Abstract: The present invention includes systems, devices and methods for treating and/or diagnosing a heart arrhythmia, such as atrial fibrillation. Specifically, the present invention provides a system including a diagnostic catheter and an ablation catheter. The diagnostic catheter includes a shaft, multiple dipole mapping electrodes and multiple ultrasound transducers. The ablation catheter is slidingly received by the diagnostic catheter shaft.

Abstract: A method for attaching a split ring electrode to a catheter tip section includes providing a tubing with a lumen and an opening in the tubing side wall, passing an electrode lead wire through the opening, and wrapping the lead wire around the tubing. A split ring electrode is mounted on the tubing over the wrapped lead wire and opening, with electrically-conductive thermoplastic elastomeric adhesive applied between the ring electrode and the outer surface of the tubing, and reheated to reflow.

Abstract: Intermittent delivery of ventricular pacing pulses synchronized to occur during an atrial diastole time period can be used to provide atrial stretch therapy and augment the production and release of atrial natriuretic hormone.

Abstract: A mapping ablation catheter is provided comprising: a catheter conduit having a hollow inner space in which a guide member is disposed; a monitoring electrode unit arranged to surround the outer circumferential surface of the distal portion of the catheter conduit and perform a mapping on the lesion region by being in side-contact with a cardiac organ; an ablation electrode unit arranged to be spaced apart from the monitoring electrode unit and surround the outer circumferential surface of the distal portion of the catheter conduit and which removes the lesion region; a plurality of liquid discharge holes arranged on the outer circumferential surface of the ablation electrode; a current application unit which applies current to the monitoring electrode unit and the ablation electrode unit; and a liquid supply unit having a liquid supply tube, one end of the liquid-supply tube connected to the liquid discharge holes in the catheter conduit.

Abstract: An electrosurgical device is provided and includes a handset having a shaft extending therefrom. The electrosurgical device includes a pair of electrodes disposed at a distal end of the shaft. One or more sensors are in operable communication with the pair of electrodes to detect a pressure applied thereto. The amount of electrosurgical energy that is transmitted to the pair of electrodes is proportional to the amount of pressure that is applied to the pair of electrodes and detected by the sensor.

Abstract: A medical probe includes an insertion tube for insertion into a patient's body, and multiple arms that are attached to a distal end of the insertion tube. Each arm includes a braid of wires that traverse the arm. Multiple electrodes are coupled to the arms and electrically connected to respective selected wires of the braid. The electrodes are configured to exchange signals over the wires with a system external to the patient body.

Abstract: A sensor device for sensing endoluminal geometry may include an expandable element disposed on the distal region of a shaft. The expandable element may be configured to move a collapsed configuration and an expanded configuration. The expandable element may include one or more sensor elements configured to sense proximity of the sensor element to tissue. The sensor device may include an indicator configured to distinguish between contact of the sensor element with tissue, loss of contact and proximity of the sensor element to tissue.

Abstract: An electrophysiology catheter is provided. In one embodiment, the catheter includes an elongate, deformable shaft having a proximal end and a distal end and a basket electrode assembly coupled to the distal end of the shaft. The basket electrode assembly has a proximal end and a distal end and is configured to assume a compressed state and an expanded state. The electrode assembly further includes one or more tubular splines having a plurality of electrodes disposed thereon and a plurality of conductors. Each of the plurality of conductors extends through the tubular spline from a corresponding one of the plurality of electrodes to the proximal end of the basket electrode assembly. The tubular splines are configured to assume a non-planar (e.g., a twisted or helical) shape in the expanded state.

Abstract: Disclosed herein, among other things, are methods and apparatus related to radio frequency (RF) ablation catheters. The present subject matter provides an ablation catheter system including an ablation catheter, multiple RF electrodes positioned along a distal end of a catheter, an electrical stimulation generator, and a control circuit electrically connected to the stimulation generator. According to various embodiments, the RF electrodes are each connected to the stimulation generator using a switch, and the control circuit is configured to distribute RF power from the stimulation generator to the RF electrodes using the switches to provide ablation therapy.

