Abstract: A coronary access catheter system simplifies the insertion of objects into distal branches of the coronary sinus. The system incorporates a real-time forward-imaging means to view the os and the branches of the coronary sinus. Preferably, the catheter uses near-infrared light as the forward-imaging means, but it could also include ultrasound or electromagnetic transducer. As the image is viewed, the catheter tip can be steered into the coronary sinus os and deflected in a tight radius bend on the distal end to navigate the short radius, right angle turns found in the coronary sinus branches. At that point, a flexible sheath can be placed over the guide catheter or objects such as guidewires can be inserted into channels of the guide catheter. The system consists of a catheter and image acquisition unit, which displays the forward image.

Abstract: A coronary sinus locater sheath is stabilized in the vicinity of the coronary sinus by a guidewire exiting the side of the sheath near the distal end and inserted into an identifiable anatomical feature. The procedure includes (1) inserting the guide sheath into a vein, (2) advancing the sheath until the right atrium is entered, (3) advancing the sheath into the IVC, (4) extending a guidewire through a port near the sheath's distal end, (5) retracting the sheath above the IVC into the right atrium, (6) articulating or rotating the sheath until the sheath is near the coronary sinus ostium, while the sheath is stabilized by the guidewire. Thus the sheath can be positioned near the coronary sinus ostium limiting the motion imparted to the sheath from the beating heart. An imaging catheter may be used in conjunction with the sheath. The sheath or catheter may include pacing electrodes.

Abstract: A novel transparent electrode that uses a conductive coating to allow delivery of current to the heart as well as outward imaging through the electrode is described. The embodiments disclose a catheter incorporating an endoscope, whose imaging tip is coated with a conductive coating that is transparent in the endoscopic image. However, a transparent electrode may be fashioned for any imaging modality, such as intracardiac echocardiography (ICE), that finds the electrode to be transparent to the energy used. This electrode coating may be a thin, optically transparent or translucent coating of platinum or gold or may be a pattern with enough open spaces to see the underlying tissue, such as looking through a screen. A wire is connected to the conductive coating and routed to a radiofrequency generator. Novel means of measuring surface temperatures during ablation are disclosed. Adding another deposition of a dissimilar metal under the electrode deposition creates a thermocouple on the electrode surface.

Abstract: A coronary access catheter system simplifies the insertion of objects into distal branches of the coronary sinus. The system incorporates a real-time forward-imaging means to view the os and the branches of the coronary sinus. Preferably, the catheter uses near-infrared light as the forward-imaging means, but it could also include ultrasound or electromagnetic transducer. As the image is viewed, the catheter tip can be steered into the coronary sinus os and deflected in a tight radius bend on the distal end to navigate the short radius, right angle turns found in the coronary sinus branches. At that point, a flexible sheath can be placed over the guide catheter or objects such as guidewires can be inserted into channels of the guide catheter. The system consists of a catheter and image acquisition unit, which displays the forward image.

Abstract: Devices (1) and methods for accomplishing tasks within a body using infrared imaging are disclosed which, in connection with other known components, are useful in ablation, stitching and other operations, identification of sizes and composition of objects, and the creation of maps by taking multiple images at different positions or times.

Abstract: A cardiac pacer, which generates pacing pulses at a predetermined basic pacing rate, includes a device for sensing physical activity and for generating a control signal dependent thereon, a device for varying the predetermined basic pacing rate independent on the control signal and a device for forcing the pacing rate back to a lower rate if the pacing rate runs at or above a predetermined high rate for a predetermined time period.

Abstract: A cardiac pacer, which generates pacing pulses at a predetermined basic pacing rate, includes a multiplicity of body activity sensors for sensing body activity dependent on different physiological variables and monitors for generating a corresponding body activity output signal dependent thereon. The predetermined basic pacing rate is then varied dependent on the body activity output signals.