Abstract: A pump and a pump controller which uses an algorithm to quickly achieve and maintain a stable plasma field in a surgical site are provided. The algorithm calculates an electrical characteristic value to determine if a suction rate by the pump should be increased or decreased to achieve the stable plasma field. A method of using the pump and the pump controller is also provided.

Abstract: An irreversible electroporation and radio frequency ablation (IRE/RFA) generator incudes an IRE pulse generator, harmonic filtration circuitry, and a waveform interleaver. The IRE pulse generator is configured to generate biphasic IRE pulses. The harmonic filtration circuitry is configured to convert the IRE pulses into an RF signal. The waveform interleaver, which is configured to receive the IRE pulses and the RF signal and generate an IRE/RFA output signal by interleaving in alternation one or more of the IRE pulses with one or more periods of the RF signal.

Abstract: An apparatus (20) includes a tube (22), configured to advance to a blockage, and including a proximal hub (24) configured to connect to a suction-applying device such that, following the advancement of the tube to the blockage, a suction force generated by the suction-applying device is applied, via the tube, to the blockage, a shaft (26), including first and second electrically-conductive circumferential portions (28, 30), configured to pass through the tube, and first and second electrically-conductive elements (34, 38), configured to connect the first and second electrically-conductive circumferential portions to respective terminals of a power source (36).

Abstract: According to one aspect, a retrieval device may include a sheath having a distal end. The retrieval device may also include an end effector movable relative to the distal end of the sheath. The end effector may include first and second arms. The first arm may include a first opening at a distal portion of the first arm. The second arm may include a second opening at a distal portion of the second arm. The end effector may also include a third arm. The third arm may be slidably received in the first and second openings. A distal portion of the third arm may form at least part of a loop. The loop may extend through the first and second openings.

Abstract: A handle assembly for controlling a steerable catheter includes a handle extending about a longitudinal axis from a proximal end to a distal end. A lumen extends through the handle to a distal tip extending outwardly from the distal end of the handle and a pair of control wires are interconnected to the distal end of extend the lumen. A lever assembly is disposed within the handle and includes a lever rotatable about a lever axis to control deflection of the distal end of the lumen. The lever assembly includes a first and second gear assembly disposed in opposing relationship to one another and offset relative to the longitudinal axis for allowing the lumen to pass therebetween. Each of the gear assemblies are interconnected to one of the pair of control wires to individually pull a respective one of the control wires in response to rotation of the lever.

Abstract: A method for performing an intravascular procedure includes inserting a guide catheter into a blood vessel, and passing a device guide through the guide catheter so that a distal portion of the device guide, having a semi-tubular shape, protrudes from a distal end of the guide catheter into the blood vessel. An intravascular device is inserted through the guide catheter via the distal portion of the device guide to a target site in the blood vessel.

Abstract: A system including a catheter navigable to a location within a patient, a lumen extending through the catheter and ending at the distal end in an orifice, a fluid controller in fluid communication with the lumen of the catheter and capable of supplying a fluid to or removing a fluid from an area proximate the desired location. The control of the fluid in the area proximate the desired location affecting a dielectric constant of the area proximate the desired location. The system includes a microwave energy source, and a microwave ablation probe connected to the microwave energy source, the microwave ablation probe being navigable to a desired location within the patient. Application of energy from the microwave energy source to the microwave ablation probe in an area proximate the desired location having the affected dielectric constant results in a substantially spherical tissue effect in the area proximate the desired location.

Abstract: Apparatus, consisting of a probe configured to be inserted into contact with a myocardium, and an electrode attached to the probe. A temperature sensor, incorporated in the probe, is configured to output a temperature signal. A pump irrigates the myocardium, via the probe, with an irrigation fluid at a controllable rate, and a radiofrequency (RF) signal generator applies RF power via the electrode to the myocardium, so as to ablate the myocardium. The apparatus also has processing circuitry that measures a temperature of the probe, based on the temperature signal, while the RF power is applied and, when the measured temperature exceeds a preset target temperature, iteratively reduces the RF power applied by the signal generator and concurrently iteratively varies a rate of irrigation of the irrigation fluid provided by the pump, until the measured temperature is reduced to the preset target temperature.

