Various embodiments described and disclosed herein relate to the field of medicine generally, and more particularly to electrophysiological (EP) mapping systems, and EP mapping catheters, and techniques, procedures and methods associated therewith.
Atrial fibrillation (or AF) is the most common type of heart arrhythmia or cardiac rhythm disorder. In atrial fibrillation, normal beating in the atria of the heart is irregular, and blood flow from the atria to the ventricles is compromised. Millions of people in the United States have AF. With the aging of the U.S. population, even more people will develop AF. Approximately 2% of people younger than age 65 have AF, while about 9% of people aged 65 years or older have AF. In some cases AF is treated with drugs. In other cases, external electrical shocks (electrical cardioversion) are delivered to the patient's heart. Open heart surgery can also be performed on a patient to treat AF.
Persistent atrial fibrillation (AF) is often caused by structural changes in atrial tissue, which can manifest themselves as multiwavelet re-entry and/or stable rotor mechanisms (see, e.g., De Groot M S et al., “Electropathological Substrate of Longstanding Persistent Atrial Fibrillation in Patients with Structural Heart Disease Epicardial Breakthrough,” Circulation, 2010, 3: 1674-1682). Radio frequency (RF) ablation targeting such host drivers of AF is generally accepted as one of the best therapeutic approaches to treating AF. RF ablation success rates in treating AF cases are currently limited, however, by a lack of sufficiently accurate and cost-effective diagnostic tools that are capable of quickly, cost-effectively, and precisely determining the source (or type), and location, of such AF drivers. Better diagnostic tools would help reduce the frequency and extent of cardiac ablation procedures to the minimum amount required to treat AF, and would help balance the benefits of decreased fibrillatory burden against the morbidity of increased lesion load.
What is needed are medical systems, devices, components and methods that can be employed to more quickly, efficiently, cost-effectively, and accurately diagnose and treat patients who have AF using intravascular techniques, where cardiac or pulmonary vein tissue is likely to be ablated, and where accurate and enhanced EP mapping of the heart can be carried out. What is also needed are improved means and methods of acquiring intracardiac electrogram signals that quickly, reliably and accurately yield the precise locations and sources of cardiac rhythm disorders in a patient's heart. Doing so would enable cardiac ablation procedures to be carried out with greater speed, greater locational precision, lower risk to the patient, reduced cost, and higher rates of success in treating cardiac rhythm disorders such as AF. Still further, what is needed are lower cost methods of making EP mapping catheters, and improved designs, function, resolution, and reliability of EP mapping catheters.
In one embodiment, there is provided a Nitinol basket for an electrophysiological (EP) mapping catheter, where the catheter comprises a plurality of basket splines, each basket spline having a distalmost portion and a proximal end, and a distal tip uninterruptedly contiguous with the distalmost portions of the basket splines and formed from the same piece, slab or ingot comprising Nitinol as the splines, and wherein the basket splines and distal tip are cut and formed from a same single length of Nitinol tubing or a Nitinol hypotube, the respective distal portions of each of the Nitinol splines being continuous and contiguous with, and connected to, the Nitinol distal tip, each spline being configured to extend outwardly away from an imaginary central axis of the Nitinol basket and its proximal end and distal portion to form a curved shape therebetween when the Nitinol basket is in an undeformed and deployed state, the proximal ends of the splines being configured to be grouped adjacent or near one another and to extend together in a proximal direction for incorporation into or onto a distal end or distal portion of a catheter body, and further wherein the splines are configured to be spaced approximately equal distances apart from one another when the Nitinol basket is in an undeformed and deployed state, and still further wherein the splines collectively form a basket shape when the Nitinol basket is in an undeformed and deployed state.
