Abstract: An embodiment of a handle assembly for an elongate medical device that may reduce the weight and/or expense of traditional handle may include an exterior adjusting knob extending along a longitudinal axis and configured to rotate about the axis, an insert, and a dowel pin. The insert may be configured to engage the adjusting knob and to rotate about the axis responsive to rotation of the adjusting knob. The insert may comprise an annular groove configured to engage a dowel pin, the annular groove comprising a sidewall comprising a chamfer. The dowel pin may be configured to engage the annular groove to resist rotation of the insert. In an embodiment, the insert may comprise plastic or polymer.

Abstract: An irrigated balloon catheter for use in an ostium of a pulmonary vein, includes a flex circuit electrode assembly adapted for circumferential contact with the ostium when the balloon is inflated. Adapted for both diagnostic and therapeutic applications and procedures, the balloon catheter may be used with a lasso catheter or focal catheter. The flex circuit electrode assembly includes a substrate, a contact electrode on an outer surface of the substrate, the contact electrode having a “fishbone” configuration with a longitudinally elongated portion and a plurality of transversal fingers, and a wiring electrode on an inner surface of the substrate, and conductive vias extending through the substrate electrically coupling the contact electrode and the writing electrodes. Microelectrodes with exclusion zones are strategically positioned relative to the electrodes. The electrodes may also be split into electrode portions.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed, with the device including a set of splines coupled to a catheter for medical ablation therapy. Each spline of the set of splines may include a set of electrodes formed on that spline. The set of splines may be configured for translation to transition between a first configuration and a second configuration. The devices described herein may be used to form a lesion via focal ablation.

Abstract: A volume mapping instrument (20), deployable within a partially or a completely enclosed anatomical volume, employs one or more medical tools (40) with each medical tool (40) being transitional between a deployable structural configuration to orderly position each medical tool (40) within the anatomical volume and a mapping structural configuration to anchor the medical tool (40) against the boundary of the anatomical volume. The volume mapping instrument (20) further employs an optical shape sensor (30) to generate one or more encoded optical signals indicative of a shape of the boundary of the anatomical volume in response to each medical tool (40) being transitioned from the deployable structural configuration to the mapping structural configuration within the anatomical volume. Based on the encoded optical signal(s), a volume mapping module (51) is utilized to map a portion or an entirety of the boundary of the anatomical volume.

Abstract: A deployment device for positioning a soft tissue repair prosthesis includes a self-expanding support body releasably attachable to the prosthesis. The support body may be removably insertable into a pocket of the prosthesis. A handle coupled to the support body facilitates positioning the patch and/or removal of the support body from the pocket. The support body may substantially occupy the pocket in an expanded configuration. The handle may be arranged to direct a pulling force to the outer peripheral edge of the support body and/or cause a portion thereof to be pulled downward and below the body during withdrawal of the deployment device from the prosthesis. The support body may include support segments pivotally coupled together and foldable to collapse the support body for insertion into and removal from the pocket. One or more resilient support members may be provided for collapsing and expanding the support body and the prosthesis.

Abstract: A method of subcutaneously injecting and anchoring a device to a bone, a muscle, and/or a tissue in a patient, the device having a clip configured to anchor the device to the bone, the muscle, or the tissue, includes making an incision in the patient. An instrument pre-loaded with the device is inserted through the incision. The instrument is advanced to the bone, the muscle, and/or the tissue upon which the device is to be anchored. A clip of the device is pushed onto the bone, the muscle, and/or the tissue using the instrument. The device is anchored to the bone, the muscle, and/or the tissue using the clip on the device.

Abstract: Disclosed are a radio-frequency ablation catheter having a spiral structure and device thereof. The radio-frequency ablation catheter has an elongated catheter body. A spiral electrode support is arranged at the front end of the catheter body. Multiple electrodes are arranged on the electrode support. A control handle is arranged at the rear end of the catheter body. Wall-attachment adjusting wires having various structures can be arranged in the radio-frequency ablation catheter, so that the radio-frequency ablation catheter having a spiral structure can be adapted to target vessels of different diameters, and so that the electrodes on the electrode support have a good wall-attachment state.

