Abstract: A medical device handle may include an elongated handle housing, a rotatable collar disposed about the handle housing, a rotatable control knob disposed about the collar, and a slidable door disposed about the collar. The door may be rotatably locked to the collar to prevent relative rotation between the door and the collar. The door may slidable from a closed position to a first open position, and slidable from the first open position to a second open position.

Abstract: A catheter adapted for use in a tubular region of the heart, has a catheter body, a deflectable intermediate section and a distal a mapping assembly that has a generally circular portion adapted to sit on or in a tubular region of the heart. A control handle of the catheter allows for deflection of the catheter via a first and second puller wire responsive to a deflection assembly and manipulation of distal assembly via a third puller wire responsive to a linear motion actuator assembly. The linear motion actuator assembly includes a pair of user interface knobs, a body to which a proximal end of the third puller wire anchored, and a pair of arms that movably suspends the body and transmits longitudinal travel of the knobs to the body in a manner that multiples the travel of the body relative to the travel of the knobs.

Abstract: Deflectable catheter systems, apparatuses and methods utilizing thermal expansion to influence catheter deflection. A representative embodiment includes a catheter having one or more pull wires or other tensioning elements. One end of the tensioning element(s) is connected at a distal portion of the catheter to facilitate shaft deflection upon pulling the tensioning element(s). A heat-sensitive control member(s) is coupled to a proximal portion of the tensioning element(s). The elongate tensioning element(s) is pulled in a proximal direction to deflect the distal portion of the catheter in response to a temperature change applied to the heat- sensitive control member.

Abstract: An electrophysiology catheter includes a tubular body having a proximal region, a neck region, and a distal region predisposed into a loop and including electrodes. A first deflection wire extends through at least a portion of the proximal region of the catheter body and includes a first flattened section, while a second deflection wire extends through the neck region and at least a portion of the distal region and includes a second flattened section within the neck region. A first activation wire is joined to the flattened section of the first deflection wire, while a second activation wire is joined to the flattened section of the second deflection wire. Thus, forces acting on the first and second activation wires, such as forces imposed by a handle-based actuator, are respectively transmitted to the first and second deflection wires, thereby deflecting the proximal and neck regions, respectively.

Abstract: A catheter includes a handle, a catheter sheath and a stylet received within a lumen of the catheter sheath. A carrier arrangement projects from the distal end of the handle, the carrier arrangement mounting the catheter sheath and at least part of the deflection stylet. The catheter handle includes an adjustment unit having a gear mechanism that controls at least one of the deflection of the distal part of the stylet and the extent of deflection of the distal part of the stylet.

Abstract: A medical device control handle has with a distal component which is adjustable by an actuator assembly by means of a puller member or wire. The actuator assembly includes a user interface rotational dial, a detent tab washer and a spool, where the dial is rotationally coupled to the detent tab washer which transmits rotational movement of the dial to the spool. The spool has a shaft body and a drum end onto which an proximal end portion of the puller member can be wound to manipulate or adjust the distal component. Rotational movement of the detent washer is limited to prevent overrotation and breakage of the puller member. At least one washer is mounted on the shaft body of the spool to help apply compression load on the actuator assembly in friction-inducing contact with one or more components of the actuator assembly.

Abstract: A medical device control handle has a first actuation member for actuating at least one puller wire in one manipulation of a medical device, including uni-directional deflection, if not a pair of puller wires for bi-directional deflection of a catheter, and a second actuation member for actuating an additional puller wire in another manipulation of the medical device, wherein the first and second actuation members have a common rotational axis without being rotationally coupled. In one embodiment, a first actuation assembly has a first actuator, an arm rotatable about an axis, and a first shaft. The first deflection actuator and the arm are rotationally coupled by the rotation shaft, and the arm has at least one pulley that is engaged with a puller wire. The second wire actuation assembly has a second actuator and a second shaft having a spool portion.

