A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.

Medical probe device and method

An image guided catheter navigation system for navigating a region of a patient includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of the patient. The tracking device tracks the location of the catheter in the region of the patient. The controller superimposes an icon representing the catheter onto the images generated from the imaging device based upon the location of the catheter. The display displays the image of the region with the catheter superimposed onto the image at the current location of the catheter.

Navigation system for cardiac therapies

Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.

Method and apparatus for thoracoscopic intracardiac procedures

An electrosurgical generator has an output power control system that causes the impedance of tissue to rise and fall in a cyclic pattern until the tissue is desiccated. The advantage of the power control system is that thermal spread and charring are reduced. In addition, the power control system offers improved performance for electrosurgical vessel sealing and tissue welding. The output power is applied cyclically by a control system with tissue impedance feedback. The impedance of the tissue follows the cyclic pattern of the output power several times, depending on the state of the tissue, until the tissue becomes fully desiccated. High power is applied to cause the tissue to reach a high impedance, and then the power is reduced to allow the impedance to fall. Thermal energy is allowed to dissipate during the low power cycle. The control system is adaptive to tissue in the sense that output power is modulated in response to the impedance of the tissue.

Electrosurgical generator with adaptive power control

Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

Fluid-assisted medical devices, systems and methods

Method and apparatus for ablation of cardiac tissue includes a catheter (2, 60) having an elongated flexible body (6, 64), a tissue characterization assembly including a transducer (34) at the distal end (16) of the body and a tissue ablation assembly having a tissue ablation tip (32) at the distal end of the body. The tissue ablation tip is positioned adjacent the tissue to be ablated using the visualization assembly and then activated.

Cardiac imaging and ablation catheter

A coaxial antenna assembly conducts a pressurized medium for absorbing heat along the coaxial cable.

Steerable microwave antenna systems for cardiac ablation that minimize tissue damage and blood coagulation due to conductive heating patterns

Collapsible electrode assemblies and associated methods employ an array of filaments assembled to form a mesh structure. The mesh structure is adapted to selectively assume an expanded geometry having a first maximum diameter and a collapsed geometry having a second maximum diameter less than the first maximum diameter. Preferably, at least one of the filaments includes an electrically conductive material adapted for coupling to a source of ablation energy for transmitting ablation energy.

Expandable-collapsible mesh electrode structures

Tissue heating and ablation systems and methods use a porous electrode assembly with an electrically conductive surface. The electrode assembly includes an exterior peripherally surrounding an interior area. At least a portion of the wall comprises an electrically conductive material. A lumen conveys a medium containing ions into the interior area. According to the invention, at least a portion of the wall also comprising a porous material sized to pass ions contained in the medium. In a preferred embodiment, the electrode assembly further includes an element coupling the electrically conductive material to a source of electrical energy to transmit electrical energy. In this preferred embodiment, the electrically conductive material is also porous to pass ions contained in the medium. The assembly also preferably includes a conductive element coupling the medium within the interior area to a source of electrical energy to enable ionic transport of electrical energy by the medium through the porous material.

Tissue heating and ablation systems and methods using porous electrode structures with electrically conductive surfaces

Collapsible electrode assemblies and associated methods employing a structure having an axis and a distal end. The structure comprises a wall peripherally enclosing an interior. The structure is adapted to selectively assume an expanded geometry having a first maximum diameter about the axis and a collapsed geometry having a second maximum diameter about the axis less than the first maximum diameter. An electrically conductive material is carried by the wall, forming an electrode region adapted to conform to both the normally expanded geometry and the collapsed geometry of the structure. In one implementation, a flexing element in the interior of the structure bends within the interior along the axis of the structure to displace the distal end relative to the axis. In another implementation, a stilette element within the interior of the structure imparts axial force upon the distal end along the axis of the structure, thereby axially elongating or shortening the structure.

Patrick M. Owens

Papers

Cardiac imaging and ablation catheter

Steerable microwave antenna systems for cardiac ablation that minimize tissue damage and blood coagulation due to conductive heating patterns

Expandable-collapsible mesh electrode structures

Tissue heating and ablation systems and methods using porous electrode structures with electrically conductive surfaces

Expandable-collapsible electrode structures with distal end steering or manipulation