Abstract: An irrigated finned ablation head that provides enhanced cooling. The irrigated finned ablation head comprises a plurality of radial fins that are distributed about a central axis and that extend axially from a common base. The plurality of fins are arranged to define a central passageway along the central axis, as well as a plurality of slots therebetween, the slots extending in an axial direction along the irrigated finned ablation head. In one embodiment, the central passageway extends through the irrigated finned ablation head, defining an opening at the distal extremity, with the slots extending from the base to the opening. In another embodiment, the irrigated finned ablation head includes a cap portion at a distal portion that is common to all the radial fins, so that the slots are terminated at the distal portion of the irrigated finned ablation head. The radial flow distribution along the central axis can be tailored by the configuration of the central passageway.

Abstract: A catheter may be adapted to map a chamber of the heart. The catheter may include a magnetic and/or ultrasound sensor for navigation. The body of the catheter may be pliable and configured to form a predetermined shape upon exiting a catheter sheath. Upon exiting the catheter sheath, the catheter body may be configured to form one or more loops, and the loops may be non-overlapping loops. In some examples, the non-overlapping loops may be concentric loops. Alternatively, the catheter body may be configured to form one or more splines. The catheter body may include an embedded electrode assembly. The electrodes of the electrode assembly may be may be arranged in one or more rows and configured to detect a wave front. The electrode assembly may also be configured to generate and activation sequence and determine a direction of an activation source.

Abstract: The ablation device (11) according to the invention is distinguished by a head (20) having a noncircular cross-section and by electrodes (32, 33) being positioned at an acute angle relative to each other. Due to the angular arrangement of the electrodes and the appropriate configuration of the channels (28, 29), there results an approximately fan-shaped plasma beam with which—in particular with the alternating activation of the two electrodes—a wide strip-shaped ablation region can be achieved on hollow organs of living beings. Handling is reliable and simplified, and, compared to existing measures, the treatment time is reduced.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed in the context of esophageal ablation. An ablation device may include a first catheter defining a longitudinal axis and a lumen therethrough. A balloon may be coupled to the first catheter. The balloon may be configured to transition between a deflated configuration and an inflated configuration. A second catheter may extend from a distal end of the first catheter lumen. A set of splines including electrodes formed on a surface of each of the splines may couple to the distal end of the first catheter lumen and a distal portion of the second catheter. The second catheter may be configured for translation along the longitudinal axis to transition the set of splines between a first configuration and a second configuration.

Abstract: An electrophysiological laboratory system comprises a subsystem configured to perform diagnostic and/or therapeutic functions, a medical device, and an interface module disposed therebetween. The medical device comprises a shaft having proximal and distal portions, high- and low-impedance electrical pathways disposed within the shaft, and an electrode disposed at the distal portion of the shaft and electrically coupled to one or both of the high- and low-impedance electrical pathways. The electrode is configured to perform diagnostic and/or therapy delivery functions. The interface module comprises a high-impedance channel configured to couple the high-impedance pathway of the medical device to the subsystem, and to attenuate magnetic resonance RF and gradient field pulses generated by the MRI system. The interface module further comprises a low-impedance channel configured to couple the low-impedance pathway of the medical device to the subsystem.

Abstract: Systems and methods for noncontact ablation of tissues or materials in/on the body using a luminal catheter and a catheter inserted into the lumen. In one embodiment, the luminal catheter is an ablation catheter and the other catheter is a recording/measurement/positioning catheter. The luminal catheter incorporates a noncontact ablation element such as an ultrasonic transducer. The luminal catheter can be inserted through the skin and into the body (e.g., into the heart) and the recording/measurement/positioning catheter can be inserted into the lumen so that the ablation and recording/measurement/positioning catheters are simultaneously positioned to record/measure the electrical activity of the target tissue and ablate the target tissue without causing the trauma that results from the introduction of additional catheters. Either of the ablation and recording/measurement/positioning catheters can be steerable, and either may incorporate recording/measurement electrodes.

Abstract: An integrated electrode structure can comprise a catheter shaft comprising a proximal end and a distal end, the catheter shaft defining a catheter shaft longitudinal axis. A flexible tip portion can be located adjacent to the distal end of the catheter shaft, the flexible tip portion comprising a flexible framework. A plurality of microelectrodes can be disposed on the flexible framework and can form a flexible array of microelectrodes adapted to conform to tissue. A plurality of conductive traces can be disposed on the flexible framework, each of the plurality of conductive traces can be electrically coupled with a respective one of the plurality of microelectrodes.

