RAPID EXCHANGE BIAS LASER CATHETER DESIGN

Embodiments of a balloon biasing laser catheter are provided. In some embodiments, the laser catheter may include a distal tip that extends from the distal end of the catheter from a point near the light guide aperture. The distal tip may be disposed at the periphery of the catheter. In some embodiments, a balloon may be disposed between the light guide aperture and the distal tip, such that the a light guide extending from the aperture may be disposed proximate with the distal tip having the balloon in between. A retaining wire may be coupled with the distal tip and slidably coupled with the light guide. The retaining wire may keep the light guide biased relatively parallel with the distal tip and/or the catheter body when the balloon is inflated. The light guide may include a guidewire lumen the extends to the distal end of the distal tip.

Reentry catheter and method thereof

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port arranged on a exterior portion of the catheter configured to the receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space.

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal end and a distal end, and wherein the shaft includes an inner lumen running from the proximal end to the distal end to receive at least one of an implanted object and a mechanical traction device, the inner lumen defining a longitudinal axis of the shaft; a leading edge disposed at a distal portion of the tissue abrading device; and', 'an abrading tip, wherein the abrading tip is disposed adjacent to the leading edge, wherein the abrading tip includes at least one reciprocating grinder, the at least one reciprocating grinder having at least one abrasive surface, wherein the at least one reciprocating grinder is configured to be operatively coupled with an actuator, and wherein the at least one reciprocating grinder is configured to reciprocate in a direction relative to the shaft via an actuation force provided by the actuator; and', 'wherein the tissue abrading device is configured to wear a separation in a tissue growth along a side and a length of the tissue growth, and wherein the tissue slitting apparatus separates a first, but not a second, portion of the tissue growth around a circumference of the implanted object., 'a tissue abrading device disposed adjacent to the distal end of the ...

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Endocardial Lead Removing Apparatus

The invention provides an apparatus having a tubular member for receiving an endocardial lead implanted within a patient's body. Disposed generally at a distal end of the tubular member is at least one blade or cutting surface. An adjustment mechanism moves the blade between retracted and extended positions to engage the cutting surface with the endocardial lead to cut the lead. Once severed, the cut portion of the lead remains within an inner channel of the tubular member and the apparatus and cut portion of the lead are removed from within the patient. Various embodiments include the blade pivotally connected to the distal end of the tubular member and activated by a wire adjustment mechanism. Others include a metallic wire for slicing through the lead. Still others include a pneumatically actuated adjustment mechanism that inflates to move the blade and engage the cutting surface with the lead. 149-. (canceled)50. An endocardial lead removing apparatus for removing a lead implanted within a patient , comprising:a tubular member having a proximal end and a distal end;at least one blade pivotally connected to said distal end and moveable between a retracted position and an extended position; andan adjustment mechanism for pivoting said at least one blade between said retracted and extended positions.51. The apparatus of claim 50 , wherein said at least one blade is coupled to said distal end of said tubular member by at least one pin to pivot said at least one blade between said retracted and extended positions.52. The apparatus of claim 50 , wherein said adjustment mechanism includes an outer sheath receiving said tubular member and moveable longitudinally along said tubular member.53. The apparatus of claim 52 , wherein a distal end of said outer sheath engages said at least one blade to pivot from said retracted position to said extended position.54. The apparatus of claim 50 , wherein said adjustment mechanism includes a wire attached to said at least one blade ...

