Medical systems and methods for generating signal waveforms for pulsed field ablation

Abstract

A medical system may provide at least one high voltage pulse train configured to cause pulsed field ablation of tissue. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

Description

[0001] MEDICAL SYSTEMS AND METHODS FOR GENERATING SIGNAL WAVEFORMS

[0002] FOR PULSED FIELD ABLATION

[0003] CROSS-REFERENCE TO RELATED APPLICATIONS

[0004] This application claims the benefit of each of U.S. Provisional Application No. 63 / 672,841, filed July 18, 2024; U.S. Provisional Application No. 63 / 827,324, filed June 20, 2025; and U.S. Provisional Application No. 63 / 829,978, filed June 25, 2025, the entire disclosure of each of these applications is hereby incorporated herein by reference.

[0005] TECHNICAL FIELD

[0006] Aspects of this disclosure generally are related to medical systems and methods for generating signal waveforms for pulsed field ablation.

[0007] BACKGROUND

[0008] Cardiac surgery was initially undertaken using highly invasive open procedures. A sternotomy, which is a type of incision in the center of the chest that separates the sternum was typically employed to allow access to the heart. In the past several decades, more and more cardiac operations are performed using intravascular or percutaneous techniques, where access to inner organs or other tissue is gained via a catheter. Intravascular or percutaneous surgeries benefit patients by reducing surgery risk, complications, and recovery time.

[0009] One example of where intravascular or percutaneous medical techniques have been employed is in the treatment of a heart disorder called atrial fibrillation. Atrial fibrillation is a disorder in which spurious electrical signals cause an irregular heartbeat. Atrial fibrillation has been treated with various methods including a technique known as the “PV (pulmonary vein) isolation”. Research has shown that atrial fibrillation typically begins in the pulmonary veins or at the point where they attach to the left atrium. There are typically four major pulmonary veins, and some or all may be a focal point for activity that may cause atrial fibrillation. During this PV isolation procedure, physicians create specific patterns of lesions in the heart to block various paths taken by the spurious electrical signals. The patterns of lesions may include a pattern of one or more lesions that encircle at least one of the pulmonary veins. Lesions have typically been formed by ablating the tissue with various techniques including radiofrequency (“RF”) ablation, microwave ablation, laser ablation, and cryogenic ablation.

[0010] Recently, a new ablation modality known as pulsed field ablation (PF A) has gained significant popularity in the ablation of various tissue structures, for example, in cardiac ablation. PFA is an ablation method that employs high voltage pulsed energy delivery in proximity to target tissue. The electric field applied by the high voltage pulses in PFA physiologically changes the cells of the target tissue to which the energy is applied. In particular, the electric field applied by the high voltage pulses in PFA punctures or perforates the cell membranes to form various pores therein. If a relatively low electric field strength is established, the formed pores may close in time and cause the cells to maintain viability (e.g., a process sometimes referred to as reversible electroporation). If a relatively greater electric field strength is established, then permanent and sometimes larger, pores form in the tissue cells, which cause the cells to lose control of ion concentration gradients (both inward and outward), thereby resulting in cell death (e.g., in a process sometimes referred to as irreversible electroporation). In contrast to thermal ablation techniques such as RF ablation and cryogenic ablation, PFA is considered to be “non-thermal” in nature since the resulting tissue cellular death or destruction is not primarily or substantially dependent on thermal processes.

[0011] Conventionally, the delivered pulsed energy for PFA may have various forms, such as being formed of conventional monophasic pulses or being formed of conventional biphasic pulses. The phases of a biphasic pulse may be temporally separated by a relatively short time interval, which may be referred to as a between-phase delay or an intra-biphasic-pulse delay. Successive biphasic pulses are separated by a period of time, which may be referred to as a between-biphasic pulse delay or an inter-biphasic-pulse delay.

[0012] The present inventors recognize that PFA pulse trains including sets of biphasic pulses may have waveform characteristics whose inherent structure may adversely impact the performance of the power generation system that is employed to generate the pulsed energy for PFA. For example, PFA energy generators may employ at least one transformer. The present inventors recognize that transformer cores have a limitation on the magnetic flux that can be generated within them, and transformer saturation may occur when this limitation is exceeded. The magnetic flux accumulates based on the time integral of the applied voltage. The present inventors recognize that, in order to keep the transformer from accumulating too much magnetic flux, alternating current may be employed to balance the time and voltage of one polarity pulse with an equal time and voltage of the opposite polarity pulse. However, the present inventors recognize that, since power generation systems are not ideal and, therefore, are unable to produce idealized pulse characteristics, the net magnetic flux or charge for each set of alternating polarity monophasic pulses might not be zero due to differences (including differences within nominal tolerances) between the actual pulse shapes or other characteristics of the monophasic pulses produced by the power generation system. Accordingly, depending on the inter-biphasic pulse delays, the present inventors recognize that this net magnetic flux may accumulate in the transformer over time due to these non-ideal pulse shape or other waveform characteristic differences. The present inventors recognize that accumulated magnetic flux in a transformer of a power generation system may lead to reduced performance, which may have a negative impact on medical treatment procedures. Accordingly, the present inventors recognize that a need in the art exists at least for techniques for improving operating characteristics of power generation systems, such as those for PF A.

[0013] SUMMARY

[0014] At least the above-discussed need is addressed and technical solutions are achieved in the art by various embodiments of the present invention. According to some embodiments, a medical system may be summarized as including a data processing device system, and an inputoutput device system communicatively connected to the data processing device system. The input-output device system may be communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The medical system may include a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. According to various embodiments, the data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train including a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses including a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train. According to some embodiments, the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity. According to some embodiments, the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

[0015] In some embodiments, the first biphasic voltage pulse may include a first intra-biphasic- pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse. In some embodiments, the second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by an inter-biphasic-pulse delay, and the inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay. In some embodiments, a duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and the inter-biphasic- pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, a duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and the inter-biphasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, a duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and the inter-biphasic-pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, a duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and the inter- biphasic-pulse delay may be between 100 milliseconds and 1.5 seconds. In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a pulse duration between 1 microsecond and 8 microseconds. In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a pulse amplitude between 200 V and 3000 V. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b). In some embodiments, each respective inter-pulse-train delay may be greater in duration than the inter- biphasic-pulse delay.

[0016] In some embodiments, (a) each of the first monophasic voltage pulse and the second monophasic voltage pulse may have a same pulse duration, (b) each of the third monophasic voltage pulse and the fourth monophasic voltage pulse may have a same pulse duration, or (a) and (b). In some embodiments, (a) the first monophasic voltage pulse and the second monophasic voltage pulse may have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse may have different pulse durations, or (a) and (b).

[0017] In some embodiments, the plurality of biphasic voltage pulses may include (a) a first plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics as the first biphasic voltage pulse, and (b) a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the second plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics as the second biphasic voltage pulse. In some embodiments, the pulses of the first plurality of biphasic voltage pulses may alternate with the pulses of the second plurality of biphasic voltage pulses. In some embodiments, the plurality of biphasic voltage pulses may include an interleaving of a first plurality of biphasic voltage pulses and a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having a sequence of a first particular monophasic voltage pulse of the first polarity followed by a second particular monophasic voltage pulse of the second polarity, and each biphasic voltage pulse in the second plurality of biphasic voltage pulses having a sequence of a third particular monophasic voltage pulse of the second polarity followed by a fourth particular monophasic voltage pulse of the first polarity.

[0018] In some embodiments, the energy source device system circuit may be configured to generate each pulse train of the at least one pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

[0019] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0020] According to some embodiments, a medical system may summarized as including a data processing device system, and an input-output device system communicatively connected to the data processing device system. In some embodiments, the input-output device system may be communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. In some embodiments, the medical system may include a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. According to various embodiments, the data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. According to various embodiments, each pulse train of the at least one pulse train may include a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity. In some embodiments, the first monophasic voltage pulses of the plurality of first monophasic voltage pulses may be successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter- monophasic-pulse delay. In some embodiments, the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train may have a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

[0021] In some embodiments, the four successive pairs of first monophasic voltage pulses in the pulse train may exclude the initial monophasic pulse having the first polarity in the pulse train and the last monophasic pulse having the first polarity in the pulse train.

[0022] In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective first inter-monophasic-pulse delays, and the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic- pulse delays may cycle between a first duration and a second duration. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds.

[0023] In some embodiments, the four successive pairs of first monophasic voltage pulses in the pulse train may include a sequence of the respective first inter-monophasic-pulse delays. In some embodiments, the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays may cycle between a first duration and a second duration. In some embodiments, each pulse train of the at least one pulse train may include a particular monophasic voltage pulse having a particular pulse width, and the first duration may be longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, each pulse train of the at least one pulse train may include a particular monophasic voltage pulse having a particular pulse width, and the first duration may be longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, a polarity of the particular monophasic voltage pulse may be opposite the first polarity of the first monophasic voltage pulses of the plurality of first monophasic voltage pulses.

[0024] In some embodiments, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses may have a pulse amplitude between 200 V and 3000 V. In some embodiments, the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a same duration.

[0025] In some embodiments, the energy source device system circuit may be configured to generate each pulse train of the at least one pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains may be spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii), wherein each respective inter-pulse-train delay is greater in duration than each respective first inter-monophasic-pulse delay.

[0026] In some embodiments, each pulse train of the at least one pulse train may include a plurality of second monophasic voltage pulses, the plurality of second monophasic voltage pulses including at least four successive pairs of second monophasic voltage pulses in the pulse train, each second monophasic voltage pulse of the plurality of second monophasic voltage pulses having a same second polarity that is opposite the first polarity of the first monophasic voltage pulses of the plurality of first monophasic voltage pulses, and the second monophasic voltage pulses of the plurality of second monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay. In some embodiments, the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of each pair of the four successive pairs of second monophasic voltage pulses in the pulse train may have a different duration as compared with the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of (c) a sequentially preceding pair of the successive second monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of second monophasic voltage pulses in the pulse train, and (d) a sequentially succeeding pair of the successive second monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of second monophasic voltage pulses in the pulse train.

[0027] In some embodiments, the four successive pairs of second monophasic voltage pulses in the pulse train may exclude the initial monophasic pulse having the second polarity in the pulse train and the last monophasic pulse having the second polarity in the pulse train. In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective second inter-monophasic-pulse delays, and the successive respective second inter- monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between a first duration and a second duration, the second duration different than the first duration. In some embodiments, the four successive pairs of second monophasic voltage pulses in the pulse train may include a sequence of the respective second inter- monophasic-pulse delays, and the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between a first duration and a second duration, the second duration different than the first duration.

[0028] In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective first inter-monophasic-pulse delays. The successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays may cycle between a first duration and a second duration. In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective second inter- monophasic-pulse delays, and the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between the first duration and the second duration. According to some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, a duration of each of the respective first inter-monophasic-pulse delays and the respective second inter-monophasic-pulse delays may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses and each second monophasic voltage pulse of the plurality of second monophasic voltage pulses may have a pulse amplitude between 200 V and 3000 V. In some embodiments, a duration of each of the respective first inter-monophasic-pulse delays and the respective second inter-monophasic-pulse delays may be between 100 milliseconds and 1.5 seconds.

[0029] In some embodiments, the four successive pairs of first monophasic voltage pulses in the pulse train may include a sequence of the respective first inter-monophasic-pulse delays. The successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays may cycle between a first duration and a second duration. The four successive pairs of second monophasic voltage pulses in the pulse train may include a sequence of the respective second inter-monophasic-pulse delays, and, in some embodiments, the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between the first duration and the second duration.

[0030] In some embodiments, the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of a particular pair of successive second monophasic voltage pulses in the plurality of second monophasic voltage pulses has a duration that is different than a duration of the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a particular pair of successive first monophasic voltage pulses in the plurality of first monophasic voltage pulses, the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of the particular pair of successive second monophasic voltage pulses in the plurality of second monophasic voltage pulses occurring during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of the particular pair of successive first monophasic voltage pulses in the plurality of first monophasic voltage pulses.