Abstract: A catheter comprising an elongated catheter body, and an electrode assembly distal of the catheter body, the assembly comprising a plurality of spines, wherein each spine has a distal end that is connected to the distal end of at least one other spine, wherein each spine has an electrode-carrying portion, the electrode-carrying portions of all spines of the assembly being in a single common plane, and wherein all spines of the assembly have a uniform exposed total length.

Abstract: Electroanatomic mapping of the epicardium includes acquiring first and second electroanatomic data from first and second epicardial locations, acquiring a closed 3-dimensional image of the epicardium and modeling the image as a 3-dimensional triangular mesh. The first and second locations align with front-facing triangles and rear-facing triangles of the mesh. The second locations are projected from the rear-facing triangles onto the closest front-facing triangles. The first and second electroanatomic data are displayed on the front-facing triangles and the closest front-facing triangles, respectively.

Abstract: Introducer sheaths are described. In one embodiment, an introducer sheath comprises a sheath hub, a fixed housing coupled to the sheath hub, a rotating element rotatably coupled to the fixed housing, a sheath tube fixedly coupled to the rotating element, and a lock coupled to the rotating element. The lock is capable of preventing the rotating element and the sheath tube from rotating with respect to the sheath hub.

Abstract: A retractable, multi-tined radiofrequency (RF) probe operable for applying RF energy to tissue for therapeutic purposes, the probe having a tubular elongate member defining an interior and having a proximal end and an opposite distal end; a handle element at the proximal end of the elongate member; and an electrode element at the distal end of the elongate member, the electrode element comprising a tip portion and a plurality of tines, each of the plurality of tines being positionable in a retracted configuration within the interior of the tip portion and/or the elongate member and in a deployed configuration that extends outward of the tip portion.

Abstract: This disclosure is directed to a catheter having a basket-shaped electrode assembly with a high electrode density. The basket-shaped electrode assembly may have a plurality of spines, such as up to twelve, each with a plurality of electrodes, such as up to sixteen. The distal ends of the plurality of spines are joined at a distal hub, all of which are fashioned from a single piece of superelastic material.

Abstract: A catheter includes a flexible shaft having a distal end dimensioned for deployment within a patient's renal artery. A number of elongated resilient members are mounted along a longitudinal length of the distal end of the shaft, and are extensible radially from the shaft at regions defined between longitudinally spaced-apart engagement locations. One or more electrodes are mounted on each of the resilient members at the radially extensible regions. A number of conductors are electrically coupled to the electrodes and extend along the shaft of the catheter. The elongated resilient members are collapsible when encompassed within a lumen of an outer sheath and extensible radially outward from the shaft at the regions defined between the longitudinally spaced-apart engagement locations when the catheter and the resilient members are axially extended beyond the distal tip of the sheath. RF energy is delivered to the electrodes for ablating perivascular renal nerves.

Abstract: Aspects of the subject disclosure may include, launching, by a plurality of launchers of a waveguide system, a wave mode that propagates along a transmission medium without requiring an electrical return path, detecting, by the waveguide system, that the wave mode has a propagation loss caused by an obstruction, and generating, by the plurality of launchers, an adjusted wave mode having an electric field structure that reduces the propagation loss of the obstruction. Other embodiments are disclosed.

Abstract: Electrode systems for transvascular stimulation of target nerves include electrode arrays, elements promoting blood flow between electrode surfaces and surrounding vascular walls, electrodes shaped to promote more even current density than electrodes having angular edges, features for retaining the electrode systems with blood vessels, and features for using electrode-carrying elements to asymmetrically distend blood vessel walls towards target nerve structures.

Abstract: A method, including positioning body-electrodes in galvanic contact with a body of a patient and locating a probe in the body of the patient. The method further includes tracking positions of the probe during respiration of the patient and determining indications related to impedances between the body-electrodes during the respiration. The method also includes calculating a function relating the positions of the probe to the indications, and applying the function to identify end-expirium points of the respiration based on subsequent indications related to the impedances.

Abstract: In one example, a medical device system for at least one of delivery of electrical stimulation pulses or sensing of physiological signals, the system including an elongated carrier; and a thin film wound around the elongated carrier, wherein the thin film includes a plurality of electrical contacts, a plurality of electrodes located distal to the plurality of electrical contacts, and a plurality of conducting tracks, each of the plurality of conducting tracks providing an electrical connection between at least one of the plurality of electrodes and one of the plurality of electrical contacts, and wherein the thin film is wound around the elongated carrier from the distal end of the elongated film to the proximal end of the elongated thin film.