INNER AND OUTER TELESCOPING CATHETER DELIVERY SYSTEM

A catheter assembly employs an outer catheter with a pre-formed distal end and an open lumen. An inner catheter having an open lumen and a pre-formed distal end is movably disposed within the outer catheter. Relative rotation and extension of the inner and outer catheters provides the distal end of the catheter assembly with an adjustable range of two- and three-dimensional shapes. The inner catheter can include sections of varying stiffness, such that extension of the inner catheter within the outer catheter modifies the shape of the outer catheter's pre-formed distal end. One or both of the outer and inner catheters includes an occlusion balloon attached to the distal end thereof. The adjustable shaping of the catheter assembly's distal tip provides an improved system for locating and cannulating cardiac venous structures, particularly the coronary sinus via the right atrium. 1. A catheter assembly for accessing a destination vessel branching from a coronary sinus of a patient's heart , the catheter assembly comprising:an outer catheter having an open lumen and a pre-formed distal end defined by a plurality of curved sections and a generally straight distal tip section, all of the curved sections in the pre-formed distal end being oriented so as to assume the same general direction of curvature, the generally straight distal tip section extending from a distal-most curved section in a direction defined by the curvature of the distal-most curved section, the outer catheter further including an occlusion balloon attached to the distal end;an inner catheter having a lumen and a pre-formed distal end, the pre-formed distal end including at least two adjacent longitudinal sections of varying stiffness and a stiffness transition region between the at least two adjacent longitudinal sections of varying stiffness, at least a portion of the inner catheter including a braid covered by an exterior jacket, the inner catheter movably disposed within the open lumen of the outer ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and mechanical traction device; anda radiative energy emitting device disposed adjacent to the distal end of the shaft, wherein the radiative energy emitting device is configured to ablate a separation in a tissue growth along a side and a length of the tissue growth, and wherein the tissue slitting apparatus separates a first, but not a second, portion of the tissue growth around a circumference of the implanted object.2. The tissue slitting apparatus of claim 1 , wherein the radiative energy emitting device is configured to emit energy in the form of one or more of light claim 1 , thermal energy claim 1 , and electromagnetic energy.3. The tissue slitting apparatus of claim 1 , wherein the radiative energy emitting device further comprises:a laser light source configured to generate light energy; anda light guide, wherein the light guide is optically coupled to the laser light source, and configured to direct laser light toward the tissue growth.4. The tissue slitting apparatus of claim 3 , wherein the laser light source is configured to ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and mechanical traction device; anda tissue slitting tip disposed adjacent to the distal end of the shaft, wherein the tissue slitting tip is configured to separate a tissue growth along a side and a length of the tissue growth, and wherein the tissue slitting apparatus separates a first, but not a second, portion of the tissue growth around a circumference of the implanted object.2. The tissue slitting apparatus of claim 1 , wherein the tissue slitting tip further comprises:a leading edge disposed at a distal portion of the tissue slitting tip; andat least one sharp edge adjacent to the leading edge of the tissue slitting tip.3. The tissue slitting apparatus of claim 1 , wherein the tissue slitting tip is at least partially disposed within the distal end of the shaft claim 1 , and wherein the tissue growth is subjected to a slitting action about a partial periphery of an internal diameter of the tissue growth adjacent to and at least substantially surrounding the implanted object at any point along the implanted object.4. The tissue slitting ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and mechanical traction device; anda tissue abrading device disposed adjacent to the distal end of the shaft, wherein the tissue abrading device is configured to wear a separation in a tissue growth along a side and a length of the tissue growth, and wherein the tissue slitting apparatus separates a first, but not a second, portion of the tissue growth around a circumference of the implanted object.2. The tissue slitting apparatus of claim 1 , wherein the tissue abrading device further comprises:a leading edge disposed at a distal portion of the tissue abrading device; andan abrading tip, wherein the abrading tip is disposed adjacent to the leading edge, and wherein the abrading tip includes at least one abrasive surface.3. The tissue slitting apparatus of claim 2 , wherein the abrading tip is at least partially covered claim 2 , the partial covering disposed about the abrading tip to expose only a portion of the abrasive surface to the tissue growth.4. The tissue slitting apparatus of claim 2 , wherein the abrasive surface is manufactured ...

