Abstract: Systems for pacing the heart include a vibrational transducer which directs energy at the heart, usually at at least a ventricle, to pace the heart and to promote synchronized contraction of the ventricles. Optionally, additional vibrational and/or electrical stimulation may be provided. The vibrational transducers are usually implantable at a location proximate the heart.

Abstract: Methods and apparatus for cardiac pacing, cardioversion, and defibrillation rely on delivering ultrasonic and other vibrational energy to the heart, usually after the onset of an arrhythmia. A vibrational transducer assembly is implanted or applied externally so that vibrational energy can be directed toward at least a portion of the heart from an anterior or posterior aspect, typically being implanted over the ribs, over the sternum, between the ribs, beneath the ribs, or on the back.

Abstract: Methods and apparatus for cardiac pacing, cardioversion, and defibrillation rely on delivering ultrasonic and other vibrational energy to the heart, usually after the onset of an arrhythmia. A vibrational transducer assembly is implanted or applied externally so that vibrational energy can be directed toward at least a portion of the heart from an anterior or posterior aspect, typically being implanted over the ribs, over the sternum, between the ribs, beneath the ribs, or on the back.

Abstract: Methods, systems and devices are provided which promote the uptake of one or more agents into cellular material, wherein incorporation of such agent(s) improve the intended performance of the material upon implantation. This is particularly applicable to vascular replacements wherein uptake of agents, such as nucleic acids, induces long-term stable adaptation of the vascular replacement involving resistance to neointimal hyperplasia and atherosclerosis. The promotion of such uptake is achieved with the use of vibrational energy, particularly ultrasound. The cellular material is immersed into an acoustically transmissive solution comprising the agent. The immersed material is then exposed to vibrational energy under conditions and for a time which promotes incorporation of the agent into the cells. Portable, convenient and easy to use systems and devices are also provided for use in conjunction with these methods.

Abstract: Nucleic acid transfection of vascular smooth muscle cells is enhanced by the application of vibrational energy to the cells. By applying vibrational energy at frequency in the range from 1 kHz to 10 MHz and at an intensity in the range from 0.01 W/cm2 to 100 W/cm2, significant enhancement of the uptake of nucleic acids into vascular smooth muscle cells can be achieved.

Abstract: Methods and apparatus for inhibiting hyperplasia following stent placement are provided. The stents will be coated with pharmaceutical agent(s) and the methods provide for directing vibrational energy at the implanted stents or the blood vessel walls or region of implantation. The vibrational energy can have one or more of several beneficial effects. The vibrational energy may directly inhibit hyperplasia, may effect or modulate release of agent from the stent, or may enhance permeability of the blood vessel wall.

Abstract: A method for inhibiting hyperplasia at an anastomotic junction of a vascular fistula or vascular graft comprises exposing the anastomotic junction to vibrational energy at a mechanical index and for a time sufficient to inhibit hyperplasia. Kits are described comprising the catheter or a probe suitable for performing the methods together with instructions for use setting forth the methods. The methods and kits are particularly suitable for treating anastomotic junctions formed to provide vascular access for hemodialysis, hemofiltration, and the like. The methods and kits are also suitable for treating other vascular grafts, such as those formed during cardiac bypass graft surgery, vascular repair, and the like.

Abstract: A catheter including an elongated body member, an ultrasound transducer located on the elongated body member, and dampening means for forming an ultrasound dampening region adjacent to a portion of the ultrasound transducer, is disclosed. The ultrasound transducer is configured to transmit or receive an ultrasound signal. The ultrasound dampening region is configured to improve uniformity of said ultrasound signal in three-dimensional space. Preferably, the dampening means includes air or a material containing air.

Abstract: The immune response achieved by the administration of nucleic acid vaccines is enhanced by the application of vibrational energy to the inoculated tissue region. The vibrational energy is selected to enhance transfection of the tissue without substantial tissue damage, relying on a mechanical effect of the vibrational energy. Additionally, vibrational energy intended to mechanically injure the tissue via a thermal effect may also be applied.

