Abstract: Improved hand assemblies and methods combining a number of the separate known devices used in transseptal catheterization procedures, including sheaths, dilators, and needle assemblies (including a puncture device and a stylet, for example). The hand assemblies provide cooperating members that reduce the overall complexity and increase safety of transseptal catheterization procedures.

Abstract: Described is a system for affecting intestinal microbial flora. The system includes an intestinal sleeve that is implanted in a patient and bypasses a section of the intestine; and probiotics, prebiotics or pharmacologic therapy used in combination with the intestinal sleeve. Also described are related methods.

Abstract: A conforming electrode for delivering ablative energy to tissue generally includes a plurality of flexible metal tubes, each having a longitudinal axis, a proximal end, and a distal end. The flexible metal tubes are arranged in a bundle with their longitudinal axes aligned parallel to each other. In addition, the flexible metal tubes are electrically coupled to a conductor for transferring ablative energy to the flexible metal tubes. The conductor may be a loop around the flexible metal tubes and to which the flexible metal tubes may be secured. The proximal ends of the flexible metal tubes may be secured to the distal end of a catheter shaft.

Abstract: A medical device utilizing temperature sensing to identify or assess anatomical bodies or structures includes an elongate tubular member, at least one electrode, a thermal sensor, and a temperature response assessment system or component. The at least one electrode may be connected to the distal portion of the elongate tubular member, and the one or more electrode can be configured to provide energy or heat to a portion of an anatomical body or structure. The thermal sensor may be configured to measure the thermal response of the portion of an anatomical body or structure, e.g., tissue or blood pools. The temperature response assessment system or component can be coupled to the thermal sensor. In embodiments, the device may include a lumen and port opening, which may accommodate a tool, such as a needle. Methods for using temperature sensing to identify an anatomical body or structure are also disclosed.

Abstract: A transseptal needle includes an elongate needle body having a distal end and a proximal end and a cannular needle tip located proximate the distal end of the needle body. The needle tip has a distal segment, a proximal segment, and a longitudinal axis. An inner surface of the needle tip defines a passageway spanning at least a portion of the needle tip, and an outer surface of the needle tip defines a wall with the inner surface. The distal segment of the needle tip also includes a wedge surface and a dome-shaped region. The wedge surface forms a wedge angle of other than 90 degrees relative to the longitudinal axis. The dome-shaped region, which intersects the wedge surface, includes at least two bevels that intersect the wedge surface and that intersect each other at one or more points on the needle tip.

Abstract: An ablation catheter has improved fluid distribution structures. An ablation section at a distal end of the catheter is designed to provide a more uniform fluid flow emanating from the catheter. By creating a uniform fluid flow, a more uniform tissue lesion results and the possibility of charring the tissue is reduced. A combination of mesh material layers, porous materials, and dispersion channels or openings are used to achieve the uniform flow. The amount of fluid used as a virtual electrode to ablate the tissue is greatly reduced with the present invention. Further, the catheter may be used to create a single, uniform linear lesion by successive application of energy to adjacent portions of the ablation section, thus reducing the power required to create the desired lesion.

Abstract: A medical device utilizing temperature sensing to identify or assess anatomical bodies or structures includes an elongate tubular member, at least one electrode, a thermal sensor, and a temperature response assessment system or component. The at least one electrode may be connected to the distal portion of the elongate tubular member, and the one or more electrode can be configured to provide energy or heat to a portion of an anatomical body or structure. The thermal sensor may be configured to measure the thermal response of the portion of an anatomical body or structure, e.g., tissue or blood pools. The temperature response assessment system or component can be coupled to the thermal sensor. In embodiments, the device may include a lumen and port opening, which may accommodate a tool, such as a needle. Methods for using temperature sensing to identify an anatomical body or structure are also disclosed.

