Abstract: Systems and methods manipulate a support structure to form a composite lesion in a tissue region at or near a sphincter. The support structure carries an array of electrodes attachable to a source of energy capable of heating tissue when transmitted by the electrodes. The systems and methods advance the electrodes to penetrate the tissue region and form, when the energy is transmitted, a first pattern of lesions. The systems and methods retract the electrodes, and shift the position of the electrodes, either rotationally, or axially, or both rotationally and axially. The systems and methods advance the electrodes a second time to form, when the energy is transmitted, a second pattern of lesions either rotationally or axially or both rotationally and axially shifted from the first pattern of lesions. The first and second patterns of lesion together comprise the composite lesion.

Abstract: Systems and methods treat a tissue region. In one arrangement, the systems and methods deploy an electrode on a support structure in a tissue region at or near the cardia of the stomach. The support structure has a proximal region and a distal region. The proximal region is enlarged in comparison to the distal region, and the electrode is carried by the enlarged proximal surface. The systems and methods advance the electrode in a path to penetrate the tissue region and couple the electrode to a source of radio frequency energy to ohmically heat tissue and create a lesion in the tissue region. In another arrangement, the systems and methods treat abnormal epithelium tissue at or near the lower esophageal sphincter by bringing an array of surface electrodes into contact with abnormal epithelium tissue. The systems and methods couple the surface electrodes to a source of radio frequency energy to ohmically heat tissue and cause necrosis of the abnormal epithelium tissue.

Abstract: A device for treating a tissue region is supplied with a separate usage key card. The usage key card comprises a storage medium, which is formatted to contain an identification code unique to the usage key card. The usage key card is adapted to be read by a remote reader, to download the identification code for processing by a controller for the device. Processing of the identification code by the controller either enables or disables operation of the device according to prescribed criteria. A viewable image is generated on a display screen that changes in response to processing of the identification code.

Abstract: A device for treating a tissue region is supplied with a separate usage key card. The usage key card comprises a storage medium, which is formatted to contain an identification code unique to the usage key card. The usage key card is adapted to be read by a remote reader, to download the identification code for processing by a controller for the device. Processing of the identification code by the controller either enables or disables operation of the device according to prescribed criteria.

Abstract: An assembly for treating tissue at or near the sphincter includes a support structure for deployment in a tissue region, and a an electrode carried by the support structure. The support structure includes a spine with a lumen having an exit port, the electrode being deployable from the exit port. The spine also includes a cooling lumen and as aspiration lumen to provide and remove fluids, respectively.

Abstract: Improved electrode assemblies for treating a tissue region at or near a sphincter comprise a support structure and an electrode carried by the support structure for advancement in a path to penetrate the tissue region. In one arrangement, the electrode has a non-cylindrical cross section selected to resist deflection when advanced to penetrate the tissue region. In another arrangement, the electrode includes a tissue stop to resist tissue penetration beyond a selected depth. In another arrangement, the electrode includes a proximal portion formed from a first material and a distal tissue penetrating portion formed of a second material different than the first material. The first material can comprise, e.g., stainless steel, and the second material can comprise, e.g., nickel titanium.

Abstract: Assemblies for treating a tissue region at or near a sphincter have a support structure with a distal end and an electrode carried by the support structure for contact with the tissue region. A lumen in the support structure accommodates passage of a body through the support structure and beyond the distal end of the support structure. The body can comprise a guide wire to guide deployment of the support structure, or an endoscope to permit visualization of the support structure from beyond the distal end of the support structure.

Abstract: A method of treating a sphincter provides a sphincter electropotential mapping device with at least one of a mapping electrode or a treatment electrode. The sphincter electropotential mapping device is introduced into at least a portion of the sphincter, the lower esophageal sphincter, stomach, the cardia or the fundus. Bioelectric activity causing a relaxation of the sphincter is detected and energy is delivered from either the mapping electrode or the treatment electrode to treat the bioelectric activity.

Abstract: Electrode assemblies actively cool mucosal surface tissue at or near a sphincter while applying energy through an electrode to ohmically heat tissue beneath the surface. The applied energy creates one or more lesions, or a prescribed pattern of lesions, below the mucosal surface. Natural healing of the subsurface lesions leads to a physical tightening of the sphincter and/or adjoining tissue to treat sphincter dysfunction. The active surface cooling preserves and protects the mucosal surface against thermal damage. Furthermore, electrode assemblies can deliver a therapeutic material to the tissue region independent of or as an adjunct to lesion formation. The therapeutic material can comprise, e.g., a tissue ablating chemical; or a drug, such as a tissue growth factor, or a fibrosis inducer, or a fibroblast growth factor, or a sclerosant; or a tissue bulking agent; or an exotoxin.

Abstract: Systems and methods manipulate a support structure to form a composite lesion in a tissue region at or near a sphincter. The support structure carries an array of electrodes attachable to a source of energy capable of heating tissue when transmitted by the electrodes. The systems and methods advance the electrodes to penetrate the tissue region and form, when the energy is transmitted, a first pattern of lesions. The systems and methods retract the electrodes, and shift the position of the electrodes, either rotationally, or axially, or both rotationally and axially. The systems and methods advance the electrodes a second time to form, when the energy is transmitted, a second pattern of lesions either rotationally or axially or both rotationally and axially shifted from the first pattern of lesions. The first and second patterns of lesion together comprise the composite lesion.

