Ablation electrode assemblies include an inner core member and an outer shell surrounding the inner core member. The inner core member and the outer shell define a space or separation region therebetween. The inner core member is constructed from a thermally insulative material having a reduced thermal conductivity. In an embodiment, the space is a sealed or evacuated region. In other embodiments, irrigation fluid flows within the space. The ablation electrode assembly further includes at least one thermal sensor in some embodiments. Methods for providing irrigation fluid during cardiac ablation of targeted tissue are disclosed that include calculating the energy delivered to irrigation fluid as it flows within the ablation electrode assembly through temperature measurement of the irrigation fluid. Pulsatile flow of irrigation fluid can be utilized in some embodiments of the disclosure.

Aspects of the present disclosure are directed to flexible high-density mapping catheters with a high-density array of mapping electrodes. These mapping catheters may be used to detect electrophysiological characteristics of tissue in contact with the electrodes, and may be used to diagnose cardiac conditions, such as cardiac arrhythmias for example.

The present disclosure provides embodiments of devices that are useful in the structural remodeling of various parts of the cardiovascular system, most notably the heart. Certain of the disclosed devices relate to RAMIN procedures (“remodeling and ablation using myocardial interstitial navigation”). RAMIN procedures, as described herein, represent a new family of non-surgical catheter-based procedures in order to accomplish ablation, drug delivery, re-shaping, pacing, and related structural heart interventional procedures, as desired.

Apparatuses and methods are disclosed for the perforation of a communication between the aorta and left atrium. The method includes introducing the apparatus, positioning the apparatus at a location along the aorta, and energizing the apparatus to create a perforation. For example, one method may include: introducing a flexible wire into the left atrium, advancing a dilator along the flexible wire to position the flexible wire adjacent a selected location along the aorta and energizing the flexible wire to create a perforation from the left atrium into the aorta.

A method for ablating a patient, consisting of ascertaining a CHA.sub.2DS.sub.2-VASc score for the patient and inserting a probe into the patient, so as to contact a pulmonary vein of the patient. The method further includes applying energy via the probe so as to ablate the pulmonary vein until pulmonary vein isolation (PVI) is achieved. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is less than a preset value, ablation of the pulmonary vein is ceased. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is greater than or equal to the preset value, energy is applied to perform a further ablation.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for electroporation ablation. The electroporation catheter may include an electrode assembly comprising one or more ablation electrodes configured to generate electric fields proximate to target tissue in response to a plurality of electrical pulse sequences delivered in a plurality of therapy sections, and one or more mapping electrodes configured to measure cardiac electrical signals. In some embodiments, the measured electrical signals are used to create an electro-anatomical map.

The disclosed invention provides a transseptal insertion device which is suitable for facilitating precise and safe transseptal puncture of a cardiac interatrial septum. The transseptal insertion device includes a sheath that defines at least one lumen therein, one or more positioning balloons that are connected to a distal end of the sheath, a puncture member movably positioned within the at least one lumen, and a puncture member balloon located on the puncture member. The sheath has one or more deflation ports to deflate the one or more positioning balloons. The puncture member balloon, when inflated, is capable of sealing the one or more deflation ports in the sheath, permitting the inflation of the one or more positioning balloons. When the puncture member moves toward fossa ovalis, the inflated puncture member balloon moves away from the deflation ports, allowing the positioning balloons to be deflated.

The disclosed technology includes a medical probe including a tubular shaft having an expandable basket assembly coupled to a distal end of the tubular shaft. The basket assembly can have at least one spine extending along a longitudinal axis and configured to bow radially outward from the longitudinal axis when the basket assembly is transitioned from a collapsed form to an expanded form. The basket assembly can include electrode assemblies each attached to the spine. Each electrode assembly includes an electrode and a first and second electrically insulating portion that electrically isolate the electrode from the spine. The electrode, the first electrically insulating portion, and the second electrically insulating portion are interlocked onto the spine such that the plurality of electrode assemblies are prevented from sliding proximally or distally along a length of the spine.

The disclosed technology includes a medical probe comprising a tubular shaft having a proximal end and a distal end, the tubular shaft extending along a longitudinal axis. The medical probe further comprises an expandable basket assembly coupled to the distal end of the tubular shaft. The basket assembly includes a plurality of electrodes with each electrode of the plurality of electrodes having a lumen therethrough. The basket assembly further includes a plurality of spines extending along the longitudinal axis and configured to bow radially outward from the longitudinal axis when the expandable basket assembly is transitioned from a collapsed form to an expanded form. Each spine includes a proximal and a distal end and a strut passing through the lumen of an electrode. The strut includes a mechanical retainer disposed on the strut to prevent the electrode from sliding proximally or distally along a length of the spine.

The disclosed technology includes a medical probe comprising a tubular shaft extending along a longitudinal axis and including a proximal end and a distal end. The medical probe further comprises an expandable basket assembly proximate the distal end of the tubular shaft. The basket assembly comprises a plurality of C-shaped spines and one or more electrodes coupled to each of the spines, each electrode defining a lumen through the electrode so that a spine extends through the lumen of each of the one or more electrodes. The spines converge at a central spine intersection at a distal end of the basket assembly. Each spine comprises a respective end connected to the distal end of the tubular shaft.