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: A powered medical device includes electronic components on a circuit board embedded within the body of a plug for connecting the device with a control apparatus. The medical device may be repaired or refurbished without the need to access the embedded circuit board through the use of a supplemental circuit board installed into the open end of the plug adjacent the plug pins. The supplemental circuit board may include a variety of electronic components, including fuses or non-volatile memory.

Abstract: An electrophysiology catheter has an elongated catheter shaft and a distal assembly with a flex circuit and a support member on which the flex circuit is supported in a generally cylindrical form. The support member has a post extending longitudinally through the cylindrical form of the flex circuit which delivers irrigation fluid into the cylindrical form. The post can be configured to define multiple irrigation chambers within the distal assembly. One or more flow directors movable in the post selectively direct irrigation fluid within the distal assembly. Apertures in the flex circuit allow the irrigation fluid to exit to outside the distal assembly.

Abstract: A method, system and device for securing conductive material on catheter elements for tissue sensing and cryogenic ablation. This may be used to deposit or embed conductive material onto or within polymeric materials. The method of manufacturing a balloon with conductive material may include extruding a polymeric material where the polymeric material includes embedded electrically conductive material. At least a portion of the polymeric material may be removed to expose at least a portion of the embedded electrically conductive material. The benefits may include allowing local bipolar recordings, contact assessment and ice thickness, and compatibility with 3-dimensional electroanatomical mapping systems.

Abstract: Systems and methods for facilitating assessment and convenient display of graphical output indicative of lesion formation and outputting data indicative of lesion formation to a 3D mapping system to display on a 3D model are disclosed herein.

Abstract: An apparatus includes a catheter and an end effector. At least a portion of the catheter is sized and configured to fit within a lumen of a human cardiovascular system. The end effector is positioned at a distal end of the catheter. The end effector includes an expandable assembly and at least one flex circuit. The expandable assembly is configured to transition between a non-expanded state and an expanded state. The expandable assembly includes at least one deformable strut or cage. Each flex circuit includes a flexible substrate secured, without an adhesive, to the expandable assembly and an electrode secured to the flexible substrate. The expandable assembly in the expanded state is configured to urge the electrode into contact with tissue. The electrode has a fishbone-like configuration that defines a longitudinally elongated portion and a plurality of fingers extending transversely from the longitudinally elongated portion.

Abstract: Embodiments of the present disclosure include a medical device. The medical device can include a catheter shaft that includes 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, wherein the flexible framework is curved about a transverse framework axis that is disposed transverse to the catheter shaft longitudinal axis without application of a force external to the medical device. A plurality of microelectrodes can be disposed on the flexible framework and can form a flexible array of microelectrodes adapted to conform to tissue.

Abstract: Catheterization is carried out by inserting a probe into a cavity in a body of a subject. The probe has a contact force, a transmitter, a receiver, and an ultrasound transducer in its distal segment. After navigating the probe into contact with a target in a wall of the cavity using the contact force sensor, a desired contact force is established and maintained between the probe and the target. Responsively to readings by the receiver of signals from the transmitter, the distal end of the probe is oriented orthogonally to the target.

Abstract: A bipolar electrosurgical pleura sealing device includes an electrosurgical probe assembly having a coaxial arrangement that includes an inner stylet, a first intermediate cannula, a second intermediate cannula, and an outer cannula, having appropriate insulation. A first mesh electrode connects to and extends between a distal end portion of the inner stylet and a distal end of the first intermediate cannula, and is movable between a first extended position and a first retracted position by an axial movement of the inner stylet and/or the first intermediate cannula. A second mesh electrode connects to and extends between a distal end of the second intermediate cannula and a distal end of the outer cannula, and is movable between a second extended position and a second retracted position by an axial movement of the second intermediate cannula and/or the outer cannula.

