Medtronic, Inc.

Medtronic Cryocath LP

Boston Scientific Corporation

Cryocath Technologies Inc.

Other

Koninklijke Philips Corporation N.v.

Ep Technologies, Inc.

Baylis Medical Company Inc.

Sonometrics Corporation

Klein, George J.

George J Klein

Marwan Abboud

Fredric L Milder

Josef Vincent Koblish

Kenneth M Anderson

Glenn C Zillmer

Ursula Gebhardt

Charles L Dennis

Rahul Mehra

Sean Carroll

Dan Wittenberger

Brian Bruce Lee

Michael R Ujhelyi

Thomas P Coen

Thomas T Coen

Gust H Bardy

Timothy G Laske

James Kevin Carney

Gareth Davies

William J Combs

Robert A Martin

Cristian Petre

Anthony J Varrichio

Tom Dean Bennett

Claudia Lueckge

Steven G Arless

Dwight H Warkentin

Kenneth M Riff

Ivan Vesely

Wayne L Smith

Daniel Burkhoff

Gregg Turi

Jean-Pierre LaLonde

Kallok, Michael J

Glen C Zillmer

Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes advancing a puncture device towards a heart, the puncture device including an energy delivery device; measuring an electrical impedance at the energy delivery device; delivering energy from the energy delivery device to at least partially puncture a pericardium; and repeating one or more of the above steps, if necessary, until the energy delivery device is located at least partially within the pericardial cavity. Some embodiments of the method include using supplemental means of monitoring, including measuring voltage to plot an ECG, medical imaging and using contrast fluid, using tactile feedback, and aspirating fluid.

Cardiac electrosurgery

The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method a tissue ablation device is provided and tissue in the antrum of the left atrium is ablated with the device. In an exemplary method, only tissue in the antrum is ablated, and the ablation is created by freezing tissue.

Wide area ablation of myocardial tissue

An implantable medical device is configured so that all of the major components including a housing and attached leads are disposed within the vasculature of a patient. A tether extends from the housing of the device to an implant location where the tether is secured to tissue outside of the vasculature. In this manner, an intravascular medical device may be implanted at a location remote from final placement, delivered via the vasculature and anchored at the initial entry point.

Intravascular medical device

A method and system is provided for responding, from internally within a patient, to an atrial arrhythmia in a heart including measuring from within the patient at least one electrocardiogram characteristic indicative of the atrial arrhythmia, and controlling from within the patient drug therapy delivery to the patient responsive to measuring the at least one electrocardiogram characteristic. Drug therapy is initiated to the patient responsive to measuring the at least one electrocardiogram characteristic. According to one aspect of the present invention, the drug therapy is staged within the patient prior to measuring the at least one electrocardiogram characteristic. According to another example embodiment, the heart is paced from within the patient at a predefined rate responsive to measuring the at least one electrocardiogram characteristic, pacing occurring alone, or in combination with drug therapy.

Method and system for terminating an atrial arrhythmia

An atrial defibrillator includes a portable, non-implantable housing, a pair of defibrillator pads, a shock generator, and an analyzer. The pads are applied to the outside of a patient's body, and the shock generator delivers a shock to the patient via the pads. The analyzer receives a cardiac signal from the patient, determines from the signal whether the patient is experiencing atrial fibrillation, and enables the shock generator if the patient is experiencing atrial fibrillation. Unlike conventional external atrial defibrillators, such an atrial defibrillator can be used by a layperson in the comfort of a patient's own home. Furthermore, such a defibrillator does not cause the surgery-related problems associated with implantable atrial defibrillators. Moreover, because the patient can choose when to receive a shock, such a defibrillator is less likely to surprise and embarrass the patient than automatic implantable defibrillators are.

External atrial defibrillator and method for personal termination of atrial fibrillation

A physiological pacing system including a physiological pacing lead having an electrode array and a means for fixation, including a collar for securing the fixation means to a lead body of the pacing lead, is inserted into a bore within a heart wall at a physiological pacing site. The system further includes a means to create the bore, the means being a piercing tip, which is either coupled to a piercing tool or the pacing lead. The piercing tool may be an elongated hollow shaft into which the pacing lead is slideably insertable or a stylet wire, which is slideably insertable within a lumen of the pacing lead. Once the electrode array is implanted within the bore, a first pair of electrodes is selected for sensing and a second pair of electrodes is selected for pacing.

Multipolar pacing method and apparatus

A cryocatheter for treatment of tissue has a tip adapted to provide a signal indicative of the quality and/or orientation of the tip contact with surrounding tissue. In one embodiment, a signal conductor extends through the catheter to the tip and connects to a thermally and electrically conductive shell or cap that applies an RF current to the region of tissue contacted by the tip. The tissue impedance path between the signal lead and a surface electrode mounted on the patient's skin is monitored to develop a quantitative measure of tissue contact at the distal tip, which is preferably displayed on the screen of a catheter monitoring console. In yet a further embodiment, the catheter is provided with a split tip having temperature monitoring sensors, such as thermistors, mounted on opposed halves of the tip so as to sense temperature on two sides of the catheter axis. The thermistor signals are processed to determine and display differential temperature between the two sides of the tip, thus revealing which side lies in contact. In yet a further aspect of the first embodiment, two separate and distinct high frequency electrical signals are applied to the two halves of a split metal shell or cap at the tip. Signals received at the surface electrode are filtered into first and second frequency components, and these are processed to determine the relative magnitude of the signal or the impedance of the path for each of the injected signals to determine and display the tissue contact orientation of the catheter. The catheter preferably has two separate cooling chambers within the cooling tip, positioned with one chamber on each side of the axis, and a separate cooling inlet to each chamber is switched on by a valve which directs the flow of coolant to the contact side during active cryotreatment. In another embodiment, the cap provides an RF electrode that may be opposed to the cooling side so that either the cryogenic or the RF ablation side may be rotated into contact to selectively heat or cool, or in representative protocol treat, then thaw, the same tissue site.

Catheter system

Catheter and system for monitoring tissue contact

Growing community of inventors

London, Canada

George J Klein