Magnetically coupled ablation components

Abstract

Ablation systems, components thereof, and associated methods are disclosed. An example ablation system may include a first ablation component including a first ablation component end effector configured to be positioned on a first side of a target tissue, and a second ablation component including a second ablation component end effector configured to be positioned on a second side of the target tissue. The first ablation component may include a first ablation component permanent magnet that is translationally repositionable between an engaged configuration and a disengaged configuration. The second ablation component may include a second ablation component permanent magnet that is freely rotatable and configured to rotationally reorient into a magnetically attractive orientation with the first ablation component permanent magnet.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Patent Application No. 63 / 294,191, entitled "MAGNETICALLY COUPLED ABLATION COMPONENTS," filed on December 28, 2021, U.S. Provisional Patent Application No. 63 / 365,692, entitled "MAGNETICALLY COUPLED ABLATION COMPONENTS," filed on June 1, 2022, and U.S. Provisional Patent Application No. 63 / 383,004, entitled "MAGNETICALLY COUPLED ABLATION COMPONENTS," filed on November 9, 2022, the contents of each of which are incorporated by reference in their entirety herein.

[0002] FIELD OF THE DISCLOSURE The present disclosure is directed to medical devices and associated methods, and more particularly, to devices and associated methods for ablating tissue. [Background technology]

[0003] The present disclosure contemplates that cardiac arrhythmias affect millions of people in the U.S. For example, atrial fibrillation is a cardiac arrhythmia in which the electrical activity of the upper chambers of the heart is disrupted. Other common arrhythmias include ventricular tachycardia and / or inappropriate sinus tachycardia.

[0004] The present disclosure contemplates that treatment for cardiac arrhythmias may include creating anatomically based lesion patterns ("mazes") of scar lesions and / or targeted point or line lesions per electrical mapping of the patient's heart to block erroneous electrical impulses in the cardiac tissue. The lesions may be created by cutting and suturing the cardiac tissue back together. Alternatively, the lesions may be created by ablating the cardiac tissue using various modalities, such as, for example, radio frequency (RF) energy ablation, pulsed field ablation, cryoablation, ultrasonic ablation, and / or laser ablation. As used herein, "ablation" may refer to the removal or destruction of a function of a body part, such as cardiac tissue, regardless of the device or process used to perform the ablation.

[0005] The present disclosure contemplates that in some circumstances it may be desirable for cardiac ablation lesions to span the entire thickness of the cardiac tissue. Accordingly, some ablation devices and methods may be configured to create transmural lesions. As used herein, "transmural" may refer to penetrating a wall or thickness, such as penetrating the wall or thickness of a hollow organ or vessel.

[0006] The present disclosure contemplates that because RF ablation delivers energy between two electrodes to heat the target tissue, an effective electrode configuration for achieving a transmural lesion with RF energy may include ablation electrodes positioned on either side of the tissue targeted for ablation. Similar approaches may be utilized with other ablation modalities.

[0007] The present disclosure contemplates that in the context of cardiac ablation, catheter-based ablation devices may be used to access the endocardial (internal) surface of the heart, but may not have easy access to the epicardial (external) surface of the heart. Surgery-based ablation devices may easily access the epicardial surface through either open chest or minimally invasive procedures, but may require an atriotomy to directly access the endocardial surface. In other situations, epicardial access may be obtained percutaneously. Some devices may use a vacuum to fold the tissue so that the endocardial surface is between the electrodes, but these devices may be limited by the amount of tissue that can be engaged. RF pinching devices may include electrodes on opposing jaws and may be used epicardially by pinching the two walls together, or with one jaw endocardial and one jaw epicardial. Summary of the Invention [Problem to be solved by the invention]

[0008] The present disclosure contemplates that problems faced in cardiac ablation procedures may include difficulties in accurately positioning an ablation device in a target tissue and difficulties with ablation of the tissue. For example, in some circumstances it may be difficult to create a sufficiently continuous and deep (e.g., transmural) line of ablation tissue that may be necessary to electrically isolate a portion of the heart.

[0009] Although known devices have been used to ablate tissue (such as cardiac tissue), improvements in the structure and operation of devices for ablating tissue may be beneficial to users (e.g., surgeons, electrophysiologists, interventionalists) and patients. The present disclosure includes various improvements that may enhance the structure, operation, and method of use of devices for ablating tissue, such as cardiac tissue. [Means for solving the problem]

[0010] It is an aspect of the present disclosure to provide an ablation system including a first ablation component and / or a second ablation component. The first ablation component may comprise a first ablation component end effector configured to be positioned on a first side of a target tissue, the first ablation component end effector housing, a first ablation component tissue contact portion configured to engage the first side of the target tissue, a first ablation component ablation element selectively operable to cause ablation of the target tissue, and / or a first ablation component permanent magnet translationally repositionable relative to the first ablation component end effector housing between an engaged configuration and a disengaged configuration, and / or a mechanical linkage operably coupled to translationally reposition the first ablation component permanent magnet relative to the first ablation component end effector housing between an engaged configuration and a disengaged configuration. The second ablation component may be configured for cooperative operation with the first ablation component. The second ablation component may comprise a second ablation component end effector configured to be positioned on a second side of the target tissue opposite the first side of the target tissue, the second ablation component end effector housing, a second ablation component tissue contact portion configured to engage the second side of the target tissue, a second ablation component ablation element, the second ablation component being selectively operable to cause ablation of the target tissue, and / or a second ablation component end effector comprising a second ablation component permanent magnet that is freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing without substantial translation relative to the second ablation component end effector housing and configured to rotatably self-orient into a magnetically attractive orientation with the first ablation component permanent magnet.In the engaged configuration, the first ablation component permanent magnet can be configured to magnetically attract the second ablation component permanent magnet with the second ablation component end effector positioned on the second side of the target tissue substantially adjacent to the first ablation component tissue contact portion. In the disengaged configuration, with the second ablation component end effector positioned on the second side of the target tissue substantially adjacent to the first ablation component tissue contact portion, the magnetic attraction between the first ablation component permanent magnet and the second ablation component permanent magnet can be reduced compared to the engaged configuration.

[0011] In detailed embodiments, the first ablation component permanent magnet may be translationally repositionable relative to the first ablation component end effector housing between an engaged configuration and a disengaged configuration without substantial rotation. The first ablation component permanent magnet may be translationally repositionable between an engaged configuration and a disengaged configuration along a longitudinal axis of the first ablation component permanent magnet.

[0012] In a detailed embodiment, in the engaged configuration, the first ablation component permanent magnet can be positioned substantially laterally adjacent to the first ablation component tissue contacting portion, and in the disengaged configuration, the first ablation component permanent magnet can be positioned substantially non-laterally adjacent to the first ablation component tissue contacting portion.

[0013] In a detailed embodiment, the first ablation component end effector may include at least one vacuum port disposed at the first ablation component tissue contacting portion, the vacuum port configured to be fluidly coupled to a vacuum source. The vacuum port may be configured such that upon application of a vacuum to the vacuum port, the vacuum port releasably secures the first ablation component tissue contacting portion to the target tissue. The first ablation component ablation element may be disposed substantially within a periphery at least partially surrounding the vacuum port.

[0014] In a detailed embodiment, the first ablation component ablation element may comprise a first ablation component ablation electrode. The first ablation component may be configured to deliver radio frequency ablation energy to the target tissue via the first ablation component ablation electrode. The first ablation component ablation electrode may comprise an elongated electrode having one dimension substantially greater than a vertical dimension.

[0015] In a detailed embodiment, a distal end portion of the first ablation component may be steerable.

[0016] In a detailed embodiment, the first ablation component end effector may include an outwardly extending generally circumferential first ablation component end effector skirt. The first ablation component tissue contacting portion may include the first ablation component end effector skirt. The first ablation component ablation element may be disposed within a perimeter defined at least in part by the first ablation component end effector skirt.

[0017] In a detailed embodiment, the first ablation component end effector may include at least one aperture configured to deliver irrigation fluid to a first side of the target tissue proximate the first ablation component ablation element.

[0018] In a detailed embodiment, the first ablation component ablation element can comprise a first ablation component ablation electrode. The first ablation component ablation electrode can comprise at least one internal passageway. The at least one internal passageway can be operably coupled to a source of cooling fluid.

[0019] In a detailed embodiment, the first ablation component may include a first ablation component connecting element. The first ablation component end effector may be disposed distally at the first ablation component connecting element. The first ablation component may include a first ablation component handle disposed proximally at the first ablation component connecting element. The first ablation component handle may include a first ablation component magnet actuator operably connected to the first ablation component permanent magnet via a mechanical linkage for repositioning the first ablation component permanent magnet between an engaged configuration and a disengaged configuration.

[0020] In a detailed embodiment, the first ablation component may comprise at least one first ablation component auxiliary electrode.

[0021] In detailed embodiments, the second ablation component permanent magnet may be freely rotatable about three axes of rotation relative to the second ablation component end effector housing. The second ablation component permanent magnet may comprise a substantially spherical permanent magnet. The substantially spherical permanent magnet may be rotatably disposed within a substantially spherical interior of the second ablation component end effector housing. The second ablation component permanent magnet may be disposed on a substantially spherical mounting portion. The substantially spherical mounting portion may be rotatably disposed within a substantially spherical interior of the second ablation component end effector housing.

[0022] In a detailed embodiment, the second ablation element tissue contacting portion may be bulbous. The second ablation element tissue contacting portion may be at least partially generally spherical.

[0023] In a detailed embodiment, the second ablation component end effector housing can be constructed from a highly magnetically permeable, non-ferrous, electrically conductive material. The second ablation component end effector housing can be constructed from copper.

[0024] In a detailed embodiment, the second ablation component ablation element can include a second ablation component ablation electrode. The second ablation component ablation electrode can form at least a portion of the second ablation component end effector housing.

[0025] In a detailed embodiment, the second ablation component may include at least one second ablation component auxiliary electrode. The at least one second ablation component auxiliary electrode may be disposed at a distal tip of the second ablation component end effector housing. The at least one second ablation component auxiliary electrode may be disposed laterally on the second ablation component end effector housing.

[0026] In detailed embodiments, the second ablation component end effector housing can be at least partially generally spherical. The second ablation component end effector housing can include a distal portion constructed from a conductive material and a proximal portion constructed from a non-conductive material.

[0027] In a detailed embodiment, the second ablation component can include a second ablation component connecting element. The second ablation component end effector can be disposed distally at the second ablation component connecting element.

[0028] In a detailed embodiment, the second ablation component connecting element may comprise a generally tubular first connecting element with a first connecting element distal portion, a second connecting element operably coupled to the first connecting element distal portion, the second ablation component end effector being disposed distally on the second connecting element, and / or an engaging element configured to selectively engage the second ablation component end effector with the first connecting element distal portion. The second connecting element may be selectively repositionable relative to the first connecting element distal portion between (i) a retracted configuration in which the second connecting element may be disposed substantially within the first connecting element and the engaging element may operably couple to the second ablation component end effector and the first connecting element distal portion, and (ii) a deployed configuration in which at least a portion of the second connecting element may extend from the first connecting element distal portion and the engaging element may be disengaged from at least one of the second ablation component end effector or the first connecting element distal portion. The second connecting element may have greater flexibility than the distal portion of the first connecting element.

[0029] In a detailed embodiment, the ablation system may include a second ablation component handle disposed proximally at the first connecting element. The second ablation component handle may include a deployment actuator operable to reposition the second connecting element relative to the first connecting element distal portion.

[0030] In detailed embodiments, the first connecting element distal portion can be steerable. The second ablation component handle can include a steering actuator operable to steer the first connecting element distal portion.

[0031] In a detailed embodiment, the engagement element can be disposed at a distal end of the first connecting element distal portion. In the retracted configuration, the engagement element can be configured to receive at least a portion of the end effector therein. The engagement element can include a distally oriented opening. The opening can be generally conical.

[0032] It is an aspect of the present disclosure to provide a method of creating a lesion in a target tissue, the method including the steps of positioning a first ablation component proximate to a first surface of the target tissue, the first ablation component comprising a first ablation component end effector with a first ablation component end effector housing, a first ablation component permanent magnet translationally repositionable within the first ablation component end effector housing, and a first ablation component ablation element. The method may include the steps of positioning a second ablation component proximate to a second surface of the target tissue opposite the first surface of the target tissue, the second ablation component comprising a second ablation component end effector with a second ablation component end effector housing, a second ablation component permanent magnet freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing, and a second ablation component ablation element. The method may include rotating the second ablation component permanent magnet about at least one axis of rotation without substantial translation relative to the second ablation component end effector housing to self-orient the second ablation component permanent magnet into a magnetically attractive orientation with the first ablation component permanent magnet. The method may include positioning one or both of the first ablation component end effector and the second ablation component end effector at the target tissue using an attractive magnetic coupling between the first ablation component permanent magnet and the second ablation component permanent magnet. The method may include creating a first lesion at the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element. The method may include translationally repositioning the first ablation component permanent magnet from an engaged configuration to a disengaged configuration within the first ablation component end effector housing to reduce the attractive magnetic coupling between the first ablation component permanent magnet and the second ablation component permanent magnet.

[0033] In a detailed embodiment, translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing may include translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing without substantial rotation of the first ablation component permanent magnet relative to the first ablation component end effector housing. Translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing may include translationally repositioning the first ablation component permanent magnet along a longitudinal axis of the first ablation component permanent magnet. Translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing may include translationally repositioning the first ablation component permanent magnet from substantially laterally adjacent to the first ablation component tissue contacting portion of the first ablation component end effector housing to substantially not laterally adjacent to the first ablation component tissue contacting portion.

[0034] In a detailed embodiment, the first ablation component can include a first ablation component connecting element, and the first ablation component end effector is disposed distally at the first ablation component connecting element. The first ablation component can include a first ablation component handle disposed proximally at the first ablation component connecting element. The first ablation component handle can include a first ablation component magnet actuator operably connected to the first ablation component permanent magnet for translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing between an engaged configuration and a disengaged configuration. Translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing from an engaged configuration to a disengaged configuration can include operating the first ablation component magnet actuator to translationally reposition the first ablation component permanent magnet within the first ablation component end effector housing from an engaged configuration to a disengaged configuration.

[0035] In a detailed embodiment, the method may include applying a vacuum to a vacuum port of the first ablation component end effector to secure the first ablation component end effector to the target tissue. The method may include ceasing application of the vacuum to the vacuum port.

[0036] In a detailed embodiment, the first ablation component ablation element may comprise a first ablation component ablation electrode. The second ablation component ablation element may comprise a second ablation component ablation electrode. Creating a first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may include applying bipolar radio frequency energy to the target tissue using the first ablation component ablation element and the second ablation component ablation element to create the first lesion in the target tissue.

[0037] In a detailed embodiment, the first ablation component may comprise at least one electrode. The method may include using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping. The at least one electrode may comprise at least one of a first ablation component ablation electrode and a first ablation component auxiliary electrode. Using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping may include using at least one of a first ablation component ablation electrode and a first ablation component auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

[0038] In a detailed embodiment, the second ablation component permanent magnet may be freely rotatable about three axes of rotation relative to the second ablation component end effector housing. The step of self-orienting the second ablation component permanent magnet into a magnetically attractive orientation with the first ablation component permanent magnet may include rotating the second ablation component permanent magnet about three axes of rotation. The second ablation component permanent magnet may comprise a generally spherical second ablation component permanent magnet. The second ablation component end effector housing may comprise a generally spherical interior. Rotating the second ablation component permanent magnet about three axes of rotation includes rotating the generally spherical second ablation component permanent magnet about three axes of rotation within the generally spherical interior of the second ablation component end effector housing.

[0039] In a detailed embodiment, the step of positioning one or both of the first ablation component end effector and the second ablation component end effector at the target tissue may include engaging a generally bulbous tissue contacting surface of the second ablation component end effector with a second surface of the target tissue.

[0040] In a detailed embodiment, the method may include removing at least one of the first ablation component end effector and the second ablation component end effector from the target tissue.

[0041] In a detailed embodiment, the step of positioning the first ablation component proximate to the first surface of the target tissue may include steering a distal portion of the first ablation component connecting element, wherein the first ablation component end effector is positioned distally at the first ablation component connecting element.

[0042] In a detailed embodiment, the second ablation component may comprise at least one electrode. The method may include using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping. The at least one electrode may comprise at least one of a second ablation component ablation electrode and a second ablation component auxiliary electrode. Using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping may include using at least one of a second ablation component ablation electrode and a second ablation component auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

[0043] In a detailed embodiment, the step of positioning the second ablation component proximate to the second surface of the target tissue may include steering a distal portion of the second ablation component connecting element. The second ablation component end effector may be positioned distally at the second ablation component connecting element.

[0044] In a detailed embodiment, the second ablation component may comprise a second ablation component connection element, the second ablation component connection element comprising a generally tubular first connection element comprising a first connection element distal portion and a second connection element operably coupled to the first connection element distal portion. The second ablation component end effector may be disposed distally on the second connection element. The method may include repositioning the second connection element and the second ablation component end effector from a retracted configuration in which the second connection element may be disposed substantially within the first connection element to a deployed configuration in which at least a portion of the second connection element may extend from the first connection element distal portion. Creating a first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may be performed while the second connection element and the second ablation component end effector are in the deployed configuration.

[0045] In a detailed embodiment, the second ablation component may include a second ablation component handle disposed proximally at the first connection element, the second ablation component handle including a deployment actuator operable to reposition the second connection element relative to the first connection element distal portion. Repositioning the second connection element and the second ablation component end effector from a retracted configuration to a deployed configuration may include operating the deployment actuator. The method may include repositioning the second connection element and the second ablation component end effector from a deployed configuration to a retracted configuration. Repositioning the second connection element and the second ablation component end effector from a retracted configuration to a deployed configuration may include disengaging the second ablation component end effector from an engagement element configured to selectively engage the second ablation component end effector with the first connection element distal portion. Repositioning the second connecting element and the second ablation component end effector from the deployed configuration to the retracted configuration may include engaging the second ablation component end effector with the engagement element.

[0046] It is an aspect of the present disclosure to provide an ablation component comprising a generally tubular first connecting element comprising a first connecting element distal portion, a second connecting element operably coupled to the first connecting element distal portion, an end effector disposed distally on the second connecting element, the end effector comprising an end effector housing, an ablation element, and a permanent magnet, and / or an engaging element configured to selectively engage the end effector with the first connecting element distal portion. The second connecting element may be selectively repositionable relative to the first connecting element distal portion between (i) a retracted configuration in which the second connecting element may be disposed substantially within the first connecting element, and the engaging element operably couples the end effector and the first connecting element distal portion, and (ii) a deployed configuration in which at least a portion of the second connecting element may extend from the first connecting element distal portion, and the engaging element may be disengaged from at least one of the end effector or the first connecting element distal portion.

[0047] In detailed embodiments, the second connecting element can have greater flexibility than the first connecting element distal portion.The permanent magnet can be freely rotatable relative to the end effector housing about three axes of rotation.

[0048] In detailed embodiments, the permanent magnet may comprise a substantially spherical permanent magnet. The substantially spherical permanent magnet may be rotatably disposed within the substantially spherical interior of the end effector housing. The permanent magnet may be disposed on a substantially spherical mounting portion. The substantially spherical mounting portion may be rotatably disposed within the substantially spherical interior of the end effector housing.

[0049] In detailed embodiments, the end effector may include a generally bulbous tissue contacting surface. The end effector may include a tissue contacting surface that is at least partially generally spherical. The end effector housing may be constructed from a highly magnetically permeable, non-ferrous, electrically conductive material. The second ablation component end effector housing may be constructed from copper.

[0050] In a detailed embodiment, the ablation element may comprise an electrode. The end effector housing may include an electrode. The electrode may generally comprise two primary electrodes in the form of cooperating laterally disposed hemispheres separated by an insulator.

[0051] In a detailed embodiment, the ablation component may include a handle disposed proximally at the first connection element, the handle including a deployment actuator operable to reposition the second connection element relative to the first connection element distal portion.

[0052] In detailed embodiments, the first connecting element distal portion can be steerable. The first connecting element distal portion can be steerable at least about 180 degrees. The ablation component can include a handle disposed proximally at the first connecting element, the handle including a steering actuator operable to steer the first connecting element distal portion.

[0053] In a detailed embodiment, the engagement element can be disposed at a distal end of the first connecting element distal portion. In the retracted configuration, the engagement element can be configured to receive at least a portion of the end effector therein. The engagement element can include a distally oriented opening. The opening can be generally conical.

[0054] In detailed embodiments, the ablation component may include at least one auxiliary electrode. The at least one auxiliary electrode may be disposed at a distal tip of the end effector housing. The at least one auxiliary electrode may be disposed laterally on the end effector housing. The at least one auxiliary electrode may include a generally circular circumferential ring that may be disposed laterally on the end effector housing.

[0055] In detailed embodiments, the end effector housing may be at least partially generally spherical. The end effector housing may include a distal portion constructed from a conductive material and a proximal portion constructed from a non-conductive material.

[0056] It is an aspect of the present disclosure to provide a method of creating lesions in a target tissue, the method including positioning an ablation component proximate a first surface of the target tissue, the ablation component including an end effector including an end effector housing, a permanent magnet freely rotatable about at least one axis of rotation relative to the end effector housing, and an ablation element. The method may include rotating the permanent magnet about the at least one axis of rotation to self-orient the permanent magnet into a magnetically attractive orientation with a cooperating ablation component magnetic element of a cooperating ablation component positioned proximate a second surface of the target tissue opposite the first surface of the target tissue. The method may include positioning the end effector at the target tissue using an attractive magnetic coupling between the permanent magnet and the cooperating ablation component magnetic element. The method may include creating lesions in the target tissue using the ablation element.

[0057] In a detailed embodiment, the permanent magnet may be freely rotatable relative to the end effector housing about three axes of rotation. Self-orienting the permanent magnet into a magnetically attractive orientation with a cooperating ablation component magnetic element may include rotating the permanent magnet about the three axes of rotation.

[0058] In a detailed embodiment, the permanent magnet may comprise a generally spherical permanent magnet. The end effector housing may comprise a generally spherical interior. Rotating the permanent magnet about three axes of rotation may include rotating the generally spherical permanent magnet about the three axes of rotation within the generally spherical interior of the end effector housing.

[0059] In a detailed embodiment, the step of positioning the end effector at the target tissue may include engaging a generally bulbous tissue contacting surface of the end effector with a first surface of the target tissue.

[0060] In a detailed embodiment, the step of positioning the ablation component proximate to the first surface of the target tissue may include steering a distal portion of the connecting element, the end effector being disposed distally on the connecting element. Steering the distal portion of the connecting element may include operating a steering actuator disposed on a handle of the ablation component, the handle being disposed proximally on the connecting element.

[0061] In detailed embodiments, the ablation element may comprise an electrode. Creating lesions in the target tissue using the ablation element may include applying radio frequency ablation energy to the target tissue using the electrode. Applying radio frequency ablation energy to the target tissue using the electrode may include applying bipolar radio frequency ablation energy to the target tissue using the electrode and a cooperating electrode of a cooperating ablation component.

[0062] In a detailed embodiment, the end effector may include at least one electrode. The method may include using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping. The at least one electrode may include at least one of an ablation electrode and an auxiliary electrode. Using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping may include using at least one of an ablation electrode and an auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

[0063] In a detailed embodiment, the ablation component may comprise a connecting element, the connecting element comprising a generally tubular first connecting element comprising a first connecting element distal portion and a second connecting element operably coupled to the first connecting element distal portion. The end effector may be disposed distally on the second connecting element. The method may include repositioning the second connecting element and the end effector from a retracted configuration in which the second connecting element is disposed substantially within the first connecting element to a deployed configuration in which at least a portion of the second connecting element extends from the first connecting element distal portion. The step of creating a lesion in the target tissue using the ablation element may be performed while the second connecting element and the end effector are in the deployed configuration.

[0064] In a detailed embodiment, the ablation component includes a handle disposed proximally on the first connection element, the handle including a deployment actuator operable to reposition the second connection element relative to the first connection element distal portion. Repositioning the second connection element and the end effector from the retracted configuration to the deployed configuration may include operating the deployment actuator. The method may include repositioning the second connection element and the end effector from the deployed configuration to the retracted configuration. Repositioning the second connection element and the end effector from the retracted configuration to the deployed configuration may include disengaging the end effector from an engagement element configured to selectively engage the end effector with the first connection element distal portion. Repositioning the second connection element and the end effector from the deployed configuration to the retracted configuration may include engaging the end effector with the engagement element.

[0065] It is an aspect of the present disclosure to provide an ablation system including a first ablation component and / or a second ablation component. The first ablation component may comprise a first ablation component end effector configured to be positioned at a first side of a target tissue, the first ablation component comprising a first ablation component end effector housing, a first ablation component tissue contact portion configured to engage with the first side of the target tissue, a first ablation component ablation element, the first ablation component selectively operable to cause ablation of the target tissue, and / or a first ablation component permanent magnet freely rotatable about at least one axis of rotation relative to the first ablation component end effector housing without substantial translation relative to the first ablation component end effector housing and configured to rotatably self-orient into a magnetically attractive orientation with a cooperating magnetic element. The second ablation component can be configured for cooperative operation with the first ablation component.The second ablation component may comprise a second ablation component end effector configured to be positioned on a second side of the target tissue opposite the first side of the target tissue, the second ablation component comprising a second ablation component end effector housing, a second ablation component tissue contact portion configured to engage the second side of the target tissue, a second ablation component ablation element, the second ablation component being selectively operable to cause ablation of the target tissue, and / or a second ablation component permanent magnet comprising a cooperating magnetic element, the second ablation component permanent magnet being freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing without substantial translation relative to the second ablation component end effector housing and configured to rotatably self-orient into a magnetically attractive orientation with the first ablation component permanent magnet.

[0066] In a detailed embodiment, the first ablation component permanent magnet can be freely rotatable about three axes of rotation relative to the first ablation component end effector housing, and the second ablation component permanent magnet can be freely rotatable about three axes of rotation relative to the second ablation component end effector housing.

[0067] In a detailed embodiment, the first ablation component ablation element may comprise a first ablation component ablation electrode. The first ablation component ablation electrode may form at least a portion of the first ablation component end effector housing. The second ablation component ablation element may comprise a second ablation component ablation electrode. The second ablation component ablation electrode may form at least a portion of the second ablation component end effector housing.

[0068] In a detailed embodiment, the first ablation component may comprise at least one first ablation component auxiliary electrode, and the second ablation component may comprise at least one second ablation component auxiliary electrode.

[0069] In a detailed embodiment, the first ablation component may include a first ablation component connecting element. The first ablation component end effector may be disposed distally at the first ablation component connecting element. The second ablation component may include a second ablation component connecting element. The second ablation component end effector may be disposed distally at the second ablation component connecting element.

[0070] In detailed embodiments, the first ablation component connecting element may comprise a generally tubular first ablation component first connecting element comprising a first ablation component first connecting element distal portion, a first ablation component second connecting element operably coupled to the first ablation component first connecting element distal portion, wherein the first ablation component end effector is disposed distally at the first ablation component second connecting element, and / or a first ablation component engaging element configured to selectively engage the first ablation component end effector with the first ablation component first connecting element distal portion. The first ablation component second connecting element may be selectively repositionable relative to the first ablation component first connecting element distal portion between (i) a retracted configuration in which the first ablation component second connecting element may be disposed substantially within the first ablation component first connecting element and the first ablation component engaging element may be operably coupled to the first ablation component end effector and the first ablation component first connecting element distal portion, and (ii) a deployed configuration in which at least a portion of the first ablation component second connecting element may extend from the first ablation component first connecting element distal portion and the first ablation component engaging element may be disengaged from at least one of the first ablation component end effector or the first ablation component first connecting element distal portion. The second ablation component connecting element may comprise a generally tubular second ablation component first connecting element comprising a second ablation component first connecting element distal portion, a second ablation component second connecting element operably coupled to the second ablation component first connecting element distal portion, wherein the second ablation component end effector is disposed distally at the second ablation component second connecting element, and / or a second ablation component engaging element configured to selectively engage the second ablation component end effector with the second ablation component first connecting element distal portion.The second ablation component's second connecting element may be selectively repositionable relative to the second ablation component's first connecting element distal portion between (i) a retracted configuration in which the second ablation component's second connecting element may be disposed substantially within the second ablation component's first connecting element and the second ablation component engaging element may be operably coupled to the second ablation component end effector and the second ablation component's first connecting element distal portion, and (ii) a deployed configuration in which at least a portion of the second ablation component's second connecting element may extend from the second ablation component's first connecting element distal portion and the second ablation component engaging element may be disengaged from at least one of the second ablation component end effector or the second ablation component's first connecting element distal portion.

[0071] In a detailed embodiment, the second connecting element of the first ablation component can have greater flexibility than the first connecting element distal portion of the first ablation component.The second connecting element of the second ablation component can have greater flexibility than the first connecting element distal portion of the second ablation component.

[0072] In a detailed embodiment, the system may include a first ablation component handle disposed proximally at a first connecting element of a first ablation component, the first ablation component handle comprising a first ablation component deployment actuator operable to reposition a second connecting element of the first ablation component relative to a first connecting element distal portion of the first ablation component.The system may include a second ablation component handle disposed proximally at a first connecting element of a second ablation component, the second ablation component handle comprising a second ablation component deployment actuator operable to reposition a second connecting element of the second ablation component relative to a first connecting element distal portion of the second ablation component.

[0073] In a detailed embodiment, the first ablation component engaging element can be disposed at a distal end of the first connecting element distal portion of the first ablation component. In the retracted configuration, the first ablation component engaging element can be configured to receive at least a portion of the first ablation component end effector therein. The second ablation component engaging element can be disposed at a distal end of the first connecting element distal portion of the second ablation component. In the retracted configuration, the second ablation component engaging element can be configured to receive at least a portion of the second ablation component end effector therein.

[0074] In a detailed embodiment, the first ablation component engaging element can include a distally oriented opening, and the second ablation component engaging element can include a distally oriented opening.

[0075] It is an aspect of the present disclosure to provide a method of creating a lesion in a target tissue, the method including the step of positioning a first ablation component proximate to a first surface of the target tissue, the first ablation component comprising a first ablation component end effector with a first ablation component end effector housing, a first ablation component permanent magnet that is freely rotatable about at least one axis of rotation relative to the first ablation component end effector housing, and / or a first ablation component ablation element. The method may include the step of positioning a second ablation component proximate to a second surface of the target tissue, the second ablation component comprising a second ablation component end effector with a second ablation component end effector housing, a second ablation component permanent magnet that is freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing, and / or a second ablation component ablation element. The method may include freely rotating a first ablation component permanent magnet to self-orient the first ablation component permanent magnet into a magnetically attractive orientation with the second ablation component permanent magnet, and / or freely rotating the second ablation component permanent magnet to self-orient the second ablation component permanent magnet into a magnetically attractive orientation with the first ablation component permanent magnet. The method may include positioning the first ablation component end effector and the second ablation component end effector at the target tissue using an attractive magnetic coupling between the first ablation component permanent magnet and the second ablation component permanent magnet. The method may include creating a first lesion at the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element.

[0076] In a detailed embodiment, the step of placing the first ablation component proximate to the first surface of the target tissue may include steering a distal portion of the first ablation component connecting element, the first ablation component end effector being disposed distally at the first ablation component connecting element, and the step of placing the second ablation component proximate to the second surface of the target tissue may include steering a distal portion of the second ablation component connecting element, the second ablation component end effector being disposed distally at the second ablation component connecting element.

