Abstract: A method of treating or preventing ARDS includes advancing a cryogenic treatment element into a target bronchus of a mammal and exchanging cryogenic energy between the target bronchus and the cryogenic treatment element for a predetermined period of time until a target temperature of the target bronchus is reached to cause neuropraxia of nerves within the target bronchus.

Abstract: A method, system, and device for predicting lesion quality. Specifically, lesion quality may be predicted based on an assessment of pulmonary vein occlusion using injection of an impedance-modifying agent and evaluation of changes in impedance measurements recorded by an electrode located distal to an occlusion element of the treatment device used to inject the impedance-modifying agent. The quality of the occlusion may be rated based on the changes in impedance over time within the pulmonary vein. For example, the quality of the occlusion may be rated as being good, fair, or poor. This assessment may be quickly and easily communicated to an operator.

Abstract: An epicardial device, system, and method for stabilizing the left atrial appendage during a left atrial appendage ligation/occlusion procedure. A cryoadhesion device including a stabilization element is positioned within the pericardial space proximate the left atrial appendage through subxiphoid access. Once the stabilization element is in contact with the left atrial appendage, the stabilization element is cooled to a temperature that is sufficient to cryoadhere the stabilization element to the left atrial appendage. In this way, the cryoadhesion device stabilizes the left atrial appendage in order to perform left atrial appendage ligation/occlusion with a secondary medical device.

Abstract: Devices, systems, and methods for assessing contact between a treatment element and an area of target tissue using resistive-type and/or capacitive-type contact sensing elements. In one embodiment, a medical system for determining tissue contact includes an elongate body including a distal portion and a proximal portion and a treatment element coupled to the elongate body distal portion. The treatment element may have a first expandable element, a second expandable element, the first expandable element being within the second expandable element, and at least one contact sensing element between the first and second expandable elements. In one example, the device may include a plurality of contact sensing elements arranged in a matrix or in a plurality of linear configurations. In another example, the device may include a layer of conductive microparticles or a contact-sensing film.

Abstract: A method, system, and device for predicting lesion quality. Specifically, lesion quality may be predicted based on an assessment of pulmonary vein occlusion using injection of an impedance-modifying agent and evaluation of changes in impedance measurements recorded by an electrode located distal to an occlusion element of the treatment device used to inject the impedance-modifying agent. The quality of the occlusion may be rated based on the changes in impedance over time within the pulmonary vein. For example, the quality of the occlusion may be rated as being good, fair, or poor. This assessment may be quickly and easily communicated to an operator.

Abstract: A system and device for cryoablation of tissue that is suitable for use within an MRI environment. The device may include an elongate body, a treatment element at the distal portion of the elongate body, and one or more pull fibers. The pull fibers may be composed of a non-ferromagnetic material, such as a polymer. Likewise, none of the other device components may be composed of a ferromagnetic material. The device may also include at least one fiber optic sensor. The elongate body distal portion may include a distal tip to which the pull fibers are directly coupled. Additionally or alternatively, the elongate body may include one or more pull fiber lumens configured to allow the pull fibers to deflect the distal portion when a pull force is exerted on the pull fibers.

Abstract: A method, system, and device for predicting lesion quality. Specifically, lesion quality may be predicted based on an assessment of pulmonary vein occlusion using injection of an impedance-modifying agent and evaluation of changes in impedance measurements recorded by an electrode located distal to an occlusion element of the treatment device used to inject the impedance-modifying agent. The quality of the occlusion may be rated based on the changes in impedance over time within the pulmonary vein. For example, the quality of the occlusion may be rated as being good, fair, or poor. This assessment may be quickly and easily communicated to an operator.

Abstract: An epicardial device, system, and method for stabilizing the left atrial appendage during a left atrial appendage ligation/occlusion procedure. A cryoadhesion device including a stabilization element is positioned within the pericardial space proximate the left atrial appendage through subxiphoid access. Once the stabilization element is in contact with the left atrial appendage, the stabilization element is cooled to a temperature that is sufficient to cryoadhere the stabilization element to the left atrial appendage. In this way, the cryoadhesion device stabilizes the left atrial appendage in order to perform left atrial appendage ligation/occlusion with a secondary medical device.

