Abstract: The disclosed technology includes a medical probe. The medical probe includes an elongated body, a flexible circuit and one or more electrodes. The elongated body extends along a longitudinal axis from a proximal end to a distal end, defines a lumen, and includes a tube and outer wall jacket. The tube extends along the longitudinal axis and includes slits that permit the elongated body to deflect relative to the longitudinal axis. The outer wall jacket surrounds the tube. The flexible circuit is disposed on the outer wall jacket. The one or more electrodes are disposed on the flexible circuit and are designed to be placed in contact with tissue of an organ.

Abstract: The disclosed technology includes medical probe that includes an elongated shaft, a guidewire, coils, and electrodes. The elongated shaft extends along a longitudinal axis and is dimensioned to be inserted into a vein of Marshall. The guidewire extends through a lumen in the elongated shaft. The coils are connected to the distal dip of the elongated shaft and each coil is configured to generate a current when subjected to a magnetic field, the current being indicative of a position of the respective coil. The electrodes are connected to the distal tip. Each electrode is designed to (i) sense anatomical signals in the vein of Marshall and provide electrical signals which are indicative of the anatomical signals or (ii) convey ablation energy to a target tissue region proximal the vein of Marshall.

Abstract: A tool to determine a pre-puncture needle shape to provide a desired approach to a target location based on measured patient anatomy is disclosed herein. Anatomical relationship between an outlet of an access vessel and a desired puncture sight on the interatrial septum is used to determine the pre-puncture needle shape. The tool may be used to provide a recommended preferred needle shape from a collection of predetermined needle shapes (e.g. commercially available needle shapes) and/or recommend a bent shape to which a physician may modify a predetermined needle shape to fit. Additionally, or alternatively, the tool may be used to provide a recommended preferred needle shape to manufacturers to create a bespoke needle shape for a given patient and/or a recommended preferred needle shape for patient cohort having similar anatomy within the cohort.

Abstract: Described embodiments include an apparatus that includes an expandable structure, configured for insertion into a body of a subject, and a plurality of conducting elements coupled to the expandable structure. Each of the conducting elements comprises a respective coil and has an insulated portion that is electrically insulated from tissue of the subject, and an uninsulated portion configured to exchange signals with the tissue, while in contact with the tissue. Other embodiments are also described.

Abstract: A tool to determine a pre-puncture needle shape to provide a desired approach to a target location based on measured patient anatomy is disclosed herein. Anatomical relationship between an outlet of an access vessel and a desired puncture sight on the interatrial septum is used to determine the pre-puncture needle shape. The tool may be used to provide a recommended preferred needle shape from a collection of predetermined needle shapes (e.g. commercially available needle shapes) and/or recommend a bent shape to which a physician may modify a predetermined needle shape to fit. Additionally, or alternatively, the tool may be used to provide a recommended preferred needle shape to manufacturers to create a bespoke needle shape for a given patient and/or a recommended preferred needle shape for patient cohort having similar anatomy within the cohort.

Abstract: A sensor unit for a medical probe having coils that each have a respective central axis that is orthogonal to a longitudinal axis of the medical probe such that the coils are disposed one or more substrates. A first coil can have conductive surfaces exposed to an external environment while a second coil has its conductive surfaces insulated or sealed from the external environment. The coils can be configured to output 1) physiologic electrical signals (e.g., ECG) received at the at least two exposed windings, and 2) signals indicative of environmental impedance/conductance in the vicinity of the at least two exposed windings. The coils can further be configured to determine a position of the sensor based on magnetic field, determine a curvature of the sensor, directionally measure environmental impedance/conductance, and/or measure temperature.

Abstract: A sensor for a medical probe having one or more coils with at least two exposed winding portions. The one or more coils can be configured to output 1) electrocardiogram (ECG) signals received at the at least two exposed windings, and 2) signals indicative of environmental impedance/conductance in the vicinity of the at least two exposed windings. The one or more coils can further be configured to determine a position of the sensor based on magnetic field, determine a curvature of the sensor, directionally measure environmental impedance/conductance, and/or measure temperature. Insulated portions of the one or more coils can be interleaved with the at least two exposed winding portions. The sensor can be integral to a catheter or guide wire.

Abstract: A stabilized coronary sinus catheter system having a proximal section and a distal section with a memory shape portion, and a tip, distal of the memory shape portion. A handle having a body, a tip deflection actuator, a memory shape portion deployment actuator, and an axis. The tip is in line with the axis and the tip deflection actuator is at a first position. The tip is deflected out of alignment with the axis when the tip deflection actuator is at a second position. A third position is a delivery configuration where the memory shape portion and the tip are in line with the axis. The memory shape portion deployment actuator is at a first location. A deployed configuration allows the memory shape portion to form a predetermined shape conforming to the shape of the coronary sinus when the memory shape portion deployment actuator is at a second location.

Abstract: Catheters are presented herein having planar end effectors of various configurations, generally providing a two-sided and multi-layered platform for electrodes and sensors. In some examples, the end effector has a support frame (e.g. nitinol) between a pair of flexible circuits. The end effector can also include a polymer (e.g. silicone, LCP, etc.) between the flexible circuits and encapsulating the support frame. This platform facilitates positioning of electrodes on either side (including both sides) of the end effector in a variety of spacings and facilitates ultra-tight electrode spacing and/or a large area electrode. Sensors (ultrasound transducers, navigation coils, etc.) can be layered within the end effector between outer surfaces of the flexible circuits in a variety of configurations.