Abstract: A delivery system assembly includes an elongate outer tube, an elongate inner member extending within a lumen of the outer tube, and an articulation sheath surrounding the outer tube between a handle of the assembly and a distal-most portion of the outer tube. The outer tube is longitudinally moveable within the sheath; and an inner diameter of the sheath is preferably smaller than that of the handle and the distal-most portion of the outer tube. Navigation of the assembly through a venous system, for deployment of an implantable medical device, is facilitated by deflection of the sheath, to orient a distal-most portion of the outer tube, within which an entirety of the medical device is contained/loaded, and by subsequent advancement of the distal-most portion, with respect to the sheath, to move the distal end of the inner member, along with the contained/loaded device into proximity with a target implant site.

Abstract: A catheter assembly includes a handle assembly, and a catheter body coupled with the handle assembly, where the catheter body extends to a deflectable distal end portion, and the deflectable distal end is controllable by a flexible element. A lever actuator member is operatively coupled with the flexible element, and movement of the actuator member provides for movement of the flexible element.

Abstract: The invention relates to a flexible assembly for use in a region of a medical or surgical device. In preferred embodiments, the flexible region comprises a set of pull wires for controllably moving a treatment end of the device, and elements to separate the pull wires and maintain the integrity of the shaft of the flexible region in order to improve the operating aspects of the device. The devices and methods can be especially useful in ablation treatments, such as ablation at cardiac or epicardial tissues.

Abstract: Some embodiments relate to a catheter system having a changeable or adjustable working length. The catheter system can comprise a proximal end, a distal end, and a first axial lumen configured to receive a guidewire formed through at least a portion of the catheter body. A first opening can be formed through a portion of the catheter body and be in communication with the first lumen. The sheath can be rotatable, axially movable, or otherwise changeable from at least a first position to a second position, wherein the sheath can substantially cover the first opening in the catheter body in the first position, and can substantially expose the first opening in the catheter body in the second position.

Abstract: An electromechanical drive system with drop-in capability allows manipulation of the majority of existing endoscopes. The invention does not require retrofitting of existing endoscopes and maintains the current clinical workflow. The drive system can be controlled through a human/machine interface, which could consist of a variety of different input devices, including a joystick, keyboard, or game controller.

Abstract: A catheter adapted for use in a tubular region of the heart, has a catheter body, a deflectable intermediate section and a distal a mapping assembly that has a generally circular portion adapted to sit on or in a tubular region of the heart. A control handle of the catheter allows for deflection of the catheter via a first and second puller wire responsive to a deflection assembly and manipulation of distal assembly via a third puller wire responsive to a linear motion actuator assembly. The linear motion actuator assembly includes a pair of user interface knobs, a body to which a proximal end of the third puller wire anchored, and a pair of arms that movably suspends the body and transmits longitudinal travel of the knobs to the body in a manner that multiples the travel of the body relative to the travel of the knobs.

Abstract: An endoscope includes an insertion portion, a bending operation input portion, a first bending drive mechanism and a second bending drive mechanism. The insertion portion includes a first bending portion and a second bending portion disposed at the proximal end of the first bending portion. The bending operation input portion can bend the first bending portion. The first bending drive mechanism bends the first bending portion in accordance with the operation of the bending operation input portion. The second bending drive mechanism can automatically bend the second bending portion in the same direction as the bending direction of the first bending portion in conformity to the first bending portion after the start of the bending of the first bending portion.

Abstract: An endoscope including a shaft having a deflectable distal end; a handle at a proximal end of the shaft; and a deflection control connected to the distal end. The deflection control includes a combined lock and deflection control member at the handle. The control member is adapted to be moved to a selected location by a single finger of a user and thereby deflect the distal end. The control member is adapted to be locked at the user selected location by movement of the control member to a locked position by the single finger of the user.

