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: A phacoemulsification method includes specifying a target intraocular pressure (IOP) level to be maintained in an eye of a patient during a phacoemulsification procedure. A phacoemulsification probe is inserted into the eye. The eye is irrigated with irrigation fluid and material is aspired from the eye while aiming to maintain the target IOP level, including controlling IOP fluctuations by (i) when an actual IOP in the eye is in a defined high range, limiting the IOP fluctuations to a given value, and (ii) when the actual IOP is in a defined low range that is lower than the high range, allowing the IOP fluctuations to exceed the given value.

Abstract: A catheter includes a shaft for insertion into an organ of a patient, and an expandable distal-end assembly, which is coupled to the shaft and to an apex of the catheter, and includes multiple splines. In at least a given spline among the multiple splines, at least sixty percent of a length of the given spline is non-insulated and is configured to make contact with tissue of the organ and to apply radiofrequency (RF) pulses to the tissue.

Abstract: A catheter includes a shaft for insertion into an organ of a patient, an expandable distal-end assembly, and one or more electrodes. The expandable distal-end assembly is coupled to the shaft and to an apex of the catheter, and includes multiple splines. In at least a given spline among the multiple splines, at least sixty percent of a length of the given spline is non-insulated and is configured to make contact with tissue of the organ and to apply radiofrequency (RF) pulses to the tissue. The one or more electrodes are coupled to at least one of (i) an insulated section of one or more of the splines, and (ii) the apex, and, when placed in contact with the tissue, the one or more electrodes are configured to sense electrical signals in the tissue.

Abstract: A system includes an interface and a processor. The interface is configured to receive a lesion parameter indicative of a specification of a lesion intended to be formed in tissue of an organ using at least one of first and second ablation modes intended to be applied sequentially to multiple sections of the tissue. The processor is configured to (i) select, for the first and second ablation modes, first and second sets of parameters, respectively, that when applied to the tissue, form the lesion having the lesion parameter, (ii) detect, for a section selected among the multiple sections, whether the first or second ablation mode has been selected, and (iii) control a catheter having at least an ablation electrode, to apply to the section ablation signals that are based on the selected ablation mode and are corresponding to the first or second ablation modes.

Abstract: A registration device, including a wand, a light guide passing through the wand, and a position sensor fixed to the wand. A light source outputs a modulated beam of light into a light guide proximal end, so that the light is emitted from a light guide distal end toward a surface in proximity to a wand distal tip. A detector receives, from the light guide proximal end, light reflected from the surface into the light guide distal end, and outputs a signal indicative of the reflected light intensity. A processor computes a distance from the distal tip of the wand to the surface by extracting a phase difference between the output beam and the reflected light from the signal, and computes a position of the surface in a sensor frame of reference responsively to the computed distance and the location of the distal tip found from the position sensor.

Abstract: A method for radiographic imaging of a body cavity includes imaging the body cavity using computerized tomography (CT) to form a CT image, registering a tracking system with the CT image, inserting into the body cavity a guidewire, including a position sensor, operating in the tracking system, attached to a distal end of the guidewire, in response to signals from the position sensor acquired by the tracking system, displaying a position of the distal end of the guidewire on the CT image. The method further includes assigning voxels within a predefined imaging volume relative to the distal end and having a radiodensity less than a predetermined threshold to have a uniform radiodensity of a predefined default value, incorporating the voxels with the assigned predefined default value into the CT image so as to form an updated CT image, and displaying the updated CT image.

Abstract: A system includes a catheter, a pulse generator and a controller. The catheter is configured for insertion into a body of a patient, and includes at least a first electrode, a second electrode and a third electrode, which are disposed at a distal end of the catheter and are configured to contact tissue within the body. The pulse generator is configured to apply one or more bipolar ablation pulses between the first and second electrodes, for ablating the tissue in contact with the first and second electrodes. The controller is configured to: (i) control the pulse generator to apply the one or more bipolar ablation pulses between the first and second electrodes, (ii) receive a signal indicative of a voltage, measured between the third electrode and a reference during application of the ablation pulses, and (iii) issue a notification in response to detecting that the voltage violates a predefined criterion.

Abstract: A medical probe includes a shaft and an expandable flexible distal-end assembly. The shaft is configured for insertion into a cavity of organ of a patient. The expandable flexible distal-end assembly, which is fitted at a distal-end of the shaft, includes a flat flexible backing sheet, including irrigation channels, and two flexible substrates having respective arrays of electrodes disposed thereon, the substrates attached one on either side of the backing sheet.

Abstract: A method includes emitting an ultrasound beam, having a predefined field of view (FOV), from an array of ultrasound transducers in a catheter in an organ of a patient. Echo signals are received in the array, in response to the ultrasound beam. A position of a target object is estimated within the FOV. When the estimated position of the target object violates a centering condition, the FOV of the ultrasound beam is automatically modified to re-meet the centering condition.

