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 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: A method for ablation in which a portion of atrial tissue around the pulmonary veins of the heart is ablated by a first elongated ablation component and a second elongated ablation component movable relative to the first ablation component and having means for magnetically attracting the first and second components toward one another. The magnetic means draw the first and second components toward one another to compress the atrial tissue therebetween, along the length of the first and second components and thereby position the device for ablation of the tissue.

Abstract: A method for ablation in which a portion of atrial tissue around the pulmonary veins of the heart is ablated by a first elongated ablation component and a second elongated ablation component movable relative to the first ablation component and having means for magnetically attracting the first and second components toward one another. The magnetic means draw the first and second components toward one another to compress the atrial tissue therebetween, along the length of the first and second components and thereby position the device for ablation of the tissue.

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 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 of surgical dissection of tissue with a dissector comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another and the plurality of segments includes a distal segment having a distal end; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another, comprising the steps of: positioning the distal end of the dissector in a body; advancing the distal end through the body to dissect tissue; and simultaneously articulating the plurality of segments with respect to one another. A method of surgical dissection of tissue and guiding a second device to a desired physiological location with a first device.

Abstract: A device for dissecting tissue and/or guidance of a second device to a desired physiological location, the device comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another. A system for dissecting tissue and/or guiding a medical device to a desired physiological location.

Abstract: An ablation apparatus including a maneuvering mechanism, a conductive element attached to the apparatus, a sensor attached to the apparatus and an output device in communication with the sensor is provided. The sensor senses vibration during the ablation procedure and sends a signal to the output device to reduce power to the conductive element.

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: Methods for delivering precise amounts of fluid into cardiac tissue for the purpose of facilitating ablation of the tissue along a desired lesion line. One method injects fluid through a hollow needle. The injected fluid can be a highly conductive fluid injected in conjunction with radiofrequency ablation to create an ablative virtual electrode. The injected conductive fluid can provide deeper and narrower conduction paths and resulting lesions. Radiofrequency ablation can be performed at the same time as the fluid injection, using the injection device as an electrode, or subsequent to the fluid injection, using a separate device. In some methods, the injected fluid is a protective fluid, injected to protect tissue adjacent to the desired lesion line. Fluid delivery can be endocardial, epicardial, and epicardial on a beating heart. The present methods find one use in performing maze procedures to treat atrial fibrillation.

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: 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. A swiveling head assembly can allow the jaws to be adjusted in pitch and roll. Malleable jaws can permit curved lesion shapes. A locking detent can secure the jaws in a closed position during the procedure. An illuminated indicator provides confirmation that the device is operating. A fluid delivery system simplifies irrigated ablation procedures.

Abstract: A method for ablation in which a portion of atrial tissue around the pulmonary veins of the heart is ablated by a first elongated ablation component and a second elongated ablation component movable relative to the first ablation component and having means for magnetically attracting the first and second components toward one another. The magnetic means draw the first and second components toward one another to compress the atrial tissue therebetween, along the length of the first and second components and thereby position the device for ablation of the tissue.

Abstract: A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber that includes an elongated guide catheter body extending between guide catheter proximal and distal ends. A distal segment of the guide catheter is adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber. The catheter body encloses a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening.

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: 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: 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 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: 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: 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.