Abstract: The disclosure provides a catheter for positioning in a contralateral femoral approach in highly angulated iliac bifurcations. The catheter comprises an elongate shaft, an adjustable element, and a wire entrance port on the elongate shaft. The elongate shaft has a proximal portion, an intermediate portion, a curved portion, and a distal portion. The curved portion connects the intermediate portion and the distal portion. The adjustable element is configured to encompass the distal portion and the intermediate portion together in a closed position. The adjustable element can be removed away from the distal portion permitting the distal portion in an open position. The wire entrance port is disposed in the intermediate portion near the curved portion. The distal portion is biased to be spaced away from the intermediate portion in the open position. The adjustable element is connected to an operating wire configured to advance and retreat through the wire entrance port.

Abstract: An apparatus for imparting a tensile force to deflect a distal portion of a catheter while maintaining its exterior dimensions may include a handle grip including a cross-section of generally predetermined exterior dimensions, and a longitudinal axis. A flexible elongate member may include proximal and distal end portions, with the proximal end portion being coupled to the handle grip. An adjustment knob may include a cross-section of generally predetermined exterior dimensions, and is rotatably coupled to the handle grip around the longitudinal axis. An elongate deflection member may be operably coupled to the adjustment knob and to the distal end portion of the elongate member. Rotation of the adjustment knob may impart a tensile force to the deflection member thereby causing the distal end portion of the elongate member to deflect from a prior configuration while maintaining the generally predetermined exterior dimensions of the handle grip and the adjustment knob.

Abstract: A surgical instrument having a long shaft comprises, in the shaft, a sealing element produced by primary shaping at the installation location. The sealing element is produced such that any actuating mechanisms are installed and held in place in the shaft and then a curable plastic material is injected into the shaft such that the material encloses the actuating element along a length that is greater than the inside diameter and smaller than its length.

Abstract: The present invention is directed to a novel shape-transferring cannula system, which provides access to tortuous and unsupported paths. The shape-transferring cannula system and method enables exploration of hollow body structures, and creates a custom-contoured access port for insertion and removal of, for example, diagnostic, surgical, or interventional instruments to and from a site within the body to which the physician does not have line-of-sight access.

Abstract: The long nose manipulatable catheter includes a main lumen, a wire lumen with a push-pull wire therethrough, and a flexible joint region. The catheter section includes a control including a handle and a wire control member engaging the push-pull wire for manipulating the flexible joint region. The push-pull wire may be tapered, having a proximal portion of a first diameter and a smaller diameter distal portion. A coil may be placed around the smaller diameter to prevent buckling of the smaller diameter portion. A strapping coil may also disposed around the outside of the catheter, and an outer covering may be disposed around the strapping coil. An outer covering of a mesh may also be disposed around the distal tip of the catheter.

Abstract: A guide device including a polymer and/or plastic tube, in particular a tube containing a polysiloxane, through the continuous opening of which a cable which is moveable in the continuous opening has been routed. To markedly reduce the wear caused by the cable rubbing in the continuous opening of the tube, a coating is provided on the outer surface of the cable and/or the inner surface of the continuous opening, which includes mainly particles that are substantially spherical and/or cylindrical and can move freely at least on the particular surface (e.g., outer surface of the cable and/or inner surface of the continuous opening). Furthermore, a medical device containing such a guide device, and a method for manufacturing the guide device or the medical device are described.

Abstract: Catheters and methods are provided for performing medical procedures, such as tissue ablation, adjacent the ostia of anatomical vessels, such as pulmonary veins. The catheter comprises an elongated flexible integrated catheter body having proximal and distal shaft portions and at least one operative element carried by the distal shaft portion. The distal shaft portion has a proximal section configured to be internally actuated (e.g., using a steering mechanism or pre-shaping the proximal section) to form a simple curve with an apex that can be inserted into the vessel ostium, an intermediate section pre-shaped to form a curve that bends opposite the simple curve, and a distal section configured to be placed into a non-radial relationship (tangential or oblique) with the vessel ostium when the apex of the simple curve is inserted into the vessel ostium.

