Biosense Webster (Israel)

Methods and systems of mapping electrophysiological signals in a heart using a catheter having an ultra-high density electrode array are disclosed. The disclosed technology can include a method including navigating a medical probe to a target location in a patient's heart; receiving electrophysiological signals from at least some of the electrodes of the plurality of electrodes; identifying, based on the electrophysiological signals and the location signal, an earliest activation point identified as having the earliest activation time; identifying, based on the electrophysiological signals and the location signal, a plurality of points closest to the earliest activation point having an activation time less than a predetermined time duration from the earliest activation time; and generating an electro-anatomical map of the heart based on data corresponding to the plurality of points, the electro-anatomical map representing the location of the earliest activation point for subsequent ablation.

A system includes a catheter, an electrocardiogram (ECG) system, and a processor. The catheter is configured to apply pacing to given tissue location inside a ventricle of heart of patient. The ECG system is configured to acquire a set of ECG signals generated in response to the pacing, wherein electrodes of the ECG system attached to the patient define respective directions in space relative to an origin located in the heart. The processor is configured to (i) calculate respective set of signal differences between the acquired set of ECG signals and reference set of ECG signals, (ii) calculate corresponding set of deviation vectors along the respective directions in space, the deviation vectors having amplitudes corresponding to the respective signal differences, (iii) using the deviation vectors, calculate direction vector from the given location to new ventricle location at which to apply the pacing, and (iv) indicate calculated direction vector to user.

Methods may include receiving, at a computing device, at least one coordinate set associated with a catheter tip. Methods may include receiving, at the computing device, at least one three-dimensional (3D) model of a heart. Methods may include determining, based on at least the at least one 3D model, an endocardial surface of the heart. Methods may include determining, based on at least the at least one 3D model, an epicardial surface of the heart. Methods may include causing a vector to be projected from the catheter tip. The vector may intersect the endocardial surface at a first point. The vector may intersect the epicardial surface at a second point. Methods may include determining, using at least the first point and the second point, a tissue thickness. Methods may include causing, via a display, output of an indication of the tissue thickness.

A catheter is presented having a planar end effector with elongated ablation electrodes configured to provide electrical signals to achieve IRE in target tissue. The planar end effector can be aligned along a longitudinal axis of a shaft of the catheter and configured to flex away from the longitudinal axis when making contact with tissue. Bipolar electrical signals can be applied between the elongated ablation electrodes in various pair combinations to achieve PFA. The end effector may also include diagnostic electrodes configured to receive electrical signals from tissue to map tissue, pairs of tissue contact electrodes to determine which portions of the end effector are in contact with tissue, or reference electrodes configured to measure blood voltage.

A medical apparatus includes a probe, which includes an insertion tube configured for insertion into a body cavity of a patient, and a distal assembly, which is connected distally to the insertion tube and includes a plurality of electrodes, which are configured to contact tissue within the body cavity. The apparatus further includes an electrical signal generator, which is configured to apply electrical pulses to a group of two or more of the electrodes with an amplitude sufficient to irreversibly electroporate the tissue contacted by the electrodes in the group, and a controller, which is coupled to measure a change in an electrical impedance between an electrode in the group and a further electrode as a result of application of the electrical pulses and to output a measure of ablation of the tissue responsively to the measured change in the electrical impedance.

The disclosed technology includes a medical probe comprising a tubular shaft extending along a longitudinal axis of the medical probe. The medical probe further comprises an expandable basket assembly coupled to the distal end of the tubular shaft. The basket assembly comprises a plurality of spines and a plurality of electrodes. The electrode comprises an electrode body that defines a lumen therethrough such that the respective spine extends through the lumen. The basket assembly comprises an electrically insulative jacket disposed between each respective spine and each respective electrode. Each electrode body and electrically insulative jacket comprises a substantially circular cross-sectional shape.

The disclosed technology includes a distal tip of a medical probe. The distal tip includes spines extending radially outward from a longitudinal axis of the end effector in an expanded configuration, a membrane connected to the spines, a first flexible circuit disposed on a first surface of the membrane proximate each of the plurality of spines, a second flexible circuit disposed on a second surface of the membrane proximate each of the plurality of spines, a plurality of first pairs of electrodes disposed on the first flexible circuit proximal to one another and a spine of the plurality of spines, and a plurality of second pairs of electrodes disposed on the second flexible circuit proximal to one another and a spine of the plurality of spines such that the first and second pairs of electrodes define a mirror image configuration.

The disclosed technology includes an end effector of a medical probe. The end effector includes spines and a membrane. The spines are coupled to a distal portion of a tubular member, with each spine including a proximal spine end coupled to the distal portion of the tubular member and a free distal end. The membrane and spines are fixed relative to each other to define a single member. The membrane defines a plurality of leaves, each of which, in an expanded configuration, extending curvilinearly outward and being separated from adjacent free distal ends of adjacent leaves of the plurality of leaves. Each leaf includes flexible circuits including electrodes.

The disclosed technology includes a flexible circuit for an end effector of a medical probe. The flexible circuit comprises a flexible substrate layer, a plurality of electrodes, and a stiffening layer. The stiffening layer is disposed on the first side of the flexible substrate layer and in the first zone of the flexible circuit such that a first thickness of a first zone of the flexible circuit is greater than a second thickness of the second zone of the flexible circuit, the thickness being measured along the vertical axis, and such that a first flexural rigidity of the first zone is greater than a second flexural rigidity of a second zone of the flexible substrate layer.

An apparatus includes a flexible catheter shaft, one or more electrodes, and one or more position sensors, at least one of the one or more position sensors being positioned on the distal portion of the catheter shaft, the one or more position sensors being configured to provide a signal indicating respective positions of the one or more position sensors in three-dimensional space in response to a magnetic field. The flexible catheter shaft includes a lumen in fluid communication with an open distal end of the shaft. The lumen is configured to receive a guidewire and to communicate a therapeutic fluid out through the open distal end. The shaft has an outer diameter ranging from approximately 0.67 mm to approximately 1.33 mm. At least one of the one or more electrodes is operable to apply electrical energy to tissue.