Abstract: Described herein are cannulas that comprise a cannula tube and a cannula tip. The cannula tube comprises a proximal end, a distal end, a cannula tube lumen, a sidewall, and a sidewall opening extending through the sidewall, the sidewall opening a proximal end and distal end. The cannula tip is secured to the distal end of the cannula tube and comprises a proximal tip portion that is inserted into the cannula tube lumen and a distal tip portion that extends beyond the distal end of the cannula tube. The cannula tip is configured to allow fluid to flow therethrough and is configured to eject a distal tip of an elongated device through the sidewall opening of the cannula tube as the elongated device is inserted through the cannula tube from the proximal end of the cannula tube.

Abstract: Devices, systems, and methods relating to a low-voltage, pre-treatment pulse routine for evaluating a potential for non-target tissue damage from the delivery of energy, such as electroporation energy to an area of target tissue. In one embodiment, a medical system includes a medical device having a treatment element; and a control unit in communication with the medical device, the control unit being configured to: deliver a low-voltage, pre-treatment pulse routine through the treatment element to an area of target tissue; determine whether the low-voltage, pre-treatment pulse routine has a stimulation effect on an area of non-target tissue; and deliver an ablation energy routine through the treatment element to the area of target tissue when the control unit determines that the low-voltage, pre-treatment pulse routine does not have a stimulation effect on the area of non-target tissue.

Abstract: A severed nerve may be surgically rejoined and severed axons fused via sequential administrations of solutions. The solutions may include a priming solution comprising methylene blue in a Ca2+-free saline solution, a fusion solution comprising about 50% (w/w) PEG, and a sealing solution comprising Ca2+-containing saline. The PEG fusion solution may be applied in a nerve treatment device configured to isolate the injured segment of the nerve. The device may include a containment chamber for creating a fluid containment field around the anastomosis. The device may have slits, slots, and/or apertures in opposing endwalls of the device designed to receive the nerve. The device may have an open bath configuration or may include separable lower and upper bodies to create a closed bath configuration. The device may include one or more fluid ports in fluid communication with the containment chamber for introducing and/or removing fluid.

Abstract: Methods for estimating of the effectiveness of catheter ablation procedures to form lesions. Lesion effectiveness parameters are received, and effectiveness of a corresponding ablation (optionally planned, current, and/or already performed) is estimated. The estimating is based on use by computer circuitry of an estimator constructed based on observed associations between previously analyzed lesion effectiveness parameters, and observed lesion effectiveness. The estimator is used by application to the received lesion effectiveness parameters.

Abstract: A forceps includes first and second shafts each having a jaw disposed at a distal end thereof configured to rotate about a pivot to move the jaws between open and closed positions, the shafts defining a longitudinal axis therebetween. A knife deployment mechanism including a rack and pinion mechanism or a series of links is disposed within the first shaft and includes a trigger moveable along the longitudinal axis to deploy a knife between the jaws. A knife lockout is configured to move upon approximation of the first and second shafts between an engaged position preventing deployment of the knife and a disengaged position allowing deployment of the knife. A knife kickout mechanism is disposed within the first shaft in opposition to the second shaft and is configured to force the knife forward upon movement of the first and second shafts from an approximated position to a more open position.

Abstract: Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

Abstract: Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the thrombectomy system. The system can include a catheter having a distal portion configured to be positioned adjacent to a thrombus in a blood vessel, an electrode disposed at the distal portion of the catheter, and an interventional element configured to be delivered through a lumen of the catheter. The electrode and the interventional element are each configured to be electrically coupled to an extracorporeal current generator. Delivery of current to the interventional element can be gradually ramped up during initialization to improve patient comfort and safety.

