Abstract: A high frequency power supply for applying electrical energy to a target site on or within a patient's body includes an electrical output driver, an output current sensor detecting the current output from the driver, and a power limiting device coupled to the current sensor during normal conditions, the power limiting device operates on a continuous basis. When current output exceeds a predetermined threshold level, the power limiting device is adapted to reduce power on the output driver to a standby mode. The power limiting device operates on a periodic detection or duty cycle when in the standby mode. The power limiting device switches into the stand-by mode to prevent excessive power drains. The power supply operates at a low power, pulsatile manner when an attached probe is in conductive or isotonic fluid but is not engaging body tissue or near a high impedance source. In this pulsatile mode, the power supply operates in a cyclical manner, typically at a predetermined duty cycle.

Abstract: Electrode assemblies and associated systems employ a nonporous wall having an exterior for contacting tissue. The exterior peripherally surrounds an interior area. The wall is essentially free of electrically conductive material. The wall is adapted to assume an expanded geometry having a first maximum diameter and a collapsed geometry having a second maximum diameter less than the first maximum diameter. The assemblies and systems include a lumen that conveys a medium containing ions into the interior area. An element free of physical contact with the wall couples the medium within the interior area to a source of electrical energy to enable ionic transport of electrical energy from the source through the medium to the wall for capacitive coupling to tissue contacting the exterior of the wall.

Abstract: A method and apparatus for creating a virtual electrode to ablate bodily tissue. The apparatus includes an outer tube, a first electrode, an inner tube and a second electrode. The outer tube is fluidly connected to a source of conductive fluid and defines a proximal end and a distal end. The distal end includes an opening for delivering conductive fluid from the outer tube. The first electrode is disposed at the distal end of the outer tube for applying a current to conductive fluid delivered from the outer tube. The inner tube is coaxially received within the outer tube and is connected to a source of conductive fluid. The inner tube defines a proximal end and a distal end, with the distal end forming an opening for delivering conductive fluid from the inner tube. Finally, the second electrode is disposed at the distal end of the inner tube for applying a current to conductive fluid delivered from the inner tube.

Abstract: The present invention provides an apparatus method for performing rf intraluminal reduction and/or occlusion with a virtual electrode. An apparatus in accord with the present invention includes a catheter and a guide wire. The guide wire includes a conductive core having a proximal end electrically connected to a generator of rf current and an exposed distal end. An insulative material having disposed therein at least one microlumen for providing a conductive fluid to a target site within the lumen encases the guide wire.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: The present invention provides a method of controlling cardiac fibrillation, tachycardia, or cardiac arrhythmia by the use of an electrophysiology catheter having a tip section that contains at least one stimulating electrode, the electrode being stably placed at a selected intravascular location. The electrode is connected to a stimulating means, and stimulation is applied across the wall of the vessel, transvascularly, to a sympathetic or parasympathetic nerve that innervates the heart at a strength sufficient to depolarize the nerve and effect the control of the heart.

Abstract: The present tool and associated methods provide for precisely controlled positioning of an ablative element, or an array of ablative elements, against a tissue targeted for treatment. Such treatment is in the form of a lesion, caused by energy emitted from the ablative element, selectively changing or destroying cells within the target tissue. The tool incorporates an element array. This element array consists of one or more energy emitting (ablative) elements. The energy delivered may be in the form of radio frequency, microwave, ultrasound, light, and cryogenics, among others. The element array may also incorporate one or more temperature sensing elements. Further, this element array may incorporate a fluid system providing recirculative cooling or fluid delivery to cool the element array and/or surrounding tissue. In one use of the tool, the element array, which is located at the distal end of an elongate member, is positioned against cardiac tissue during an open heart procedure.