In such an embodiment and others, the Nitinol basket may further comprise one or more of: (a) when the Nitinol basket is in an undeformed and deployed state, the basket shape is one of a spherical shape, a near-spherical shape, a tear-drop shape, a D-shape, a bulging asymmetric shape, and a shape where the splines are helically wound; (b) the single piece of Nitinol tubing prior to cutting has an initial inner diameter and an initial outer diameter, the initial inner diameter ranging between about 0.050 inches and about 0.070 inches, the initial outer diameter ranging between about 0.070 inches and about 0.080 inches; (c) the single piece of Nitinol tubing prior to cutting has an initial inner diameter and an initial outer diameter, the initial inner diameter ranging between about 0.1 inches and about 0.17 inches, the initial outer diameter ranging between about 0.1 inches and about 0.2 inches; (d) the proximal ends of the splines are configured collectively to form a plurality of adjoining and bunched splines or struts configured for insertion into or operable connection with the distal end or distal portion of the catheter body; (e) at least portions of the proximal ends of the splines comprise one or more of holes, recesses, shoulders, undercuts, and corners configured to promote attachment or securing of an adhesive or of a polymeric material or flowed, reflowed or reformed therethrough, therearound, or therein; (f) the basket comprises between 6 and 16 splines; (g) the basket comprises 8 splines, and the splines are configured to be spaced about 45 degrees apart from one another when the Nitinol basket is in an undeformed and deployed state; (h) the finished splines have opposing top and bottom surfaces, and the thickness between the top and bottom surfaces of the finished splines ranges between about 0.005 inches and about 0.008 inches; (i) the finished splines have opposing top and bottom surfaces, and the thickness between the top and bottom surfaces of the finished splines ranges between about 0.003 inches and about 0.012 inches; (j) the finished splines have opposing top and bottom surfaces, and one or more of the splines have variable thicknesses configured to induce flexing or bending of the splines at one or more predetermined locations; (k) the finished splines of the Nitinol basket have widths ranging between about 0.0150 inches and about 0.0180 inches; (I) the finished splines of the Nitinol basket have widths ranging between about 0.010 inches and about 0.025 inches; (m) the distal tip of the basket comprises an atraumatic shape or a polymeric covering or shield attached thereto, the atraumatic shape, covering or shield being configured to prevent or minimize injury to an interior surface of a patient's heart; (n) a flex circuit mounted on or attached to each or selected splines, each flex circuit comprising a plurality of electrodes mounted on or attached thereto; (o) a polymeric material flowed, reflowed or reformed onto at least portions of each spline to at least one of hold, secure and register or orient each flex circuit and its electrodes thereon or thereto; (p) the electrodes are unipolar electrodes or bipolar electrodes; and (q) after the splines and the distal tip have been cut from the Nitinol tubing or Nitinol hypotube, and before flex circuits, electrodes, and polymeric materials are flowed, reflowed or reformed onto or into the splines, the splines and basket are at least one of heat-set, quenched, media blasted, acid etched, and electropolished.
In another embodiment, there is provided a method of making a Nitinol basket for an electrophysiological (EP) mapping catheter, where the method comprises drawing or forming a Nitinol tube or hypotube from a single piece, slab or ingot comprising Nitinol, the drawn or formed Nitinol tube or hypotube having an initial inner diameter and an initial outer diameter; if required, cutting the drawn or formed Nitinol tube or hypotube to a desired length; cutting the drawn or formed Nitinol tube or hypotube of the desired length to form a plurality of basket splines and a distal tip, each cut basket spline having a distalmost portion and a proximal end, wherein the cut distal tip is uninterruptedly contiguous and continuous with, and connected to, the respective distalmost portions of the basket splines and is formed from the same Nitinol tube or hypotube as the splines; and wherein each spline of the resulting Nitinol basket is configured to extend outwardly away from an imaginary central axis of the Nitinol basket and its proximal end and distal portion to form a curved shape therebetween when the Nitinol basket is in an undeformed and deployed state, the proximal ends of the splines are configured to be grouped adjacent or near one another and to extend together in a proximal direction for incorporation into or onto a distal end or distal portion of a catheter body, and further wherein the splines are configured to be spaced approximately equal distances apart from one another when the Nitinol basket is in an undeformed and deployed state, and still further wherein the splines collectively form a basket shape when the Nitinol basket is in an undeformed and deployed state.
