Systems and methods for electroporation are provided. An electroporation system includes a catheter including a plurality of electrodes, and a pulse generator coupled to the catheter, the pulse generator configured to generate a waveform to be delivered using at least one of the plurality of electrodes. The waveform includes a first pulse having a first polarity, a first pulse amplitude, and a first pulse width, and a second pulse having a second polarity, a second pulse amplitude, and a second pulse width, wherein the first and second pulses are separated by an interpulse delay, and wherein at least one of i) the first pulse amplitude is different than the second pulse amplitude and ii) the first pulse width is different than the second pulse width.

A conformational state of a medical device operated within a body lumen is determined by measuring, using the medical device as an electrode, an electrical parameter which varies in a correspondence with a conformational state (e.g., deployment state) of the portion of the medical device used as the electrode. The conformational state of the medical device is determined, based on the electrical parameter; and an image is presented indicating the determined conformational state. In some embodiments, the electrical parameter is a self-impedance of the portion of the medical device used as the electrode. In some embodiments, current positioning of the medical device is used as part of calibrating a parametric relationship between the electrical parameter and conformational states of the medical device.

Electrical field-guided positioning of a second device within a body cavity, using electrical field mapping information generated from electrical field measurements by electrodes of a first device. The first device, in some embodiments, is a catheter electrode probe, and the second device is an internally implantable and/or operated medical device. An exposed, electrically conductive portion of the second device is optionally configured to be used as an electrical field measuring electrode. A rule is applied to measurements made by this electrode to estimate its position within a body cavity. The rule is generated, in some embodiments, using measurements made by the first device. In some embodiments, electrical measurements are used to guide implantation verification. In some embodiments, electrical measurements are used to guide navigation at and through a septal wall between body cavities.

A surgical instrument for use with a robotic system that has a control unit and a shaft portion that includes an electrically conductive elongated member that is attached to a portion of the robotic system. The elongated member is configured to transmit control motions from the robotic system to an end effector.

This document relates to the apparatus and methods used in the minimally invasive creation of arteriovenous fistula (AVF). In particular, the invention relates to the creation of an AVF using catheters and an alignment methodology that is based upon detection of asymmetric electric fields. The invention finds particular application in vascular access (VA) in the hemodialysis (HD) population.

A surgical instrument for use with a robotic system that has a control unit and a shaft portion that includes an electrically conductive elongated member that is attached to a portion of the robotic system. The elongated member is configured to transmit control motions from the robotic system to an end effector.

A method and system for determining a target location for a medical device having complex geometry relative to an anatomical feature, and for navigating and positioning the medical device at the target location. The system may include a medical device including a treatment element having a centroid, one or more navigation electrodes, and a longitudinal axis and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to define a plane that approximates a surface of the anatomical feature, define a centroid of the anatomical feature, define a vector that is normal to the plane and extends away from the centroid of the anatomical feature, and determine a target location for the treatment element of the medical device based on the vector to assist the user in placing the device for treatment.

An apparatus includes a tube, a tip electrode coupled to a distal end of the tube and shaped to define at least one cavity, a microelectrode disposed within the cavity and including an outer surface that is of lesser convexity than that of a portion of the tip electrode surrounding the cavity, and a conductive polymeric coating that coats the outer surface. Other examples are also described.

Systems and methods are described for implementing a catheter model to estimate shape of a deformable catheter in a three-dimensional space. The catheter model includes two or more model segments that correspond to two or more segments of the deformable catheter. Each model segment includes a length and location of model electrode(s) and/or model magnetic sensor(s) corresponding electrodes and/or magnetic sensors of the deformable catheter. Variable shape parameter define a curvature of the segment. Varying the shape parameters generates a plurality of potential catheter shapes. In conjunction with generating the potential catheter shapes, impedance and/or magnetic responses (e.g., measured responses) are obtained for the physical electrodes and/or physical magnetic sensors of the deformable catheter. Using a selected one (e.g., most likely) of the potential catheter shapes and the measured responses, the shape parameters are updated and a catheter shape is generated and displayed.

An apparatus includes a flexible electrically-insulating substrate including an inner surface and an outer surface. The substrate is shaped to define multiple channels passing between the inner surface and the outer surface, at least some of the channels being concave channels. The apparatus further includes an outer layer of an electrically-conducting metal covering at least part of the outer surface, an inner layer of the electrically-conducting metal covering at least part of the inner surface, and respective columns of the electrically-conducting metal that fill the channels such as to connect the outer layer to the inner layer.