[0031] In some embodiments, the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a same first duration, and the second monophasic voltage pulses in the plurality of second monophasic voltage pulses may have a same second duration. In some embodiments, the second duration may be equal to the first duration. In some embodiments, (i) each of the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses in the plurality of second monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

[0032] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above. According to some embodiments, a medical system may be summarized as including a data processing device system, and an input-output device system communicatively connected to the data processing device system. In some embodiments, the input-output device system may be communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. In some embodiments, the medical system may include a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. According to some embodiments, the data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity. In some embodiments, the first monophasic voltage pulses may be successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay. In some embodiments, the data processing device system may be configured by the program at least to cause provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

[0033] In some embodiments, each pulse train of the at least one pulse train may be provided such that the pulse train exhibits the different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the monophasic voltage pulses of at least four pairs of successive ones of the first monophasic voltage pulses in the pulse train. In some embodiments, the different numbers of second monophasic voltage pulses may cycle between a first number of second monophasic voltage pulses and a second number of second monophasic voltage pulses, the second number of second monophasic voltage pulses different than the first number of second monophasic voltage pulses. In some embodiments, the first number of second monophasic voltage pulses is zero and the second number of monophasic voltage pulses is an integer greater than or equal to two.

[0034] In some embodiments, for each pulse train of the at least one pulse train, the second monophasic voltage pulses may be successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay. In some embodiments, the data processing device system may be configured by the program at least to cause provision of each pulse train of the at least one pulse train such that multiple first monophasic voltage pulses are provided during the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of a first pair of successive second monophasic voltage pulses in the pulse train. In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective second inter-monophasic-pulse delays, and the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between a first duration and a second duration. In some embodiments, each of the first duration and the second duration may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first duration and the second duration may be between 100 milliseconds and 1.5 seconds.

[0035] In some embodiments, for each pulse train of the at least one pulse train, the second monophasic voltage pulses may be successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay. The data processing device system may be configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of first monophasic voltage pulses during the respective second inter-monophasic-pulse delays between the second monophasic voltage pulses of at least two pairs of successive second monophasic voltage pulses in the pulse train.

[0036] In some embodiments, for each pulse train of the at least one pulse train, the second monophasic voltage pulses may be successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay. The data processing device system may be configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of first monophasic voltage pulses during the respective second inter-monophasic-pulse delays between the second monophasic voltage pulses of at least four pairs of successive second monophasic voltage pulses in the pulse train. According to some embodiments, the different numbers of first monophasic voltage pulses may cycle between a first number of first monophasic voltage pulses and a second number of first monophasic voltage pulses in the plurality of first monophasic voltage pulses of the pulse train, the second number of first monophasic voltage pulses different than the first number of first monophasic voltage pulses.

[0037] In some embodiments, one of the different numbers of second monophasic voltage pulses that is provided during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of the at least two pairs of successive first monophasic voltage pulses in the pulse train is zero.

[0038] In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective first inter-monophasic-pulse delays, and the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic- pulse delays may cycle between a first duration and a second duration. In some embodiments, each of the first duration and the second duration may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each first monophasic voltage pulse and each second monophasic voltage pulse may have a pulse amplitude between 200 V and 3000 V. In some embodiments, each of the first duration and the second duration may be between 100 milliseconds and 1.5 seconds. In some embodiments, each pulse train of the at least one pulse train may include a particular monophasic voltage pulse having a particular pulse width. In some embodiments, the first duration may be longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, the first duration is longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, the particular monophasic voltage pulse may be from the plurality of second monophasic voltage pulses.

[0039] In some embodiments, the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a same duration. In some embodiments, the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a same first duration, and the second monophasic voltage pulses in the plurality of second monophasic voltage pulses may have a same second duration. In some embodiments, the second duration may be equal to the first duration.

[0040] In some embodiments, (i) each of the first monophasic voltage pulses in the plurality of first monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses in the plurality of second monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

[0041] In some embodiments, the energy source device system circuit may be configured to generate each pulse train of the at least one pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains may be spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii). According to various embodiments, each respective interpulse-train delay may be greater in duration than each respective first inter-monophasic-pulse delay.

[0042] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0043] According to some embodiments, a medical system may be summarized as including a data processing device system, and an input-output device system communicatively connected to the data processing device system. The input-output device system may be communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. In some embodiments, the medical system may include a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. In some embodiments, the data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train may include multiple groups of voltage pulses sequentially arranged in the pulse train. According to various embodiments, each group of voltage pulses of the multiple groups of voltage pulses may include: (a) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omits provision of any voltage pulses in the pulse train having other than the first polarity, and (b) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter- monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity. According to various embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses may be provided after completion of the provision of the sequence of first monophasic voltage pulses. According to various embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses may be different than (i) a duration of each respective first inter-monophasic- pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

[0044] In some embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses may be shorter than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses. In some embodiments, a duration of each respective first inter-monophasic-pulse delay and each respective second inter-monophasic-pulse delay may be between 100 milliseconds and 1.5 seconds.

[0045] In some embodiments, a duration of each respective first inter-monophasic-pulse delay and each respective second inter-monophasic-pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, a duration of each respective first inter- monophasic-pulse delay and each respective second inter-monophasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, a duration of each respective first inter-monophasic-pulse delay and each respective second inter-monophasic- pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, each first monophasic voltage pulse and each second monophasic voltage pulse may have a pulse amplitude between 200 V and 3000 V.

[0046] In some embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, the monophasic voltage pulses in the sequence of first monophasic voltage pulses may have a same duration. In some embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, the monophasic voltage pulses in the sequence of second monophasic voltage pulses may have a same duration. In some embodiments, for each group of voltage pulses of the multiple groups of voltage pulses the monophasic voltage pulses in the sequence of first monophasic voltage pulses may have a same first duration, and the monophasic voltage pulses in the sequence of second monophasic voltage pulses may have a same second duration. In some embodiments, the second duration may be equal to the first duration. In some embodiments, for each group of voltage pulses of the multiple groups of voltage pulses, (i) each of the monophasic voltage pulses in the sequence of first monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, (ii) each of the monophasic voltage pulses in the sequence of second monophasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

[0047] In some embodiments, the energy source device system circuit may be configured to generate each pulse train of the at least one pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains may be spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii). According to some embodiments, each respective interpulse-train delay may be greater in duration than (iii) each respective first inter-monophasic- pulse delay, (iv) each respective second inter-monophasic-pulse delay, or each of (iii) and (iv).

[0048] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0049] According to some embodiments, a medical system may be summarized as including a data processing device system, and an input-output device system communicatively connected to the data processing device system. The input-output device system may be communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. According to some embodiments, the medical system may include a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. According to some embodiments, the data processing device system may be configured by the program at least to cause, via the inputoutput device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train including a plurality of biphasic voltage pulses. According to some embodiments, each biphasic voltage pulse in the plurality of biphasic voltage pulses may include a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity. According to some embodiments, the first monophasic voltage pulses of the biphasic voltage pulses may have a same duration and the second monophasic voltage pulses of the biphasic voltage pulses may have a same duration. According to some embodiments, the biphasic voltage pulses may be successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay. According to some embodiments, the respective inter-biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train may be different than the respective inter-biphasic-pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present. In some embodiments, the pulse train may include a sequence of the respective inter- biphasic-pulse delays, and the successive respective inter-biphasic-pulse delays in the sequence of the respective inter-biphasic-pulse delays may cycle between a first duration and a second duration. In some embodiments, each of the first duration and the second duration may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first duration and the second duration may be between 100 milliseconds and 1.5 seconds.

[0050] In some embodiments, a biphasic pulse width of each biphasic voltage pulse of the plurality of biphasic voltage pulses may have a same duration. In some embodiments, (i) the first monophasic voltage pulse of each biphasic voltage pulse of the plurality of biphasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, (ii) the second monophasic voltage pulse of each biphasic voltage pulse of the plurality of biphasic voltage pulses may have a duration between 1 microsecond and 8 microseconds, or both (i) and (ii). In some embodiments, (i) the first monophasic voltage pulse of each of at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses may have a pulse amplitude between 200 V and 3000 V, (ii) the second monophasic voltage pulse of each of the at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses may have a pulse amplitude between 200 V and 3000 V, or both (i) and (ii).

[0051] In some embodiments, each of the biphasic voltage pulses of the plurality of biphasic voltage pulses may include an intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse. According to some embodiments, the intra- biphasic-pulse delay of each particular biphasic voltage pulse of at least some of the biphasic voltage pulses in the plurality of biphasic voltage pulses may have a duration that is less than a duration of the respective inter-biphasic-delay between any pair of successive biphasic voltage pulses in the pulse train. In some embodiments, the intra-biphasic-pulse delay of each of at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses may have a duration between 0 and 8 microseconds. In some embodiments, each respective inter-biphasic- pulse delay may have a duration between 300 microseconds and 1000 microseconds. In some embodiments, each respective inter-biphasic-pulse delay may have a duration between 0.5 milliseconds and 15 milliseconds. In some embodiments, each respective inter-biphasic-pulse delay may have a duration between 15 milliseconds and 30 milliseconds. In some embodiments, each respective inter-biphasic-pulse delay may have a duration that is between 100 milliseconds and 1.5 seconds.

[0052] In some embodiments, the energy source device system circuit may be configured to generate each pulse train of the at least one pulse train. In some embodiments, the data processing device system may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains may be spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii). According to some embodiments, each respective interpulse-train delay may be greater in duration than each respective inter-biphasic-pulse delay. In some embodiments, the plurality of biphasic voltage pulses may include (a) a first plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics, and (b) a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the second plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics. According to various embodiments, the pulses of the first plurality of biphasic voltage pulses may alternate with the pulses of the second plurality of biphasic voltage pulses. In some embodiments, the plurality of biphasic voltage pulses may include an interleaving of a first plurality of biphasic voltage pulses and a second plurality of biphasic voltage pulses. According to some embodiments, each biphasic voltage pulse in the first plurality of biphasic voltage pulses may have a sequence of a first particular monophasic voltage pulse of the first polarity followed by a second particular monophasic voltage pulse of the second polarity, and each biphasic voltage pulse in the second plurality of biphasic voltage pulses may have a sequence of a third particular monophasic voltage pulse of the second polarity followed by a fourth particular monophasic voltage pulse of the first polarity.

[0053] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0054] According to some embodiments, a medical system may summarized as including a data processing device system; an input-output device system communicatively connected to the data processing device system; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity. The third biphasic voltage pulse may include a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse, the fifth monophasic voltage pulse having the first polarity and the sixth monophasic voltage pulse having the second polarity. Each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse may be provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets.

[0055] In some embodiments, each electrode in each respective electrode set of the plurality of electrode sets is not included in any other electrode set of the plurality of electrode sets.

[0056] In some embodiments, the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse may be a first group of three sequential biphasic voltage pulses in the pulse train, and the three sequential biphasic voltage pulses may be repeated as a second group of three sequential biphasic voltage pulses in the pulse train. Each biphasic voltage pulse in the second group of three sequential biphasic voltage pulses may be provided to the same respective electrode set of the plurality of electrode sets to which the corresponding biphasic voltage pulse of the first group of three sequential biphasic voltage pulses is provided. In some embodiments, the pulse train may include at least one biphasic voltage pulse between the first group of three sequential biphasic voltage pulses and the second group of three sequential biphasic voltage pulses.

[0057] In some embodiments, the first biphasic voltage pulse may include a first intra-biphasic- pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, and the third biphasic voltage pulse may include a third intra-biphasic-pulse delay between the fifth monophasic voltage pulse and the sixth monophasic voltage pulse. In some embodiments, the second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the third biphasic voltage pulse may be spaced from the second biphasic voltage pulse by a second inter-biphasic-pulse delay.

[0058] In some embodiments, the first inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic-pulse delay, and the second inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic-pulse delay. In some embodiments, a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay may be between 0 and 8 microseconds, and a respective duration of each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra- biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra- biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra- biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay may be between 100 milliseconds and 1.5 seconds. In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse may have a respective pulse duration between 1 microsecond and 8 microseconds. In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse may have a respective pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, the second inter-biphasic-pulse delay may have a different duration than the first inter-biphasic-pulse delay. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains may be spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), and each respective inter-pulse-train delay may be greater in duration than each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay.

[0059] In some embodiments, (a) the first monophasic voltage pulse and the second monophasic voltage pulse may have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse may have different pulse durations, (c) the fifth monophasic voltage pulse and the sixth monophasic voltage pulse may have different pulse durations, or (a) and (b), (a) and (c), (b) and (c), or (a), (b), and (c).