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient and including a plurality of electrodes configured to contact tissue within the body. An electrical signal generator applies bipolar trains of pulses having a voltage amplitude of at least 200 V and having a duration of each of the bipolar pulses less than 20 ?s between at least one pair of the electrodes in contact with the tissue, thereby causing irreversible electroporation of the tissue between the at least one pair of the electrodes. One or more electrical sensors sense an energy dissipated between the at least one pair of the electrodes during the trains of the pulses. A controller controls electrical and temporal parameters of the trains of the pulses applied by the electrical signal generator, responsively to the one or more electrical sensors, so that the dissipated energy satisfies a predefined criterion.

Abstract: A method includes emitting an ultrasound beam from an array of ultrasound transducers in a catheter placed in a blood pool in an organ. Echo signals reflected in response to the ultrasound beam are received in the array. Distinction is made in the echo signals between (i) first spectral signal components having Doppler shifts characteristic of blood and (ii) second spectral signal components having Doppler shifts characteristic of tissue of the organ. The first spectral signal components are suppressed relative to the second spectral signal components in the echo signals. An ultrasound image of at least a portion of the organ is reconstructed from the echo signals having the suppressed first spectral signal components. The reconstructed image is displayed to a user.

Abstract: A method includes receiving a 3D image of a portion of an organ including a cavity, the image comprising voxels having respective values. A wall of the cavity is identified in the image, by (i) positioning virtual solid objects inside respective sub-volumes of the cavity, (ii) moving the virtual solid objects inside the cavity according to a predefined rule of motion, (iii) while the virtual solid objects move inside the cavity, adapting the traversed voxels to predefined value indicative of the interior of the cavity, (iv) responsively to detecting that a virtual solid object comes into contact with the wall, rolling the virtual solid object over the wall, and adapting a surface of the virtual solid object with the values of the voxels over which the surface rolls, and (v) converting adapted voxel values that are lower than a threshold voxel value into the predefined value indicative of the interior.

Abstract: A medical procedure system, including a medical instrument to be inserted into a body part, and including position-tracking transducers to provide position signals, a distal end, and at least one radiopaque marker, a position tracking sub-system to compute a position including at least one location and orientation of the distal end in a position-tracking sub-system coordinate frame responsively to the position signals, a fluoroscope to capture fluoroscopic images of an interior of the body part and the radiopaque marker(s), and a registration sub-system to render, to a display, the captured fluoroscopic images including at least one marker-image of the radiopaque marker(s), and at least one graphical representation indicative of the computed position of the distal end, receive user-alignment input aligning the graphical representation(s) with the marker-image(s), and register the position-tracking sub-system coordinate frame with a coordinate frame of the fluoroscope responsively to the received user-alignmen

Abstract: In one embodiment, a catheter apparatus is configured to be inserted into a body part of a living subject, and including an elongated deflectable element including a distal end, an expandable basket assembly disposed at the distal end and comprising a plurality of splines and a plurality of electrodes disposed on the splines, an irrigation channel disposed in the elongated deflectable element, and an inflatable balloon disposed in the expandable basket assembly and including a plurality of irrigation holes in fluid connection with the irrigation channel.

Abstract: A system includes a display and a processor a display and a processor. The display is configured to display multiple pixels of an image of an organ having a cavity and tissue surrounding the cavity. The processor is configured to: (1) receive an ultrasound (US) signal of at least the cavity and the tissue and one or more position signals in the organ indicative of one or more positions of one or more catheters having a known geometry, respectively, and (2) based on the one or more position signals, the known geometry, and the US signal: (i) identify in the image a given pixel at a given position, and (ii) display the given pixel as: (a) a first pixel indicative of the cavity responsively to identifying that the given position corresponds to the one or more positions, or (b) a second pixel indicative of the tissue.

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: A switching assembly for transferring trains of pulses, including a first terminal and a second terminal. A first plurality of first relays is connected in parallel, and have first contacts connected to the first assembly terminal, and second contacts. A first capacitor is connected in parallel with the first relays. A second plurality of second relays is connected in parallel, and have third contacts, and fourth contacts connected to the second assembly terminal. A second capacitor is connected in parallel with the second relays. A connection connects the second contacts to the third contacts. The pulses have amplitudes of at least 2 kilovolts. On activation of the first and second relays the first and second contacts connect and the third and fourth contacts connect, so that the first and second assembly terminals connect. On deactivation of the first and second relays the first and second assembly terminals disconnect.

Abstract: A tissue puncture system includes a guidewire and a handle. The guidewire is configured to be inserted into an organ of a patient and to puncture tissue of the organ by conducting an electrical signal from a power source and applying to the tissue electrical current induced between a distal surface of the guidewire and the tissue. The handle is configured to: (i) electrically connect between the power source and a proximal surface of the guidewire, and (ii) move the distal surface to the tissue.

Abstract: A medical apparatus includes a probe, which includes an insertion tube configured for insertion into a body cavity of a patient, and a distal assembly, which is connected distally to the insertion tube and includes a plurality of electrodes, which are configured to contact tissue within the body cavity. The apparatus further includes an electrical signal generator, which is configured to apply electrical pulses to a group of two or more of the electrodes with an amplitude sufficient to irreversibly electroporate the tissue contacted by the electrodes in the group, and a controller, which is coupled to measure a change in an electrical impedance between an electrode in the group and a further electrode as a result of application of the electrical pulses and to output a measure of ablation of the tissue responsively to the measured change in the electrical impedance.