Abstract: A transseptal needle includes an elongate needle body having a distal end and a proximal end and a cannular needle tip located proximate the distal end of the needle body. The needle tip has a distal segment, a proximal segment, and a longitudinal axis. An inner surface of the needle tip defines a passageway spanning at least a portion of the needle tip, and an outer surface of the needle tip defines a wall with the inner surface. The distal segment of the needle tip also includes a wedge surface and a dome-shaped region. The wedge surface forms a wedge angle of other than 90 degrees relative to the longitudinal axis. The dome-shaped region, which intersects the wedge surface, includes at least two bevels that intersect the wedge surface and that intersect each other at one or more points on the needle tip.

Abstract: Catheter systems with blood measurement device and methods are disclosed. An exemplary catheter system for use in positioning a distal end of a catheter body at a desired location in a patient's body may include a needle provided at the distal end of the catheter body to withdraw blood from the patient's body. The needle is fluidically connected to a proximal end of the catheter body. The catheter system may also include a measurement device provided at the proximal end of the catheter body. The measurement device is configured to receive blood withdrawn by the needle for measuring a blood gas value of the blood for use in positioning the distal end of the catheter body at the desired location in the patient's body.

Abstract: A catheter is designed with a virtual electrode structure for creating a linear lesion. The catheter includes a sensor array that measures temperatures of adjacent tissue along the length of the virtual electrode section. The sensors in the sensor array include a conductive material that is substantially coated with an electrically and thermally insulating material. An aperture is formed in the insulating coating to expose an area of the conductive material. Leads are coupled with each sensor and are connected at their opposite, proximal ends with a discrimination circuit. The circuit processes the signals induced in the sensors to output a single temperature measurement, for example, the highest temperature, the lowest temperature, or the average temperature. The sensors also measure cardiac electrical activity and the leads are further connected to an electrocardiograph monitor to determine the efficacy of treatment.

Abstract: A catheter for treating tissue is disclosed, the catheter having slotted openings on a circumference of its distal portion, wherein each slotted opening spans at least about 25% of the circumference of the catheter. The disclosed catheter is capable of treating a variety of tissue in a variety of configurations. For example, in an ablation catheter of the disclosed invention, the slotted openings on the distal portion allow the ablation catheter to create effective lesions in both the pulmonary veins and the posterior wall of the left atrium. The ablation catheter preferably carries a conductive medium to help deliver ablation energy (e.g., RF) to the tissue being ablated. The configuration of the catheter permits ablation to be conducted in many varieties and geometric orientations independently of the tissue orientation. Also disclosed is a method of ablating tissue using catheter with slotted openings.

Abstract: A conforming electrode for delivering ablative energy to tissue generally includes a plurality of flexible metal tubes, each having a longitudinal axis, a proximal end, and a distal end. The flexible metal tubes are arranged in a bundle with their longitudinal axes aligned parallel to each other. In addition, the flexible metal tubes are electrically coupled to a conductor for transferring ablative energy to the flexible metal tubes. The conductor may be a loop around the flexible metal tubes and to which the flexible metal tubes may be secured. The proximal ends of the flexible metal tubes may be secured to the distal end of a catheter shaft.

Abstract: Improved hand assemblies and methods combining a number of the separate known devices used in transseptal catheterization procedures, including sheaths, dilators, and needle assemblies (including a puncture device and a stylet, for example). The hand assemblies provide cooperating members that reduce the overall complexity and increase safety of transseptal catheterization procedures.

Abstract: An ablation catheter has improved fluid distribution structures. An ablation section at a distal end of the catheter is designed to provide a more uniform fluid flow emanating from the catheter. By creating a uniform fluid flow, a more uniform tissue lesion results and the possibility of charring the tissue is reduced. A combination of mesh material layers, porous materials, and dispersion channels or openings are used to achieve the uniform flow. The amount of fluid used as a virtual electrode to ablate the tissue is greatly reduced with the present invention. Further, the catheter may be used to create a single, uniform linear lesion by successive application of energy to adjacent portions of the ablation section, thus reducing the power required to create the desired lesion.