[0060] In some embodiments, the second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay of a first duration, the third biphasic voltage pulse may be spaced from the second biphasic voltage pulse by a second inter-biphasic- pulse delay of a second duration, and the first duration may be different than the second duration.

[0061] In some embodiments, the first biphasic voltage pulse may include a first intra-biphasic- pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, and the third biphasic voltage pulse may include a third intra-biphasic-pulse delay between the fifth monophasic voltage pulse and the sixth monophasic voltage pulse, and each of the first intra- biphasic-pulse delay and the third intra-biphasic-pulse delay may be of a first duration, and the second intra-biphasic-pulse delay may be of a second duration.

[0062] In some embodiments, each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse may have a duration between 1 microsecond and 8 microseconds. In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0063] According to some embodiments, a medical system may summarized as including a data processing device system; an input-output device system communicatively connected to the data processing device system; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter. Each electrode set of the plurality of electrode sets may include at least one electrode that is not included in any other electrode set of the plurality of electrode sets. The data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of sequences of biphasic voltage pulses. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses. In each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be provided to a respective electrode set of the plurality of electrode sets. The second biphasic voltage pulse in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided. The particular monophasic voltage pulse may have the second polarity.

[0064] In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the particular monophasic voltage pulse in the pulse train may be the second monophasic voltage pulse of the first biphasic voltage pulse of another sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses.

[0065] In some embodiments, each electrode in each electrode set of the respective electrode sets of the plurality of electrode sets may be other than any electrode in any other electrode set of the respective electrode sets of the plurality of electrode sets.

[0066] In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the pulse train does not include any pulse between the first and second monophasic voltage pulses of the first biphasic voltage pulse of the sequence of biphasic voltage pulses. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the pulse train does not include any pulse between the third and fourth monophasic voltage pulses of the second biphasic voltage pulse of the sequence of biphasic voltage pulses.

[0067] In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: the first biphasic voltage pulse may include a first intra- biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, the second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the first inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 100 milliseconds and 1.5 seconds. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a respective pulse duration between 1 microsecond and 8 microseconds. In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a respective pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains. Each pulse train in the sequence of pulse trains may be spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b). And, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, each respective inter-pulse-train delay may be greater in duration than the first inter-biphasic-pulse delay.

[0068] In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: (a) the first monophasic voltage pulse and the second monophasic voltage pulse may have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse may have different pulse durations, or (a) and (b).

[0069] In some embodiments, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a duration between 1 microsecond and 8 microseconds.

[0070] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0071] According to some embodiments, a medical system may summarized as including a data processing device system; an input-output device system communicatively connected to the data processing device system; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The data processing device system may be configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include at least three biphasic voltage pulses. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses may include a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse, the respective second monophasic voltage pulse following the respective first monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses may be successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses. For each pulse train of the at least one pulse train, the pulse train may include at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may include a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse, the respective second particular monophasic voltage pulse following the respective first particular monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may have a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses.

[0072] In some embodiments, for each pulse train of the at least one pulse train, three biphasic pulses of the at least three biphasic voltage pulses are successively arranged in the pulse train, and wherein each of the three biphasic pulses may be provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets. In some embodiments, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses in the pulse train may be other than the at least three biphasic voltage pulses in the pulse train.

[0073] In some embodiments, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses in the pulse train may be included in the at least three biphasic voltage pulses in the pulse train.

[0074] In some embodiments, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses may be provided to the particular electrode set of the at least some electrodes of the plurality of electrodes according to a particular sequence, and for each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train, the second particular biphasic voltage pulse may occur immediately after the first particular biphasic voltage pulse in the particular sequence.

[0075] In some embodiments, for each pulse train of the at least one pulse train, the pulse train may include at least one biphasic voltage pulse provided to an electrode set of the at least some electrodes of the plurality of electrodes. The electrode set may be other than the particular electrode set, and the at least one biphasic voltage pulse may occur between the first particular biphasic voltage pulse and the second particular biphasic voltage pulse in the pulse train. In some embodiments, the electrode set may be mutually exclusive with the particular electrode set.

[0076] In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: the first biphasic voltage pulse may include a first intra-biphasic-pulse delay between the respective first monophasic voltage pulse and the respective second monophasic voltage pulse, and the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the respective first monophasic voltage pulse and the respective second monophasic voltage pulse. The second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the first inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra-biphasic- pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 100 milliseconds and 1.5 seconds. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse may have a respective pulse duration between 1 microsecond and 8 microseconds, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse may have a respective pulse duration between 1 microsecond and 8 microseconds. In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse may have a respective pulse duration between 0.01 microseconds and 1 microsecond, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse may have a respective pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence of pulse trains. Each pulse train in the sequence of pulse trains may be spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b). For each pulse train of the plurality of pulse trains and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train, each respective inter-pulse-train delay may be greater in duration than the first inter-biphasic-pulse delay.

[0077] In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: (a) the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse may have different pulse durations, (b) the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse may have different pulse durations, or (a) and (b).

[0078] In some embodiments, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse may have a duration between 1 microsecond and 8 microseconds, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse may have a duration between 1 microsecond and 8 microseconds.

[0079] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0080] According to some embodiments, a medical system may summarized as including a data processing device system; an input-output device system communicatively connected to the data processing device system; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The data processing device system configured by the program at least to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse. Each of the first biphasic voltage pulse and the second biphasic voltage pulse may be provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse having the first polarity.

[0081] In some embodiments, for each pulse train of the at least one pulse train, the pulse train does not include any pulse between the first and second monophasic voltage pulses of the first biphasic voltage pulse.

[0082] In some embodiments, for each pulse train of the at least one pulse train, the pulse train does not include any pulse between the third and fourth monophasic voltage pulses of the second biphasic voltage pulse.

[0083] In some embodiments, for each pulse train of the at least one pulse train: the first biphasic voltage pulse may include a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse may include a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse. The second biphasic voltage pulse may be spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay. The first inter-biphasic-pulse delay may be greater in duration than each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay. In some embodiments, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 300 microseconds and 1000 microseconds. In some embodiments, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic- pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter- biphasic-pulse delay may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 15 milliseconds and 30 milliseconds. In some embodiments, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra-biphasic-pulse delay may be between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay may be between 100 milliseconds and 1.5 seconds. In some embodiments, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a respective pulse duration between 1 microsecond and 8 microseconds. In some embodiments, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a respective pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, the at least one pulse train includes a plurality of pulse trains arranged in a sequence of pulse trains. Each pulse train in the sequence of pulse trains may be spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b). For each pulse train of the at least one pulse train, each respective inter-pulse-train delay may be greater in duration than the first inter-biphasic-pulse delay.

[0084] In some embodiments, for each pulse train of the at least one pulse train: (a) the first monophasic voltage pulse and the second monophasic voltage pulse may have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse may have different pulse durations, or (a) and (b).

[0085] In some embodiments, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a duration between 1 microsecond and 8 microseconds.

[0086] In some embodiments, various medical systems may include combinations and subcombinations of the systems described above.

[0087] Various embodiments of the present invention may include systems, devices, or machines that are or include combinations or subsets of any one or more of the systems, devices, or machines and associated features thereof summarized above or otherwise described herein (which should be deemed to include the figures).

[0088] Further, all or part of any one or more of the systems, devices, or machines summarized above or otherwise described herein or combinations or sub-combinations thereof may implement or execute all or part of any one or more of the processes or methods described herein or combinations or sub-combinations thereof.

[0089] For example, in some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system may also be communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

[0090] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system also may be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses of the plurality of first monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter-monophasic-pulse delay. The respective first inter- monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train may have a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

[0091] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system also may be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity. The first monophasic voltage pulses may be successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay. The method may include causing provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train. The method may include causing provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

[0092] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising multiple groups of voltage pulses sequentially arranged in the pulse train. Each group of voltage pulses of the multiple groups of voltage pulses may include:

[0093] (a) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omits provision of any voltage pulses in the pulse train having other than the first polarity, and

[0094] (b) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter-monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity.

[0095] For each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses may be provided after completion of the provision of the sequence of first monophasic voltage pulses.

[0096] For each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses may be different than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

[0097] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train including a plurality of biphasic voltage pulses. Each biphasic voltage pulse in the plurality of biphasic voltage pulses may include a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity, the first monophasic voltage pulses of the biphasic voltage pulses having a same duration and the second monophasic voltage pulses of the biphasic voltage pulses having a same duration. The biphasic voltage pulses may be successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay. The respective inter- biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train may be different than the respective inter-biphasic- pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present.

[0098] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, and the third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse having the first polarity. The third biphasic voltage pulse may include a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse. The fifth monophasic voltage pulse may have the first polarity and the sixth monophasic voltage pulse may have the second polarity. Each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse may be provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes. Each electrode set of the plurality of electrode sets may include at least one electrode not included in any other electrode set of the plurality of electrode sets.

[0099] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter. Each electrode set of the plurality of electrode sets may include at least one electrode that is not included in any other electrode set of the plurality of electrode sets. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of sequences of biphasic voltage pulses. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses. In each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be provided to a respective electrode set of the plurality of electrode sets. The second biphasic voltage pulse in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided. The particular monophasic voltage pulse may have the second polarity.

[0100] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include at least three biphasic voltage pulses. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses may include a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse. The respective second monophasic voltage pulse may follow the respective first monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses may be successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses. For each pulse train of the at least one pulse train, the pulse train may include at least two biphasic voltage pulses. Each biphasic voltage pulse of the at least two biphasic voltage pulses may be provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may include a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse. The respective second particular monophasic voltage pulse may follow the respective first particular monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may have a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses.

[0101] In some embodiments, a method may be executed by a data processing device system according to a program stored by a communicatively connected memory device system. The data processing device system may also be communicatively connected to an input-output device system. The input-output device system maybe communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The method may include causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse. Each of the first biphasic voltage pulse and the second biphasic voltage pulse may be provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity.

[0102] It should be noted that various embodiments of the present invention include variations of the methods or processes summarized above or otherwise described herein (which should be deemed to include the figures) and, accordingly, are not limited to the actions described or shown in the figures or their ordering, and not all actions shown or described are required according to various embodiments. According to various embodiments, such methods may include more or fewer actions and different orderings of actions. Any of the features of all or part of any one or more of the methods or processes summarized above or otherwise described herein may be combined with any of the other features of all or part of any one or more of the methods or processes summarized above or otherwise described herein.

[0103] In addition, a computer program product may be provided that includes program code portions for performing some or all of any one or more of the methods or processes and associated features thereof described herein, when the computer program product is executed by a computer or other computing device or device system. Such a computer program product may be stored on one or more computer-readable storage mediums, also referred to as one or more computer-readable data storage mediums or a computer-readable storage medium system.

[0104] For example, in some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an input-output device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the inputoutput device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train. The first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

[0105] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses of the plurality of first monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter-monophasic-pulse delay. The respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train may have a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

[0106] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity. The first monophasic voltage pulses may be successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay. The provision instructions may be configured to cause provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train. The provision instructions may be configured to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

[0107] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising multiple groups of voltage pulses sequentially arranged in the pulse train. Each group of voltage pulses of the multiple groups of voltage pulses may include (a) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter- monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omits provision of any voltage pulses in the pulse train having other than the first polarity, and (b) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter-monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity. For each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses may be provided after completion of the provision of the sequence of first monophasic voltage pulses. For each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses may be different than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

[0108] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses. Each biphasic voltage pulse in the plurality of biphasic voltage pulses may include a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity. The first monophasic voltage pulses of the biphasic voltage pulses may have a same duration and the second monophasic voltage pulses of the biphasic voltage pulses may have a same duration. The biphasic voltage pulses may be successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay. The respective inter-biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train may be different than the respective inter-biphasic-pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present.

[0109] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity. The third biphasic voltage pulse may include a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse. The fifth monophasic voltage pulse may have the first polarity and the sixth monophasic voltage pulse may have the second polarity. Each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse may be provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes. Each electrode set of the plurality of electrode sets may include at least one electrode not included in any other electrode set of the plurality of electrode sets.

