Abstract: This invention describes an energy delivery apparatus for delivering electrical energy at a target location, said energy delivery apparatus being usable in combination with a magnetic field and comprising an electrical conductor having a substantially elongated configuration; an electrode for delivering electrical energy at the target location, with the electrode being electrically coupled to the electrical conductor and having an exposed surface with at least a portion of the exposed surface having one of its principal radii of curvature smaller than 0.35 mm; an insulating dielectric coating along a substantial portion of the length of the electrical conductor, with the dielectric coating having a dielectric constant smaller than about 3; at least one guiding element mounted to the electrical conductor, with at least one of the guiding elements including a magnetically responsive material.

Abstract: A method of determining the quality of contact between a remotely navigated medical device and a cyclically moving anatomical structure includes measuring movement of the device, and processing the measured movement of the device to determine the contact between the device and the moving anatomical structure.

Abstract: A medical device guide having an inner member having a proximal end, a distal end, and at least one lumen therein. An outer member surrounds the proximal portion of the inner member such that the distal end of the inner member projects beyond the distal end of the outer member, the portion of the inner member being sufficient flexible to flex with a guide wire extending through the lumen. The outer member is sufficiently stiff that the proximal end of the medical device guide can be engaged by a driven by a medical device advancer.

Abstract: A magnetically guidable electrophysiology catheter has an elongate catheter body having a proximal end and a distal end. At least one magnetically responsive element is disposed adjacent the distal end for aligning the distal end relative to an externally applied magnetic field. The portion of the catheter adjacent the distal end is formed in a generally planar loop, adjacent the distal end, with the distal end of the catheter projecting from the center of the loop, generally perpendicularly to the plane of the loop. A plurality of electrodes are disposed on the loop for measuring electrical activity in the tissue with which the loop is in contact.

Abstract: A method of determining the quality of contact between a remotely navigated medical device and a cyclically moving anatomical structure includes measuring movement of the device, and processing the measured movement of the device to determine the contact between the device and the moving anatomical structure.

Abstract: This invention describes an energy delivery apparatus for delivering electrical energy at a target location, said energy delivery apparatus being usable in combination with a magnetic field and comprising an electrical conductor having a substantially elongated configuration; an electrode for delivering electrical energy at the target location, with the electrode being electrically coupled to the electrical conductor and having an exposed surface with at least a portion of the exposed surface having one of its principal radii of curvature smaller than 0.35 mm; an insulating dielectric coating along a substantial portion of the length of the electrical conductor, with the dielectric coating having a dielectric constant smaller than about 3; at least one guiding element mounted to the electrical conductor, with at least one of the guiding elements including a magnetically responsive material.

Abstract: Devices for the generation and detection of an ablative plasma discharge in a subject are presented. Methods of use, including navigation and operation of the devices to facilitate minimally invasive therapeutic procedures are disclosed.

Abstract: This invention describes an occlusion crossing apparatus for creating an opening in occluded tissue at a target location in interventional and surgical applications with simultaneous or nearly simultaneous intravascular imaging.

Abstract: Various systems for advancing medical devices within a subject's body are provided that configured to engage the outer surface of the medical device at a number of points about the circumference of the medical device, to thereby grip the medical device for enabling advancement of the device. The advancing systems include engaging portions configured to engage the outer surface of a medical device at a number of points about the circumference of the medical device. The engaging portions preferably engage opposing sides of the medical device's outer surface over a predetermined longitudinal length, to clamp against a longitudinal portion of the medical device that provides improved surface contact with the medical device over conventional roller guides. Various methods for performing medical procedures utilizing various medical devices and advancer systems are also provided.

Abstract: A method of treating vessel occlusions including chronic total occlusions (CTO) of the coronary arteries is presented that relies on remote navigation of a remotely steered medical device to the occlusion and controlled application of ablative energy or mechanical push together with real-time local imaging of the vasculature or real-time vessel wall sensing. The combinative use of remote navigation methods and real-time imaging or real-time sensing enables crossing of elongated lesions and CTOs, calcified lesions and CTOs and lesions and CTOs located at vessel branches.