In such an embodiment and others, the method may further comprise one or more of: (a) shaping and treating the splines such that, when the finished Nitinol basket is in an undeformed and deployed state, the basket shape is one of a spherical shape, a near-spherical shape, a tear-drop shape, a D-shape, a bulging asymmetric shape, and a shape where the splines are helically wound; (b) drawing or forming the Nitinol tube or hypotube into a desired wall thickness comprising an initial outer diameter and a desired initial inner diameter; (c) the cutting is performed by one or more lasers; (d) heat-setting the cut plurality of basket splines and distal tip while disposed in a first die or tool configured to hold or retain the basket splines and distal tip in first predetermined positions and orientations during the heat-setting step; (e) quenching the heat-set and cut plurality of basket splines and distal tip while still disposed in the die or tool configured to hold or retain the basket splines and distal tip in the first predetermined positions and orientations during the quenching step; (f) heat-setting and quenching at least once more the previously heat-set and cut plurality of basket splines and distal tip; (g) heat-setting and quenching at least once more the previously heat-set and cut plurality of basket splines and distal tip while disposed in a second die or tool configured to hold or retain the basket splines and distal tip in second predetermined positions and orientations during the subsequent quenching step, the second die or tool being different from the first die or tool, and the second predetermined positions and orientations being different from the first predetermined positions and orientations; (h) the single piece, slab or ingot comprising Nitinol has super-elastic properties associated therewith; (i) super-elastic properties of the Nitinol basket are imparted thereto or enhanced therein by one or more of heat-setting steps and quenching steps; (j) an Austenite finish temperature of the Nitinol basket is less than the interior temperature of a live human patient, thereby to preserve or enhance super-elastic properties associated with the Nitinol basket; (k) after heat-setting and quenching steps, the Nitinol basket is subjected to one or more of media blasting, acid etching, and electropolishing; (I) imparting and forming an atraumatic shape, or providing an atraumatic covering or protective shield over, the distal tip, thereby preventing or minimizing injury to an interior surface of a patient's heart; (m) mounting or attaching a flex circuit on each spline, each flex circuit comprising a plurality of electrodes mounted on or attached thereto; and (n) flowing, reflowing or reforming a polymeric material onto or into at least portions of each spline to at least one of hold, secure and register or orient each flex circuit and its electrodes thereon or thereto.
Further embodiments are disclosed herein or will become apparent to those skilled in the art after having read and understood the claims, specification and drawings hereof.
Different aspects of the various embodiments will become apparent from the following specification, drawings and claims in which:
The drawings are not necessarily to scale. Like numbers refer to like parts or steps throughout the drawings.
Disclosed herein are various embodiments of systems, devices, components and methods for diagnosing and treating cardiac rhythm disorders in a patient's heart using improved EP mapping and ablation catheters. Various embodiments described and disclosed herein also relate to systems, devices, components and methods for discovering with enhanced precision the location(s) of the source(s) of different types of cardiac rhythm disorders and irregularities. Such cardiac rhythm disorders and irregularities, include, but are not limited to, arrhythmias, atrial fibrillation (AF or A-fib), atrial tachycardia, atrial flutter, paroxysmal fibrillation, paroxysmal flutter, persistent fibrillation, ventricular fibrillation (V-fib), ventricular tachycardia, atrial tachycardia (A-tach), ventricular tachycardia (V-tach), supraventricular tachycardia (SVT), paroxysmal supraventricular tachycardia (PSVT), Wolff-Parkinson-White syndrome, bradycardia, sinus bradycardia, ectopic atrial bradycardia, junctional bradycardia, heart blocks, atrioventricular block, idioventricular rhythm, areas of fibrosis, breakthrough points, focus points, re-entry points, premature atrial contractions (PACs), premature ventricular contractions (PVCs), and other types of cardiac rhythm disorders and irregularities.