Abstract: A linear lesion ablation catheter includes a conductive ablating portion having a predetermined resistivity profile for ablating tissue in a generally even temperature profile. In one embodiment, the conductive ablating portion is disposed on a distal portion of an elongate flexible member and has a resistance that increases exponentially along its length from a center of the ablating portion to a non-infinite value at opposite ends of the ablating portion. The ablating portion is adapted to produce a generally even temperature profile along a length of its surface when the ablating portion is in contact with a target tissue within a patient's body. In one example, the conductive ablating portion comprises a plurality of electrically connected conductive regions which extend from the center to the opposite ends of the ablating portion.

Abstract: An apparatus for delivering energy to a surgical site from an energy source is provided. The apparatus includes; a handle, an actuator, a shaft, and a deflection wire. The actuator is movably coupled to the handle. The actuator moves from a first position to a second position. The shaft includes a proximal end, a deflectable portion and an energy delivery portion. The proximal end of the shaft is coupled to the handle. The energy delivery portion is coupled to the energy source to deliver energy to the surgical site. The deflection wire includes a proximal portion and a distal portion. The distal portion is affixed to the shaft. The proximal portion is affixed to the actuator. A movement of the actuator from the first position to the second position moves the deflection wire to produce a deflection of the deflectable portion. In an alternate embodiment of the invention a sensor and feedback control module are provided.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within of a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove, contract or otherwise modify the structure of tissue structures. In one aspect of the invention, a method is provided for treating herniated discs within a patient's spine by applying sufficient electrical energy to the disc tissue to reduce a volume of the disc, thereby relieving pressure on a spinal nerve. In one embodiment, the high frequency voltage is sufficient to ablate a portion of the nucleus pulposis, either the extruded portion outside of the annulus or a portion or all of the pulposis within the annulus.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within of a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove, contract or otherwise modify the structure of tissue structures. In one aspect of the invention, a method is provided for treating herniated discs within a patient's spine by applying sufficient electrical energy to the disc tissue to reduce a volume of the disc, thereby relieving pressure on a spinal nerve. In one embodiment, the high frequency voltage is sufficient to ablate a portion of the nucleus pulposis, either the extruded portion outside of the annulus or a portion or all of the pulposis within the annulus.

Abstract: The invention provides improved devices, methods, and systems for shrinking of collagenated tissues, particularly for treating urinary incontinence in a noninvasive manner by directing energy to a patient's own support tissues. This energy heats fascia and other collagenated support tissues, causing them to contract. The energy can be applied intermittently, often between a pair of large plate electrodes having cooled flat electrode surfaces, the electrodes optionally being supported by a clamp structure. Such cooled plate electrodes are capable of directing electrical energy through an intermediate tissue and into fascia while the cooled electrode surface prevents injury to the intermediate tissue, particularly where the electrode surfaces are cooled before, during, and after an intermittent heating cycle. Ideally, the plate electrode comprises an electrode array including discrete electrode surface segments so that the current flux can be varied to selectively target the fascia.

Abstract: A system for treating a target region in tissue beneath a tissue surface comprises a probe for deploying an electrode array within the tissue and a surface electrode for engaging the tissue surface above the treatment site. Preferably, surface electrode includes a plurality of tissue-penetrating elements which advance into the tissue, and the surface electrode is removably attachable to the probe. The tissue may be treated in a monopolar fashion where the electrode array and surface electrode are attached to a common pole on an electrode surgical power supply and powered simultaneously or successively, or in a bipolar fashion where the electrode array and surface electrode are attached to opposite poles of the power supply. The systems are particularly useful for treating tumors and other tissue treatment regions which lie near the surface.

Abstract: Radio frequency current pulses are applied to the skin in a controlled manner in order to heat selected volumes of skin, thereby inducing the removal of unwanted pigments from the skin. A probe provides the radio frequency current pulses to the skin, where the probe includes first and second metallic stripes, and where the probe is connected to two coaxial cables that are respectively connected to the first and second metallic stripes. The two coaxial cables are connected to a balanced/unbalanced transformer, which in turn is connected to a radio frequency generator that provides radio frequency pulses.