Abstract: One aspect of the present disclosure relates to lead assemblies for stimulating tissue. The lead assemblies can include lead bodies that are slidably coupled to each other and include one or more contacts that are moveably disposed within the slits of the lead bodies. The positions of the one or more contacts can be adjusted to change the direction of stimulation. For example, the positions of the one or more contacts can be adjusted based on theoretically-optimal positions determined from a patient-specific computer model. Parameters of the stimulation applied by the one or more contacts can also be optimized based on the patient-specific computer model.

Abstract: A medical device is disclosed for delivering energy to a body lumen. The device includes an elongate member including a proximal portion and a distal portion adapted for insertion into a body lumen; and an energy delivery device disposed adjacent the distal portion of the elongate member, the energy delivery device including at least one elongate electrode arm, wherein the elongate electrode arm is configured to transition between a first configuration and a second configuration different than the first configuration. The at least one elongate electrode arm includes an active region configured to contact and deliver energy to the body lumen. When the elongate electrode arm is in the first configuration, at least a portion of the active region of the elongate electrode arm extends radially inward toward a longitudinal axis of the energy delivery device.

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: An irrigated catheter with uniform cooling and/or uniform fluid distribution in longitudinally spaced apart elution holes by varying the diameter of a fluid delivery lumen. A number of elution holes are provided in a tip region of a catheter body, and these elution holes are in fluid communication with the lumen through ducts. The fluid delivery lumen may be provided with a flow constrictor to restrict flow of fluid towards the distal region.

Abstract: Various embodiments of this disclosure concern assembly of a lead having one or two modular lead ends. A modular lead end can be made by aligning a plurality of wires exposed on an end of a main lead body with a plurality of conductors exposed on an end of a lead end. The lead end may comprise a spine, the plurality of conductors circumferentially arrayed about the spine, and an outer surface comprising a plurality of exposed electrical elements and polymer material, the plurality of electrical elements arrayed on the spine and electrically connected with the plurality of conductors. The assembly can further include making electrical connections between the plurality of electrical wires and the plurality of conductors and insulating the plurality of wires and the plurality of conductors.

Abstract: A catheter assembly comprises a first elongate tubular member having a proximal end portion defining a proximal end, a distal end portion having an opening therein and defining a distal end, and at least one lumen defined between the proximal end and the distal end. A second elongate tubular member has a proximal end portion defining a proximal end, a distal end portion defining a distal end, and at least one lumen defined between the proximal end and the distal end. The second elongate tubular member is received within the at least one lumen of the first elongate tubular member, such that the distal end portion of the second elongate tubular member projects from the opening in the distal end portion of the first elongate tubular member. An elongate, shape-imparting element is receivable in the at least one lumen of at least one of the first elongate tubular member and the second elongate tubular member.

Abstract: A catheter comprising an elongated catheter body, an electrode array distal of the catheter body, the array having a mounting member and at least first and second spine supports. Each spine support includes a base having a planar configuration, and a plurality of spines extending from the base, wherein the first base extends in a first plane and the second base extends in a second plane different from the first plane in the mounting member.

Abstract: An intravascular catheter for peri-vascular nerve activity sensing or measurement includes multiple needles advanced through supported guide tubes (needle guiding elements) which expand with open ends around a central axis to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the perivascular space. The system also may include means to limit and/or adjust the depth of penetration of the needles. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall.

Abstract: Methods, systems, and devices for providing treatment to a tissue in body lumens are described. The system may include a catheter, an expansion member coupled with a distal portion of the catheter, an ablation structure including one or more longitudinal electrode segments, and an ablation structure support coupled to the ablation structure configured to at least partially unfurl as the expansion member expands and furl as the expansion member contracts. The ablation structure may include multiple separately wired and/or separately controlled longitudinal electrodes, longitudinal electrode zones, or both, such that each longitudinal electrode or longitudinal electrode zone may be selectively enabled or selectively disabled. In some instances, one or more springs are coupled to the ablation structure configured to promote unfurl or furl around the expansion member. In some instances, one or more protection elements are be positioned along the catheter.

Abstract: An irrigated ablation catheter includes a tip electrode with a thin shell and a plug to provide a plenum chamber. The tip electrode has an inlet of a predetermined size and noncircular shape, and outlets in the form of fluid ports formed in the thin shell wall. The plurality of the fluid ports is predetermined, as is their diameter. Each fluid port has a tapered configuration, for example, a frustoconical configuration, with a smaller inlet diameter and a larger outlet diameter.