[0110] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter. Each electrode set of the plurality of electrode sets may include at least one electrode that is not included in any other electrode set of the plurality of electrode sets. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of sequences of biphasic voltage pulses. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses. In each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity. Each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be provided to a respective electrode set of the plurality of electrode sets. The second biphasic voltage pulse in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses may be sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided. The particular monophasic voltage pulse may have the second polarity.

[0111] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include at least three biphasic voltage pulses. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses may include a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse. The respective second monophasic voltage pulse may follow the respective first monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses may be successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses. For each pulse train of the at least one pulse train, the pulse train may include at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. For each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may include a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse. The respective second particular monophasic voltage pulse may follow the respective first particular monophasic voltage pulse in the pulse train. For each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train may have a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses.

[0112] In some embodiments, one or more computer-readable storage mediums may store a program executable by a data processing device system communicatively connected to an inputoutput device system. The input-output device system may be communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter. The program may include provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train. Each pulse train of the at least one pulse train may include a plurality of biphasic voltage pulses. The plurality of biphasic voltage pulses may include a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse. Each of the first biphasic voltage pulse and the second biphasic voltage pulse may be provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. The first biphasic voltage pulse may include a first monophasic voltage pulse followed by a second monophasic voltage pulse. The first monophasic voltage pulse may have a first polarity and the second monophasic voltage pulse may have a second polarity opposite the first polarity. The second biphasic voltage pulse may include a third monophasic voltage pulse followed by a fourth monophasic voltage pulse. The third monophasic voltage pulse may have the second polarity and the fourth monophasic voltage pulse may have the first polarity.

[0113] In some embodiments, each of any of one or more or all of the computer-readable storage mediums or medium systems (also referred to as processor-accessible memory device systems) described herein is a non-transitory computer-readable (or processor-accessible) data storage medium or medium system (or memory device system) including or consisting of one or more non-transitory computer-readable (or processor-accessible) storage mediums (or memory devices) storing the respective program(s) which may configure a data processing device system to execute some or all of any of one or more of the methods or processes described herein.

[0114] Further, any of all or part of one or more of the methods or processes and associated features thereof discussed herein may be implemented or executed on or by all or part of a device system, apparatus, or machine, such as all or a part of any of one or more of the systems, apparatuses, or machines described herein or a combination or sub-combination thereof. BRIEF DESCRIPTION OF THE DRAWINGS

[0115] It is to be understood that the attached drawings are for the purposes of illustrating aspects of various embodiments and may include elements that are not to scale. It is noted that like reference characters in different figures refer to the same objects.

[0116] FIG. 1 includes a schematic representation of a medical system according to various example embodiments, the medical system including a data processing device system, an inputoutput device system, and a memory device system.

[0117] FIG. 2 includes a cutaway diagram of a heart showing a transducer-based device percutaneously placed in a left atrium of the heart, according to various example embodiments.

[0118] FIG. 3A includes a partially schematic representation of a medical system according to various example embodiments, the medical system including a data processing device system, an input-output device system, a memory device system, and a transducer-based device including a plurality of transducers and an expandable structure shown in a delivery or unexpanded configuration.

[0119] FIG. 3B includes the representation of the medical system of FIG. 3 A with the expandable structure shown in a deployed or expanded configuration, according to some embodiments.

[0120] FIG. 4 includes a schematic representation of a transducer-based device that includes a flexible circuit structure, according to various example embodiments.

[0121] FIG. 5 A includes a block diagram of various methods for generating signal waveforms for pulsed field ablation, according to various example embodiments.

[0122] Each of FIGS. 5B, 5C, 5D, and 5E includes a block diagram of various respective embodiments of the methods of FIG. 5 A, according to various example embodiments.

[0123] Each of FIGS. 6A, 6B illustrates at least a portion of a pulse train including a plurality of biphasic voltage pulses sequentially arranged in the pulse train, the biphasic voltage pulses having different polarity sequences, according to various example embodiments.

[0124] FIG. 6C illustrates at least a portion of a pulse train including a plurality of biphasic voltage pulses sequentially arranged in the pulse train, the biphasic voltage pulses having different polarity sequences where inter-biphasic-pulse delays between biphasic voltage pulses are different, according to various example embodiments.

[0125] FIG. 6D illustrates at least a portion of a pulse train including a plurality of biphasic voltage pulses sequentially arranged in the pulse train, each biphasic voltage pulse including a first monophasic voltage pulse having a first particular polarity followed by a second monophasic voltage pulse having a second particular polarity opposite the first particular polarity, where inter -biphasic-pulse delays between biphasic voltage pulses are different, according to various example embodiments.

[0126] FIG. 6E illustrates at least a portion of a pulse train including a plurality of biphasic voltage pulses sequentially arranged in the pulse train, the biphasic voltage pulses having different polarity sequences, and the pulses shown having different pulse widths, according to various example embodiments.

[0127] FIG. 6F illustrates at least a portion of a pulse train including a plurality of sequences of biphasic voltage pulses distributed to respective electrode sets, according to various example embodiments.

[0128] FIG. 7A illustrates a model of the magnetic flux effects associated with a transformer of a PFA power generator from a provided biphasic voltage pulse.

[0129] FIG. 7B illustrates an enlarged view of a portion of FIG. 7A showing residual magnetic flux associated with a transformer of a PFA power generator from a provided biphasic voltage pulse.

[0130] DETAILED DESCRIPTION

[0131] At least the above-discussed need in the art is addressed, and technical solutions are achieved by various embodiments of the present invention. In some embodiments, improved pulse train waveform characteristics are provided, which may be particularly beneficial at least in the context of PFA. In some embodiments, an energy source device system circuit is configured to provide pulsed field ablative energy at least by providing a pulse train including sequential biphasic voltage pulses having different voltage polarity sequences. Such a configuration of signal waveforms for pulsed field ablation, according to some embodiments, may reduce the rate of accumulation of magnetic flux in a transformer of the energy source device system circuit, in some contexts or use cases. In some embodiments, an energy source device system circuit is configured to provide pulsed field ablative energy at least by providing a pulse train including sequential biphasic voltage pulses having different inter-biphasic-pulse delays. Such a configuration of signal waveforms for pulsed field ablation, according to some embodiments and in some contexts or use cases, may provide a mechanism to help control an amount of residual magnetic flux in a transformer of the energy source device system circuit, may allow improved control over the temporal spacing of same polarity pulses to be sufficient to reset membrane charges and avoid a potentially adverse additive effect from repeat samepolarity applications, and may allow improved control to reset thermal and electrolytic environments around the applying electrode(s), potentially reducing the risk of microbubble formation.

[0132] It should be noted that various embodiments of the invention are not limited to these features and benefits, which are referred to for purposes of illustration only, and additional and alternative features and benefits will become apparent from the following description in conjunction with reference to the figures.

[0133] In this regard, in the descriptions herein, certain specific details are set forth in order to provide a thorough understanding of various embodiments of the invention. However, one skilled in the art will understand that the invention may be practiced at a more general level without one or more of these details. In other instances, well-known structures have not been shown or described in detail to avoid unnecessarily obscuring descriptions of various embodiments of the invention.

[0134] Any reference throughout this specification to “one embodiment”, “an embodiment”, “an example embodiment”, “an illustrated embodiment”, “a particular embodiment”, and the like means that a particular feature, structure or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, any appearance of the phrase “in one embodiment”, “in an embodiment”, “in an example embodiment”, “in this illustrated embodiment”, “in this particular embodiment”, or the like in this specification is not necessarily all referring to one embodiment or a same embodiment. Furthermore, the particular features, structures or characteristics of different embodiments may be combined in any suitable manner to form one or more other embodiments. In one embodiment, all references to “some embodiments” may refer to the same single embodiment.

[0135] Unless otherwise explicitly noted or required by context, the word “or” is used in this disclosure in a non-exclusive sense. In addition, unless otherwise explicitly noted or required by context, the word “set” is intended to mean one or more. For example, the phrase, “a set of objects” means one or more of the objects. In some embodiments, the word “subset” is intended to mean a set having the same or fewer elements of those present in the subset’s parent or superset. In other embodiments, the word “subset” is intended to mean a set having fewer elements of those present in the subset’s parent or superset. In this regard, when the word “subset” is used, some embodiments of the present invention utilize the meaning that “subset” has the same or fewer elements of those present in the subset’s parent or superset, and other embodiments of the present invention utilize the meaning that “subset” has fewer elements of those present in the subset’s parent or superset. Further, the phrase “at least” is or may be used herein at times merely to emphasize the possibility that other elements may exist besides those explicitly listed. However, unless otherwise explicitly noted (such as by the use of the term “only”) or required by context, nonusage herein of the phrase “at least” nonetheless includes the possibility that other elements may exist besides those explicitly listed. For example, the phrase, ‘based at least on A’ includes A as well as the possibility of one or more other additional elements besides A. In the same manner, the phrase, ‘based on A’ includes A, as well as the possibility of one or more other additional elements besides A. However, the phrase, ‘based only on A’ includes only A. Similarly, the phrase ‘configured at least to A’ includes a configuration to perform A, as well as the possibility of one or more other additional actions besides A. In the same manner, the phrase ‘configured to A’ includes a configuration to perform A, as well as the possibility of one or more other additional actions besides A. However, the phrase, ‘configured only to A’ means a configuration to perform only A.

[0136] The word “device”, the word “machine”, the word “system”, and the phrase “device system” all are intended to include one or more physical devices or sub-devices (e.g., pieces of equipment) that interact to perform one or more actions, regardless of whether such devices or sub-devices are located within a same housing or different housings. However, it may be explicitly specified according to various embodiments that a device or machine or device system resides entirely within a same housing to exclude embodiments where the respective device, machine, system, or device system resides across different housings. The word “device” may equivalently be referred to as a “device system” in some embodiments, and the word “system” may equivalently be referred to as a “device system” in some embodiments.

[0137] Further, the phrase “in response to” may be used in this disclosure. For example, this phrase may be used in the following context, where an event A occurs in response to the occurrence of an event B. In this regard, such phrase includes, for example, that at least the occurrence of the event B causes or triggers or is a necessary precondition for the event A, according to various embodiments.

[0138] In some embodiments, the word “adjacent”, the word “proximate”, and the like refer at least to a sufficient closeness between the objects or events defined as adjacent, proximate, or the like, to allow the objects or events to interact in a designated way. For example, in the case of physical objects, if object A performs an action on an adjacent or proximate object B, objects A and B would have at least a sufficient closeness to allow object A to perform the action on object B. In this regard, some actions may require contact between the associated objects, such that if object A performs such an action on an adjacent or proximate object B, objects A and B would be in contact, for example, in some instances or embodiments where object A needs to be in contact with object B to successfully perform the action. In some embodiments, the word “adjacent”, the word “proximate”, and the like additionally or alternatively refer to objects or events that do not have another substantially similar object or event between them. For example, object or event A and object or event B could be considered adjacent or proximate (e.g., physically or temporally) if they are immediately next to each other (with no other object or event between them) or are not immediately next to each other but no other object or event that is substantially similar to object or event A, object or event B, or both objects or events A and B, depending on the embodiment, is between them. In some embodiments, the word “adjacent”, the word “proximate”, and the like additionally or alternatively refer to at least a sufficient closeness between the objects or events defined as adjacent, proximate, and the like, the sufficient closeness being within a range that does not place any one or more of the objects or events into a different or dissimilar region or time period, or does not change an intended function of any one or more of the objects or events or of an encompassing object or event that includes a set of the objects or events. Different embodiments of the present invention adopt different ones or combinations of the above definitions. Of course, however, the word “adjacent”, the word “proximate”, and the like are not limited to any of the above example definitions, according to some embodiments. In addition, the word “adjacent” and the word “proximate” do not have the same definition, according to some embodiments.

