A controllable stiffness endoscope overtube includes an overtube shaft including an inner sheath defining an access lumen and an outer sheath surrounding the inner sheath from proximal to distal end of inner sheath to define an annulus therebetween having a proximal portion with a vacuum connection. The sheath distal ends are longitudinally fixed to one another and sized to receive an endoscope. The outer sheath has a constant outer diameter over at least a distal portion of the annulus proximate to the distal ends of the sheaths. A vacuum device is fluidically connected to the vacuum connection and applies vacuum to the annulus. Responsive thereto, annulus pressure is lowered, the sheaths are drawn together, and the overtube shaft is stiffened over at least the distal portion to stiffen and maintain a current shape of the overtube shaft over at least the distal portion of the annulus.

A self-contained, battery powered transseptal crossing system is disclosed. An elongate, flexible electrically conductive needle body has a proximal end and a distal end. An insulation layer surrounds the sidewall and leaves exposed a distal electrode tip. A generator is configured to deliver RF energy to the electrode tip, and includes a processor configured to take impedance measurements at the tip to confirm contact with the intra atrial septum and/or confirm entry into the left atrium.

Systems, devices, and methods for electroporation ablation therapy are disclosed, with a protection device for isolating electronic circuitry, devices, and/or other components from a set of electrodes during a cardiac ablation procedure. A system can include a first set of electrodes disposable near cardiac tissue of a heart and a second set of electrodes disposable in contact with patient anatomy. The system can further include a signal generator configured to generate a pulse waveform, where the signal generator coupled to the first set of electrodes and configured to repeatedly deliver the pulse waveform to the first set of electrodes. The system can further include a protection device configured to selectively couple and decouple an electronic device to the second set of electrodes.

Transducer-based systems can be configured to display a graphical representation of a transducer-based device, the graphical representation including graphical elements corresponding to transducers of the transducer-based device, and also including between graphical elements respectively associated with a set of the transducers and respectively associated with a region of space between the transducers of the transducer-based device. Selection of graphical elements and/or between graphical elements can cause activation of the set of transducers associated with the selected elements. Selection of a plurality of graphical elements and/or between graphical elements can cause visual display of a corresponding activation path in the graphical representation. Visual characteristics of graphical elements and between graphical elements can change based on an activation-status of the corresponding transducers. Activation requests for a set of transducers can be denied if it is determined that a transducer in the set of transducers is unacceptable for activation.

A medical device control handle has a first actuation assembly and a second actuation assembly, wherein each assembly has a shaft that is axially aligned but not rotationally coupled with the other shaft. The first actuation assembly includes a first actuation member and a clutch mechanism having a friction disk for generating frictional torque in rendering the first actuation member self-holding. The first actuation member has a cam portion adapted to impart translational motion and rotational motion for disengaging the clutch mechanism upon pivotation of the first actuation member, thus allowing rotation of the first shaft to manipulate a feature of the medical device, for example, deflection. The second actuation assembly includes a second actuation member and a translating member that is responsive to rotation of the second shaft so as to manipulate another feature of the medical device. The second actuation member is also self holding.

Transducer-based systems and methods may be configured to display a graphical representation of a transducer-based device, the graphical representation including graphical elements corresponding to transducers of the transducer-based device, and also including between graphical elements respectively associated with a set of the transducers and respectively associated with a region of space between the transducers of the transducer-based device. Selection of graphical elements and/or between graphical elements can cause activation of the set of transducers associated with the selected elements. Transducer activation characteristics, such as initiation time, activation duration, activation sequence, and energy delivery characteristics, can vary based on numerous factors. Visual characteristics of graphical elements and between graphical elements can change based on an activation-status of the corresponding transducers. Activation requests for a set of transducers can be denied if it is determined that a transducer in the set of transducers is unacceptable for activation.

Devices, systems, and methods of the present disclosure are directed to controlling distribution of electrical energy moving from an ablation electrode at a treatment site within a patient to a plurality of return electrodes on skin of the patient. Control over the distribution of electrical energy moving from the ablation electrode to the plurality of return electrodes can reduce or eliminate the need for manual intervention (e.g., repositioning the plurality of return electrodes on the skin of the patient, repositioning the patient, etc.) to achieve a suitable distribution of the electrical energy. Additionally, or alternatively, the devices, systems, and methods of the present disclosure can respond rapidly and automatically to changes in distribution of the electrical energy to reduce the likelihood and magnitude of inadvertent changes in the distribution of electrical energy over the course of a medical procedure.

In one embodiment, a medical procedure system includes a probe for insertion into a chamber of a heart of a living subject, and including a first electrode to apply a sequence of pacing pulses at a position in the chamber, a second electrode to sense an electrical activation signal responsively to electrical activations induced by capture of the pacing pulses in a myocardium of the chamber, a display, and processing circuitry to evaluate a successful acquisition by the second electrode of the induced electrical activations responsively to the electrical activation signal, the successful acquisition being indicative of a successful capture of the pacing pulses by the myocardium, compute a capture grade responsively to the evaluation of the successful acquisition of the induced electrical activations, the capture grade being indicative of a count of the induced electrical activations evaluated as being successfully acquired, and render the capture grade to the display.

A method for tissue assessment includes ablating tissue at a site within a body of a living subject using an invasive probe applied to the site. At a first stage in ablation of the tissue, first measurements are made of scattered light intensities from the site at a plurality of different wavelengths. At a second stage in the ablation of the tissue, subsequent to the first stage, second measurements are made of the scattered light intensities from the site at the plurality of different wavelengths. Progress of the ablation is assessed by computing different, respective measures of change in the scattered light intensities at the different wavelengths occurring between the first and second measurements, and comparing the respective measures.

A device, system, and method for treating an area of tissue and evaluating lesion formation and quality. The system may include a medical device having a plurality of mapping electrodes on a treatment element, the plurality of mapping electrodes being configured to record from the area of tissue at least one of unipolar impedance measurements, bipolar impedance measurements, local electrical activity, and pace threshold measurements before, during, and after circulation of the cryogenic fluid within the treatment element. These measurements may be transmitted to a control unit having processing circuitry configured to compare pre-treatment measurements, in-treatment measurements, and/or post-treatment measurements to each other and/or to threshold values to determine occlusion and/or lesion quality, such as lesion transmurality.