[0077] In a detailed embodiment, steering a distal portion of the first ablation component connecting element can include operating a first ablation component steering actuator disposed on a first ablation component handle of the first ablation component, the first ablation component handle being disposed proximally at the first ablation component connecting element. Steering a distal portion of the second ablation component connecting element can include operating a second ablation component steering actuator disposed on a second ablation component handle of the second ablation component, the second ablation component handle being disposed proximally at the second ablation component connecting element.

[0078] In a detailed embodiment, the first ablation component ablation element may comprise a first ablation component ablation electrode. The second ablation component ablation element may comprise a second ablation component ablation electrode. Creating a first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may include applying radio frequency ablation energy to the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element. Applying radio frequency ablation energy to the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may include applying bipolar radio frequency ablation energy to the target tissue using the first ablation component ablation element and the second ablation component ablation element.

[0079] In a detailed embodiment, the first ablation component end effector may include at least one first ablation component electrode. The second ablation component end effector may include at least one second ablation component electrode. The method may include performing at least one of pacing, sensing, stimulating, and mapping using at least one of the at least one first ablation component electrode and the at least one second ablation component electrode.

[0080] In a detailed embodiment, the first ablation component may comprise a first ablation component connecting element, the first ablation component connecting element comprising a generally tubular first ablation component first connecting element comprising the first ablation component first connecting element distal portion, and / or a first ablation component second connecting element operably coupled to the first ablation component first connecting element distal portion. The first ablation component end effector may be disposed distally at the first ablation component second connecting element. The method may include repositioning the first ablation component second connecting element and the first ablation component end effector from a retracted configuration, in which the first ablation component second connecting element may be disposed substantially within the first ablation component first connecting element, to a deployed configuration, in which at least a portion of the first ablation component second connecting element may extend from the first ablation component first connecting element distal portion.

[0081] In a detailed embodiment, the step of creating a first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may be performed while the second connecting element of the first ablation component and the first ablation component end effector are in the deployed configuration.

[0082] In a detailed embodiment, the first ablation component may include a first ablation component handle disposed proximally at the first connecting element of the first ablation component, the first ablation component handle including a first ablation component deployment actuator operable to reposition the second connecting element of the first ablation component relative to the first connecting element distal portion of the first ablation component. Repositioning the second connecting element of the first ablation component and the first ablation component end effector from the retracted configuration to the deployed configuration may include operating the first ablation component deployment actuator.

[0083] In a detailed embodiment, the second ablation component may comprise a second ablation component connecting element, the second ablation component connecting element comprising a generally tubular second ablation component first connecting element comprising the second ablation component first connecting element distal portion, and / or a second ablation component second connecting element operably coupled to the second ablation component first connecting element distal portion. The second ablation component end effector may be disposed distally at the second ablation component second connecting element. The method may include repositioning the second ablation component second connecting element and the second ablation component end effector from a retracted configuration, in which the second ablation component second connecting element may be disposed substantially within the second ablation component first connecting element, to a deployed configuration, in which at least a portion of the second ablation component second connecting element may extend from the second ablation component first connecting element distal portion.

[0084] In a detailed embodiment, the step of creating a first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element may be performed while the second connecting element of the first ablation component and the first ablation component end effector are in the deployed configuration and while the second connecting element of the second ablation component and the second ablation component end effector are in the deployed configuration.

[0085] In a detailed embodiment, the second ablation component may include a second ablation component handle disposed proximally at the first connecting element of the second ablation component, the second ablation component handle including a second ablation component deployment actuator operable to reposition the second connecting element of the second ablation component relative to the first connecting element distal portion of the second ablation component. Repositioning the second connecting element of the second ablation component and the second ablation component end effector from the retracted configuration to the deployed configuration may include operating the second ablation component deployment actuator.

[0086] In a detailed embodiment, repositioning the second connecting element of the first ablation component and the first ablation component end effector from the retracted configuration to the deployed configuration may include disengaging the first ablation component end effector from a first ablation component engaging element configured to selectively engage the first ablation component end effector with a first connecting element distal portion of the first ablation component. Repositioning the second connecting element of the first ablation component and the first ablation component end effector from the deployed configuration to the retracted configuration may include engaging the first ablation component end effector with the first ablation component engaging element.

[0087] In a detailed embodiment, the target tissue may include a ventricular septum of the heart. The first surface of the target tissue may include a right ventricular surface of the ventricular septum. The second surface of the target tissue may include a left ventricular surface of the ventricular septum. Creating a first lesion in the target tissue may include ablating the ventricular septum using a first ablation component ablation element and a second ablation component ablation element.

[0088] It is an aspect of the disclosure to provide a system comprising a first component configured to be positioned on a first side of cardiac tissue and comprising a first component end effector comprising a first component electrode, and / or a second component configured to be positioned on a second side of cardiac tissue opposite the first side and comprising a second component end effector comprising a second component electrode, The first and second components may be configured for cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping.

[0089] In a detailed embodiment, the system may include a control unit configured for cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping.

[0090] In a detailed embodiment, the cooperative use of the first and second component electrodes to perform said at least one of sensing, pacing, stimulating, and mapping may include cooperative sensing using the first and second component electrodes. The cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative pacing using the first and second component electrodes. The cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative stimulation using the first and second component electrodes. The cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative mapping using the first and second component electrodes.

[0091] In a detailed embodiment, the cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping may include delivering an electrical current to the cardiac tissue using one of the first and second component electrodes, and detecting at least one electrical parameter associated with the cardiac tissue using the other of the first and second component electrodes.

[0092] In detailed embodiments, the first component end effector may be configured to be positioned on an epicardial surface of the heart. The first component end effector may be configured to be positioned on an endocardial surface of the heart. The second component end effector may be configured to be positioned on the epicardial surface of the heart. The second component end effector may be configured to be positioned on the endocardial surface of the heart.

[0093] In a detailed embodiment, at least one of the first and second component end effectors may include an ablation element.

[0094] In detailed embodiments, the first component end effector may comprise a first component magnetic element, the second component end effector may comprise a second component magnetic element, and / or the first component magnetic element and the second component magnetic element may be configured for cooperative magnetic attraction across cardiac tissue.

[0095] It is an aspect of the disclosure to provide a method that includes the steps of: positioning a first component proximate to a first surface of cardiac tissue, the first component comprising a first component end effector having a first component electrode; positioning a second component proximate to a second surface of the cardiac tissue opposite the first surface, the second component comprising a second component end effector having a second component electrode; and / or using the first component electrode and the second component electrode in cooperation to perform at least one of sensing, pacing, stimulating, and mapping.

[0096] In a detailed embodiment, the step of cooperatively using the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping may include delivering an electrical current to the cardiac tissue using one of the first and second component electrodes, and / or detecting at least one electrical parameter associated with the cardiac tissue using the other of the first and second component electrodes.

[0097] In a detailed embodiment, the method may include creating a lesion in the cardiac tissue. Creating a lesion in the cardiac tissue may include creating a lesion in the cardiac tissue using at least one of a first component end effector and a second component end effector. Creating a lesion in the cardiac tissue using at least one of the first component end effector and the second component end effector includes delivering ablation energy to the cardiac tissue using at least one of a first component electrode and a second component electrode.

[0098] In a detailed embodiment, using the first and second component electrodes in cooperation to perform at least one of sensing, pacing, stimulating, and mapping may include identifying a target location in the cardiac tissue for future ablation. In a detailed embodiment, using the first and second component electrodes in cooperation to perform at least one of sensing, pacing, stimulating, and mapping may include evaluating the ablation.

[0099] It is an aspect of the present disclosure to provide any method, operation, process, system, device, and / or apparatus associated with any of the preceding aspects or described elsewhere herein.

[0100] It is an embodiment of the present disclosure to provide any combination of any one or more elements of any of the preceding embodiments or described elsewhere herein.

[0101] Example embodiments are described in combination with the accompanying drawing figures, all of which are in accordance with at least some aspects of the present disclosure. [Brief description of the drawings]

[0102] [Figure 1] 1 is a simplified schematic diagram of an example ablation system in use in the heart. [Diagram 2] FIG. 1 is a perspective view of two example ablation components, one shown alone and one shown inserted through an example delivery device. [Diagram 3] FIG. 3 is a simplified perspective view of a distal portion of the ablation component of FIG. 2. [Figure 4] 3 is a detailed perspective view of a distal end portion of the ablation component of FIG. 2 in a generally straight orientation. FIG. [Diagram 5] FIG. 3 is a detailed perspective view of a distal end portion of the ablation component of FIG. 2 in an articulated orientation. [Figure 6] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation component. [Figure 7] 7 is a perspective cross-sectional view of a distal end portion of the ablation component of FIG. 6. FIG. [Figure 8] FIG. 13 is a perspective cross-sectional view of a distal end portion of an alternative example ablation component. [Figure 9] FIG. 13 is a perspective view of an alternative example ablation component comprising an ablation element comprising linear electrodes. [Figure 10] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation component. [Figure 11] FIG. 11 is a perspective view of a distal end portion of the ablation component of FIG. [Figure 12] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation component. [Figure 13] FIG. 13 is a perspective view of a distal end portion of the ablation component of FIG. 12. [Figure 14] FIG. 13 is a perspective view of an alternative example ablation component. [Figure 15]FIG. 15 is a detailed perspective view of the end effector of the ablation component of FIG. 14. [Figure 16] 13A-13C are simplified schematic diagrams of alternative example ablation components with rotationally repositionable magnets in an engaged configuration. [Figure 17] FIG. 17 is a simplified schematic diagram of the ablation component of FIG. 16 in a disengaged configuration. [Figure 18] FIG. 13 is a simplified perspective view of an alternative example ablation component with translationally and rotationally repositionable magnets in an engaged configuration. [Figure 19] FIG. 19 is a simplified perspective view of the ablation component of FIG. 18 in a disengaged configuration. [Figure 20] 19 is a simplified longitudinal cross-sectional view of the ablation component of FIG. 18 in an intermediate configuration. [Figure 21] FIG. 13 is a simplified schematic diagram of an alternative example ablation component with a freely rotatable magnetic element in a retracted configuration. [Figure 22] FIG. 22 is a simplified transverse cutaway view of the end effector of the ablation component of FIG. 21. [Diagram 23] FIG. 22 is a simplified transverse cutaway view of an alternative end effector of the ablation component of FIG. 21. [Figure 24] FIG. 22 is a perspective view of the distal end portion of the ablation component of FIG. 21 in a retracted configuration. [Diagram 25] FIG. 22 is a perspective view of a distal end portion of the ablation component of FIG. 21 in a deployed configuration. [Figure 26] FIG. 13 is a detailed schematic diagram of a distal end portion of an alternative example ablation component 1300 in a deployed configuration. [Figure 27] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation component comprising a freely rotatable magnetic element. [Figure 28] FIG. 13 is a perspective view of an alternative example end effector. [Figure 29] FIG. 13 is a perspective view of an alternative example end effector. [Diagram 30] FIG. 13 is a perspective view of an alternative example end effector. [Diagram 31] FIG. 13 is a perspective view of an alternative example end effector. [Diagram 32] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation component in a retracted configuration. [Diagram 33] FIG. 33 is a perspective view of the ablation component of FIG. 32 in a deployed configuration. [Diagram 34] FIG. 33 is a detailed perspective view of an end effector of the example ablation component of FIG. 32. [Diagram 35] FIG. 35 is a detailed perspective partial view of the end effector of FIG. 34. [Diagram 36] FIG. 13 is a detailed perspective view of an alternative end effector. [Figure 37] FIG. 13 is a detailed perspective view of an alternative end effector. [Figure 38] FIG. 38 is a detailed perspective cutaway view of the end effector of FIG. 37. [Figure 39] FIG. 13 is a detailed perspective view of a distal end portion of an alternative ablation component. [Diagram 40] FIG. 40 is a detailed perspective view of an end effector of the example ablation component of FIG. 39. [Diagram 41] FIG. 13 is a detailed perspective view of an alternative example end effector. [Diagram 42] FIG. 13 is a detailed perspective view of an alternative example end effector. [Diagram 43] FIG. 13 is a detailed perspective partial cutaway view of an example end effector deployment mechanism in a retracted configuration. [Diagram 44] FIG. 44 is a detailed perspective partial cutaway view of the example deployment mechanism of FIG. 43 in a deployed configuration. [Diagram 45] FIG. 44 is a detailed perspective partial cutaway view of the deployment mechanism of FIG. 43 in an intermediate position. [Diagram 46] FIG. 44 is a detailed perspective partial cutaway view of the deployment mechanism of FIG. 43 in an intermediate position. [Figure 47] FIG. 13 is a detailed perspective cutaway view of an alternative deployment mechanism in a deployed configuration. [Figure 48] FIG. 13 is a perspective view of a distal end portion of an alternative example ablation system in use at a target tissue. [Figure 49] FIG. 49 is a perspective view of a distal end portion of the ablation system of FIG. 48. [Figure 50] FIG. 49 is a perspective view of a distal end portion of the ablation system of FIG. 48. [Figure 51] 49 is a perspective view of the heart illustrating the operation involving approaching the heart with the first ablation component of FIG. 48. [Figure 52] 49 is a perspective view of the heart illustrating operations involving positioning the first ablation component of FIG. 48 in the heart. [Diagram 53] 49 is a perspective view of the heart illustrating operations involving positioning the first ablation component of FIG. 48 in the heart. [Figure 54] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 55] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 56] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 57] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 58] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 59] 49 is a perspective cross-sectional view of an example procedure using the ablation system of FIG. 48 in a heart wall. [Figure 60] FIG. 13 is a perspective view of a distal end portion of an alternative ablation system in use at a target tissue. [Figure 61] FIG. 13 is a simplified cross-sectional view of an alternative example ablation component. [Figure 62] 1 is a simplified cross-sectional view of an alternative ablation system. [Figure 63]FIG. 13 is a simplified schematic diagram of an alternative example ablation system comprising a first ablation component comprising multiple independently positionable end effector units in use in the heart. [Figure 64] FIG. 64 is a perspective view of the end effector of the first ablation component of FIG. 63 in a deployed configuration. [Figure 65] FIG. 64 is a perspective view of the end effector of the first ablation component of FIG. 63 in a stowed configuration. [Figure 66] 64 is a perspective view of the end effector of the first ablation component of FIG. 63 showing an independently positionable end effector unit in use with cooperating magnetic elements. [Figure 67] FIG. 64 is a simplified schematic diagram showing the electrical configuration of the example ablation component of FIG. 63. [Figure 68] FIG. 1 is a simplified schematic diagram of an example system in use in a heart, in accordance with at least some aspects of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0103] Example embodiments according to the present disclosure are described and illustrated below to encompass devices, methods, and techniques related to medical treatment. Of course, it will be clear to those skilled in the art that the embodiments discussed below are examples and can be reconfigured without departing from the scope and spirit of the present disclosure. It is also understood that variations of the example embodiments discussed by those skilled in the art may simultaneously comprise part of the present disclosure. However, for clarity and accuracy, the example embodiments as discussed below may include optional steps, methods, and features that those skilled in the art should recognize as not being necessary to be within the scope of the present disclosure.

[0104] The present disclosure includes, inter alia, medical instruments and devices, and related methods, and more particularly, devices for ablating tissue, and related methods. Some example embodiments according to at least some aspects of the present disclosure may be useful in the context of ablation of cardiac tissue, such as to treat cardiac arrhythmias, such as atrial fibrillation, ventricular tachycardia, and / or inappropriate sinus tachycardia, for reasons detailed above in the introduction. Some example embodiments according to at least some aspects of the present disclosure may be configured to deliver ablation energy, such as through the cardiac wall, to create efficient transmural lesions while minimizing collateral tissue trauma.

[0105] 1 is a simplified schematic diagram of an example ablation system 100 in use in a heart 10 in accordance with at least some aspects of the present disclosure. The following description of ablation system 100 provides a context for the description of various detailed example embodiments below. Although numerous features and aspects are described with reference to FIG. 1 and subsequent figures, each of these features and aspects is optional, and these features and aspects may be implemented in any combination.

[0106] Example ablation system 100 may include a first ablation component 102 configured to be positioned on a first side of a target tissue and / or a second ablation component 104 configured to be positioned on a second side of a target tissue. Generally, each of ablation components 102, 104 may include any ablation component described herein. For example, without limitation, in some embodiments, first ablation component 102 may include an ablation component such as those described herein with reference to FIGS. 2-20 and / or second ablation component 104 may include an ablation component such as those described herein with reference to FIGS. 21-47. In some embodiments, first ablation component 102 and second ablation component 104 may include an ablation component such as those described herein with reference to FIGS. 2-20. In some embodiments, first ablation component 102 and second ablation component 104 may include an ablation component such as those described herein with reference to FIGS. 21-47.

[0107] Each ablation component 102, 104 may include an end effector 102A, 104A, respectively. The first and second sides of the target tissue may be opposing sides. For example, when a portion of the heart wall 18 is the target tissue, the first ablation component end effector 102A may be configured to be positioned on the epicardial (external) surface 12 of the heart 10. The second ablation component end effector 104A may be configured to be positioned on the endocardial (internal) surface 14 of the heart 10. In some circumstances, the first ablation component 102 and the second ablation component 104 may be positioned on opposing endocardial sides of the target tissue (e.g., atrial septum, ventricular septum, papillary muscles). In general, from the perspective of one ablation component 102, 104, the other ablation component 102, 104 may be referred to as the "cooperating" ablation component 102, 104, and the components of the cooperating ablation components 102, 104 may be similarly referred to as "cooperating."

[0108] In the illustrated embodiment, the first ablation component 102 may include at least one ablation element 106, such as one or more electrodes configured to deliver ablation energy, and / or the second ablation component 104 may include at least one ablation element 108, such as one or more electrodes configured to deliver radio frequency ablation energy. In some embodiments, the ablation elements 106, 108 may be configured to cooperate to create a lesion 16 in the target tissue, such as a transmural lesion extending through the entire thickness of the heart wall 18. For example, the ablation elements 106, 108 may be configured to operate cooperatively to perform bipolar radio frequency ablation. In other embodiments, only one of the first ablation component 102 and the second ablation component 104 may include the ablation elements 106, 108, or only one of the ablation elements 106, 108 may be utilized at a time. For example, one or both of the ablation elements 106, 108 (if present) may be configured to operate independently to perform ablation.

[0109] It is understood that various example embodiments are described herein in connection with creating lesions in a target tissue. It is within the scope of this disclosure to perform an ablation procedure to create lesions of any shape. Example lesion shapes include linear lesions (curved or straight), point-like lesions, or special shapes (e.g., elliptical, triangular, arcuate, etc.). It is understood that the above list is merely exemplary and is not to be considered limiting. The ablation elements may be configured to generate desired lesion shapes in single and / or multiple applications. For example, in some circumstances it may be advantageous to create two or more lesions, or to create a larger lesion that comprises multiple smaller overlapping lesions. Thus, it is understood that various steps in the example methods described herein may be repeated as desired to create any desired lesion or set of lesions. For example, one or both of the ablation components may be repositioned in the target tissue to create a subsequent lesion, or may be detached from the target tissue after a lesion is created and then repositioned in the target tissue.

[0110] It is within the scope of this disclosure to ablate tissue using any suitable ablation modality, device, and method. Thus, in various alternative example embodiments, any ablation element, such as ablation element 106 and / or ablation element 108, may be configured for any suitable ablation modality or modalities. For example, any ablation element described herein in connection with any example embodiment may be configured to individually and / or cooperatively deliver one or more of radio frequency (RF) ablation energy (monopolar and / or bipolar), pulsed field energy, cryoablation energy, ultrasound energy, laser energy, and / or ablative chemicals (e.g., ethanol) for tissue ablation. It is understood that the above list is merely exemplary and is not to be considered limiting.

[0111] In some example embodiments configured to perform radio frequency (RF) ablation, known RF ablation devices and / or algorithms may be used. For example, the ablation components described herein may be connected to an existing electrosurgical generator and an appropriate ablation pen algorithm and / or an appropriate ablation clamp algorithm may be used. In some example embodiments, the electrosurgical generator may be configured to measure one or more parameters (e.g., impedance) associated with the tissue to be ablated, and RF energy delivery may be adjusted based on the measured parameters. For example, some RF ablation algorithms may measure impedance and use the measurements to determine when RF energy delivery is terminated or altered.

[0112] In some example embodiments, bipolar radio frequency ablation energy can be applied followed by monopolar radio frequency ablation energy. In other embodiments, monopolar radio frequency ablation energy can be applied using one or more ablation components followed by bipolar radio frequency ablation energy. In some such embodiments, bipolar and monopolar ablation can create overlapping lesions such that a combined transmural lesion of a desired shape is formed. Similarly, some example embodiments can utilize pulsed field ablation in conjunction with monopolar and / or bipolar radio frequency ablation. In some example embodiments configured for use with multiple ablation modalities applied via electrodes, the various ablation components can be connected to one or more electrosurgical generators via one or more switching units that can be operable to select between two or more ablation modalities. More broadly, it is within the scope of the present disclosure to utilize multiple energy modalities within an ablation procedure to create one or more lesions that may overlap and provide a desired combined size and / or shape.

[0113] In various ablation systems with cooperating ablation components according to at least some aspects of the present disclosure, the size and / or shape of the ablation elements (e.g., electrodes) may be selected to create a desired lesion shape. In some embodiments, cooperating electrodes having similar shapes may be utilized. For example, in some embodiments, linear electrodes may be used in conjunction with other linear electrodes, or point electrodes may be used in conjunction with other point electrodes. In alternative embodiments, electrodes of different shapes may be used in conjunction. For example, linear electrodes may be used in conjunction with point electrodes.

[0114] In the illustrated embodiment, the first ablation component 102 comprises at least one magnetic element 110 and the second ablation component 104 comprises at least one magnetic element 112. Various example embodiments according to at least some aspects of the present disclosure may comprise one or more magnetic elements. The magnetic elements may comprise, for example, one or more permanent magnets, electromagnets, and / or any combination of ferromagnetic materials. The individual magnetic elements referred to above may comprise one or more magnetic subcomponents that may be shaped, positioned, configured, combined, and / or controlled to achieve desired magnetic and / or mechanical properties. In some example embodiments, electromagnets may be supplied with energy (constant or varying current) to attract and / or repel other magnetic elements, such as by reversing current direction to reverse magnetic poles and / or varying current to adjust magnetic field strength. In some example embodiments, magnetic elements (such as permanent magnets) may be repositionable (e.g., translated and / or reoriented / rotated) to change the location and / or orientation of the magnetic field.

[0115] In the illustrated embodiment, the magnetic elements 110, 112 are configured to cooperate to facilitate positioning the first ablation component 102 and / or the second ablation component 104. For example, the magnetic elements 110, 112 may be configured for mutual attraction, such as to align the ablation elements 106, 108 across a target tissue (e.g., the heart wall 18) to create a lesion 16 at a desired location. The ablation components 102, 104 in some examples may be configured to at least partially compress tissue therebetween. For example, the magnetic elements 110, 112 may be configured to cooperate to compress the target tissue (e.g., the heart wall 18) between the ablation components 102, 104 using the magnetic attraction of the magnetic elements 110, 112, which may improve ablation results in some circumstances.

[0116] The present disclosure contemplates that the magnetic attraction between two magnets may be estimated given specific information about each magnet, the separation between the magnetic bodies, and the magnetic permeability of the intervening medium. Accordingly, various embodiments according to at least some aspects of the present disclosure may be configured for use in conjunction with a particular target tissue, tissue thickness, and / or tissue type. For example, the size, shape, positioning, and / or strength of each magnetic element in the ablation system may be configured in conjunction with the configuration of each ablation component to provide a desired tissue compression that facilitates desired ablation characteristics. For example, an ablation system configured for use with a relatively thicker target tissue may utilize magnetic elements configured to provide a relatively large compression force over a larger separation of the thicker target tissue, while an ablation system configured for use with a relatively thinner target tissue may utilize magnetic elements configured to provide a relatively smaller compression force over a smaller separation of the thinner target tissue. Similarly, some target tissue types, regardless of thickness, may require greater compression to achieve a desired ablation result, while other target tissue types may be easily injured and therefore require less compression force.

[0117] In some example embodiments, one or more of the magnetic elements 110, 112 may be movable relative to other portions of the respective end effectors 102A, 104A. For example, in some embodiments, one or more of the magnetic elements 110, 112 may be substantially freely rotatable relative to other portions of the respective end effectors 102A, 104A. In some embodiments, one or more of the magnetic elements 110, 112 may be selectively repositionable (e.g., by and / or under the control of a user) relative to other portions of the respective end effectors 102A, 104A.

[0118] In the illustrated embodiment, the magnetic element 110 is selectively repositionable (e.g., by and / or under the control of a user) relative to a housing 102B forming part of the first ablation component end effector 102A, as indicated by arrows 110A and / or 110B. For example, the magnetic element 110 can be moved relative to the housing 102B to facilitate decoupling of the magnetic element 110 from the magnetic element 112, such as when it may be desired to disengage one or both of the ablation components 102, 104 from the tissue 18. As described in more detail below, in various example embodiments, one or more of the magnetic elements 110, 112 can be translatable, rotatable, or both translatable and rotatable relative to the respective ablation component housings 102B, 104B. As used herein, "translation" and related terms can be used to describe motion of an object in which all points on the object move substantially uniformly along the same line or direction. Translational movement can be linear or curvilinear, for example. As used herein, "rotation" and related terms may be used to describe the motion of an object in which the object moves in a circle about an axis of rotation. Some motions of an object may involve a combination of translation and rotation.

[0119] In some example embodiments comprising a magnetic element that is repositionable relative to the end effector housing, repositioning of the magnetic element can be used to correspondingly move a cooperating magnetic element. For example, translation of a repositionable permanent magnet in a first ablation component can be used to translate a cooperating end effector positioned on the opposite side of the target tissue. In some example embodiments, such movement can be used to create elongated lesions of any desired shape.

[0120] In the illustrated embodiment, the example ablation system 100 may include a control unit 114. The control unit 114 may be operable to control the operation of one or more aspects of the ablation components 102, 104. In some example embodiments, the control unit 114 may be configured to selectively provide ablation energy (e.g., RF energy from an electrosurgical generator) to electrodes comprising the ablation elements 106, 108. In some alternative example embodiments, the control unit 114 may be configured to selectively provide cryogenic fluid (e.g., nitrous oxide from a pressurized source) to one or more cryogenic elements comprising one or more of the ablation elements 106, 108. In some embodiments, the control unit 114 may include a vacuum source. In some example embodiments, the control unit 114 may be configured for sensing, pacing, stimulating, and / or mapping using one or both of the ablation components 102, 104, such as using one or more electrodes associated with one or more of the ablation components 102, 104. Although the control unit 114 is illustrated as a simple square for clarity, it is understood that the ablation components 102, 104 may be operatively coupled to one or more separate or combined devices (e.g., an electrosurgical generator, a cryogenic unit, a vacuum source, etc.) that collectively provide the associated functionality of the control unit 114 as described herein.

[0121] In the illustrated embodiment, the ablation components 102, 104 may comprise respective connection elements 116, 118 that may operably couple the ablation elements 106, 108 and / or the magnetic elements 110, 112 to the control unit 114. The connection elements 116, 118 may comprise or be used in conjunction with one or more electrical conductors, fluid conduits, mechanical force transmission components (e.g., mechanical linkages), catheters, wires, steerable portions, sheaths, trocars, hemostatic components, and the like. For example, the connection elements 116, 118 may comprise one or more fluid conduits for carrying cooling fluid in a closed-loop manner. In some embodiments, the connection elements 116, 118 may comprise one or more fluid conduits for carrying irrigation fluid for open irrigation and / or cooling, such as for one or more of the ablation elements 106, 108 (e.g., electrodes). In such an embodiment, portions of the end effectors 102A, 104A may be perforated to allow irrigation fluid to exit where desired.

[0122] In some example embodiments, the connecting elements 116, 118 may comprise a user interface. For example, some ablation components may comprise handles and end effectors constructed with high rigidity, rigid handles with steerable end effectors, and / or flexible or steerable devices (e.g., catheters). Some embodiments may comprise user-operated actuators, such as sliding or rotating elements, to steer the end effector components (e.g., magnetic elements). Some embodiments may comprise a substantially rigid connecting element (e.g., shaft). It is understood that the above list is merely exemplary and should not be considered limiting.

[0123] In some example embodiments, the example ablation system 100 may be configured to access the target tissue (e.g., the heart wall 18) via a surgical approach (open chest and / or minimally invasive) and / or via the patient's vasculature. For example, the first ablation component 102 may be positioned at the epicardial surface 12 via a percutaneous or surgical subxiphoid or intercostal access or incision 120, such as through the chest wall 20. The second ablation component 104 may be positioned at the endocardial surface 14 via a blood vessel 22 (e.g., a femoral vein or artery). In various situations, the pathways used to gain access to the epicardial and endocardial surfaces may be determined based at least in part on factors such as the portion of the heart wall 18 that comprises the target tissue for ablation, potential anatomical differences in the patient, previous surgeries, etc. More generally, in various exemplary embodiments, either or both of the first ablation component 102 and the second ablation component 104 may access the target tissue by any suitable route, such as thoracotomy, thoracotomy, subxiphoid, transdiaphragmatic, and / or vascular access. For example, endocardial access may be obtained using a percutaneous approach (e.g., arterial and / or venous) and / or a surgical approach (e.g., transapical, femoral-femoral bypass (venous), femoral-femoral bypass (arterial), bypass cannula conventional (arterial), bypass cannula conventional (venous), and / or atriotomy). Epicardial access may be obtained using a percutaneous approach (e.g., subxiphoid) and / or a surgical approach (e.g., lateral (right or left), surgical fenestration, and / or sternotomy (full or partial)). It is understood that the above list is merely exemplary and is not to be considered limiting.

[0124] Generally, some example embodiments may be operated as follows: Appropriate access to the target tissue may be obtained. For example, access may be obtained to the epicardial surface 12 and the endocardial surface 14. The first ablation component 102 may be positioned at a desired location on the epicardial surface 12. The magnetic elements 110, 112 may be utilized to position and / or secure (e.g., magnetically couple) the second ablation component 104 to the endocardial surface 14. For example, the magnetic element 110 of the first ablation component 102 may magnetically attract the magnetic element 112 of the second ablation component 104. In other embodiments, the second ablation component 104 may be positioned at a desired location on the endocardial surface 14, and the magnetic elements 110, 112 may be utilized to position and / or secure the first ablation component 102 at the epicardial surface 12. One or more of the ablation elements 106, 108 may be operated to ablate the target tissue and to create the lesion 16. The magnetic elements 110, 112 may be at least partially decoupled. In some example embodiments, the magnetic elements 110, 112 may be reconfigured to a less magnetically attractive and / or more magnetically repelling configuration, such as to disengage one or more of the first ablation component 102 and / or the second ablation component 104 from the target tissue 18. The first ablation component 102 and the second ablation component 104 may be repositioned for subsequent ablation and / or withdrawn from the patient.

[0125] In some example embodiments, the ablation components 102, 104 may be passively oriented and / or positioned at the target tissue. For example, the ablation components 102, 104 may be generally positioned at the target tissue 18, such as by direct imaging and / or visualization through an endoscope. In some example embodiments, the ablation components 102, 104 may be releasably attached to the target tissue, such as by vacuum or other tissue anchoring. Associated elements associated with the ablation components 102, 104 may include single lumen sheaths, multi-lumen sheaths, and / or expandable elements, such as space creating elements.