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

REENTRY CATHETER AND METHOD THEREOF

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port, arranged on an exterior portion of the catheter configured to receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space. 136-. (canceled)37. A rapid exchange catheter system , comprising:a shaft having an inner lumen and an exchange port fluidly coupled with the inner lumen, the exchange port arranged on a distal portion of the rapid exchange catheter system, and the inner lumen and the exchange port configured to receive a first wire; anda rigid shroud coupled to the shaft on the distal portion of the rapid exchange catheter system, the rigid shroud comprising a second lumen and a lateral port fluidly coupled with the second lumen, the second lumen and the lateral port configured to receive a second wire;wherein, as viewed from an end view of the rapid exchange catheter system, the exchange port is exterior of the rigid shroud.38. The rapid exchange catheter system of claim 37 , further comprising a cannula disposed within the lumen claim 37 , the cannula configured to extend from the lateral port and receive the second wire.39. The rapid exchange catheter system of claim 37 , wherein the exchange port is disposed proximally relative to the rigid shroud.40. The rapid exchange catheter system ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A device for slitting tissue , comprising: a proximal end;', 'a distal end comprising a top portion and a bottom portion, wherein the distal end is tapered from the top portion to the bottom portion, wherein the bottom portion is distal to the top portion, wherein the bottom portion is biased, thereby creating a left-facing biased bottom portion and a right-facing biased bottom portion;', 'an inner lumen running from the distal end and configured to receive at least one implanted object, wherein the inner lumen is parallel to a longitudinal axis running along the inner lumen of the shaft; and', 'a plurality of optical fibers carried by the shaft and exposed at the bottom portion of the distal end of the shaft, wherein at least one of the plurality of optical fibers is exposed from the left-facing biased bottom portion and another of the plurality of optical fibers is exposed from the right-facing biased bottom portion, and wherein the plurality of optical fibers transmit light energy at an angle relative to the longitudinal axis to ablate tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen., 'a shaft configured to be coupled to a laser light source, wherein the shaft is flexible, the shaft comprising2. The device of claim 1 , ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and mechanical traction device; anda tissue slitting tip disposed adjacent to the distal end of the shaft, wherein the tissue slitting tip is configured to separate a tissue growth along a side and a length of the tissue growth, and wherein the tissue slitting apparatus separates a first, but not a second, portion of the tissue growth around a circumference of the implanted object.247-. (canceled) The present application is a continuation of U.S. Application Ser. No. 13/828,231, filed Mar. 14, 2013, entitled “TISSUE SLITTING METHODS AND SYSTEMS,” now U.S. Patent No., which claims the benefit of and priority, under 35 U.S.C. § 119(e), to U.S. Provisional Application Ser. No. 61/701,521, filed Sep. 14, 2012, entitled “TISSUE SEPARATING METHODS AND SYSTEMS,” which are hereby incorporated herein by reference in their entireties for all that they teach and for all purposes.This application is also related to U.S. patent application Ser. Nos. 13/828,310 filed on Mar. 14, 2013, entitled, “Tissue Slitting Methods and Systems”; Ser. No. 13/828,383, ...

REENTRY CATHETHER AND METHOD THEREOF

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port arranged on a exterior portion of the catheter configured to the receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space. 1. A method for forming a pathway in an interstitial space within a blood vessel and lumen of the blood vessel , comprising the steps of:advancing a first wire into the interstitial space;advancing a rapid exchange catheter system over the first wire into the subintimal space;advancing a second wire down a central lumen of the rapid exchange catheter system; andadvancing the second wire through a lateral port of the rapid exchange catheter system into the lumen of the blood vessel.2. The method of claim 1 , further comprising the step of orientating the lateral port of the rapid exchange catheter to be aligned with the lumen of the blood vessel.3. The method of claim 2 , wherein the lateral port has an exit orientation arranged at about ninety degrees from a longitudinal axis of the catheter.4. The method of claim 1 , wherein the step of advancing the second wire comprises the steps of:advancing a cannula over the second wire into the lumen of the blood vessel; andadvancing a second wire through a lumen of cannula into the lumen of the blood vessel.5. The method of claim 1 ...

TISSUE SLITTING METHODS AND SYSTEMS

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A tissue slitting apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and mechanical traction device; anda fluid conveying device disposed adjacent to the distal end of the shaft, wherein the fluid conveying device is configured to separate a tissue growth along a side and a length of the tissue growth using a pressurized fluid.2. The tissue slitting apparatus of claim 1 , wherein the fluid conveying device further comprises:at least one fluid channel; andat least one port, operatively connected to the at least one fluid channel, wherein the at least one port is configured to direct the pressurized fluid in a direction toward a section of the tissue growth.3. The tissue slitting apparatus of claim 2 , wherein the at least one port further comprises a nozzle disposed at a distal end of the at least one port claim 2 , the nozzle having an inlet side and an outlet side claim 2 , and wherein the nozzle is configured to receive a fluid at a first pressure at the inlet side and increase the pressure of the fluid to a second pressure at the outlet side.4. The tissue slitting apparatus of claim 2 , wherein the ...