Abstract: A catheter for denervation includes a catheter body extending in one direction to have a proximal end and a distal end and having an inner space formed along the longitudinal direction thereof, a movable member provided at the distal end of the catheter body to be movable along the longitudinal direction of the catheter body, an operating member having a distal end connected to the movable member to move the movable member, a plurality of support members having one end connected to a terminal of the catheter body and the other end connected to the movable member, wherein when the movable member moves to decrease a distance between the terminal of the catheter body and the movable member, at least a partial portion of the plurality of support members is bent so that the bending portion moves away from the catheter body, a plurality of electrodes respectively provided at the bending portion of the plurality of support members to generate heat, and a lead wire respectively electrically connected to the plurality

Abstract: Catheter devices for ablation and removal of occlusions from blood vessels and methods of using the same are provided. Catheter devices are useful to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Distal features of the catheter devices comprise arrangements of laser ablative or mechanical cutting features that generally provide enhanced surface areas and cutting functions. Spiral or helical arrangements are provided to aid in cutting operations.

Abstract: A subcutaneously implantable device includes a housing, a clip attached to a top side of the housing, a first prong with a proximal end attached to the housing and a distal end extending away from the housing, and a first electrode on the first prong. The clip is configured to anchor the device to a muscle, a bone, and/or a tissue. The first prong is configured to contact a heart. The first electrode is configured to contact the heart. Sensing circuitry in the housing that is configured to sense an electrical signal from the heart, and therapeutic circuitry in the housing is in electrical communication with the first electrode and is configured to deliver electrical stimulation to the heart through the first electrode.

Abstract: A microsurgical tool is configured for monitoring, evaluating, mapping, and/or modulating electrophysiological activity in the vicinity of a lumen within a body. The microsurgical tool may be part of a system used in evaluating the sympathetic tone of a subject and/or neuromodulating an anatomical site in the vicinity of a lumen within a body. Such systems include a catheter system for controlled sympathectomy procedures and/or controlled micro ablation procedures. Such systems may be used in methods for performing a controlled surgical procedure, including performing controlled surgical procedures in a minimally invasive manner.

Abstract: A system for determining electrophysiological data comprising an electronic control unit configured to acquire electrophysiology signals from a plurality of electrodes (130) of one or more catheters, select at least one clique of electrodes from the plurality of electrodes (136) to determine a plurality of local E field data points, determine the location and orientation of the plurality of electrodes, process the electrophysiology signals from the at least one clique from a full set of bipole subcliques to derive the local E field data points associated with the at least one clique of electrodes, derive at least one orientation independent signal from the at least one clique of electrodes (138) from the information content corresponding to weighted parts of electrogram signals, and display or output catheter orientation independent electrophysiologic information to a user or process.

Abstract: A neuromodulation catheter includes an elongate shaft and a neuromodulation element operably connected to the shaft. The neuromodulation element includes an elongate support member and a plurality of bow springs operably connected to the support member. The individual bow springs are configured to independently expand radially outward from the support member when the neuromodulation element transitions from a low-profile delivery state to a deployed state at a treatment location within a body lumen. The individual bow springs include a distal leg and a proximal leg and carry an electrode and/or a transducer between their respective distal and proximal legs. The distal and proximal legs of the plurality of bow springs are longitudinally interdigitated. The plurality of bow springs is configured to urge the electrodes and/or the transducers into contact with an inner surface of a wall of the body lumen at a series of contact regions.

Abstract: An energy delivery system and a method of delivering energy to a tissue are provided. The energy delivery system includes an overtube. The overtube includes a body having a proximal portion, a distal portion and a lumen extending at least partially therethrough. The proximal portion is adapted to be positioned over a distal portion of an endoscope. The body also includes a first plurality of openings formed in the body and connected to the lumen and an electrode operably connected to the body and extending over at least a portion of a surface of the body. The lumen is operably connectable to a vacuum source and the electrode is operably connectable to a power source.

Abstract: Devices for detecting organ contents using impedance and methods of using the same to provide various therapies. In an exemplary embodiment of a device for detecting organ contents of the present disclosure, the device comprises a body having a detector coupled thereto, the device configured for placement at or near an outside of an organ and operable to detect contents on an inside of the organ using impedance.

