Methods and apparatuses are described herein for inactivation of bacterial biofilms using sub-microsecond pulsed electric field application to an affected surface or region. In some examples, a bacterial biofilm may be inactivated while planktonic bacteria in the vicinity of the biofilm are not inactivated. These methods and systems provide an electrical-based therapeutic modality for which bacteria in biofilms may have difficulty developing resistance, unlike antibiotic therapies.

A system includes a processor circuit in communication with an intraluminal imaging device and a laser atherectomy device. An intraluminal imaging procedure is performed within a lumen with the intraluminal imaging device. The processor circuit receives the intraluminal images acquired. The intraluminal images are analyzed to determine a tissue classification for each intraluminal image. One or more laser atherectomy settings are determined for each intraluminal image based on the tissue classification. The intraluminal images and corresponding tissue classifications and laser atherectomy settings are then associated with the location at which each intraluminal image was acquired along the lumen. A laser atherectomy procedure is then performed within the same lumen. As the laser atherectomy device is moved to positions within the vessel, the laser atherectomy setting associated with each position is retrieved from the memory and automatically applied to the laser atherectomy device.

An electrosurgical generator is presented including a radio frequency (RF) amplifier coupled to an electrical energy source and configured to generate electrosurgical energy, the RF amplifier including an inverter configured to convert a direct current (DC) to an alternating current (AC), and a plurality of sensors configured to sense voltage and current of the generated electrosurgical energy. The electrosurgical generator further includes a controller coupled to the RF amplifier and the plurality of sensors. The electrosurgical may be further configured to determine a power level based on the sensed voltage and the sensed current, determine an efficiency of the electrosurgical generator, and insert a predetermined integer number of off cycles when the efficiency of the electrosurgical generator reaches a threshold power efficiency.

Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

Methods and system are provided to mitigate RF interferences during operation of an electrosurgical system. An electrosurgical system configured to output therapeutic RF energy may refrain from outputting RF energy in order to measure an RF interference for a group of candidate frequencies, and to select a frequency from the group of candidate frequencies for which the measured RF interference is below a threshold value, and to produce a feedback signal (a control signal) at the selected frequency to control operation of the electrosurgical system. During operation of the electrosurgical system the feedback signal may be filtered by a BPF whose fundamental frequency is set to the selected frequency, to thus obtain an interference free feedback signal and, consequently, a reliable control of the electrosurgical system.

Treatment systems are provided, which comprise a treatment element applying a treatment to a tissue, a stimulation element optically stimulating nerves in the tissue, a sensing unit sensing an electrical signal produced by nerves in the tissue in response to the optical stimulation, and a control unit controlling the application of the treatment according to the sensed signal. The systems and methods are used to avoid damaging nerves by sensing them during operation and immediately before local treatment application and preventing energy emission when the treatment tool is too close to specified nerves. Additional electric stimulation may be provided to enable avoidance of nerve damages on a larger scale, the treatment may be applied by a cold laser, and the control unit may control the treatment in realtime and in a closed loop and immediate prevent further treatment upon sensing optically stimulated nerves.

Aspects of the present disclosure are presented for managing simultaneous outputs of surgical instruments. In some aspects, methods are presented for synchronizing the current frequencies. In some aspects, methods are presented for conducting duty cycling of energy outputs of two or more instruments. In some aspects, systems are presented for managing simultaneous monopolar outputs of two or more instruments, including providing a return pad that properly handles both monopolar outputs in some cases.

An electrophysiology catheter is disclosed having a balloon with a membrane. Electrodes may be disposed on the membrane. Each electrode may include a radiopaque marker. The markers may have different forms, e.g., alphanumeric or polygonal, to facilitate visualization of the electrodes using a bi-stable image and allow for selection of the appropriate electrodes to be energized during ablation of tissue. The inventive subject matter allows for proper orientation of electrodes on the balloon under a two-dimensional imaging system. This allows the operator or physician to determine if certain electrodes are adjacent or contiguous to the posterior surface of the left atrium and ablate such posterior surface for shorter duration or at a lower power to create an effective transmural lesion on the posterior wall of the left atrium while reducing the chances of damaging the adjacent anatomical structures.

A ratio of reversible electroporation and irreversible electroporation may be controlled by selecting a symmetric waveform or asymmetric waveform to either minimize or enhance irreversible effects on cells in the target tissue. Combined reversible and irreversible electroporation includes inserting one or more therapeutic electrodes into a target tissue, introducing an electroporation compound into the target tissue, selecting a pulse waveform that is either 1) asymmetric bipolar that has positive and negative pulses with different durations, or 2) symmetric bipolar that has positive and negative pulses with the same duration, and delivering to the target tissue a series of electrical pulses having the selected pulse waveform.

A connector is configured to electrically connect a plasma emitter array with an identification chip to a power supply controller, and to further mechanically support the emitter device supporting the array during use. Cooperating components of the connector and emitter device form a magnetic latch assembly: the connector includes one or more magnets flush with a top receiving surface of the connector, and one or more alignment pegs extending outward from the receiving surface; the emitter device includes a steel plate attached to a substrate, and one or more holes disposed through the plate and the substrate. The holes align with the alignment pegs and the magnets attract the plate and secure the emitter device against the top receiving surface. Electrical contacts of the connector establish electrical communication with the identification chip, providing power to the emitter device and enabling the controller to read data stored in the identification chip.