Abstract: Ablation systems and methods detect and address distortion caused by a variety of factors. A method includes measuring a temperature curve at target tissue; applying ablation energy to the target tissue; determining a peak temperature on the temperature curve; if the peak temperature is greater than the predetermined peak temperature, determining a time at which the temperature curve crosses to a lower temperature; and if the determined time is greater than a predetermined time, generating a message indicating that the target tissue was successfully ablated. Another method includes determining a distance between a remote temperature probe and an ablation probe, applying ablation energy to target tissue, measuring temperature at the remote temperature probe, estimating ablation size based on the determined distance and the temperature measured by the remote temperature probe, and determining whether the target tissue is successfully ablated based on the estimated ablation size.

Abstract: Methods, systems, devices, assemblies and apparatuses for treatment of hypertension in a patient using renal denervation. The therapeutic assembly includes an energy delivery element. The energy delivery element is configured to provide renal denervation energy to a nerve within a blood vessel of a patient. The therapeutic assembly includes a controller. The controller is coupled to the energy delivery element. The controller is configured to determine that the hypertension in the patient is orthostatic. The controller is configured to apply renal denervation energy to the patient using the energy delivery element.

Abstract: The invention provides for a system for estimating a 3-dimensional treatment volume for a device that applies treatment energy through a plurality of electrodes defining a treatment area, the system comprising a memory, a display device, a processor coupled to the memory and the display device, and a treatment planning module stored in the memory and executable by the processor. In one embodiment, the treatment planning module is adapted to generate an estimated first 3-dimensional treatment volume for display in the display device based on the ratio of a maximum conductivity of the treatment area to a baseline conductivity of the treatment area. The invention also provides for a method for estimating 3-dimensional treatment volume, the steps of which are executable through the processor. In embodiments, the system and method are based on a numerical model which may be implemented in computer readable code which is executable through a processor.

Abstract: An electrosurgical generator and associated methods determine a real part of the impedance of treated tissue. The electrosurgical generator includes an output stage, a plurality of sensors, and a controller that controls the output stage. The controller includes a signal processor that determines an RMS voltage, an RMS current, an average power, and a real part of the impedance of the treated tissue based on measured voltage and current by using a plurality of averaging filters. The controller controls the output stage to generate electrosurgical energy based on at least the determined real part of the impedance.

Abstract: An end effector assembly includes first and second jaw members movable between an open and closed position to grasp tissue therebetween. First and second proximal flanges extending proximally from the second jaw member and defining a space therebetween, a proximal flange extend proximally from a proximal portion of the first jaw member and define a cam slot. A cam driver operably is coupled to the proximal flange of the first jaw member to define a space between the cam driver and the proximal flange of the first jaw member. A cam bar is disposed within the space defined between the cam driver and the proximal flange of the first jaw member. The cam bar includes a cam pin configured to move within a cam slot of the cam driver to move the first jaw member relative to the second jaw member between the open position and the closed position.

Abstract: The present disclosure relates to systems and methods for generating three-dimensional tissue maps, and particularly fibrosis maps of cardiac tissue. An intravascular device includes an elongated member and a distal tip. An imaging assembly is integrated with the elongated member to enable imaging of the microstructure of tissue near the distal tip. One or more navigation electrodes are positioned at or near the distal tip. Electrical mapping and/or ablation assemblies may also be integrated with the device. Images may be characterized according to a level of fibrosis and, using the corresponding determined locations of the images, a three-dimensional map showing areas of differential fibrosis may be generated. Electrical mapping data may also be integrated with the fibrosis map to generate a composite fibrosis and voltage map.

Abstract: A system for recording or recalling ablation information includes a workstation, and control circuitry. The workstation may include a display, a user input device, and a memory. The workstation may be configured to be in electrical communication with an ablation device. The control circuitry may be in electrical communication with the ablation device and the memory. The control circuitry may be configured to receive input associated with an ablation procedure performed by the ablation device, and associate the input with an anatomical structure of the patient.