[0139] The phrase “pulsed field ablation” (“PF A”) as used in this disclosure refers, in some embodiments, to an ablation method that employs high voltage pulse delivery in a monopolar or bipolar ablation mode in proximity to target tissue. Each high voltage pulse may be a monophasic pulse including a single voltage polarity, or a biphasic pulse including a first component having a first particular voltage polarity and a second component having a second particular voltage polarity opposite the first particular voltage polarity. Each of the first component and the second component of a biphasic pulse may be referred to as a monophasic pulse, such that a biphasic pulse may be considered to be made of two adjacent or successive monophasic pulses of opposite polarity, in some embodiments. In some embodiments, the second component of the biphasic pulse follows immediately after the first component of the biphasic pulse. In some embodiments, the first and second components of the biphasic pulse are temporally separated by a relatively short time interval (e.g., an intra-biphasic-pulse delay) during which a zero or nominally zero voltage occurs. In some embodiments, successive monophasic pulses are separated by a period of time referred to as an inter-monophasic-pulse delay. In some embodiments, successive biphasic pulses are separated by a period of time referred to as an inter-biphasic-pulse delay. In the case where a biphasic pulse is considered to be made of two monophasic pulses of opposite polarity, a delay between such two monophasic pulses may be considered an intra-biphasic-pulse delay, whereas a delay between the last of such two monophasic pulses and the first monophasic pulse of the next biphasic pulse may be considered an inter-biphasic-pulse delay. In some embodiments, the duration of the inter- biphasic-pulse delay may be greater than the duration of each of the monophasic or biphasic pulses.

[0140] The word "proximal", in the context of a proximal portion, proximal location, and the like of a medical device, includes, for example, the portion, location, and the like, being or being configured to be further away from a patient or portion of or region within a patient (e.g., a bodily cavity) intended to be treated or assessed by the medical device, as compared to a distal portion, location, and the like of the medical device, according to some embodiments. In some embodiments, the word "proximal", in the context of a proximal portion, proximal location, and the like of a medical device, includes, for example, the portion, location, and the like, being or being configured to be delivered (e.g., percutaneously or intravascularly) toward a patient or portion of or region within a patient (e.g., a bodily cavity) intended to be treated or assessed by the medical device, after or behind a distal portion, location, and the like of the medical device. On the other hand, the word "distal", in the context of a distal portion, distal location, and the like of a medical device, includes, for example, the portion, location, and the like, being or being configured to be closer to a patient or portion of or region within a patient (e.g., a bodily cavity) intended to be treated or assessed by the medical device, as compared to a proximal portion, location, and the like of the medical device, according to some embodiments. In some embodiments, the word "distal", in the context of a distal portion, distal location, and the like of a medical device, includes, for example, the portion, location, and the like, being or being configured to be delivered (e.g., percutaneously or intravascularly) toward a patient or portion of or region within a patient (e.g., a bodily cavity) intended to be treated or assessed by the medical device, before or ahead of a proximal portion, location, and the like of the medical device.

[0141] According to some embodiments, the word “fluid” as used in this disclosure should be understood to include any fluid that can be contained within a bodily cavity or can flow into or out of, or both into and out of a bodily cavity via one or more bodily openings positioned in fluid communication with the bodily cavity. In the case of cardiac applications, fluid such as blood will flow into and out of various intra-cardiac cavities (e.g., a left atrium or right atrium).

[0142] According to some embodiments, the phrase “bodily opening” as used in this disclosure should be understood to include, for example, a naturally occurring bodily opening or channel or lumen; a bodily opening or channel or lumen or perforation formed by an instrument or tool using techniques that can include, but are not limited to, mechanical, thermal, electrical, chemical, and exposure or illumination techniques; a bodily opening or channel or lumen or perforation formed by trauma to a body; or various combinations of one or more of the above. Various elements having respective openings, lumens, or channels and positioned within the bodily opening (e.g., a catheter sheath or catheter introducer) may be present in various embodiments. These elements may provide a passageway through a bodily opening for various devices employed in various embodiments.

[0143] The phrase “bodily cavity” as used in this disclosure should be understood to mean a cavity in a body. The bodily cavity may be a cavity or chamber provided in a bodily organ (e.g., an intra-cardiac cavity or chamber of a heart). The bodily cavity may be provided by a bodily vessel.

[0144] The word “tissue” as used in this disclosure should be understood to include, for example, any surface-forming tissue that is used to form a surface of a body or a surface within a bodily cavity, a surface of an anatomical feature or a surface of a feature associated with a bodily opening positioned in fluid communication with the bodily cavity. The tissue may include, for example, part or all of a tissue wall or membrane that defines a surface of the bodily cavity. In this regard, the tissue may form an interior surface of the cavity that surrounds a fluid within the cavity. In the case of cardiac applications, tissue may include, for example, tissue used to form an interior surface of an intra-cardiac cavity such as a left atrium or right atrium. In some embodiments, tissue is non-excised tissue. In some embodiments, the word “tissue” may refer to a tissue having fluidic properties (e.g., blood) and may be referred to as fluidic tissue.

[0145] According to some embodiments, the word “transducer” as used in this disclosure should be interpreted broadly as any device configured to transmit or deliver energy; distinguish between fluid and tissue; sense temperature; generate heat; ablate tissue; sense, sample, or measure electrical activity of a tissue surface (e.g., sense, sample, or measure intra-cardiac electrograms, or sense, sample, or measure intra-cardiac voltage data); stimulate tissue; provide location information (e.g., in conjunction with a navigation system); or any combination thereof. A transducer may convert input energy of one form into output energy of another form. Without limitation, a transducer may include, for example, an electrode that functions as, or as part of, a sensing device included in the transducer, an energy delivery device included in the transducer, or both a sensing device and an energy delivery device included in the transducer. A transducer may be constructed from several parts, which may be discrete components or may be integrally formed. In this regard, although transducers, electrodes, or both transducers and electrodes are referenced with respect to various embodiments, it is understood that other transducers or transducer elements may be employed in other embodiments. It is understood that a reference to a particular transducer in various embodiments may also imply a reference to an electrode, as an electrode may be part of the transducer as shown, e.g., at least with FIG. 4 discussed below.

[0146] The term “activation” as used in this disclosure, according to some embodiments, should be interpreted broadly as making active a particular function as related to various transducers such as those disclosed herein, for example. Particular functions can include, but are not limited to, tissue ablation; sensing, sampling, or measuring electrophysiological activity (e.g., sensing, sampling, or measuring intra-cardiac electrogram information, or sensing, sampling, or measuring intra-cardiac voltage data); sensing, sampling, or measuring temperature; and sensing, sampling, or measuring electrical characteristics (e.g., tissue impedance or tissue conductivity). For example, in some embodiments, activation of a tissue ablation function of a particular transducer or electrode is initiated by causing energy sufficient to cause tissue ablation to be delivered to the particular transducer or electrode from an energy source device system (also known as a power supply system in some embodiments). In some embodiments, activation of a tissue ablation function of a particular transducer or electrode is initiated by causing energy sufficient for tissue ablation to be delivered by the particular transducer or electrode. Alternatively, in some embodiments, the activation can be deemed to be initiated when the particular transducer or particular electrode causes tissue that is to be ablated to exhibit tissueablative damage. In some embodiments, the activation can last for a duration concluding when the ablation function is no longer active, such as when energy sufficient for the tissue ablation is no longer delivered or provided to, or transmitted by, the particular transducer or particular electrode. Alternatively, in some embodiments, the activation period can be deemed to be concluded when the tissue that is being ablated no longer accrues tissue-ablative damage, which may be due to a reduction or cessation of the energy provided or transmitted by the energy source device system or delivered by the particular transducer or electrode. In some contexts and embodiments, however, the word “activation” may merely refer to the initiation of the activating of a particular function, as opposed to referring to both the initiation of the activating of the particular function and the subsequent duration in which the particular function is active. In these contexts, the phrase or a phrase similar to “activation initiation” may be used. For example, in some embodiments, activation initiation may cause initiation of a delivery of energy (e.g., energy sufficient for tissue ablation) to or from a particular transducer or electrode. Various ranges of values are disclosed herein. In some embodiments, one or more or all of the disclosed ranges are inclusive of both endpoints of the respective range. In some embodiments, one or more or all of the disclosed ranges are inclusive of one of the endpoints of the respective range. In some embodiments, one or more or all of the disclosed ranges are exclusive of one of the endpoints of the respective range. In some embodiments, one or more or all of the disclosed ranges are exclusive of both endpoints of the respective range. Various embodiments include various sub-ranges of each of the disclosed ranges.

[0147] Some embodiments of the present invention may be implemented at least in part by a data processing device system, or a controller system configured by a software program. Such a program may equivalently be implemented as multiple programs, and some, or all, of such software program(s) may be equivalently constructed in hardware. Reference to “a program” should be interpreted to include one or more programs.

[0148] According to some embodiments, the term “program” in this disclosure should be interpreted to include one or more programs including a set of instructions or modules that may be executed by one or more components in a system, such as a controller system or data processing device system, in order to cause or configure the system to perform one or more operations. The set of instructions or modules may be stored by any kind of memory device, such as those described subsequently with respect to the memory device system 130, 330, or both, shown in FIGS. 1 and 3, respectively. In addition, this disclosure may describe or similarly describe that the instructions or modules of a program are configured to cause the performance of an action. The phrase “configured to” in this context is intended to include, for example, at least (a) instructions or modules that are presently in a form executable by one or more data processing devices to cause performance of the action (e.g., in the case where the instructions or modules are in a compiled and unencrypted form ready for execution), and (b) instructions or modules that are presently in a form not executable by the one or more data processing devices, but could be translated into the form executable by the one or more data processing devices to cause performance of the action (e.g., in the case where the instructions or modules are encrypted in a non-executable manner, but through performance of a decryption process, would be translated into a form ready for execution). In some instances, this disclosure may describe that the instructions or modules of a program perform an action. Such descriptions should be deemed to be equivalent to describing that the instructions or modules are configured to cause the performance of the action. The term “module” may be defined as a set of instructions. The term “program” and the term “module” may each be interpreted to include multiple sub-programs or multiple sub-modules, respectively. In this regard, reference to a program or a module may be considered to refer to multiple programs or multiple modules.

[0149] Further, it is understood that information or data may be operated upon, manipulated, or converted into different forms as it moves through various devices or workflows. In this regard, unless otherwise explicitly noted or required by context, it is intended that any reference herein to information, signals, or data or the like includes modifications to that information, signals, or data. For example, “data X” may be encrypted for transmission, and a reference to “data X” is intended to include both its encrypted and unencrypted forms, unless otherwise required or indicated by context. For another example, “image information Y” may undergo a noise filtering process, and a reference to “image information Y” is intended to include both the pre- processed form and the noise-filtered form, unless otherwise required or indicated by context. In other words, both the pre-processed form and the noise-filtered form are considered to be “image information Y”, unless otherwise required or indicated by context. In order to stress this point, the phrase “or a derivative thereof’ or the like may be used herein. Continuing the preceding example, the phrase “image information Y or a derivative thereof’ refers to both the pre-processed form and the noise-filtered form of “image information Y”, unless otherwise required or indicated by context, with the noise-filtered form potentially being considered a derivative of “image information Y”. However, non-usage of the phrase “or a derivative thereof’ or the like nonetheless includes derivatives or modifications of information or data unless otherwise explicitly noted or required by context.

[0150] Example methods are described herein with respect to FIGS. 5A-5E (collectively FIGS. 5). Such figures are described to include blocks associated with actions, computer-executable instructions of one or more programs, or both actions and computer-executable instructions, according to various embodiments. It should be noted that the respective instructions associated with any such blocks therein need not be separate instructions and may be combined with other instructions to form a combined instruction set. The same set of instructions may be associated with more than one block. In this regard, the block arrangements shown in FIGS. 5A-5E are not limited to an actual structure of any program or set of instructions or required ordering of method tasks, and such method figures, according to some embodiments, merely illustrate the tasks that instructions are configured to perform, for example, upon execution by a data processing device system in conjunction with interactions with one or more other devices or device systems.

[0151] FIG. 1 schematically illustrates a portion of a transducer-activation system or controller system thereof 100 that may be employed to at least select, control, activate, or monitor a function or activation of a number of electrodes or transducers (e.g., ablation transducers configured to cause PF A), according to some embodiments. The system 100 includes a data processing device system 110, an input-output device system 120, and a processor-accessible memory device system 130. The processor-accessible memory device system 130 and the inputoutput device system 120 are communicatively connected to the data processing device system 110. According to some embodiments, various components such as data processing device system 110, input-output device system 120, and processor-accessible memory device system 130 form at least part of a controller system (e.g., controller system 324 shown in FIGS. 3).