Also described herein is an EP mapping catheter having a Nitinol basket 10 that is capable of electrographically imaging a patient's atrium, left atrial appendage, portions of the pulmonary vein (PV) near the atrium, other heart chambers, and/or other internal organs at high or relatively high resolutions, and that can be manufactured at a lower cost, and with improved reliability, relative to high-electrode-density intra-cardiac EP mapping catheters of the prior art.
In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of example embodiments or aspects. It will be evident, however, to those skilled in the art that an example embodiment may be practiced without necessarily using all of the disclosed specific details, and that other embodiments not specifically or wholly disclosed are also contemplated and fall within the scope of the various inventions.
Problems that can and do occur using conventional basket catheters, such as spline bunching and poor electrode coverage, are described in considerable detail in the following publications: (a) “Basket-Type Catheters: Diagnostic Pitfalls Caused by Deformation and Limited Coverage” to Oesterlein et al., BioMed Research International, Volume 2016, Article ID 5340574 (“the Oesterlein publication”); (b) “Practical Considerations of Mapping Persistent Atrial Fibrillation With Whole-Chamber Basket Catheters” to Laughner et al., JACC: Clinical Electrophysiology, Volume 2, Issue 1, February 2016, Pages 55-65 (“the first Laughner publication”); and (c) “Atrial Mapping With Basket Catheters— A Basket Case?” To Hummel et al., JACC: Clinical Electrophysiology, Volume 2, Issue 1, February 2016, Pages 66-68 (“the second Laughner publication”).
Referring now to
Continuing to refer to
In some embodiments, however, the single piece of Nitinol tubing prior to cutting from which basket 10 is formed has an initial inner diameter and an initial outer diameter, where the initial inner diameter ranges between about 0.050 inches and about 0.070 inches, and the initial outer diameter ranges between about 0.070 inches and about 0.080 inches. In other embodiments where EP mapping catheter 1 has an inner lumen large enough to accept an ablation catheter therein and therethrough, the single piece of Nitinol tubing prior to cutting from which Nintinol basket 10 is formed has an initial inner diameter and an initial outer diameter, where the initial inner diameter ranges between about 0.1 inches and about 0.17 inches, and the initial outer diameter ranges between about 0.1 inches and about 0.2 inches.
As further shown in
According to various embodiments, when Nitinol basket 10 is in an undeformed and deployed state, the basket shape of Nitinol basket 10 may be one or a combination of a spherical shape, a near-spherical shape, a tear-drop shape, a D-shape, a bulging asymmetric shape, and/or a shape where splines 12 are helically wound. Other suitable shapes for basket 10 are also contemplated.
Referring now to
Referring now to
In some embodiments, at least portions of splines 12a-12h can be configured to include or comprise one or more of holes, recesses, shoulders, undercuts, corners or other suitable structural features so that the attachment or securing of flex circuits 11a-11h along, atop or otherwise situated on or to splines 12a-12h can be facilitated using an adhesive, or a polymeric material such as PEBAX® (or Polyether block amide or PEBA, which is a thermoplastic elastomer or TPE), which can be disposed upon, flowed, reflowed or reformed through, around, or in portions of splines 12a-12h. In the embodiments shown in
Continuing to refer to
In some embodiments, and with continued reference to
Referring now to
In addition, after splines 12 and distal tip 14 have been cut from Nitinol tubing or a Nitinol hypotube, and before flex circuits 11, electrodes 21, and adhesives are applied thereto, or polymeric materials are flowed, reflowed or reformed onto or into splines 11, splines 11 and basket 10 are at least one of heat-set, quenched, media blasted, acid etched, and electropolished, as described in further detail below.