Abstract: The present disclosure provides a strong, flexible catheter shaft for use in a catheter system. The flexible catheter shaft includes a braided polyimide tube including one or more outer layers of material of varying flexibility. The flexible catheter shaft provides a shaft having sufficient stiffness and kink resistance to allow an operator to advance an electrode basket connected to the flexible catheter shaft through a guide catheter to a target ablation site without causing vessel trauma. The distal tip of the flexible catheter shaft is designed to have sufficient flexibility to reduce any risk of kicking out a guide catheter when tracking the electrode basket around turns into side branches or bifurcations in the vasculature of a patient and includes a distal spring coil.

Abstract: The present invention relates to a monitoring apparatus (101) for monitoring an ablation procedure. The monitoring apparatus (101) comprises an ultrasound signal providing unit for providing an ultrasound signal that depends on received echo series of an object (4) that is ablated. The monitoring apparatus (101) further comprises an ablation depth determination unit (103) for determining an ablation depth from the provided ultrasound signal. The ablation depth can be determined directly from the ultrasound signal and is an important parameter while performing an ablation procedure. For example, it can be used for determining the progress of ablation within the object (4) and for determining when the ablation has reached a desired progression.

Abstract: A method of generating a cardiac electrophysiology map includes receiving a reference biological signal and an electrical signal indicative of electrical activity at a location on a patient's heart. Using a graphical user interface, a practitioner designates at least two trigger point icons, one upward-pointing and one downward-pointing, on a graphical representation of the reference biological signal (e.g., a waveform). By pairing one upward-pointing icon with one downward-pointing icon, a plurality of triggering criteria are defined. Electrophysiology data points are captured and/or added to the electrophysiology map when the triggering criteria are satisfied.

Abstract: A method, computer medium, and system for programming a controller is provided. The controller controls electrical stimulation energy output to electrodes, and stores a set of programmed stimulation parameters associated with the electrodes. The programmed stimulation parameter set is compared with sets of reference stimulation parameters, each of the reference sets of stimulation parameters being associated with the electrodes. If an identical match is determined between the programmed stimulation parameter set and any one of the reference stimulation parameter sets exists based on the comparison, the identically matched stimulation parameter set is selected as an initial stimulation parameter set. If an identical match does not exist, a best between the programmed stimulation parameter set and the reference stimulation parameter sets is determined and selected as the initial stimulation parameter set.

Abstract: In some implementations, a method of ablating body tissue includes (a) locating an inflatable balloon portion of a cryotherapy balloon catheter at a treatment site internal to a patient's body, and inflating the inflatable balloon portion; (b) employing electrodes that are disposed on an expandable surface of the inflatable balloon portion to electrically characterize body tissue at the treatment site; (c) ablating the body tissue by supplying a cryotherapy agent to the inflatable balloon portion to cool the body tissue to a therapeutic temperature; (d) employing the electrodes to determine whether the ablating caused desired electrical changes in the body tissue; and (e) repeating (c) and (d) when it is determined that the ablating did not cause the desired electrical changes.

Abstract: Electrical sensing/stimulation apparatuses for positioning at least one electrode within body tissue are provided. An electrical sensing/stimulation apparatus may comprise an elongate lead body having at least one internal lumen, at least one sensing/stimulation electrode, a deployable/retractable displacement member that moves or biases at least one electrode towards a prescribed direction by the user, a tissue attachment mechanism for affixing the distal segment of the device to body tissue, and an atraumatic distal lead body termination. In a retracted configuration, the attachment mechanism is positioned substantially within the distal segment of the lead body, and in the deployed configuration, the attachment mechanism extends from the axis of the lead body to engage body tissue.

Abstract: The local conduction velocity of a cardiac activation wavefront can be computed by collecting a plurality of electrophysiology (“EP”) data points using a multi-electrode catheter, with each EP data point including both position data and local activation time (“LAT”) data. For any EP data point, a neighborhood of EP data points, including the selected EP data point and at least two additional EP data points, can be defined. Planes of position and LATs can then be defined using the positions and LATs, respectively, of the EP data points within the neighborhood. A conduction velocity can be computed from an intersection of the planes of positions and LATs. The resultant plurality of conduction velocities can be output as a graphical representation (e.g., an electrophysiology map), for example by displaying vector icons arranged in a uniform grid over a three-dimensional cardiac model.