Abstract: A method is disclosed that enables intra-chamber needle injection treatment using a navigable interventional device. The method includes navigation steps to systematically inject cells, drugs, or other agents in diagnostically identified target tissues, such as ischemic heart wall tissues. Magnetic navigation of a specifically designed needle catheter permits safe access to remote structures of the heart and depth-adaptable needle injections.

Abstract: Methods of designing an x-ray tube shielded for operation in static and dynamic externally applied magnetic fields are described. The methods include passive shielding of the insert frame, housing, design of an external shield envelope, tube port, tube collimator, and combinations thereof. The resulting x-ray tube devices are appropriate for use in a variety of applications ranging from magnetic navigation with x-ray monitoring and guidance for interventional procedures to multi-modality imaging and interventional procedures using an x-ray system in the vicinity of an MRI system.

Abstract: A medical device guide having an inner member having a proximal end, a distal end, and at least one lumen therein. An outer member surrounds the proximal portion of the inner member such that the distal end of the inner member projects beyond the distal end of the outer member, the portion of the inner member being sufficient flexible to flex with a guide wire extending through the lumen. The outer member is sufficiently stiff that the proximal end of the medical device guide can be engaged by a driven by a medical device advancer.

Abstract: An electrophysiology catheter includes a tube having a proximal end, a distal end, and a lumen therebetween. The tube is preferably comprised of multiple sections of different flexibility, arranged so that the flexibility of the catheter increases from the proximal end to the distal end. There is a first generally hollow electrode member at the distal end. At least one magnetically responsive element is disposed at least partially in the hollow electrode, for orienting the distal end of the catheter with an externally applied magnetic field. Multiple magnets can be distributed over the distal portion of the device. The end electrode can have openings for delivering irrigating fluid, and/or a sleeve can be provided around the tube to create an annular space for the delivering of irrigating fluid. A temperature sensor can be provided to control the operation of the catheter. A localization coil can also be included to sense the position and orientation of the catheter.

Abstract: An electrophysiology catheter includes a tube having a proximal end, a distal end, and a lumen therebetween. The tube is preferably comprised of multiple sections of different flexibility, arranged so that the flexibility of the catheter increases from the proximal end to the distal end. There is a first generally hollow electrode member at the distal end. At least one magnetically responsive element is disposed at least partially in the hollow electrode, for orienting the distal end of the catheter with an externally applied magnetic field. Multiple magnets can be distributed over the distal portion of the device. The end electrode can have openings for delivering irrigating fluid, and/or a sleeve can be provided around the tube to create an annular space for the delivering of irrigating fluid. A temperature sensor can be provided to control the operation of the catheter. A localization coil can also be included to sense the position and orientation of the catheter.

Abstract: An electrophysiology catheter includes a tube having a proximal end, a distal end, and a lumen therebetween. The tube is preferably comprised of multiple sections of different flexibility, arranged so that the flexibility of the catheter increases from the proximal end to the distal end. There is a first generally hollow electrode member at the distal end. At least one magnetically responsive element is disposed at least partially in the hollow electrode, for orienting the distal end of the catheter with an externally applied magnetic field. Multiple magnets can be distributed over the distal portion of the device. The end electrode can have openings for delivering irrigating fluid, and/or a sleeve can be provided around the tube to create an annular space for the delivering of irrigating fluid. A temperature sensor can be provided to control the operation of the catheter. A localization coil can also be included to sense the position and orientation of the catheter.

Abstract: A shield for controlling a magnetic field emanating from a magnetic in a magnetic medical treatment instrument has the form of a circular shaped band with opposite open ends and a center axis extending perpendicularly between the open ends. The magnet in the magnetic medical treatment instrument moves about an operating table having a surface upon which a patient being operated on by a physician reposes. The circular shaped shield surrounds the magnet and is spaced away from the magnet in a manner to allow the physician to enter the interior of the band and operate on the patient. The band has opposite first and second parallel planar portions. The top surface of the operating table and the first and second planar portions of the band are parallel to each other. The operating table has a length and a width, and the length of the operating table is parallel to the center axis of the band.