Turning now to
As described above, and in the embodiment shown in
Methods of cutting tube or hypotube 5 include not only the use of suitable laser cutting methods, but also of mechanical and chemical cutting or shaping methods, including but not limited to mechanical cutting or sawing, abrading, grinding, chemical dissolution or etching, and other suitable means and methods of forming cut-outs and other feature in tube or hypotube 5.
Turning now to
As shown in
Continuing to refer to
Once splines 12, distal tip 14, and additional features are cut into Nitinol tube or hypotube 5, a heat-setting process is performed with in some embodiments can comprise submerging the proto-basket 10 into a material forming a heated medium (e.g., a suitable molten salt medium), followed by a rapid quenching step. The first step of heat-setting is placing the laser cut Nitinol basket 10 in a fixture, tool or die that expands splines 12 out into a basket shape. The expanded Nitinol basket 10 and its fixture are then submerged into a heated medium bath (e.g., fluidized sand or aluminum oxide bath, molten salt bath). Typical temperatures of the heated medium range from 400°-600° C., but may be higher or lower depending on the material, tooling, and desired final properties. Similarly, time in the heated bath can range from a few seconds to several minutes depending on the density of the material, the tooling, and the desired process outcome. Once removed from the heated medium bath, basket 10 and the tooling are quenched in either liquid or air to rapidly reduce the temperature. The time of submergence in the heated bath and quench environment have an effect on the final properties. The heat-setting process may be performed multiple times in order to achieve the final desired shape, mechanical, and thermal properties. For example, the tool used in the first heat step cycle may only expand the laser cut nitinol splines out to 50% of the final shape. After the first heat-setting cycle the material might be loaded into a second tool that expands the nitinol splines out the rest of the way to 100% of the desired basket dimensions (followed by a quenching step).
Superelasticity, the ability to withstand higher than strains without deformation, is a desirable property of the finished nitinol basket 10. As such, selecting nitinol hypotube with certain initial phase transition values and either maintaining or altering those values as desired through the heat-setting processes important to the final form. For a mapping basket catheter, it is important that the Af temperature (Austenite finish) temperature be below the interior body temperature of a patient in order to realize the super-elastic properties during use.
After the shape setting process is complete, post-processing steps including media blasting, acid etching, and electropolishing are performed to remove residual oxide layers from the heat-setting process, surface defects like cracks and notches, and free nickel from the surface. Once these surface finish processes are complete, the nitinol basket is ready for assembly with the additional components of the catheter.
As described above, the use of a nitinol shape memory or super-elastic element for a particular application generally requires the setting of a custom shape in a piece of nitinol. The process required to set the shape is similar whether beginning with nitinol in the form of wire, strip, sheet, tubing, rod or bar. Shape setting (or training) is accomplished by constraining the nitinol element on a mandrel or fixture of the desired shape and applying an appropriate heat treatment. The heat treatment methods used to set shapes in both shape memory and super-elastic forms of nitinol are similar.
The heat treatment parameters chosen to set both the shape and the properties of the part are critical, and usually need to be determined experimentally for each desired part's requirements. In general, temperatures as low as 400 deg. C. and times as short as 1-2 minutes can set the shape, but generally one uses a temperature closer to 500 deg. C. and times over 5 minutes. Rapid cooling of some form is preferred via a water quench or rapid air cool (if both the parts and the fixture are small). Higher heat treatment times and temperatures will increase the actuation temperature of the part and often gives a sharper thermal response (in the case of shape memory elements). However, there is usually a concurrent drop either in peak force (for shape memory elements) or in plateau stresses (for super-elastic elements). There is also an accompanying decrease in the ability of the Nitinol element to resist permanent deformation.
In some embodiments, splines 12 disclosed and described herein comprise a biocompatible shape memory alloy (e.g., nickel titanium, or Nitinol), and have been treated and configured during the process of manufacturing splines 12 and catheter 1 such that splines 12 assume an outwardly curving shape as they are progressively exposed by the withdrawal of a sheath or introducer, or as splines 12 are advanced from a distal end of catheter 1.