Abstract: Systems, apparatus and methods for ablation, resection, aspiration, collagen shrinkage and/or hemostasis of tissue and other body structures in open and endoscopic spine surgery. In particular, the present invention includes a channeling technique in which small holes or channels are formed within spinal discs, and thermal energy is applied to the tissue surface immediately surrounding these holes or channels to cause thermal damage to the tissue surface, thereby stiffening the surrounding tissue structure and for reducing the volume of the disc to relieve pressure on the surrounding nerves. High frequency voltage is applied between one or more active electrode(s) and one or more return electrode(s) to volumetrically remove or ablate at least a portion of the disc tissue, and the active electrode(s) are advanced through the space left by the ablated tissue to form a channel, hole, divot or other space in the disc tissue.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within of a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove, contract or otherwise modify the structure of tissue structures. In one aspect of the invention, a method is provided for treating herniated discs within a patient's spine by applying sufficient electrical energy to the disc tissue to reduce a volume of the disc, thereby relieving pressure on a spinal nerve. In one embodiment, the high frequency voltage is sufficient to ablate a portion of the nucleus pulposis, either the extruded portion outside of the annulus or a portion or all of the pulposis within the annulus.

Abstract: Systems and methods are provided for selectively applying electrical energy to a target location on an external body surface, such as skin tissue removal and/or collagen shrinkage in the epidermis or dermis, e.g., the removal of pigmentations, vascular lesions (e.g., leg veins), scars, tattoos, etc., and for other surgical procedures on the skin, such as tissue rejuvenation, cosmetic surgery, wrinkle removal, hair removal and/or transplant procedures. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals adjacent an external body surface, such as the outer surface of the skin, to remove and/or modify the structure of tissue structures within the skin. Depending on the specific cosmetic procedure, the present invention may be used to: (1) volumetrically remove tissue or hair (i.e.

Abstract: A catheter for exchanging heat with a body fluid is disclosed. The catheter includes a main shaft and a heat exchange region having a plurality of heat exchange elements each having a length and opposed ends. Each of the elements is attached on at least one of its ends to the shaft and disposed so that when inserted in a fluid body cavity having body fluid therein, the body fluid may circumferentially surround each heat exchange element along a portion of the length of the heat exchange element. The catheter includes a fluid circulation path therein, which desirably includes the hollow lumen within each of heat exchange elements. The heat exchange elements may be connected at two points along the shaft using manifolds that are in fluid communication with fluid flow paths within the shaft. Alternatively, the heat exchange elements may be connected at only one point and be permitted to float in a proximal or distal direction with respect to the catheter.

Abstract: A bipolar electrosurgical instrument is described which may be used for heating the inner lining of a lumen or cavity within a patient. In particular, the present invention is directed to an electrosurgical instrument including a flexible elongated tube having a proximal and a distal end, a first balloon electrode attached to the distal end of the flexible elongated tube. The first balloon electrode includes a first expandable sleeve formed from an electrically insulating material and a first electrically conductive fluid in the expandable sleeve. A first electrode is positioned in electrical contact with the first electrically conductive fluid. A return balloon electrode is spaced proximally from the first balloon electrode, wherein the return balloon electrode includes a second expandable formed from an electrically insulating material and a second electrically conductive fluid disposed within the second expandable sleeve.

Abstract: A probe that facilitates the creation of lesions in bodily tissue. The probe includes a relatively short shaft and an inflatable therapeutic element.

Abstract: A catheter assembly and method for treatment of cardiac arrhythmia. In one preferred embodiment, the catheter assembly includes a catheter body, at least one electrode, and a fluid source. The catheter body includes a proximal portion, an intermediate portion, a distal portion, a first lumen, and an ablation section. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a helix or coil. The first lumen extends from the proximal portion to the distal portion. Finally, the ablation section is formed along the helix of the distal portion and defines a loop transverse to the longitudinal axis. The ablation section is, in one preferred embodiment, comprised of a microporous material in fluid communication with the first lumen so as to irrigate fluid from the first lumen to an exterior surface of the ablation section. The electrode is associated with the ablation section.