Abstract: A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Abstract: An endoscope manipulation adapter includes a support frame having a first end configured to be rigidly fixed relative to a handpiece of a flexible endoscope, and a manipulation assembly arranged at a second end of the support frame. The manipulation assembly defines a channel for at least one of a flexible endoscope shaft or a flexible endoscope insertion component to traverse through in an axial direction to assist in manipulating the at least one of the flexible endoscope shaft or the flexible endoscope insertion component during use of the flexible endoscope.

Abstract: A catheter assembly includes a handle assembly, and a catheter body coupled with the handle assembly, where the catheter body extends to a deflectable distal end portion, and the deflectable distal end is controllable by a flexible element. A lever actuator member is operatively coupled with the flexible element, and movement of the actuator member provides for movement of the flexible element.

Abstract: A steerable tube (100), comprising a hollow elongate tubular member (1) having a proximal end (2), distal end (3), a wall surface disposed between said proximal (2) and distal end (4), a bend-resistive zone (6) flanked by a proximal bendable zone (4) that forms a controller and a distal bendable zone (5) that forms an effector that moves responsive to movements of the controller, whereby the wall of the tubular member (1) in the bend-resistive zone (6) comprises a structure that is a plurality of longitudinal slits (7), forming a plurality of longitudinal strips (8, 8?), the wall of the tubular member (1) in the proximal bendable zone (4) and the distal bendable zone (5) comprises a structure that is a plurality of longitudinal wires (9, 9?, 10, 10?), at least one strip (8) is in connection with a wire (9) in the proximal bendable zone (4) and a wire (10) in the distal bendable zone (5), such that translation by said wire (9) in the controller is transmitted via the strip (8) to said wire (10) in the effector

Abstract: A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Abstract: A robotic instrument system having an elongate sheath instrument and an elongate catheter instrument positioned within a working lumen of the sheath instrument is controlled by selectively operating an instrument driver coupled to the catheter instrument to place a control element extending through the catheter instrument in tension, and thereby articulate at least a distal end portion the catheter instrument, while automatically compensating for a torsional force exerted on the sheath instrument in a first direction due to articulation of the distal end portion of the catheter, by urging the sheath instrument to twist in a second direction opposite of the first direction.

Abstract: A haptic feedback system for a robotic catheter system including a robotic catheter manipulator assembly including one or more removably mounted robotic catheter device cartridges and robotic sheath device cartridges, with each cartridge being generally linearly movable relative to the robotic catheter manipulator assembly. The haptic feedback system may include a user interface device for controlling an operation associated with the catheter and/or sheath device cartridges, and a control system for evaluating a predetermined and/or a measured operational parameter of the haptic feedback system. The user interface device may provide haptic feedback to a user based on the evaluation by the control system.

Abstract: This invention relates to devices for navigating passageways in a body, and in particular, to a steerable catheter that can be used to navigate the tortuous anatomy of a body's vasculature. In one embodiment of the invention the deflectable catheter comprises an inner catheter body having a first strut spine member and a cantilevered second strut tang member. An outer catheter body is cooperatively associated with the second strut tang member and an actuator is cooperatively associated with the first strut spine member. The actuator is slideably engaged within the outer catheter body.

Abstract: A bi-directional electrophysiology catheter having improved steerability which includes orientation sheaths, or thin walled tubes, placed in diametrically opposed lumen at the distal portion of the catheter for producing in-plane deflection of the distal portion of the catheter.

Abstract: Medical devices capable of having variable stiffness, and related methods, are disclosed. In some embodiments, a medical device includes an elongated member adapted to be inserted into a subject, and an electrorheological fluid carried by the elongated member.

Abstract: A deflectable medical device incorporates a strut that is configured to reduce or eliminate axial shortening of the deflectable portion of the medical device, for example, the deflectable distal end portion of a catheter or access sheath. The strut may is coaxially disposed in the medical device in the section that is contemplated to undergo the repeated deflection. The strut provides improved column strength and axial restoration. The strut may be stent-like device, an elongate device having opposing ends coupled by a connecting lattice involving a plurality of helical connecting elements or a tube having a plurality of circumferentially-extending slots arranged in longitudinally-extending rows.