Abstract: A computer-implemented method for medical device modeling includes accessing an electronic definition for a model of a three-dimensional item and an electronic definition of a three-dimensional spline relating to an internal anatomical volume; determining, with a computer-based finite element analysis system and using the electronic definitions, stresses created by the three-dimensional item along the three-dimensional spline, for different points along the three-dimensional spline; and displaying stress data generated by the finite element analysis system with a visualization system, the display of the stress data indicating levels of stress on portions of the three-dimensional item at particular locations along the three-dimensional spline.

Abstract: Embodiments of the present disclosure provide a method of determining an inter-chamber delay within a heart of an individual that may include determining a position of a first sensor in a first chamber of the heart, determining a position of a second sensor in a second chamber of the heart, automatically computing a distance between the first and second sensors, and automatically determining the inter-chamber delay based on the automatically computing operation.

Abstract: The present disclosure provides ablation catheters that are constructed such that they may be inserted into the body and into a target blood vessel in a linear conformation and subsequently changed into a helical conformation using a pull wire secured to the ablation catheter prior to an ablation procedure to allow electrodes present on the ablation catheter to contact the wall of the blood vessel. After the ablation is complete, the helical-shaped ablation catheter may be returned to its linear conformation by reversing the tensioned pull wire for extraction from the body.

Abstract: The present invention is an ablation device having a screen sphere configuration for the ablation of marginal tissue surrounding a tissue cavity. The device includes a probe having a nonconductive elongated shaft including at least one lumen therethrough and a nonconductive distal portion extending from the shaft. The nonconductive distal portion includes a plurality distal ports and a plurality of proximal ports in communication with the at least one lumen of the shaft. The device further includes an electrode array including a plurality of independent conductive wires extending through the lumen and positioned along an external surface of the nonconductive distal portion, each of the plurality of wires passes through at least an associated one of the proximal ports and through at least a corresponding one of the distal ports.

Abstract: Provided herein are methods, systems, and devices for increasing heat shock protein expression and treating conditions for which increased heat shock protein expression is expected to be beneficial using thermal ablation.

Abstract: A system for use in a renal denervation procedure includes a catheter having proximal and distal end portions, a sensor configured to sense a condition of one or more nerves, the sensor operatively associated with the distal end portion of the catheter, and at least one electrode disposed on the distal end portion of the catheter for delivering energy to renal tissue. A catheter includes a catheter body defining a distal end portion and a proximal end portion, and a sensor for sensing a renal sympathetic nerve, the sensor disposed on the distal end portion of the catheter body, wherein the sensor is configured to sense an electromagnetic signal from the renal sympathetic nerve.

Abstract: The present invention is an ablation device having a screen sphere configuration for the ablation of marginal tissue surrounding a tissue cavity. The device includes a probe having a nonconductive elongated shaft including at least one lumen therethrough and a nonconductive distal portion extending from the shaft. The nonconductive distal portion includes a plurality distal ports and a plurality of proximal ports in communication with the at least one lumen of the shaft. The device further includes an electrode array including a plurality of independent conductive wires extending through the lumen and positioned along an external surface of the nonconductive distal portion, each of the plurality of wires passes through at least an associated one of the proximal ports and through at least a corresponding one of the distal ports.

Abstract: Cardiac catheterization is performed with a catheter having a basket-shaped assembly at its distal end. A plurality of spline electrodes are disposed on the splines of the assembly. The assembly is configurable in an expanded arrangement wherein the splines bow radially outwardly and in a collapsed arrangement, wherein the splines are arranged generally along the longitudinal axis of the catheter body. A far-field electrode is disposed in the interior of the assembly. An intracardiac electrogram and a far-field electrogram are obtained with at least one of the spline electrodes and the far-field electrode, respectively. The far-field component is removed from the intracardiac electrogram using the far-field electrogram.