Abstract: A device, system, and method for providing support to a mapping catheter during mapping or pacing and for adjusting the diameter of a distal loop portion of currently available mapping catheters. A medical device support device includes an elongate body defining a wall and an at least substantially linear proximal portion and a distal portion being transitionable between an at least substantially linear configuration and an expanded configuration, the elongate body defining a lumen extending through the proximal portion and distal portion, the lumen being entirely surrounded by the wall in the proximal portion and being partially surrounded by the wall in the distal portion. For example, the lumen may be sized to receive a mapping catheter therein such that adjustment of the configuration or diameter of the distal portion of the elongate body will likewise modify the configuration or diameter of the distal portion of the mapping catheter.

Abstract: A method and system for monitoring phrenic nerve function and preventing phrenic nerve injury during cardiac ablation. The system includes a pacing device operable to transmit stimulation energy to the phrenic nerve through target tissue proximate the phrenic nerve, a plurality of assessment electrodes operable to make comparisons between baseline, real-time, and predetermined threshold values for CMAP signal amplitude and amplitude over time. The processing device may be connected to an ablation console, and the processing device may interrupt or adjust an ablation procedure controlled by the ablation console and/or generate a system alert in response to one of these comparisons, if the comparison indicates phrenic nerve injury.

Abstract: A method and system for preventing phrenic nerve injury during a cardiac ablation procedure. The method generally includes stimulating a phrenic nerve with a pacing electrode at a location proximate a target treatment location, ablating tissue at the target treatment location with a treatment element, obtaining a heart audio signal with an audio sensor positioned proximate the target treatment location, and determining whether phrenic nerve stimulation (PNS) is present based as least in part on the obtained heart audio signal. A processor may be used to compare an amplitude of the obtained heart audio signal to a predetermined threshold amplitude. The processor may determine that PNS is present if the amplitude of the obtained audio signal is greater than the threshold amplitude. If PNS is present, ablation of the tissue may continue at the current or greater energy level and/or at the current treatment location without injuring the phrenic nerve.

Abstract: A method of treating tissue is provided, including positioning a stimulation device proximate a phrenic nerve; stimulating the phrenic nerve with the stimulation device; measuring a physiological response to the stimulation; defining a threshold physiological response value based at least in part on the measured physiological response; positioning a thermal treatment element proximate to an arrhythmogenic cardiac tissue region; applying a thermal treatment regimen to the cardiac tissue region with the medical device; measuring a physiological parameter during the thermal treatment regimen application; and conveying the measured physiological parameter to a controller, the controller comparing the measured physiological parameter to the defined physiological response value threshold, the controller adjusting the thermal treatment regimen in response to the comparison of the measured physiological parameter to the defined physiological response value threshold.

Abstract: A method of treating tissue is provided, including positioning a stimulation device proximate a phrenic nerve; stimulating the phrenic nerve with the stimulation device; measuring a physiological response to the stimulation; defining a threshold physiological response value based at least in part on the measured physiological response; positioning a thermal treatment element proximate to an arrhythmogenic cardiac tissue region; applying a thermal treatment regimen to the cardiac tissue region with the medical device; measuring a physiological parameter during the thermal treatment regimen application; and conveying the measured physiological parameter to a controller, the controller comparing the measured physiological parameter to the defined physiological response value threshold, the controller adjusting the thermal treatment regimen in response to the comparison of the measured physiological parameter to the defined physiological response value threshold.

Abstract: The present invention advantageously provides a method and system for the improved isolation and corresponding treatment of tissue targeted for cryogenic or other thermal therapy to increase the thermal efficacy and thermal efficiency of the treatment. In particular, the present invention provides methods and systems for improved thermal treatment of target tissue, such as a pulmonary vein and/or regions of the left atrium by reducing the resistive forces and/or increased thermal energy experienced from blood flow exiting the pulmonary vein into the left atrium during treatment.