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 and medical device for detecting a cardiac event that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector sensing a first interval of the cardiac signal during a predetermined time period and a second sensing vector simultaneously sensing a second interval of the cardiac signal during the predetermined time period, identifying each of the first interval and the second interval as being one of shockable and not shockable in response to first processing of the first interval and the second interval and in response to second processing of one or both of the first interval and the second interval, the second processing being different from the first processing, and determining whether to deliver therapy for the cardiac event in response to identifying each of the first interval and the second interval as being one of shockable and not shockable in response to both the first processing and the second processing of the first interval and the second interval.

The implantable cardiac treatment system of the present invention is capable of choosing the most appropriate electrode vector to sense within a particular patient. In certain embodiments, the implantable cardiac treatment system determines the most appropriate electrode vector for continuous sensing based on which electrode vector results in the greatest signal amplitude, or some other useful metric such as signal-to-noise ratio (SNR). The electrode vector possessing the highest quality as measured using the metric is then set as the default electrode vector for sensing. Additionally, in certain embodiments of the present invention, a next alternative electrode vector is selected based on being generally orthogonal to the default electrode vector. In yet other embodiments of the present invention, the next alternative electrode vector is selected based on possessing the next highest quality metric after the default electrode vector. In some embodiments, if analysis of the default vector is ambiguous, the next alternative electrode vector is analyzed to reduce ambiguity.

Methods, systems, and devices for signal analysis in an implanted cardiac monitoring and treatment device such as an implantable cardioverter defibrillator. In some examples, captured data including detected events is analyzed to identify likely overdetection of cardiac events. In some illustrative examples, when overdetection is identified, data may be modified to correct for overdetection, to reduce the impact of overdetection, or to ignore overdetected data. Several examples emphasize the use of morphology analysis using correlation to static templates and/or inter-event correlation analysis.

An apparatus for deflecting a distal portion of a catheter, a sheath, a medical device, or other flexible elongate member may generally include a handle portion, a pair of adjusting knobs, and deflection wires. The adjusting knobs may be rotatably coupled to the handle portion and operably coupled to the deflection wires. The deflection wires may be in further communication with the distal portion of the flexible elongate member. Rotation of the adjustment knobs may translate or otherwise displace particular deflection wires with respect to the rest of the flexible elongate member, thereby causing the distal portion of the flexible elongate member to deflect. Further, the deflection wires may be oriented such that the distal portion of the flexible elongate member may be deflected in a multitude of directions.

Medical devices and methods for making and using medical devices are disclosed. An example method may include a method of mapping the electrical activity of a heart. The method may include sensing a plurality of signals with a plurality of electrodes positioned within the heart, determining a dominant frequency of the plurality of signals and generating an alternate signal for each of the plurality of signals corresponding to the dominant frequency. The alternate signals may have a phase-shift corresponding to one of the plurality of signals. The method may also include displaying a characteristic of the alternate signal over time.

A method and system are provided for subdividing a region of interest. The method and system utilize an intravascular mapping tool configured to be inserted into at least one of the endocardial or epicardial space. The mapping tool is maneuvered to select locations proximate to surfaces of the heart, while collecting map points at the select locations to form a point cloud data set during at least one cardiac cycle. The method and system further include selecting a region of interest from the point cloud data set, and forming a triangulation area that include a set of map points from the point cloud data set corresponding to the region of interest. Further, the method and system use a triangulation technique algorithm to generate at least one triangle within the triangulation area formed from at least a portion of the set of map points.

Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

Disclosed are devices (100), systems (500), and methods for determining the dipole densities on heart walls. In particular, a triangularization of the heart wall is performed in which the dipole density of each of multiple regions correlate to the potential measured at various located within the associated chamber of the heart. To create a database of dipole densities, mapping information recorded by multiple electrodes (316) located on one or more catheters (310) and anatomical information is used. In addition, skin electrodes may be implemented. Additionally, one or more ultrasound elements (340) are provided, such as on a clamp assembly or integral to a mapping electrode, to produce real time images of device components and surrounding structures.

An electrophysiology system comprises an ablation catheter, a radiofrequency generator, and a mapping processor. The ablation catheter has a tissue ablation electrode and a plurality of microelectrodes distributed about the circumference of the tissue ablation electrode and electrically isolated therefrom. The plurality of microelectrodes define a plurality of bipolar microelectrode pairs. The mapping processor is configured to acquire output signals from the bipolar microelectrode pairs, compare the output signals, and generate an output to a display providing a visual indication of a characteristic of the microelectrodes and the tissue ablation electrode relative to myocardial tissue to be mapped and/or ablated.