Abstract: A catheter for ablation of tissue through irreversible electroporation includes an electrode assembly comprising a flexible circuit having a distally located central flex circuit hub and a plurality of flex circuit branches extending proximally from the hub portion, each of the flex circuit branches defining, at least in part, an electrode assembly spline. The flexible circuit further includes a distal ablation electrode including an ablation electrode hub portion, and a plurality of radial segments integrally formed with the ablation electrode hub portion, each of the radial segments extending proximally along a portion of a respective one of the flex circuit branches and terminating in a proximal end, a plurality of proximal ablation electrodes, each of the proximal ablation electrodes located on a respective one of the flex circuit branches and having a distal end spaced from the proximal end of the adjacent radial segment of the distal ablation electrode.

Abstract: A system for electroporation ablation including a catheter having an electrode assembly and one or more states. The electrode assembly may be in different shapes when the catheter is at different states. The controller is configured to generate, based on one or more models of electric fields, graphical representations of electric fields generated by the electrode assembly when the catheter is at different states. In some embodiments, the controller is configured to overlay the graphical representations of the one or more electric fields on an anatomical map of a patient.

Abstract: At least some embodiments of the present disclosures are directed to a hybrid electroporation ablation catheter. In some embodiments, the hybrid electroporation ablation catheter comprises a catheter shaft having a proximal end and an opposite distal end and an electrode assembly extending from the distal end of the catheter shaft and the electrode assembly comprising a plurality of energy-delivering electrodes. The electrode assembly is configured to be selectively operable in a plurality of different operation modes.

Abstract: Various aspects of the present disclosure are directed towards apparatuses, systems and methods that may include an electroporation ablation device. The electroporation ablation device may include a shaft defining a longitudinal axis and an electrode assembly including a first pair of electrodes having a first electrode and a second electrode, and a second pair of electrodes disposed adjacent to the first pair of electrodes and having a third and a fourth electrode. In some embodiments, the first electrode has a first edge portion, and a first side view of the first edge portion along the longitudinal axis is rounded at a first corner.

Abstract: Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Abstract: Systems and methods for managing communication strategies between implanted medical devices. Methods include temporal optimization relative to one or more identified conditions in the body. A selected characteristic, such as a signal representative or linked to a biological function, is assessed to determine its likely impact on communication capabilities, and one or more communication strategies may be developed to optimize intra-body communication.

Abstract: An electroporation ablation system for treating targeted tissue in a patient. The electroporation ablation system including an ablation catheter and an electroporation generator. The ablation catheter including a handle, a shaft having a distal end, and catheter electrodes situated at the distal end of the shaft and spatially arranged to generate electric fields in the targeted tissue in response to electrical pulses. The electroporation generator operatively coupled to the catheter electrodes and configured to deliver the electrical pulses in an electroporation pulse sequence to one or more catheter electrodes. Wherein, the electroporation pulse sequence includes multiple pulse bursts, and each of the multiple pulse bursts includes pulses separated by an inter-pulse length of between 200 and 350 microseconds to reduce muscle stimulation while creating electroporation lesions.

Abstract: At least some embodiments of the present disclosure are directed to an electroporation ablation catheter having tissue-contactless electrodes. In some embodiments, the electroporation ablation catheter comprises a catheter shaft defining a longitudinal axis and having a proximal end and a distal end; and an electrode assembly extending from the distal end of the catheter shaft, the electrode assembly configured to assume a first collapsed state and a second expanded state. In some cases, the electrode assembly includes an expandable component, and a plurality of electrodes disposed on the expandable component, where in the second state the expandable component have portions configured to protrude from adjacent electrodes.

Abstract: Disclosed herein are apparatus, systems, and methods for ablating tissue in a patient by electroporation. Embodiments generally include an ablation catheter having a hand, a shaft, and an electroporation electrode arrangement. The shaft has a distal end and defines a longitudinal axis of the ablation catheter. The electroporation electrode arrangement is at the distal end of the shaft and is configured to generate a multidirectional electric field when at least one pulse sequence is delivered thereto. The multidirectional electric field includes at least two of the following directions relative to the longitudinal axis: generally axial, circumferential, and transverse. The electroporation electrode arrangement is configured to operatively couple to an electroporation generator that is configured to generate the at least one pulse sequence and is configured to receive the at least one pulse sequence from the electroporation generator.

Abstract: At least some embodiments of the present disclosure are directed to an electroporation ablation device having a first catheter and a second catheter. The first catheter comprises one or more first electrodes and has a first surface area. The second catheter comprises one or more second electrodes and has a second surface area. When the electroporation ablation device is in operation for ablating a target tissue, the first catheter is configured to be disposed in an extracardiac location and anatomically proximate to the target tissue, the second catheter is configured to be disposed at an intracardiac location proximate to the target tissue, and the electroporation ablation device is configured to generate an electric field between the one or more first electrodes and the one or more second electrodes with electric field strength sufficient to ablate the target tissue via irreversible electroporation.