[0152] The data processing device system 110 includes one or more data processing devices that implement or execute, in conjunction with other devices, such as one or more of those in the system 100, various methods and actions described herein, including those described with respect to methods exemplified in FIGS. 5. Each of the phrases “data processing device”, “data processor”, “processor”, “controller”, “computing device”, “computer” and the like is intended to include any data or information processing device, such as a central processing unit (CPU), a control circuit, a desktop computer, a laptop computer, a mainframe computer, a tablet computer, a cellular or smart phone, and any other device configured to process information or data, manage information or data, or handle information or data, whether implemented with electrical, magnetic, optical, quantum components, or otherwise. The data processing device system 110 may be a distributed data processing device system including multiple communicatively connected data processing devices. On the other hand, the data processing device system 110 need not be a distributed data processing device system and, consequently, may include one or more data processing devices located within a single housing.

[0153] The memory device system 130 includes one or more processor-accessible memory devices configured to store one or more programs and information, including the program(s) and information needed to execute the methods or actions described herein, including those described with respect to FIGS. 5. In some embodiments, each of the actions illustrated in the example methods of FIGS. 5 may represent or be associated with program instructions stored in the memory device system 130 and configured to cause execution of the respective action(s). The memory device system 130 may be a distributed processor-accessible memory device system including multiple processor-accessible memory devices communicatively connected to the data processing device system 110 via a plurality of computers and / or devices. However, the memory device system 130 need not be a distributed processor-accessible memory system and, consequently, may include one or more processor-accessible memory devices located within a single data processing device or housing. Each of the phrases “processor-accessible memory” and “processor-accessible memory device” and the like is intended to include any processor-accessible data storage device or medium, whether volatile or nonvolatile, electronic, magnetic, optical, quantum, or otherwise, including but not limited to, registers, hard disk drives, Compact Discs, DVDs, SSDs, flash memories, ROMs, and RAMs. In some embodiments, each of the phrases “processor-accessible memory” and “processor-accessible memory device” is intended to include or be a processor- accessible (or computer-readable) data storage medium. In some embodiments, each of the phrases “processor-accessible memory” and “processor-accessible memory device” may include or may be a non-transitory processor-accessible (or computer-readable) data storage medium. In some embodiments, the processor-accessible memory device system 130 may include or may be a non-transitory processor-accessible (or computer-readable) data storage medium system. In some embodiments, the processor-accessible memory device system 130 may include or may be a non-transitory processor-accessible (or computer-readable) storage medium system or data storage medium system including or consisting of one or more non-transitory processor- accessible (or computer-readable) data storage mediums.

[0154] The phrase “communicatively connected” is intended to include any type of connection, whether wired or wireless, between devices, data processors, or programs between which data may be communicated. Further, the phrase “communicatively connected” is intended to include a connection between devices or programs within a single data processor or computer, a connection between devices or programs located in different data processors or computers, and a connection between devices not located in data processors or computers at all. In this regard, although the memory device system 130 is shown separately from the data processing device system 110 and the input-output device system 120, one skilled in the art will appreciate that the memory device system 130 may be located completely or partially within the data processing device system 110 or the input-output device system 120. Further in this regard, although the input-output device system 120 is shown separately from the data processing device system 110 and the memory device system 130, one skilled in the art will appreciate that such system may be located completely or partially within the data processing device system 110 or the memory device system 130, for example, depending upon the contents of the input-output device system 120. Further still, the data processing device system 110, the input-output device system 120, and the memory device system 130 may be located entirely within the same device or housing or may be separately located, but communicatively connected, among different devices or housings. In at least the case where the data processing device system 110, the input-output device system 120, and the memory device system 130 are located within the same device, the system 100 of FIG. 1 may be implemented by a single application-specific integrated circuit (ASIC), field programmable gate array (FPGA), system on chip (SOC), or other type of integrated circuit, in some embodiments. In this regard, in some embodiments, the processor- accessible memory device system 130 may be considered to be integrated with the data processing device system 110, such that circuitry or hardware may itself be encoded with the equivalent of computer-executable program instructions described herein to execute the methods and actions described herein, including those described with respect to the methods 500 of FIGS. 5A-5E. Such integration may be considered a type of communicative connection between the data processing device system 110 and the processor-accessible memory device system 130. Such integration may also be considered control circuitry or a controller that combines at least some functionality of the processor-accessible memory device system 130 and the data processing device system 110, such that the control circuitry or controller is communicatively connected to the input-output device system 120 and is configured (e.g., via circuitry or hardware encoded with the equivalent of computer-executable program instructions) at least to perform the methods and actions described herein, including those described with respect to the methods 500 of FIGS. 5A-5E.

[0155] The input-output device system 120 may include a display device (e.g., display device 332 in FIGS. 3A and 3B), a mouse (e.g., a mouse 335 in FIGS. 3A and 3B), a keyboard, a touch screen, another computer, a processor-accessible memory device system, a network-interface card or network-interface circuitry, or any device or combination of devices from which a selection, information, instructions, or any other data is input to the data processing device system 110. The input-output device system 120 may include any suitable interface for receiving information, instructions, or any data from other devices and systems described in various ones of the embodiments. In this regard, the input-output device system 120 may include various ones of other systems described in various embodiments. For example, the input-output device system 120 may include at least a portion of a transducer-based device (e.g., a catheter, or portion thereof) that includes a spatial distribution of electrodes. Each of the phrases “transducer-based device” and “transducer-based device system” is intended to include one or more physical systems that include various transducers (e.g., electrodes).

[0156] The input-output device system 120 also may include an image generating device system, a display device system, a speaker or audio output device system (e.g., speaker or audio output device system 334 shown in FIGS. 3A and 3B, discussed below), a computer, a processor-accessible memory device system, a network-interface card or network-interface circuitry, or any device or combination of devices to which information, instructions, or any other data is output by the data processing device system 110. In this regard, the input-output device system 120 may include various other devices or systems described in various embodiments. The input-output device system 120 may include any suitable interface for outputting information, instructions, or data to other devices and systems described in various ones of the embodiments. If the input-output device system 120 includes a processor-accessible memory device, such memory device may, or may not, form part, or all, of the memory device system 130. In some embodiments, the input-output device system 120 may include a transducer-based device, as discussed above, and in some embodiments, the transducer-based device may act as a device or device system that provides information to, receives instructions or energy from, or both provides information to and receives instructions or energy from the data processing device system 110. In this regard, the input-output device system 120 may include various devices or systems described in various embodiments. In some embodiments, the input-output device system 120 may include one or more display devices that display one or more of the graphical interfaces.

[0157] According to some embodiments of the present invention, the system 100 includes some or all of the system 200 shown in FIG. 2 (discussed below), or vice versa. According to some embodiments, the system 100 includes some or all of the system 300 shown in FIGS. 3 (discussed below), or vice versa. Various embodiments of transducer-based devices (e.g., forming part of catheters) are described herein in this disclosure. Some of the described devices are tissue ablation (e.g., PF A) devices that are percutaneously or intravascularly deployed. Some of the described devices are movable between a delivery or unexpanded configuration (e.g., FIG. 3A discussed below) in which a portion of the device is sized for passage through a bodily opening leading to a bodily cavity, and an expanded or deployed configuration (e.g., FIGS. 2 and 3B discussed below) in which the portion of the device has a size too large for passage through the bodily opening leading to the bodily cavity. An example of an expanded or deployed configuration, in some embodiments, is when the portion of the transducer-based device (e.g., catheter, or part thereof) is in its intended-deployed-operational state, which may be inside the bodily cavity when, e.g., performing an intended therapeutic or diagnostic procedure for a patient, or which may be outside the bodily cavity when, e.g., performing testing, quality control, or other evaluation of the device. Another example of the expanded or deployed configuration, in some embodiments, is when the portion of the transducer-based device (e.g., catheter, or part thereof) is being changed from the delivery configuration to the intended- deployed-operational state to a point where the portion of the device now has a size too large for passage through the bodily opening leading to the bodily cavity. In some example embodiments, the described devices are part of a transducer-activation system capable of ablating tissue in a desired pattern within the bodily cavity using various techniques (e.g., via PFA, etc., according to various embodiments).

[0158] In some example embodiments, the devices are capable of sensing various cardiac functions (e.g., electrophysiological activity including intra-cardiac voltages which form the basis of recorded electrograms, according to some embodiments). In some example embodiments, the devices are capable of providing stimulation (e.g., electrical stimulation) to tissue within the bodily cavity. Electrical stimulation may include pacing.

[0159] FIG. 2 is a representation of a transducer-based device 200 useful in investigating or treating a bodily organ, for example, a heart 202, according to at least one example embodiment.

[0160] Transducer-based device 200 can be percutaneously or intravascularly inserted into a portion of the heart 202, such as an intra-cardiac cavity like left atrium 204. In this example, the transducer-based device 200 is part of a catheter 206 inserted via the inferior vena cava 208 and penetrating through a bodily opening in transatrial septum 210 from right atrium 212. (In this regard, transducer-based devices or device systems described herein that include a catheter may also be referred to as catheters, catheter devices or catheter-based devices, in some embodiments). In other embodiments, other paths may be taken.

[0161] Catheter 206 includes an elongated flexible rod or shaft member appropriately sized to be delivered percutaneously or intravascularly. Various portions of catheter 206 may be steerable. Catheter 206 may include one or more lumens. The lumen(s) may carry one or more communications or power paths, or both. For example, the lumens(s) may carry one or more electrical conductors 216 (two shown). Electrical conductors 216 provide electrical connections to transducer-based device 200 that are accessible externally from a patient in which the transducer-based device 200 is inserted.

[0162] According to some embodiments, transducer-based device 200 includes a frame or structure 218 which assumes an unexpanded configuration for delivery to left atrium 204. Structure 218 is expanded (e.g., shown in a deployed or expanded configuration in FIG. 2) upon delivery to left atrium 204 to position a plurality of transducers 220 (three called out in FIG. 2) proximate the interior surface formed by tissue 222 of left atrium 204. In some embodiments, at least some of the transducers 220 are used to sense a physical characteristic of a fluid (e.g., blood) or tissue 222, or both, that may be used to determine a position or orientation (e.g., pose), or both, of a portion of a device 200 within, or with respect to left atrium 204. For example, transducers 220 may be used to determine a location of pulmonary vein ostia or a mitral valve 226, or both. In some embodiments, at least some of the transducers 220 may be used to selectively ablate portions of the tissue 222. In some embodiments, at least some of the transducers 220 are used to sense a physical characteristic of a fluid (e.g., blood) or tissue 222, or both, that may be used to determine contact or a degree of contact between a portion of a device 200 and a tissue surface (e.g., an internal tissue surface). In some embodiments, some of the transducers 220 may be used to ablate a pattern around the bodily openings, ports or pulmonary vein ostia, for instance to reduce or eliminate the occurrence of atrial fibrillation. In some embodiments, at least some of the transducers 220 are used to ablate cardiac tissue. In some embodiments, at least some of the transducers 220 are used to sense or sample intracardiac voltage data or sense or sample intra-cardiac electrogram data.

[0163] FIGS. 3A and 3B (collectively, FIGS. 3) include a transducer-based device system (e.g., a portion thereof shown schematically) that includes a catheter including a transducer-based device 300 according to some embodiments. Transducer-based device 300 includes a plurality of elongate members 304 (not all of the elongate members called out in each of FIG. 3A and 3B) and a plurality of transducers 306 (not all of the transducers called out in FIGS. 3). It is noted that, for clarity of illustration, all the elongate members shown in FIG. 3B are not represented in FIG. 3A. The plurality of transducers 306 are positionable within a bodily cavity. For example, in some embodiments, the transducers 306 are able to be positioned in a bodily cavity by movement into, within, or into and within the bodily cavity, with or without a change in a configuration of the plurality of transducers 306. In some embodiments, the plurality of transducers 306 are arrangeable into various spatial distributions including two- or three- dimensional distributions, grids or arrays of the transducers capable of mapping, ablating or stimulating an inside surface of a bodily cavity or lumen. As shown, for example, in FIG. 3A, the plurality of transducers 306 are arranged in a configuration that is receivable in a bodily cavity. In various ones of FIGS. 3, each of at least some of transducers 306 includes a respective electrode 315 (not all of the transducers 306 or electrodes 315 are called out in each of the FIGS. 3). According to various embodiments, the input-output device system 120 is communicatively connected to each electrode in the spatial distribution of electrodes 315 provided by the catheter. In some embodiments, the data processing device system (e.g., 110, 310) is communicatively connected to the plurality of electrodes 315 via the input-output device system (e.g., 120, 320).

