Abstract: Devices and related methods to engage tissue layers to access the space between the layers are provided. The access devices include engagement arms that can be deployed and retracted to easily engage the top tissue layer and allow it to be separated from the underlying layer. The engagement arms are coupled to an actuation rod that is in turn coupled to a switch or lever that allows a user to control the actuation from outside the patient. The engagement arms and coupling to the actuation rod are unique and compact to ensure the entire mechanism fits in a small diameter shaft.

Abstract: A flexible guide tube having a deflectable distal end is disclosed with at least first and second tensioning lines coupled to a deflectable distal end of the flexible guide tube. The first tensioning line is configured to deflect the distal end of the flexible guide tube in a first direction and the second tensioning line is configured to deflect the distal end of the flexible guide tube in a second direction that is opposite the first direction. A handle is coupled to flexible tube, the handle having a medial portion with a longitudinal axis substantially parallel with at least a portion of the flexible guide tube, a first actuator disposed proximal the medial section, and a second actuator disposed distal the medial section.

Abstract: A flexible guide tube having a deflectable distal end is disclosed with at least first and second tensioning lines coupled to a deflectable distal end of the flexible guide tube. The first tensioning line is configured to deflect the distal end of the flexible guide tube in a first direction and the second tensioning line is configured to deflect the distal end of the flexible guide tube in a second direction that is opposite the first direction. A handle is coupled to flexible tube, the handle having a medial portion with a longitudinal axis substantially parallel with at least a portion of the flexible guide tube, a first actuator disposed proximal the medial section, and a second actuator disposed distal the medial section.

Abstract: A method can include engaging the pericardium of a patient at two engagement positions of the pericardium. The method can further include moving the two engagement positions of the pericardium away from each other to tension a portion of the pericardium. The method can further include advancing an access device through the tensioned portion of the pericardium to introduce the access device into the pericardial space of the patient. Other and further methods are also disclosed.

Abstract: Tissue engagement devices can include a sheath, a first arm, a second arm and an actuation cannula. At least a proximal portion of each arm is within the sheath. The actuation cannula is also within the sheath, and can move within the sheath between a retracted position and an extended position. The actuation cannula moves at least a portion of each of the first and second arms into a region between an exterior surface of the actuation cannula and an interior surface of the sheath as the actuation cannula moves to the extended position.

Abstract: Devices and related methods to engage tissue layers to access the space between the layers are provided. The access devices include engagement arms that can be deployed and retracted to easily engage the top tissue layer and allow it to be separated from the underlying layer. The engagement arms are coupled to an actuation rod that is in turn coupled to a switch or lever that allows a user to control the actuation from outside the patient. The engagement arms and coupling to the actuation rod are unique and compact to ensure the entire mechanism fits in a small diameter shaft.

Abstract: Tissue engagement devices can include a sheath, a first arm, a second arm and an actuation cannula. At least a proximal portion of each arm is within the sheath. The actuation cannula is also within the sheath, and can move within the sheath between a retracted position and an extended position. The actuation cannula moves at least a portion of each of the first and second arms into a region between an exterior surface of the actuation cannula and an interior surface of the sheath as the actuation cannula moves to the extended position.