Abstract: Impression devices are provided for making an impression of a desired feature. The impression devices include: a flexible bladder having a cavity formed therein, the flexible bladder being capable of conforming to the details of the desired feature; a rheological material, such as a magnetorheological fluid, disposed in the cavity of the flexible bladder; and an activator for applying an external stimulus to the rheological material to change the state of the rheological material and thereby capture an impression of the desired feature.

Abstract: An ablation method and device contacts one surface of a target layer and positions the tissue to ablate entirely through the layer. The tissue may be a wall of the heart (ablated, for example, to form blocking lesions for atrial fibrillation), and ablation may be performed with the heart stopped or beating, and effected by either endocardial or epicardial contact. Access may be through an open incision or a minimally invasive technique involving a small opening through which one or more elongated surgical tools are inserted. Illustratively, an atrial ablation treatment can be performed prophylactically (after CABG), or independently to treat an existing condition. A tool of the present invention has a handle at a proximal end, a bipolar ablation head, and an elongated body interconnecting the handle and the ablation head.

Abstract: A surgical instrument useful in harvesting blood vessels such as veins and arteries and for manipulating and grasping tissue. The instrument has a pair of jaws and a closing tube to open and close the jaws. One of the jaws is preferably movable between the open and closed positions and has an insert for providing lateral strength and stiffness while providing the flexibility necessary to open and close the jaws.

Abstract: An ablation method and device contacts one surface of a target layer and positions the tissue to ablate entirely through the layer. The tissue may be a wall of the heart (ablated, for example, to form blocking lesions for atrial fibrillation), and ablation may be performed with the heart stopped or beating, and effected by either endocardial or epicardial contact. Access may be through an open incision or a minimally invasive technique involving a small opening through which one or more elongated surgical tools are inserted. Illustratively, an atrial ablation treatment can be performed prophylactically (after CABG), or independently to treat an existing condition. A tool of the present invention has a handle at a proximal end, a bipolar ablation head, and an elongated body interconnecting the handle and the ablation head.

Abstract: Ablation instruments and methods for ablating tissue, and more particularly for treating atrial fibrillation utilizing RF energy are provided. The ablation instrument generally includes two components: a first member adapted to be placed on or adjacent to a first tissue surface, and a second member opposed to the first member and adapted to be placed on or adjacent to a second, opposed tissue surface. Each member includes a conductive element disposed on a portion thereof that is effective to communicate with a source of ablative energy. First and second conductor elements can be provided for transmitting ablative energy from an energy source to the first and second conductive elements. In use, ablative radiation is transmitted between the first and second members through the intervening tissue to form a lesion in the tissue.

Abstract: A method of forming a lesion at a predetermined heart location is provided. An energy-delivering electrode is positioned proximal to the predetermined heart location; a return electrode is positioned in contact with cardiac tissue. An electrosurgical current, capable of delivering energy through the energy-delivering electrode to the predetermined heart location at a magnitude and for a duration effective to form a lesion is established. A system for treating atrial fibrillation by forming transmural lesions and a heart-positioning device including a return electrode are also provided. In one embodiment, one of the electrodes includes at least a portion that is selectively movable between a first, retracted position in which the electrode is adapted to be deployed through tissue, and a second, expanded position in which the electrode is adapted to be placed within a chamber of a heart.

Abstract: A method and device for treating atrial arrhythmia forms a conduction block along a circumferentially oriented path in myocardial tissue circumscribing one or more pulmonary veins at their juncture with the wall of the atrium to transect electrical conductivity of the vein and block conduction between the longitudinal portion of the vein wall and the wall of the left atrium. The method treats a patient with a focal arrythmogenic origin in the pulmonary vein, either ablating the focal origin or isolating the focal origin with an epicardially-formed circumferential conduction block. An ablation device includes a curved or curveable lasso or hook, or a curved tip with an epicardial ablation mechanism that forms small diameter conduction blocks, preferably isolating individual pulmonary veins or a pair of veins while avoiding stenotic sequelae. The lesion sets advantageously reduce the central connecting mass of myocardial tissue at the ostia so it does not sustain a re-entrant signal.