Abstract: A low profile intravascular electrophysiology (EP) device for the formation of linear lesions which has particular utility in the treatment of atrial fibrillation and flutter. The EP device of the invention has an elongated shaft with a proximal section, a distal section, and a plurality of at least partially exposed electrodes disposed on an outer surface of the distal section. The electrodes are spaced along a length of the distal section with at least one temperature sensor located between adjacent electrodes. High frequency, e.g. RF, electrical energy delivered to the electrodes on the distal shaft section of the EP device will form a linear lesion which terminates the fibrillation or flutter.

Abstract: A method of treating a brain disorder by heat transfer from brain tissue comprising the steps of surgically cutting a heat transfer aperture into a patient's skull, thereby exposing a predetermined portion of patient's brain; surgically implanting into said heat transfer aperture a heat pump having one or more electrical sensor elements and one or more temperature sensor elements; surgically implanting a heat transfer management unit in a body cavity of said patient such that a micro controller of the heat transfer management unit is connected to one or more activity sensor elements and one or more temperature sensor elements contacting brain tissue and connecting the heat transfer management unit to said heat pump via a lead bundle. Optionally, the heat transfer unit may be located external to the patient's body.

Abstract: Relief of urethral obstruction is achieved by heat ablation of prostatic tissue by an ablation instrument passed within the urethra to a position in the prostate near the point of urethral obstruction. An electrode is coupled to a high-frequency power supply to ablatively heat the urethra and the prostatic tissue near the urethra. Guidance of the electrode placement may be monitored by an imaging device. The instrument may consist of a catheter with an inflatable balloon structure for positioning the instrument. The temperature of the tissue may be sensed at the electrode to control the high-frequency heating energy and ablation process.

Abstract: A method is disclosed for forming and contracting scar collagen below a tissue surface in a selected tissue site. An electromagnetic energy apparatus is provided and includes an electromagnetic energy source and a delivery device. The delivery device is positioned on the tissue surface. Electromagnetic energy is produced from the electromagnetic energy source and delivered through the tissue surface to the selected tissue site for a sufficient time to induce scar collagen formation in the selected tissue site. No more than a second degree burn is formed on the tissue surface. The scar collagen is then contracted. This method is particularly useful in tissue sites that are devoid or deficient in collagen.

Abstract: A left atrium ablation catheter (4), including a sheath (8) and a deflectable electrophysiology catheter (10) housed within the sheath, is used to ablate coronary tissue at a target site within the left atrium (LA) of a heart. The electrophysiology catheter has ablation electrodes (24) along the tip (10). The ablation catheter is introduced into the right atrium (RA) through either the superior vena cava (SVC) or the inferior vena cava (IVC). The distal open end of the sheath is guided through a punctured hole in the interatrial septum and into the left atrium. The distal end (20) of the sheath is either precurved or is steerable so the electrode tip can be directed to the coronary target site in the left atrium. The electrode tip is sized and configured to create the desired lesion at the target site without movement of the electrode tip.

Abstract: A method of ablating tissue in the heart to treat atrial fibrillation introduces into a selected atrium an energy emitting element. The method exposes the element to a region of the atrial wall and applies ablating energy to the element to thermally destroy tissue. The method forms a convoluted lesion pattern comprising elongated straight lesions and elongated curvilinear lesions. The lesion pattern directs electrical impulses within the atrial myocardium along a path that activates the atrial myocardium while interrupting reentry circuits that, if not interrupted, would cause fibrillation. The method emulates the surgical maze procedure, but lends itself to catheter-based procedures that do not require open heart surgical techniques. A composite structure for performing the method is formed using a template that displays in planar view a desired lesion pattern for the tissue. An array of spaced apart element is laid on the template.

Abstract: A multiple electrode array for ablating tissue carries at least two electrode segments that are circumferentially spaced from each other. Insulation electrically isolates the separated electrode segments from each other. Signal wires attached to the separated electrode segments convey ablating energy independently to the separated electrode segments. Because of its segmented structure, the array can place only one of the electrode segments in contact with tissue at one time. Because each segment is electrically isolated, and because each segment is independently served by its own signal wire, a physician can operate an ablation energy generator to selectively channel the ablation energy only to the segment actually contacting the tissue.