Abstract: A bi-directional electrophysiology catheter having improved steerability which includes orientation sheaths, or thin walled tubes, placed in diametrically opposed lumen at the distal portion of the catheter for producing in-plane deflection of the distal portion of the catheter.

Abstract: A steerable catheter and a method of steering a catheter are provided. The steerable catheter includes a flexible elongate shaft having a proximal end portion, a distal end portion and a cable lumen extending from the proximal end portion to the distal end portion. The steerable catheter includes a control cable having a first portion and a second portion, the first portion of the control cable fixed in position relative to the shaft and the second portion movable relative to the shaft and at least a portion of the second portion is extendable through at least a portion of the cable lumen and extendable through the opening. The control cable has a first position where the at least the portion of the second portion is axially extendable away from a wall of the shaft and a second position for delivery of the catheter.

Abstract: Guidewires, actuators and methods of using the guidewires and actuators are described. These tools and methods allow a user to select and maintain different guidewire stiffness characteristics such that a single guidewire can address a range of access capabilities.

Abstract: Systems and methods that utilize shape sensing fibers are described herein. In certain variations, a fiber may include a service loop or other length that allows for sliding or displacing of a fiber within the lumen of an elongate instrument when the distal portion of the elongate instrument is articulated. Systems and methods for registering a shape sensing fiber, including registration fixtures and registration techniques are also described herein.

Abstract: Apparatus, consisting of a probe, having a proximal end and a distal end, which is deflectable in first and second directions. The apparatus includes a probe manipulator, which is coupled to the proximal end of the probe and has first and second tactile control elements. The elements are operable by a user of the probe to deflect the distal end in the first and second directions, respectively, and are tactilely distinguishable one from the other.

Abstract: A steerable multi-lumen catheter is provided which can be used in cardiology procedures where the catheter allows clinicians to access the small pulmonary arteries for monitoring and performing interventional procedures. The catheter allows precise changes in direction and simplifies challenging navigation procedures such as crossing a thick and calcified aortic valve with a wire. A bendable tip aids navigation during interventional radiology and neurology procedures to enter tortuous vessels or aneurysms.

Abstract: A catheter shaft design facilitates allows for simultaneous stringing of wires and maintains a desired spacing and separation of the wires. In one implementation, a catheter shaft (504) and a core structure (500) are formed in separate manufacturing sequences. The core structure (500) includes a number of receptacles (506) formed in an external surface thereof and may further include a central lumen (508). Wires (501a,b, and 502a,b) are placed into the receptacles (506) and the core structure (500) with wires (501a,b and 502a,b) are inserted into the lumen of the catheter shaft (504). The wires (501a,b, and 502a,b,) can then be connected to electrodes or attached to a catheter tip so as to permit steering of the tip. The design can serve as a platform for various types of catheter.

Abstract: The present invention provides a bi-directional catheter with nearly double the throw in its catheter tip deflection. In particular, the travel path of each the puller wire includes a U-turn or doubling-back around a pulley which minimizes the offset angle between the puller wire and the longitudinal axis of the control handle while maximizing the travel distance of that puller wire for any given distance traveled by the pulley drawing the puller wire. In one embodiment, the catheter has an elongated catheter body, a catheter tip section with first and second diametrically-opposed off-axis lumens, and a control handle which includes a steering assembly having a lever structure carrying a pair of pulleys for simultaneously drawing and releasing corresponding puller wires to deflect the tip section of the catheter.

Abstract: A robotic catheter system including one or more robotic catheter manipulator assemblies supported on a manipulator support structure. The robotic catheter manipulator assembly may include one or more removably mounted robotic catheter device cartridges and robotic sheath device cartridges, with each cartridge being generally linearly movable relative to the robotic catheter manipulator assembly. An input control system may be provided for controlling operation of the robotic catheter manipulator assembly. A visualization system may include one or more display monitors for displaying a position of a catheter and/or a sheath respectively attached to the robotic catheter and sheath device cartridges.