[0126] In some example embodiments, the ablation components 102, 104 may be oriented and / or positioned at the target tissue using an image-guided catheter and / or an electrophysiological mapping system. For example, one or more of the ablation components 102, 104 may include guidance features. In some example embodiments, the ablation components 102, 104 may include pacing features, sensing features, mapping features, and / or stimulation features and / or may be used in conjunction with cooperating ablation components 102, 104 that include pacing features, sensing features, mapping features, and / or stimulation features.

[0127] Some example embodiments may provide sensing capabilities for various parameters. For example, tissue impedance may be sensed between the ablation electrodes 106, 108, such as to assess the magnitude of the ablation 16. In some example embodiments, magnetic field measurements may be utilized to determine the distance between certain components, etc. In some example embodiments, one or more temperatures may be measured.

[0128] The ablation elements 106, 108 and the magnetic elements 110, 112 are illustrated as separate elements in FIG. 1 for clarity. However, in some example embodiments, one or more of the ablation elements 106, 108 and / or one or more of the magnetic elements 110, 112 may be combined into a single element. For example, at least a portion of the magnetic elements 110, 112 may act as the ablation elements 106, 108 (e.g., RF electrodes), or a dedicated electrode material may be used around or adjacent to the magnetic elements 110, 112.

[0129] The foregoing description of example ablation system 100 provides context for various other example embodiments described below. The various detailed example embodiments described below may comprise components of example ablation system 100 or may be utilized independently or in concert in alternative systems and environments. Any feature, component, or operation described in connection with any example embodiment herein may be utilized in any combination in connection with any other embodiment, and repeated descriptions of features, components, and operations have been omitted for brevity.

[0130] It is understood that any example ablation component described herein may be used in conjunction with a delivery sheath (which may be steerable) or other similar device for directing the ablation component to a target tissue. For example, FIG. 2 is a perspective view of two example ablation components 200, one shown alone and one shown inserted through an example delivery device 290, according to at least some aspects of the present disclosure. The ablation component 200 may be generally similar in structure and operation to other ablation components described elsewhere herein, and repeated description will be omitted for brevity. Similarly, any features described in conjunction with the ablation component 200 may be utilized in conjunction with any other embodiment described elsewhere herein. The ablation component 200 may be similar to and / or utilized as the first ablation component 102 of FIG. 1, for example. In some example embodiments, the delivery device 290 may be similar in structure and / or operation to that described in U.S. patent application Ser. No. 17 / 695,210, entitled DELIVERY DEVICES AND RELATED METHODS, filed March 15, 2022, which is hereby incorporated by reference in its entirety.

[0131] 2, the ablation component 200 may include a distally disposed end effector 202 configured to be positioned on a first side 12 (FIG. 1) of a target tissue 18, an elongated connecting element 204, and a proximally disposed handle 206. The handle 206 may include a gripping portion 208 configured to be grasped by a user, and / or one or more actuators 210, 212, 214 configured to operate other elements of the ablation component 200. Although the actuators 210, 212, 214 are shown on one side of the handle 206 in FIG. 2, some alternative embodiments may include one or similar actuators on the opposite side or other portion of the handle 206, such as to facilitate two-handed operation. The various actuators described herein may be operably coupled to their respective actuation elements by one or more mechanical couplings (e.g., linkages, bars, wires, cables, etc.) that may extend longitudinally through the connecting element 204.

[0132] In the illustrated embodiment, one or more magnet actuators 210 may be configured to reposition one or more magnetic elements, as described in more detail below. In this embodiment, the magnet actuator 210 is longitudinally slidable (e.g., distally and proximally), although alternative embodiments may include magnet actuators configured for alternative actuation motions, such as those described elsewhere herein.

[0133] In the illustrated embodiment, one or more steering actuators 212 may be configured to articulate a distal end portion of the ablation component 200. For example, in the illustrated embodiment, the steering actuators 212 may be in the form of rotatable tabs generally configured to articulate a distal end portion of the ablation component 200 (e.g., including the end effector 202), as described in more detail below.

[0134] In the illustrated embodiment, one or more locking actuators 214 can be configured to secure a distal end portion of the ablation component 200 in a desired orientation. For example, the locking actuators 214 are generally in the form of a rotatable knob configured to lock the steering actuator 212, thereby securing a distal end portion of the ablation component 200 in a desired orientation.

[0135] In the illustrated embodiment, an electrical connection element 216 is operably connected to the end effector 202 and configured to electrically couple the ablation component 200 to a control unit 114 ( FIG. 1 ), which may comprise an electrosurgical generator, such as via electrical conductors extending longitudinally through the connection element 216. In the illustrated embodiment, a vacuum connection element 218 is operably connected to the end effector 202 and configured to fluidly couple the ablation component 200 to a control unit 114 ( FIG. 1 ), which may comprise a vacuum source, such as via a suction or vacuum lumen extending longitudinally through the connection element 204. It is understood that similar connection elements, lumens, conductors, and / or connectors can be utilized in connection with other components and / or embodiments described herein. For example, an ablation component configured for irrigation can include similar irrigation connection elements, an ablation component configured for closed-loop cooling may include cooling connection elements including supply and return conduits, etc. In some example embodiments, some connection elements may extend separately from ablation component 200, such as shown in Figure 2 with separate electrical connection element 216 and vacuum connection element 218. In other example embodiments, two or more connection elements may be provided together, such as generally shown in Figure 1 with connection element 116.

[0136] 3 is a simplified perspective view of a distal portion of an ablation component 200 including a magnetic element with a repositionable permanent magnet 220, according to at least some aspects of the present disclosure. In the illustrated embodiment, the ablation component 200 is configured to utilize vacuum fixation to releasably couple the end effector 202 to a target tissue. The end effector 202 includes at least one vacuum port 222 at the tissue contacting portion 224. The vacuum port 222 is fluidly connected to a vacuum source by a vacuum conduit 226 that may extend longitudinally through the connecting element 204. An electrode 228 (or other ablation element) is configured to deliver ablation energy to the target tissue adjacent the tissue contacting portion 224. In the illustrated embodiment, the electrode 228 is disposed substantially within a peripheral wall 230 that defines the vacuum port 222, although other suitable arrangements may be utilized in alternative embodiments. For example, other embodiments may include one or more ablation elements disposed adjacent to a vacuum port. Additionally, other example embodiments may include more than one vacuum port in the tissue contacting portion 224. It is understood that similar vacuum ports may be utilized in connection with the other embodiments described herein.

[0137] In the illustrated embodiment, the end effector 202 includes a housing 232 within which the magnet 220 is disposed. The magnet 220 is configured to cooperate with a magnetic element of a corresponding ablation component, such as the magnetic element 112 (FIG. 1) of the second ablation component 104. In the illustrated embodiment, the magnet 220 is translatable (e.g., longitudinally repositionable) within the housing 232 generally along a longitudinal axis 220A of the magnet 220, which may be collinear with and / or parallel to the longitudinal axis of the end effector 202. For example, in the illustrated embodiment, the magnet actuator 210 (FIG. 2) may be operable to translate the magnet 220 proximally and distally, such as via a mechanical linkage 234 that may extend longitudinally through the connecting element 204. In other example embodiments, the magnet 220 may be repositionable in other manners, such as being translatable along other suitable axes.

[0138] In the illustrated embodiment, the magnet 220 is diametrically magnetized and arranged such that its north and south poles are oriented substantially toward and substantially away from the associated magnetic element 112. That is, one of the north and south poles is oriented substantially toward the target tissue contacting portion 224 and the other of the north and south poles is oriented substantially away from the tissue contacting portion 224. Thus, the magnetic (NS) axis 236 of the magnet 220 is oriented substantially in line with and / or generally perpendicular to the tissue contacting portion 224. In the illustrated embodiment, the rotational orientation of the magnet (e.g., the relative angular orientation of the magnetic axis 236 with respect to the end effector 202) remains substantially the same as the magnet 220 is repositioned proximally and / or distally by the magnet actuator 210 (FIG. 2). That is, the magnet 220 moves proximally and / or distally without substantial rotation relative to the housing 232 .

[0139] Some example embodiments may include a magnet follower spring 238, which may comprise a helical compression spring arranged for compression as the magnet 220 is retracted proximally. In some embodiments, the magnet follower spring 238 may exert a distal force on the magnet 220, which may facilitate distal movement of the magnet 220 using the magnet actuator 210.

[0140] FIG. 4 is a detailed perspective view of a distal end portion of ablation component 200 in a generally straight orientation, and FIG. 5 is a detailed perspective view of a distal end portion of ablation component 200 in an articulated orientation, all according to at least some embodiments of the present disclosure.

[0141] 2-5, in some example embodiments, the housing 232 may be constructed at least in part from a flexible material. For example, in some embodiments, the flexible material may be substantially completely encasing. Alternatively, the flexible material may form a flexible outer portion, which may be disposed over a more rigid inner portion. In some example embodiments, the housing 232 may include an electrode insulating portion 240 disposed at least in part generally around the ablation element (e.g., electrode 228). The electrode insulating portion 240 may act to electrically and / or thermally insulate the electrode 228 from nearby components, except where exposure of the electrode 228 (e.g., to the target tissue) is desired.

[0142] In some embodiments, the tissue contacting portion of the electrode 228 may extend through and / or protrude beyond the surrounding insulating portion 240 to ensure that only the desired portion of the electrode 228 (e.g., the raised circular portion) can contact the target tissue. In some embodiments, the electrode may include portions shielded by the insulating portion 240 that do not contact the target tissue, such as additional mass for heat dissipation, heat transfer features such as fins, etc. In some example embodiments, an irrigation conduit may extend within the housing 232, such as near the distal tip.

[0143] In the illustrated embodiment, the tissue contacting portion 224 is oriented generally transverse to the proximal-distal direction. The tissue contacting portion 224 may include a generally circumferential outwardly projecting skirt 242 that at least partially defines the vacuum port 222. The tissue contacting portion 224 may include one or more openings 244 disposed within the periphery of the skirt 242 (e.g., through the insulating portion 240). The openings 244 may be configured to deliver, for example, irrigation fluid and / or may be fluidly coupled to a vacuum source. The irrigation fluid may provide cooling, for example, to the target tissue, adjacent tissue, and / or the electrode 228. In general, the tissue contacting portion 224 of the illustrated embodiment may be shorter (e.g., longitudinally) than in other similar example embodiments described herein.

[0144] In the illustrated embodiment, the electrode 228 is generally circular so that it can act as a focal electrode for, for example, bipolar and / or unipolar radio frequency ablation. In the illustrated embodiment, the electrode 228 is generally longitudinally and / or laterally centrally disposed within the tissue contacting portion 224. Additionally, in the illustrated embodiment, the electrode 228 is recessed within the skirt 242 such that the skirt 242 protrudes laterally outwardly further than the tissue contacting surface 224 of the electrode 228.

[0145] In the illustrated embodiment, the distal portion of the ablation component 200 may be steerable using the steering actuator 212. For example, the distal portion of the ablation component 200 may be steerable between a generally straight orientation shown in FIG. 4, an approximately 90 degree left orientation shown in FIG. 5, and a mirror image approximately 90 degree right orientation. While the illustrated embodiment is generally symmetrically bidirectionally steerable from about 0 to 90 degrees left and about 0 to 90 degrees right (e.g., through about a total of 180 degrees), it is understood that alternative embodiments may be unidirectionally steerable (e.g., 0 to 180 degrees in one direction) or symmetrically or asymmetrically bidirectionally steerable (e.g., 0 to 180 degrees in each direction, through a total of 0 to 360 degrees). In the illustrated embodiment, the distal end portion of the ablation component 200 is generally flexible in the superior-inferior plane (e.g., generally perpendicular to the inferior-inferior plane in which the device is steerable). Some alternative embodiments may be generally rigid in the superior-subordinate plane, or may be steerable (unidirectional or bidirectional).

[0146] In the illustrated embodiment, the magnet 220 is selectively translatable (e.g., longitudinally repositionable) within the housing 232 between a generally distal engaged position ( FIG. 5 ) and a proximal disengaged position ( FIG. 4 ). In this embodiment, the housing 232 at least partially defines an internal cavity within which the magnet 220 is translatable. Generally, prior to ablation, the magnet 220 may be moved to (or verified to be already in) an engaged position generally adjacent the electrode 228, as described in more detail below. The magnet 220 may be used in conjunction with a cooperating magnet 112 ( FIG. 1 ) to position the end effector 202 at the target tissue 18 ( FIG. 1 ). In some embodiments, magnetic attraction between the magnet 220 and the cooperating magnet 112 may at least partially compress the target tissue 18. After the desired ablation has been performed, the magnet 220 may be repositioned, such as to a disengaged position generally proximal to the electrode 228 as shown in FIG. 4 . Such retraction can facilitate ceasing and / or reducing the magnetic attraction between the magnet 220 and the cooperating magnet 112 .

[0147] In alternative embodiments, the distal position may be a disengaged position and / or the proximal position may be an engaged position. In some such embodiments, the magnet 220 may be retracted to an engaged position proximal to the electrode and / or extended to a disengaged position distal to the electrode.

[0148] 4 and 5, some example embodiments may include one or more mechanical stops 246 configured to facilitate positioning of the permanent magnet 220. For example, in the illustrated embodiment, the mechanical stop 246 is generally distally disposed within the housing 232. The stop 246 acts as a distal stop for the permanent magnet 220, thereby ensuring that the permanent magnet 220 is positioned when desired in a distal engaged position. For example, the stop 246 may ensure that the permanent magnet 220 is substantially centered relative to the ablation element 228 when the permanent magnet 220 is in the distal engaged position. As a result, cooperating magnetic elements of cooperating ablation components (e.g., on opposite sides of the target tissue) may be operable to align the respective ablation elements across the target tissue. In other embodiments, similar mechanical stops may be used in conjunction with other positions of the magnetic elements, such as a proximal disengaged position.

[0149] FIG. 6 is a perspective view of a distal end portion of an alternative example ablation component 300, and FIG. 7 is a perspective cross-sectional view of the distal end portion of the ablation component 300 taken at line AA in FIG. 6, all according to at least some aspects of the present disclosure. The ablation component 300 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 200, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 300 may be utilized in connection with any other embodiment described elsewhere herein. In the illustrated embodiment, the ablation element comprises a generally circular primary electrode 302. One or more auxiliary electrodes 304, 306, 308, 310 are provided in addition to the primary electrode 302. In this embodiment, the primary electrode 302 and the auxiliary electrodes 304, 306, 308, 310 are disposed within a periphery defined by a skirt 312.

[0150] The auxiliary electrodes 304, 306, 308, 310 may be used, for example, for sensing, stimulation, mapping, and / or pacing. Such sensing, stimulation, mapping, and / or pacing may be performed, for example, in conjunction with identifying target locations for future ablations and / or to evaluate the effectiveness of previous ablations, and even for diagnostic purposes only (e.g., not immediately before and / or after ablation). In some example embodiments, the primary electrode 302 may be used for non-ablative purposes, such as sensing, stimulation, mapping, and / or pacing, in place of or in addition to one or more of the auxiliary electrodes 304, 306, 308, 310. In some embodiments, one or more of the auxiliary electrodes 304, 306, 308, 310 may be used for ablation purposes in addition to or in place of the primary electrode 302.

[0151] In this embodiment, two of the auxiliary electrodes 304, 306 are disposed distally relative to the primary electrode 302, and two of the auxiliary electrodes 308, 310 are disposed proximally relative to the primary electrode 302. In the illustrated embodiment, all five electrodes 302, 304, 306, 308, 310 are generally disposed longitudinally in a line; that is, they form a one-dimensional array. In some alternative embodiments, one or more of the electrodes 302, 304, 306, 308, 310 may be positioned in an alternative arrangement, such as in a two-dimensional array (e.g., a partial or complete grid array). In some alternative embodiments, one or more of the auxiliary electrodes 304, 306, 308, 310 may be disposed laterally relative to the primary electrode 302. That is, in some embodiments, all five electrodes 302, 304, 306, 308, 310 may not be generally disposed in a line. For example, one or more auxiliary electrodes 304, 306, 308, 310 may be positioned on one or both lateral sides of the primary electrode, offset both longitudinally and laterally from the primary electrode 302. In some embodiments, one or more auxiliary electrodes 304, 306, 308, 310 may be positioned on one or both lateral sides of the primary electrode 302, offset laterally from the same (or nearly the same) longitudinal position as the primary electrode 302.

[0152] 7, in the illustrated embodiment, the primary electrode 302 may at least partially define one or more internal passages 314, 316, 318. In this embodiment, the passages 314, 316, 318 extend generally longitudinally and generally parallel, and are defined in part by a base portion 320 of the primary electrode 302. Specifically, in the orientation shown in FIG. 7, the primary electrode 302 defines an upper aspect of each of the passages 314, 316, 318, and a dividing member 322, which may be formed as part of the housing 324, defines a lower aspect of each of the passages 314, 316, 318. The passages 314, 316, 318 may be fluidly coupled to a source of cooling fluid, such as via one or more connecting elements 116, 118 (FIG. 1). For example, irrigation fluid may be delivered to the target tissue via one or more of the passages 314, 316, 318. Thus, in some such embodiments, the main electrode 302 may be cooled not only internally by irrigation fluid flowing through the passages 314, 316, 318 (e.g., in an open loop configuration), but also externally by irrigation fluid present within the area bounded by the skirt 312. In some alternative embodiments, one or more of the passages 314, 316, 318 may be fluidly connected to a source of cooling fluid in a closed loop configuration.

[0153] Still referring to FIG. 7, this example embodiment may comprise a longitudinally repositionable magnetic element including a permanent magnet 326 that may include one or more protrusions, such as one or more longitudinal wings 328, 330 that may be disposed to slide longitudinally within one or more corresponding grooves 332, 334 within the housing. In this embodiment, the protrusions 328, 330 may be integrally formed with other portions of the magnet 326. For example, the magnet 326 may be substantially integrally formed with the wings 328, 330. In other similar embodiments, the magnetic element may have other shapes. For example, some alternative embodiments may comprise a longitudinally repositionable permanent magnet in the form of a generally rectangular solid (e.g., no protrusions) or in the form of a generally right cylindrical solid.

[0154] 8 is a perspective cross-sectional view of a distal end portion of an alternative example ablation component 400, according to at least some aspects of the present disclosure. Ablation component 400 may be generally similar to and / or may be used in a generally similar manner to various ablation components described elsewhere herein, including previously described ablation component 300, and repeated descriptions of similar elements and operations have been omitted for the sake of brevity. Similarly, any features described in connection with ablation component 400 may be utilized in connection with any other embodiment described elsewhere herein.

[0155] In the embodiment of FIG. 8, the ablation element comprises an electrode 402, which may comprise one or more internal passages 404, 406, 408. In this embodiment, the passages 404, 406, 408 extend generally parallel to one another in a generally longitudinal direction through a base portion 410 of the electrode 402. In the illustrated embodiment, unlike the embodiment of FIG. 7, the passages 404, 406, 408 are substantially completely defined by the base portion 410. Thus, the embodiment of FIG. 8 may not include a dividing member 322 as shown in FIG. 7. In other embodiments, the one or more internal passages 404, 406, 408 may be disposed in different positions and / or orientations. In the illustrated embodiment, the passages 404, 406, 408 may be fluidly coupled to a source of cooling fluid, such as via one or more connecting elements 116, 118 (FIG. 1). For example, irrigation fluid may be delivered to the target tissue via one or more of the passages 404, 406, 408. Thus, in some such embodiments, the electrode 402 may be cooled not only internally by irrigation fluid flowing through the passages 404, 406, 408 (e.g., in an open loop configuration), but also externally by irrigation fluid present in the vicinity of the electrode 402. In some alternative embodiments, one or more of the passages 404, 406, 408 may be fluidly connected to a source of cooling fluid in a closed loop configuration.

[0156] Still referring to Figure 8, this example embodiment may comprise a magnetic element including a permanent magnet 412 including one or more protrusions, such as one or more longitudinal wings 414, 416, which may be disposed to slide longitudinally within one or more corresponding grooves 418, 420 within a housing 422. This configuration is generally similar to that described above with reference to Figure 7, except that in the embodiment of Figure 8, the protrusions 414, 416 may be formed separately and secured to the magnet 412. The magnet 412 may be formed to receive the protrusions 414, 416, such as in respective longitudinal recesses 422, 424.

[0157] 9 is a perspective view of an alternative example ablation component 500 comprising an ablation element comprising linear electrodes, according to at least some aspects of the present disclosure. The ablation component 500 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 300, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 500 may be utilized in connection with any other embodiment described elsewhere herein. In the illustrated embodiment, the ablation element comprises an elongated electrode 502. In this embodiment, the electrode 502 has one dimension that is substantially greater than its vertical dimension. For example, the electrode 502 has a longitudinal length 504 that is approximately eight times the lateral width 506 of the electrode 502. In this embodiment, the electrode 502 is elongated in the longitudinal direction, but in some alternative embodiments, the electrode may be elongated in other directions, such as in the lateral and / or diagonal directions. In this embodiment, the electrode 502 is generally straight, although other embodiments may include electrodes having one or more curves and / or angles. Additionally, in some embodiments, the width 506 may vary over the length 504 of the electrode 502.

[0158] 9 also shows the magnet driven spring 508, which may be a helical compression spring positioned for compression as the magnet 510 is retracted proximally. In the embodiment shown, the spring 508 is configured to hold open an interior lumen of the flexible portion 512 of the end effector 514 for receiving the magnet 510 therein upon retraction. Furthermore, in some embodiments, the compression of the spring 508 as the magnet 510 is retracted proximally can exert a distal force on the magnet 510, which can facilitate distal movement of the magnet 510 to the extended position.

[0159] 10 and 11 are perspective views of a distal end portion of an alternative example ablation component 600, all according to at least some aspects of the present disclosure. The ablation component 600 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 300, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 600 may be utilized in connection with any other embodiment described elsewhere herein. As with the ablation component 300, in the ablation component 600, a primary electrode 602 is disposed within an outwardly extending skirt 604, and one or more auxiliary electrodes 606, 608, 610, 612 are provided in addition to the primary electrode 602. However, in this embodiment, one or more of the auxiliary electrodes 606, 608, 610, 612 are disposed outside the perimeter defined by the skirt 604. Specifically, in the illustrated embodiment, two auxiliary electrodes 606 , 608 are disposed distally of the skirt 604 and two auxiliary electrodes 610 , 612 are disposed proximally of the skirt 604 .

[0160] 11 , in some example embodiments, one or more auxiliary electrodes 606, 608, 610, 612 can be disposed on one or more outwardly extending protrusions 614, 616 that can facilitate electrical contact between the auxiliary electrodes 606, 608, 610, 612 and anatomical tissue. For example, in the illustrated embodiment, the distal auxiliary electrodes 606, 608 are disposed on the distal protrusion 614 and the proximal auxiliary electrodes 610, 612 are disposed on the proximal protrusion 616.

[0161] 12 and 13 are perspective views of a distal end portion of an alternative example ablation component 700, all according to at least some aspects of the present disclosure. The ablation component 700 is generally similar in structure and operation to the ablation components described elsewhere herein, including ablation component 600, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with ablation component 700 may be utilized in connection with any other embodiment described elsewhere herein. Similar to ablation component 600, in ablation component 700, a primary electrode 702 is disposed within an outwardly extending skirt 704, and one or more auxiliary electrodes 706, 708, 710, 712 are provided on protrusions 714, 716 outside the periphery defined by skirt 704.

[0162] In the embodiment of Figures 12 and 13, two of the auxiliary electrodes 706, 708 are in the form of point-like electrodes generally similar to those of the ablation component 600, as previously described. Two of the auxiliary electrodes 710, 712 are elongated electrodes (e.g., each having a length substantially greater than its width). In the illustrated embodiment, the elongated auxiliary electrodes 710, 712 are oriented generally transversely (e.g., substantially perpendicularly) to the longitudinal direction. More broadly, any one or more of the auxiliary electrodes 706, 708, 710, 712 may be elongated, and the elongated electrodes may be positioned in any desired location and / or orientation, such as within and / or outside the skirt 704.

[0163] FIG. 14 is a perspective view of an alternative example ablation component 800, and FIG. 15 is a detailed perspective view of an end effector 802 of the ablation component 800, all according to at least some aspects of the present disclosure. The ablation component 800 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 200, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 800 may be utilized in connection with any other embodiment described elsewhere herein. The ablation component 800 may be similar to and / or utilized as the first ablation component 102 of FIG. 1, for example.

[0164] With reference to Figure 14, in the illustrated embodiment, ablation component 800 comprises an end effector 802, an elongated connecting element 804, and a handle 806. With reference to Figures 14 and 15, an electrical connector 808 is configured to electrically couple ablation component 200 to an electrosurgical generator, such as via electrical conductors 808A extending longitudinally through connecting element 804. Similar connecting elements, handles, conductors, and / or electrical connectors may be utilized in connection with other embodiments described herein, and similar components described in connection with other embodiments herein may be utilized in connection with this embodiment.

[0165] 15, in the illustrated embodiment, the end effector 802 is disposed distally at the connecting element 804. The end effector 802 comprises a distally positioned ablation portion 810 including an electrode 812. The end effector 802 also comprises a proximally positioned bending region 814. In this embodiment, the bending region 814 comprises a generally helical reinforcement 816. The end effector 802 further comprises a permanent magnet 818 disposed within the housing 802A. The magnet 818 is configured to cooperate with a magnetic element of a corresponding ablation component, such as the magnetic element 112 of the second ablation component 104 (FIG. 1). In the illustrated embodiment, the magnet 818 is diametrically magnetized.

[0166] In the illustrated embodiment, the magnet 818 is translatable (e.g., longitudinally repositionable) within the housing 802A generally between the ablation portion 810 and the bending region 814, such as generally along a longitudinal axis of the magnet 818. For example, in the illustrated embodiment, the handle 806 includes an actuator 806A (FIG. 14) operable to translate the magnet 818 proximally and distally, such as via a mechanical linkage extending through the connecting element 804. In other example embodiments, the magnet 818 may be translatable along other suitable axes. In this embodiment, the stiffener 816 of the bending region 814 at least partially defines an interior cavity into which the magnet 818 may be retracted proximally. In the illustrated embodiment, the bending region 814 is generally flexible, but the helical stiffener 816 leaves an inner diameter open to receive the magnet 818 therein as the magnet 818 is retracted proximally.

[0167] 14 and 15, in the illustrated embodiment, the magnet 818 is movable proximally and distally by a mechanical linkage 822 that extends proximally within the connecting element 804 for actuation by a user, such as from the proximal handle 806. The mechanical linkage 822 may, for example, extend proximally and / or be operably connected to an actuator in the handle 806 for operation by a user. In the illustrated embodiment, the rotational orientation of the magnet (e.g., orientation of the magnetic axis) remains substantially the same as the magnet 818 is repositioned proximally and / or distally. That is, the magnet 818 moves proximally and / or distally without substantial rotation relative to the housing 802A.

[0168] In the illustrated embodiment, prior to ablation, the magnet 818 may be moved (or verified to already be in a distal position) generally adjacent the electrode 812. The magnet 818 may be used in conjunction with the cooperating magnet 112 (FIG. 1) to position the end effector 802 at the target tissue 18 (FIG. 1). In some embodiments, the magnetic attraction between the magnet 818 and the cooperating magnet 112 may at least partially compress the target tissue 18. After the desired ablation has been performed, the magnet 818 may be retracted, such as to a position generally proximal to the electrode 812 as shown in FIG. 3. Such retraction may facilitate ceasing and / or reducing the magnetic attraction between the magnet 818 and the cooperating magnet 112.

[0169] FIG. 16 is a simplified schematic diagram of an alternative example ablation component 900 comprising a magnetic element comprising a rotationally repositionable magnet in an engaged configuration, and FIG. 17 is a simplified schematic diagram of the ablation component 900 in a disengaged configuration, all according to at least some aspects of the present disclosure. The ablation component 900 is generally similar in structure and operation to the ablation components described elsewhere herein, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 900 may be utilized in connection with any other embodiment described elsewhere herein. However, in the embodiment of FIG. 16 and FIG. 17, the magnetic element comprising a permanent magnet 902 is rotationally repositionable relative to the housing 904A of the end effector 904 (or the tissue contacting surface of the end effector 904) between the engaged and disengaged configurations. In the illustrated embodiment, the magnet 902 is rotationally repositionable about a longitudinal axis 906 of the magnet 902. In alternative example embodiments, the magnet 902 may be rotationally repositionable about other suitable axes. In the illustrated embodiment, the magnet 902 is diametrically magnetized.

[0170] 16 , which depicts the magnet 902 in an engaged configuration, the magnet 902 is rotationally oriented such that its north and south poles are oriented substantially toward and substantially away from a target tissue contacting surface 908 of the end effector 904. That is, one of the north and south poles is oriented substantially toward the tissue contacting surface 908, and the other of the north and south poles is oriented substantially away from the tissue contacting surface 908. In this embodiment, a magnetic (NS) axis 910 of the magnet 902 is disposed substantially coaxially with a direction 912 extending from the magnet 902 through the tissue contacting surface 908 (e.g., toward the associated magnetic element 112). Thus, in this orientation, the magnet 902 is disposed to attract the associated magnetic element 112.

[0171] 17, which depicts the magnet 902 in a disengaged configuration, the magnet 902 is oriented such that a magnetic axis 910 of the magnet 902 is oriented substantially perpendicular (e.g., at about 90 degrees) to a direction 912 from the magnet 902 through the tissue contacting surface 908 (e.g., toward the cooperating magnetic element 112). Thus, in this orientation, the magnet 902 is not positioned to attract the cooperating magnetic element 112. In the illustrated embodiment, the magnet 902 is rotationally repositionable without substantial translation, such as in a longitudinal direction.

[0172] 16 and 17, in the illustrated embodiment, the magnet 902 can be repositioned from the engaged configuration (FIG. 16) to the disengaged configuration (FIG. 17) by rotating about 90 degrees about the longitudinal axis 906 of the end effector 904 in the direction of the arrow 912. In some example embodiments, the magnet 902 can be further rotated another about 90 degrees (e.g., about 180 degrees total) such that the magnetic axis 910 is again substantially coaxial with the direction 912, but the polarity is reversed from the engaged configuration (FIG. 16) so that the magnet 902 can operate to repel the cooperating magnetic element 112. That is, the magnetic fields are disposed in opposite orientations so that the magnet 902 can repel the magnetic element 112.

[0173] 16 and 17, prior to ablation, the magnet 902 may be moved to (or verified to already be in) an engaged configuration (FIG. 16). The magnet 902 may be used in conjunction with a cooperating magnet 112 to position a cooperating end effector at a target tissue 18 (FIG. 1). Magnetic attraction between the magnet 902 and the cooperating magnet 112 may at least partially compress the target tissue 18. After the desired ablation has been performed, the magnet 902 may be rotated to a disengaged configuration (FIG. 17), or the like. Such retraction may facilitate ceasing the magnetic attraction between the magnet 902 and the cooperating magnet 112.

