Abstract: An efficient system for diagnosing arrhythmias and directing catheter therapies may allow for measuring, classifying, analyzing, and mapping spatial electrophysiological (EP) patterns within a body. The efficient system may further guide arrhythmia therapy and update maps as treatment is delivered. The efficient system may use a medical device having a high density of sensors with a known spatial configuration for collecting EP data and positioning data. Further, the efficient system may also use an electronic control system (ECU) for computing and providing the user with a variety of metrics, derivative metrics, high definition (HD) maps, HD composite maps, and general visual aids for association with a geometrical anatomical model shown on a display device.

Abstract: An introducer sheath for a medical device is provided. The sheath includes a deformable, elongate body disposed about a longitudinal axis. The body has proximal and distal ends and defines a lumen extending between the proximal and distal ends and configured to allow passage of the medical device therethrough. The body is configured to allow an electric current to pass radially between a space outside of the body and the lumen such that the position of the medical device within a patient can be monitored and electrogram readings from body tissues can be measured while the device is in the sheath. In some embodiments of the invention, the body may include a one or more apertures extending from the radially outer surface of the body to the lumen or a portion of the body may be made from a conductive and/or fluid permeable material.

Abstract: A medical device includes one or more sensors used to acquire a multi-dimensional signal. In one embodiment, principal component analysis is performed on the multi-dimensional signal to produce signal data. The principal component analysis results are used to cancel signal artifact in one embodiment. A medical device controller produces one of a therapy control and a diagnostic output in response to the signal data.

Abstract: The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.

Abstract: An intracardiac imaging system configured to display electrode visualization elements within an intracardiac echocardiography image where the electrode visualization elements represent intracardiac electrodes in close proximity to the plane of the image. The system further allows cross sections of tissue structures embodied in intracardiac echocardiography images to be modeled within a visualization, navigation, or mapping system when automatically segmented to generate shell elements for modifying the modeled tissue structures.

Abstract: An apparatus and method for identifying objects in an ultrasound image that includes acquiring ultrasound information from a catheter, locating the ultrasound information to a three-dimensional cardiac model having two or more distinct anatomic objects, displaying at least one of the distinct anatomic objects from the cardiac model within a visual representation of the ultrasound information, and identifying the at least one of the distinct anatomic objects within the visual representation of the ultrasound information using the identifier provided for that object in the three-dimensional cardiac model.

Abstract: A method of refining an anatomical model includes acquiring a two-dimensional echocardiogram that has a variable intensity, relating the two-dimensional echocardiogram to a plurality of mapping points that exist in three-dimensional space, and determining a confidence value for each of two or more mapping points that corresponds to an intensity at a point on the two-dimensional echocardiogram.

Abstract: A method of displaying the influence of an aspect of a model includes acquiring a two-dimensional echocardiogram having a variable intensity; relating the two-dimensional echocardiogram to a plurality of mapping points, the mapping points existing in a three-dimensional model space; determining a degree of influence value for a mapping point; and displaying the mapping point with a visual attribute that corresponds to the determined degree of influence value.

Abstract: A system and method for identifying a location of a physical structure in a body is provided. The system includes an electronic control unit configured to register a first image of a portion of the body in a three-dimensional coordinate system. The electronic control unit is further configured to identify the location of the physical structure in the three-dimensional coordinate system responsive to flow of a fluid shown in the image. The fluid may comprise blood. In one embodiment, the electronic control unit is further configured to generate a second image, such as a three dimensional model, incorporating a representation of the physical structure within a larger physical environment in the three-dimensional coordinate system.

Abstract: A method and system for determining tissue type is provided. The system comprises an electronic control unit (ECU) configured to acquire a value of an electrical parameter between a first electrode electrically coupled with tissue and a second electrode. The ECU is further configured to identify a tissue type from a plurality of tissue types based at least on the acquired value, and in an exemplary embodiment, to generate a tissue morphology map comprising a marker representative of the identified tissue type. The method comprises acquiring a value of an electrical parameter between a first electrode electrically coupled with tissue and a second electrode. The method further comprises identifying a tissue type from a plurality of tissue types based on at least the acquired value of the electrical parameter, and in an exemplary embodiment, the method further comprises generating a tissue morphology map based on the identified tissue type.

