A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

A method of monitoring a patient for phrenic nerve collateral damage during a cardiac ablation procedure. The method includes measuring at least one from the group consisting of compound motor action potential (CMAP) and accelerometer signals in response to stimulating of the phrenic nerve. Real-time data is displayed on a display, the real-time data including the at least one from the group consisting of the measured CMAP and accelerometer signals. Long-term trend data is simultaneously displayed on the display, the long-term trend data being associated with the measured at least one from the group consisting of CMAP and accelerometer signals.

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.

RF tissue ablation devices are provided. Aspects of the RF tissue ablation devices include an elongated member having a proximal and distal end, first and second jaws at the distal end, wherein the first and second jaws are configured to apply intra and inter RF energy to tissue disposed between the jaws during use, and a connector at the proximal end for operatively connecting to a RF energy source. Also provided are systems that include an RF tissue ablation device operatively coupled to a RF energy source, as well as kits that include the devices and methods of using the devices in RF tissue ablation applications, including cardiac applications.

Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

Treating patients with therapeutically effective electroporation requires the use of voltage potentials which when applied to the patient can be painful due to the noxious overstimulation of the afferent pain-receptive nerve fibres. An electrode assembly which includes electrodes for applying effective electroporation voltages, also comprises at least one electrode configured to apply a non-noxious, non-painful electrical stimulation which may be referred to as a “nerve block adjacent to the electroporation site.

Systems, devices, and methods for electroporation ablation therapy are disclosed, with the device including a set of splines coupled to a catheter for medical ablation therapy. Each spline of the set of splines may include a set of electrodes formed on that spline. The set of splines may be configured for translation to transition between a first configuration and a second configuration. The devices described herein may be used to form a lesion via focal ablation.

A medical apparatus includes a probe configured for insertion into a body of a patient and including a plurality of electrodes configured to contact tissue within the body. An electrical signal generator applies bipolar trains of pulses having a voltage amplitude of at least 200 V and having a duration of each of the bipolar pulses less than 20 μs between at least one pair of the electrodes in contact with the tissue, thereby causing irreversible electroporation of the tissue between the at least one pair of the electrodes. One or more electrical sensors sense an energy dissipated between the at least one pair of the electrodes during the trains of the pulses. A controller controls electrical and temporal parameters of the trains of the pulses applied by the electrical signal generator, responsively to the one or more electrical sensors, so that the dissipated energy satisfies a predefined criterion.