[0174] FIG. 18 is a simplified perspective view of an alternative example ablation component 1000 comprising a translationally and rotationally repositionable magnet in an engaged configuration, FIG. 19 is a simplified perspective view of the ablation component 1000 in a disengaged configuration, and FIG. 20 is a simplified longitudinal cross-sectional view of the ablation component 1000 in an intermediate configuration, all according to at least some aspects of the present disclosure. The ablation component 1000 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 900, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 1000 may be utilized in connection with any other embodiment described elsewhere herein. However, in the embodiment of FIGS. 18-20, the magnetic element comprising the permanent magnet 1002 is simultaneously translationally and rotationally repositionable. In alternative embodiments, the permanent magnet may be continuously translationally and rotationally repositionable (e.g., translation and then rotation, or rotation and then translation). In the illustrated embodiment, the magnet 1002 is translationally and rotationally repositionable about the longitudinal axis 1006 of the magnet 1002. In alternative example embodiments, the magnet 1002 may be translationally repositionable along and / or rotationally repositionable about other suitable axes, such as the longitudinal axis of the end effector 1004. In the illustrated embodiment, the magnet 1002 is a diametrically magnetized generally cylindrical permanent magnet with a generally circular cross-section. Alternative embodiments may include magnets of any suitable shape, such as rectangular or square cross-sections.

[0175] 18, which depicts the magnet 1002 in an engaged configuration, the magnet 1002 is rotationally positioned such that its north and south poles are oriented substantially toward and substantially away from the tissue contacting surface 1008 of the end effector 1004. That is, one of the north and south poles is oriented substantially toward the tissue contacting surface 1008, and the other of the north and south poles is oriented substantially away from the tissue contacting surface 1008. In other words, the magnetic axis 1010 of the magnet 1002 is positioned substantially parallel to a direction 1012 extending from the magnet 1002 through the ablation element 1028 (e.g., toward the cooperating magnetic element). Thus, in this position, the magnet 1002 is positioned to attract the cooperating magnetic element. Also, in the illustrated embodiment, the magnet 1002 is substantially laterally adjacent to the tissue contacting surface 1008 of the ablation element 1028 in the engaged configuration. In some alternative embodiments, the magnet 1002 may at least partially laterally abut the tissue contacting surface 1008 of the ablation element 1028 in the engaged configuration.

[0176] 19, which depicts the magnet 1002 in a disengaged configuration, the magnet is oriented such that the magnetic axis 1010 of the magnet 1002 is oriented parallel to the direction 1012, but the polarity is reversed from the engaged configuration (FIG. 18). Thus, in the disengaged configuration shown in FIG. 19, the magnet 1002 can operate to repel a cooperating magnetic element. In this embodiment, the orientation of the magnetic axis 1010 in the disengaged configuration is approximately 180 degrees from the orientation of the magnetic axis 1010 in the engaged configuration. Also, in the illustrated embodiment, in the disengaged configuration, the magnet 1002 has been retracted proximally such that it is no longer located substantially (or at least partially) laterally adjacent to the tissue contacting surface 1008. That is, the magnet 1002 is substantially proximal to the tissue contacting surface 1008 adjacent to the ablation element 1028 in this embodiment in the disengaged configuration. It will be appreciated that alternative embodiments may include magnets that, in the disengaged configuration, remain at least partially laterally adjacent to the tissue contacting surface proximate the ablation element.

[0177] In the illustrated embodiment, moving the magnet 1002 from the engaged configuration of FIG. 18 to the disengaged configuration of FIG. 19 includes moving the magnet through an intermediate orientation of FIG. 20 in which the magnetic axis 1010 of the magnet 1002 is oriented at about 90 degrees relative to a direction 1012 from the magnet 1002 through the tissue contacting surface 1008 (e.g., similar to the orientation of the magnet 902 in FIG. 17). Some alternative example embodiments may be configured to operate between the engaged configuration of FIG. 18 and a disengaged configuration in which the magnetic axis 1010 of the magnet 1002 is oriented at about 90 degrees relative to a direction 1012 from the magnet 1002 through the tissue contacting surface 1008, similar to FIGS. 17 and 20. That is, the disengaged configuration may be about 90 degrees from the engaged configuration.

[0178] 20, in the illustrated embodiment, the magnet 1002 is movable in translation and rotation by a mechanical linkage 1014. The mechanical linkage 1014 may extend proximally and / or may be operably connected to an actuator in a handle for actuation by a user, for example. In this embodiment, the magnet 1002 is operably coupled to the linkage 1014 by a travel portion 1016. The travel portion 1016 is selectively movable within a housing 1018. Although FIG. 20 illustrates the housing 1018 as an internal component of the end effector 1004, in some alternative embodiments, the housing 1018 may be integrally formed as part of the end effector 1004. In this embodiment, the housing 1018 is generally tubular in shape and at least partially receives the travel portion 1016 and the magnet 1002 therein.

[0179] 20, in the illustrated embodiment, the radially inner surface of the housing 1018 includes a generally longitudinally oriented generally helical groove 1020 that slidably receives a protrusion 1022 of the travel portion. Thus, longitudinal movement of the travel portion 1016 (and magnet 1002) results in rotation of the travel portion 1016 (and magnet 1002) and / or rotational movement of the travel portion 1016 (and magnet 1002) results in longitudinal movement of the travel portion 1016 (and magnet 1002). In the illustrated embodiment, the housing 1018 includes a second generally helical groove 1024, and the travel portion 1016 includes a second corresponding protrusion 1026 that are configured for operation in a similar manner in cooperation with the groove 1020 and protrusion 1022.

[0180] 18-20, prior to ablation, the magnet 1002 may be moved to (or verified to already be in) an engaged position, such as generally adjacent the electrode 1028 (FIG. 18). The magnet 1002 may be used in conjunction with a cooperating magnet 112 (FIG. 1) to position the end effector 1004 at the target tissue 18 (FIG. 1). Magnetic attraction between the magnet 1002 and the cooperating magnet 112 may at least partially compress the target tissue 18. After the desired ablation has been performed, the magnet 1002 may be rotated and longitudinally retracted, such as to a disengaged configuration (FIG. 19). Such retraction may facilitate ceasing the magnetic attraction between the magnet 1002 and the cooperating magnet 112 and removing the end effector 1004 from the target tissue 18.

[0181] 21 is a simplified schematic diagram of an alternative example ablation component 1100 with a freely rotatable magnetic element in a retracted configuration, according to at least some aspects of the present disclosure. The ablation component 1100 is generally similar in structure and operation to the ablation components described elsewhere herein, and repeated descriptions of similar elements have been omitted for brevity. For example, the ablation component 1100 may be similar to and / or utilized as the second ablation component 104 of FIG. 1. Similarly, any features described in connection with the ablation component 1100 may be utilized in connection with any other embodiment described elsewhere herein.

[0182] 21 , the ablation component 1100 may include a proximally disposed handle 1102, an elongated connecting element 1104, and / or a distally disposed end effector 1110. In the illustrated embodiment, the connecting element 1104 may include a first connecting element 1106 (e.g., generally in the form of a deflectable and / or steerable sheath) and a second connecting element 1108 (e.g., generally in the form of a flexible push / pull element). The end effector 1110 may be generally disposed distally at the second connecting element 1108. In some example embodiments, the first connecting element 1106 may include two or more regions having differing flexibility, such as a relatively stiff (e.g., more semi-rigid) proximal portion and a relatively flexible distal portion.

[0183] In the illustrated embodiment, the first connecting element 1106 may be generally tubular and / or may comprise a first connecting element distal portion 1112. In some example embodiments, the first connecting element distal portion 1112 may be relatively more flexible and / or may be deflectable or steerable. The second connecting element 1108 may be operably coupled to the first connecting element distal portion 1112. For example, the second connecting element 1108 may be slidably disposed within the first connecting element 1106. The second connecting element 1108 and / or the end effector 1110 may be selectively repositionable relative to the first connecting element distal portion 1112, such as between a retracted configuration ( FIG. 21 ) and a deployed configuration ( FIG. 25 , described below).

[0184] In the illustrated embodiment, an engagement element 1114 may operably interpose the first connection element distal portion 1112 and the end effector 1110. The end effector 1110 may comprise an end effector housing 1116, an ablation element 1118, and / or a magnetic element 1120. The handle 1102 may comprise a deployment actuator 1122 operable to reposition the second connection element 1108 and / or the end effector 1110 between a retracted configuration and a deployed configuration. In some embodiments, such as those comprising a steerable first connection element 1106, the handle 1102 may comprise a steering / deflection actuator 1124, which may be disposed on the handle 1102 and / or operable to steer and / or deflect at least a portion of the first connection element 1106. In some embodiments, the steering / deflection actuator 1124 may be generally in the form of a rotatable annulus.

[0185] In some example embodiments, the first connecting element distal tip portion 1112 may be deflectable about 180 degrees. That is, the first connecting element distal tip portion 1112 may be deflected about 180 degrees into a generally J-shaped configuration. In some embodiments, the first connecting element distal portion 1112 may be deflectable in one direction. In alternative embodiments, the first connecting element distal portion 1112 may be steerable in both directions and / or in one or more planes. Some example embodiments may include one or more anti-twist elements in the first connecting element 1106, such as in the first connecting element distal portion 1112. For example, the first connecting element distal portion 1112 may be constructed with an elongated helical spring arranged to prevent twisting when the first connecting element distal portion 1112 is deflected.

[0186] FIG. 22 is a simplified transverse cutaway view of the end effector 1110 of the ablation component 1100 of FIG. 21 in accordance with at least some aspects of the present disclosure. In the illustrated embodiment, the magnetic element 1120 is movable relative to the housing 1116. Specifically, in this embodiment, the magnetic element 1120 is substantially freely rotatable relative to the housing 1116 about all three orthogonal axes (e.g., X, Y, Z, and / or pitch, roll, yaw) while being constrained against substantial translation relative to the housing 1116. As used herein, "freely rotatable" may refer to a condition in which an element is rotatable about at least one axis of rotation with substantially no mechanical constraint (except incidental friction) relative to other components. As used herein, "freely rotatable" may exclude a condition in which the rotation is controlled by a control element, such as a user-operated actuator and / or mechanical linkage. As used herein, "freely rotatable" may include a state in which a rotatable element may be at least partially oriented and / or constrained by an externally applied magnetic field, such as by the proximity of a cooperating magnetic element of a cooperating ablation component. Thus, in this embodiment, the magnetic element 1120 has three rotational degrees of freedom that are substantially mechanically unconstrained relative to the housing 1116. That is, the magnetic element 1120 is freely rotatable such that its magnetic axis 1120A may self-orient in any orientation relative to the housing 1116. As used herein, "self-orienting" and related terms may refer to movement of an element that is not actively controlled or influenced by a user or control element, etc. For example, self-orienting may include reorienting the freely rotatable magnetic element 1120 on its own due to an externally applied magnetic field (e.g., a magnetic field from a cooperating magnetic element of a cooperating ablation component) without externally applied mechanical interference.

[0187] In the illustrated embodiment, the magnetic element 1120 is in the form of a substantially spherical permanent magnet, such as a rare earth permanent magnet. The housing 1116 may be at least partially hollow and may at least partially define a substantially spherical interior 1126 that may be configured to rotatably house the magnetic element 1120 therein. In various embodiments, free rotation may be facilitated by forming the element with a specifically machined surface finish, electroplating, lubricants, material selection (e.g., non-wearing), and / or manufacturing to precise tolerances, or other suitable techniques.

[0188] In the illustrated embodiment, the ablation element 1108 (e.g., an electrode) may form at least a portion of the housing 1116. For example, the housing 1116 may be constructed from a highly magnetically permeable, non-ferrous material, which may be electrically conductive. In the illustrated embodiment, the housing 1116 is constructed from copper and configured to be electrically coupled to a source of radio frequency energy (e.g., the control unit 114 (FIG. 1)) to act as an electrode to perform ablation in cooperation with the ablation element of a cooperating ablation component. In some embodiments, the housing 1116 may be constructed from copper plated with nickel and / or gold.

[0189] In this embodiment, at least a portion of the exterior surface of the housing 1116 that includes the ablation elements 1108 (e.g., electrodes) has a generally bulbous shape, such as being at least partially generally spherical. As used herein, "bulbous" can refer to an enlarged (relative to adjacent structures) exterior surface and / or a generally convex rounded exterior surface. In other embodiments, the housing 1116 can include a generally dome-shaped tip with a substantially uniform diameter and / or cross-section along its longitudinal length. In the illustrated embodiment, the ablation elements 1108 are generally spherical and form at least a portion of the housing 1116. In alternative embodiments, the ablation elements 1108 (e.g., electrodes) may be disposed in the housing 1116. As used herein, "ball electrode" can refer to an at least partially spherical electrode, at least a portion of which has a generally ball-like appearance. Additionally, in some embodiments, the ablation elements 1108 can include two or more electrodes, such as two or more elongated generally parallel electrodes. In general, other embodiments may utilize any suitable arrangement of ablation elements 1108 and / or other electrodes.

[0190] 23 is a simplified transverse cutaway view of an alternative end effector 1210 of the ablation component 1100 of FIG. 21, in accordance with at least some aspects of the present disclosure. The end effector 1210 can be used in place of the previously described end effector 1110. The end effector 1210 is generally similar in structure and operation to the end effectors described elsewhere herein, such as the end effector 1110, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the end effector 1210 may be utilized in connection with any other embodiment described elsewhere herein.

[0191] 23 embodiment, the magnetic element 1220 may be non-spherical (e.g., generally cylindrical), but disposed in a substantially spherical mounting portion 1202. The mounting portion 1202 is freely rotatably disposed within the housing 1216 of the end effector 1210 in a manner similar to the magnetic element 1120 and housing 1116 of the end effector 1110 (FIG. 21).

[0192] 24 is a perspective view of a distal end portion of the ablation component 1100 of FIG. 21 in a retracted configuration, and FIG. 25 is a perspective view of the distal end portion of the ablation component 1100 of FIG. 21 in a deployed configuration, all according to at least some aspects of the present disclosure. In the illustrated embodiment, in the retracted configuration (FIG. 24), the second connecting element 1108 can be disposed substantially within the first connecting element 1106, and / or the engaging element 1114 can operably couple the end effector 1110 and the first connecting element distal portion 1112. In the deployed configuration (FIG. 25), at least a portion of the second connecting element 1108 can extend from the first connecting element distal portion 1112, and the engaging element 1114 can be disengaged from at least one of the end effector 1110 or the first connecting element distal portion 1112.

[0193] 24 and 25, in the illustrated embodiment, the engaging element 1114 may be disposed at the distal end 1128 of the distal portion 1112 of the first connecting element 1106. With reference to FIG. 24, in the illustrated embodiment, in the retracted configuration, the end effector engages the engaging element 1114. In the retracted configuration, the end effector 1110 may be substantially mechanically coupled to the first connecting element distal portion 1112, such as by the engaging element 1114. Thus, the retracted configuration can facilitate precise positioning of the end effector 1110 using the connecting element 1104 (FIG. 21) when desired. The retracted configuration can also facilitate withdrawing the end effector 1110 away from the target tissue following ablation, such as when a substantial force is used to overcome the magnetic attraction between the magnetic element 1120 and the cooperating magnetic element of the cooperating ablation component (see, e.g., FIG. 1). For example, when using an associated ablation component with a translationally repositionable magnetic element, it may be desirable to place the ablation component 1100 in a retracted configuration prior to translating the associated magnetic element in order to decouple it to prevent the end effector 1110 from translating with the associated magnetic element. Additionally, in some circumstances, withdrawing the ablation component 1000 from its operable field in the retracted configuration can reduce the possibility of injury from a partially unconstrained end effector 1110.

[0194] 25 , in the illustrated embodiment, in the deployed configuration, the end effector is disengaged from the engaging element 1114 but remains attached to the second connecting element 1108 extending distally from the first engaging element 1106. In the deployed configuration, a portion of the second connecting element 1108 extending distally from the distal portion 1112 of the first connecting element 1106 can act as a tether for the end effector 1110. That is, the second connecting element 1108 can be operatively connected (e.g., mechanically and / or electrically) to the end effector 1110, but the second connecting element 1108 can be configured to move the end effector 1110 substantially independently of the first connecting element distal portion 1112 (e.g., except for moving further from the first connecting element distal portion 1112 than allowed by the deployed length of the second connecting element 1108).

[0195] In the illustrated embodiment, the second connection element 1108 may have substantially greater flexibility than the first connection element distal portion 1112. Thus, in the deployed configuration, the end effector 1110 may be substantially more freely movable than in the retracted configuration (FIG. 24). Thus, the first connection element distal portion 1112 may be at least partially mechanically decoupled from the end effector 1110. Consequently, when the magnetic element 1120 (FIG. 21) of the end effector 1110 is magnetically coupled with a cooperating magnetic element of a cooperating ablation component (see, e.g., FIG. 1), some movement of the first connection element distal portion 1112 (e.g., a limited degree of movement in some directions) may exert a sufficiently small force on the end effector 1110 that the end effector 1110 may remain held in place by the attractive forces between the magnetic element 1120 and the cooperating magnetic element of the cooperating ablation component. For example, when the connecting element 1104 ( FIG. 21 ) extends into an interior chamber of the heart, such as through a heart valve, beating of the heart can cause substantial movement of the first connecting element distal portion 1112. When the ablation component 1110 is positioned into a deployed configuration, the end effector 1110 can be held by magnetic attraction with the cooperating magnetic element of the epicardium due to partial mechanical decoupling of the end effector 1110 from the first connecting element distal portion 1112, allowing it to remain in a desired location on the endocardial surface.

[0196] 21 and 25, in some embodiments, the deployment actuator 1122 may be configured to extend the second connection element 1108 and / or the end effector 1110 a predetermined deployment distance between the retracted configuration and the deployed configuration. The deployment distance may be selected based on the expected use of the device. For example, if the ablation component 1100 is intended to be used endocardium via vascular access, a deployment distance of about 5 mm to about 30 mm may provide sufficient mechanical decoupling between the first connection element distal portion 1112 and the end effector 1110, but may also limit the possibility that the end effector 1110 and / or the second connection element 1108 may unintentionally engage with the chordae tendineae. In the illustrated embodiment, the deployment distance may be fixed at the time of assembly. In some alternative embodiments, the deployment distance may be changed by the end user either prior to deployment or while in the deployed configuration.

[0197] 25, in the illustrated embodiment, the engaging element 1114 may include a distally oriented tapered opening 1130. The opening 1130 may be generally conical. With reference to FIGS. 24 and 25, in the retracted configuration, the opening 1130 may receive at least a portion of the end effector 1110 therein. Thus, in the retracted configuration, the end effector 1110 may be operably coupled to the distal end portion 1112 of the first connecting element 1106. In some example embodiments, the engaging element 1114 may be substantially rigid. In some example embodiments, the engaging element 1114 may be at least partially flexible to securely seat the end effector 1110 despite slight misalignment.

[0198] 26 is a detailed schematic diagram of a distal end portion of an alternative example ablation component 1300 in a deployed configuration, in accordance with at least some aspects of the present disclosure. Ablation component 1300 is generally similar in structure and operation to the ablation components described elsewhere herein, including ablation component 1100, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with ablation component 1300 may be utilized in connection with any other embodiment described elsewhere herein.

[0199] In the illustrated embodiment, the ablation component 1300 may include a connecting element 1304 including a first connecting element 1306, a second connecting element 1308, and an end effector 1310. The end effector 1310 may include a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments. Unlike the embodiment of FIG. 21 described previously, the embodiment of FIG. 26 includes an engaging element 1314 disposed on a proximal aspect of the end effector 1310. The engaging element 1314 is configured to selectively engage a distal portion 1312 of the first connecting element 1306 in a retracted configuration. In the illustrated embodiment, the engaging element 1314 is generally in the form of a proximally opening, generally tubular body having a generally cylindrical cross-section configured to receive the first connecting element distal portion 1312 therein. Some embodiments may include a proximally oriented opening 1330 that may be tapered.

[0200] 27 is a perspective view of a distal end portion of an alternative example ablation component 1400 with a freely rotatable magnetic element, according to at least some aspects of the present disclosure. The ablation component 1400 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 1100, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 1400 may be utilized in connection with any other embodiment described elsewhere herein. In FIG. 27, the ablation component 1400 is shown as being inserted through an example delivery device 292, which may be similar to the delivery device 290 described above with reference to FIG. 2.

[0201] In the illustrated embodiment, the ablation component 1400 comprises an end effector 1410 disposed distally at the connecting element 1404. The end effector 1410 may comprise a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments. In this embodiment, the connecting element may not comprise separate, relatively movable first and second connecting elements, such as those of the ablation component 1100 previously described. Instead, the end effector 1410 is disposed at the connecting element 1404. For example, the end effector 1410 may be fixedly coupled directly to a distal end of the connecting element 1404. In some embodiments, the connecting element 1404 may be generally flexible. In some embodiments, the connecting element 1404 may be steerable / deflectable. In this embodiment, the ablation component 1400 may not comprise an engagement element operably interposing the end effector 1410 and the connecting element 1404.

[0202] 28-31 are perspective views of alternative example end effectors 1500, 1520, 1540, 1560, all according to at least some aspects of the present disclosure. The alternative example end effectors 1500, 1520, 1540, 1560 are generally similar in structure and operation to the end effectors described elsewhere herein, including end effectors 1110, 1210, 1310, 1410, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with end effectors 1500, 1520, 1540, 1560 may be utilized in connection with any other embodiment described elsewhere herein. Each of the end effectors 1500, 1520, 1540, 1560 may include a magnetic element, such as a generally spherical permanent magnet, that may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments.

[0203] 25, 27, and 28-31, various end effector features, shapes, and / or configurations may be utilized individually or in any combination with any embodiment according to at least some aspects of the present disclosure. Some example end effectors may be configured to facilitate a desired heat transfer, such as by including one or more features operable as a heat sink. For example, some end effectors may include a proximally extending neck configured to transfer heat between the end effector and a surrounding fluid. When used, for example, on the endocardium, the neck may transfer heat (e.g., from an ablation) from the end effector housing to the blood. The size, shape, material, and / or other configuration of the neck may be configured to facilitate a desired heat transfer and / or may be specifically configured for a specific location of use and / or procedure. In some example embodiments, at least a portion of the end effector housing may be electrically and / or thermally insulated, such as by an insulating coating (e.g., an externally disposed insulator) and / or by constructing at least a portion of the end effector from an insulating material (e.g., a polymer). Such insulators can reduce the amount of ablation energy (e.g., radio frequency energy) that may be dissipated into non-target tissue and / or fluids. Such insulation may also be used to achieve desired thermal performance of the ablation component.

[0204] With reference to FIG. 25, the end effector 1110 includes a relatively short proximally extending neck 1132. In the illustrated embodiment, the neck 1132 is constructed from copper and is partially covered by a circumferential insulator 1134, which may include a polymer. With reference to FIG. 27, the end effector 1410 includes a medium length, relatively wide, generally cylindrical neck 1432. With reference to FIG. 28, the end effector 1500 includes an elongated, generally narrow, substantially uniform cylindrical neck 1502. With reference to FIG. 29, the end effector 1520 includes a relatively short, distally tapered cylindrical, generally dome-shaped neck 1522, optionally with a circumferential recess 1524. 30, the end effector 1540 includes a neck 1542 having an elongated substantially uniform cylindrical distal portion 1544 followed by a proximal frusto-conical portion 1546. With reference to FIG. 31, the end effector 1560 is generally bullet-shaped and / or hemispherical. Specifically, in this embodiment, the end effector 1560 includes a generally dome-shaped (e.g., hemispherical) and bulbous distal portion 1562 that may include an ablation element, and a generally uniform cylindrical proximal portion 1564. In some example embodiments, the proximal portion 1564 may include an engagement element configured to receive a distal end portion of the first connecting element therein, such as in a generally cylindrical proximal opening similar to that shown in FIG.

[0205] FIG. 32 is a perspective view of a distal end portion of an alternative example ablation component 1600 in a retracted configuration, FIG. 33 is a perspective view of the ablation component 1600 of FIG. 32 in a deployed configuration, FIG. 34 is a detailed perspective view of an end effector 1610 of the example ablation component 1600 of FIG. 32, and FIG. 35 is a detailed perspective partial view of the end effector 1610 of FIG. 34, all according to at least some aspects of the present disclosure. The ablation component 1600 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 1100, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 1600 may be utilized in connection with any other embodiment described elsewhere herein.

[0206] 32 and 33, the illustrated ablation component 1600 may include an elongated connecting element 1604 and a distally disposed end effector 1610. The end effector 1610 may include a magnetic element, such as a generally spherical permanent magnet, that may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments. In the illustrated embodiment, the connecting element 1604 may include a first connecting element 1606 (e.g., generally in the form of a deflectable sheath or catheter) and a second connecting element 1608 (e.g., generally in the form of a flexible push / pull element) that may be movable within and relative to the first connecting element 1606. The end effector 1610 may be generally disposed distally at the second connecting element 1608. An engaging element 1614 may operably interpose the first connecting element distal portion 1612 and the end effector 1610 .

[0207] 32-35, in the illustrated embodiment, the end effector 1610 may include a housing 1616 that is at least partially generally spherical. The end effector 1610 may include a magnetic element, such as a generally spherical permanent magnet, that may be freely rotatable about three axes of rotation within the end effector housing 1616, as previously described with reference to other similar embodiments. The end effector housing 1616 may include a generally bulbous tissue contacting surface that may be at least partially generally spherical. At least a portion of the end effector housing 1616 may be constructed from a high magnetic permeability, non-ferrous, electrically conductive material, such as copper. In some embodiments, the ablation element may include a primary electrode 1618, and a conductive portion of the end effector housing 1616 may form the primary electrode 1618.

[0208] 33-35, in the depicted embodiment, the end effector housing 1616 can include a proximally extending neck 1626 to which the second connecting element 1608 is coupled. In the embodiment shown in FIGS. 32-35, the neck 1626 is generally shaped as a relatively short distally tapered cylinder. Various other neck configurations, such as those described elsewhere herein, may be utilized in alternative embodiments.

[0209] 34 and 35, in the illustrated embodiment, a distal portion 1628 of the end effector housing 1616 includes the primary electrode 1618. A proximal portion 1630 of the end effector housing 1616 may be constructed from a non-conductive material, such as a polymer. Together, the distal portion 1628 and the proximal portion 1630 define a generally spherical interior within which a generally spherical magnetic element (e.g., a permanent magnet) may be freely rotatable, generally in the manner described elsewhere herein with reference to similar embodiments.

[0210] In the illustrated embodiment, the end effector 1610 may include one or more auxiliary electrodes 1632, 1634, 1636, 1638, 1640. For example, the illustrated embodiment includes one distal tip auxiliary electrode 1632 and four lateral auxiliary electrodes 1634, 1636, 1638, 1640, which may be generally evenly spaced circumferentially (e.g., at angular intervals of about 90 degrees). As shown in FIG. 35, recesses 1634 may be formed in the proximal portion 1630 of the housing 1616 to allow for routing of wires to the auxiliary electrodes 1632, 1634, 1636, 1638, 1640. In some example embodiments, the auxiliary electrodes 1632, 1634, 1636, 1638, 1640 may be electrically isolated from the main electrode 1618, such as by an insulator.

[0211] FIG. 36 is a detailed perspective view of an alternative end effector 1710 according to at least some aspects of the present disclosure. The end effector 1710 is generally similar in structure and operation to the ablation components described elsewhere herein, including the end effector 1610, and repeated descriptions of similar elements are omitted for brevity. Similarly, any features described in connection with the end effector 1710 may be utilized in connection with any other embodiment described elsewhere herein. The end effector 1710 may include a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments. In the embodiment of FIG. 36, one or more lateral auxiliary electrodes 1702, 1704, 1706, 1708 are provided in the form of elongated electrodes that may be generally longitudinally oriented around a proximal portion of the circumference of the end effector 1710.

[0212] FIG. 37 is a detailed perspective view of an alternative end effector 1750, and FIG. 38 is a detailed perspective cutaway view of the end effector 1750, all according to at least some aspects of the present disclosure. The end effector 1750 is generally similar in structure and operation to the ablation components described elsewhere herein, including the end effectors 1520, 1710, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the end effector 1750 may be utilized in connection with any other embodiment described elsewhere herein. The end effector 1750 may include a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments. In the illustrated embodiment, the end effector 1750 is similar in shape to the end effector 1520 of FIG. 29, which includes a generally dome-shaped neck 1522 with a circumferential recess 1524. However, in the embodiment of Figures 37 and 38, the end effector 1750 includes a distal tip auxiliary electrode 1752 and four circumferentially spaced lateral auxiliary electrodes 1754, 1756, 1758 (a fourth lateral auxiliary electrode is not visible in Figures 37 and 38).

[0213] FIG. 39 is a detailed perspective view of a distal end portion of an alternative ablation component 1800, and FIG. 40 is a detailed perspective view of an end effector 1802 of the example ablation component 1800 of FIG. 39, all according to at least some aspects of the present disclosure. The ablation component 1800 is generally similar in structure and operation to the ablation components described elsewhere herein, including the ablation component 1600, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation component 1800 may be utilized in connection with any other embodiment described elsewhere herein. The end effector 1802 may comprise a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing, as previously described with reference to other similar embodiments.

[0214] In the illustrated embodiment, the end effector 1802 comprises a generally spherical housing 1804 that includes a primary electrode 1806 as well as five auxiliary electrodes 1808, 1810, 1812, 1814 (other lateral auxiliary electrodes are similarly provided but are not visible in FIGS. 39 and 40). The auxiliary electrodes 1808, 1810, 1812 are disposed on an outer surface of the primary electrode 1806. Also disposed on the outer surface of the primary electrode 1806 are passageways 1816, 1818, 1820 that allow for routing of wires to the auxiliary electrodes 1808, 1810, 1812, 1814. In the illustrated embodiment, one passageway 1816 operably connects to both the distal tip auxiliary electrode 1808 and one of the lateral auxiliary electrodes 1810, and the other passageways 1818, 1820 operably connect to the individual lateral auxiliary electrodes.

[0215] 41 is a detailed perspective view of an alternative example end effector 1900 according to at least some aspects of the present disclosure. End effector 1900 is generally similar in structure and operation to the ablation components described elsewhere herein, including end effector 1610, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with end effector 1900 may be utilized in connection with any other embodiment described elsewhere herein.

[0216] In the illustrated embodiment, the end effector 1900 may comprise a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing 1902, as described above with reference to other similar embodiments. The end effector housing 1902 may comprise a generally bulbous tissue contacting surface, which may be at least partially generally spherical. At least a portion of the end effector housing 1902 may be constructed from a high magnetic permeability, non-ferrous, electrically conductive material, such as copper. In some embodiments, the ablation element comprises two or more main electrodes 1904, 1906. In the illustrated embodiment, the end effector housing 1902 comprises main electrodes 1904, 1906 that are generally in the form of cooperating hemispheres. The main electrodes may be electrically and / or mechanically separated by an insulator 1908, which may be in the form of a plastic spacer. In the illustrated embodiment, the main electrodes 1904, 1906 are disposed laterally relative to one another (e.g., one on each side of the longitudinal axis). In other embodiments, the generally hemispherical primary electrodes 1904, 1906 may be arranged in other relative configurations, such as longitudinally relative to one another. In some alternative embodiments, the generally spherical housing 1902 may include three or more partially spherical sections that may be arranged in any desired configuration, interposed by one or more spacers (e.g., insulators). In some embodiments, the primary electrodes 1904, 1906 may be utilized with one another for ablation of the target tissue from one side. In some embodiments, the primary electrodes 1904, 1906 may be utilized in cooperation with one or more cooperating electrodes positioned on the opposite side of the target tissue. In some such embodiments, the primary electrodes 1904, 1906 may be selectively switched on and off to create the desired ablation in the target tissue. Although not shown in FIG. 41, one or more auxiliary electrodes, such as those previously described, may be utilized in connection with this embodiment.

