Abstract: Device, system and method for evaluating the effectiveness of tissue ablations of a heart of a patient. The tissue is clamped between a pair of opposing jaws. A portion of the tissue is ablated at a first generally linear position on the tissue by applying ablative energy to two of a plurality of elongate electrodes, each of the two of the plurality of elongate electrodes being coupled in opposing relationship to each other and the pair of opposing jaws, respectively. An effectiveness of the ablation is sensed at a second generally linear position on the tissue with at least one of the plurality of elongate electrodes positioned on one of the pair of opposing jaws. The second linear position on the tissue is laterally distal to the first linear position on the tissue with respect to the atrium of the heart.

Abstract: A hemostat-type device for ablative treatment of tissue, particularly for treatment of atrial fibrillation, is constructed with features that provide easy and effective treatment. The device may include a swiveling head assembly that allows the jaws to be adjusted in pitch and/or roll. The device may include a malleable or articulating handle shaft, as well as, malleable or curved rigid jaws that can permit curved lesion shapes. A locking detent can secure the jaws in a closed position during the procedure. The device may include one or more remote actuators making the hemostat-type device useful for minimally invasive procedures.

Abstract: A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. The power applied to the tissue site can be increased in response to detection of a power plateau or application of a first power for a minimum time according to some embodiments. A power applied to the tissue site can be reduced in response to an increase in impedance according to some embodiments. Transmurality can be indicated in response to a transmurality plateau following a rise in impedance according to some embodiments.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. A clamping ablation tool can include an upper arm having an upper neck, a link assembly, and an upper actuator. The link assembly can include a distal electrode and a proximal electrode. The clamping ablation tool can include a lower arm that mates with the upper arm. The lower arm can include a lower neck, a distal jaw, and a lower actuator. The distal jaw can include a jaw electrode, and the lower actuator can control movement of the distal jaw.

Abstract: Device and method for sub-xiphoid ablation of patient tissue. A sub-xiphoid access clamp has a handle, an elongate neck coupled to the handle and first and second opposing jaws. The first and second opposing jaws have first and second opposing relief segments being generally co-planar and concave with respect to one another to form a void therebetween, and first and second opposing elongate ablation elements positioned along the first and second opposing jaws and distal of the first and second opposing relief segments relative to the handle. The first and second opposing jaws are articulate between a closed position and an open position to admit, at least in part, a second portion of tissue of the patient within the void created by the first and second opposing relief segments while the first portion of tissue is positioned between the first and second ablation elements in the closed position.

Abstract: A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the local electrogram is measured with electrodes located adjacent tissue to be ablated so that the ablation energy to ablation elements can be selectively reduced or terminated when transmurality is detected.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. The ablation device can include a lower jaw assembly including a proximal jaw having a proximal electrode and a distal jaw having a distal electrode, and an upper jaw assembly including an upper jaw having an upper electrode. A proximal actuator can be movable between a first position in which the proximal jaw is open and a second position in which the proximal jaw is clamped with respect to the upper jaw. A distal actuator can be movable between a third position in which the distal jaw is open and a fourth position in which the distal jaw is clamped with respect to the upper jaw.

Abstract: A device and method for ablating tissue is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding an ablating member within the patient while tracking the position of the ablating member in the patient, positioning the ablating member in a desired position to ablate tissue, emitting ablating energy from the ablating member to form an ablated tissue area and removing the ablating member from the patient.

Abstract: Some embodiments of the invention provide a system for occluding a left atrial appendage of a patient. Some embodiments of the system can include a ring occluder that can be positioned around the left atrial appendage and a ring applicator to position the ring occluder with respect to the left atrial appendage. One embodiment discloses a method of accessing endocardial surfaces of the heart through the atrial appendage. Additional embodiments of the invention provide a clip occluder that can be positioned around the left atrial appendage. A clip applicator can position the clip occluder with respect to the left atrial appendage.

Abstract: A device and method for valve replacement or valve repair is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding a valve replacement delivery member or a valve repair delivery member within the patient while tracking the position of the delivery member in the patient, positioning the valve replacement member or valve repair member in a desired position to place a valve or repair valve and removing the delivery member from the patient. In one aspect of the invention, a delivery system is provided for percutaneous delivery of a heart valve to a predetermined position in the heart of a patient, where the delivery system itself includes features that allow it to be accurately positioned in the heart. In another aspect of the invention, a delivery system is provided for percutaneous repair of a heart valve in the heart of a patient, where the repair system itself includes features that allow it to be accurately positioned in the heart.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. The ablation device can include a lower jaw assembly including a proximal jaw having a proximal electrode and a distal jaw having a distal electrode, and an upper jaw assembly including an upper jaw having an upper electrode. A proximal actuator can be movable between a first position in which the proximal jaw is open and a second position in which the proximal jaw is clamped with respect to the upper jaw. A distal actuator can be movable between a third position in which the distal jaw is open and a fourth position in which the distal jaw is clamped with respect to the upper jaw.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. A clamping ablation tool can include an upper arm having an upper neck, a link assembly, and an upper actuator. The link assembly can include a distal electrode and a proximal electrode. The clamping ablation tool can include a lower arm that mates with the upper arm. The lower arm can include a lower neck, a distal jaw, and a lower actuator. The distal jaw can include a jaw electrode, and the lower actuator can control movement of the distal jaw.

