Embodiments of the present disclosure provide a grounding cuff having a flexible body and an inflatable bladder disposed within the flexible body. The inflatable body is configurable to an inflated state and a deflated state. In the inflated stated, the inflatable bladder applies pressure to the grounding cuff to provide and maintain improved contact between the ground cuff and skin of a patient. Additionally, the inflatable bladder includes an inlet configured to receive a fluid from a hose, the inflatable bladder configured to the inflated state based on the fluid received via the hose. The grounding cuff may include a grounding pad coupled to a ground terminal to extract energy from the patient during a medical therapy, such as ablation therapy. The inflatable bladder may be configured to the inflated state to promote strong contact between the grounding pad and skin of the patient.

Provided herein are catheter devices, systems, and methods to ablate a tissue location. The devises, systems, and methods disclosed herein include ablation systems including a catheter system with inner and outer shafts that deliver an ablation medium (e.g., a cryogenic ablation medium) to a body lumen and evacuate the ablation medium from the body lumen. In some embodiments, devices, systems, and methods disclose herein include expandable structures that facilitate in positioning of nozzles and/or evacuation of ablation medium from a body lumen.

A sub-microsecond pulsed electric field generator is disclosed. The field generator includes a controller, which generates a power supply control signal and generates a pulse generator control signal, and a power supply, which receives the power supply control signal and generates one or more power voltages based on the received power supply control signal. The field generator also includes a pulse generator which receives the power voltages and the pulse generator control signal, and generates one or more pulses based on the power voltages and based on the pulse generator control signal. In some embodiments, the controller receives feedback signals representing a value of a characteristic of or a result of the pulses and generates at least one of the power supply control signal and the pulse generator control signal based on the received feedback signals.

An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the bipolar electrosurgical instrument. The electrosurgical generator is arranged to supply RF energy through the bipolar electrosurgical instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.

Apparatus, consisting of a probe configured to be inserted into contact with a myocardium, and an electrode attached to the probe. A temperature sensor, incorporated in the probe, is configured to output a temperature signal. A pump irrigates the myocardium, via the probe, with an irrigation fluid at a controllable rate, and a radiofrequency (RF) signal generator applies RF power via the electrode to the myocardium, so as to ablate the myocardium. The apparatus also has processing circuitry that measures a temperature of the probe, based on the temperature signal, while the RF power is applied and, when the measured temperature exceeds a preset target temperature, iteratively reduces the RF power applied by the signal generator and concurrently iteratively varies a rate of irrigation of the irrigation fluid provided by the pump, until the measured temperature is reduced to the preset target temperature.

A catheter ablation system includes: a catheter probe having distal end including: a temperature sensor; a plurality of irrigation holes; and an ablating electrode; a radiofrequency (RF) heating controller coupled to the catheter probe and configured to supply RF energy to the ablating electrode to control the ablating electrode to emit heat at a target power; an irrigation controller coupled to the catheter probe and configured to supply an irrigation fluid at a continuously adjustable irrigation flow rate through the catheter probe to exit through the irrigation holes; and an operating console having a processor and memory, the memory storing instructions that, when executed by the processor, cause the processor to control the irrigation controller to set the irrigation flow rate based on the target power and a target average temperature.

Control systems and methods for delivery of energy that may include control algorithms that prevent energy delivery if a fault is detected and may provide energy delivery to produce a substantially constant temperature at a delivery site. In some embodiments, the control systems and methods may be used to control the delivery of energy, such as radiofrequency energy, to body tissue, such as lung tissue.

Apparatus, consisting of a probe, containing a lumen and having a distal end configured to contact tissue of a living subject. A temperature sensor is located at the distal end, and a pump, having a pump motor, is coupled to deliver a cryogenic fluid through the lumen to the distal end of the probe and to receive the cryogenic fluid returning from the probe. There is a separator, coupled to separate the returning cryogenic fluid into a returning cryogenic liquid and a returning cryogenic gas, and a flow meter, coupled to measure a rate of flow of the returning cryogenic gas. A processor is configured to control a rate of pumping of the pump motor in response to a temperature measured by the temperature sensor and the rate of flow of the returning cryogenic gas.

A method for use with an intra-body probe, a distal end of which includes an ablation electrode and a temperature sensor, is described. While (i) the ablation electrode is driving an ablating current into tissue of a subject, and (ii) fluid is passed from the distal end of the intra-body probe at a fluid-flow rate, a processor receives a temperature sensed by the temperature sensor. The processor estimates a temperature of the tissue, based at least on the sensed temperature and at least one parameter selected from the group consisting of: the fluid-flow rate, and a parameter of the ablating current. The processor generates an output in response to the estimated temperature. Other embodiments are also described.

Temperature sensing catheters and systems that can be used during cardiac ablation procedures to measure and monitor temperatures, and the rate and spread of temperature changes in the heart. The temperature data can be used to calculate temperature gradients, which may be used to estimate if and when certain regions of heart may undergo injury due to thermal exposure. The temperature data can be used to limit or cut-off power delivery to an ablation catheter, or otherwise modify the ablation procedure, to prevent injury to certain regions of heart. In some cases, the temperature data is used to control aspects of the ablation in a feedback loop control scheme.