[0217] 42 is a detailed perspective view of an alternative example end effector 1950 according to at least some aspects of the present disclosure. The end effector 1950 is generally similar in structure and operation to the ablation components described elsewhere herein, including the end effector 1610, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the end effector 1950 may be utilized in connection with any other embodiment described elsewhere herein.

[0218] In the illustrated embodiment, the end effector 1950 may comprise a magnetic element, such as a generally spherical permanent magnet, which may be freely rotatable about three axes of rotation within the end effector housing 1952, as described above with reference to other similar embodiments. The end effector housing 1952 may comprise a generally bulbous tissue contacting surface, which may be at least partially generally spherical. At least a portion of the end effector housing 1952 may be constructed from a high magnetic permeability, non-ferrous, electrically conductive material, such as copper. In some embodiments, the ablation element comprises a distally disposed, generally hemispherical primary electrode 1954. The illustrated embodiment comprises two auxiliary electrodes 1956, 1958 in addition to the primary electrode 1954. In this embodiment, one of the auxiliary electrodes 1956, 1958 comprises a distal tip auxiliary electrode 1956 and the other comprises a lateral auxiliary electrode 1958. The lateral auxiliary electrode 1958 may be in the form of a generally circular circumferential metal ring disposed proximal to the primary electrode 1954. In the illustrated embodiment, the auxiliary electrode 1956 is electrically insulated from the primary electrode 1954, such as by an intervening insulator 1960, which may be in the form of a plastic spacer. In the illustrated embodiment, the proximal portion 1962 of the end effector housing 1952 may be constructed from a non-conductive material, such as plastic. Generally, electrodes of any shape (e.g., generally hemispherical, generally circular, generally ring-shaped, etc.) may be used as primary and / or auxiliary electrodes in connection with any of the embodiments described herein and may be oriented in any desired orientation in the end effector housing.

[0219] 43 is a detailed perspective partial cutaway view of an example end effector deployment mechanism 2000 in a retracted configuration, and FIG. 44 is a detailed perspective partial cutaway view of the example deployment mechanism 2000 of FIG. 43 in a deployed configuration, all according to at least some aspects of the present disclosure. The deployment mechanism 2000 is described with reference to the ablation component 1100 shown in FIGS. 21, 22, 24, and 25. However, it should be understood that the ablation component 1100 does not require the deployment mechanism 2000, and the illustrated deployment mechanism 2000 may be used in connection with other embodiments, such as those in which the end effector may be deployed and / or retracted in a similar manner.

[0220] 21, 22, 24, 25, 43, and 44, in some embodiments, a deployment mechanism 2000 can be disposed in the handle 1102 and configured to extend and / or retract the second connecting element 1108 (e.g., relative to the first connecting element 1106) to deploy and / or retract the end effector 1110. The illustrated deployment mechanism 2000 can include a first proximal ferrule 2002 and a second distal ferrule 2004. The ferrules 2002, 2004 can each be fixed to the second connecting element 1108. A compression spring 2006 can act between the fixed stop 2008 (distally) and the proximal ferrule 2002 (proximally) to apply a proximal pull to the second connecting element 1108. A deployment actuator 1122 can selectively engage the distal ferrule 2004.

[0221] 43, in the illustrated embodiment, in the retracted configuration, the deployment actuator 1122 can be in a proximal, retracted position. In this position, the deployment actuator 1122 can disengage from the distal ferrule 2004 and a proximal pull applied by the compression spring 2006 through the proximal ferrule 2002 can hold the second connecting element 1108 in the proximal, retracted position.

[0222] Also, in the illustrated embodiment, in the retracted configuration, the compression spring 2006 is partially compressed. Thus, the spring 2006 maintains tension on the second connection element 1108 even when the second connection element 1108 is moved proximally a small amount. Similarly, the spring 2006 allows a small amount of distal movement of the second connection element 1108 (e.g., when the second connection element is pulled distally). This small proximal or distal movement of the second connection element 1108 can occur, for example, when the first connection element distal portion 1112 is deflected or straightened. Because the deployment mechanism 2000 is configured to apply a continuous proximal pull to the second connection element 1108 through such small movements of the second connection element 1108, a firm engagement between the engagement element 1114 and the end effector 1110 and / or the first connection element distal portion 1112 can be maintained during deflection and / or straightening of the first connection element distal portion 1112.

[0223] 44, in the illustrated embodiment, in the deployed configuration, the deployment actuator 1122 may be in a distal, deployed position. In this position, the deployment actuator 1122 may be engaged with the distal ferrule 2004. Specifically, the deployment actuator 1122 may distally hold the distal ferrule 2004 such that it is not directly visible in the cutaway view of FIG. 43. As the distal ferrule 2004 is moved distally by the deployment actuator 1122, and both the distal ferrule 2004 and the proximal ferrule 2002 are securely attached to the second connecting element 1108, the compression spring 2006 is further compressed against the fixed stop 2008.

[0224] 45 and 46 are detailed perspective partial cutaway views of the deployment mechanism 2000 in an intermediate position, all according to at least some aspects of the present disclosure. The deployment actuator 1122 may be held in the retracted (proximal) position and / or the deployed (distal) position by one or more latching mechanisms. Specifically, in the illustrated embodiment, the deployment actuator 1122 may be held in the retracted and / or deployed position by one or more magnetic latching mechanisms. Generally, example magnetic latching mechanisms may utilize magnet-to-magnet and / or magnet-to-ferrous attraction. The magnetic components may be selected to provide a desired magnetic strength. In the illustrated embodiment, the deployment actuator 1122 may include a latching magnet 2040. Referring to FIG. 45, a proximally facing inner surface at the distal end of the deployment mechanism 2000 may include a magnetic element 2042 configured to cooperate with the latching magnet 2040 in the deployed position. 46, a distally facing surface of the fixed stop 2008 may comprise a magnetic element 2044 configured to cooperate with the latching magnet 2040 in the retracted position. In the illustrated embodiment, the magnetic elements 2042, 2044 may comprise ferromagnetic washers that may be attracted by the latching magnet 2040. In some alternative embodiments, the magnetic elements 2042, 2044 may comprise permanent magnets. In still further alternative embodiments, a mechanical latching mechanism (e.g., a catch, a detent, etc.) may be utilized to retain the deployment actuator 1122 in the retracted and / or deployed positions.

[0225] 47 is a detailed perspective cutaway view of an alternative deployment mechanism 2050 in a deployed configuration, according to at least some aspects of the present disclosure. Deployment mechanism 2050 is generally similar in structure and operation to other deployment mechanisms described herein, specifically deployment mechanism 2000, and repeated descriptions of similar structure and operation have been omitted for brevity. Similarly, any features described in connection with deployment mechanism 2050 may be utilized in connection with any other embodiments described elsewhere herein.

[0226] In the illustrated embodiment, the deployment mechanism 2050 includes a deployment actuator 2052 configured to longitudinally translate a transport 2054 between a retracted position and a deployed position. The transport 2054 includes a fixed stop 2056. Thus, unlike the previously described deployment mechanism 2000 (FIGS. 43-46) in which the fixed stop 2008 does not move with the deployment actuator 1122, the fixed stop 2056 of the embodiment of FIG. 47 moves with the deployment actuator 2052. As a result, the spring 2058 is not substantially further compressed when the deployment actuator 2052 is moved from the retracted position to the deployed position.

[0227] Methods of using various example embodiments according to at least some aspects of the present disclosure, such as methods of creating lesions, may include one or more of the operations described herein in any order. This description of example methods includes a general overview of the situation, followed by example methods focusing on specific embodiments. It is understood that any operation described herein may be performed alone and / or in conjunction with any other part of the procedure or any other procedure. Furthermore, although this description of methods and operations refers to specific elements of some example embodiments described elsewhere herein, it is understood that the various methods and operations are similarly related to other similar or related embodiments according to the present disclosure, regardless of whether such other embodiments are specifically referred to.

[0228] The following method focuses on, but is not limited to, ablation components similar to those shown in Figures 1-20. It is understood that any operations described in connection with this method may be used in connection with any operations of any other method described herein, such as operations described elsewhere herein that focus on ablation components similar to those shown in Figures 21-47.

[0229] 1, an example method of creating a lesion 16 may include positioning a first ablation component 102 proximate to a first surface 12 of a target tissue 18. The first ablation component 102 may comprise any ablation component described herein. The first ablation component 102 may comprise an end effector 102A including a housing 102B, a magnetic element 110, and a first ablation element 106. The method may include positioning a second ablation component 104 proximate to a second surface 14 of the target tissue 18. The second ablation component may comprise any ablation component described herein. The second ablation component 104 may comprise a magnetic element 112. The method may include positioning the end effector 102A and / or the second ablation component 104 using an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component magnetic element 112. The method may include creating a first lesion 16 in the target tissue 18 using the first ablation element 106 and / or the ablation element 108 of the second ablation component 104. In some example embodiments, creating a lesion 16 in the target tissue 18 using the ablation element 106 of the first ablation component 102 and / or the ablation element 108 of the second ablation component 104 may include, for example, one or more of radio frequency (RF) energy ablation (monopolar and / or bipolar), pulsed field ablation, cryoablation, ultrasonic ablation, or laser ablation. Some or all of these operations may be repeated as desired to create multiple lesions. When all ablation operations are completed, the first ablation component 102 and the second ablation component 104 may be withdrawn from the operating area.

[0230] The method may include reducing an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component magnetic element 112, such as by repositioning the magnetic element 110 relative to the housing 102B (e.g., from an engaged position to a disengaged position). In some example embodiments, repositioning the magnetic element 220, 1002 relative to the housing 232, 1018, such as the ablation component 200, 1000, may include translationally repositioning the magnetic element 220, 1002 relative to the housing 232, 1018. In some embodiments, repositioning the magnetic element 220 relative to the housing 232, such as the ablation component 200, may include translationally repositioning the magnetic element 220 relative to the housing 232 without substantial rotation. Translationally repositioning the magnetic element 220, 1002 relative to the housing 232, 1018 may include translationally repositioning the magnetic element 220, 1002 along the longitudinal axis 220A, 1006 of the magnetic element 220, 1002. In some embodiments, translationally repositioning the magnetic element 220, 1002 relative to the housing 232, 1018 may include translationally repositioning the magnetic element 220, 1002 from substantially laterally adjacent the tissue contacting surface 224, 1008 of the end effector 202, 1004 to substantially not laterally adjacent the tissue contacting surface 224, 1008.

[0231] In some example embodiments, repositioning the magnetic element 902, 1002 relative to the housing 904A, 1018, such as the ablation component 900, 1000, may include rotationally repositioning the magnetic element 902, 1002 relative to the housing 904A, 1018. In some embodiments, rotationally repositioning the magnetic element 902 relative to the housing 904A may include rotationally repositioning the magnetic element 902 relative to the housing 904A without substantial translation. Rotationally repositioning the magnetic element 902, 1002 relative to the housing 904A, 1018 may include rotationally repositioning the magnetic element 902, 1002 about the longitudinal axis 906 of the end effector 904 and / or about the longitudinal axis 1006 of the magnetic element 1002. Rotationally repositioning the magnetic elements 902, 1002 relative to the housing 904A, 1018 may include rotationally repositioning the magnetic elements 902, 1002 from an orientation in which the magnetic axes 910, 1010 of the magnetic elements 902, 1002 are substantially aligned with a direction 912, 1012 extending from the magnetic elements 902, 1002 through the tissue contacting surfaces 908, 1008 of the end effector 904, 1004 for magnetic attraction with the magnetic element 112 of the second ablation component 104, to an orientation in which the magnetic axes 910, 1010 of the magnetic elements 902, 1002 are substantially perpendicular to the direction 912, 1012 extending from the magnetic elements 902, 1002 through the tissue contacting surfaces 908, 1008. Rotationally repositioning the magnetic elements 902, 1002 relative to the housing 904A, 1018 may include rotationally repositioning the magnetic elements 902, 1002 from an orientation in which the magnetic axes 910, 1010 of the magnetic elements 902, 1002 are substantially aligned with a direction 912, 1012 extending from the magnetic elements 902, 1002 through the tissue contacting surfaces 908, 1008 of the end effector 904, 1004 for magnetic attraction with the magnetic element 112 of the second ablation component 104, to an orientation in which the magnetic axes 910, 1010 of the magnetic elements 902, 1002 are substantially aligned with a direction 912, 1012 extending from the magnetic elements 902, 1002 through the tissue contacting surfaces 908, 1008 for magnetic repulsion of the magnetic element 112 of the second ablation component 104.

[0232] In some example embodiments, repositioning the magnetic element 1002 relative to the housing 1018, such as the ablation component 1000, may include simultaneously repositioning the magnetic element 1002 translationally and rotationally relative to the housing 1018. Translationally repositioning the magnetic element 1002 relative to the housing 1018 may include translationally repositioning the magnetic element 1002 along a longitudinal axis 1006 of the magnetic element 1002. Rotationally repositioning the magnetic element 1002 relative to the housing 1018 may include rotationally repositioning the magnetic element 1002 about the longitudinal axis 1006 of the magnetic element 1002. In some embodiments, the magnetic element 1002 may be operably coupled to a travel portion 1016. The travel portion 1016 may include a protrusion 1022 slidably disposed in a helical groove 1020. Simultaneously repositioning the magnetic element 1002 translationally and rotationally relative to the housing 1018 may include sliding the protrusion 1022 along the helical groove 1020 .

[0233] In some example embodiments, the method may include securing the ablation component 200 to the target tissue 18 ( FIG. 1 ) by applying a vacuum to the vacuum port 222 of the end effector 202. The method may include ceasing application of the vacuum to the vacuum port 222.

[0234] The following method focuses on ablation components similar to those shown in, but not limited to, Figures 1 and 21-47. It is understood that any operations described in connection with this method may be used in connection with any operations of any other method described herein, such as operations described elsewhere herein that focus on ablation components similar to those shown in Figures 2-20.

[0235] 1, an example method of creating a lesion 16 in a target tissue 18 may include disposing a first ablation component 102 on a first surface 12 of the target tissue 18. The first ablation component 102 may include a first ablation component end effector 102A, which may include a first ablation component end effector housing 102B and a first ablation component magnetic element 110. The method may include disposing a second ablation component 104 on a second surface 14 of the target tissue 18. The second ablation component 104 may include a second ablation component ablation element 108 and a second ablation component permanent magnet 112. In some embodiments, such as the ablation component 1100 and similar embodiments, the second ablation component permanent magnet 112, 1120 may be freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing 104B, 1116. The method may include rotating the second ablation component permanent magnet 112, 1120 about at least one axis of rotation to self-orient the second ablation component permanent magnet 112, 1120 into a magnetically attractive orientation with the first ablation component permanent magnet 110. The method may include positioning one or both of the first ablation component end effector 102A, 1110 or the second ablation component end effector 104A using an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component permanent magnet 112, 1120. The method may include creating a first lesion 16 in the target tissue 18 using the first ablation component ablation element 106 and / or the second ablation component ablation element 108, 1118.In some example embodiments, creating lesions 16 in target tissue 18 using the ablation elements 106 of the first ablation component 102 and / or the ablation elements 108, 1118 of the second ablation component 104, 1100 may include, for example, one or more of radio frequency (RF) energy ablation (monopolar and / or bipolar), pulsed field ablation, cryoablation, ultrasonic ablation, or laser ablation. Some or all of these operations may be repeated as desired to create multiple lesions. When all ablation operations are completed, the first ablation component 102 and the second ablation component 104, 1100 may be withdrawn from the operating area.

[0236] In some example embodiments, self-orienting the second ablation component permanent magnet 1120, such as the ablation component 1100, into a magnetically attractive orientation with the first ablation component magnetic element 110 may include self-orienting the second ablation component permanent magnet 1120 into a magnetically attractive orientation with the first ablation component magnetic element 110 without substantial translation of the second ablation component permanent magnet 1120 relative to the second ablation component end effector housing 1116.

[0237] In some example embodiments, the second ablation component permanent magnet 1120, such as the ablation component 1100, may be freely rotatable about three axes of rotation relative to the second ablation component end effector housing 1116. Self-orienting the second ablation component permanent magnet 1120 into a magnetically attractive orientation with the first ablation component magnetic element 110 may include rotating the second ablation component permanent magnet 1120 about three axes of rotation. In some example embodiments, the second ablation component permanent magnet 1120 may comprise a generally spherical second ablation component permanent magnet 1120, and the second ablation component end effector housing 1116 may include a generally spherical interior 1126. Rotating the second ablation component permanent magnet 1120 about three axes of rotation may include rotating the generally spherical second ablation component permanent magnet 1120 about three axes of rotation within the generally spherical interior 1126 of the second ablation component end effector housing 1116.

[0238] In some example embodiments, positioning the second ablation component 104, 1110 on the second surface 14 of the target tissue 18 may include engaging a generally bulbous tissue contacting surface of the second ablation component 104, 1110 (e.g., the electrode 1108) with the second surface 14 of the target tissue 18.

[0239] In some example embodiments, the second ablation component ablation element 108, 1108 can comprise a second ablation component electrode 108, 1108, and creating the first lesion 16 in the target tissue 18 using the second ablation component ablation element 108, 1108 includes applying radio frequency ablation energy to the target tissue 18 using the second ablation component electrode 108, 1108. In some example embodiments, the first ablation component 102 can comprise a first ablation component ablation element 106 including a first ablation component electrode 106. Creating the first lesion 16 in the target tissue 18 using the second ablation component ablation element 108, 1108 can include applying bipolar radio frequency ablation energy to the target tissue 18 using the first ablation component electrode 106 and the second ablation component electrode 108, 1108.

[0240] In some example embodiments, the method may include reducing an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component permanent magnet 112, 1120 and / or removing at least one of the first ablation component end effector 102A or the second ablation component end effector 104A, 1110 from the target tissue 18. In some example embodiments, the first ablation component magnetic element 110 may comprise a first ablation component permanent magnet 110 repositionably disposed relative to the first ablation component end effector housing 102B. The method may include reducing an attractive magnetic coupling between the first ablation component permanent magnet 110 and the second ablation component permanent magnet 112, 1120 by repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B. For example, repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B may include translationally repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B. Repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B may include translationally repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B without substantial rotation of the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B.

[0241] In some example embodiments, repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B may include rotationally repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B. Rotationally repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B may include rotationally repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B without substantial translation of the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B. In some example embodiments, repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B can include simultaneously repositioning the first ablation component permanent magnet 110 translationally and rotationally relative to the first ablation component end effector housing 102B. In some example embodiments, such as the ablation component 200, the method can include securing the first ablation component end effector 202 to the target tissue 18 by applying a vacuum to the vacuum port 222 of the first ablation component end effector 202. The method can further include ceasing application of the vacuum to the vacuum port 222.

[0242] The following method focuses on, but is not limited to, the use of ablation components similar to those shown in Figures 1-20 in the context of ablation components similar to those shown in Figures 1 and 21-47. It will be understood that any acts described in the context of this method may be used in the context of any acts of any other method described herein.

[0243] 48 is a perspective view of a distal end portion of an alternative example ablation system 2100 in use at a target tissue, according to at least some aspects of the present disclosure. In the illustrated embodiment, the ablation system 2100 includes a first ablation component 2102 configured to be positioned at a first side 2113 of the target tissue 2118, such as the epicardial surface 12 (FIG. 1) of the heart wall 18. The ablation system 2100 includes a second ablation component 2104 configured to be positioned at a second side 2114 of the target tissue 2118, such as the endocardial surface 14 (FIG. 1) of the heart wall 18. In the illustrated embodiment, each ablation component 2102, 2104 includes a respective end effector 2102A, 2104A including a respective housing 2102B, 2104B. Generally, the ablation system 2100 and ablation components 2102, 2104 can be similar in structure and operation to other ablation systems and ablation components described herein, and any suitable ablation components described herein can be used as the ablation components 2102, 2104. For example, the first ablation component 2102 can comprise the ablation component 200 (FIG. 3) or related embodiments, and the second ablation component 2104 can comprise the ablation component 1100 (FIG. 21) or related embodiments. Repetitive descriptions have been omitted for the sake of brevity. Similarly, any features or operations described in connection with the ablation system 2100 or ablation components 2102, 2104 can be utilized in connection with any other embodiments described elsewhere herein.

[0244] In the illustrated embodiment, the first ablation component 2102 may include at least one ablation element 2106, such as an electrode, and the second ablation component 2104 may include at least one ablation element 2108, such as an electrode. The ablation elements 2106, 2108 may be configured to cooperate to create a lesion 2116 in the target tissue 2118, such as a transmural lesion 2116 extending through the entire thickness of the target tissue 2118. In other embodiments, only one of the first ablation component 2102 and the second ablation component 2104 may include an ablation element 2106, 2108.

[0245] In the illustrated embodiment, the first ablation component 2102 comprises at least one magnetic element 2110 and the second ablation component 2104 comprises at least one magnetic element 2112. The magnetic elements 2110, 2112 are configured to cooperate to facilitate positioning the first ablation component 2102 and / or the second ablation component 2104. For example, the magnetic elements 2110, 2112 may be configured for mutual attraction, such as to attract one another from a distance and / or to align the ablation elements 2106, 2108 across the target tissue 2118 to create a lesion 2116 at a desired location. The ablation components 2102, 2104 in some examples may be configured to at least partially compress tissue therebetween. For example, the ablation components 2102, 2104 may be configured to cooperate to compress the target tissue 2118 between the ablation components 2102, 2104 using the magnetic attraction of the magnetic elements 2110, 2112, which may improve ablation results in some circumstances. In the illustrated embodiment, the magnetic element 2110 is a generally cylindrical permanent magnet that is diametrically magnetized. In other embodiments, a bar magnet having a generally square or rectangular cross section may be used. In the illustrated embodiment, the magnetic element 2112 is a generally spherical permanent magnet.

[0246] In some example embodiments, one or more of the magnetic elements 2110, 2112 may be movable relative to their respective housings 2102B, 2104B. For example, in the illustrated embodiment, the magnetic element 2110 of the first ablation component 2102 is selectively translationally repositionable relative to the housing 2102B, such as to facilitate decoupling of the magnetic element 2110 from the magnetic element 2112, such as when it may be desired to disengage one or both of the ablation components 2102, 2104 from the target tissue 2118. Generally, in various example embodiments, the magnetic element 2110 may be translationally and / or rotationally repositionable relative to the housing 2102B. Also, in the illustrated embodiment, the first ablation component 2102 includes a tissue contacting surface 2120 that includes a vacuum port 2122. Various embodiments may be configured to provide internal (e.g., closed circuit) fluid cooling and / or open circuit irrigation and / or cooling in association with one or more of the housings 2102B, 2104B.

[0247] 49 and 50 are perspective views of a distal end portion of the ablation system 2100 of FIG. 48, in accordance with at least some aspects of the present disclosure. FIGS. 47-49 illustrate various angles at which the second ablation component 2104 can approach and / or magnetically cooperate with the first ablation component 2102. Generally, in this and similar embodiments, the second ablation component 2104 is configured to approach the target tissue 2118 from a wide range of approach angles (e.g., both in the plane of FIGS. 47-49 and in a plane generally perpendicular to the plane of FIGS. 47-49, or any plane therebetween). In particular, because the magnetic element 2112 of the second ablation component 2104 is freely rotatable in any direction, the magnetic element 2112 is configured to self-align with the cooperating magnetic element 2110 of the first ablation component 2102 into a magnetically attractive orientation regardless of the approach angle of the second ablation component 2104. Furthermore, because the generally bulbous exterior surface of the housing 2104B carrying the ablation elements (e.g., electrodes) 2108 is configured to adequately contact the target tissue over a wide range of approach angles, ablation of the target tissue 2118 can be effectively performed regardless of the approach angle. Additionally, in some embodiments comprising a tether configuration for the second ablation component 2104, the ability of the end effector 2104A of the second ablation component 2104 to move generally independently from other portions of the second ablation component 2104 can provide additional freedom of movement to facilitate magnetic attraction and cooperation between the first ablation component 2102 and the second ablation component 2104.

[0248] 51-59 are various views illustrating an example ablation procedure using a first ablation component 2102 and a second ablation component 2104, all in accordance with at least some aspects of the present disclosure. It is understood that any operations described herein may be performed alone and / or in conjunction with any other portion of this or any other procedure. Additionally, while this description of methods and operations refers to certain elements of some example embodiments described elsewhere herein, it is understood that the various methods and operations likewise relate to other similar or alternative embodiments in accordance with the present disclosure, whether or not such other embodiments are expressly referenced.

[0249] 51-53 are perspective views of a heart 10 illustrating operations involving approaching the heart 10 with a first ablation component 2102 and positioning the first ablation component 2102 on the heart 10, all according to at least some aspects of the present disclosure. With reference to FIG. 51, the heart 10 is positioned within the pericardium 11. A distal end portion of an ablation device 2102 including an end effector 2102A is routed proximate to the heart 10. For example, suitable open minimally invasive or percutaneous access can be obtained. Optionally, a delivery device 2102D can be used to direct the first ablation component 2102.

[0250] With reference to FIG. 52, shown without the pericardium, a first ablation component 2102 can be positioned adjacent to the epicardial (external) surface 12 of the heart 10, and the first ablation component 2102 can be positioned at a desired ablation location. A delivery device 2102D can be positioned to facilitate positioning of the end effector 2102A adjacent to the desired ablation site of the heart 10. If desired, the ablation component 2102 can be articulated to facilitate positioning. In the illustrated embodiment, the end effector 2102 can generally be held against the heart 10 by overlying tissue, such as the pericardium 11. With reference to FIG. 53, also shown without the pericardium, a vacuum can be applied to a vacuum port of the end effector 2102A to secure the first ablation component 1102 to the epicardial surface 12.

[0251] 54-59 are perspective cross-sectional views of an example procedure using the ablation system 2100 at the wall 18 of the heart 10, all according to at least some aspects of the present disclosure. With reference to FIGS. 54 and 55, after the first ablation component 2102 is positioned as desired at the heart wall 18 and optionally secured therein with a vacuum, the first ablation component magnetic element 2110 may be repositioned to an engaged configuration or may be confirmed as already in an engaged configuration. In the illustrated embodiment, the first ablation component magnetic element 2110 is moved distally from a proximal disengaged configuration (FIG. 54) to a distal engaged configuration (FIG. 55). In other embodiments, the first ablation component magnetic element 2110 may be in an engaged configuration when the first ablation component is positioned proximate to the first surface 2113, thereby eliminating the need to reposition the first ablation component permanent magnet 2110.

[0252] 56, the second ablation component 2104 is positioned adjacent to a second surface 2114 of the target tissue 18. For example, suitable vascular access or surgical endocardial access (such as purse string access) can be obtained and the second ablation component 2104 can be positioned adjacent to the endocardium.

[0253] 57, the cooperative magnetic attraction between the first ablation component magnetic element 2110 and the second ablation component magnetic element 2112 is used to facilitate positioning the first ablation component 2102 and / or the second ablation component 2104 at a desired ablation location in the target tissue 18. In some embodiments configured for sensing, stimulation, mapping, and / or pacing, any one or more electrodes (e.g., primary and / or auxiliary electrodes) associated with either ablation component 2102, 2104 may be used for sensing, stimulation, mapping, and / or pacing, such as to identify a desired ablation location, to confirm placement of either or both ablation components 2102, 2104, and / or to assess (after ablation) the effectiveness of the ablation or the need for further ablation. In embodiments constructed in a tethered configuration, the second ablation component 2104 may be reconfigured into a deployed (e.g., extended) configuration. The magnetic attraction between the first ablation element magnetic element 2110 and the second ablation element magnetic element 2112 compresses the target tissue 18. Bipolar radio frequency ablation energy is delivered to the electrodes of the first ablation element 2102 and the second ablation element 2104 to create a first lesion in the target tissue 18.

[0254] 58, the first ablation component magnetic element 2110 is moved proximally from a distal engaged configuration (FIG. 57) to a proximal disengaged configuration (FIG. 58). This reduces the attractive magnetic coupling between the first ablation component magnetic element 2110 and the second ablation component magnetic element 2112, and the second ablation component 2104 is moved away from the ablation site in the target tissue 18. In the illustrated embodiment, this action was performed with the second ablation component 2104 remaining in the deployed configuration. In other situations, the second ablation component 2104 may be reconfigured to the retracted configuration before the first ablation component 2102 is reconfigured to the disengaged configuration.

[0255] 59, the vacuum applied to the vacuum port 2122 of the first ablation component 2102 is turned off and the first ablation component 2102 is removed from the first surface of the target tissue 18. In some situations, the vacuum applied to the vacuum port 2122 of the first ablation component 2102 may be turned off before the first ablation component magnetic element 2110 is moved to the disengaged configuration. In other situations, the vacuum applied to the vacuum port 2122 of the first ablation component 2102 may be turned off after the first ablation component permanent magnet 2110 is moved to the disengaged configuration. In FIG. 59, the first ablation component ablation element 2106 and the corresponding lesion 16 on the first side 2113 of the target tissue 18 are visible.

[0256] The various actions may be repeated as desired to create additional lesions. The ablation components 2102, 2104 may be withdrawn from the surgical site upon completion of the desired ablation.

[0257] 60 is a perspective view of a distal end portion of an alternative ablation system 2200 in use at a target tissue 2218, according to at least some aspects of the present disclosure. In general, the ablation system 2200 and ablation components 2202, 2204 can be similar in structure and operation to other ablation systems and ablation components described herein, such as ablation systems 100, 2100, and any suitable ablation components described herein can be used as the ablation components 2202, 2204. For example, the first ablation component 2202 and the second ablation component 2204 can comprise the ablation component 1100 (FIG. 21) or related embodiments. Repetitive descriptions have been omitted for the sake of brevity. Similarly, any features or operations described in connection with the ablation system 2200 or ablation components 2202, 2204 may be utilized in connection with any other embodiments described elsewhere herein.

[0258] In the illustrated embodiment, the first ablation component 2202 and the second ablation component 2204 each include a respective freely rotatable (around three axes of rotation) magnetic element (e.g., permanent magnet) 2210, 2212. In this embodiment, the first ablation component magnetic element 2210 and the second ablation component magnetic element 2212 are configured to self-orient into a magnetically attractive orientation with the cooperating magnetic element 2210, 2212 of the cooperating ablation component 2202, 2204 regardless of the target tissue approach angle. Furthermore, because the generally bulbous exterior surface of each end effector housing 2202A, 2204A including the respective ablation elements (e.g., electrodes) 2220, 2222 is configured to adequately contact the target tissue 2218 over a wide range of approach angles, ablation of the target tissue 2218 can be effectively performed regardless of the approach angle on either side of the target tissue 2218.

[0259] The embodiment of FIG. 60 may be used, for example, in ablation, for example, in the atrial or ventricular septum. Such procedures may be generally similar to the ablation procedures described above, except that endocardial access may be obtained on each side of the target tissue 2218 (e.g., the septum) and respective ablation components 2202, 2204 may be routed to each side of the target tissue 2218. Also, rather than having one cooperating magnetic element at a fixed orientation and one freely rotatable magnetic element, the embodiment of FIG. 60 may utilize two ablation components 2202, 2204, each with a respective freely rotatable (self-orienting) magnetic element 2210, 2212. Ablation energy, such as bipolar and / or unipolar radio frequency ablation energy, may be applied to the target tissue using the first ablation component 2202 and the second ablation component 2204. In a specific example, the target tissue may include the ventricular septum. The first side of the target tissue may include a right ventricular surface of the interventricular septum and the second side of the target tissue may include a left ventricular surface of the interventricular septum. The ablation energy may be applied to create a transmural lesion in the interventricular septum.