[0164] According to some embodiments, the elongate members 304 may be arranged in a frame or structure 308 that is selectively movable between an unexpanded or delivery configuration (e.g., as shown in FIG. 3 A) and an expanded or deployed configuration (e.g., as shown in FIG. 3B) that may be used during a positioning of the elongate members 304 against a tissue surface within the bodily cavity or during a positioning of the elongate members 304 in the vicinity of the tissue surface. At least the expanded or deployed configuration shown in FIG. 3B is an example of a spatial distribution of the transducers 306 (e.g., a three-dimensional spatial distribution). In some embodiments, structure 308 has a size in the unexpanded or delivery configuration suitable for delivery through a bodily opening (e.g., via catheter sheath 312 (shown in FIG. 3 A but removed from FIG. 3B for clarity) to the bodily cavity. At least in a state in which the structure 308 is in the expanded or deployed configuration, the structure 308 may be considered to have two opposing poles 341a and 341b, marked by the intersection with axis 342 extending through the structure 308 as shown in FIG. 3B according to some embodiments. In some embodiments, at least some of the plurality of transducers 306 are circumferentially arranged, e.g., in successive ring-like arrangements, about each of the poles 341a and 341b according to some embodiments. Such a ring-like arrangement is illustrated, for example, as broken-line ring 343b in FIG. 3B. According to some embodiments, at least some of the plurality of transducers 306 are arranged in a plurality of groups of the transducers 306, the groups of transducers 306 arranged like lines of longitude (e.g., along respective elongate members 304) about the structure 308 between each of the poles 341a and 341b, according to some embodiments.

[0165] In some embodiments, structure 308 has a size in the expanded or deployed configuration too large for delivery through a bodily opening (e.g., via catheter sheath 312) to the bodily cavity. The elongate members 304 may form part of a flexible circuit structure (e.g., also known as a flexible printed circuit board (PCB)). The elongate members 304 may include a plurality of different material layers. Each of the elongate members 304 may include a plurality of different material layers. The structure 308 may include a shape memory material, for instance, Nitinol. The structure 308 can include a metallic material, for instance stainless steel, or non-metaHic material, for instance polyimide, or both a metallic and non-metallic material by way of non-limiting example. The incorporation of a specific material into structure 308 may be motivated by various factors including the specific requirements of each of the unexpanded or delivery configuration and expanded or deployed configuration, the required position or orientation (e.g., pose), or both of structure 308 in the bodily cavity or the requirements for successful ablation of a desired pattern.

[0166] FIG. 4 is a schematic side elevation view of at least a portion of a transducer-based device 400 that includes a flexible circuit structure 401 that is employed to provide a plurality of transducers 406 (two called out), according to an example embodiment. In some embodiments, the flexible circuit structure 401 may form part of a structure (e.g., structure 308) that is selectively movable between a delivery configuration sized for percutaneous delivery and an expanded or deployed configuration sized too large for percutaneous delivery. In some embodiments, the flexible circuit structure 401 may be located on, or form at least part of, a structural component (e.g., elongate member 304) of a transducer-based device system.

[0167] The flexible circuit structure 401 can be formed by various techniques including flexible printed circuit techniques. In some embodiments, the flexible circuit structure 401 includes various layers including flexible layers 403a, 403b and 403c (e.g., collectively flexible layers 403). In some embodiments, each of flexible layers 403 includes an electrical insulator material (e.g., polyimide). One or more of the flexible layers 403 can include a different material than another of the flexible layers 403. In some embodiments, the flexible circuit structure 401 includes various electrically conductive layers 404a, 404b, and 404c (collectively electrically conductive layers 404) that are interleaved with the flexible layers 403. In some embodiments, each of the electrically conductive layers 404 is patterned to form various electrically conductive elements. For example, electrically conductive layer 404a is patterned to form a respective electrode 415 of each of the transducers 406. Electrodes 415 have respective electrode edges 415-1 that form a periphery of an electrically conductive surface associated with the respective electrode 415. It is noted that other electrodes employed in other embodiments may have electrode edges arranged to form different electrode shapes (e.g., as shown by electrode edges 315-1 in FIG. 3B).

[0168] Electrically conductive layer 404b is patterned, in some embodiments, to form respective temperature sensors 408 for each of the transducers 406 as well as various leads 410a arranged to provide electrical energy to the temperature sensors 408. In some embodiments, each temperature sensor 408 includes a patterned resistive member 409 (two called out) having a predetermined electrical resistance. In some embodiments, each resistive member 409 includes a metal having relatively high electrical conductivity characteristics (e.g., copper). In some embodiments, electrically conductive layer 404c is patterned to provide portions of various leads 410b arranged to provide an electrical communication path to electrodes 415. In some embodiments, leads 410b are arranged to pass though vias in flexible layers 403a and 403b to connect with electrodes 415. Although FIG. 4 shows flexible layer 403c as being a bottom-most layer, some embodiments may include one or more additional layers underneath flexible layer 403 c, such as one or more structural layers such as a steel or composite layer. These one or more structural layers, in some embodiments, are part of the flexible circuit structure 401 and can be part of, e.g., elongate member 304. In some embodiments, the one or more structural layers may include at least one electrically conductive surface (e.g., a metallic surface) exposed to blood flow. In addition, although FIG. 4 shows only three flexible layers 403a-403c and only three electrically conductive layers 404a-404c, it should be noted that other numbers of flexible layers, other numbers of electrically conductive layers, or both, can be included.

[0169] In some embodiments, electrodes 415 are employed to selectively deliver ablative energy (e.g., PFA energy) to various tissue structures within a bodily cavity (e.g., an intra-cardiac cavity or chamber). The energy delivered to the tissue structures may be sufficient for ablating portions of the tissue structures. Energy that is sufficient for tissue ablation may be dependent upon factors including transducer location, size, shape, relationship with respect to another transducer or a bodily cavity, material or lack thereof between transducers, et cetera.

[0170] In some embodiments, each electrode 415 is employed to sense or sample an electrical potential in the tissue proximate the electrode 415 typically at a different time than delivering PFA energy sufficient for tissue ablation. In some embodiments, each electrode 415 is employed to sense or sample intra-cardiac voltage data in the tissue proximate the electrode 415. In some embodiments, each electrode 415 is employed to sense or sample data in the tissue proximate the electrode 415 from which an electrogram may be derived. In some embodiments, each resistive member 409 is positioned adjacently to a respective one of the electrodes 415. In some embodiments, each of the resistive members 409 is positioned in a stacked or layered array with a respective one of the electrodes 415 to form a respective one of the transducers 406. In some embodiments, leads 410a are arranged to allow for a sampling of electrical voltage between resistive members 409. This arrangement allows for the electrical resistance of each resistive member 409 to be accurately measured. The ability to accurately measure the electrical resistance of each resistive member 409 may be motivated by various reasons including determining temperature values at locations at least proximate the resistive member 409 based at least on changes in the resistance caused by convective cooling effects (e.g., as provided by blood flow).

[0171] Referring to FIGS. 3A and 3B transducer-based device 300 can communicate with, receive power from or be controlled by a transducer-activation system 322 (e.g., via leads 317). In some embodiments, the transducer-activation system 322 represents one or more particular implementations of the system 100 illustrated in FIG. 1. In some embodiments, the transducerbased device 300 or the transducer-based device 200 may be considered part of the transduceractivation system 322 or 100. However, the transducer-activation system 322 (which may be an implementation of system 100 in some embodiments) is not limited to including or interacting with either of the particular transducer-based devices 200, 300, and may include or interact with one or more other types of transducer-based devices, according to some embodiments. The transducer-activation device system 322 may include a controller 324 that includes a data processing device system 310 (which may be a particular implementation of data processing device system 110 from FIG. 1) and a memory device system 330 (which may be a particular implementation of the memory device system 130 from FIG. 1) that stores data and instructions that are executable by the data processing device system 310 to process information received from transducer-based device 300 or to control operation of transducer-based device 300, for example, activating various selected transducers 306 to ablate tissue (e.g., via PF A) according to various embodiments including at least those described below with respect to FIGS. 5A-5E. Controller 324 may include one or more controllers.

[0172] Transducer-activation device system 322 includes an input-output device system 320 (which may be a particular implementation of the input-output device system 120 from FIG. 1) communicatively connected to the data processing device system 310 (e.g., via controller 324 in some embodiments). Input-output device system 320 may include a sensing device system 325 configured to detect various characteristics including, but not limited to, at least one of tissue characteristics (e.g., electrical characteristics such as tissue impedance, tissue conductivity, tissue type, tissue thickness) and thermal characteristics. In this regard, the sensing device system 325 may include one, some, or all of the transducers 306 (or 406 of FIG. 4) of the transducer-based device 300, including the internal components of such transducers shown in FIG. 4, such as the electrodes 415 and temperature sensors 408.

[0173] Transducer-activation device system 322 may also include an energy source device system circuit 340 (which may be a PFA power supply system in some embodiments) including one or more energy source devices (e.g., one or more power delivery drivers 344 (two shown in FIGS. 3A and 3B as 344a, 344b) in some embodiments) selectively connectable (e.g., via electrical switches) to transducers 306. In this regard, although various ones of FIGS. 3 show a communicative connection between the energy source device system circuit 340 and the controller 324 (and its data processing device system 310), the energy source device system circuit 340 may also be connected (e.g., via electrical switches) to the transducers 306 via a communicative connection that is independent of the communicative connection between the energy source device system circuit 340 and the controller 324 (and its data processing device system 310). For example, the energy source device system circuit 340 may receive control signals via the communicative connection with the controller 324 (and its data processing device system 310), and, in response to such control signals, provide energy to one or more of the transducers 306 via a communicative connection with such transducers 306 (e.g., via one or more electrical switches and communication lines through catheter body or shaft 314, elongated cable 316 or catheter sheath 312) that does not pass through the controller 324. In this regard, the energy source device system circuit 340 may provide results of its delivering energy to, receiving energy from, or both delivering energy to and receiving energy from one or more of the transducers 306 to the controller 324 (and its data processing device system 310) via the communicative connection between the energy source device system circuit 340 and the controller 324.

[0174] The energy source device system circuit 340 may, for example, be connected to various selected transducers 306 or electrodes thereof to selectively provide energy, e.g., via one or more power delivery drivers 344, in the form of electrical current or power (e.g., PFA energy) to cause ablation of tissue. In some embodiments, a power delivery driver may be a circuit used to deliver electrical power to a load. In some embodiments, the load may be a transducer set (e.g., electrode set). In some embodiments, the load may be tissue, such as tissue proximate a transducer set. A power delivery driver may include a circuit that is controllable to produce a specified voltage output (e.g., high voltage pulses), in some embodiments. In some embodiments, a power delivery driver may include a circuit that is controllable to produce a specified current output (e.g., the power delivery driver may adjust its output voltage as required to achieve a specified current). The energy source device system circuit 340 may selectively provide energy, e.g., via one or more power delivery drivers 344, in the form of electrical current to various selected transducers 306 or electrodes thereof and such transducers 306 or electrodes thereof may measure a temperature characteristic, an electrical characteristic, or both at a respective location at least proximate each of the various transducers 306 utilizing energy provided by the energy source device system circuit 340. The energy source device system circuit 340 may include various electrical current or voltage sources, such as power delivery drivers 344, as energy source devices.

[0175] It is understood that input-output device system 320 may include various systems. In some embodiments, input-output device system 320 may include energy source device system circuit 340, transducer-based device 300, or both energy source device system circuit 340 and transducer-based device 300 by way of non-limiting example. Input-output device system 320 may include the memory device system 330 in some embodiments.

