Abstract: An irrigated ablation electrode assembly comprises a distal member, a first manifold, and a second manifold. The distal member includes an outer surface; an inner surface; and at least one radially extending passageway that extends from the inner surface of the distal member to the outer surface of the distal member. The first manifold includes an outer surface, an inner cavity, and at least one radially extending passageway that extends from the inner cavity to the outer surface of the first manifold. The second manifold includes an outer surface, an inner surface, and at least one radially extending passageway that extends from the inner surface of the second manifold to the outer surface of the second manifold. Other irrigated ablation electrode assemblies are also presented.

Abstract: An ablation electrode assembly is provided with improved irrigation cooling of the assembly and ablation site. The assembly includes a proximal end configured to be coupled to a catheter shaft and a distal end configured to deliver ablation energy to tissue. The assembly further includes a fluid manifold extending from the proximal end to the distal end and configured to fluidly communicate with a fluid lumen in the catheter shaft. The fluid manifold defines an axial passageway centered about a longitudinal axis extending in the longitudinal direction of the assembly. The axial passageway has a distal end terminating prior to the distal end of the electrode assembly. The assembly further includes means for creating turbulence in fluid exiting the first axial passageway.

Abstract: Suction-assisted tissue-engaging devices, systems, and methods are disclosed that can be employed through minimal surgical incisions to engage tissue during a medical procedure through application of suction to the tissue through a suction member applied to the tissue. A shaft is introduced into a body cavity through a first incision, and a suction head is attached to the shaft via a second incision. The suction head is applied against the tissue by manipulation of the shaft and suction is applied to engage the tissue while the medical procedure is performed through the second incision. A system coupled to the shaft and a fixed reference point stabilizes the shaft and suction head. When the medical procedure is completed, suction is discontinued, the suction head is detached from the shaft and withdrawn from the body cavity through the second incision, and the shaft is retracted through the first incision.

Abstract: Cardiac ablation systems include vacuum-stabilized, irrigated ablation devices that have ablating elements capable of providing regions of relatively low pressure to maintain the ablating element in a stable position relative to the tissue, or minimize relative movement of the ablating element relative to the tissue. The ablation elements have integrated structures for vacuum-stabilization. The devices also include one or more electrodes for both orienting the ablating element as well as for diagnostic purposes.

Abstract: Embodiments of the invention provide a vessel support system and a method of vessel harvesting. The system can include a cutting device, a catheter adapted to be inserted into a section of the vessel in order to support the vessel as the cutting device is advanced over the vessel, and a cannula adapted to be coupled to the vessel and adapted to receive the catheter as the catheter is inserted into the section of the vessel. The method can include orienting a cutting device coaxially with the cannula and the catheter and advancing the cutting device over the cannula, the catheter, and the section of the vessel in order to core out the section of the vessel and a portion of the surrounding tissue.

Abstract: The invention provides a system and method for harvesting a vessel section. The system comprises a vessel support member, a handle, and a tubular cutting device. The vessel support member is introduced into the vessel section to be harvested. The tubular cutting device may comprise an outer tubular member or an outer and an inner tubular member. The outer tubular member carries at least one cutting element. The tubular member or members are advanced over the vessel section and vessel support member to core out the vessel section and tissue adjoining the vessel section.

Abstract: Suction-assisted tissue-engaging devices, systems, and methods are disclosed that can be employed through minimal surgical incisions to engage tissue during a medical procedure through application of suction to the tissue through a suction member applied to the tissue. A shaft is introduced into a body cavity through a first incision, and a suction head is attached to the shaft via a second incision. The suction head is applied against the tissue by manipulation of the shaft and suction is applied to engage the tissue while the medical procedure is performed through the second incision. A system coupled to the shaft and a fixed reference point stabilizes the shaft and suction head. When the medical procedure is completed, suction is discontinued, the suction head is detached from the shaft and withdrawn from the body cavity through the second incision, and the shaft is retracted through the first incision.

Abstract: A system for providing irrigation fluid during ablation of tissue includes a catheter, an electrode assembly, at least one thermal sensor adapted to be connected to the catheter, and a control system. The electrode assembly is adapted to be connected to an ablation generator. The thermal sensor is adapted to be operatively connected to an electronic control unit (ECU). The ECU receives as an input temperature measurement data from the thermal sensor; determines a power delivery rate value for the ablation generator responsive to the temperature measurement data; and outputs the power delivery rate value. The control system also delivers irrigation fluid to the irrigated catheter at a first flow rate in a first time period and at a second flow rate in a second time period that is temporally after the first time period. The second flow rate is at least half of the first flow rate.

Abstract: Ablation electrode assemblies include an inner core member and an outer shell surrounding the inner core member. The inner core member and the outer shell define a space or separation region therebetween. The inner core member is constructed from a thermally insulative material having a reduced thermal conductivity. In an embodiment, the space is a sealed or evacuated region. In other embodiments, irrigation fluid flows within the space. The ablation electrode assembly further includes at least one thermal sensor in some embodiments. Methods for providing irrigation fluid during cardiac ablation of targeted tissue are disclosed that include calculating the energy delivered to irrigation fluid as it flows within the ablation electrode assembly through temperature measurement of the irrigation fluid. Pulsatile flow of irrigation fluid can be utilized in some embodiments of the disclosure.

Abstract: Ablation electrode assemblies having a longitudinal axis include an electrode core member; an electrode shell; and an irrigant distribution element. The electrode core member comprises a thermal insulator and has a first end; a second end; and at least one irrigation passageway. The electrode shell comprises an electrically conductive material, defines an inner volume, and has a first end; and a second end. The second end of the electrode shell is configured for connection to the first end of the electrode core member. The electrode shell is sufficiently flexible for deflection of the distal end of the electrode shell relative to the longitudinal axis of the ablation electrode assembly. The irrigant distribution assembly comprises a first end; and a second end, wherein the second end of the irrigant distribution element defines a circumferential irrigation port between the irrigant distribution element and the electrode core member.