Abstract: Disclosed herein is a system for ablating and characterizing tissue. The system comprises an ablation element configured to emit ablative energy toward a tissue of interest, an imaging apparatus configured to emit energy and collect imaging data including reflected signals from the tissue of interest, and a characterization application. The characterization application comprises a signal analyzer for analyzing the imaging data and determining one or more signal properties from the reflected signals, and a correlation processor configured to associate the one or more signal properties to pre-determined tissue signal properties of different tissue components through a pattern recognition technique. The pre-determined tissue signal properties are embodied in a database, and the correlation processor is configured to identify a tissue component and an ablation level of the tissue of interest based on the pattern recognition technique.

Abstract: Medical devices are provided, comprising a medical device and a sensor.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example electrophysiology medical device may include a catheter shaft including a distal end portion and a sensing assembly having three or more terminals. The sensing assembly includes one or more current-carrying electrodes and one or more sensing electrodes. The one or more current-carrying electrodes, the one or more sensing electrodes, or both includes a mini-electrode. The mini-electrode is disposed on one of the other electrodes. The medical device may also include a controller coupled to the sensing assembly.

Abstract: For robotically operating a catheter, a medical catheter is controlled by rotation of the catheter as well as steering in one or more planes of a distal end of the catheter. To robotically rotate the catheter, a handle is rotated. The steering is performed separately using one or more knobs on the handle. The rotation of the handle complicates the robotic control of the knob. A mechanical decoupling is used so that rotation of the handle maintains the position of the knob relative to the handle. Gearing or transmission is used to avoid independent control of the knob and handle rotation. In an alternative or additional approach, the handle may be robotically controlled while also guiding the catheter shaft spaced away from the handle, allowing fine-tuned control of the catheter at the access point to the patient.

Abstract: There is disclosed a method of treating affected external or surface tissue comprising the steps of providing a source of affected external or surface tissue; generating a source of microwave energy; transmitting said microwave energy into said affected external or surface tissues; exposing said affected external and surface tissues to said microwave energy to raise the local temperature to thereby ablate, remove, coagulate or otherwise alter said affected external and surface tissues.

Abstract: A method is disclosed. The method includes providing a plurality of blades, movably connecting the plurality of blades to an outer member via a plurality of arm members, disposing the plurality of blades in a human or animal body, and moving the plurality of blades from a first position outward to a second position when the plurality of blades are disposed in the human or animal body. The plurality of blades are disposed further from each other in the second position than the first position. Moving the plurality of blades outward from the first position to the second position includes moving the plurality of arm members. Moving the plurality of blades includes maintaining equidistance between the plurality of blades as the plurality of blades move from the first position to the second position.

Abstract: A system for deploying needles in tissue includes a controller and a visual display. A treatment probe has both a needle and tines deployable from the needle which may be advanced into the tissue. The treatment probe also has adjustable stops which control the deployed positions of both the needle and the tines. The adjustable stops are coupled to the controller so that the virtual treatment and safety boundaries resulting from the treatment can be presented on the visual display prior to actual deployment of the system.

Abstract: The invention generally relates to systems and methods for therapeutically modulating nerves in or associated with a nasal region of a patient for the treatment of a rhinosinusitis condition.

Abstract: A method for use with an intra-body probe, a distal end of which includes an ablation electrode and a temperature sensor, is described. While (i) the ablation electrode is driving an ablating current into tissue of a subject, and (ii) fluid is passed from the distal end of the intra-body probe at a fluid-flow rate, a processor receives a temperature sensed by the temperature sensor. The processor estimates a temperature of the tissue, based at least on the sensed temperature and at least one parameter selected from the group consisting of: the fluid-flow rate, and a parameter of the ablating current. The processor generates an output in response to the estimated temperature. Other embodiments are also described.

