A medical device includes a guidewire extending between a proximal portion defining a proximal end and a distal portion defining a distal end. The distal portion includes a radially expandable part, and the guidewire is movable between a retracted configuration in which the part is radially retracted and an expanded configuration in which the part is radially expanded. The part is radiopaque.

Electrosurgical pericardiotomy devices are disclosed. An example electrosurgical pericardiotomy device configured to create an opening through a pericardium may include an end effector comprising a tip portion and at least one electrosurgical electrode. The tip portion may include an opening configured to engage a target portion of a pericardium, and the tip portion may be configured, upon application of vacuum to the tip portion, to separate the target portion of the pericardium from an external surface of a heart. The electrosurgical electrode may be disposed proximate the tip portion so that, with vacuum applied to the tip portion, the target portion of the pericardium contacts the electrosurgical electrode. The electrosurgical electrode may be configured to create an opening through the target portion of the pericardium using electrosurgical energy.

Surgical devices and related methods are disclosed. An example end effector for a surgical device may include a first jaw, a second jaw, and an articulating mechanism operable to move the first jaw between an open position, an intermediate position, and a closed position. An example articulating mechanism may include a first jaw mount coupled to the first jaw so that movement of the first jaw mount along a path causes rotation and translation of the first jaw mount and the first jaw. A pivotably mounted crank may operably couple an actuator linkage to the first jaw mount so that moving the actuator linkage rotates the crank, and rotation of the crank may move the first jaw mount along the path.

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 system of medical devices includes a puncture device and an introducer. The puncture device extends from a puncture device proximal end to a puncture device distal end. The puncture device includes a radiofrequency puncture electrode at the puncture device distal end. The electrode is radiopaque. The introducer extends between an introducer proximal end and an introducer distal end. The introducer has a lumen extending therethrough from the introducer proximal end to the introducer distal end. The introducer includes at least a first radiopaque marker associated with the introducer distal end. The puncture device is advanceable through the lumen from the introducer proximal end towards the introducer distal end to position the puncture device in a puncture position in which the radiofrequency puncture electrode is proud of the introducer distal. When the puncture device is in the puncture position, the electrode is spaced distally from the first radiopaque marker.

A system includes a pulse waveform generator and an ablation device coupled to the pulse waveform generator. The ablation device includes at least one electrode configured for ablation pulse delivery to tissue during use. The pulse waveform generator is configured to deliver voltage pulses to the ablation device in the form of a pulsed waveform. The pulsed waveform can include multiple levels of hierarchy, and multiple sets of electrodes can be activated such that their pulsed delivery is interleaved with one another.

An apparatus and methods for performing ablation of myocardial tissues are disclosed. The apparatus includes a plurality of ablation electrode configurations to which nanosecond pulsed electric fields are applied. The methods relate to therapies to treat cardiac arrhythmias, such as, atrial fibrillation and scar-related ventricular tachycardia, amongst others. The affected myocardial tissues are ablated creating a plurality of lesions enabled by the nanosecond pulsed electric fields applied to either penetrating electrodes, endo-endo electrodes, or endo-epi electrodes. Different electrophysiological tests are performed to assess the application of nanosecond pulsed electric field ablation to specific desired tissue location within the heart. Test results show the potential to overcome limitations of current ablation therapies, thereby providing patients and doctors a superior treatment for cardiac arrhythmias.

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.

An elongated medical needle includes an electrically-insulated elongated body having an outer surface extending between an electrically-insulated distal section and an electrically-insulated proximal section. An insulated electrically-conductive wire is aligned proximately along the outer surface between the electrically-insulated distal section and the electrically-insulated proximal section. An exposed electrically-conductive portion is mounted at the electrically-insulated distal section. The exposed electrically-conductive portion is electrically connected to the insulated electrically-conductive wire.

The devices and method described herein allow for therapeutic damage to increase volume in these hyperdynamic hearts to allow improved physiology and ventricular filling and to reduce diastolic filling pressure by making the ventricle less stiff. For example, improving a diastolic heart function in a heart by creating at least one incision in cardiac muscle forming an interior heart wall of the interior chamber where the at least one incision extends into one or more layers of the interior heart wall without puncturing through the interior heart wall and the incision is sufficient to reduce a stiffness of the interior chamber to increase volume of the chamber and reduce diastolic filing pressure.