Abstract: A cardiac tissue ablation system includes an elongate catheter configured to deliver a distal end thereof to a patient's heart and an expandable member formed at the distal portion of the catheter. The expandable member has an elastic portion configured to conform to the shape of a target tissue region upon expansion. The expandable member has a plurality of inflation settings that correspond to different levels of inflation of the expandable member. The system also includes a controller for selecting an inflation setting for the expandable member and an energy emitter movably disposed within a lumen of the catheter. The energy emitter is configured to deliver radiant ablative energy to the target tissue region.

Abstract: A system is provided for identifying the sufficiency of lesions formed during a tissue ablation procedure. The system captures live and still images from the surgical site and provides composite imaging to the operator. Through the use of the system, the aiming light used to direct ablative energy is captured on the still images and used to indicate locations in a surgical site where energy has been directed. Through the use of processing modules, the system can analyze the lesions and determine the sufficiency thereof.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment, a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, a deflectable end section at the distal end of the catheter body, which upon deflection causes the distal end segment to bend into various curved positions within a plane of deflection, and a bent tip oriented in a direction that is out of the plane of deflection.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical wave guide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the wave guide projects an annular light pattern, e.g., a circle or a halo.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical wave guide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the wave guide projects an annular light pattern, e.g., a circle or a halo.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site to form a series of lesions on the target tissue.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical wave guide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the wave guide projects an annular light pattern, e.g., a circle or a halo.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a method for ablating tissue about an ostium of a right inferior vein of a heart includes positioning a sheath catheter having a deflectable distal end segment with a bent tip element in the left atrium of a heart, causing the distal end segment to deflect in a compound curve as the catheter is advanced towards an ostium of a right inferior vein, orienting said sheath catheter such that an ablation instrument can be delivered through the sheath catheter to a position proximal to the right inferior vein, and activating the ablation instrument to form at least one lesion about the right inferior vein.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment, a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, a deflectable end section at the distal end of the catheter body, which upon deflection causes the distal end segment to bend into various curved positions within a plane of deflection, and a bent tip oriented in a direction that is out of the plane of deflection.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical wave guide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the wave guide projects an annular light pattern, e.g., a circle or a halo.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment method for treatment of atrial fibrillation is provided that includes positioning a sheath catheter having a deflectable distal end segment in the left atrium of a heart, orienting said sheath catheter such that an ablation instrument can be delivered through the sheath catheter to a position proximal to a first pulmonary vein, activating the ablation instrument to form a circumferential lesion around the first pulmonary vein, repositioning the sheath catheter by deflecting the distal end segment to another orientation, and activating the ablation instrument to form a circumferential lesion around at least one additional pulmonary vein.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, the distal end having a distal tip region that includes a plurality of flexible segments with varying degrees of stiffness. A handle portion can be located at the proximal end of the catheter body to provide a steering mechanism that causes the distal tip region to deflect according to a compound curve.

Abstract: An apparatus and method for phototherapy are described in which laser light or other radiation is projected from within a catheter, through a balloon member, and toward the surface of tissue. The light reflected from body fluids or the tissue surface is captured by a collecting device located within the catheter, e.g., within the balloon member, and the intensity of the reflected light is ascertained. The apparatus and method provides for accurately positioning the apparatus against the tissue treatment site.

Abstract: Methods and systems are disclosed for detecting overheating in an optical device before harmful consequences, such as severe local heating, can result. In one embodiment of the invention, a blackbody emitter is disposed in close proximity to a therapeutic optical fiber to absorb therapeutic radiation at a fault and re-emit blackbody (infrared) radiation. The emitter can be coupled to the fiber but, during normal operation, lies outside the optical path between the output of the laser radiation and the site of treatment. Systems and catheters incorporating such emitters are also described for effective monitoring of the laser power transmitted along the optical fiber within the phototherapy device.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein.

Abstract: Malleable surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. The malleable instruments disclosed are well adapted for use in or around the intricate structures of the heart. In one example, the distal end of the instrument can have a malleable shape or be in the shape of an open loop so as to allow the loop to be placed around at least one a pulmonary vein or artery. Such instruments can incorporate various ablative elements such as ablative radiation, RF heating, cryogenic cooling, ultrasound, microwave, ablative fluid injection and the like.

Abstract: Surgical ablation instruments are disclosed for creating circumferential lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. These photoablative instruments include an elongate housing and an ablation element disposed within a lumen of the housing. A connecting element associated with the elongate housing brings together the proximal and distal ends of the elongate housing to form a loop, thereby creating an encircling lesion to be formed with the ablation energy.

Abstract: An apparatus and method are disclosed for ablation of diseased tissue. The method includes introducing a flexible elongate member into a predetermined tissue site with a flexible elongate member having a proximal end, a distal end and a longitudinal first lumen extending therebetween. A slidable conductor is positioned through the lumen proximate to the tissue site and energy is transmitted to the distal end of the elongate member through the conductor. A deflection member fixedly attached to the distal end of the elongate member can be manipulated to cause the distal end of the elongate member to bend. The target tissue is ablated, coagulated or photochemically modulated without damaging surrounding tissue. The apparatus can be energy transparent and include deflection members to manipulate distal portions of the apparatus. Suitable types of energy for ablation include ultrasound and laser energy.

Abstract: Surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. These photoablative instruments include a housing and an ablation element disposed within a lumen of the housing. An irrigation system associated with the instruments enables a cooling fluid to be introduced to the ablation element during delivery of the ablation energy.