Abstract: Medical devices and methods are used to treat cardiac dysfunction conditions which involve delivery of stimulation pulses in cardiac refractory periods in order to modulate an effective refractory period (ERP). Such devices and methods may be used in conjunction with or in place of other therapies, including increased cardiac contractility (ICC) therapy, post extrasystolic potentiation (PESP) therapy, and other therapies to achieve increased heart contractility, provide a safer and more effective regimen for the corresponding stimulation therapies, and reduce the risk of inducing an arrhythmia.

Abstract: A three dimensional physiological mapping system utilizing an intracardiac echo catheter capable of being located in six degrees of freedom by a visualization, navigation, or mapping system. An echocardiography image of the intracardiac echo catheter may be projected within a geometric model of the visualization, navigation, or mapping system where the location of the projected image is adjusted in response to user input identifying a structure present in the echocardiography image and the geometric model.

Abstract: A method and apparatus for optimizing and assessing the response to extra-systolic stimulation (ESS) are provided. An optimization/monitoring parameter is calculated as a function of potentiation ratio, PR, and recirculation fraction, RF, derived from measurements of myocardial contractile function during and after ESS. PR may be computed as the ratio of the contractile function on post-extra-systolic beats during ESS to baseline contractile function. RF may be computed as the slope of a linear regression performed on a plot of the contractile function for a post-extra-systolic beat versus the contractile function for the previous post-extra-systolic beat after ESS is ceased. The ESI resulting in a maximum optimization/monitoring parameter, preferably computed as the product of PR and RF, is determined as the optimal ESI. The operating ESI may be automatically adjusted, and/or PR and RF data may be stored for monitoring purposes.

Abstract: An external cardiac medical device for delivering Cardiac Potentiation Therapy (CPT). Techniques used with the device include initial diagnosis of the patient, delivery of the CPT, and configuration of the external device, so that CPT can be effectively and efficiently provided. In particular, these techniques include initially determining whether a patient should receive CPT, how to set the coupling interval for delivering CPT, how to configure the external medical device to deliver CPT stimulation pulses while not adversely affecting the device's ability to sense a patient's cardiac parameters and/or signals.

Abstract: A system and method for assessing effective delivery of ablation therapy to a tissue in a body is provided. A three-dimensional anatomical map of the tissue is generated and displayed with the map defining a corresponding volume. An index is generated corresponding to a location within the volume with the index indicative of a state of ablation therapy at the location. The index may be derived from one or more factors such as the duration an ablation electrode is present at the location, the amount of energy provided, the degree of electrical coupling between an ablation electrode and the tissue at the location and temperature. A visual characteristic (e.g., color intensity) of a portion of the anatomical map corresponding to the location is then altered responsive to the index.

Abstract: A medical device having a sensor sensing an n-dimensional signal during a first known variable condition and during a second known variable condition different from the first known variable condition, a processor performing principal component analysis (PCA) on the sensed n-dimensional signal to generate a first template corresponding to a principal component of variation associated with the first known variable condition and a second template corresponding to a principal component of variation associated with the second known variable condition, a storage device storing the first template and the second template, and a controller detecting a patient condition in response to the stored templates.

Abstract: A medical device includes one or more sensors used to acquire a multi-dimensional signal. In one embodiment, principal component analysis is performed on the multi-dimensional signal to produce signal data. The principal component analysis results are used to cancel signal artifact in one embodiment. A medical device controller produces one of a therapy control and a diagnostic output in response to the signal data.

Abstract: A medical device includes one or more sensors used to acquire a multi-dimensional signal. In one embodiment, principal component analysis is performed on the multi-dimensional signal to produce signal data. The principal component analysis results are used to cancel signal artifact in one embodiment. A medical device controller produces one of a therapy control and a diagnostic output in response to the signal data.

Abstract: The invention is directed to a multi-electrode ablation sensing catheter and system suitable for medical procedures such as cardiac ablation. In one embodiment of the invention, a catheter is provided having an elongated catheter shaft and a catheter tip having two or more closely spaced electrodes mounted on the catheter tip, where the electrodes are coupled to a plurality of electronic circuitries and are used for electrogram sensing, impedance sensing, and location sensing and orientation. In another embodiment of the invention, a catheter system is provided having a catheter with an elongated catheter shaft and a catheter tip with two or more closely spaced electrodes mounted on the catheter tip, and an RF generator circuitry, an electrogram sensing circuitry, an impedance sensing circuitry, and a location sensing and orientation circuitry.

Abstract: A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.