Abstract: An irrigated ablation electrode assembly comprises a distal member, a first manifold, and a second manifold. The distal member includes an outer surface; an inner surface; and at least one radially extending passageway that extends from the inner surface of the distal member to the outer surface of the distal member. The first manifold includes an outer surface, an inner cavity, and at least one radially extending passageway that extends from the inner cavity to the outer surface of the first manifold. The second manifold includes an outer surface, an inner surface, and at least one radially extending passageway that extends from the inner surface of the second manifold to the outer surface of the second manifold. Other irrigated ablation electrode assemblies are also presented.

Abstract: Systems capable of providing force and displacement outputs sufficient to actuate remote mechanisms to enhance catheter capabilities include both low-force and remote actuation arrangements. The remote actuation and low-force actuation systems may be used for catheter distal end deflection, sensor deployment, feedback controlled movement, fluid delivery rate and directional control applications as well as catheter retention mechanism deployment. Remote actuation mechanism may employ phase change based, magnetic based or hydraulic based. Low-force remote actuation structures include a coaxially-extending pull wire, a reaction member, and a remote mechanism responsive to the pull force.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. A clamping ablation tool can include an upper arm having an upper neck, a link assembly, and an upper actuator. The link assembly can include a distal electrode and a proximal electrode. The clamping ablation tool can include a lower arm that mates with the upper arm. The lower arm can include a lower neck, a distal jaw, and a lower actuator. The distal jaw can include a jaw electrode, and the lower actuator can control movement of the distal jaw.

Abstract: System, device and method for ablating target tissue adjacent pulmonary veins of a patient through an incision. An ablation device can include a hinge including a cam assembly, a moving arm, a floating jaw, and a lower jaw. Fingers can engage the floating jaw to hold the floating jaw in a first position with respect to the moving arm. Some embodiments of the invention can provide an ablation device including a central support, an upper four-bar linkage coupled to the central support, an upper jaw coupled to the upper linkage, a lower four-bar linkage coupled to the central support, and a lower jaw coupled to the lower linkage. Some embodiments of the invention can provide an ablation device having an upper jaw including a first cannula connection and a lower jaw including a second cannula connection. The system can include a first catheter coupled to the first cannula connection and a second catheter coupled to the second cannula connection.

Abstract: Tissue stabilizers including a clamp assembly, a turret assembly, an articulating arm having a tension element extending therethrough, a collet assembly and a head-link assembly are disclosed. Methods of stabilizing tissue are also disclosed.

Abstract: A tissue ablation apparatus includes a body having at least two lumens extending therethrough and an ultrasound ablation element positioned within a distal region of the body. The ultrasound ablation element includes an ultrasound transducer and a membrane. One of the lumens is arranged so as to deliver a fluid into a cavity defined between the transducer and the membrane. A first orifice is provided in the body proximal of the ultrasound ablation element and is open to the first lumen to define a first vacuum pathway. A distal vacuum chamber, opening to a second orifice in the body, is defined by the body distal of the ultrasound ablation element and is in communication with the first lumen to define a second vacuum pathway. At least one flow control apparatus is provided to regulate flow through one of the vacuum pathways independent of flow through the other vacuum pathway.

Abstract: Embodiments of the invention provide a cutting device and method of vessel harvesting. The cutting device can include at least one tubular member, a cutting element, and a centering member. The cutting device can include at least one tubular member with a flexible section and a cutting element. The method of vessel harvesting can include spacing a cutting element of the cutting device from the vessel as the cutting element is advanced over the vessel.

Abstract: System, device and method for ablating target tissue adjacent pulmonary veins of a patient through an incision. An ablation device can include a hinge including a cam assembly, a moving arm, a floating jaw, and a lower jaw. Fingers can engage the floating jaw to hold the floating jaw in a first position with respect to the moving arm. Some embodiments of the invention can provide an ablation device including a central support, an upper four-bar linkage coupled to the central support, an upper jaw coupled to the upper linkage, a lower four-bar linkage coupled to the central support, and a lower jaw coupled to the lower linkage. Some embodiments of the invention can provide an ablation device having an upper jaw including a first cannula connection and a lower jaw including a second cannula connection. The system can include a first catheter coupled to the first cannula connection and a second catheter coupled to the second cannula connection.

Abstract: Method and apparatus for ablating target tissue adjacent pulmonary veins of a patient. A clamping ablation tool can include an upper arm having an upper neck, a link assembly, and an upper actuator. The link assembly can include a distal electrode and a proximal electrode. The clamping ablation tool can include a lower arm that mates with the upper arm. The lower arm can include a lower neck, a distal jaw, and a lower actuator. The distal jaw can include a jaw electrode, and the lower actuator can control movement of the distal jaw.

Abstract: System, device and method for ablating target tissue adjacent pulmonary veins of a patient through an incision. An ablation device can include a hinge including a cam assembly, a moving arm, a floating jaw, and a lower jaw. Fingers can engage the floating jaw to hold the floating jaw in a first position with respect to the moving arm. Some embodiments of the invention can provide an ablation device including a central support, an upper four-bar linkage coupled to the central support, an upper jaw coupled to the upper linkage, a lower four-bar linkage coupled to the central support, and a lower jaw coupled to the lower linkage. Some embodiments of the invention can provide an ablation device having an upper jaw including a first cannula connection and a lower jaw including a second cannula connection. The system can include a first catheter coupled to the first cannula connection and a second catheter coupled to the second cannula connection.