Abstract: A system of medical devices includes a needle, an endoscope, and an introducer. The needle extends between a needle proximal portion and a needle distal portion having a puncturing tip. The endoscope extends between an endoscope proximal portion and an endoscope distal portion having a camera. The introducer is for guiding the needle and the endoscope towards a target location. The introducer extends between an introducer proximal portion and an introducer distal portion and has a first lumen extending therethrough from the introducer proximal portion to the introducer distal portion and a second lumen extending therethrough from the introducer proximal portion to the introducer distal portion. The needle is advanceable through the first lumen to position the puncturing tip proud of the introducer distal portion and the endoscope is advanceable through the second lumen to position the camera proximate the introducer distal portion and outside of the lumen.

Abstract: An electrosurgical device comprises an electrically conductive elongate member for traversing body vasculature defining a hollow lumen with one or more apertures at or near its distal end, wherein electrical energy can flow through the wall of the elongate member; and an energy delivery device in electrical communication with the elongate member is located distal to the end of the elongate member. The energy delivery device includes an electrode for delivering energy. Methods of using the electrosurgical device include cutting through occlusions and creating transseptal punctures.

Abstract: An electrosurgical device comprises an electrically conductive elongate member for traversing body vasculature defining a hollow lumen with one or more apertures at or near its distal end, wherein electrical energy can flow through the wall of the elongate member; and an energy delivery device in electrical communication with the elongate member is located distal to the end of the elongate member. The energy delivery device includes an electrode for delivering energy. Methods of using the electrosurgical device include cutting through occlusions and creating transseptal punctures.

Abstract: An elongated medical sheath is configured to be movable and positionable proximate to a biological feature of a patient. An expandable-and-collapsible support structure is configured to be selectively movable, at least in part, between an interior of the elongated medical sheath and an exterior of the elongated medical sheath. An energy-emitting assembly is supported by the expandable-and-collapsible support structure.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

Abstract: Methods and apparatus are disclosed for puncturing tissue, including a surgical introducer with a stiff main body and a flexible tip which can be used with a puncture device to gain epicardial access. The surgical introducer comprises an introducer shaft having a rigid portion and a flexible tip portion. The rigid portion has a metal tube extending to the rigid portion distal end. The flexible tip portion is distal of the metal tube distal end. The flexible tip portion includes a first polymer and a second polymer, wherein the second polymer is more flexible than the first polymer. The second polymer extends distally from the metal tube distal end to define a second polymer flexible tip segment. The first polymer extends distally from the second polymer flexible tip segment end to define a flexible tip portion cap.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

Abstract: An elongated medical needle includes an electrically-insulated elongated body having an outer surface extending between an electrically-insulated distal section and an electrically-insulated proximal section. An insulated electrically-conductive wire is aligned proximately along the outer surface between the electrically-insulated distal section and the electrically-insulated proximal section. An exposed electrically-conductive portion is mounted at the electrically-insulated distal section. The exposed electrically-conductive portion is electrically connected to the insulated electrically-conductive wire.

Abstract: Embodiments of medical devices and methods are disclosed. The medical devices typically comprise a flexible elongate member defining a lumen, and a support spine affixed to the distal end and extending proximally therefrom within the elongate member lumen. In some embodiments, the support spine is pre-shaped such that the support spine biases the distal region of the elongate member to adopt a straight configuration, or the support spine biases at least a portion of the distal region of the elongate member to adopt a curved shape to form a curved portion. Some embodiments include apertures at or near the distal end for enabling fluid communication between the lumen and the outside environment. In some embodiments, the support wire extends proximally from the distal end within a distal portion of the lumen such that a proximal portion of the lumen is substantially unobstructed.

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 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. The RF guidewire includes an electrode tip at a distal end of the guidewire for delivering the energy and an electrically insulative thermal shield between the electrode tip and electrical insulation for thermally protecting the electrical insulation from heat produced by delivering the energy. Some embodiments include electrical insulation inside of the electrically insulative thermal shield.

Abstract: A system for pericardial puncture includes a medical device having an elongate shaft extending between a proximal end and a distal end, and having a distally facing electrode at the distal end of the shaft. An impedance meter is electrically connectable with the electrode for measuring an impedance associated with the electrode. A display is provided for displaying an indication of a position of the electrode. The indication of the position is based on of the impedance.

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.

Abstract: A system of medical devices includes a needle, an endoscope, and an introducer. The needle extends between a needle proximal portion and a needle distal portion having a puncturing tip. The endoscope extends between an endoscope proximal portion and an endoscope distal portion having a camera. The introducer is for guiding the needle and the endoscope towards a target location. The introducer extends between an introducer proximal portion and an introducer distal portion and has a first lumen extending therethrough from the introducer proximal portion to the introducer distal portion and a second lumen extending therethrough from the introducer proximal portion to the introducer distal portion. The needle is advanceable through the first lumen to position the puncturing tip proud of the introducer distal portion and the endoscope is advanceable through the second lumen to position the camera proximate the introducer distal portion and outside of the lumen.

Abstract: Methods and apparatus are disclosed for puncturing tissue, including a surgical introducer with a stiff main body and a flexible tip which can be used with a puncture device to gain epicardial access. The surgical introducer comprises an introducer shaft having a rigid portion and a flexible tip portion. The rigid portion has a metal tube extending to the rigid portion distal end. The flexible tip portion is distal of the metal tube distal end. The flexible tip portion includes a first polymer and a second polymer, wherein the second polymer is more flexible than the first polymer. The second polymer extends distally from the metal tube distal end to define a second polymer flexible tip segment. The first polymer extends distally from the second polymer flexible tip segment end to define a flexible tip portion cap.

Abstract: A method and apparatus are disclosed for puncturing a target tissue. Apparatus includes an elongate puncture device having a tip electrode that is configured for collecting EGMs and for delivering energy for puncturing the target tissue. The method comprising collecting EGMs to indirectly measure and monitor a pressure applied against the target tissue by the elongate puncture device, thereby confirming a position of the tip electrode of the elongate puncture device relative to the target tissue.

Abstract: An electrosurgical device comprises an electrically conductive elongate member for traversing body vasculature defining a hollow lumen with one or more apertures at or near its distal end, wherein electrical energy can flow through the wall of the elongate member; and an energy delivery device in electrical communication with the elongate member is located distal to the end of the elongate member. The energy delivery device includes an electrode for delivering energy. Methods of using the electrosurgical device include cutting through occlusions and creating transseptal punctures.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

Abstract: Embodiments of medical devices and methods are disclosed. The medical devices typically comprise a flexible elongate member defining a lumen, and a support spine affixed to the distal end and extending proximally therefrom within the elongate member lumen. In some embodiments, the support spine is configured to support at least a portion of the elongate member when the elongate member is bent or curved. Some embodiments include apertures at or near the distal end for enabling fluid communication between the lumen and the outside environment. In some embodiments, the support wire extends proximally from the distal end within a distal portion of the lumen such that a proximal portion of the lumen is substantially unobstructed, thereby reducing turbulence of fluid flowing through the lumen.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.