Abstract: Cardiac anodal electrostimulation detection systems and methods are described, such as for distinguishing between cathodal-only capture and at least partially anodal capture (e.g., combined anodal and cathodal capture, or between two anodes of which only one captures nearby cardiac tissue, etc.).

Abstract: A system and method for tracking a position of an interventional medical device configured to be deployed into a subject during a medical procedure. An anatomical dataset of the subject is acquired while at least one electrical sensor is disposed along the interventional medical device. A feedback signal is generated from the electrical sensor and is processed and analyzed to identify positional information of the interventional medical device. A position of the interventional medical device with respect to the anatomical dataset is identified and the position of the interventional medical device with respect to the anatomical dataset is shown on a display.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed, with the system including a pulse waveform signal generator for medical ablation therapy, and an endocardial ablation device includes at least one electrode for ablation pulse delivery to tissue. The signal generator may deliver voltage pulses to the ablation device in the form of a pulse waveform. The system may include a cardiac stimulator for generation of pacing signals and for sequenced delivery of pulse waveforms in synchrony with the pacing signal.

Abstract: The present invention relates to systems and methods for accessing the left heart of a subject. For example, the invention includes a percutaneous inter-ventricular transseptal technique for accessing the left ventricle. In certain embodiments, the invention includes guiding a transseptal sheath to the right ventricle and positioning the transseptal sheath within the inter-ventricular septum.

Abstract: The present disclosure provides ablation catheter systems and electrode assemblies and electrode baskets for use in the ablation catheter systems that include an interlinked diamond configuration formed from a plurality of strut assemblies. Each strut assembly includes one or more struts that are manufactured from a thermoplastic or metallic material. The interlinked diamond configuration facilitates reducing an overall length of the electrode assembly. Further, the interlinked diamond configuration facilitates expanding and contracting the struts simultaneously and by the same amount.

Abstract: Devices and systems for ultrasonically imaging tissue and performing ablation therapy are disclosed. An ablation probe for treating and imaging body tissue includes an ablation electrode tip with a number of acoustic openings and a plurality of ultrasonic imaging sensors disposed within an interior lumen of the tip. The ultrasonic imaging sensors are supported within the interior lumen via an insert equipped with a number of recesses that receive the ultrasonic imaging sensors. An acoustically transparent shell disposed between the ultrasonic imaging sensors and the acoustic openings forms a fluid channel in the acoustic pathway of the sensors. During an ablation procedure, cooling fluid from an external fluid source is delivered through the fluid channel, providing an acoustic coupling effect between the ultrasonic imaging sensors and the surrounding body tissue.

Abstract: A method is described to enhance the ability to evaluate the depth of a tissue component or a lesion having optical properties different from a surrounding tissue using time resolved optical methods. This invention may be particularly suitable for the evaluation of lesion depth during RF ablation (irreversible tissue modification/damage) using specially designed devises (catheters) that deliver heat in a localized region for therapeutic reasons. The technique allows for increased ability to evaluate the depth of the ablated lesion or detect the presence of other processes such as micro-bubble formation and coagulation with higher sensitivity compared to that offered by steady state spectroscopy. The method can be used for in-vivo, real-time monitoring during tissue ablation or other procedures where information on the depth of a lesion or tissue is needed. Exemplary uses are found in tissue ablation, tissue thermal damage, lesion and tissue depth assessment in medical applications.

Abstract: Systems and methods for guiding a sensor to locate a source of a propagating wave. The methods involve: presenting an electronic display comprising an image representing an object in which the sensor is placed and a visual indicator representing the sensor; receiving signals generated by electrodes while the sensor resides at a first location in the object; determining a First Recommended Direction of Travel (“FRDT”) for the sensor based on the received signals; using the FRDT to generate a mask that is to cover at least a portion of the image representing a portion of the object that is absent of the source; and modifying the electronic display to include the mask overlaid on top of the image and an arrow showing FRDT.

Abstract: Methods, systems, and devices for providing treatment to a target site are described. The system may include a guide assembly, an expandable support device coupled with the distal end of the guide assembly, and an operative member disposed on the expandable support device. The expandable support device may be configured to transition between a collapsed and expanded configuration. The expandable support device may be supported by one or more flexible supports aligned in parallel with an axis about which the expandable support device collapses and/or multiple splines arranged in a pattern configured to promote transitioning of the expandable support device between an expanded and collapsed configuration. The guide assembly may be configured to provide torque to the expandable support device. The operative member can include multiple electrodes arranged in parallel to the axis about which the expandable support device collapses.