Cardiovascular imaging system

Embodiments of the present invention include a laser catheter that includes a catheter body, a light guide, and a distal tip that extends beyond the exit aperture of the light guide. In some embodiments, an imaging device is disposed on the distal tip such that the imaging device is distal relative to the exit aperture of the light guide. In some embodiments, the imaging device can be gated to record images during and/or slightly beyond periods when the laser catheter is not activated.

RF ablation apparatus and method having electrode/tissue contact assessment scheme and electrocardiogram filtering

A method of assessing the adequacy of contact between an ablation electrode and biological tissue within a biological organ having biological fluid therein includes the steps of positioning the ablation electrode proximal the biological tissue; positioning a reference electrode a distance from the ablation electrode; measuring the impedance between the ablation electrode and the reference electrode at a first frequency and measuring the impedance between the ablation electrode and the reference electrode at a second frequency. The percentage difference between the first-frequency impedance and the second-frequency impedance provides an indication of the state of electrode/tissue contact. In general, a percentage difference of at least approximately 10% serves as an indication of substantially complete electrode/tissue contact. A percentage difference in the approximate range between 5% and 10% serves as an indication of partial electrode/tissue contact. A percentage difference less than approximately 5% serves as an indication of no electrode/tissue contact. Ratiometric measurements may also be used to assess the state of electrode/tissue contact.

System and method for assessing electrode-tissue contact and lesion quality during RF ablation by measurement of conduction time

The efficacy of a lesion produced between a pair of ablation electrodes is assessed by analyzing the time it takes for a pulse of energy to travel from one electrode to the other. During a first time period, a first pulse of energy is applied to a first electrode. The time it takes for the pulse to conduct through the tissue to a second electrode is determined. During a time period subsequent to the first time, a subsequent pulse of energy is applied to the first electrode and the time it takes for the subsequent pulse to conduct through the tissue to the second electrode is determined. Changes in the conduction times are monitored by calculating the difference between consecutive conduction times and comparing the difference to a preset value. If the difference is below the preset value the lesion is considered adequate.

Endocardial lead removing apparatus

Steerable catheter with preformed distal region and method for use

A catheter has a stylet formed of a shape-retentive and resilient material having a preformed curved shape at its distal end resulting in the catheter sheath having the preformed curved shape. The catheter sheath has a plurality of electrodes at its distal end for contacting selected biological tissue for imparting ablation energy thereto. The catheter sheath also has an axially mounted tendon for causing deflection of the distal end. The stylet material permits straightening the catheter sheath during insertion into the patient and advancing the electrodes to the target tissue. Upon removal of the straightening forces, such as by entry into a chamber of the heart, the stylet material resumes its preformed curved distal shape thereby forcing the catheter distal end withthe electrodes into the same preformed curved shape. The operator may place the curved distal end into contact with the target tissue and axially move the tendon as desired to gain greater control over the bend in the distal end of the catheter sheath to adjust the radius of curvature of the distal end to obtain greater contact of the electrodes with the heart tissue. Preferably, the stylet is formed of nitinol.

Lead locking device and method

A lead locking device has a lead engaging member with a mandrel extending along a lumen and attached to the distal end of the lead engaging member such that it extends beyond the proximal end of the lead engaging member. The lead locking device also has a loop handle attached to the proximal end of the mandrel. The lead engaging member has a first configuration which is narrower than a second configuration and is sufficiently long to extend along substantially the entire length of a lead to be removed from a patient's body. At the distal end, a spring coil is disposed around a tapered section of the mandrel to improve tracking of the lead locking device through the inner lumen of a pacing or defibrillator lead.

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Steerable catheter with torque transfer system

A catheter (20) includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, and a torque transfer system at the distal portion to enhance torque transfer from the handle to the distal tip. The steering mechanism includes two steering tendons (54, 56). The steering tendons are attached to the distal-end region (24) of the catheter. The steering tendons may be located approximately angularly aligned, thus causing the deflection profiles to be unidirectional. Alternatively, the steering tendons may be located angularly separated from each other, thus causing the deflection profiles to be bidirectional. The torque transfer system may include a flat ribbon (124) within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter. An electrode (34) may be located in the distal-end region (24).

