Abstract: Improved devices, systems and methods for treating a tissue region provide straightforward, yet reliable ways for installing diverse functional components within the confined space of a catheter-based instrument.

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: Improved devices, systems and methods for treating a tissue region provide straightforward, yet reliable ways for installing diverse functional components within the confined space of a catheter-based instrument.

Abstract: Improved devices, systems and methods for treating a tissue region provide straightforward, yet reliable ways for installing diverse functional components within the confined space of a catheter-based instrument.

Abstract: Methods treat a tissue region. In one arrangement, the methods deploy an electrode on a support structure in a tissue region at or near the cardia of the stomach. In one embodiment, 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 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.

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: 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: Multifunction and radial deflection wires (66, 64) extend from a catheter shaft (8) and into a handle (4). The multifunction wire is pulled and pushed longitudinally and is rotated about its axis to change the stiffness of and to laterally deflect the tip portion (12). A curve size manipulator (32) on the handle body (24) moves the multifunction wire longitudinally but does not hinder its rotational movement. Rotation of a lateral deflection manipulator (38) on the handle causes the proximal end (70) of the multifunction wire to rotate about its own axis; the free longitudinal movement of the proximal end is unhindered. Any initial corkscrewing or other deflection of the tip portion can be removed at assembly by rotating the proximal end (68) of the radial deflection wire. The longitudinal movement of the manipulators can be limited by movable stops (120).

Abstract: An electrophysiology catheter (2) includes a handle (4) and a catheter shaft (6) having a flexible tip portion (22) with one or more electrodes (26, 28). A radial deflection wire (42) connects the tip portion to a first manipulator (10) at the handle to radially deflect the tip portion to a curved shape. A multifunction wire (60) extends from a second manipulator (11) at the handle to the tip portion. The second manipulator slides the multifunction wire longitudinally to position the distal end (64) of the multifunction wire along the multifunction lumen (38). The distal end of the multifunctional wire and the multifunction lumen are configured to provide interfering torquing surfaces (68, 70) so that when a third manipulator (12) rotates or torques the proximal end (62) of the multifunctional wire, the torquing force exerted between the interfering torquing surface causes lateral deflection of the radially curved tip portion.

Abstract: Mulifunction and radial deflection wires (66, 64) extend from a catheter shaft (8) and into a handle (4). The multifunction wire is pulled and pushed longitudinally and is rotated about its axis to change the stiffness of and to laterally deflect the tip portion (12). A curve size manipulator (32) on the handle body (24) moves the multifunction wire longitudinally but does not hinder its rotational movement. Rotation of a lateral deflection manipulator (38) on the handle causes the proximal end (70) of the multifunction wire to rotate about its own axis; the free longitudinal movement of the proximal end is unhindered. Any initial corkscrewing or other deflection of the tip portion can be removed at assembly by rotating the proximal end (68) of the radial deflection wire. The longitudinal movement of the manipulators can be limited by movable stops (120). The longitudinal positions of the abutment faces (126, 128) of the stops preferably change according to their longitudinal (distal or proximal) orientation.

Abstract: An electrophysiology catheter (2) includes a handle (4) and a catheter shaft (6) having a flexible tip portion (22) with one or more electrodes (26, 28). A radial deflection wire (42) connects the tip portion to a first manipulator (10) at the handle to radially deflect the tip portion to a curved shape. A multifunction wire (60) extends from a second manipulator (11) at the handle to the tip portion. The second manipulator slides the multifunction wire longitudinally to position the distal end (64) of the multifunction wire along the multifunction lumen (38). The distal end of the multifunctional wire and the multifunction lumen are configured to provide interfering torquing surfaces (68, 70) so that when a third manipulator (12) rotates or torques the proximal end (62) of the multifunctional wire, the torquing force exerted between the interfering torquing surface causes lateral deflection of the radially curved tip portion.

Abstract: Multifunction and radial deflection wires (66, 64) extend from a catheter shaft (8) and into a handle (4). The multifunction wire is pulled and pushed longitudinally and is rotated about its axis to change the stiffness of and to laterally deflect the tip portion (12). A curve size manipulator (32) on the handle body (24) moves the multifunction wire longitudinally but does not hinder its rotational movement. Rotation of a lateral deflection manipulator (38) on the handle causes the proximal end (70) of the multifunction wire to rotate about its own axis; the free longitudinal movement of the proximal end is unhindered. Any initial corkscrewing or other deflection of the tip portion can be removed at assembly by rotating the proximal end (68) of the radial deflection wire. The longitudinal movement of the manipulators can be limited by movable stops (120).