Nitinol is a metal alloy of nickel and titanium, where the two elements are typically present in roughly equal atomic percentages, e.g., Nitinol 55, Nitinol 60. The properties of the Nitinol or other suitable shape memory alloy employed in tube or hypotube 5 and splines 12 are particular to the precise composition of the alloy used and its processing, and in some embodiments exhibit shape memory effect (SME) and superelasticity (SE; also called pseudoelasticity, PE). Nitinol is highly biocompatible, and has properties suitable for use in medical devices inserted or implanted within the human body. Due to Nitinol's unique properties, Nitinol finds application in catheters, stents, and super elastic needles.
In embodiments where the shape memory alloy selected for use in catheter 1 and basket 10 is Nitinol, tight compositional control of the Nitinol is required during the manufacturing process due to the high reactivity of titanium. By way of example, melting methods of the Nitinol employed to form tube or hypotube 5, splines 12 and distal tip 14 may include vacuum arc remelting (VAR) or vacuum induction melting (VIM). High vacuums may be required during a Nitinol spline manufacturing process. Alternatives to VAR and VIM include, but are not limited to, plasma arc melting, induction skull melting, and e-beam melting. Physical vapor deposition may also be employed. Some methods of working Nitinol for use in splines 12 include, but are not limited to, grinding, abrasive cutting, electrical discharge machining (EDM), and laser cutting. Heat treating of Nitinol employed in splines 12 can include varying aging time and temperature controls to obtain a desired Ni-rich phase and transformation temperature of splines 12, and thus control how much nickel resides in the resulting NiTi lattice. With respect to catheter 1, basket 10 and splines 12 thereof, Nitinol is worked, treated and formed so that it will consistently and reliably behave and assume one or more of the various configurations shown and described herein as mapping electrode assembly or basket 10 is progressively deployed from a distal end of catheter 1.
In alternative embodiments, splines 12 and distal tip 14 may comprise a biocompatible material having shape memory characteristics and attributes, but are not formed of Nitinol or other shape memory alloys (or at least are not formed primarily or solely of one or more shape memory alloys). By way of non-limiting example, in such alternative embodiments splines 12 and distal tip 14 are formed of biocompatible shape memory materials such as shape-memory polymers, laminated 3D printed splines comprising shape memory materials, shape memory composites, and/or shape memory hybrids.
Various aspects and features of basket 10 and catheter 1 described and disclosed herein may be modified to include elements, features and steps described and disclosed in one or more of the '183, '697, '069, '637, '873, '368, and '594 patent applications described hereinabove in the “Related Applications” section. The various systems, devices, components and methods described and disclosed herein may also be adapted and configured for use in EP mapping applications in the heart's atria, ventricles, pulmonary vein or arteries, or other portions of the heart, and may further be configured for use in EP mapping in organs other than those involving the interior of a patient's heart or the pulmonary veins or arteries. These alternative applications include, but are not limited to, EP mapping and diagnosis, or other forms, means or methods of electrically sensing, a patient's stomach, colon, esophagus, veins, arteries, aorta, or any other suitable portion of a patient's body. The various embodiments further include within their scope methods of implanting, using and making the catheters described hereinabove.
What have been described above are examples and embodiments of the devices and methods described and disclosed herein. It is, of course, not possible to describe every conceivable combination of components or methodologies for purposes of describing the invention, but one of ordinary skill in the art will recognize that many further combinations and permutations of the devices and methods described and disclosed herein are possible. Accordingly, the devices and methods described and disclosed herein are intended to embrace all such alterations, modifications and variations that fall within the scope of the appended claims. In the claims, unless otherwise indicated, the article “a” is to refer to “one or more than one.”
