A steerable catheter. A catheter tube is connected to a catheter handle. A steering wire has a center point affixed to the distal tip of the catheter tube, and each leg of the steering wire is affixed to respective racks inside the catheter handle. The racks are toothed and slidable and are mounted in opposition to each other within the catheter handle. A gear is disposed between the toothed racks and a knob is attached to the gear. Operating the knob rotates the gear and causes the racks to slide in opposite directions thereby pulling one of the steering wire legs to deflect the distal end of the catheter tube.

Methods and systems of computing parameter values of one or more model parameters are described. The model models structural and dielectric properties of a structure in a human or an animal body. An exemplary method includes: accessing voltage measurements made at different places in the vicinity of the structure by one or more in-body field sensing electrodes in response to currents applied to one or more field supplying electrodes; and computing the parameter values by adjusting the parameter values to fit predicted voltage values to the accessed voltage measurements, wherein the predicted voltage values are predicted from the model for the currents applied to the field supplying in-body electrodes.

Ablation and diagnostic tools having a wrapped flexible circuit are provided. The wrapped flexible circuit can include one or more electrodes on a surface layer, one or more conductive traces on one or more lower layers, and an electrically insulating substrate. The surface layer can be patterned to have multiple electrodes. The lower layer(s) can include electrode contact trace(s) and/or traces for forming thermocouple junctions. The wrapped flexible circuit can be affixed to an outer surface of a metallic tube. The electrodes can be electrically isolated from the metallic tube. The metallic tube can have a sharp end to puncture tissue during ablation or intravascular diagnostic procedure. Additionally, or alternatively, the wrapped flexible circuit can have a pointed end and sufficient structural integrity to puncture tissue during ablation or intravascular diagnostic procedure without the support of a metallic tube.

A system for controlled sympathectomy procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Methods for performing a controlled surgical procedure are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. Systems and methods for accessing target tissues as part of a neuromodulation procedure from within a lumen are disclosed.

An open-irrigated ablation catheter system includes a catheter body, and an electrode tip body mounted on a distal portion of the catheter body. The electrode tip body includes a proximal end configured for connection to the catheter body and a wall defining an open interior region and including one or more irrigation ports. The wall is conductive for delivering radio frequency (RF) energy. The catheter system further includes a proximal insert positioned partially within the catheter body and at least partially within the proximal end of the electrode tip body. The proximal insert includes a fluid inlet for receiving a cooling fluid delivered via the catheter body. The proximal insert forms a flow path configured to direct the cooling fluid from the fluid inlet to cool the distal portion of the catheter body and to cool a junction of the catheter body and the electrode tip body.

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site.

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site.

A method, including recording parameters indicative of a quality of ablation performed at one or more sites in a region of a human heart, and receiving a set of electrophysiological signals indicative of a wave of electrical activation flowing through the region. The method further includes identifying locations within the region at which the wave is blocked from flowing and estimating confidence levels with respect to a blockage of the wave at the locations in response to the signals and the parameters. The method also includes displaying a map of the human heart including an indication of the confidence levels.

A system and method for Brugada syndrome epicardial ablation comprising preparing an endocardial duration map; preparing a baseline epicardial duration map comprising at least one or more areas of delimination; and when some of the areas of delimination are greater than 200 ms, performing epicardial ablation of the areas of delimination greater than 200 ms. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not a BrS pattern appears in the updated epicardial duration map; and when the BrS pattern appears, performing epicardial ablation. The method may further comprise preparing an updated epicardial duration map after performing epicardial ablation, and determining whether or not an abnormal EGM exists in the updated epicardial duration map; and when the abnormal EGM exists, performing epicardial ablation. The method may further comprise preparing an updated epicardial map comprising maintaining anatomical volume data and adding electroanatomical data.

A method for guiding a procedure is provided. A volumetric map of an interior portion of a body of a subject is presented, and, during the procedure, in response to movements of a sensor with respect to the portion, the presented volumetric map is updated, by changing a manner in which the presented volumetric map shows areas of the portion from which material was removed by the procedure. Other embodiments are also described.