Disclosed herein are methods to restore myocardial conduction via the injection of conductive nanoparticles into the myocardium via an endovascular injection catheter.

The present invention provides transseptal puncture devices configured to access structures on the left side of the heart from the right side of the heart without requiring open-heart surgery. The devices have adjustable stiffness to enter the vasculature in a flexible, atraumatic fashion, then become rigid once in place to provide a stable platform for penetration of the fossa ovalis. The devices are further configured to controllably and stably extend a needle to puncture the FO. The devices include an indwelling blunt stylus that can extend perpendicularly from the device to increase the accuracy of placement near the fossa ovalis.

Devices, systems, and methods for treating a heart of a patient may make use of one or more implant structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart.

Shapeable guide catheters and methods for manufacturing and using such shapeable guide catheters. In one embodiment, the shapeable guide catheter comprises a tubular member having a shapeable region, a malleable shaping member attached to the shapeable region such that, when the shape of the shapeable region is changed from a first shape to a second shape, the shaping member will plastically deform to thereafter substantially hold the shapeable region in the second shape, a tubular outer jacket disposed about the outer surface of the tubular member and a tubular inner jacket disposed within the lumen of the tubular member. The shapeable region of the guide catheter may be manually formed into a desired shape before insertion of the guide catheter into the body. In some embodiments, the guide catheter is sized to be inserted through a nostril of a human patient and used to guide the transnasal insertion of another device (e.g., a guidewire, catheter, etc.) to a desired location within the nose, throat, ear or cranium of the subject.

Apparatus for attaching a prosthetic tether between a leaflet of a patient's heart valve and another portion of the patient's heart to help prevent prolapse of the leaflet and/or to otherwise improve leaflet function. The apparatus can be used with relatively low invasiveness of the patient's body. The apparatus releasably clamps the leaflet during attachment of the tether to the leaflet. The apparatus may include an integrated display for indicating how extensively the leaflet is being clamped, as well as structure for stabilizing the leaflet for better clamping. The apparatus may enter the heart through an aperture in the wall of the heart, and may include structure for helping to reduce blood leakage from that aperture. The apparatus may be able to enter the heart by following a guide wire. The apparatus may include various means for attaching the tether to the leaflet.

Methods and apparatus are provided to facilitate the minimally invasive removal of tissue biopsies and to facilitate the direct approach to anesthetizing the chest wall, in accordance with embodiments of the present invention. A pull-type cutting device 1 comprises two coaxially nested tubes, each extending from a proximal end 21 to a distal end 22. The first tube 61 defines a guide wire lumen 23 for slidingly receiving a guide wire. The second tube 63 extends over the first tube 60 and coupled thereto at the distal end 22 defining an expandable portion 13 adjacent the distal end 22. The second tube 63 defines an inflation lumen 25 extending from the shaft proximal end 21 to the expandable portion 13. The inflation lumen 25 communicates inflation fluid from the proximal end 21 to the expandable portion 13 so as to inflate and deploy the expandable portion 13. Disposed adjacent the shaft distal end 22 is a cutting head 10 comprising the expandable portion 13 having a cutting portion 11 distal from the shaft distal end 22.

Devices, systems, and methods for treating a heart of a patient may make use of one or more implant structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart.

A method includes, receiving from a calibration probe multiple data points acquired in an organ of a patient, each data point including (i) a respective position of the calibration probe, and (ii) a respective set of electrical values indicative of respective impedances between the position and multiple electrodes attached externally to the patient. A mapping between sets of the electrical values and respective positions in the organ is constructed, by performing for each received data point: if the mapping already contains one or more existing data points in a predefined vicinity of the data point, the one or more existing data points are adjusted responsively to the received data point, and if the predefined vicinity does not contain any existing data points, the received data point is added to the mapping. A position of a medical probe is subsequently tracked in the organ using the mapping.

A method for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased valve.

A tissue treatment system configured to ablate a tissue, the system comprising: (a) a clamp assembly comprising a first jaw mechanism and a second jaw mechanism configured to receive and compress a tissue therebetween; (b) a first electrode disposed on the first jaw mechanism and configured to contact the tissue; and (c) a second electrode disposed on the second jaw mechanism and configured to contact the tissue, where the first electrode and the second electrode are configured so that at least one of an ablation energy output of the first electrode and an ablation energy output of the second electrode is automatically adjusted to accommodate variable tissue thicknesses between the first electrode and the second electrode.