The foregoing outlines features of several embodiments so that those skilled in the art may better understand the detailed description set forth herein. Those skilled in the art will now understand that many different permutations, combinations and variations of basket 10 and method 100 fall within the scope of the various embodiments. Those skilled in the art should appreciate that they may readily use the present disclosure as a basis for designing or modifying other processes and structures for carrying out the same purposes and/or achieving the same advantages of the embodiments introduced herein. Those skilled in the art should also realize that such equivalent constructions do not depart from the spirit and scope of the present disclosure, and that they may make various changes, substitutions and alterations herein without departing from the spirit and scope of the present disclosure.
After having read and understood the present specification, those skilled in the art will now understand and appreciate that the various embodiments described herein provide solutions to long-standing problems, both in the use of electrophysiological mapping systems and in the use of cardiac ablation systems.
This application claims priority and other benefits from each of the following provisional patent applications: (1) U.S. Provisional Patent Application Ser. No. 62/414,183 to Ruppersberg entitled “Electrophysiological Mapping Catheter” filed on Oct. 28, 2016 (“the '183 patent application”); (2) U.S. Provisional Patent Application Ser. No. 62/770,697 to Ruppersberg entitled “Electrophysiological Mapping Catheter” filed on Nov. 21, 2018 (“the '697 patent application”); and (3) U.S. Provisional Patent Application Ser. No. 62/828,069 to Ruppersberg entitled “Methods, Systems, Devices and Components for Electrophysiological Mapping Catheters” filed on Apr. 2, 2019 (“the '069 patent application”). This application is also a continuation-in-part, and claims priority and other benefits from, each of the following pending utility patent applications: (4) U.S. Utility patent application Ser. No. 16/156,637 to Ruppersberg entitled “Multiple Configuration Electrophysiological Mapping Catheter, and Systems, Devices, Components and Methods Associated Therewith” filed on Oct. 10, 2018 (“the '637 patent application”); (5) U.S. Utility patent application Ser. No. 16/387,873 to Ruppersberg entitled “Systems, Devices, Components and Methods for Detecting the Locations of Sources of Cardiac Rhythm Disorders in a Patient's Heart and Classifying Same” filed on Apr. 18, 2019 (“the '873 patent application”); and (6) U.S. Utility patent application Ser. No. 16/691,368 to Ruppersberg entitled “Electrophysiological Mapping Catheter” filed on Nov. 21, 2019 (“the '368 patent application”). Through the foregoing pending '637, '873 and '368 patent applications, this application further claims priority and other benefits from U.S. patent application Ser. No. 15/793,594 (now U.S. Pat. No. 10,813,590) to Ruppersberg entitled “Electrophysiological Mapping Catheter” filed on Oct. 25, 2017 (“the '594 patent application”). Each of the '637, '873 and '368 patent applications is a continuation-in-part of the '594 patent application. The '594 application claims priority from the foregoing '183 provisional patent application. The '873 and '368 patent applications each claim priority to both of the foregoing '697 and '069 provisional applications. The '873 patent application is a C-I-P of the '637 patent application. Each of the foregoing '183, '697, '069, '637, '873, '368, and '594 patent applications is hereby incorporated by reference herein, each in its respective entirety.
Number | Date | Country | |
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62414183 | Oct 2016 | US | |
62770697 | Nov 2018 | US | |
62828069 | Apr 2019 | US | |
62770697 | Nov 2018 | US | |
62828069 | Apr 2019 | US |
Number | Date | Country | |
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Parent | 16156637 | Oct 2018 | US |
Child | 17685192 | US | |
Parent | 16387873 | Apr 2019 | US |
Child | 16156637 | US | |
Parent | 16691368 | Nov 2019 | US |
Child | 16387873 | US | |
Parent | 15793594 | Oct 2017 | US |
Child | 16156637 | US | |
Parent | 15793594 | Oct 2017 | US |
Child | 16387873 | US | |
Parent | 15793594 | Oct 2017 | US |
Child | 16691368 | US | |
Parent | 16156637 | Oct 2018 | US |
Child | 16387873 | US |