Improved lead locking device

A lead locking device has a lead engaging member with a mandrel extending along a lumen and attached to the distal end of the lead engaging member such that it extends beyond the proximal end of the lead engaging member. The lead locking device also has a loop handle attached to the proximal end of the mandrel. The lead engaging member has a first configuration which is narrower than a second configuration and is sufficiently long to extend along substantially the entire length of a lead to be removed from a patient's body. At the distal end, a spring coil is disposed around a tapered section of the mandrel to improve tracking of the lead locking device through the inner lumen of a pacing or defibrillator lead.

Steerable catheter with torque transfer system

A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, and a torque transfer system at the distal portion to enhance torque transfer from the handle to the distal tip. The steering mechanism includes two steering tendons. The steering tendons are attached to the distal-end region of the catheter. The steering tendons may be located approximately angularly aligned, thus causing the deflection profiles to be unidirectional. Alternatively, the steering tendons may be located angularly separated from each other, thus causing the deflection profiles to be bidirectional. In other aspects, the torque transfer system includes a flat ribbon within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter.

Apparatus and methods for directional delivery of laser energy

In some embodiments, without limitation, the invention comprises a catheter (10) having an elongated housing (12) with a channel disposed therein. A laser delivery member is movable and at least partially disposed within the channel. A ramp (20) is adapted to move the distal end of the laser delivery member outwardly from the central axis odf the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the the extent to which the laser delivery member travels on the ramp (20), and disposition of the laser delivery member on the guide wire maintains the offset tip substantially apralell to the central axis of the housing., thus, in accordance with the invention, the distal end of the laser delivery member may be biased ina desired direction or offset, permitting ablation of an area larger than an area of the distal end (16) of the catheter (10).

Ablation catheter with covered electrodes allowing electrical conduction therethrough

A surface covering including a primary layer of a porous polymer structure and a secondary surface covering one or both of a metallic element layer and a hydrophilic layer is positioned over the surface of an ablation electrode. The pores of the surface covering are sized such that blood platelets are prevented from contacting the surface of the electrode while physiological fluid is allowed to pass through and contact the electrode surface to hereby provide a conduction path for current from the electrodes. The surface covering may further include an electrically non-conductive and thermally conductive portion positioned over another portion of the electrode to prevent alternate or non-intended site ablations.

Endocardial lead removing apparatus

The invention provides an apparatus having a tubular member for receiving an endocardial lead implanted within a patient's body. Disposed generally at a distal end of the tubular member is at least one blade or cutting surface. An adjustment mechanism moves the blade between retracted and extended positions to engage the cutting surface with the endocardial lead to cut the lead. Once severed, the cut portion of the lead remains within an inner channel of the tubular member and the apparatus and cut portion of the lead are removed from within the patient. Various embodiments include the blade pivotally connected to the distal end of the tubular member and activated by a wire adjustment mechanism. Others include a metallic wire for slicing through the lead. Still others include a pneumatically actuated adjustment mechanism that inflates to move the blade and engage the cutting surface with the lead.

Apparatus and methods for directional delivery of laser energy

In some embodiments, without limitation, the invention comprises a catheter have an elongated housing with a channel disposed therein. A laser delivery member is moveable and at least partially disposed within the channel. A ramp is disposed within the housing at an angle to its central axis and proximate to its distal end. The ramp is adapted to move the distal end of the laser delivery member outwardly from the central axis of the housing. A guidewire biases the distal end of the laser delivery member generally inwardly toward the central axis of the housing. In some embodiments, without limitation, the offset of the central axis of the tip of the laser delivery member from the central axis of the housing is determined by adjusting the extent to which the laser delivery member travels on the ramp, and disposition of the laser delivery member of the guidewire maintains the offset tip substantially parallel to the central axis of the housing. Thus, in accordance with the invention, the distal end of the laser delivery member may be biased in a desired direction or offset, permitting ablation of an area larger than the area of the distal end of the catheter.

Steerable catheter with shaft support system for resisting axial compressive loads

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.