Abstract: Medical apparatus includes an insertion tube configured for insertion into a body cavity of a patient and an expandable assembly connected distally to the insertion tube and comprising electrodes, which are configured to apply electrical energy to tissue within the body cavity. A flexible porous sheath is fitted over the expandable assembly and configured to contact the tissue within the body cavity so that the electrical energy is applied from the electrodes through the sheath to the tissue.

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 system and method for performing a non-fluoroscopic transseptal procedure may comprise a catheter and a device comprising a sheath, an introducer and a transducer embedded on the introducer and configured to perform a measurement during the non-fluoroscopic transseptal procedure. In this system, the transducer may be embedded on the outer surface of the introducer, or embedded on the inner surface of the introducer, or embedded within the introducer. The transducer may be a ring transducer or a circular transducer. The measurement is based on a plurality of ultrasonic pulses transmitted from the transducer, and the measurement determines a location of the catheter and/or a puncture location. In another embodiment, the transducer is embedded on a needle instead of an introducer.

Abstract: A cardiac pacing and irreversible electroporation (IRE) apparatus includes a pulse generator and a shaping circuit. The pulse generator is configured to generate IRE pulses of prespecified shape and repetition rate. The shaping circuit is configured to convert some of the IRE pulses into pacing pulses of prespecified frequency and amplitude, to generate an output signal including ones of the IRE pulses interleaved with ones of the pacing pulses, and to output the output signal to a probe in a heart of a patient for applying the output signal to cardiac tissue.

Abstract: A catheter includes: (a) a shaft for insertion into a heart of a patient, (b) an expandable distal-end assembly, which is coupled to the shaft and is configured to make contact with tissue of the heart, (c) at least first and second electrocardiogram (ECG) electrodes, which are coupled to an outer surface of the expandable distal-end assembly, and when placed in contact with the tissue, are configured to sense ECG signals in the tissue, and (d) a reference electrode, which is positioned within an inner volume of the distal-end assembly, and in an expanded position of the distal-end assembly, the reference electrode: (i) has no physical contact with the tissue, and (ii) is positioned at a first distance from the first ECG electrode and at a second distance from the second ECG electrode, and the difference between the first and second distances is smaller than a predefined threshold.

Abstract: A method includes, receiving multiple signals from multiple respective electrodes arranged along an inner circumference of a blood vessel that has been ablated. Based on the multiple signals, one or more quality measures of the ablated blood vessel are produced. A graphical presentation indicative of the one or more quality measures, is displayed to a user in a two-dimensional (2D) polar coordinate system.

Abstract: A method includes, inserting into an organ of a patient, a catheter having an expandable distal-end assembly, which is coupled to a shaft and includes multiple splines, at least a given spline among the multiple splines includes an electrode that is being placed in contact with tissue of the organ. At least a size of a section of the electrode in contact with the tissue, is controlled by moving a tube over at least a portion of the expandable distal-end assembly.

Abstract: In one embodiment, an ablation system includes a catheter including at least one electrode, and configured to be inserted into a chamber of a heart of a living subject, an ablation power generator configured to apply an electrical signal to the at least one electrode to ablate tissue of the chamber, at least one body surface patch configured to be applied to a body surface of the living subject, and provide at least one position signal, and a processor configured to compute an index of a measurement of diaphragm movement responsively to the at least one position signal, and perform an action responsively to the computed index.

Abstract: A catheter, consisting of an insertion probe, having a distal end configured for insertion into a lumen of a human subject. The catheter also has a resilient tube, extending distally from the distal end of the insertion probe and having, when unconstrained, a planar serpentine shape contained within a plane that contains a longitudinal axis of the distal end of the insertion probe. A plurality of electrodes are fixedly attached to the resilient tube and are configured to transfer ablation energy to the human subject. Other shapes for the insertion tube are also provided.

Abstract: A method includes generating an ablation programming language, which defines commands for (i) setting ablation protocol parameters and respective values, (ii) setting a configuration of an ablation system, (iii) applying automatic logic that relates the ablation protocol parameters and the values to the configuration of the ablation system, and (iv) generating one or more graphical user interfaces (GUIs) showing one or more of the parameters of the ablation protocol and the system configuration. The ablation programming language is provided for subsequent use with the ablation system.

Abstract: A method for use with an intra-body probe, a distal end of which includes an ablation electrode and a temperature sensor, is described. While (i) the ablation electrode is driving an ablating current into tissue of a subject, and (ii) fluid is passed from the distal end of the intra-body probe at a fluid-flow rate, a processor receives a temperature sensed by the temperature sensor. The processor estimates a temperature of the tissue, based at least on the sensed temperature and at least one parameter selected from the group consisting of: the fluid-flow rate, and a parameter of the ablating current. The processor generates an output in response to the estimated temperature. Other embodiments are also described.