Abstract: A medical catheter includes a deflectable and compressible catheter shaft; a pull ring near a distal end of the catheter shaft; a distal tip that includes a tip element and a mounting shaft; and an attachment apparatus for securely attaching the distal tip to the catheter shaft, the attachment apparatus including a compression ring which compresses the catheter shaft and the mounting shaft together. The compression ring can be located around the catheter shaft to compress the catheter shaft against an outer surface of the mounting shaft, or within the catheter shaft to compress the catheter shaft outwardly against an inner surface of the mounting shaft. The catheter can be a non-irrigated ablation catheter, with the tip element being a tip electrode, and it can be an irrigated ablation catheter, with the distal tip including a fluid manifold.

Abstract: A system includes a steerable device, such as a sheath or shaft, having proximal and distal ends. The steerable device includes an elongated body having a proximal section, a steering section, and a distal tip. Control wires are routed through the body and connected at or near the distal end of the steerable device. The system further includes a control unit to which the proximal end of the steerable device is functionally connected. In one embodiment, the control unit includes an actuator connected to one control wire and a biasing force generating device connected to a second control wire. The steering section is controllably manipulated by the control unit to facilitate steering of the distal tip of the steerable device as the steerable device is advanced through tortuous passageways of a patient's body.

Abstract: A catheter assembly comprises a first catheter including a wall with an inner surface at least partially defining a lumen. A second catheter is connected to the wall of the first catheter and is disposed outward of the inner surface of the wall. The second catheter is at least partially covered by a sheath portion of the first catheter. A first portion of the wall of the first catheter is made of a relatively low durometer elastomeric material and is relatively extensible. A second portion of the wall is formed of a relatively high durometer elastomeric material and is relatively inextensible.

Abstract: Systems and methods for steering catheters to facilitate advancing the catheters through the body, wherein the catheters employ multiple steering stages, each of which can move in multiple planes. The steering stages are independently controlled to enable them to form complex shapes. In one embodiment, the steerable catheter includes an elongated catheter body with the steering stages incorporated into the distal end of the catheter. The steering stages may incorporate multiple memory wires and corresponding heating elements that control the temperatures of the memory wires and consequently control the shapes of the wires and the steering stages in which they are embedded. The catheter may be any type of catheter (e.g., a lumen catheter) and may include features that enable the catheter to perform functions such as delivering therapies (e.g., ablation) to target tissues within the body.

Abstract: In a device (1) for monitoring and/or manipulating objects that are arranged in a cavity that can be accessed through a narrow opening, a tubular or hose-shaped insertion part (2) is provided, on which a flexible section (4) is formed, which can be controlled by a Bowden cable (5), the Bowden cable (5) acting on an actuating element (10) which is rotatably supported in a joint (11) which includes a joint socket (13) and a corresponding joint ball (12) that engages with the joint socket (13).

Abstract: The present invention encompasses apparatus and methods for mapping electrical activity within the heart. The present invention also encompasses methods and apparatus for creating lesions in the heart tissue (ablating) to create a region of necrotic tissue which serves to disable the propagation of errant electrical impulses caused by an arrhythmia.

Abstract: Steerable medical delivery devices and their methods of use.

Abstract: An operation mechanism includes: a longitudinal member having a channel; a subject operation section provided at a distal end side of the member; an operation section provided at a proximal end side of the member; a first transmission means connected to the subject operation section at a distal end side thereof and formed to penetrate the operation section transmitting a first driving force; a first input portion provided in the operation section and connected to a proximal end side of the first transmission means to operate the subject operation section; a second input portion provided closer to the subject operation section side of the operation section than the first input portion and operated by a medical instrument inserted through the channel; and second transmission means connected to the first input portion and the second input portion and transmits a second driving force.