A steering catheter includes an elongate shaft with an actively steerable distal part. An internal pull wire and an external pullwire extend through the shaft. The shaft has a first position in which the elongate shaft is generally straight and the external pullwire extends along the exterior of the distal portion of the shaft, a second position in which the shaft is curved and in which the external pullwire extends along the exterior of the distal portion of the shaft, and a third position in which the shaft is curved and in which the external pullwire extends laterally between laterally adjacent portions of the distal portion of the shaft, wherein the external pull wire locks the shaft in the curved position.

A steerable guide catheter includes a tip ring at a distal end and one or more pullwires configured to engage with the tip ring when put in tension, the pullwire(s) thereby subjecting the steerable guide catheter to a curving or turning force. The tip ring includes a saddle and one or more pullwire channels allowing the pullwire to be looped over the saddle such that when the pullwire is placed under tension, it abuts against the saddle of the tip ring. Some embodiments include additional catheters axially aligned within or outside of the steerable guide catheter, and include a keying feature aligning the rotation of the multiple catheters. The keys of the keying feature can be formed of a polyamide with a glass microsphere filler, and can be thermally welded to the catheter.

The disclosure of this application relates generally to medical devices and in particular to a steerable medical instrument applicable to guide interventional tools and instruments, such as percutaneous biopsy and ablations tools and endoscopes. The steerable medical instrument has an outer and an inner tube where the inner tube is movable at the proximal end and fixed at the distal end. At least one of the outer tube and inner tube has a plurality of openings, which creates deformable portions so that the outer and the inner tubes can bend by moving the inner tube at the proximal end.

A transport system for delivery or retrieval of a biostimulator, such as a leadless cardiac pacemaker, is described. The biostimulator transport system includes a docking cap supported by a bearing within a bearing housing. The bearing allows relative rotation between a torque shaft connected to the docking cap and an outer catheter connected to the bearing housing. The bearing housing and the docking cap include respective bearing retainers that constrain the bearing within the bearing housing without a weld attachment. The weldless retainers of the biostimulator transport system provide a robust mechanical securement of the bearing that is not vulnerable to corrosion. Other embodiments are also described and claimed.

A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal tip, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position spaced from the distal tip of the sheath. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a straight configuration to a dual hinged curved configuration that positions the electrodes in the vicinity of the bundle of His.

A multi-directionally guided endoscope includes an endoscope body. The endoscope body is connected to a catheter. At least four pulling wires are evenly distributed in the endoscope body. One ends of the pulling wires are connected to an end of the catheter away from the endoscope body. The pulling wires are respectively fixed to pulling mechanisms. The pulling mechanisms are respectively sleeved on guide rods. The guide rods are fixed in the endoscope body. The endoscope body is provided with a plurality of elongated grooves. One ends of the pulling mechanisms respectively extend from the elongated grooves. The multi-directionally guided endoscope is provided with pulling mechanisms that are simple in structure, convenient to operate, and accurate and stable to pull.

A catheter including: an elongated body sized to traverse vasculature, defining a longitudinal axis, and including: an outer surface; and a proximal end and a distal end disposed on opposite sides thereof; an orientation lumen formed in the elongated body and defining a curved path extending proximally from the distal end towards the proximal end and about the longitudinal axis; an orientation insert disposed within the orientation lumen, the orientation insert including an oriented pull-wire attached to the distal end of the elongated body such that tightening the oriented pull-wire deflects the distal end to form a curve; and a flexible circuit disposed on the outer surface of the elongated body, the elongated body being substantially rotationally fixed about the longitudinal axis relative to the oriented pull-wire such that the flexible circuit is disposed toward an outer bend of the curve when the oriented pull-wire is tightened.

An intracardiac echocardiography (“ICE”) catheter handle, including a housing having a longitudinal axis, the housing having a proximal end and a distal end. A first actuator can be positioned on a first portion of the housing in a plane aligned with the longitudinal axis, the first actuator coupled to a first controller, the first actuator and first controller configured to control a catheter coupled to the first controller in a first direction and a second direction in the first plane. A second actuator can be positioned on a second portion of the housing in a second plane aligned with the longitudinal axis, the second actuator coupled to a second controller, the second actuator and second controller configured to control a catheter coupled to the second controller in a third direction and a fourth direction in the second plane, wherein first plane is aligned orthogonally to the second plane.

A catheter includes a catheter shaft, an operating portion coupled to a proximal end portion of the catheter shaft, and at least one operating wire. A distal end portion of each operating wire is fixed to a distal end portion of the catheter shaft, and a proximal end portion of each operating wire is fixed to the operating portion or the proximal end portion of the catheter shaft. The operating portion includes a first rotary member. The first rotary member makes relative rotation with respect to the catheter shaft around an axis parallel to an extending direction of the proximal end portion of the catheter shaft to change a tensile force of the operating wire and thus change a degree of bending of the distal end portion of the catheter shaft.

A medical device control handle or catheter includes deflection assembly and at least one of the following: a disk actuator, a lever actuator and a ring actuator for actuating additional puller wires in manipulation of multiple features of the medical device or catheter independently of each other. The disk actuator has a common rotational axis with but is rotationally independent of the deflection assembly. The lever actuator has a separate rotational axis. The ring is mounted outside of the control handle and rotatable relative to the control handle to actuate another puller wire for manipulating another feature of the catheter. Each of the disk, lever and ring actuators are of a design that allows existing control handles and catheters to be readily modified to include these actuators.