Abstract: This invention relates to the destruction of pathological volumes or target structures such as cancerous tumors or aberrant functional target tissue volumes by direct thermal destruction. In the case of a tumor, the destruction is implemented in one embodiment of the invention by percutaneous insertion of one or more radiofrequency probes into the tumor and raising the temperature of the tumor volume by connection of these probes to a radiofrequency generator outside of the body so that the isotherm of tissue destruction enshrouds the tumor. The ablation isotherm may be predetermined and graded by proper choice of electrode geometry and radiofrequency (rf) power applied to the electrode with or without temperature monitoring of the ablation process. Preplanning of the rf electrode insertion can be done by imaging of the tumor by various imaging modalities and selecting the appropriate electrode tip size and temperature to satisfactorily destroy the tumor volume.

Abstract: A method and apparatus for creating a virtual electrode to ablate bodily tissue. The apparatus includes an outer tube, a first electrode, an inner tube and a second electrode. The outer tube is fluidly connected to a source of conductive fluid and defines a proximal end and a distal end. The distal end includes an opening for delivering conductive fluid from the outer tube. The first electrode is disposed at the distal end of the outer tube for applying a current to conductive fluid delivered from the outer tube. The inner tube is coaxially received within the outer tube and is connected to a source of conductive fluid. The inner tube defines a proximal end and a distal end, with the distal end forming an opening for delivering conductive fluid from the inner tube. Finally, the second electrode is disposed at the distal end of the inner tube for applying a current to conductive fluid delivered from the inner tube.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within or on a patient's body. In particular, methods and apparatus are provided for resecting, cutting, partially ablating, aspirating or otherwise removing tissue from a target site, and ablating the tissue in situ. The systems and methods of the present invention are particularly useful for ablation and hemostasis of tissue in sinus surgery (e.g., chronic sinusitis and/or removal of polypectomies) and for resecting and ablating soft tissue structures, such as the meniscus and synovial tissue within a joint.

Abstract: A cell necrosis apparatus includes an introducer with a distal end sufficiently sharp to penetrate tissue, an energy delivery including a plurality of electrodes and a slidable sensing member. Each electrode of the plurality of electrodes has a tissue piercing distal end and is positionable in the introducer as the introducer is advanced through tissue. At least one electrode of the plurality of electrodes is deployable with curvature from the introducer. The slidable sensing member is positionable within the introducer and electrically coupled to the energy delivery device. The sensing member is configured to measure a property of the energy delivery device or at least one electrode of the plurality of electrodes.

Abstract: A device for a heat treatment of a body part, comprising a heating element (1) and means (2) for holding the heating element against the body part to be heat-treated. The heat element (1) comprises a plurality of separate heating cells (6) and is flexible in such a manner that it may be adapted to abut said body part.

Abstract: The invention provides improved devices, methods, and systems for repeatably and reliably contracting fascia and other support tissues, particularly for the treatment of urinary incontinence. Rather than relying on a surgeon's ability to observe, direct, and control the selective shrinking of pelvic support tissues, probes generally limit heating so that only sufficient controlled energy is transmitted from a surface of the probe into the engaged tissue to contract the tissue and inhibit incontinence (or otherwise provide the desired therapeutic results).

Abstract: A catheter adapted to increase the patency of a body conduit includes an elongate tube having an axis extending between a proximal end and a distal end, and a balloon disposed at the distal end of the tube and having properties for being expanded to a high-profile state and for being contracted to a low-profile state. A sleeve disposed over the balloon has a pair of ends disposed on opposing sides of a central section, the ends having a floating relationship relative to the tube with the central section disposed circumferentially of the balloon. An electrode disposed outwardly of the sleeve has properties for being electrosurgically energized to incise materials defining the body conduit when the balloon is in the high-profile state. The electrode can be formed of a plurality of elements stranded to increase the surface area of the electrode.