Abstract: A method of forming a lesion at a predetermined heart location is provided. An energy-delivering electrode is positioned proximal to the predetermined heart location; a return electrode is positioned in contact with cardiac tissue. An electrosurgical current, capable of delivering energy through the energy-delivering electrode to the predetermined heart location at a magnitude and for a duration effective to form a lesion is established. A system for treating atrial fibrillation by forming transmural lesions and a heart-positioning device including a return electrode are also provided.

Abstract: A surgical instrument useful in harvesting blood vessels such as veins and arteries and for manipulating and grasping tissue. The instrument has a pair of jaws and a closing tube to open and close the jaws. One of the jaws is preferably movable between the open and closed positions and has an insert for providing lateral strength and stiffness while providing the flexibility necessary to open and close the jaws.

Abstract: A system and method for providing improved defibrillation thresholds. In one embodiment of the invention, following the detection of fibrillation, a pacing pulse train is applied to a pacing electrode placed in the low gradient region of the left ventricular freewall to capture the tissue. In one embodiment, a pacing rate of about 80-95% of the VF cycle length is applied to achieve capture. Once capture of the tissue of the critical region is achieved, a high energy shock is delivered when the captured tissue is in the process of activation. The defibrillation shock is delivered at the end of the pacing train, with a coupling interval of either about 80-95% of the pacing rate (i.e., about 64-90% of the VF cycle length), or, alternatively, about 5-20% of the pacing rate (i.e., about 4-19% of the VF cycle length).

Abstract: Methods and apparatus for achieving atrial defibrillation in a heart. Atrial pacing is first conducted from multiple pacing sites in an independent (asynchronous) manner so as to have the desired effect of maximizing the extent of phase-locked area of atrial tissue. Next, an ADF shock is introduced, if still needed, to achieve atrial defibrillation. ADFT energy requirements have been shown to be dramatically reduced on account of using pacing rates set proportionally to the sensed local atrial fibrillation cycle lengths such that large areas of atrial tissues are phase-locked, and consequently atrial defibrillation can be effected in the patient with greatly reduced energy requirements for ADFTs.

Abstract: A system and method for providing improved defibrillation thresholds. In one embodiment of the invention, following the detection of fibrillation, a pacing pulse train is applied to a pacing electrode placed in the low gradient region of the left ventricular freewall to capture the tissue. In one embodiment, a pacing rate of about 80-95% of the VF cycle length is applied to achieve capture. Once capture of the tissue of the critical region is achieved, a high energy shock is delivered when the captured tissue is in the process of activation. The defibrillation shock is delivered at the end of the pacing train, with a coupling interval of either about 80-95% of the pacing rate (i.e., about 64-90% of the VF cycle length), or, alternatively, about 5-20% of the pacing rate (i.e., about 4-19% of the VF cycle length).

Abstract: Methods and apparatus for achieving atrial defibrillation in a heart. Atrial pacing is first conducted from a single pacing site so as to have the desired effect of maximizing the extent of phase-locked area of atrial tissue. Next, an ADF shock is introduced, if still needed, to achieve atrial defibrillation. ADFT energy requirements have been shown to be dramatically reduced on account of using a pacing rate set proportionally to the atrial fibrillation cycle length such that large areas of atrial tissues are phase-locked, and consequently atrial defibrillation can be effected in the patient with greatly reduced energy requirements for ADFTs.

Abstract: Methods and apparatus for achieving atrial defibrillation in a heart. Atrial pacing is first conducted from multiple pacing sites in a synchronous manner so as to have the desired effect of maximizing the extent of phase-locked area of atrial tissue. Next, an ADF shock is introduced, if still needed, to achieve atrial defibrillation. ADFT energy requirements have been shown to be dramatically reduced on account of using pacing rates set proportionally to the sensed atrial fibrillation cycle length(s) such that large areas of atrial tissues are phase-locked, and consequently atrial defibrillation can be effected in the patient with greatly reduced energy requirements for ADFTs.