Abstract: A wide beam ultrasound delivery system providing a uniform exposure field is used to enhance the uptake of injected substances and/or to enhance the transfection of DNA in the tissues of human subject, or reduce the amount of vascular intimal hyperplasia in human subjects following vascular injury.

Abstract: A wide beam ultrasound delivery system providing a uniform exposure field is used to enhance the uptake of injected substances and/or to enhance the transfection of DNA in the tissues of human subject, or reduce the amount of vascular intimal hyperplasia in human subjects following vascular injury.

Abstract: Atherosclerotic plaque and blood vessels may be stabilized by directing vibrational energy, typically ultrasonic energy, into the adjacent blood vessel wall. Application of the vibrational energy, optionally in combination with growth factors, growth factor genes, or other substances which enhance growth stability of a fibrotic cap over the plaque, will reduce the risk of rupture of unstable plaque and inhibit the conversion of stable plaque into unstable plaque.

Abstract: Post-interventional neointimal hyperplasia in arteries is treated by the application of ultrasonic energy. Usually, an intravascular catheter having an interface surface is positioned at a target site in the artery which has previously been treated. The interface surface is vibrationally excited to apply energy to the arterial wall in a manner which inhibits smooth muscle cell proliferation in the neointimal layer.

Abstract: Nucleic acid transfection of vascular smooth muscle cells is enhanced by the application of vibrational energy to the cells. By applying vibrational energy at frequency in the range from 1 kHz to 10 MHz and at an intensity in the range from 0.01 W/cm2 to 100 W/cm2, significant enhancement of the uptake of nucleic acids into vascular smooth muscle cells can be achieved.

Abstract: A method of treating a target region in a body lumen, said method comprising: directing a uniform dose of ultrasonic energy from an interior of the lumen radially outward over a treatment length of the lumen, wherein the dosage of ultrasonic energy received at any one point along the length varies by no more than plus or minus 6 decibels from that received at any other point along the length.

Abstract: A method of enhancing cellular absorption of a substance delivered into a target region of a patient's body, comprising: (a) delivering the substance to the target region; and (b) directing vibrational energy to the target region, wherein the vibrational energy is of a type and in an amount sufficient to enhance absorption into cells of the target region.

Abstract: Post-interventional neointimal hyperplasia in arteries is treated by the application of ultrasonic energy. Usually, an intravascular catheter having an interface surface is positioned at a target site in the artery which has previously been treated. The interface surface is vibrationally excited to apply energy to the arterial wall in a manner which inhibits smooth muscle cell proliferation in the neointimal layer.

Abstract: Post-interventional neointimal hyperplasia in arteries is treated by the application of ultrasonic energy. Usually, an intravascular catheter having an interface surface is positioned at a target site in the artery which has previously been treated. The interface surface is vibrationally excited to apply energy to the arterial wall in a manner which inhibits smooth muscle cell proliferation in the neointimal layer.

Abstract: A catheter comprises a catheter body having an oscillating driver, an interface surface mechanically coupled to the driver, and an inflatable balloon disposed near the interface surface. The balloon may be an angioplasty balloon, in which case the interface surface will deliver ultrasonic or other vibratory energy into a blood vessel as part of an angioplasty or related procedure. Alternatively, the catheter may comprise a pair of axially spaced-apart isolation balloons, in which case the interface surface can deliver ultrasonic or other vibratory energy into a treatment region defined between said balloons. The energy can thus act to mix or enhance penetration of a treatment held between said balloons in performing a vascular treatment procedure.

Abstract: A catheter including an elongated body member, an ultrasound transducer located on the elongated body member, and dampening means for forming an ultrasound dampening region adjacent to a portion of the ultrasound transducer, is disclosed. The ultrasound transducer is configured to transmit or receive an ultrasound signal. The ultrasound dampening region is configured to improve uniformity of said ultrasound signal in three-dimensional space. Preferably, the dampening means includes air or a material containing air.