Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a handle or hub which includes an electrical connector configured to receive, in a releasable manner, an electrically conductive component operable to be electrically coupled to an energy source.

Abstract: This disclosure describes embodiments of a kit and its constituent components which together form an apparatus in which fluid communication between a medical device's lumen and the surrounding environment is provided by a conduit cooperatively defined by the medical device and a tubular member into which the device is inserted. The medical device and tubular member are configured to fit together such that an outer surface of the distal region of the medical device cooperates with an inner surface of the tubular member to define the conduit between the side-port of the medical device and a distal end of the tubular member. The conduit is operable to be used for injecting fluid, withdrawing fluid, and measuring pressure, for example. Methods of assembling and using the apparatus are described as well.

Abstract: This invention relates to crystals of the human Gremlin-1 protein, and the human Gremlin-1 protein in complex with an inhibitory antibody. The invention also relates to the structure of human Gremlin-1 (on its own, or in complex with the antibody) and uses of these structures in screening for agents which modulate Gremlin-1 activity. The invention further provides antibodies which bind an allosteric inhibitory site on Gremlin-1, together with pharmaceutical compositions and medical uses of such antibodies and agents identified by the screening methods.

Abstract: Novel and unique medical devices and associated methods are disclosed, for facilitating efficient and repeatable puncture of a tissue site while allowing vascular access from various access sites of a patient's body. Disclosed medical devices include dilators and wires usable alone or in combination and configured to facilitate tissue access and puncture at various anatomical locations from desired access sites. The medical devices each include one or more sections having sufficient flexibility for accessing the tissue site from the access site while retaining sufficient stiffness to perform one or more additional functions.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an electrosurgical device, while avoiding coring when energy is delivered to the electrosurgical device. The device has a distal face defining an opening, with the distal face including at least one cutting portion and at least one non-cutting portion. An embodiment of the electrosurgical device for puncturing tissue includes an elongate member defining a lumen for fluid; a distal portion including an electrode and the distal face which defines at least one aperture. The portion of the at least one cutting portion defines a leading portion partially surrounding a circumference of the at least one aperture wherein the outer diameter of the at least one of the distal portion of the electrosurgical device or the electrode decreases towards a distal tip of the electrosurgical device.

Abstract: A processing system includes a program processor for executing a program, and a dedicated processor for executing operations of a particular type (e.g. vector processing operations). The program processor uses an interfacing module and a group of two or more register banks to offload operations of the particular type to the dedicated processor for execution thereon. While the dedicated processor is accessing one register bank for executing a current operation, the interfacing module can concurrently load data for a subsequent operation into a different one of the register banks. The use of multiple register banks allows the dedicated processor to spend a greater proportion of its time executing operations.

Abstract: Embodiments of medical devices and methods are disclosed. The medical devices typically comprises a needle with a rigid proximal shaft, a flexible distal shaft and a distal tip. The distal tip includes an electrode for delivering energy to puncture a tissue. In some embodiments, the distal shaft comprises a superelastic material. In other embodiments, the distal shaft is comprised of both a superelastic material and a non-superelastic material.

Abstract: Novel and unique medical devices and associated methods are disclosed, for facilitating efficient and repeatable puncture of a tissue site while allowing vascular access from various access sites of a patient's body. Disclosed medical devices include dilators and wires usable alone or in combination and configured to facilitate tissue access and puncture at various anatomical locations from desired access sites. The medical devices each include one or more sections having sufficient flexibility for accessing the tissue site from the access site while retaining sufficient stiffness to perform one or more additional functions.

Abstract: Embodiments of medical devices and methods are disclosed. The medical devices typically comprises an elongate member with a proximal region and a distal region. The distal region comprises a flexible portion that is more flexible than the proximal region of the medical device. The flexible region includes gaps in the sidewall of the elongate member. Furthermore, the medical device comprises a rigid energy delivery device at the distal end which is configured to deliver energy to tissue when energy is supplied to the energy delivery device. In some embodiments, the medical device comprises a support spine configured to provide support to the flexible portion of the elongate member.

Abstract: A logging unit is used to log entries for events in a computer system. Each entry includes an n-bit timestamp field and a payload. The payload includes information about the event and the timestamp field includes the n least significant bits of an N-bit timestamp for the event, where N>n. If the n least significant bits of the timestamp have wrapped compared to the corresponding n bits of the timestamp of the preceding entry then a timing entry is logged which includes other bits of the timestamp. Therefore, an N-bit timestamp can be determined for an event, but only the n least significant bits of the timestamp are stored in the timestamp field of an entry for the event. Therefore, the time flow of events in the store is better maintained (by having a larger timestamp) without increasing the number of bits (n) in the timestamp field of each entry.