Abstract: A catheter for focal cardiac ablation by irreversible electroporation includes a flexible catheter body, a plurality of tines disposed at a distal end of the catheter body, a flexible shaft, a return electrode, and an electrical conductor. The plurality of tines are formed of an electrically conductive material and configured to deploy from a lumen at the distal end of the catheter body. Each tine of the plurality of tines is configured to self-bias from a linear configuration within the lumen to a curved configuration when deployed from the lumen. The shaft is mechanically and electrically coupled to the plurality of tines. The shaft is configured to deploy the tines from the lumen when the shaft is moved toward the distal end of the catheter body. The return electrode is disposed on an outer surface of the catheter body. The electrical conductor is electrically coupled to the return electrode.

Abstract: A subcutaneous implantable cardioverter-defibrillator (S-ICD) comprising shocking electrodes configured to reduce the defibrillation threshold. The S-ICD may include a canister housing a source of electrical energy, a capacitor, and operational circuitry that senses heart rhythms and an electrode and lead assembly. The electrode and lead assembly may comprise a lead, at least one sensing electrode, and at least one shocking electrode. The at least one shocking electrode may extend over a length in the range of 50 to 110 millimeters and a width in the range of 1 to 40 millimeters.

Abstract: An implantable medical device (IMD) may include a housing having a proximal end and a distal end and a set of one or more electrodes connected to but spaced apart from the housing. The IMD may further include a controller disposed within the housing, wherein the controller is configured to sense cardiac electrical signals, and deliver electrical stimulation pulses via the first set of one or more electrodes. In some embodiments, a first portion of the housing is configured to be disposed at least partly within a coronary sinus of a patient's heart and a second portion of the housing is configured to be disposed at least partly within a right atrium of the patient's heart.

Abstract: Systems and methods for treating cardiac arrhythmias are disclosed. In one embodiment, an SICD comprises two or more electrodes, a charge storage device, and a controller operatively coupled to two or more of the electrodes and the charge storage device. In some embodiments, the controller is configured to monitor cardiac activity of the heart of the patient, detect an occurrence of a cardiac arrhythmia based on the cardiac activity, and determine a type of the detected cardiac arrhythmia from two or more types of cardiac arrhythmias. If the determined type of cardiac arrhythmia is one of a first set of cardiac arrhythmia types, the controller sends an instruction for reception by an LCP to initiate the application of ATP therapy by the LCP. If the determined type of cardiac arrhythmia is not one of the first set cardiac arrhythmia types, the controller does not send the instruction.

Abstract: Methods and devices for testing and configuring implantable medical device systems. A first medical device and a second medical device communicate with one another using test signals configured to provide data related to the quality of the communication signal to facilitate optimization of the communication approach. Some methods may be performed during surgery to implant one of the medical devices to ensure adequate communication availability.

Abstract: Delivery devices, systems, and methods for delivering implantable leadless pacing devices are disclosed. An example delivery device may include a tubular member and a distal holding section extending distally of a distal end of the tubular member and defining a cavity therein for receiving an implantable leadless pacing device. The delivery device may facilitate vascular delivery of the pacing device to a left side of a patient's heart. In one example, a distal tip portion may extend distal of the distal holding section and may be actuated between a closed and an opened position. When in the closed position, the distal tip portion may have a tip that can puncture or engage an opening in a septum between a left atrium and a right atrium of a patient's heart. Actuating the distal tip portion to an opened position may be utilized to dilate the puncture or opening in the septum.

Abstract: Catheter and implantable leadless pacing devices, systems, and methods utilizing catheters and implantable leadless pacing devices are disclosed. An example catheter system may include a holding structure extending distally from a tubular member. An implantable device, such as a leadless pacing device, may be located within a cavity of the holding structure. The holding structure may include one or more electrical ports adjacent the proximal end of the holding structure and adjacent or proximal of the proximal end of the implantable device. The electrical ports may provide a conductive pathway extending through the distal structure to allow electrical signals to pass through the distal structure to and/or from the implantable device.

Abstract: Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Abstract: Systems, methods and implantable devices configured to provide cardiac resynchronization therapy and/or bradycardia pacing therapy. A first device located in the heart of the patient is configured to receive a communication from a second device and deliver a pacing therapy in response to or in accordance with the received communication. A second device located elsewhere is configured to determine an atrial event has occurred and communicate to the first device to trigger the pacing therapy. The second device may be configured for sensing the atrial event by the use of vector selection and atrial event windowing, among other enhancements. Exception cases are discussed and handled as well.

Abstract: An implantable medical device (IMD) may include a housing having a proximal end and a distal end and a set of one or more electrodes connected to but spaced apart from the housing. The IMD may further include a controller disposed within the housing, wherein the controller is configured to sense cardiac electrical signals, and deliver electrical stimulation pulses via the first set of one or more electrodes. In some embodiments, a first portion of the housing is configured to be disposed at least partly within a coronary sinus of a patient's heart and a second portion of the housing is configured to be disposed at least partly within a right atrium of the patient's heart.