Abstract: A surgical stapling system comprising an end effector, a firing member, a motor, and a control system is disclosed. The end effector comprises an elongate channel, a staple cartridge, and an anvil. The staple cartridge comprises staples removably stored therein. The elongate channel and the anvil are configurable in a closed configuration to capture tissue therebetween. The anvil comprises an impedance sensor configured to sense an impedance of the tissue. The firing member is moveable between a starting position and an ending position. The staples are deployable from the staple cartridge based on the firing member moving toward the ending position. The motor is configured to drive the firing member toward the ending position. The control system comprises a multiplexer configured to control the impedance sensor. The control system is configured to interrogate the impedance sensor to determine the impedance and control the motor based on the determined impedance.

Abstract: An apparatus and a method for measuring physiological parameters of an eye. The apparatus includes a transmitter for transmitting a first set of electromagnetic waves of a first set of frequencies towards the eye, a receiver for receiving reflected electromagnetic waves corresponding to the transmitted first set of electromagnetic waves of the first set of frequencies, a comparator configured to compare the transmitted first set of electromagnetic waves with the received reflected electromagnetic waves for determining an amplitude response and a phase response for each of the electromagnetic waves of the first set of frequencies, and a calculation unit configured to fit the determined amplitude response and phase response to a physiological model of the eye to determine the physiological parameters of the eye.

Abstract: A method for ablating a patient, consisting of ascertaining a CHA2DS2-VASc score for the patient and inserting a probe into the patient, so as to contact a pulmonary vein of the patient. The method further includes applying energy via the probe so as to ablate the pulmonary vein until pulmonary vein isolation (PVI) is achieved. When PVI is achieved and the CHA2DS2-VASc score is less than a preset value, ablation of the pulmonary vein is ceased. When PVI is achieved and the CHA2DS2-VASc score is greater than or equal to the preset value, energy is applied to perform a further ablation.

Abstract: Described herein are methods and systems for performing a procedure for ovarian rebalancing. The methods and systems may be used in the treatment of polycystic ovary syndrome (PCOS). The systems and methods may also be useful in the treatment of infertility associated with PCOS.

Abstract: A system for modulating bladder function is disclosed. A system for evaluating the electrophysiological function of a bladder is disclosed. Methods for performing a controlled surgical procedure on a bladder are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. An implantable device for monitoring and/or performing a neuromodulation procedure on a bladder is disclosed.

Abstract: A prostate therapy system is provided that may include any of a number of features. One feature of the prostate therapy system is that it can access a prostate lobe transurethrally. Another feature of the prostate therapy system is that it can deliver condensable vapor into the prostate to ablate the prostate tissue. Methods associated with use of the prostate therapy system are also covered.

Abstract: Described embodiments include apparatus that includes a catheter and a tip electrode, at a distal end of the catheter, shaped to define a plurality of microelectrode apertures. The apparatus further includes at least one printed circuit board (PCB) disposed within a lumen of the catheter, and a plurality of microelectrodes coupled to the PCB and at least partly situated within the microelectrode apertures, the PCB being configured to carry signals from the microelectrodes. Other embodiments are also described.

Abstract: A tip electrode of a catheter includes an outer wall and a temperature sensor assembly. The outer wall includes a thermally conductive multilayer printed circuit board (TCM-PCB) that includes a void. The temperature sensor assembly, which is fitted in the void of the TCM-PCB, includes a temperature sensor, one or more thermally insulating layers that surround a volume of the temperature sensor excluding one facet of the volume, and a heat conductive layer covering the excluded facet.

Abstract: An elongate medical device having an axis comprises an inner liner, a jacket radially outward of the liner, a braid comprising metal embedded in the jacket, a sensor, and at least one wire electrically connected to said sensor. The at least one wire is one of: embedded in the jacket and optionally disposed helically around the braid; extending longitudinally within a tube which extends generally parallel to the device axis and wherein the tube is embedded in the jacket; and disposed within a lumen, wherein the lumen extends longitudinally within the jacket.

Abstract: An electrosurgical instrument can be provided that includes a pair of opposing jaws, a channel in at least one of the opposing jaws for receiving a reciprocating blade, and a fluid distribution system in communication with the one or more fluid openings located within the channel for delivering a fluid to the jaws.