Abstract: A novel occluder application and clip device for treatment of embolic stroke caused by atrial fibrillation uses multiple sutures in a non directional handle to affix the occlusion device to the applicator and manipulate the occluder from an open and receiving position to a closed and occluding position. The occluder is retained in place by a clamping means related to locks retainers, resilient material or otherwise. An actuator mechanism is used to manipulate the occluder to a locked or occluding position. The applicator with the occluder attached has a low profile and remote manipulations to allow the occluder to be delivered to the clamping location within a patient through a small incision or delivery port such as a trocar cannula or the like.

Abstract: Embodiments of the invention provide an ablation apparatus for ablating target tissue adjacent pulmonary veins of a patient. The ablation apparatus can include a tube capable of being advanced around the pulmonary veins to form a loop. The tube can receive or include electrodes to ablate target tissue. Some embodiments provide a loop ablation device, which may include a cannula and two or more electrode rods carrying two or more bipolar electrodes. The electrode rods can be advanced through the distal ends toward the proximal ends of the loop and toward the target tissue. The bipolar electrodes can receive energy to ablate the target tissue. The bipolar electrodes may be surrounded by the liquid within the cannula while ablating the target tissue. The loop ablation device can further include a rotating grasping mechanism coupled to the electrode rods.

Abstract: A method of thermal ablation using high intensity focused ultrasound energy includes the steps of positioning one or more ultrasound emitting members within a patient, emitting ultrasound energy from the one or more ultrasound emitting members, focusing the ultrasound energy, ablating with the focused ultrasound energy to form an ablated tissue area and removing the ultrasound emitting member.

Abstract: Embodiments of the invention provide an ablation apparatus for ablating target tissue adjacent pulmonary veins of a patient. The ablation apparatus can include a tube capable of being advanced around the pulmonary veins to form a loop. The tube can receive or include electrodes to ablate target tissue. Some embodiments provide a loop ablation device, which may include a cannula and two or more electrode rods carrying two or more bipolar electrodes. The electrode rods can be advanced through the distal ends toward the proximal ends of the loop and toward the target tissue. The bipolar electrodes can receive energy to ablate the target tissue. The bipolar electrodes may be surrounded by the liquid within the cannula while ablating the target tissue. The loop ablation device can further include a rotating grasping mechanism coupled to the electrode rods.

Abstract: An instrument including an elongated shaft and a non-conductive handle is disclosed. The shaft defines a proximal section and a distal section. The distal section forms an electrically conductive tip. Further, the shaft is adapted to be transitionable from a straight state to a first bent state. The shaft is capable of independently maintaining the distinct shapes associated with the straight state and the first bent state. The handle is rigidly coupled to the proximal section of the shaft. The instrument is useful for epicardial pacing and/or mapping of the heart for temporary pacing on a beating heart, for optimizing the placement of ventricular leads for the treatment of patients with congestive heart failure and ventricular dysynchrony and/or for use in surgical ablation procedures.

Abstract: A device for ablating tissue is provided. The device comprises a conductive element with a channel for irrigating fluid formed therein, which is in contact with a non-conductive microporous interface. All or a portion of the interface may be removable. When the interface is removed, a portion of the conductive element is exposed for use in ablating tissue. Methods of using the device and of removing the interface are also provided.

Abstract: A system for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.

Abstract: A method and system for ablating tissue to provide a desired set of lesions. The system includes an ablation apparatus having an elongated shapeable section carrying a mechanism such as an electrode for applying ablation energy along the shapeable section. The shapeable section includes a member of shape memory material having a memorized configuration. The shapeable section is shaped manually or using fixtures to display a configuration corresponding to one of the desired lesions and is then employed to create the desired lesion. Thereafter the shapeable section is heated to cause it to resume its memorized configuration. Shaping, heating and ablating to create lesions are continued as necessary provide the desired set of lesions. In some embodiments of the invention, heating may be accomplished using heating elements built into the shapeable section.