A method, system, and device for electroporation. A system may include a medical device with a plurality of electrodes borne on an expandable element and an energy generator in communication with the electrodes. The energy generator may have processing circuitry configured to selectively deliver electroporation energy to at least one of the electrodes. The processing circuitry may determine whether an alert condition is present and, if so, cease the delivery of electroporation energy to one or more electrodes identified as the cause of the alert condition and/or prevent the delivery of electroporation energy to the one or more electrodes identified as the cause of the alert condition. The energy generator may also be configured to deliver electroporation energy in a sequence of a plurality of energy delivery patterns to enhance lesion formation.

An example medical system for ablating and occluding the left atrial appendage is disclosed. The example system includes a catheter sized and shaped for vascular access and including an elongate body extending between a proximal end and a distal end. A first expandable member may be positioned near the distal end of the elongate body and have a first region configured to permeate a liquid therethrough. A first set of one or more electrodes may be arranged within the first expandable member and may be configured to deliver energy to the tissue region. An occlusive implant may be releasably secured to the distal end of the elongate body.

This disclosure is directed to a catheter having a dual node multiray electrode assembly at the distal end of the catheter body. The dual node multiray electrode assembly includes a proximal multiray array with a plurality of spines connected at one end, each spine having at least one ablation electrode, and a distal node. The dual node multiray electrode assembly may have an expanded configuration and a collapsed configuration wherein the spines are arranged generally along a longitudinal axis of the catheter body. The distal node may be configured to be deployed within a vessel and the proximal multiray array may be configured to engage tissue forming an ostium of the vessel with the ablation electrodes. In some embodiments, the relative distance between the proximal multiray array and the distal node is adjustable.

Embodiments of the present disclosure include a system for determining an error associated with an electrode disposed on a medical device. The system comprises a processor and a memory storing instructions on a non-transitory computer-readable medium. The instructions are executable by the processor to receive an electrode signal from the electrode disposed on the medical device. The instructions are further executable by the processor to receive a plurality of other electrode signals from a plurality of other electrodes disposed on the medical device. The instructions are further executable by the processor to determine that the electrode signal received from the electrode disposed on the medical device is an outlier in relation to the plurality of other electrode signals from the plurality of other electrodes disposed on the medical device, based on a comparison between the electrode signal and the plurality of other electrode signals.

Aspects of the present disclosure are directed to the localization of an introducer sheath relative to an intravascular catheter. Further embodiments of the present disclosure are directed to the visualization of the introducer sheath on a graphical user interface of a navigation system.

This disclosure is directed to a catheter having a dual node multiray electrode assembly at the distal end of the catheter body. The dual node multiray electrode assembly includes a proximal multiray array with a plurality of spines connected at one end, each spine having at least one ablation electrode, and a distal node. The dual node multiray electrode assembly may have an expanded configuration and a collapsed configuration wherein the spines are arranged generally along a longitudinal axis of the catheter body. The distal node may be configured to be deployed within a vessel and the proximal multiray array may be configured to engage tissue forming an ostium of the vessel with the ablation electrodes. In some embodiments, the relative distance between the proximal multiray array and the distal node is adjustable.

Devices, systems, and methods of the present disclosure can overcome physical constraints associated with catheter introduction to facilitate the use of a catheter with a large distal portion as part of a medical procedure benefitting from such a large distal portion, such as, for example, cardiac ablation. More specifically, devices, systems, and methods of the present disclosure can compress an expandable tip of a catheter from an expanded state to a compressed state along a tapered surface of an insertion sleeve for advancement of the expandable tip into vasculature of a patient. The tapered surface of the insertion sleeve can, for example, apply compressive forces at an angle against the advancing expandable tip. As compared to other approaches to the application of compressive force to an expandable tip, compressing the expandable tip using an angled force can reduce the likelihood of unintended deformation of the expandable tip.

Precision control systems for tissue visualization and manipulation assemblies are described herein where such devices may utilize a variety of apparatus and methods for facilitating advancement, articulation, control, navigation, etc. of systems which may be used to visual and/or treat tissue regions. Additionally, methods and devices for enhancing navigation of the device through a patient body are also described.

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter.

A kit for use in cryoablation procedures includes a cryoablation catheter having a cryoballoon positioned about its distal region. A pressure sensor is positioned distally of the cryoballoon. The catheter can be introduced into a patient's left atrium and the cryoballoon inflated. The cryoballoon can then be advanced into contact with a pulmonary vein wall in a manner that occludes the pulmonary vein. Occlusion can be verified by measuring a pressure within the pulmonary vein. Once occlusion is verified, the cryoballoon can be cooled to form a circumferential lesion about the pulmonary vein.