Abstract: An electrosurgical handpiece that is bipolar or unipolar in operation and that is configured for use in MIS. The bipolar operation confines the electrosurgical currents to a small active region between the active ends of the bipolar electrode and thus reduces the possibility that excessive heat will be developed that can damage patient tissue. The position of the active region can be controlled to avoid patient tissue that may be more sensitive to excessive heat. In one embodiment, the handpiece is constructed with a flexible end controllable by the surgeon so as to allow the surgeon to manipulate the end as desired during the surgical procedure. This feature allows the surgeon to position the active electrode end at the optimum location within, say, a herniated disk to remove undesired regions and to provide controlled heat to shrink the tissue during surgery.

Abstract: Methods and apparatus are provided for an achieving low-rate collagen shrinkage using an electrode array comprising an elongated insulator strip having at least one pair of spaced-apart bi-polar RF electrodes, and a “channeling” disposed on the strip between the bi-polar electrodes to direct the flow of RF current therebetween. The channeling electrode is not directly coupled to the RF power source, but only indirectly through the tissue in contact with the channeling electrode. The apparatus enables low RF power levels (e.g., 0.5 watts to 25 watts) to be applied over time intervals of 5 seconds to 180 seconds to attain low-rate collagen shrinkage by directing or focusing the path of the RF current.

Abstract: Systems and methods are provided for selectively applying electrical energy to a target location on an external body surface, such as skin tissue removal and/or collagen shrinkage in the epidermis or dermis, e.g., the removal of pigmentations, vascular lesions (e.g., leg veins), scars, tattoos, etc., and for other surgical procedures on the skin, such as tissue rejuvenation, cosmetic surgery, wrinkle removal, hair removal and/or transplant procedures. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals adjacent an external body surface, such as the outer surface of the skin, to remove and/or modify the structure of tissue structures within the skin. Depending on the specific cosmetic procedure, the present invention may be used to: (1) volumetrically remove tissue or hair (i.e.

Abstract: A method using an ablation apparatus for treating tissues or atherosclerosis on a patient having a pre-implanted medical stent, the method including applying RF energy to the tissue lesion site underlying the stent for therapeutic purposes at different energy levels, different post-procedure times, and different modes of energy delivery.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: An apparatus for ablating tissue has an elongate member, at least two electrodes housed within an axial lumen of the elongate member, and an electrode actuator for advancing the electrodes beyond a distal end of the elongate member and into tissue to a site targeted for ablation. The electrode actuator rapidly advances the electrodes beyond the distal end of the elongate member so that the electrodes assume a uniform outwardly everted configuration.

Abstract: An RF ablation system comprises irrigated split tip electrode catheter, an RF generator and a signal processor. The catheter comprises four orthogonally arranged electrodes at the distal tip. The catheter is used to map the electrical activity of a heart chamber to locate site(s) of aberrant electrical pathways to be ablated. Once an ablation site has been located, the signal processor activates the RF generator to transmit a low level RF current to each electrode member of the split tip electrode. The signal processor receives signals indicative of the impedance between each electrode member and one or more surface indifferent electrodes and determines which electrode members are associated with the highest impedance. Such electrode members are those in greatest contact with the myocardium. The signal processor then automatically activates the RF generator to transmit an RF ablation current to the electrode members in contact with the myocardium to create a lesion.

Abstract: Devices and methods for performing percutaneous myocardial revascularization (PMR). A catheter in accordance with the invention includes an elongate shaft having a proximal end and a distal end. The elongate shaft defines a lumen, and a conductor is disposed inside the lumen. An electrode portion is formed by the bent portion of the conductor which extends from the distal end of the elongate shaft. A method in accordance with the present invention may be used to form a wound through the endocardium and into the myocardium of a patient's heart. Collateral damage to the myocardium may be created by infusing pressurized fluid into the wound. A number of fluids may be delivered to a location proximate the wound via the catheter.

