact quality between the probe and a tissue in the body cavity is measured. The inputs for which the respective contact quality is outside a defined range are rejected, and a map of the body cavity is created using the inputs that are not rejected.

Abstract: A method for producing an image of a body tissue surface. The method includes transforming a source 3-D model of the body tissue surface into a flattened model comprising details of the body tissue surface represented visually on an unwrapped and flattened surface, wherein the flattened model represents transformed positions of the source 3-D model of the body tissue surface defined between a first edge and a second edge. The first edge is formed about a lumen defined by the body tissue surface, and the body tissue surface projects about the lumen to the second edge. The method further includes producing an image from the flattened model.

Abstract: A method, including receiving, from electrodes positioned within a heart, first signals from at least three of the electrodes indicating electrical activity in tissue with which the at least three of the electrodes engage, and second signals indicating locations of the at least three electrodes. The second signals are processed to compute the locations of the at least three electrodes and to determine a geometric center of the locations. Based on the signals, an electroanatomical map is generated for an area of the tissue including the geometric center, and an arrhythmia focus is determined in the map. A circle is presented, and within the circle, a region of the map is presented including the geometric center and the focus so that the geometric center on the map aligns with a center of the circle, the region within the circle indicating a spatial relationship between the geometric center and the focus.

Abstract: An electrical apparatus includes a spiral electrode and an interface circuit. The spiral electrode is disposed on a distal end of a probe for insertion into a body of a patient. The interface circuit is configured to (a) transfer a radiofrequency (RF) ablation signal to the electrode for ablating tissue in the body, (b) output a voltage that develops across the electrode in response to an external magnetic field, for measuring a position of the distal end in the body, and (c) transfer electrical current through the electrode for measuring a resistivity that is indicative of tissue temperature in a vicinity of the electrode.

Abstract: An ablation system includes multiple electrodes configured to contact body tissue of a patient, including two or more ablation electrodes for contacting respective locations in a target organ and a return electrode. A signal-generating unit includes multiple signal generators, which are configured to apply respective composite signals to respective ones of the ablation electrodes. The composite signals include multiple, respective signal components, including respective ablation signals, having different, respective ablation-signal amplitudes and phases at a common ablation-signal frequency, and respective probe signals having respective probe-signal amplitudes and different respective probe-signal frequencies. A processor is coupled to measure the probe signals received by each of the multiple electrodes, and responsively to the measured probe signals, to control the ablation-signal amplitudes and phases.