Abstract: Systems and methods deploy an electrode structure in contact with the tissue region. The electrode structure carries a sensor at a known location on the electrode structure to monitor an operating condition. The systems and methods provide an interface, which generate an idealized image of the electrode structure and an indicator image to represent the monitored operating condition in a spatial position on the idealized image corresponding to the location of the sensor on the electrode structure. The interface displays a view image comprising the idealized image and indicator image. The systems and methods cause the electrode structure to apply energy to heat the tissue region while the view image is displayed on the display screen.

Abstract: Systems and methods deploy an electrode structure in contact with the tissue region. The electrode structure carries a sensor at a known location on the electrode structure to monitor an operating condition. The systems and methods provide an interface, which generate an idealized image of the electrode structure and an indicator image to represent the monitored operating condition in a spatial position on the idealized image corresponding to the location of the sensor on the electrode structure. The interface displays a view image comprising the idealized image and indicator image. The systems and methods cause the electrode structure to apply energy to heat the tissue region while the view image is displayed on the display screen.

Abstract: Multiple electrodes are coupled together in monopolar or bipolar arrays to form lesion patterns in tissue regions at or near a sphincter. A controller couples the electrodes to a generator so that a single power channel serves more than a single electrode.

Abstract: Systems and methods manipulate a support structure to form a composite lesion in a tissue region at or near a sphincter. The support structure carries an array of electrodes attachable to a source of energy capable of heating tissue when transmitted by the electrodes. The systems and methods advance the electrodes to penetrate the tissue region and form, when the energy is transmitted, a first pattern of lesions. The systems and methods retract the electrodes, and shift the position of the electrodes, either rotationally, or axially, or both rotationally and axially. The systems and methods advance the electrodes a second time to form, when the energy is transmitted, a second pattern of lesions either rotationally or axially or both rotationally and axially shifted from the first pattern of lesions. The first and second patterns of lesion together comprise the composite lesion.

Abstract: Systems and methods treat a tissue region at or near a sphincter by deploying a carrier, which carries an electrode that can be advanced to penetrate tissue. Negative pressure is applied through a suction port on the carrier near the electrode, to draw tissue in the tissue region inward against the carrier. The systems and methods advance the electrode to penetrate tissue drawn against the carrier. The vacuum anchors the surrounding tissue and mediates against the “tenting” of tissue during electrode penetration. Without tenting, the electrode penetrates mucosal tissue fully, to obtain a desired depth of penetration.

Abstract: Systems and methods integrate the control of an energy generator, to supply energy to an electrode structure to heat a tissue region, and the control of a pumping mechanism, to supply cooling fluid to control tissue temperature in the region.

Abstract: Expandable assemblies for treating a tissue region at or near a sphincter comprises a support basket formed from an array of spines. A mechanism flexes the spines to expand and collapse the basket. Electrodes carried by the spines for advancement in a path to penetrate the tissue region upon expansion of the basket. The basket can be formed from a mechanical array of molded, jointed spines, or from an extruded tube having axial slits forming the spines.

Abstract: A steerable electrophysiology catheter includes a shaft having a distal ablation segment with one or more electrodes coupled to a source of electrical energy by a connector extending through the shaft. The distal ablation segment of the shaft is movable between a collapsed configuration sized for percutaneous introduction into the patient and/or endoluminal delivery to the target site and an expanded configuration, in which the distal ablation segment forms a substantially continuous surface transverse to the shaft axis for engaging the heart tissue and creating a linear lesion thereon. The catheter includes one or more force element(s) positioned to apply an axial force between the distal and proximal ends of the ablation segment. The force element(s) provide a sufficiently uniform force against the distal ablation segment to establish continuous contact pressure between the electrodes and the patient's heart tissue.

Abstract: A steerable electrophysiology catheter includes a shaft having a distal ablation segment with one or more electrodes coupled to a source of electrical energy by a connector extending through the shaft. The distal ablation segment of the shaft is movable between a collapsed configuration sized for percutaneous introduction into the patient and/or endoluminal delivery to the target site and an expanded configuration, in which the distal ablation segment forms a substantially continuous surface transverse to the shaft axis for engaging the heart tissue and creating a linear lesion thereon. The catheter includes one or more force element(s) positioned to apply an axial force between the distal and proximal ends of the ablation segment. The force element(s) provide a sufficiently uniform force against the distal ablation segment to establish continuous contact pressure between the electrodes and the patient's heart tissue.

Abstract: The invention provides a control system for a vehicle fluid spring suspension system consisting of four fluid springs which support the vehicle body from two longitudinally-spaced trucks. Typically such a vehicle is a rail car employing air springs. The two air springs on each truck are disposed on opposite sides of the longitudinal center line of the vehicle, corresponding to its direction of travel. Three of the springs are provided with levelling valves which keep them at a constant height. A measuring device, either mechanical or electrical, measures the difference in internal spring pressure in the two springs on one truck that both have levelling valves; it also measures the difference in internal spring pressures in the two springs on the other truck and then adjusts the pressure in the spring without a levelling valve until the pressure difference is the same as for the two springs on the other truck.