The invention relates to an auxiliary instrument for insertion into vessels or lumens with small inner diameters. The auxiliary instrument has a proximal end and a distal end and has at least one localization element whose position and orientation can be determined with an electromagnetic position detection system. The localization element is located directly adjacent to or at least close to the distal end of the auxiliary instrument and is configured to capture an alternating electromagnetic field. A distal end region of the auxiliary instrument extends from the distal end of the auxiliary instrument to a proximal end of the localization element such that the localization element is located within the distal end region. In that part of the distal end region in which the localization element is located, the auxiliary instrument has a low bending stiffness of less than 10 Nmm.sup.2, at least in sections. At least two lines are led from the localization element to the proximal end of the auxiliary instrument and are electrically conductively connected at least to the localization element. The localization element has a length with an amount that is at least ten times the amount of an outer diameter of the localization element.

The invention relates to a cardiac lead extraction system, comprising: a handle; an elongated body in communication with said handle; a bendable flexible portion in communication with said elongated body, said bendable flexible portion comprising a first lumen sized and shaped to fit over a cardiac lead; said bendable flexible portion being more flexible than said elongated body; an operational distal end in communication with said bendable flexible portion; where said bendable portion is configured to bend to a bending radius of less than 4 cm while keeping said first lumen open; and where said operational distal end comprises at least one lead extraction assistive tool, said operational distal end comprising a second lumen sized and shaped to fit over a cardiac lead, said second lumen being in communication with said first lumen, and said first lumen comprises an inner diameter of from about 1 mm to about 5 mm.

A catheter includes an expandable frame for insertion into an organ of a patient, one or more first electrodes, and a second electrode. The one or more first electrodes are disposed on the expandable frame at one or more first positions for placing in contact with a target tissue of the organ, and are configured to perform one or both of: (i) sensing one or more electrical signals from the target tissue, and (ii) applying one or more ablation pulses to the target tissue. The second electrode is disposed within an internal volume of the expandable frame, at a second position that is not in contact with the target tissue while the one or more first electrodes contact the target tissue, and is configured to serve as a return or common electrode for the electrical signals.

Body tissue ablation is carried out by inserting a probe into a body of a living subject, urging the probe into contact with a tissue in the body, generating energy at a power output level, and transmitting the generated energy into the tissue via the probe. While transmitting the generated energy the ablation is further carried out by determining a measured temperature of the tissue and a measured power level of the transmitted energy, and controlling the power output level responsively to a function of the measured temperature and the measured power level. Related apparatus for carrying out the ablation is also described.

A method of displaying electrophysiology information includes obtaining a three-dimensional medical image of an anatomical region, registering a localization system to the model; localizing an electrophysiology catheter within the anatomical region; displaying a representation of the localization of the electrophysiology catheter on the model; and displaying image slices of the model. The image slices are selected based upon the localization of the electrophysiology catheter. For example, the image slices can pass through a user-selected localization element carried by the electrophysiology catheter. Rigid and/or non-rigid transforms can be used to register the localization system to the model. Electrophysiology data collected by the catheter can be displayed on the model and/or the image slices thereof. The three-dimensional medical image and/or the electrophysiology data can also be time-varying. In embodiments, scalar maps can also be displayed on the model.

An introducer may comprise a shaft and a proximal electrode. The shaft may have a proximal end portion and an interior lumen, the interior lumen configured to receive a catheter therethrough. The proximal electrode may be coupled with the proximal end portion and may be configured to act as an electrical source or sink so as to create an electrical field within the interior lumen. A position of an electrode coupled with the catheter may be determined according to the electrical field.

A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

A system and method are provided for determining electrophysiological data. The system comprises an electronic control unit that is configured to receive electrical signals from a set of electrodes, receive position and orientation data for the set of electrodes from a mapping system, compensate for position and orientation artifacts of the set of electrodes, compose cliques of a subset of neighboring electrodes in the set of electrodes, determine catheter orientation independent information of a target tissue, and output the orientation independent information to a display. The method comprising receiving electrogram data for a set of electrodes (80), compensating for artifacts in sensor positions in the mapping system (81), resolving the bipolar signals into a 3D vector electrogram in the mapping system coordinates (82), manipulating observed unipolar voltage signals and the tangent component of the e-field to estimate the conduction velocity vector (83), and outputting the catheter orientation independent information (84).

A method is provided. The method is implemented by an interface engine stored as processor executable code on a memory coupled to a processor. The method includes aggregating data from completed cases, analyzing the data for accuracy, consistency, or error within or across the one completed cases, and generating one or more grades based on the analysis of the data. Note that the data includes location information and registration information, and the completed cases include at least one ear, nose, and throat navigation and registration procedure.