Abstract: An electrode assembly for use with an electrophysiological catheter has a plurality of independently controlled ablation electrodes distributed radially around the electrode assembly. Two ablation electrodes may be positioned in opposition to each other. The electrode assembly may also have microelectrodes for sensing tissue and/or temperature. Methods for using a catheter equipped with such an electrode assembly may include preferentially emitting energy in a radial direction.

Abstract: A stabilized coronary sinus catheter system having a proximal section and a distal section with a memory shape portion, and a tip, distal of the memory shape portion. A handle having a body, a tip deflection actuator, a memory shape portion deployment actuator, and an axis. The tip is in line with the axis and the tip deflection actuator is at a first position. The tip is deflected out of alignment with the axis when the tip deflection actuator is at a second position. A third position is a delivery configuration where the memory shape portion and the tip are in line with the axis. The memory shape portion deployment actuator is at a first location. A deployed configuration allows the memory shape portion to form a predetermined shape conforming to the shape of the coronary sinus when the memory shape portion deployment actuator is at a second location.

Abstract: The disclosed technology includes a catheter comprising an elongated deflectable element extending along a longitudinal axis from a proximal end to a distal end, a position electrode attached to the elongated deflectable element proximate the distal end and configured for impedance-based position tracking, and a covering at least partially enclosing the position electrode. The covering can comprise a plurality of apertures such that a portion of a conductive surface of the position electrode is exposed through each aperture of the plurality of apertures.

Abstract: A microcatheter with a guidewire therein can be steered to target tissue, then the target tissue can be punctured with the guidewire to create a transseptal puncture. The microcatheter can have a diameter substantially smaller than known sheaths which are typically used to guide a needle to a target puncture site in known transseptal puncture treatments. The guidewire can have an atraumatic, electrically conductive distal end that can be electrically energized to puncture the target tissue. Once the guide wire is across, ancillary devices such as a dilator and sheath can be delivered over the guide wire across the transseptal puncture. The microcatheter can include one or more location sensors. A navigation module can use the electrically conductive distal end as a reference electrode to the location sensor(s) of the microcatheter.

Abstract: A guiding sheath has a hemostatic valve and a central lumen into which a diagnostic or treatment catheter can be introduced and guided into a patient. The hemostatic valve also includes an electrically conducting element or proximity sensing element on its proximal end that interacts with a second electrically conducting element or proximity sensing element on a proximal end of the diagnostic or treatment catheter that can be passed through the central lumen of the guiding sheath and into the patient's heart. The interaction between the two electrically conducting elements or proximity sensing elements enables the location of the distal end of the diagnostic or treatment catheter in the patient's heart without the need for irradiating the patient.

Abstract: A catheter is presented herein which includes inductive coils which conform to the curved surface of a tubular catheter body and collectively can function as a three axis sensor during an intravascular and/or intracardiac treatment. The inductive coils can be fabricated on a flexible circuit substrate and affixed to the tubular catheter body. The catheter can include a distal portion that can be moved into a circular shape (“lasso”) when within vasculature or the heart. The inductive coils can be positioned around the circular shape such that a position and orientation of the distal portion can be determined in three dimensions when the distal portion is within a known fluctuating magnetic field.

Abstract: An example RF ablation system including a transseptal needle having an ablation electrode thereon can be used to perform a transseptal perforation using RF energy. Ablation energy can be applied and/or terminated based on a change in impedance at the ablation electrode when the electrode come into or out of contact with tissue. The transseptal needle can further include magnetic field sensors and one or more electrodes. The magnetic field sensors can be positioned approximate a distal end of the transseptal needle and can be configured to provide location information of the distal end.

Abstract: A stabilized coronary sinus catheter system having a proximal section and a distal section with a memory shape portion, and a tip, distal of the memory shape portion. A handle having a body, a tip deflection actuator, a memory shape portion deployment actuator, and an axis. The tip is in line with the axis and the tip deflection actuator is at a first position. The tip is deflected out of alignment with the axis when the tip deflection actuator is at a second position. A third position is a delivery configuration where the memory shape portion and the tip are in line with the axis. The memory shape portion deployment actuator is at a first location. A deployed configuration allows the memory shape portion to form a predetermined shape conforming to the shape of the coronary sinus when the memory shape portion deployment actuator is at a second location.

Abstract: An electrode assembly for use with an electrophysiological catheter has a plurality of independently controlled ablation electrodes distributed radially around the electrode assembly. Two ablation electrodes may be positioned in opposition to each other. The electrode assembly may also have microelectrodes for sensing tissue and/or temperature. Methods for using a catheter equipped with such an electrode assembly may include preferentially emitting energy in a radial direction.

Abstract: Techniques are disclosed for contemporaneously assessing the success of a renal denervation procedure. One or more characteristics of a patient's heart, such as atrioventricular (AV) interval, PR interval and/or heart rate are monitored during an ablation procedure. A change in the heart characteristic detected during the ablation may indicate successful denervation. Accordingly, successive new locations may be targeted for ablation until a change is detected.

Abstract: A method and device that provide improved visualization of soft tissue, such as renal arteries, renal veins and lymph nodes in guiding catheter placement and positioning in the renal region or vasculature. The method and device enable visualization of an electrophysiology catheter application in the renal region which provides for improved imaging of renal structures, including renal arteries, along with one or more adjacent anatomical structures, including renal veins, lymph nodes, other adjacent organs and and/or other adjacent soft tissues that may adversely impact the formation of a lesion during a catheter ablation procedure in or around a renal artery.