Abstract: An electrophysiology catheter (2) includes a handle (4) and a catheter shaft (6) having a flexible tip portion (22) with one or more electrodes (26, 28). A radial deflection wire (42) connects the tip portion to a first manipulator (10) at the handle to radially deflect the tip portion to a curved shape. A multifunction wire (60) extends from a second manipulator (11) at the handle to the tip portion. The second manipulator slides the multifunction wire longitudinally to position the distal end (64) of the multifunction wire along the multifunction lumen (38). The distal end of the multifunctional wire and the multifunction lumen are configured to provide interfering torquing surfaces (68, 70) so that when a third manipulator (12) rotates or torques the proximal end (62) of the multifunctional wire, the torquing force exerted between the interfering torquing surface causes lateral deflection of the radially curved tip portion.

Abstract: An electrode catheter (2) includes a handle (4) to which a catheter shaft (6) is mounted. The catheter shaft has a distal end (10) carrying plurality of electrodes (12). Dual purpose wires (18) extend from an electrical connector (14) on the handle, through separate axial lumens (16) in the catheter shaft and to the electrodes. The dual purpose wires are physically secured at their distal and proximal ends to the distal end of the catheter shaft and to the handle, respectively, so that rotation of the handle causes a rotational torque to be transmitted through the dual purpose wires to the distal end of the catheter shaft. Each dual purpose wire has an electrical resistance of no greater than about 0.80 ohms per centimeter and a torsional stiffness of at least about 0.25 to 1.0 inch-ounce (17654 to 70616 dyne-cm) for each 110 cm length of catheter shaft when the proximal end of the catheter shaft is rotated 3 turns. This construction provides a simply constructed, low cost torquing electrode catheter.

Abstract: A reduced stiffness, bidirectionally deflecting catheter assembly (2) includes a handle (4) and flexible catheter shaft (6) with a tip section (12) secured to its distal end (14). The tip section has a radially offset, longitudinally extending core wire lumen (42) through which a tapered core wire (24), extending from a core wire manipulator (56) on the handle, passes. The core wire manipulator can be moved in two different directions (58, 60) to pull or push on the core wire to cause the tip section to deflect axially in opposite directions in the same plane. The ends of the core wire are non-rotatably secured to the handle and the tip section so that rotating the handle about its axis (63) causes the tip section to deflect laterally due to torsionally forces exerted on the tip section by both the catheter shaft and the core wire. The taper on the core wire determines the size and shape of the curved tip section when the tip is axially deflected.

Abstract: An electrophysiology catheter (20) comprises a shaft (22) having a first bending stiffness and a deflectable tip (28) secured to the distal end (24) of the shaft with a second bending stiffness less than the first bending stiffness. At least one electrode (34, 36) is mounted to the tip for delivering current to or monitoring electrical activity of tissue. A manipulator wire (58) is coupled to the distal end of the deflectable tip, whereby the deflectable tip may be deflected by axial force applied to the manipulator wire. A stiffener member (66) is axially slidable relative to the tip so as to adjust the tip curvature without removing the catheter from the body. The catheter may further include a core wire (72) configured to rotate the deflectable tip about a longitudinal axis (2) without rotating the proximal end (26) of the catheter shaft, wherein the distal end of the deflectable tip remains in a substantially constant axial position, preferably in a plane perpendicular to the longitudinal axis.

Abstract: An electrophysiology catheter (20) comprises a shaft (22) having a first bending stiffness and a deflectable tip (28) secured to the distal end (24) of the shaft with a second bending stiffness less than the first bending stiffness. At least one electrode (34, 36) is mounted to the tip for delivering current to or monitoring electrical activity of tissue. A manipulator wire (58) is coupled to the distal end of the deflectable tip, whereby the deflectable tip may be deflected by axial force applied to the manipulator wire. A stiffener member (66) is axially slidable relative to the tip so as to adjust the tip curvature without removing the catheter from the body. The catheter may further include a core wire (72) configured to rotate the deflectable tip about a longitudinal axis (2) without rotating the proximal end (26) of the catheter shaft, wherein the distal end of the deflectable tip remains in a substantially constant axial position, preferably in a plane perpendicular to the longitudinal axis.