[0260] 61 is a simplified cross-sectional view of an alternative example ablation component 2304 according to at least some aspects of the present disclosure. The ablation component 2304 is generally similar in structure and operation to the ablation components described elsewhere herein, and repeated descriptions of similar elements are omitted for brevity. Similarly, any features described in connection with the ablation component 2304 may be utilized in connection with any other embodiment described elsewhere herein. In some embodiments, the ablation component 2304 may be substituted for the second ablation component 104 as well as other ablation components described herein. In the ablation component 2304, one or more magnetic elements 2312, 2314 are rotatably mounted for rotation about an axis of rotation 2316, which may be defined by an axis 2316A. Thus, the magnetic elements 2312, 2314 have one rotational degree of freedom relative to the housing 2304B.

[0261] In the illustrated embodiment, the axis 2316 is oriented generally parallel to a longitudinal axis of the end effector 2304A of the ablation component 2304. The magnetic axes 2312A, 2314A of the individual magnetic elements 2312, 2314, respectively, are oriented generally perpendicular to the axis of rotation 2316. When used in conjunction with one or more cooperating magnetic elements 2318 (e.g., of a cooperating ablation component), the magnetic elements 2312, 2314 can engage a lateral surface 2320 of the end effector 2304A with target tissue 2322. In the illustrated embodiment, which may have a generally cylindrical end effector 2304A oriented generally longitudinally, the ablation elements 2324 (e.g., electrodes) can extend across substantially the entire outer diameter of the end effector 2304A (e.g., about 360 degrees).

[0262] In this embodiment, the ablation component 2304 is configured to approach the target tissue 2322 from a wide range of approach angles relative to the axis of rotation 2316 of the magnetic elements 2312, 2314. Specifically, because the magnetic elements 2312, 2314 are freely rotatable about the axis of rotation 2316, the magnetic elements 2312, 2314 are configured to self-align into a magnetically attractive orientation with the cooperating magnetic element 2318 of the cooperating ablation component regardless of the approach angle relative to the axis of rotation 2316. Furthermore, because the generally right cylindrical exterior surface 2320 of the housing 2304B, which includes the ablation elements (e.g., electrodes) 2324, is configured to adequately contact the target tissue over a wide range of approach angles relative to the axis of rotation 2316, ablation of the target tissue 2322 can be effectively performed regardless of the approach angle relative to the axis of rotation 2316.

[0263] 62 is a simplified cross-sectional view of an alternative ablation system 2350 according to at least some aspects of the present disclosure. The ablation system 2350 is generally similar in structure and operation to the ablation systems described elsewhere herein, and repeated descriptions of similar elements have been omitted for brevity. Similarly, any features described in connection with the ablation system 2350 may be utilized in connection with any other embodiment described elsewhere herein. In the illustrated embodiment, the ablation system 2350 comprises a first ablation component 2352 and a second ablation component 2354 on either side of the target tissue 2356.

[0264] In the illustrated embodiment, the first ablation component 2352 comprises a plurality of magnetic elements 2358A, 2358B, 2358C, 2358D, 2358E, 2358F, and the second ablation component 2354 comprises a respective plurality of cooperating magnetic elements 2360A, 2360B, 2360C, 2360D, 2360E, 2360F. In the illustrated embodiment, the magnetic elements 2358A-2358C and 2360A-2360F are freely rotatable spherical magnetic elements generally similar to those described elsewhere herein. The magnetic elements 2358D-2358F are gimbal mounted permanent magnets. In this embodiment, each magnetic element 2358D-2358F is rotatably mounted using two gimbals and thus has two rotational degrees of freedom. It is understood that either configuration may be utilized throughout either ablation component 2352, 2354, or that both ablation components 2352, 2354 may include both configurations (or other suitable configurations).

[0265] In the illustrated embodiment, the magnetic elements 2358A-2358C are disposed within a continuous smooth end effector housing 2362 of the first ablation component 2352. In contrast, the second ablation component 2354 includes an end effector 2364 to which the individual housings of the magnetic elements 2360A-2360F are exposed.

[0266] In this embodiment, the magnetic elements 2358A-2358C and 2360A-2360F are configured for mutual attraction across the target tissue 2356. In some embodiments, due to the aligned arrangement of the magnetic elements 2358A-2358C and 2360A-2360F, the ablation components 2352, 2354 can be configured to self-align in a generally parallel manner on either side of the target tissue 2356.

[0267] 63 is a simplified schematic diagram of an alternative example ablation system 2400 comprising a first ablation component 2402 comprising multiple independently positionable end effector units 2402B, 2402C, 2402D in use in a heart 10, according to at least some aspects of the present disclosure. As used herein, "independently positionable" may refer to two or more individual units that can be positioned and / or oriented substantially independently from one another, including, for example, units that may be tethered or otherwise connected to one another by a flexible member, provided that such tether or connection permits substantially independent positioning and / or orientation of at least some of the individual units. In the illustrated embodiment, the first ablation component 2402 of the ablation system 2400 is configured to be positioned on a first side 12 of a target tissue 18, such as the epicardial surface 12 of the heart wall 18. In the illustrated embodiment, the first ablation component 2402 comprises an end effector 2402A comprising multiple independently positionable end effector units 2402B, 2402C, 2402D. The ablation system 2400 comprises a second ablation component 104 configured to be positioned on a second side 14 of the target tissue 18, such as an endocardial surface 14 of the heart wall 18. The second ablation component 104 and the end effector units 2402B, 2402C, 2402D of the first ablation component 2402 may be configured to cooperate to create one or more lesions 16B, 16C, 16D in the target tissue, such as a transmural lesion extending through the entire thickness of the heart wall 18. In some embodiments, the end effector units 2402B, 2402C, 2402D can be positioned to cooperate with the second ablation component 104 such that the lesions 16B, 16C, 16D at least partially overlap to form a continuous, larger, compound lesion 16E.In general, ablation system 2400 and ablation components 2402, 104 can be similar in structure and operation to other ablation systems and ablation components described herein, and repeated description has been omitted for the sake of brevity. Similarly, any features described in connection with ablation system 2400 may be utilized in connection with any of the other embodiments described elsewhere herein.

[0268] Although a generic second ablation component 104 is shown in Fig. 63, it is understood that the ablation component 2402 including multiple independently positionable end effector units 2402B, 2402C, 2402D may be utilized in conjunction with any cooperating ablation component, such as may be described elsewhere herein. For example, the ablation component 2402 may be used in cooperation with ablation components including translationally and / or rotationally repositionable magnetic elements, such as may be described elsewhere herein.

[0269] Additionally, although a first ablation component 2402 including an end effector 2402A including independently positionable end effector units 2402B, 2402C, 2402D is shown on the epicardial surface 12 of the heart 10 in FIG. 63, a similar ablation component including multiple independently positionable end effector units may be utilized on the endocardial surface 14 of the heart 10 and may operate in cooperation with any of the ablation components described herein on the opposing epicardial surface 12 of the heart. Additionally, in some embodiments, one or more ablation components including independently positionable end effector units may be utilized for endocardial-endocardial ablation (e.g., septal) where one or both of the ablation components include independently positionable end effector units. In some example embodiments, the first and second ablation components are each on either side of the target tissue and may each include independently positionable multiple end effector units similar to the first ablation component 2402 of FIG. 63.

[0270] FIG 64 is a perspective view of the end effector 2402A of the first ablation component 2402 of FIG 63 in a deployed configuration, FIG 65 is a perspective view of the end effector 2402A of the first ablation component 2402 of FIG 63 in a stowed configuration, and FIG 66 is a perspective view of the end effector 2402A of the first ablation component 2402 of FIG 63 showing independently positionable end effector units 2402B, 2402C, 2402D in use with cooperating magnetic elements, all according to at least some aspects of the present disclosure. With reference to FIG 63-FIG 66, in the illustrated embodiment, the first ablation component 2402 comprises a connection element 2416 that operably couples the end effector 2402A to the control unit 114. The connecting element 2416 may comprise or be used in conjunction with one or more electrical conductors, fluid conduits, mechanical force transmission components (e.g., mechanical linkages), catheters, wires, steerable portions, sheaths, trocars, hemostatic components, etc. In the illustrated embodiment, the connecting element 2416 is generally tubular and at least partially defines an internal lumen configured to selectively receive the end effector units 2402B, 2402C, 2402D.

[0271] 63-66 show an example embodiment including three independently positionable end effector units 2402B, 2402C, 2402D, various alternative example embodiments may include two or more (e.g., two, three, four, five, etc.) independently positionable end effector units. Additionally, while FIGS. 62-65 show an example embodiment in which the independently positionable end effector units 2402B, 2402C, 2402D are substantially identical, various alternative example embodiments may include one or more independently positionable end effector units that differ in at least one respect from one or more other independently positionable end effector units.

[0272] 64 and 66, the first ablation component 2402 can include end effector unit connection elements 2416B, 2416C, 2416D operably coupled to the end effector units 2402B, 2402C, 2402D. In the embodiment shown in FIGS. 63-66, the first end effector unit connection element 2416B extends between the connection element 2416 and the first end effector unit 2402B. The second end effector unit connection element 2416C extends between the first end effector unit 2402B and the second end effector unit 2402C. The third end effector unit connection element 2416D extends between the second end effector unit 2402C and the third end effector unit 2402D. Thus, the end effector unit connection elements 2416B, 2416C, 2416D operatively link the independently positionable end effector units 2402B, 2402C, 2402D in a daisy chain (e.g., serial, one after the other) arrangement. Each end effector unit connection element 2416B, 2416C, 2416D may comprise one or more electrical conductors, fluid conduits, mechanical force transmission components (e.g., mechanical linkages), catheters, wires, steerable portions, sheaths, trocars, hemostatic components, etc.

[0273] 63 and 64, in the illustrated embodiment, each end effector unit 2402B, 2402C, 2402D includes a respective ablation element, such as a respective electrode 2406B, 2406C, 2406D. In this embodiment, the electrodes 2406B, 2406C, 2406D may include axially magnetized, generally cylindrical, permanent magnets positioned such that their axial end faces at least partially define the tissue contacting surface. Thus, in this embodiment, the electrodes also each include a magnetic element, similar to those described elsewhere herein. In some alternative embodiments, the electrodes 2406B, 2406C, 2406D may be provided separately from the magnetic elements, similar to those described elsewhere herein. In still further embodiments, other types of ablation elements may be utilized, such as ablation elements associated with alternative ablation modalities, as may be detailed elsewhere herein.

[0274] FIG 67 is a simplified schematic diagram illustrating an electrical configuration of the example ablation component 2402 of FIGS. 62-65, in accordance with at least some aspects of the present disclosure. In the illustrated embodiment, the electrodes 2406B, 2406C, 2406D of the end effector units 2402B, 2402C, 2402D are electrically connected in a parallel configuration, i.e., all three of the electrodes 2406B, 2406C, 2406D are simultaneously electrically connected to a proximally positioned electrical connector 2428, which is configured to electrically couple the ablation component 2402 to the electrosurgical generator 114 (FIG. 31) and / or to an electrosurgical sensing, stimulation, mapping, and / or pacing unit. For example, one or more electrical conductors 2428A may electrically couple the electrical connector 2428 to the electrode 2406B of the first end effector unit 2402B, such as by extending generally longitudinally through the connection element 2416 and / or the first end effector unit connection element 2416B. Electrical conductors 2428B may electrically couple the electrode 2406B of the first end effector unit 2402B to the electrode 2406C of the second end effector unit 2402C, such as by extending through and / or forming at least a portion of the second end effector unit connection element 2416C. The conductor 2428C can electrically couple the electrode 2406C of the second end effector unit 2402C and the electrode 2406D of the third end effector unit 2402D, such as by extending through and / or forming at least a portion of the third end effector unit connection element 2416D.

[0275] 64 and 65, some example embodiments may be reconfigurable between a stowed configuration (FIG. 65) and a deployed configuration (FIG. 64). For example, the stowed configuration may be utilized while the first ablation component 2402 is routed to the target tissue 18 and / or when removing the first ablation component 2402 from the surgical site. The deployed configuration may be utilized to facilitate positioning of the individual end effector units 2402B, 2402C, 2402D and / or ablation of the target tissue 18.

[0276] 65 , in the illustrated embodiment, in the stowed configuration, the end effector units 2402B, 2402C, 2402D are substantially received within the first ablation component connecting element 2416. For example, the end effector units 2402B, 2402C, 2402D can be received within an interior lumen of the connecting element 2416. In the stowed configuration, the end effector unit connecting elements 2416B, 2416C, 2416D are also substantially received within the connecting element 2416.

[0277] 64 , in the illustrated embodiment, in the deployed configuration, the end effector units 2402B, 2402C, 2402D may be disposed substantially outside the connection element 2416. In the deployed configuration, the first end effector unit connection element 2416B may extend at least partially within the connection element 2416 and / or may extend at least partially outside the connection element 2416 (e.g., to the first end effector unit 2402B). In the deployed configuration, the second end effector unit connection element 2416C and / or the third end effector unit connection element 2416D may be disposed substantially outside the connection element 2416.

[0278] 63-67, some example methods of using the ablation system 2400 may include one or more of the following operations in any order. An example method of creating a lesion 16 in a target tissue 18 may include positioning a second ablation component 104 proximate to a second surface 14 of the target tissue 18. The second ablation component 104 may include a second ablation component magnetic element 112 (FIG. 1) that may act as a cooperating magnetic element. The method may include positioning a first ablation component 2402 proximate to a first surface 12 of the target tissue 18. The first ablation component 2402 may include a first ablation component connecting element 2416 and a first ablation component end effector 2402A extending distally from the first ablation component connecting element 2416. The first ablation component end effector 2402A may comprise a first end effector unit 2402B and a second end effector unit 2402C. Some embodiments may comprise a third end effector unit 2402D and / or additional end effector units. The end effector units 2402B, 2402C, 2402D may be independently positionable and / or may be linked in a daisy chain arrangement by one or more end effector unit connecting elements 2416B, 2416C, 2416D, etc. The first end effector unit 2402B may comprise a first end effector unit magnetic element 2406B and / or a first end effector unit ablation element 2406B. The second end effector unit 2402C may include a second end effector unit magnetic element 2406C and / or a second end effector unit ablation element 2406C. The third end effector unit 2402D and additional end effector units may be similarly constructed. The method may include attractively magnetically coupling the first end effector unit magnetic element 2406B with the second ablation component magnetic element 112 and / or attractively magnetically coupling the second end effector unit magnetic element 2406C with the second ablation component magnetic element 112.Similarly, the third end effector unit magnetic element 2406D can be attractively magnetically coupled to the second ablation component magnetic element 112. The attractive magnetic coupling can facilitate positioning of the ablation components 2402, 104 and / or compression of the target tissue 18, as described elsewhere herein. The method can include creating a first lesion 16B in the target tissue using the first end effector unit ablation element 2406B and / or creating a second lesion 16C in the target tissue 18 using the second end effector unit ablation element 2406C. Similarly, the third lesion 16C can be created using the third end effector unit ablation element 2406D.

[0279] In some embodiments, the first lesion 16B and the second lesion 16C (and / or the third lesion 16D and further lesions) can overlap to form a continuous compound lesion 16. In some embodiments, creating the first lesion 16B and creating the second lesion 16C (and / or the third lesion 16D and further lesions) may be performed simultaneously. In some embodiments, the second ablation component 104 may comprise a second ablation component ablation element 108 ( FIG. 1 ). Creating the first lesion 16B in the target tissue 18 using the first end effector unit ablation element 2406B may include creating the first lesion 16B in the target tissue 18 by applying bipolar radio frequency ablation energy to the target tissue 18 using the first end effector unit ablation element 2406B and the second ablation component ablation element 108. Creating a second lesion 16C in the target tissue 18 using the second end effector unit ablation element 2406C may include creating a second lesion 16C in the target tissue 18 by applying bipolar radio frequency ablation energy to the target tissue 18 using the second end effector unit ablation element 2406C and the second ablation component ablation element 108. Additional lesions can be similarly created with additional end effector units.

[0280] In some embodiments, the method may include independently positioning the first end effector unit 2402B and the second end effector unit 2402C at respective target locations on the first surface 12 of the target tissue 18. For example, one or more end effector units 2402B, 2402C, 2402D may be positioned using one or more surgical tools positioned at the surgical site, such as forceps.

[0281] In some embodiments, disposing the first ablation component 2402 proximate to the first surface 12 of the target tissue 18 may include disposing the first ablation component end effector 2402A proximate to the first surface 12 of the target tissue 18 while the first ablation component end effector 2402A is in a stowed configuration. In the stowed configuration, the first end effector unit 2402B and the second end effector unit 2402C (and / or the third end effector unit 2402D and additional units) may be substantially received within the first ablation component connecting element 2416. The method may include reconfiguring the first ablation component end effector 2402A from the stowed configuration to a deployed configuration. In the deployed configuration, the first end effector unit 2402B and the second end effector unit 2402C (and / or the third end effector unit 2402D and the additional units) may be disposed substantially outside the first ablation component connection element 2416. Reconfiguring the first ablation component 2402 from the stowed configuration to the deployed configuration may include detaching the first end effector unit 2402B from the first ablation component connection element 2416 and / or detaching the second end effector unit 2402C from the first ablation component connection element 2416. Similarly, the third end effector unit 2402D and the additional units may be detached from the first ablation component connection element 2416. The method may include reconfiguring the first ablation component end effector 2402A from the deployed configuration to the stowed configuration after creating the first lesion 16B and the second lesion 16C. The method may include reconfiguring the first ablation component end effector 2402A from a deployed configuration to a stowed configuration and then withdrawing the first ablation component end effector 2402A from proximity of the target tissue 18.

[0282] In some embodiments, the method may include reducing attractive magnetic coupling between magnetic element 2406B and the cooperating magnetic element, and between magnetic element 2406C and the cooperating magnetic element, by repositioning the cooperating magnetic elements relative to their respective end effector housings, generally as described elsewhere herein. For example, attractive magnetic coupling may be reduced by rotationally and / or translationally repositioning the cooperating magnetic elements relative to their respective end effector housings.

[0283] In some embodiments, at least one of (i) attractively magnetically coupling magnetic element 2406B with a cooperating magnetic element and (ii) attractively magnetically coupling magnetic element 2406C with a cooperating magnetic element may include rotationally self-orienting the cooperating magnetic element into a magnetically attractive orientation with at least one of magnetic element 2406B and magnetic element 2406C. For example, the cooperating magnetic elements may be freely rotatable about one or more axes of rotation with various rotational degrees of freedom as detailed elsewhere herein.

[0284] In some example embodiments according to at least some aspects of the present disclosure, one or more auxiliary electrodes may be used, for example, for sensing, stimulation, mapping, and / or pacing. Such sensing, stimulation, mapping, and / or pacing may be performed, for example, for diagnostic purposes and / or in connection with identifying target locations for future ablation and / or to evaluate the effectiveness of previous ablation. In some example embodiments, the primary or ablation electrodes may be used for non-ablative purposes, such as sensing, stimulation, mapping, and / or pacing, instead of or in addition to one or more auxiliary electrodes. Thus, various example methods using a device with one or more electrodes may include operations associated with sensing, stimulation, mapping, and / or pacing using one or more auxiliary electrodes and / or the primary electrode before, after, or separately from delivering ablation energy, such as by delivering radio frequency energy using the primary electrode. Similarly, any of the example embodiments described herein as including electrodes may be used for sensing, stimulation, mapping, and / or pacing using one or more auxiliary and / or primary electrodes before, after, or separately from delivering ablation energy.

[0285] Various example embodiments useful for sensing, stimulating, mapping, and / or pacing may be arranged for simultaneous and / or sequential use of individual electrodes, pairs of electrodes, and / or three or more electrodes. For example, some devices (e.g., ablation components) configured for sensing, stimulating, mapping, and / or pacing may be coupled to a control unit that includes one or more external devices configured for sensing, stimulating, mapping, and / or pacing. Such sensing, stimulating, mapping, and / or pacing devices may be configured to selectively connect to individual electrodes and / or multiple electrodes, or such sensing, stimulating, mapping, and / or pacing devices may be configured to connect to all available electrodes. In some example embodiments, sensing, stimulating, mapping, and / or pacing may be performed individually by epicardial components. That is, one or more electrodes on the epicardial components may be used for sensing, stimulating, mapping, and / or pacing. Similarly, in some example embodiments, sensing, stimulating, mapping, and / or pacing may be performed individually by endocardial components. That is, one or more electrodes on the endocardial component may be used for sensing, stimulation, mapping, and / or pacing.

[0286] In some example embodiments, one or more epicardial components may be used in cooperation with one or more endocardial components for sensing, stimulation, mapping, and / or pacing. For example, sensing, stimulation, mapping, and / or pacing may be performed using one or more electrodes of one or more epicardial components in cooperation with one or more electrodes of one or more endocardial components. More broadly, sensing, stimulation, mapping, and / or pacing may be performed across the thickness of the target tissue using components positioned on both sides of the target tissue. In some circumstances, cooperative sensing, stimulation, mapping, and / or pacing on opposing surfaces of the target tissue may provide three-dimensional information about locations of interest in the target tissue, such as locations of potential future ablation lesions.

[0287] Although various example embodiments described herein are referred to as ablation components, these or similar embodiments may be useful for sensing, stimulation, mapping, and / or pacing in addition to or separate from ablation operations. Furthermore, any of the components described herein may be constructed without an ablation element, and such components may include one or more electrodes that may be used for sensing, stimulation, mapping, and / or pacing.

[0288] For example, Figure 68 is a simplified schematic diagram of an example system 2500 in use in heart 10 according to at least some aspects of the present disclosure. System 2500 and its components may be generally similar in structure and operation to other devices described elsewhere herein, such as ablation system 100 of Figure 1, and repeated description has been omitted for the sake of brevity. Similarly, any features described in connection with system 2500 may be utilized in connection with any other embodiment described elsewhere herein.

[0289] Example system 2500 may include a first component 2502 configured to be positioned on a first side of a target tissue (e.g., heart wall 18) and / or a second component 2504 configured to be positioned on a second side of the target tissue. Generally, each of components 2502, 2504 may include any ablation component described herein and / or may be similar to any ablation component described herein. For example, without limitation, in some embodiments, first component 2502 may include an ablation component such as those described herein with reference to FIGS. 2-20 and / or second component 2504 may include an ablation component such as those described herein with reference to FIGS. 21-47. In some embodiments, first component 2502 and second component 2504 may include an ablation component such as those described herein with reference to FIGS. 2-20. In some embodiments, each of the first component 2502 and the second component 2504 can comprise an ablation component, such as those described herein with reference to Figures 21-47.

[0290] Alternatively, as shown in FIG. 68, the first part 2502 and / or the second part 2504 may not include an ablation part and / or a magnetic element. In the illustrated embodiment, the first part may include a first part end effector 2502A configured to be positioned on a first side 12 of the cardiac tissue (wall) 18. The first part end effector 2502A may include a first part electrode 2506. The second part may include a second part end effector 2504A configured to be positioned on a second side 14 of the cardiac tissue 18 opposite the first side 12. The second part end effector may include a second part electrode 2508. The first part 2502 and the second part 2504 may be configured for use of the first part electrode 2506 and the second part electrode 2508 in cooperation to perform at least one of sensing, pacing, stimulating, and mapping. As used herein, "concerted use" may include the coordinated use of two or more elements to obtain results or information that would not be available through the use of only one of the elements or through the use of the two or more elements in an uncoordinated manner.

[0291] In the illustrated embodiment, the system 2500 may include a control unit 114 configured for cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping. The cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative sensing using the first component electrode 2506 and the second component electrode 2508. The cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative pacing using the first component electrode 2506 and the second component electrode 2508. The cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative stimulation using the first component electrode 2506 and the second component electrode 2508. The cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping may include cooperative mapping using the first component electrode 2506 and the second component electrode 2508.

[0292] In some embodiments, the cooperative use of the first component electrode 2506 and the second component electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping may include delivering an electrical current to the cardiac tissue 18 using one of the first component electrode 2506 and the second component electrode 2508, and detecting at least one electrical parameter associated with the cardiac tissue 18 using the other of the first component electrode 2506 and the second component electrode 2508.

[0293] In the illustrated embodiment, the first component end effector 2502A may be configured to be positioned on the epicardial surface 12 of the heart 10. In some embodiments, the first component end effector 2502A may be configured to be positioned on the endocardial surface 14 of the heart 10. In the illustrated embodiment, the second component end effector 2504A may be configured to be positioned on the epicardial surface 12 of the heart 10. In some embodiments, the second component end effector 2504A may be configured to be positioned on the endocardial surface 14 of the heart 10.

[0294] In some example embodiments, at least one of the first component end effector 2502A and the second component end effector 2504A may include electrodes 2506, 2508, or may include an ablation element, such as those described elsewhere herein, that may be separate from the electrodes 2506, 2508.

[0295] In some example embodiments, the first part end effector 2502A may comprise a first part magnetic element such as those described elsewhere herein. In some example embodiments, the second part end effector 2504A may comprise a second part magnetic element such as those described elsewhere herein. The first part magnetic element and the second part magnetic element may be configured for cooperative magnetic attraction across cardiac tissue as described elsewhere herein.

[0296] Some example methods of using the system 2500 may include positioning a first part 2502 including a first part end effector 2502A including a first part electrode 2506 proximate to a first surface 12 of the cardiac tissue 18. The method may include positioning a second part 2504 including a second part end effector 2504A including a second part electrode 2508 proximate to a second surface 14 of the cardiac tissue 18 opposite the first surface 12. The method may include cooperatively using the first part electrode 2506 and the second part electrode 2508 to perform at least one of sensing, pacing, stimulating, and mapping.

[0297] In some embodiments, using the first component electrode 2506 and the second component electrode 2508 in cooperation to perform at least one of sensing, pacing, stimulating, and mapping may include delivering an electrical current to the cardiac tissue 18 using one of the first component electrode 2506 and the second component electrode 2508 and / or detecting at least one electrical parameter associated with the cardiac tissue 18 using the other of the first component electrode 2506 and the second component electrode 2508.

[0298] In some embodiments, the method may include creating the lesion 16 in the cardiac tissue 18. Creating the lesion 16 in the cardiac tissue 18 may include creating the lesion 16 in the cardiac tissue 18 using at least one of the first component end effector 2502A and the second component end effector 2504A. Creating the lesion 16 in the cardiac tissue 18 using at least one of the first component end effector 2502A and the second component end effector 2504A may include delivering ablation energy to the cardiac tissue 18 using at least one of the first component electrode 2506 and the second component electrode 2508.

[0299] In some embodiments, using the first component electrodes 2506 and the second component electrodes 2508 in cooperation to perform at least one of sensing, pacing, stimulating, and mapping may include identifying target locations in the cardiac tissue 18 for future ablation. In some embodiments, using the first component electrodes and the second component electrodes in cooperation to perform at least one of sensing, pacing, stimulating, and mapping may include evaluating the ablation.

[0300] It is an aspect of the present disclosure to provide a first ablation component 102, 200 configured for use on a first side 12 of a target tissue 18 in association with a cooperating second ablation component 104 on an opposing second side 14 of the target tissue 18. The first ablation component 102, 200, 900 may include a first ablation component end effector 102A, 202, 904 configured to be positioned on the first side 12 of the target tissue 18. The first ablation component end effector 102A, 202, 904 may comprise a first ablation component end effector housing 102B, 232, a tissue contacting surface 224, 908 configured to engage a first side 12 of a target tissue 18, a first ablation component ablation element 106, 228 selectively operable to cause ablation of the target tissue 18, and / or a first ablation component permanent magnet 110, 220, 902 repositionably disposed relative to the first ablation component end effector housing 102B, 232. The first ablation component permanent magnet 110, 220, 902 may be repositionable between an engaged configuration and a disengaged configuration relative to the first ablation component end effector housing 102B, 232. The first ablation component permanent magnet 110, 220, 902 may define a magnetic axis 236, 910. The first ablation component 102, 200, 900 may include a mechanical linkage 234 operably coupled to reposition the first ablation component permanent magnet 110, 220, 902 relative to the first ablation component end effector housing 102B, 232 between an engaged configuration and a disengaged configuration. In the engaged configuration, the first ablation component permanent magnet 110, 220, 902 may be positioned to magnetically attract a cooperating second ablation component magnetic element 112 positioned on an opposite second side 14 of the target tissue 18 substantially adjacent the tissue contacting surface 224. In the disengaged configuration, the first ablation component permanent magnet 110, 220, 902 may not be positioned to magnetically attract a cooperating second ablation component magnetic element 112 positioned on an opposite second side 14 of the target tissue 18 substantially adjacent the tissue contacting surface 224.At least one of the location of the first ablation component permanent magnet 110, 220, 902 relative to the first ablation component end effector housing 102B, 232 and the orientation of the magnetic axis 236, 910 relative to the first ablation component end effector housing 102B, 232 can differ between the engaged configuration and the disengaged configuration.

[0301] In a detailed embodiment, the first ablation component permanent magnet 110, 220 may be translationally repositionable relative to the first ablation component end effector housing 102B, 232 between an engaged configuration and a disengaged configuration.

[0302] In a detailed embodiment, the first ablation component permanent magnet 902 may be rotationally repositionable relative to the first ablation component end effector housing between an engaged configuration and a disengaged configuration.

[0303] It is an aspect of the present disclosure to provide a first ablation component 2402 for use on a first side 12 of a target tissue 18 in association with a cooperating second ablation component 104 on an opposing second side 14 of the target tissue 18. The first ablation component 2402 may include a first ablation component end effector 2402A operably coupled to a first ablation component connecting element 2416. The first ablation component end effector 2402A may comprise a first end effector unit 2402B comprising a first end effector unit ablation element, a second end effector unit 2402C comprising a second end effector unit ablation element, a first end effector unit connection element 2416B operably coupling the first end effector unit to the first ablation component connection element 2416, and / or a second end effector unit connection element 2416C operably coupling the first end effector unit 2402B to the second end effector unit 2402C. The first end effector unit 2402B and the second end effector unit 2402C may be independently positionable.

[0304] In a detailed embodiment, the first ablation component end effector 2402 may include a third end effector unit 2402D and a third end effector unit connecting element 2416D operably coupling the second end effector unit 2402C and the third end effector unit 2402D. The first end effector unit 2402B, the second end effector unit 2402C, and the third end effector unit 2402D may be independently positionable.

[0305] In detailed embodiments, the first end effector unit 2402B and the second end effector unit 2402C may be substantially identical. In other detailed embodiments, the first end effector unit 2402B may be different from the second end effector unit 2402C.

[0306] In a detailed embodiment, the first end effector unit 2402B may comprise a first end effector unit magnetic element arranged for cooperative magnetic attraction with the second ablation component magnetic element 112 of the cooperating second ablation component 104. The second end effector unit 2402C may comprise a second end effector unit magnetic element arranged for cooperative magnetic attraction with the second ablation component magnetic element 112.

[0307] In a detailed embodiment, at least one of the first end effector unit magnetic element and the second end effector unit magnetic element comprises a generally cylindrical permanent magnet that is axially magnetized.