Abstract: A transvenously implantable medical device (TIMD) includes an electrical lead and a control module. The electrical lead includes one or more electrodes and is adapted for transvenous implantation. The electrical lead is also pre-biased to expand from a collapsed state to an expanded state to mechanically engage an internal wall of a blood vessel. The control module is secured to and in electrical communication with the electrical lead. The control module includes a signal management component and a power component disposed in a housing adapted for implantation into the blood vessel. The control module is adapted for at least one of stimulating and sensing a physiologic response using the one or more electrodes of the electrical lead.

Abstract: A medical system includes an expandable structure and a first flexible circuit. The expandable structure is sized to be received in a chamber of a heart and is selectively moveable between a delivery configuration and an expanded configuration. The expandable structure includes a plurality of metal strips. The first flexible circuit includes a first flexible electrically insulative substrate and a plurality of electrically conductive traces patterned on the first flexible electrically insulative substrate. A portion of the first flexible circuit is patterned to form at least a first transducer element, and at least a part of the first flexible circuit is at least positioned between two of the plurality of metal strips that contact the first flexible circuit when the expandable structure is in the expanded configuration.

Abstract: Lead electrodes having an asymmetrically distributed current density and methods for imparting current density directionality in lead electrodes are described. An implantable medical lead includes a lead body having a proximal section that connects to another implantable device and a distal section having a pre-biased shape configured to secure the lead to an inner wall of a body vessel. An electrode coupled to the distal section of the lead body includes a conductor mass having an asymmetrically distributed current density that imparts a directionality to one or more active portions of the electrode.

Abstract: In some aspects, a method includes (i) securing multiple sets of current injecting electrodes to an organ in a patient's body, (ii) causing current to flow among the multiple sets of current injecting electrodes to generate a field in the organ, (iii) in response to current flow caused by the multiple sets of current injecting electrodes, measuring the field at each of one or more additional electrodes, (iv) determining expected signal measurements of the field inside the organ using a pre-determined model of the field, and (v) determining a position of each of the one or more additional electrodes in the organ based on the measurements made by the additional electrodes and the determined expected signal measurements of the field.

Abstract: A pair of new catheters designed to be deployed as a catheter system to allow a simultaneous acquisition of electrograms from widely dispersed electrodes in the left atrium, right atrium, and coronary sinus. The first catheter is the spiral globe catheter which has the primary shape of a spiral globe and has additional modifications to facilitate safe entry into the left atrium, to orient the primary axis of the spiral globe toward the mitral valve, and to maximize contact of electrodes to multiple areas of the left atrium. The second catheter is the right atrial and coronary sinus catheter (RA-CS catheter) which allows for electrogram acquisition from the length of the coronary sinus and dispersed areas of the right atrium. The catheter system is designed to provide adequate electrode sensor information so that panoramic mapping of the both atria and the coronary sinus may be performed.

Abstract: A physiological signal of a patient is sensed with sense electrodes symmetrically arranged relative to a stimulation electrode. In some examples, a member includes a plurality of relatively small electrodes that are configured to function as both sense and stimulation electrodes. One or more of the electrodes may be selected as stimulation electrodes and two or more different electrodes of the member may be selected as sense electrodes that are symmetrically arranged relative to the one or more selected stimulation electrodes. In some examples, a member includes a plurality of levels of segmented sense electrodes and a plurality of levels of stimulation electrodes. The levels of sense electrodes are arranged such that each level of stimulation electrodes is adjacent at least two levels of sense electrodes symmetrically arranged relative to the level of stimulation electrodes.

Abstract: A device for mapping and ablating the renal nerves distributed on the renal artery is provided, said device comprising a guide catheter (11), a mapping-ablation catheter (12), a handle (13) and a connector (15). The guide catheter (11) had at least one lumen and a distal end with adjustable curvature. The mapping-ablation catheter (12) is housed in one of the lumens of the guide catheter (11) and its distal end has one or more electrodes (22) and one or more detecting devices (23). The distal end of the mapping-ablation catheter (12) is curved, rotatable, and can be extended out of or retracted into the guide catheter (11). The handle (13) connects the guide catheter (11) and mapping-ablation catheter (12), and comprises one or more controlling components for controlling the movement of the guide catheter (11) and mapping-ablation catheter (12). The connector (15) is designed to supply energy to the electrodes (22).