Abstract: A method and apparatus are disclosed for an optimized transseptal procedure for providing left heart access, that reduces the number of devices that are used in order to minimize procedural time, complexity and cost. The apparatus comprises a hybrid dilator that comprises the combined functionality of a transseptal sheath and dilator assembly. The hybrid dilator comprises: a dilator shaft defining a lumen for receiving a crossing device therethrough, the dilator shaft being structured to provide support for the crossing device when the crossing device is used to create a puncture in a tissue; and a distal tip having an outer diameter which tapers down to an outer diameter of the crossing device for providing a smooth transition between the crossing device and the distal tip when the crossing device is inserted through the lumen and protrudes beyond the distal tip.

Abstract: Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes using an apparatus to apply pressure to a parietal pericardium, retracting the apparatus, and puncturing the parietal pericardium by delivering electrical energy using a puncture device. Another method includes moving a portion of parietal pericardium away from a surface of myocardium of the heart and puncturing the parietal pericardium by delivering electrical energy using a puncture device. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device.

Abstract: A utility management device, comprising an input for receiving a utility consumption signal for a premises, an output for outputting utility management information, and a processor configured to monitor the input utility consumption signal for a change in magnitude. If a change is detected, the processor is configured to identify an appliance event corresponding to the change, obtain information relating to the projected utility consumption of the appliance for an upcoming time period, update a projected utility consumption of the premises based on the obtained information, determine whether any projected stored and/or generated utility amount at the premises is sufficient for the projected utility consumption of the premises, and, if not sufficient, cause the device to output a request to receive a utility amount from one or more other premises connected to the premises via a communication network.

Abstract: Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes advancing a distal end of a puncture device towards the heart from a subxiphoid region of a patient wherein the distal end of the puncture device is atraumatic and comprises an energy delivery device; positioning the energy delivery device at a target site on a pericardium of the heart using ultrasound for imaging; and delivering energy from the energy delivery device to a tissue of the target site to create a channel to the pericardial cavity. The method may include repeating one or more of the above steps until the energy delivery device is located within the pericardial cavity. Some embodiments of the method include using supplemental means of monitoring, including medical imaging and using contrast fluid.

Abstract: An apparatus and method are disclosed for providing feedback for a steerable medical device assembly for deflecting a device, the assembly comprising a control handle comprising an actuation mechanism. The assembly additionally comprises a device coupled to the control handle and operable to be deflected upon actuation of the actuation mechanism, and a feedback mechanism for providing an indication of the deflection of the device, wherein the feedback mechanism is associated with the actuation mechanism for deflecting the device.

Abstract: A method and apparatus or system are disclosed for a procedure with minimal or no fluoroscopy, for example an electrosurgical procedure, and which uses a three dimensional mapping system. The procedure typically involves electrical measurement of the electrode of a needle to determine its position. Some embodiments further include intracardiac echocardiography (ICE) for tracking devices. The apparatus includes a needle with a tip electrode, an electroanatomical mapping (EAM) system, and an electrical generator, wherein a switching device is used to restrictively electrically connect the needle to only one of the mapping system or generator at a given time.

Abstract: A method of perforating a tissue of a heart of a patient when an inferior approach to the heart is contraindicated. The method utilizes an electrosurgical apparatus and a delivery system comprising at least two dilators wherein a first dilator is configured for facilitating positioning of the electrosurgical apparatus adjacent the tissue and wherein a second dilator is configured for advancement through a perforation in the tissue. An outer diameter of the second dilator is substantially equal to or less than an outer diameter of the first dilator.

Abstract: Apparatuses and methods for the perforation of heart tissue of a patient when an inferior approach to the heart is contraindicated are disclosed. The method includes using a superior approach to introduce the apparatus, positioning the apparatus at a tissue location and delivering a controlled amount of non-mechanical energy to the tissue to create a perforation. For example, a method of surgical perforation via the delivery of electrical, radiant or thermal energy may include: introducing an apparatus comprising an energy delivery device into a patient's heart via the patient's superior vena cava; positioning the energy delivery device at a first location adjacent material to be perforated; and perforating the material by delivering energy via the energy delivery device; wherein the energy is selected from the group consisting of electrical energy, radiant energy and thermal energy.

Abstract: A method and apparatus are disclosed for an RF guidewire for applying RF energy to create a channel through a region of tissue within a patient's body. The RF guidewire is configured to have a hydrophilic coating disposed thereon to reduce friction to facilitate traversal through vasculature while maintaining its mechanical, electrical and thermal properties.