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: An ENT tool has a tool chassis having a chassis channel and a tool chassis distal end. A tubular probe is dimensioned to be inserted into a human patient orifice, the probe is rotatable about a probe axis of symmetry, and the probe has a probe proximal end rotatingly connected to the tool chassis distal end. A balloon insertion mechanism is slidingly located within the chassis channel, and is configured to fixedly accept a balloon sinuplasty mechanism penetrating the tubular probe. A guidewire adjustment section is fixedly attached to the balloon insertion mechanism, and the section has a rotatable enclosure. A plurality of rollers are disposed within the enclosure and are configured so that on rotation of the enclosure the rollers grip and rotate a guidewire positioned between the rollers, and, absent rotation of the enclosure, release the guidewire and permit distal and proximal translation of the guidewire.

Abstract: A method for use with an intra-body probe, a distal end of which includes an ablation electrode and a temperature sensor, is described. While (i) the ablation electrode is driving an ablating current into tissue of a subject, and (ii) fluid is passed from the distal end of the intra-body probe at a fluid-flow rate, a processor receives a temperature sensed by the temperature sensor. The processor estimates a temperature of the tissue, based at least on the sensed temperature and at least one parameter selected from the group consisting of: the fluid-flow rate, and a parameter of the ablating current. The processor generates an output in response to the estimated temperature. Other embodiments are also described.

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient. The probe includes a plurality of electrodes configured to contact tissue within the body. The medical apparatus further includes an electrical signal generator configured to apply between one or more pairs of the electrodes signals of first and second types in alternation. The signals of the first type include a sequence of bipolar pulses having an amplitude sufficient to cause irreversible electrophoresis (IRE) in the tissue contacted by the electrodes. The signals of the second type include a radio-frequency (RF) signal having a power sufficient to thermally ablate the tissue contacted by the electrodes.

Abstract: A medical system includes an ultrasound probe and a processor. The ultrasound probe is configured for insertion into an organ of a body and includes (i) a two-dimensional (2D) ultrasound transducer array, and (ii) a sensor configured to output signals indicative of a position and orientation of the 2D ultrasound transducer array inside the organ. The processor is configured to (a) using the signals output by the sensor, register multiple ultrasound image sections, acquired by the 2D ultrasound transducer array, with one another, (b) produce a union of the multiple registered ultrasound image sections, to form a rendering of at least a portion of the organ, and (c) present the rendering to a user.

Abstract: A medical system includes an ultrasound probe configured for insertion into an organ of a body, and a processor. The probe includes a two-dimensional (2D) ultrasound transducer array, and a sensor configured to output signals indicative of a position, direction and orientation of the 2D ultrasound transducer array inside the organ. The processor is configured to (a) using the signals output by the sensor, register multiple ultrasound images of a tissue region, acquired over a given time duration by the 2D ultrasound transducer array, with one another, (b) estimate, based on the ultrasound images acquired over the given time duration, three-dimensional displacements as a function of time for one or more locations in the tissue region, (c) estimate respective mechanical strains of the one or more locations in the tissue region, based on the three-dimensional displacements, and (d) present a time-dependent rendering of the mechanical strains to a user.

Abstract: A medical system includes an ultrasound probe for insertion into an organ of a body and a processor. The ultrasound probe includes (i) a two-dimensional (2D) ultrasound transducer array, and (ii) a sensor configured to output signals indicative of a position, direction and orientation of the 2D ultrasound transducer array inside the organ. The processor is configured to (a) using the signals output by the sensor, register multiple ultrasound images of a tissue region, acquired over a given time duration by the 2D ultrasound transducer array, with one another, and (b) generate a map of the tissue region indicative of respective amounts of motion of tissue locations in the tissue region.

Abstract: A system includes a display and a processor. The processor is configured to: (i) receive a three-dimensional (3D) anatomical map including multiple vectors, and a selection of a section of the 3D anatomical map, the section including one or more given vectors among the multiple vectors, (ii) produce a two-dimensional (2D) projection of the section, which includes the one or more given vectors, and (iii) present on the display, the 2D projection overlaid on the 3D anatomical map.

Abstract: A system includes, first and second circuitries and one or more devices. The first circuitry is configured to generate a stress signal for reducing an impedance of tissue of an organ. The second circuitry is configured to generate an irreversible electroporation (IRE) signal for producing a lesion in the tissue. The one or more devices are configured to apply to the tissue, the stress signal at a first time interval, and the IRE signal at a second time interval, subsequent to the first time interval.