Abstract: The disclosure pertains to an intravascular catheter for nerve modulation, comprising an elongate member having a proximal end and a distal end, a balloon having a lumen and a balloon wall, the balloon wall comprising RF permeable sections and non-electrically conductive sections, an electrode disposed within the balloon and extending distally to the furthest distal RF permeable section. The RF permeable sections may comprise a plurality of RF permeable windows, each window having a greater circumferential dimension than an axial dimension. The intravascular system is suited for modulation of renal nerves.

Abstract: Systems and methods for assessing tissue contact, including positioning a plurality of electrodes adjacent a tissue region; delivering radiofrequency energy to the plurality of electrodes, wherein the delivered radiofrequency energy is sufficient to ablate at least a portion of the tissue region; obtaining a plurality of impedance measurements from the plurality of electrodes during the delivery of the radiofrequency energy; calculating a change in the impedance measurements for each of the plurality of electrodes over a pre-determined time period; comparing the calculated change for at least one of the plurality of electrodes to the calculated change in at least one other of the plurality of electrode to determine if there is significant variation in the calculated changes; and terminating the delivery of radiofrequency energy to at least one of the plurality if there is significant variation in the calculated changes.

Abstract: Systems, methods, and devices of the various embodiments provide a remote controller for a catheter positioning system configured to be operated with a single hand by a catheter positioning system operator. In an embodiment, the remote controller may include a thumb joystick control, first wheel control, and second wheel control. In an embodiment, the remote controller may include various visual indicators and/or haptic feedback mechanisms providing information to a catheter positioning system operator.

Abstract: Systems and methods for forming a lesion on an endocardial tissue of a patient's heart involve placing an ablation assembly inside of the heart and adjacent to the endocardial tissue, and placing a guiding assembly outside of the heart. An ablation assembly includes an ablation element and a first attraction element, and a guiding assembly includes a second attraction element. First and second attraction elements can be attracted via magnetism. Techniques involve forming an ablation on the cardiac tissue of a patient's heart with an ablation element of the ablation assembly. Optionally, techniques may include moving the second attraction element of the guiding assembly relative to the patient's heart, so as to effect a corresponding movement of the ablation element of the ablation assembly.

Abstract: One aspect of the present disclosure relates to lead assemblies for stimulating tissue. The lead assemblies can include lead bodies that are slid ably coupled to each other and include one or more contacts that are movably disposed within the slits of the lead bodies. The positions of the one or more contacts can be adjusted to change the direction of stimulation. For example, the positions of the one or more contacts can be adjusted based on theoretically-optimal positions determined from a patient-specific computer model. Parameters of the stimulation applied by the one or more contacts can also be optimized based on the patient-specific computer model.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a system for mapping the electrical activity of the heart. The system may include a catheter shaft with a plurality of electrodes. The system may also include a processor. The processor may be capable of collecting a set of signals from at least one of the plurality of electrodes. The set of signals may be collected over a time period. The processor may also be capable of calculating at least one propagation vector from the set of signals, generating a data set from the at least one propagation vector, generating a statistical distribution of the data set and generating a visual representation of the statistical distribution.

Abstract: A system for ablating internal heart tissue in an ablation pattern on a surface of the tissue within the heart. The system includes an ablation catheter with a distal end having an ablating tip portion operative to allow selective ablation of tissue. A guiding device is engageable with the ablation catheter and includes a tissue anchoring portion operable to engage with tissue proximate to the tissue to be ablated so as to temporarily anchor the guiding device relative to the tissue. Engagement of the guiding device with the ablation catheter operates to assist with guiding the ablating tip portion in moving along the pattern. Various devices and methods of use are further disclosed.

Abstract: Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.

Abstract: A catheter tip electrode has a tissue contacting surface which electrically conducts RF energy to the tissue and is more thermally conductive than adjacent non-electrically conductive coating or cover which prevents RF conduction to the tissue contacting that surface. The tip electrode has a shell with a nonablating hollow proximal neck portion and a distal ablating portion defining a fluid chamber, and a plug-like support member which is configured with a fluid channel on its outer surface so a fluid passage is provided between the member and the neck portion for convective or direct cooling of the nonablating neck portion and nonconductive tubing covering it.