[0308] In a detailed embodiment, the first end effector unit ablation element can comprise a first end effector unit ablation electrode 2406B and the second end effector unit ablation element can comprise a second end effector unit ablation electrode 2406C. In some embodiments, the first end effector unit ablation electrode and the second end effector unit ablation electrode can be electrically connected in parallel. In some embodiments, the first end effector unit ablation electrode can comprise a first end effector unit magnetic element arranged for cooperative magnetic attraction with a second ablation component magnetic element of a cooperating second ablation component. The second end effector unit ablation electrode can comprise a second end effector unit magnetic element arranged for cooperative magnetic attraction with a second ablation component magnetic element.

[0309] In a detailed embodiment, the first end effector unit connection element may include a first electrical conductor 2428A electrically connecting the proximally disposed electrical connector 2428 and the first end effector unit ablation electrode 2406B. The second end effector unit connection element 2416C may include a second electrical conductor 2428B electrically connecting the first end effector unit ablation electrode 2406B and the second end effector unit ablation electrode 2406C.

[0310] In a detailed embodiment, the first ablation component end effector 2402D may include a third end effector unit 2402D and a third end effector unit connection element 2416D that operably couples the second end effector unit 2402C and the third end effector unit 2402D. The first end effector unit 2402B, the second end effector unit 2402C, and the third end effector unit 2402D may be independently positionable. The third end effector unit connection element 2416D may include a third electrical conductor 2428C that electrically interposes the second end effector unit ablation electrode 2406C and the third end effector unit ablation electrode 2406D.

[0311] In a detailed embodiment, the first ablation component end effector 2402 may be reconfigurable between a stowed configuration and a deployed configuration. In the stowed configuration, the first end effector unit 2402B and the second end effector unit 2402C may be substantially received within the first ablation component connection element 2416. In the stowed configuration, the first end effector unit 2402B and the second end effector unit 2416C may be substantially received within the first ablation component connection element 2416. In the deployed configuration, the first end effector unit 2402B and the second end effector unit 2402C may be disposed substantially outside the first ablation component connection element 2416. In the deployed configuration, the first end effector unit 2416B may extend at least partially within the first ablation component connection element 2416 and at least partially outside the first ablation component connection element 2416. In the deployed configuration, the second end effector unit connecting element 2416C can be disposed substantially outside of the first ablation component connecting element 2416.

[0312] In a detailed embodiment, the ablation system 2400 may include a first ablation component 2402 and a second ablation component 104. The second ablation component 104 may include a second ablation component permanent magnet 112 repositionably disposed relative to the second ablation component end effector housing between an engaged configuration and a disengaged configuration.

[0313] In a detailed embodiment, the first end effector unit 2402B may comprise a first end effector unit magnetic element arranged for cooperative magnetic attraction with the second ablation component magnetic element 112 of the cooperating second ablation component 104. The second end effector unit 2402C may comprise a second end effector unit magnetic element arranged for cooperative magnetic attraction with the second ablation component magnetic element 112. The second ablation component may comprise a second ablation component permanent magnet configured to rotationally self-orient into a magnetically attractive orientation with at least one of the first end effector unit magnetic element and the second end effector unit magnetic element.

[0314] It is an aspect of the present disclosure to provide an ablation system 100 including a first ablation component 102 and a second ablation component 104. The first ablation component 102 can comprise any ablation component described herein and can comprise a first ablation component magnetic element 110. The second ablation component 104 can comprise a second ablation component connecting element 118 and a second ablation component end effector 104A extending distally from the second ablation component connecting element 118. In some embodiments, such as ablation system 2400, the second ablation component end effector 104A, 2402A can comprise multiple independently positionable end effector units 2402B, 2402C, 2402D linked in a daisy chain arrangement.

[0315] In a detailed embodiment, each end effector unit 2402B, 2402C, 2402D can include a respective end effector magnetic element. The second ablation component magnetic element can be configured for cooperative magnetic attraction with the first ablation component magnetic element 110.

[0316] It is an aspect of the present disclosure to provide a method of creating a lesion 16 in a target tissue 18, including disposing a second ablation component 104 proximate to a second surface 14 of the target tissue. The second ablation component 104 may comprise a second ablation component magnetic element 112. The method may include disposing a first ablation component 102, 2402 proximate to a first surface 12 of the target tissue. The first ablation component 102, 2402 may comprise a first ablation component connecting element 116, 2416 and a first ablation component end effector 102A, 2402A extending distally from the first ablation component connecting element 116, 2416. The first ablation component end effector 2402A may comprise a first end effector unit 2402B and a second end effector unit 2402C. The first end effector unit 2402B and the second end effector unit 2402C can be independently positionable and can be coupled in a daisy chain arrangement. The first end effector unit 2402B can comprise a first end effector unit magnetic element and a first end effector unit ablation element. The second end effector unit 2402C can comprise a second end effector unit magnetic element and a second end effector unit ablation element. The method can include attractively magnetically coupling the first end effector unit magnetic element with the magnetic element 112 of the second ablation component 104 and attractively magnetically coupling the second end effector unit magnetic element with the magnetic element 112 of the second ablation component 104. The method may include creating a first lesion 16B in the target tissue using a first end effector unit ablation element, and creating a second lesion 16C in the target tissue using a second end effector unit ablation element.

[0317] In a detailed embodiment, the first lesion 16B and the second lesion 16C can overlap to form a continuous compound lesion 16E. The operations of creating the first lesion 16B and the second lesion 16C can be performed simultaneously or sequentially.

[0318] In a detailed embodiment, the second ablation component 104 comprises a second ablation component ablation element 108. Creating a first lesion 16B in the target tissue 18 using the first end effector unit ablation element includes creating the first lesion 16B in the target tissue 18 by applying bipolar radio frequency ablation energy to the target tissue 18 using the first end effector unit ablation element and the second ablation component ablation element 108.

[0319] In a detailed embodiment, creating a second lesion 16C in the target tissue 18 using the second end effector unit ablation element includes creating a second lesion 16C in the target tissue 18 by applying bipolar radio frequency ablation energy to the target tissue using the second end effector unit ablation element and the second ablation component ablation element 108.

[0320] In a detailed embodiment, the method may include independently positioning the first end effector unit 2402B and the second end effector unit 2402C at respective target locations on the first surface 12 of the target tissue 18.

[0321] In a detailed embodiment, disposing the first ablation component 2402 proximate to the first surface 12 of the target tissue 18 includes disposing the first ablation component end effector 2402A proximate to the first surface 12 of the target tissue 18 while the first ablation component end effector 2402A is in a stowed configuration. In the stowed configuration, the first end effector unit 2402B and the second end effector unit 2402C may be substantially received within the first ablation component connecting element 2416.

[0322] In a detailed embodiment, the method may include reconfiguring the first ablation component end effector 2402A from a stowed configuration to a deployed configuration. In the deployed configuration, the first end effector unit 2402B and the second end effector unit 2402C may be disposed substantially outside the first ablation component connecting element 2416. Reconfiguring the first ablation component 2402 from the stowed configuration to the deployed configuration may include detaching the first end effector unit 2402B from the first ablation component connecting element 2416 and detaching the second end effector unit 2402C from the first ablation component connecting element 2416.

[0323] In a detailed embodiment, the method may include reconfiguring the first ablation component end effector 2402A from a deployed configuration to a stowed configuration after creating the first lesion 16B and the second lesion 16C. The method may include withdrawing the first ablation component end effector 2402A from proximity of the target tissue 18 after reconfiguring the first ablation component end effector 2402A from the deployed configuration to the stowed configuration.

[0324] In a detailed embodiment, the method may include repositioning the second ablation component magnetic element 112 relative to the second ablation component end effector housing 104A to reduce an attractive magnetic coupling between the first end effector unit magnetic element and the second ablation component magnetic element 112 and an attractive magnetic coupling between the second end effector unit magnetic element and the second ablation component magnetic element 112.

[0325] In a detailed embodiment, attractively magnetically coupling the first end effector unit magnetic element with the second ablation component magnetic element 112 and / or attractively magnetically coupling the second end effector unit magnetic element with the second ablation component magnetic element 112 includes rotationally self-orienting at least one of the first end effector unit magnetic element and the second end effector unit magnetic element into an orientation that magnetically attracts the second ablation component magnetic element 112.

[0326] It is an aspect of the present disclosure to provide a method that includes positioning a first ablation component 102 proximate to a first surface 12 of a target tissue 18, the first ablation component 102 comprising a first ablation component end effector 102A comprising a first ablation component end effector housing 102B, a first ablation component permanent magnet 110, and a first ablation component ablation element 106. The method can include positioning a second ablation component 104 proximate to a second surface 14 of the target tissue 18, the second ablation component 104 comprising a second ablation component magnetic element 112. The method can include positioning one or both of the first ablation component end effector 102A or the second ablation component 104 using an attractive magnetic coupling between the first ablation component permanent magnet 110 and the second ablation component magnetic element 112. The method may include creating a first lesion 16 in the target tissue using the first ablation component ablation element 106. The method may include repositioning the first ablation component permanent magnet 110 relative to the first ablation component end effector housing 102B to reduce an attractive magnetic coupling between the first ablation component permanent magnet 110 and the second ablation component magnetic element 112. In some embodiments, the second ablation component may include multiple independently positionable end effector units 2402B, 2402C, 2402D coupled in a daisy chain arrangement, each of the end effector units 2402B, 2402C, 2402D comprising a respective end effector unit magnetic element 2406B, 2406C, 2406D. The second ablation component magnetic element 112 may comprise an end effector magnetic element.Using an attractive magnetic coupling between the first ablation component permanent magnet 110 and the second ablation component magnetic element 112 may include using an attractive magnetic coupling between the first ablation component permanent magnet 110 and a respective end effector unit magnetic element 2406B, 2406C, 2406D of each one of the multiple independently positionable end effector units 2402B, 2402C, 2402D.

[0327] In a detailed embodiment, each of the end effector units 2402B, 2402C, 2402D includes a respective end effector unit ablation element 2406B, 2406C, 2406D. Creating a first lesion 16 in the target tissue 18 using the first ablation component ablation element 106 may include applying bipolar radio frequency ablation energy to the first ablation component ablation element 106 and to at least one of the end effector unit ablation elements 2406B, 2406C, 2406D.

[0328] It is an aspect of the disclosure to provide a method that includes disposing a first ablation component 102 on a first surface 12 of a target tissue 18, the first ablation component 102 comprising a first ablation component end effector 102A comprising a first ablation component end effector housing 102B and a first ablation component magnetic element 110. The method may include disposing a second ablation component 104 on a second surface 14 of the target tissue 18, the second ablation component 104 comprising a second ablation component ablation element 108 and a second ablation component permanent magnet 112 that is freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing 104B. The method may include rotating the second ablation component permanent magnet 112 about at least one axis of rotation to self-orient the second ablation component permanent magnet 112 into a magnetically attractive orientation with the first ablation component permanent magnet 110. The method may include positioning one or both of the first ablation component end effector 102A or the second ablation component end effector 104A using an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component permanent magnet 112. The method may include creating a first lesion 16 in the target tissue 18 using the second ablation component ablation element 108. In some embodiments, the first ablation component end effector housing 102B can include multiple independently positionable end effector units 2402B, 2402C, 2402D linked in a daisy chain arrangement, each of the end effector units 2402B, 2402C, 2402D comprising a respective end effector unit magnetic element 2406B, 2406C, 2406D. The first ablation component magnetic element 110 can comprise end effector magnetic elements 2406B, 2406C, 2406D.Using an attractive magnetic coupling between the first ablation component magnetic element 110 and the second ablation component permanent magnet 112 may include using an attractive magnetic coupling between the second ablation component permanent magnet 112 and a respective end effector unit magnetic element 2406B, 2406C, 2406D of each one of the multiple independently positionable end effector units 2402B, 2402C, 2402D.

[0329] In a detailed embodiment, each of the end effector units 2402B, 2402C, 2402D includes a respective end effector unit ablation element 2406B, 2406C, 2406D. Creating a first lesion 16 in the target tissue 18 using the second ablation component ablation element 108 includes applying bipolar radio frequency ablation energy to the second ablation component ablation element 108 and to at least one of the end effector unit ablation elements 2406B, 2406C, 2406D.

[0330] It is an aspect of the present disclosure to provide a method of making an ablation system, an ablation component, and / or any component as described herein. For example, a method of making an ablation system can include providing a first ablation component and a second ablation component as described herein. A method of making an ablation component can include assembling an end effector and a connecting element as described herein. A method of making an end effector can include assembling a housing, a magnetic element, and an ablation element as described herein. In general, such methods can involve any of the exemplary embodiments described herein in any combination.

[0331] It will be understood that any example ablation component described herein may be constructed using connecting elements of suitable rigidity, flexibility, malleability, and / or steerability.

[0332] Various example embodiments including multiple electrodes are described herein. More generally, any embodiment described herein may be provided with multiple electrodes unless expressly stated otherwise. Although some embodiments may be described in the context of specific illustrative uses of specific individual electrodes, it is understood that any electrode in any embodiment may be used for any purpose, regardless of how it may be described in a particular example. For example, an electrode described as a primary electrode or an ablation electrode may be used for pacing, stimulation, mapping, and / or sensing in some circumstances. Similarly, an electrode described as an auxiliary electrode or a pacing, stimulation, mapping, and / or sensing electrode may be used for ablation in some circumstances.

[0333] It is within the scope of the present disclosure to perform procedures involving any part of the heart using the devices and / or methods disclosed herein. For example, procedures involving the right atrium can be performed in conjunction with treatment for inappropriate sinus tachycardia (e.g., ridge, inferior vena cava, and / or superior vena cava), atrial fibrillation (e.g., Cox labyrinth lesion-right side), and / or Wolff-Parkinson-White syndrome. Procedures involving the right ventricle can be performed in conjunction with treatment for, for example, ventricular tachycardia (e.g., right ventricular posterior wall, right ventricular lateral free wall, right ventricular anterior wall, septum, right ventricular papillary muscle, and / or right ventricular outflow tract), partial ventricular contracture (e.g., right ventricular outflow tract septum, right ventricular base, and / or right ventricular outflow tract free wall), and / or Brugada syndrome (e.g., right ventricular outflow tract). Procedures involving the left atrium may be performed in conjunction with treatments for atrial fibrillation (e.g., ligament of Marshall, roof line, floor line, left atrial posterior wall, isthmus line, and / or autonomic (ganglionic plexus)), and / or left atrial appendage isolation (e.g., left atrial appendage ostium). Procedures involving the left ventricle may be performed in conjunction with, for example, syncope (e.g., autonomic (ganglionic plexus)), atrial tachycardia (e.g., anywhere in the left ventricle), atrial flutter (e.g., mitral valve), Wolff-Parkinson-White syndrome (e.g., atrioventricular groove), ventricular partial contraction (e.g., left ventricular outflow tract and / or aortic root), hypertension (e.g., anywhere in the left ventricle), and / or ventricular tachycardia (e.g., left ventricular posterior wall, left ventricular lateral free wall, left ventricular anterior wall, septum, left ventricular papillary muscle, and / or left ventricular apex). Procedures involving the right ventricular / left ventricular septum may be performed, for example, in the context of ventricular tachycardia (e.g., combined right and left ventricular injury). It is understood that the above list is merely exemplary and is not to be considered limiting.

[0334] Some example embodiments described herein and illustrated in the accompanying drawings may include and / or be utilized in conjunction with commercially available devices or components thereof. For example, some of the sheaths, catheters, etc. described above may include and / or include modifications of commercially available surgical devices or components thereof.

[0335] Unless expressly indicated, it is understood that any structural, functional, and / or methodological description of any example embodiment herein may be applied to any other example embodiment. More broadly, it is within the scope of the present disclosure to utilize any one or more features of any one or more example embodiments described herein in conjunction with any one or more other features of any other one or more other example embodiments described herein. Thus, any combination of any of the features or embodiments described herein is within the scope of the present disclosure.

[0336] It is an aspect of the present disclosure to provide any ablation system described herein, as well as to provide an ablation system comprising any one or more ablation components or components thereof described herein. Moreover, it is an aspect of the present disclosure to separately provide any one or more components of any ablation system described herein, alone or in any combination. For example, it is an aspect of the present disclosure to separately provide any ablation components described herein. Similarly, it is an aspect of the present disclosure to separately provide any one or more components of any ablation components described herein, or any components thereof, alone or in any combination. For example, it is an aspect of the present disclosure to separately provide any end effector, connecting element, handle, and / or other components of any ablation components described herein.

[0337] From the foregoing description and summary of the invention, it should be apparent to one of ordinary skill in the art that while the methods and apparatus described herein constitute example embodiments according to the present disclosure, it is to be understood that the scope of the disclosure contained herein is not limited to the precise embodiments described above, and that modifications can be made without departing from the scope of the present disclosure. Likewise, it is to be understood that it is not necessary to meet any or all of the particular advantages or objectives disclosed herein in order to be within the scope of the present disclosure, since there may be inherent and / or unexpected advantages, although they may not be expressly discussed herein. [Explanation of symbols]

[0338] 10. Heart 11 Pericardium 12 epicardial (outer) surface, first side 14 endocardial (inner) surface, second surface, second side 16 First injury, ablation 16B First Damage 16C Second injury 16D Third Damage 16E Continuous and complex injuries 18 Heart wall, target tissue, cardiac tissue 20 Battlements 22 Blood vessels 100 Ablation System 102 First ablation part 102A First Ablation Component End Effector 102B First ablation part end effector housing 104 Second ablation part 104A Second Ablation Component End Effector 104B Second ablation component end effector housing 106 First ablation component Ablation element, first ablation component electrode 108 Second ablation component Ablation element, second ablation component electrode 110 First ablation part magnetic element, first ablation part permanent magnet 112 second ablation part magnetic element, second ablation part permanent magnet 114 Control Unit 116 first ablation component connecting element 118 Second ablation component connecting element 120 Subxiphoid or Intercostal Approach or Incision 200 Ablation parts 202 first ablation part end effector 204 Connection elements 206 Handle 208 Gripping part 210 Magnetic actuator 212 Steering Actuator 214 Locking actuator 216 Electrical Connection Elements 218 Vacuum connection element 220 Permanent magnets, magnetic elements 220A Longitudinal Axis 222 Vacuum port 224 Target tissue contact area 226 Vacuum conduit 228 Electrode 230 Periphery Wall 232 Case 234 Mechanical Linkages 236 Magnetic Axis 238 Magnet driven spring 240 Electrode insulation part 242 Skirt 244 Aperture 246 Mechanical stop 290, 292 Delivery devices 300 Ablation parts 302 Main electrode 304, 306, 308, 310 Auxiliary electrode 312 Skirt 314, 316, 318 Internal passage 320 Base part 322 Partitioned parts 324 Case 326 Permanent Magnets 328, 330 Wings, protrusions 400 Ablation parts 402 Electrode 404, 406, 408 Internal passage 410 Basal part 412 Permanent Magnets 414, 416 wing section 418, 420 groove 422 Housing, recess 424 Recess 500 Ablation parts 502 Long and thin electrode 504 Longitudinal length 506 Horizontal width 508 Magnet driven spring 510 Magnet 512 Flexible part 514 End Effector 600 Ablation parts 602 Main electrode 604 Skirt 606, 608, 610, 612 Auxiliary electrode 614 Distal protrusion 616 Proximal protrusion 700 Ablation parts 702 Main electrode 704 Skirt 706, 708, 710, 712 Auxiliary electrode 714, 716 protrusion 800 Ablation parts 802 End Effector 802A Housing 804 Connection Element 806 Handle 806A Actuator 808 Electrical Connector 808A Conductor 810 Ablation part 812 Electrode 814 Bending Area 816 Reinforcement 818 Permanent Magnets 822 Mechanical Linkage Mechanism 900 Ablation parts 902 Permanent magnets, magnetic elements 904 End Effector 904A Housing 906 Longitudinal axis 908 Target Tissue Contact Surface 910 Magnetic (NS) axis 912 from the magnet 902 through the target tissue contact surface 908 1000 Ablation parts 1002 Permanent magnets, magnetic elements 1004 End Effector 1006 Longitudinal axis 1008 Tissue Contact Surface 1010 Magnetic axis 1012, direction from magnet 1002 through ablation element 1028, direction from magnet 1002 through tissue contact surface 1008 1014 Mechanical linkage mechanism 1016 Progress section 1018 Case 1020 Groove 1022 Protrusion 1028 Ablation element, electrode 1100 Second ablation part 1102 Handle 1104 Connection element 1106 First connecting element, first engaging element 1108 second connecting element, second ablation element, second ablation element electrode 1110 First ablation component end effector 1112 First connecting element distal tip portion 1114 Engagement element 1116 Second ablation component end effector housing 1118 Second ablation part ablation element 1120 Magnetic element, second ablation part permanent magnet 1120A Magnetic Axis 1122 Deployment Actuator 1124 Steer / Deflect Actuator 1126 Substantially spherical interior 1128 Distal end 1130 Aperture 1132 Neck 1134 Insulator 1202 Substantially spherical mounting part 1210 End Effector 1216 Case 1220 Magnetic Elements 1300 Ablation parts 1304 Connection Element 1306 First connecting element 1308 Second connecting element 1310 End Effector 1312 first connecting element distal portion 1314 Engagement element 1330 Aperture 1400 Ablation parts 1404 Connection Element 1410 End Effector 1432 Neck 1500 End Effector 1502 Neck 1520 End Effector 1522 Neck 1524 Recess 1540 End Effector 1542 Neck 1544 Distal part 1546 Cone-shaped part 1560 End Effector 1562 Distal part 1564 Proximal part 1600 Ablation parts 1604 Connection Element 1606 First connecting element 1608 Second connecting element 1610 End Effector 1612 first connecting element distal portion 1614 Engagement element 1616 End effector housing 1618 Main electrode 1626 Neck 1628 Distal part 1630 Proximal part 1632 Distal tip auxiliary electrode 1634, 1636, 1638, 1640 Lateral auxiliary electrode 1634 Recess 1702, 1704, 1706, 1708 Lateral auxiliary electrode 1750 End Effector 1752 Distal tip auxiliary electrode 1754, 1756, 1758 Lateral auxiliary electrode 1800 Ablation parts 1802 End Effector 1804 Case 1806 Main electrode 1808 Distal tip auxiliary electrode 1810, 1812, 1814 Lateral auxiliary electrode 1816, 1818, 1820 Passages 1900 End Effector 1902 End effector housing 1904, 1906 Main electrode 1908 Insulator 1950 End Effector 1952 End effector housing 1954 Main electrode 1956 Distal tip auxiliary electrode 1958 Lateral auxiliary electrode 1960 Insulator 1962 Proximal part 2000 End effector deployment mechanism 2002 First proximal ferrule 2004 Second Distal Ferrule 2006 Compression spring 2008 Fixed stop part 2040 Locking magnet 2042, 2044 Magnetic elements 2050 Deployment mechanism 2052 Deployment Actuator 2054 Transportation Department 2056 Stop part 2100 Ablation System 2102 First ablation part, end effector 2102A End Effector 2102B Housing 2102D Delivery Device 2104 Second ablation part 2104A End Effector 2104B Housing 2106, 2108 Ablation elements 2110 First ablation part magnetic element, first ablation part permanent magnet 2112 Second ablation part magnetic element 2113 First side, first surface 2114 Second side, second surface 2116 Transmural injury 2118 Target tissue 2120 Tissue Contact Surface 2122 Vacuum port 2200 Ablation System 2202 First ablation part 2202A End Effector Housing 2204 Second ablation part 2204A End Effector Housing 2210 First ablation component magnetic element 2212 Second ablation component magnetic element 2218 Target tissue 2220, 2222 Ablation element, electrode 2304 Ablation parts 2304A End Effector 2304B Housing 2312, 2314 Magnetic elements 2312A, 2314A Magnetic Axis 2316 Axis of Rotation 2316A axis 2318 Collaborative Magnetic Elements 2320 Lateral surface 2322 Target tissue 2350 Ablation System 2352 First ablation part 2354 Second ablation part 2356 Target tissue 2358A, 2358B, 2358C, 2358D, 2358E, 2358F Magnetic Elements 2360A, 2360B, 2360C, 2360D, 2360E, 2360F Magnetic Elements 2362 End effector housing 2364 End Effector 2400 Ablation System 2402 First ablation part 2402A First Ablation Component End Effector 2402B First End Effector Unit 2402C Second End Effector Unit 2402D 3rd End Effector Unit 2406B First end effector unit magnetic element, first end effector unit ablation element, first end effector unit ablation electrode 2406C Second end effector unit magnetic element, second end effector unit ablation element, second end effector unit ablation electrode 2406D Third end effector unit magnetic element, third end effector unit ablation element, third end effector unit ablation electrode 2416 First ablation component connecting element 2416B First end effector unit connection element 2416C Second end effector unit connecting element 2416D Third end effector unit connecting element 2428 Electrical Connector 2428A First Conductor 2428B Second Conductor 2428C Third Conductor 2500 System 2502 First Part 2502A First Part End Effector 2504 Second Part 2506 First component electrode 2508 Second part electrode

Claims

1. A first ablation component, a first ablation component end effector configured to be positioned on a first side of the target tissue, a first ablation component end effector housing; a first ablation element tissue contact portion configured to engage the first side of the target tissue; a first ablation component, an ablation element, selectively operable to cause ablation of the target tissue; and a first ablation component permanent magnet translationally repositionable relative to the first ablation component end effector housing between an engaged configuration and a disengaged configuration; a first ablation component end effector comprising: a mechanical linkage operatively coupled to translationally reposition the first ablation component permanent magnet relative to the first ablation component end effector housing between the engaged and disengaged configurations; a first ablation component comprising: a second ablation component configured for cooperative operation with the first ablation component, a second ablation component end effector configured to be positioned on a second side of the target tissue opposite the first side of the target tissue, a second ablation component end effector housing; a second ablation element tissue contact portion configured to engage the second side of the target tissue; a second ablation element, the second ablation element being selectively operable to cause ablation of the target tissue; and a second ablation component permanent magnet that is freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing without substantial translation relative to the second ablation component end effector housing and configured to rotatably self-orient into a magnetically attractive orientation with the first ablation component permanent magnet; a second ablation component end effector comprising: a second ablation component comprising: Equipped with In the engaged configuration, the first ablation component permanent magnet is configured to magnetically attract the second ablation component permanent magnet with the second ablation component end effector positioned on the second side of the target tissue substantially adjacent to the first ablation component tissue contacting portion; In the disengaged configuration, with the second ablation component end effector positioned on the second side of the target tissue substantially adjacent to a tissue contact portion of the first ablation component, magnetic attraction between the first ablation component permanent magnet and the second ablation component permanent magnet is reduced compared to the engaged configuration.

2. The ablation system of claim 1 , wherein the first ablation component permanent magnet is translationally repositionable relative to the first ablation component end effector housing between the engaged and disengaged configurations without substantial rotation.

3. The ablation system of claim 1 , wherein the first ablation component permanent magnet is translationally repositionable between the engaged and disengaged configurations along a longitudinal axis of the first ablation component permanent magnet.

4. In the engaged configuration, the first ablation element permanent magnet is positioned substantially laterally adjacent to the first ablation element tissue contacting portion; The ablation system of claim 1 , wherein in the disengaged configuration, the first ablation component permanent magnet is positioned substantially laterally non-adjacent to the first ablation component tissue contacting portion.

5. the first ablation element end effector comprises at least one vacuum port disposed at the first ablation element tissue contacting portion, the vacuum port configured to be fluidly coupled to a vacuum source; The ablation system of claim 1 , wherein the vacuum port is configured such that upon application of a vacuum to the vacuum port, the vacuum port releasably secures the first ablation component tissue contacting portion to the target tissue.

6. The ablation system of claim 5 , wherein the first ablation component ablation element is disposed substantially within a periphery at least partially surrounding the vacuum port.

7. the first ablation element comprises a first ablation electrode; The ablation system of claim 1 , wherein the first ablation component is configured to deliver radio frequency ablation energy to the target tissue via an ablation electrode of the first ablation component.

8. The ablation system of claim 1 , wherein the first ablation component ablation electrode comprises an elongated electrode having one dimension substantially greater than a vertical dimension.

9. The ablation system of claim 1 , wherein a distal end portion of the first ablation component is steerable.

10. the first ablation component end effector includes an outwardly extending generally circumferential first ablation component end effector skirt; The ablation system of claim 1 , wherein the first ablation element tissue contacting portion comprises the first ablation element end effector skirt.

11. The ablation system of claim 10 , wherein the first ablation component ablation element is disposed within a perimeter defined at least in part by the first ablation component end effector skirt.

12. 10. The ablation system of claim 1, wherein the first ablation component end effector comprises at least one aperture configured to deliver irrigation fluid to the first side of the target tissue proximate an ablation element of the first ablation component.

13. the first ablation element comprises a first ablation electrode; the first ablation component ablation electrode comprises at least one internal passageway; The ablation system of claim 1 , wherein the at least one internal passageway is operably connected to a source of cooling fluid.

14. the first ablation component comprises a first ablation component connecting element; The ablation system of claim 1 , wherein the first ablation component end effector is disposed distally at the first ablation component connecting element.

15. the first ablation component comprises a first ablation component handle disposed proximally at the first ablation component connecting element; 15. The ablation system of claim 14, wherein the first ablation component handle comprises a first ablation component magnet actuator operably connected to the first ablation component permanent magnet via the mechanical linkage for repositioning the first ablation component permanent magnet between the engaged and disengaged configurations.

16. The ablation system of claim 1 , wherein the first ablation component comprises at least one first ablation component auxiliary electrode.

17. The ablation system of claim 1 , wherein the second ablation component permanent magnet is freely rotatable relative to the second ablation component end effector housing about three axes of rotation.

18. the second ablation component permanent magnet comprises a substantially spherical permanent magnet; The ablation system of claim 1 , wherein the substantially spherical permanent magnet is rotatably disposed within a substantially spherical interior of the second ablation component end effector housing.

19. the second ablation component permanent magnet is disposed on a substantially spherical mounting portion; The ablation system of claim 1 , wherein the substantially spherical mount is rotatably disposed within a substantially spherical interior of the second ablation component end effector housing.

20. The ablation system of claim 1 , wherein the second ablation element tissue contacting portion is bulbous.

21. The ablation system of claim 1 , wherein the second ablation element tissue contacting portion is at least partially generally spherical.

22. The ablation system of claim 1 , wherein the second ablation component end effector housing is constructed from a highly magnetically permeable, non-ferrous, electrically conductive material.

23. The ablation system of claim 1 , wherein the second ablation component end effector housing is constructed from copper.

24. the second ablation element comprises a second ablation electrode; The ablation system of claim 1 , wherein the second ablation component ablation electrode forms at least a portion of the second ablation component end effector housing.

25. The ablation system of claim 1 , wherein the second ablation component comprises at least one second ablation component auxiliary electrode.

26. The ablation system of claim 25 , wherein the at least one second ablation component auxiliary electrode is disposed at a distal tip of the second ablation component end effector housing.

27. The ablation system of claim 25 , wherein the at least one second ablation component auxiliary electrode is disposed laterally on the second ablation component end effector housing.

28. the second ablation component end effector housing is at least partially generally spherical; The ablation system of claim 1 , wherein the second ablation component end effector housing comprises a distal portion constructed from a conductive material and a proximal portion constructed from a non-conductive material.

29. the second ablation component comprises a second ablation component connecting element; The ablation system of claim 1 , wherein the second ablation component end effector is disposed distally at the second ablation component connecting element.