Abstract: An RF ablation system comprises irrigated split tip electrode catheter, an RF generator and a signal processor. The catheter comprises four orthogonally arranged electrodes at the distal tip. The catheter is used to map the electrical activity of a heart chamber to locate site(s) of aberrant electrical pathways to be ablated. Once an ablation site has been located, the signal processor activates the RF generator to transmit a low level RF current to each electrode member of the split tip electrode. The signal processor receives signals indicative of the impedance between each electrode member and one or more surface indifferent electrodes and determines which electrode members are associated with the highest impedance. Such electrode members are those in greatest contact with the myocardium. The signal processor then automatically activates the RF generator to transmit an RF ablation current to the electrode members in contact with the myocardium to create a lesion.

Abstract: An electrode support structure comprises a guide body having at its distal end a flexible spline leg. The spline leg is flexed to define an arcuate shape to facilitate intimate contact against tissue. An electrode element is carried by the spline leg for movement along its axis. The structure includes a control element coupled to the electrode element. The control element remotely imparts force to move the electrode element along the axis of the spline leg. Therefore, in use, the physician can cause the electrode element to travel along a path that the spline leg defines, without otherwise changing the location of the guide body.

Abstract: A system for treating a target region in tissue beneath a tissue surface comprises a probe for deploying an electrode array within the tissue and a surface electrode for engaging the tissue surface above the treatment site. Preferably, surface electrode includes a plurality of tissue-penetrating elements which advance into the tissue, and the surface electrode is removably attachable to the probe. The tissue may be treated in a monopolar fashion where the electrode array and surface electrode are attached to a common pole on an electrode surgical power supply and powered simultaneously or successively, or in a bipolar fashion where the electrode array and surface electrode are attached to opposite poles of the power supply. The systems are particularly useful for treating tumors and other tissue treatment regions which lie near the surface.

Abstract: Systems and methods are provided for selectively applying electrical energy to a target location on an external body surface, such as skin tissue removal and/or collagen shrinkage in the epidermis or dermis, e.g., the removal of pigmentations, vascular lesions (e.g., leg veins), scars, tattoos, etc., and for other surgical procedures on the skin, such as tissue rejuvenation, cosmetic surgery, wrinkle removal, hair removal and/or transplant procedures. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals adjacent an external body surface, such as the outer surface of the skin, to remove and/or modify the structure of tissue structures within the skin. Depending on the specific cosmetic procedure, the present invention may be used to: (1) volumetrically remove tissue or hair (i.e.

Abstract: An RF ablation system comprises irrigated split tip electrode catheter, an RF generator and a signal processor. The catheter comprises four orthogonally arranged electrodes at the distal tip. The catheter is used to map the electrical activity of a heart chamber to locate site(s) of aberrant electrical pathways to be ablated. Once an ablation site has been located, the signal processor activates the RF generator to transmit a low level RF current to each electrode member of the split tip electrode. The signal processor receives signals indicative of the impedance between each electrode member and one or more surface indifferent electrodes and determines which electrode members are associated with the highest impedance. Such electrode members are those in greatest contact with the myocardium. The signal processor then automatically activates the RF generator to transmit an RF ablation current to the electrode members in contact with the myocardium to create a lesion.

Abstract: The present invention provides ultrasound-guided ablation catheters and methods for their use. In one embodiment, a tissue ablation apparatus (2) includes a flexible elongate body (12) having proximal (14) and distal (12) ends. A plurality of spaced-apart electrodes (24) are operably attached to the flexible body near the distal end. A plurality of transducer elements (28) are disposed between at least some of the electrodes. Transducers assist the physician in determining whether or not the ablation elements are in contact with the tissue to be ablated.

Abstract: A medical treatment appliance to carry out therapeutical treatment by slightly pushing it to a skin of a patient, includes a grip portion, a conductor portion consisting essentially of electrically conductive metal(s), a “different metal” portion having an ionization tendency different from the electrically conductive metal(s), and optionally a crystal portion consisting essentially of a mineral, wherein the “different metal” portion, and optionally the crystal portion is(are) attached to the conductor portion.