Abstract: The invention relates to a catheter useful in recording His electrogram alternans. The catheter includes a catheter probe containing at least one row of receiving poles positioned at an edge of the catheter probe, equidistantly spaced from each other.

Abstract: A catheter for diagnosing and ablating tissue is disclosed that has a stabilized spine electrode assembly. The stabilized spine electrode assembly has at least two spines secured to the catheter body at their proximal ends and at least one tether, secured between locations distal of the proximal ends of adjacent spines. The spines have a collapsed arrangement in which the spines are arranged generally along a longitudinal axis of the catheter body and an expanded arrangement in which at least a portion of each spine bows radially outwards from the longitudinal axis and the at least one tether exerts tension on the adjacent spines.

Abstract: A device and method for guided insertion of microelectrodes into tissue is provided. The device includes a flexible optical fiber for optical coherence tomography imaging, a metal layer coating the optical fiber for recording electrical signals and an outer insulation layer coating the metal layer along the optical fiber length. The method includes inserting an optical fiber coated with a metal layer and further coated with an insulation layer into a tissue, collecting intraoperative image data through the optical fiber by optical coherence tomography, receiving the image data on a computer and displaying the image on a monitor, using the image data to determine a location in the tissue, receiving an electrical nerve signal through the metal layer and measuring the electrical nerve signal on a electrophysiological recording system.

Abstract: An electrosurgical assembly is disclosed, the assembly having two, three or more electrodes configured to provide advantageous tissue removal and precision for conducting electrosurgical procedures, including improved ablation and coagulation of tissue. The electrodes are configured and arranged so that energy can be applied in a highly uniform and precise fashion, depending upon the application. In addition, the electrosurgical assembly allows flexibility in use by, in some embodiments, allowing selective switching of the active and return electrodes, and also selective switching between ablation and coagulation modes. In certain embodiments the invention includes one or more electrodes having the ability to undergo changes in shape.

Abstract: A system for controlled neuromodulation procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Systems and methods for imaging, monitoring, stimulating, and/or ablating neurological structures coupled to one or more organs of the lower urinary tract (LUT) are disclosed. Such processes may be used to alter the hormonal secretions from one or more organs, to modulate the growth of an organ, alter the growth rate or rate of perineural invasion of a tumor, or the like. In particular such processes may be used to slow, halt and/or reverse the growth of a prostate gland or a prostate tumor.

Abstract: This disclosure includes a catheter with an electrode array formed by an interconnected framework. The framework may have a plurality of elements interconnected by a plurality of junctions at locations intermediate the proximal and distal ends of the electrode array assembly. The electrodes may be printed on a polymeric layer of the interconnected framework.

Abstract: Various embodiments of the present disclosure can include a flexible catheter tip. The flexible catheter tip can comprise an inboard understructure that defines a tip longitudinal axis, wherein the inboard understructure is formed from a first continuous element that includes a first rectangular cross-section. In some embodiments, an outboard understructure can extend along the tip longitudinal axis, wherein the outboard understructure is formed from a second continuous element that includes a second rectangular cross-section.

Abstract: An automatic method of determining local activation time (LAT) from at least three multi-channel cardiac electrogram signals including a mapping channel and a plurality of reference channels. The method comprises (a) storing the cardiac channel signals, (b) using the mapping-channel signal and a first reference-channel signal to compute LAT values at a plurality of mapping-channel locations, (c) monitoring the timing stability of the first reference-channel signal, and (d) if the timing stability of the monitored signal falls below a stability standard, using the signal of a second reference channel to determine LAT values. Substantial loss of LAT values is avoided in spite of loss of timing stability.

Abstract: A stimulation probe apparatus as provided herein offers adjustability of a conductive probe tip thereof relative to a handle assembly thereof to which the conductive probe tip is physically attached. The adjustability of the conductive probe tip relative to the handle assembly provide for a surgeon's ability to selectively orientate the conductive probe tip with respect to the handle assembly for enabling a desired placement of the conductive probe tip relative to the handle assembly. In this respect, by allowing a surgeon to selectively control the direction of the conductive probe tip to point in a desired angle, embodiments of the present invention serve clinical needs that help surgeon to perform electrophysiological testing in diverse anatomical structures and in diverse operation procedures.