30. The second ablation component connecting element comprises: a generally tubular first connecting element having a first connecting element distal portion; a second connecting element operably coupled to the first connecting element distal portion, the second ablation component end effector being disposed distally on the second connecting element; an engaging element configured to selectively engage the second ablation component end effector with the first connecting element distal portion; Equipped with 30. The ablation system of claim 29, wherein the second connecting element is selectively repositionable relative to the first connecting element distal portion between: (i) a retracted configuration in which the second connecting element is disposed substantially within the first connecting element and the engaging element operably couples to the second ablation component end effector and the first connecting element distal portion; and (ii) a deployed configuration in which at least a portion of the second connecting element extends from the first connecting element distal portion and the engaging element is disengaged from at least one of the second ablation component end effector or the first connecting element distal portion.

31. 31. The ablation system of claim 30, wherein the second connecting element has greater flexibility than a distal portion of the first connecting element.

32. 31. The ablation system of claim 30, further comprising a second ablation component handle disposed proximally on the first connection element, the second ablation component handle comprising a deployment actuator operable to reposition the second connection element relative to the first connection element distal portion.

33. the first connecting element distal portion is steerable; 33. The ablation system of claim 32, wherein the second ablation component handle comprises a steering actuator operable to steer the first connecting element distal portion.

34. the engaging element is disposed at a distal end of the first connecting element distal portion; The ablation system of claim 30 , wherein in the retracted configuration, the engagement element is configured to receive at least a portion of the end effector therein.

35. The ablation system of claim 34 , wherein the engagement element comprises a distally oriented opening.

36. 36. The ablation system of claim 35, wherein the aperture is generally conical.

37. 1. A method for producing damage in a target tissue, comprising: positioning a first ablation component proximate to a first surface of a target tissue, the first ablation component comprising a first ablation component end effector having a first ablation component end effector housing, a first ablation component permanent magnet translationally repositionable within the first ablation component end effector housing, and a first ablation component ablation element; positioning a second ablation component proximate to a second surface of the target tissue opposite the first surface of the target tissue, the second ablation component comprising a second ablation component end effector having a second ablation component end effector housing, a second ablation component permanent magnet freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing, and a second ablation component ablation element; self-orienting the second ablation component permanent magnet into a magnetically attractive orientation with the first ablation component permanent magnet by rotating the second ablation component permanent magnet about the at least one axis of rotation without substantial translation relative to the second ablation component end effector housing; positioning one or both of the first and second ablation component end effectors at the target tissue using an attractive magnetic coupling between the first and second ablation component permanent magnets; creating a first lesion in the target tissue using at least one of the first ablation element and the second ablation element; translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing from an engaged configuration to a disengaged configuration to reduce the attractive magnetic coupling between the first ablation component permanent magnet and the second ablation component permanent magnet; The method includes:

38. 40. The method of claim 37, further comprising the step of detaching at least one of the first ablation component end effector and the second ablation component end effector from the target tissue.

39. 38. The method of claim 37, wherein translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing comprises translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing without substantial rotation of the first ablation component permanent magnet relative to the first ablation component end effector housing.

40. 38. The method of claim 37, wherein translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing comprises translationally repositioning the first ablation component permanent magnet along a longitudinal axis of the first ablation component permanent magnet.

41. 38. The method of claim 37, wherein translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing comprises translationally repositioning the first ablation component permanent magnet from substantially laterally adjacent to a first ablation component tissue contacting portion of the first ablation component end effector housing to substantially not laterally adjacent to the first ablation component tissue contacting portion.

42. the first ablation component comprises a first ablation component connecting element, the first ablation component end effector being disposed distally at the first ablation component connecting element; the first ablation component comprises a first ablation component handle disposed proximally at the first ablation component connecting element; the first ablation component handle comprises a first ablation component magnet actuator operatively connected to the first ablation component permanent magnet for translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing between the engaged and disengaged configurations; 38. The method of claim 37, wherein translationally repositioning the first ablation component permanent magnet within the first ablation component end effector housing from the engaged configuration to the disengaged configuration comprises actuating the first ablation component magnet actuator to translationally reposition the first ablation component permanent magnet within the first ablation component end effector housing from the engaged configuration to the disengaged configuration.

43. 40. The method of claim 37, further comprising the step of applying a vacuum to a vacuum port of the first ablative component end effector to secure the first ablative component end effector to the target tissue.

44. 44. The method of claim 43, further comprising the step of ceasing application of vacuum to the vacuum port.

45. the first ablation element comprises a first ablation electrode; the second ablation element comprises a second ablation electrode; 38. The method of claim 37, wherein creating the first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element comprises creating the first lesion in the target tissue by applying bipolar radio frequency energy to the target tissue using the first ablation component ablation element and the second ablation component ablation element.

46. the first ablation component comprises at least one electrode; 40. The method of claim 37, wherein the method includes using the at least one electrode to at least one of pace, sense, stimulate, and map.

47. the at least one electrode comprises at least one of a first ablation component ablation electrode and a first ablation component auxiliary electrode; 47. The method of claim 46, wherein the step of using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping comprises using the at least one of the first ablation component ablation electrode and the first ablation component auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

48. 38. The method of claim 37, wherein the step of positioning the first ablation component proximate to the first surface of the target tissue comprises steering a distal portion of a first ablation component connecting element, the first ablation component end effector being positioned distally at the first ablation component connecting element.

49. the second ablation component permanent magnet is freely rotatable about three axes of rotation relative to the second ablation component end effector housing; 38. The method of claim 37, wherein the step of self-orienting the second ablation component permanent magnet into a magnetically attractive orientation with the first ablation component permanent magnet comprises rotating the second ablation component permanent magnet about the three axes of rotation.

50. the second ablation element permanent magnet comprises a generally spherical second ablation element permanent magnet; the second ablation component end effector housing comprises a generally spherical interior; 50. The method of claim 49, wherein rotating the second ablation component permanent magnet about the three axes of rotation comprises rotating the generally spherical second ablation component permanent magnet about the three axes of rotation within the generally spherical interior of the second ablation component end effector housing.

51. 38. The method of claim 37, wherein the step of positioning one or both of the first ablation component end effector and the second ablation component end effector at the target tissue comprises engaging a generally bulbous tissue contacting surface of the second ablation component end effector with the second surface of the target tissue.

52. the second ablation component comprises at least one electrode; 40. The method of claim 37, wherein the method includes using the at least one electrode to at least one of pace, sense, stimulate, and map.

53. the at least one electrode comprises at least one of a second ablation component ablation electrode and a second ablation component auxiliary electrode; 53. The method of claim 52, wherein the step of using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping comprises using the at least one of the second ablation component ablation electrode and the second ablation component auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

54. 38. The method of claim 37, wherein the step of positioning the second ablation component proximate to the second surface of the target tissue comprises steering a distal portion of a second ablation component connecting element, the second ablation component end effector being positioned distally at the second ablation component connecting element.

55. the second ablation component comprises a second ablation component connecting element, the second ablation component connecting element comprising a generally tubular first connecting element comprising a first connecting element distal portion and a second connecting element operably coupled to the first connecting element distal portion; the second ablation component end effector is disposed distally at the second connecting element; 38. The method of claim 37, further comprising repositioning the second connecting element and the second ablation component end effector from a retracted configuration in which the second connecting element is disposed substantially within the first connecting element, to a deployed configuration in which at least a portion of the second connecting element extends from a distal portion of the first connecting element.

56. 56. The method of claim 55, wherein the step of creating the first lesion in the target tissue using the at least one of the first ablation component ablation element and the second ablation component ablation element is performed while the second connecting element and the second ablation component end effector are in the deployed configuration.

57. the second ablation component comprises a second ablation component handle disposed proximally at the first connecting element, the second ablation component handle comprising a deployment actuator operable to reposition the second connecting element relative to the first connecting element distal portion; 56. The method of claim 55, wherein repositioning the second connecting element and the second ablation component end effector from the retracted configuration to the deployed configuration comprises operating the deployment actuator.

58. 56. The method of claim 55, further comprising repositioning the second connecting element and the second ablation component end effector from the deployed configuration to the retracted configuration.

59. 56. The method of claim 55, wherein repositioning the second connecting element and the second ablation component end effector from the retracted configuration to the deployed configuration comprises disengaging the second ablation component end effector from an engaging element configured to selectively engage the second ablation component end effector with a distal portion of the first connecting element.

60. 60. The method of claim 59, wherein repositioning the second connecting element and the second ablation component end effector from the deployed configuration to the retracted configuration comprises engaging the second ablation component end effector with the engaging element.

61. a generally tubular first connecting element including a first connecting element distal portion; a second connecting element operably coupled to the first connecting element distal portion; an end effector disposed distally on the second connecting element, the end effector comprising an end effector housing, an ablation element, and a permanent magnet; an engagement element configured to selectively engage the end effector with the first connecting element distal portion; Equipped with The second connecting element is selectively repositionable relative to the first connecting element distal portion between (i) a retracted configuration in which the second connecting element is disposed substantially within the first connecting element and the engaging element operably couples to the end effector and the first connecting element distal portion, and (ii) a deployed configuration in which at least a portion of the second connecting element extends from the first connecting element distal portion and the engaging element is disengaged from at least one of the end effector or the first connecting element distal portion.

62. 62. The ablation component of claim 61, wherein the second connecting element has greater flexibility than a distal portion of the first connecting element.

63. 62. The ablation component of claim 61, wherein the permanent magnet is freely rotatable relative to the end effector housing about three axes of rotation.

64. the permanent magnet comprises a substantially spherical permanent magnet; 62. The ablation component of claim 61, wherein the substantially spherical permanent magnet is rotatably disposed within a substantially spherical interior of the end effector housing.

65. The permanent magnet is disposed on a substantially spherical mounting portion; 62. The ablation component of claim 61, wherein the substantially spherical mount is rotatably disposed within a substantially spherical interior of the end effector housing.

66. 62. The ablation component of claim 61, wherein the end effector comprises a generally bulbous tissue contacting surface.

67. 62. The ablation component of claim 61, wherein the end effector comprises a tissue contacting surface that is at least partially generally spherical.

68. 62. The ablation component of claim 61, wherein the end effector housing is constructed from a highly magnetically permeable, non-ferrous, electrically conductive material.

69. 62. The ablation component of claim 61, wherein the second ablation component end effector housing is constructed from copper.

70. the ablation element comprises an electrode; 62. The ablation component of claim 61, wherein the end effector housing comprises an electrode.

71. 71. The ablation component of claim 70, wherein the electrode generally comprises two main electrodes in the form of cooperating laterally disposed hemispheres separated by an insulator.

72. 62. The ablation component of claim 61, further comprising a handle disposed proximally on the first connecting element, the handle comprising a deployment actuator operable to reposition the second connecting element relative to the first connecting element distal portion.

73. 62. The ablation component of claim 61, wherein the first connecting element distal portion is steerable.

74. 62. The ablation component of claim 61, wherein the first connecting element distal portion is steerable at least about 180 degrees.

75. 62. The ablation component of claim 61, further comprising a handle disposed proximally on the first connecting element, the handle comprising a steering actuator operable to steer the first connecting element distal portion.

76. the engaging element is disposed at a distal end of the first connecting element distal portion; 62. The ablation component of claim 61, wherein in the retracted configuration, the engagement element is configured to receive at least a portion of the end effector therein.

77. 62. The ablation component of claim 61, wherein the engagement element comprises a distally oriented opening.

78. 78. The ablation component of claim 77, wherein the opening is generally conical.

79. 62. The ablation component of claim 61, further comprising at least one auxiliary electrode.

80. 80. The ablation component of claim 79, wherein the at least one auxiliary electrode is disposed at a distal tip of the end effector housing.

81. 80. The ablation component of claim 79, wherein the at least one auxiliary electrode is disposed laterally on the end effector housing.

82. 82. The ablation component of claim 81, wherein the at least one auxiliary electrode comprises a generally circular circumferential ring disposed laterally on the end effector housing.

83. the end effector housing is at least partially generally spherical; 62. The ablation component of claim 61, wherein the end effector housing comprises a distal portion constructed from a conductive material and a proximal portion constructed from a non-conductive material.

84. 1. A method for producing damage to a target tissue, comprising: positioning an ablation component proximate to a first surface of a target tissue, the ablation component comprising an end effector comprising an end effector housing, a permanent magnet freely rotatable about at least one axis of rotation relative to the end effector housing, and an ablation element; rotating the permanent magnet about the at least one axis of rotation to self-orient the permanent magnet into a magnetically attractive orientation with a cooperating ablation component magnetic element of a cooperating ablation component disposed proximate a second surface of the target tissue opposite the first surface of the target tissue; positioning the end effector at the target tissue using an attractive magnetic coupling between the permanent magnet and the cooperating ablation component magnetic element; creating a lesion in the target tissue using the ablation element; The method includes:

85. the permanent magnet is freely rotatable relative to the end effector housing about three axes of rotation; 85. The method of claim 84, wherein the step of self-orienting the permanent magnet into a magnetically attractive orientation with the cooperating ablation component magnetic element comprises rotating the permanent magnet about the three axes of rotation.

86. the permanent magnet comprises a generally spherical permanent magnet; the end effector housing comprises a generally spherical interior; 86. The method of claim 85, wherein rotating the permanent magnet about the three axes of rotation comprises rotating the generally spherical permanent magnet about the three axes of rotation within the generally spherical interior of the end effector housing.

87. 85. The method of claim 84, wherein positioning the end effector at the target tissue comprises engaging a generally bulbous tissue contacting surface of the end effector with the first surface of the target tissue.

88. 85. The method of claim 84, wherein the step of positioning the ablation component proximate to the first surface of the target tissue comprises steering a distal portion of a connecting element, the end effector being positioned distally on the connecting element.

89. 90. The method of claim 88, wherein steering the distal portion of the connecting element comprises operating a steering actuator disposed on a handle of the ablation component, the handle being disposed proximally on the connecting element.

90. the ablation element comprises an electrode; 85. The method of claim 84, wherein the step of creating the lesion in the target tissue using the ablation element comprises applying radio frequency ablation energy to the target tissue using the electrode.

91. 91. The method of claim 90, wherein applying radio frequency ablation energy to the target tissue using the electrodes comprises applying bipolar radio frequency ablation energy to the target tissue using the electrodes and cooperating electrodes of the cooperating ablation components.

92. the end effector comprises at least one electrode; 85. The method of claim 84, wherein the method includes using the at least one electrode to at least one of pace, sense, stimulate, and map.

93. the at least one electrode comprises at least one of an ablation electrode and an auxiliary electrode; 93. The method of claim 92, wherein the step of using the at least one electrode to perform at least one of pacing, sensing, stimulating, and mapping comprises using the at least one of the ablation electrode and the auxiliary electrode to perform at least one of pacing, sensing, stimulating, and mapping.

94. the ablation component comprises a connecting element comprising a generally tubular first connecting element having a first connecting element distal portion and a second connecting element operably coupled to the first connecting element distal portion; the end effector is disposed distally at the second connecting element; 85. The method of claim 84, further comprising repositioning the second connection element and the end effector from a retracted configuration in which the second connection element is disposed substantially within the first connection element, to a deployed configuration in which at least a portion of the second connection element extends from a distal portion of the first connection element.

95. 95. The method of claim 94, wherein the step of creating the lesion in the target tissue using the ablation element is performed while the second connecting element and the end effector are in the deployed configuration.

96. the ablation component comprises a handle disposed proximally on the first connecting element, the handle comprising a deployment actuator operable to reposition the second connecting element relative to the first connecting element distal portion; 95. The method of claim 94, wherein repositioning the second connection element and the end effector from the retracted configuration to the deployed configuration comprises operating the deployment actuator.

97. 95. The method of claim 94, further comprising repositioning the second connection element and the end effector from the deployed configuration to the retracted configuration.

98. 95. The method of claim 94, wherein repositioning the second connection element and the end effector from the retracted configuration to the deployed configuration includes disengaging the end effector from an engagement element configured to selectively engage the end effector with a distal portion of the first connection element.

99. 95. The method of claim 94, wherein repositioning the second connecting element and the end effector from the deployed configuration to the retracted configuration includes engaging the end effector with the engaging element.

100. A first ablation component, a first ablation component end effector configured to be positioned on a first side of the target tissue, the first ablation component comprising: a first ablation component end effector housing; a first ablation element tissue contact portion configured to engage the first side of the target tissue; a first ablation element, the first ablation element being selectively operable to cause ablation of the target tissue; and a first ablation component permanent magnet that is freely rotatable about at least one axis of rotation relative to the first ablation component end effector housing without substantial translation relative to the first ablation component end effector housing and configured to rotatably self-orient into a magnetically attractive orientation with a cooperating magnetic element; a first ablation component comprising: a second ablation component configured for cooperative operation with the first ablation component, a second ablation component end effector configured to be positioned on a second side of the target tissue opposite the first side of the target tissue, the second ablation component comprising: a second ablation component end effector housing; a second ablation element tissue contact portion configured to engage the second side of the target tissue; a second ablation element, the second ablation element being selectively operable to cause ablation of the target tissue; and a second ablation component permanent magnet comprising said cooperating magnetic element, said second ablation component permanent magnet being freely rotatable about at least one axis of rotation relative to said second ablation component end effector housing without substantial translation relative thereto, and configured to rotatably self-orient into a magnetically attractive orientation with said first ablation component permanent magnet; a second ablation component comprising: An ablation system comprising:

101. the first ablation component permanent magnet is freely rotatable about three axes of rotation relative to the first ablation component end effector housing; 101. The ablation system of claim 100, wherein the second ablation component permanent magnet is freely rotatable about three axes of rotation relative to the second ablation component end effector housing.

102. the first ablation element comprises a first ablation electrode; an ablation electrode of the first ablation component forming at least a portion of an end effector housing of the first ablation component; the second ablation element comprises a second ablation electrode; 101. The ablation system of claim 100, wherein the second ablation component ablation electrode forms at least a portion of the second ablation component end effector housing.

103. the first ablation component comprises at least one first ablation component auxiliary electrode; 101. The ablation system of claim 100, wherein the second ablation component comprises at least one second ablation component auxiliary electrode.

104. the first ablation component comprises a first ablation component connecting element; the first ablation component end effector is disposed distally at the first ablation component connecting element; the second ablation component comprises a second ablation component connecting element; 101. The ablation system of claim 100, wherein the second ablation component end effector is disposed distally at the second ablation component connecting element.

105. The first ablation component connecting element comprises: a generally tubular first ablation component first connecting element comprising a first ablation component first connecting element distal portion; a first ablation component second connecting element operably coupled to a distal portion of the first ablation component first connecting element, the first ablation component end effector being disposed distally at the first ablation component second connecting element; a first ablation component engaging element configured to selectively engage the first ablation component end effector with a first connecting element distal portion of the first ablation component; Equipped with the first ablation component second connecting element is selectively repositionable relative to the first ablation component first connecting element distal portion between: (i) a retracted configuration in which the first ablation component second connecting element is disposed substantially within the first ablation component first connecting element and the first ablation component engaging element is operably coupled to the first ablation component end effector and the first ablation component first connecting element distal portion; and (ii) a deployed configuration in which at least a portion of the first ablation component second connecting element extends from the first ablation component first connecting element distal portion and the first ablation component engaging element is disengaged from at least one of the first ablation component end effector or the first ablation component first connecting element distal portion; The second ablation component connecting element comprises: a generally tubular second ablation component first connecting element comprising a second ablation component first connecting element distal portion; a second ablation component second connecting element operably coupled to a distal portion of the first connecting element of the second ablation component, the second ablation component end effector being disposed distally at the second ablation component second connecting element; a second ablation component engaging element configured to selectively engage the second ablation component end effector with a first connecting element distal portion of the second ablation component; Equipped with 105. The ablation system of claim 104, wherein the second ablation component second connecting element is selectively repositionable relative to the second ablation component first connecting element distal portion between: (i) a retracted configuration in which the second ablation component second connecting element is disposed substantially within the second ablation component first connecting element and the second ablation component engaging element operably couples to the second ablation component end effector and the second ablation component first connecting element distal portion; and (ii) a deployed configuration in which at least a portion of the second ablation component second connecting element extends from the second ablation component first connecting element distal portion and the second ablation component engaging element is disengaged from at least one of the second ablation component end effector or the second ablation component first connecting element distal portion.

106. a second connecting element of the first ablation component having greater flexibility than a distal portion of a first connecting element of the first ablation component; 106. The ablation system of claim 105, wherein a second connecting element of the second ablation component has greater flexibility than a distal portion of a first connecting element of the second ablation component.

107. a first ablation component handle disposed proximally at a first connecting element of the first ablation component, the first ablation component handle comprising a first ablation component deployment actuator operable to reposition a second connecting element of the first ablation component relative to a distal portion of the first connecting element of the first ablation component; a second ablation component handle disposed proximally at a first connecting element of the second ablation component, the second ablation component handle comprising a second ablation component deployment actuator operable to reposition the second connecting element of the second ablation component relative to a distal portion of the first connecting element of the second ablation component; 106. The ablation system of claim 105, further comprising:

108. the first ablation component engaging element is disposed at a distal end of a first connecting element distal portion of the first ablation component; in the retracted configuration, the first ablation component engagement element is configured to receive at least a portion of the first ablation component end effector therein; the second ablation component engaging element is disposed at a distal end of the first connecting element distal portion of the second ablation component; 106. The ablation system of claim 105, wherein in the retracted configuration, the second ablation component engagement element is configured to receive at least a portion of the second ablation component end effector therein.

109. the first ablation component engaging element includes a distally oriented opening; 106. The ablation system of claim 105, wherein the second ablation component engaging element comprises a distally oriented opening.

110. 1. A method for producing damage to a target tissue, comprising: positioning a first ablation component proximate to a first surface of a target tissue, the first ablation component comprising a first ablation component end effector having a first ablation component end effector housing, a first ablation component permanent magnet freely rotatable about at least one axis of rotation relative to the first ablation component end effector housing, and a first ablation component ablation element; positioning a second ablation component proximate to a second surface of a target tissue, the second ablation component comprising a second ablation component end effector having a second ablation component end effector housing, a second ablation component permanent magnet freely rotatable about at least one axis of rotation relative to the second ablation component end effector housing, and a second ablation component ablation element; allowing the first ablation component permanent magnet to freely rotate, thereby causing the first ablation component permanent magnet to self-orient into a magnetically attractive orientation with the second ablation component permanent magnet; allowing the second ablation component permanent magnet to freely rotate, thereby causing the second ablation component permanent magnet to self-orient into a magnetically attractive orientation with the first ablation component permanent magnet; positioning the first ablation component end effector and the second ablation component end effector at the target tissue using an attractive magnetic coupling between the first ablation component permanent magnet and the second ablation component permanent magnet; creating a first lesion in the target tissue using at least one of the first ablation element and the second ablation element; The method includes:

111. The step of positioning the first ablation component proximate to the first surface of the target tissue includes steering a distal portion of a first ablation component connecting element such that the first ablation component end effector is positioned distally at the first ablation component connecting element; 111. The method of claim 110, wherein the step of positioning the second ablation component proximate to the second surface of the target tissue comprises steering a distal portion of a second ablation component connecting element, the second ablation component end effector being positioned distally at the second ablation component connecting element.

112. Steering the distal portion of the first ablation component connecting element includes operating a first ablation component steering actuator disposed on a first ablation component handle of the first ablation component, the first ablation component handle being disposed proximally at the first ablation component connecting element; 112. The method of claim 111, wherein steering the distal portion of the second ablation component connecting element comprises operating a second ablation component steering actuator disposed on a second ablation component handle of the second ablation component, the second ablation component handle being disposed proximally at the second ablation component connecting element.

113. the first ablation element comprises a first ablation electrode; the second ablation element comprises a second ablation electrode; 111. The method of claim 110, wherein creating the first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element comprises applying radio frequency ablation energy to the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element.

114. 114. The method of claim 113, wherein applying radio frequency ablation energy to the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element comprises applying bipolar radio frequency ablation energy to the target tissue using the first ablation component ablation element and the second ablation component ablation element.

115. the first ablation component end effector comprises at least one first ablation component electrode; the second ablation component end effector comprises at least one second ablation component electrode; 111. The method of claim 110, wherein the method includes using at least one of the at least one first ablation element electrode and the at least one second ablation element electrode to perform at least one of pacing, sensing, stimulating, and mapping.

116. the first ablation component comprises a first ablation component connecting element, the first ablation component connecting element comprising: a generally tubular first ablation component first connecting element comprising a first ablation component first connecting element distal portion; and a first ablation component second connecting element operably coupled to the first ablation component first connecting element distal portion; the first ablation component end effector is disposed distally at a second connecting element of the first ablation component; 111. The method of claim 110, further comprising repositioning the first ablation component second connecting element and the first ablation component end effector from a retracted configuration in which the first ablation component second connecting element is disposed substantially within the first ablation component first connecting element, to a deployed configuration in which at least a portion of the first ablation component second connecting element extends from a distal portion of the first ablation component first connecting element.

117. 117. The method of claim 116, wherein the step of creating the first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element is performed while a second connecting element of the first ablation component and the first ablation component end effector are in the deployed configuration.

118. the first ablation component comprises a first ablation component handle disposed proximally at a first connecting element of the first ablation component, the first ablation component handle comprising a first ablation component deployment actuator operable to reposition a second connecting element of the first ablation component relative to a first connecting element distal portion of the first ablation component; 117. The method of claim 116, wherein repositioning the first ablation component second connecting element and the first ablation component end effector from the retracted configuration to the deployed configuration comprises operating the first ablation component deployment actuator.

119. the second ablation component comprises a second ablation component connecting element comprising: a generally tubular second ablation component first connecting element comprising a second ablation component first connecting element distal portion; and a second ablation component second connecting element operably coupled to the second ablation component first connecting element distal portion; the second ablation component end effector is disposed distally at a second connecting element of the second ablation component; 117. The method of claim 116, further comprising repositioning the second connecting element of the second ablation component and the second ablation component end effector from a retracted configuration in which the second connecting element of the second ablation component is disposed substantially within the first connecting element of the second ablation component, to a deployed configuration in which at least a portion of the second connecting element of the second ablation component extends from a distal portion of the first connecting element of the second ablation component.

120. 120. The method of claim 119, wherein the step of creating the first lesion in the target tissue using at least one of the first ablation component ablation element and the second ablation component ablation element is performed while a second connecting element of the first ablation component and the first ablation component end effector are in the deployed configuration and while a second connecting element of the second ablation component and the second ablation component end effector are in the deployed configuration.

121. the second ablation component comprises a second ablation component handle disposed proximally at a first connecting element of the second ablation component, the second ablation component handle comprising a second ablation component deployment actuator operable to reposition the second connecting element of the second ablation component relative to a first connecting element distal portion of the second ablation component; 120. The method of claim 119, wherein repositioning the second connecting element of the second ablation component and the second ablation component end effector from the retracted configuration to the deployed configuration comprises operating the second ablation component deployment actuator.

122. 117. The method of claim 116, wherein repositioning the first ablation component second connecting element and the first ablation component end effector from the retracted configuration to the deployed configuration comprises disengaging the first ablation component end effector from a first ablation component engaging element configured to selectively engage the first ablation component end effector with a first connecting element distal portion of the first ablation component.

123. 123. The method of claim 122, wherein repositioning the first ablation component second connecting element and the first ablation component end effector from the deployed configuration to the retracted configuration comprises engaging the first ablation component end effector with the first ablation component engaging element.

124. the target tissue comprises the ventricular septum of the heart; the first surface of the target tissue includes a right ventricular surface of the interventricular septum; the second surface of the target tissue includes a left ventricular surface of the interventricular septum; 111. The method of claim 110, wherein creating the first lesion in the target tissue comprises ablating the ventricular septum using the first ablation component ablation element and the second ablation component ablation element.

125. a first component configured to be positioned on a first side of the cardiac tissue and including a first component end effector including a first component electrode; a second component configured to be positioned on a second side of the cardiac tissue opposite the first side, the second component comprising a second component end effector having a second component electrode; Equipped with The system, wherein the first component and the second component are configured for cooperative use of the first component electrodes and the second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping.

126. 126. The system of claim 125, further comprising a control unit configured for cooperative use of the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping.

127. 126. The system of claim 125, wherein the cooperative use of the first component electrode and the second component electrode to perform at least one of sensing, pacing, stimulating, and mapping includes cooperative sensing using the first component electrode and the second component electrode.

128. 126. The system of claim 125, wherein the cooperative use of the first component electrode and the second component electrode to perform at least one of sensing, pacing, stimulating, and mapping includes cooperative pacing using the first component electrode and the second component electrode.

129. 126. The system of claim 125, wherein the cooperative use of the first component electrode and the second component electrode to perform at least one of sensing, pacing, stimulating, and mapping includes cooperative stimulation using the first component electrode and the second component electrode.

130. 126. The system of claim 125, wherein cooperative use of the first component electrode and the second component electrode to perform at least one of sensing, pacing, stimulating, and mapping includes cooperative mapping using the first component electrode and the second component electrode.

131. 126. The system of claim 125, wherein the cooperative use of the first and second component electrodes to perform the at least one of sensing, pacing, stimulating, and mapping includes delivering an electrical current to the cardiac tissue using one of the first and second component electrodes, and detecting at least one electrical parameter associated with the cardiac tissue using the other of the first and second component electrodes.

132. 126. The system of claim 125, wherein the first component end effector is configured to be positioned on an epicardial surface of the heart.

133. 126. The system of claim 125, wherein the first component end effector is configured to be positioned on an endocardial surface of the heart.

134. 126. The system of claim 125, wherein the second component end effector is configured to be positioned on an epicardial surface of the heart.

135. 126. The system of claim 125, wherein the second component end effector is configured to be positioned on an endocardial surface of the heart.

136. 126. The system of claim 125, wherein at least one of the first part end effector and the second part end effector comprises an ablation element.

137. the first part end effector comprises a first part magnetic element; the second part end effector comprises a second part magnetic element; 126. The system of claim 125, wherein the first and second magnetic components are configured for cooperative magnetic attraction across the cardiac tissue.

138. placing a first component adjacent to a first surface of cardiac tissue, the first component comprising a first component end effector comprising a first component electrode; positioning a second component adjacent a second surface of the cardiac tissue opposite the first surface, the second component comprising a second component end effector comprising a second component electrode; using the first component-electrodes and the second component-electrodes cooperatively to perform at least one of sensing, pacing, stimulating, and mapping; The method includes:

139. using the first component-electrodes and the second component-electrodes cooperatively to perform at least one of sensing, pacing, stimulating, and mapping; delivering an electrical current to the cardiac tissue using one of the first component electrode and the second component electrode; sensing at least one electrical parameter associated with the cardiac tissue using the other of the first and second component electrodes; 139. The method of claim 138, comprising:

140. 139. The method of claim 138, further comprising creating damage in the cardiac tissue.

141. 141. The method of claim 140, wherein creating the lesion in the cardiac tissue comprises creating the lesion in the cardiac tissue using at least one of the first component end effector and the second component end effector.

142. 142. The method of claim 141, wherein creating the lesion in the cardiac tissue using at least one of the first and second component end effectors comprises delivering ablation energy to the cardiac tissue using at least one of the first and second component electrodes.

143. 139. The method of claim 138, wherein the step of cooperatively using the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping includes identifying target locations in the cardiac tissue for future ablation.

144. 139. The method of claim 138, wherein the step of cooperatively using the first and second component electrodes to perform at least one of sensing, pacing, stimulating, and mapping includes assessing ablation.

145. Any method, operation, process, system, device, and / or apparatus associated with or described in any of claims 1 to 144.

146. Any combination of any one or more elements of any of claims 1 to 145 or recited in this claim.

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