[0176] In other example embodiments, other structures besides those shown in FIGS. 2, 3 A, 3B, and 4 may be employed to support or carry transducers of a transducer-based device, such as a transducer-based catheter. For example, an elongated catheter member may be used to distribute the transducers in a linear or curvilinear array. Basket catheters or balloon catheters may be used to distribute the transducers in a two-dimensional or three-dimensional array. According to some embodiments of the present invention, the system 100 (FIG. 1) includes some, or all, of the system 200 shown in FIG. 2, or vice versa. In some embodiments, the system 100 includes some, or all, of the system 300 in FIGS. 3, or vice versa. In this regard, the system 200, the system 300, or each of the system 200 and the system 300 may be a particular implementation of the system 100, according to some embodiments. Some or all of the controller 324, energy source device system circuit 340, or input-output device system 320 described with respect to FIGS. 3 may also be implemented with the system 200 in FIG. 2, in some embodiments. Each of at least part of the transducer or electrode-based device system 400 in FIG. 4 may be part of the system 100, the system 200, or the system 300, according to various embodiments. FIG. 5 A includes a processing flow diagram, which may implement various embodiments of method 500 by way of associated computer-executable instructions, according to some example embodiments. In various example embodiments, a memory device system (e.g., memory device system 130 or 330, otherwise stated herein at times as “130, 330”) is communicatively connected to a data processing device system (e.g., data processing device systems 110 or 310, otherwise stated herein at times as “110, 310”) and stores a program executable by the data processing device system to cause the data processing device system to execute various embodiments of method 500 via interaction with at least, for example, a transducer-based or electrode-based device (e.g., transducer-based / electrode-based devices 200, 300, or 400 in various embodiments). In some embodiments, the program may include instructions configured to perform, or to cause to be performed, various ones of the instructions associated with execution of various embodiments of method 500. In some embodiments, method 500 may include additional blocks not shown in FIG. 5A, such as, e.g., one or more blocks associated with user or machine selection of one or more transducers or electrodes of a transducer-based device system (e.g., transducer-based / electrode-based devices 200, 300, or 400 in some embodiments) to which the at least one pulse train associated with block 502, discussed below, is to be provided, e.g., to cause PFA of tissue of a bodily cavity. At least U.S. Patent No. 10,368,936, issued August 6, 2019 and U.S. Patent No. 11,633,238, issued April 25, 2023 include disclosures about various techniques for user and machine selection of transducers / electrodes to cause tissue ablation.

[0177] According to some embodiments, method 500 may include block 502 associated with computer-executable instructions (e.g., pulse train provision instructions provided by a program) configured to cause a data processing device system (e.g., 110, 310) to cause, via an inputoutput device system (e.g., input-output device system 120, 320) and via operation of the energy source device system circuit (e.g., energy source device system circuit 340), provision of at least one pulse train. According to various embodiments, the energy source device system circuit 340 may be configured to generate each pulse train of the at least one pulse train. According to various embodiments, the input-output device system 120, 320 is communicatively connected to the data processing device system 110, 310, and the input-output device system 120, 320 is further connectable or is connected to the energy source device system circuit 340 to provide pulsed field ablation (PF A) energy to at least some electrodes of a plurality of electrodes (e.g., electrodes 315, 415) supported by a structure (e.g., structure 308) of a catheter or catheter device system. In some embodiments, method 500 may include provision of pulsed field ablative energy to an electrode set to or from the plurality of electrodes (315, 415), the pulsed field ablative energy including, at least within a part of the energy source device system circuit 340, at least one pulse train. In some embodiments, the data processing device system 110, 310 may be configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes 315, 415.

[0178] According to various embodiments, each pulse train of the at least one pulse train includes a plurality of voltage pulses, which may, in some embodiments, be a predetermined number of voltage pulses) that is provided or desired to be provided. Each pulse train of the at least one pulse train may also have an associated particular time interval, which may, in some embodiments, be a predetermined time interval, in which the plurality of voltage pulses are provided or desired to be provided. In some embodiments, the pulses in each set of one or more sets of pulses in each pulse train of the at least one pulse train having the same pulse waveform characteristics repeat with a respective regular frequency. According to various embodiments, pulse waveform characteristics may include pulse rise time, pulse fall time, pulse duration, pulse amplitude, pulse shape, or a combination thereof. In some embodiments, biphasic pulses are employed, and the biphasic pulses in each pulse train of the at least one pulse train repeat with a regular frequency regardless of whether the biphasic pulses have the same pulse waveform characteristics or not.

[0179] In some embodiments, the at least one pulse train may include a plurality of pulse trains arranged in a sequence or regularly repeating sequence of pulse trains. Multiple pulse trains may be employed for various reasons. For example, a relatively large number of pulses may be required for effective treatment, but deleterious thermal or microbubble generation effects may occur if all the pulses in the relatively large number of pulses were to be continuously provided. By breaking up the relatively large number of pulses into a sequence of pulse trains with each pulse train in the sequence of pulse trains spaced or separated (a) by a respective rest period (e.g., a respective inter-pulse-train delay) from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective rest period (e.g., a respective inter-pulse-train delay) from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), the rest periods or inter-pulse-train delays may be chosen to be sufficiently large (e.g., 1 or more seconds) to alleviate or lessen the above-mentioned and other potentially deleterious effects.

[0180] According to some embodiments, each inter-pulse-train delay is longer in duration than various delays between successive pulses within a given one of the pulse trains. For example, each provided pulse train may include a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses (described in further detail below) including a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse, and an inter-biphasic-pulse delay that spaces or separates (e.g., temporally spaces or separates) the second biphasic voltage pulse from the first biphasic voltage pulse. According to various embodiments, each respective inter-pulse-train delay is longer in duration than the inter- biphasic-pulse delay. According to various embodiments, the biphasic voltage pulses are successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced or separated from one another by a respective inter-biphasic-pulse delay. According to various embodiments, each respective interpulse-train delay is longer in duration than each respective inter-biphasic-pulse delay. In some embodiments, each provided pulse train may include a plurality of first monophasic voltage pulses (i.e., described in further detail below), each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity. In some embodiments, the first monophasic voltage pulses of the plurality of the first monophasic voltage pulses may be successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced or separated (e.g., temporally spaced or separated) from one another by a respective first inter-monophasic-pulse delay. According to some embodiments, each respective inter-pulse-train delay is longer in duration than each respective first inter-monophasic-pulse delay. In some embodiments, each provided pulse train may include a plurality of second monophasic voltage pulses (i.e., described in further detail below) arranged in a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity. In some embodiments, the second monophasic voltage pulses of the plurality of the second monophasic voltage pulses may be successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced separated (e.g., temporally spaced or separated) from one another by a respective second inter-monophasic-pulse delay. In some embodiments, each respective interpulse-train delay is longer in duration than each respective first inter-monophasic-pulse delay, each respective second inter-monophasic-pulse delay, or each respective first inter-monophasic- pulse delay and each respective second inter-monophasic-pulse delay.

[0181] Provision of the at least one pulse train in accordance with block 502 of method 500 in FIG. 5A may take various forms. For example, one embodiment of block 502 is represented as block 502a in FIG. 5B. According to some embodiments associated with block 502a, each pulse train of the at least one pulse train that is provided includes a plurality of biphasic voltage pulses. For example, a pulse train 610 is shown in FIG. 6A including a plurality of biphasic voltage pulses 602 sequentially arranged in the pulse train 610. In some embodiments, the pulse train 610 may represent each pulse train of the at least one pulse train referred to in block 502. It should be noted that the pulse trains represented in FIGS. 6A-6F, 7A, and 7B show various pulse durations and durations between pulses, and it should be noted that such durations may be exaggerated for purposes of clarity of viewing and may not be to scale according to some embodiments. For instance, FIG. 6C, discussed in more detail below, shows an inter-biphasic- pulse delay 603 A that has a duration approaching that of an intra-biphasic-pulse delay 613. However, in some embodiments, an inter-biphasic-pulse delay 603A may be many times greater than an intra-biphasic-pulse delay 613. Further, a time axis is not shown for the pulse sequences described in each of FIGS. 6A-6F and, thus, time may be considered to progress in either direction along such pulse sequences, according to various embodiments. In this regard, when it is indicated herein that one pulse follows, is subsequent to, or is after another pulse, or the like, or vice versa, such temporal indications may be interpreted in either direction along the pulse sequences illustrated, according to various embodiments, depending on the direction chosen for the time axis and whether “newer” is considered “first in line” or “last in line”. For example, if a time axis for FIG. 6A is chosen such that pulses to the left are newer than pulses to the right (i.e., first biphasic pulse 602A is considered to be newer than second biphasic pulse 602B), then it may be considered in some interpretations (e.g., if “newest” is considered “first in line”) that second biphasic pulse 602B follows, is subsequent to, and is after the (newest / first in line) first biphasic pulse 602A. Or, in this case, if “newest” is considered “last in line”, then it may be considered that the (newest / last in line) first biphasic pulse 602A follows, is subsequent to, and is after the second biphasic pulse 602B. On the other hand, if a time axis for FIG. 6A is chosen such that pulses to the right are newer than pulses to the left (i.e., second biphasic pulse 602B is considered to be newer than first biphasic pulse 602A), and if “newest” is considered “first in line”, then it may be considered in some interpretations that the first biphasic pulse 602A follows, is subsequent to, and is after the (newest / first in line) second biphasic pulse 602B. Or, in this case, if “newest” is considered “last in line”, then it may be considered in some interpretations that the (newest / last-in-line) second biphasic pulse 602B follows, is subsequent to, and is after the first biphasic pulse 602A.

[0182] According to some embodiments, the plurality of biphasic voltage pulses 602 includes a first biphasic voltage pulse 602A and a second biphasic voltage pulse 602B. According to various embodiments, the second biphasic voltage pulse 602B sequentially (e.g., temporally) follows the first biphasic voltage pulse 602A in the pulse train 610. It is noted in FIG. 6A that the first biphasic voltage pulse 602A is shown as the initial biphasic voltage pulse 602 in the pulse train 610 according to some embodiments. In some embodiments, the first biphasic voltage pulse 602A may be a particular biphasic voltage pulse 602 located between the initial and final biphasic pulses of the pulse train 610 (i.e., rather than being the initial or final biphasic voltage pulse of the pulse train 610). According to some embodiments, the first biphasic voltage pulse 602A includes a first monophasic voltage pulse 604A followed by a second monophasic voltage pulse 605 A. According to various embodiments, the first monophasic voltage pulse 604A has a first polarity, and the second monophasic voltage pulse 605A has a second polarity opposite the first polarity. According to some embodiments, the second biphasic voltage pulse 602B includes a third monophasic voltage pulse 605B followed by a fourth monophasic voltage pulse 604B. According to various embodiments, the third monophasic voltage pulse 605B has the second polarity (i.e., the polarity of the monophasic voltage pulse 605 A) and the fourth monophasic voltage pulse 604B has the first polarity (i.e., the polarity of monophasic voltage pulse 604A).

[0183] According to various embodiments, pulse train 610 includes a sequence of two monophasic voltage pulses (e.g., monophasic voltage pulses 605 A, 605B) having a same polarity and spaced or separated by the inter-biphasic-pulse delay 603 (described further below) between the first biphasic voltage pulse 602A and the second biphasic voltage pulse 602B. According to various embodiments, the second biphasic voltage pulse 602B has different biphasic pulse waveform characteristics than the first biphasic voltage pulse 602A. For instance, the respective initial or starting monophasic voltage pulse of a biphasic voltage pulse may be considered a biphasic pulse waveform characteristic, and, in the example of FIG. 6A, the respective initial or starting monophasic voltage pulse of each of the first biphasic voltage pulse 602A and the second biphasic voltage pulse 602B have different polarities, according to some embodiments. In some embodiments, the final or ending monophasic voltage pulse 605A of the first biphasic voltage pulse 602A has a same polarity as the initial or starting monophasic voltage pulse 605B of the second biphasic voltage pulse 602B.

[0184] In some embodiments, the plurality of biphasic voltage pulses (e.g., of the pulse train 610 in some embodiments) may include (a) a first plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics as the first biphasic voltage pulse 602A, and (b) a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the second plurality of biphasic voltage pulses having a same biphasic pulse waveform characteristics (e.g., including a same monophasic pulse polarity order) as the second biphasic voltage pulse 602B. For example, in FIG. 6A, the first plurality of biphasic voltage pulses may include first biphasic voltage pulse 602A and biphasic voltage pulse 602C, which have the same biphasic pulse waveform characteristics (e.g., including a same monophasic pulse polarity order), and the second plurality of biphasic voltage pulses may include second biphasic voltage pulse 602B and biphasic voltage pulse 602D, which have the same biphasic pulse waveform characteristics (e.g., including a same monophasic pulse polarity order), according to some embodiments. In some embodiments, the pulses of the first plurality of biphasic voltage pulses alternate or are interleaved with the pulses of the second plurality of biphasic voltage pulses e.g., as shown in FIG. 6A). For instance, in some embodiments, the plurality of biphasic voltage pulses includes an interleaving of a first plurality of biphasic voltage pulses (e.g., including at least biphasic voltage pulse 602A and biphasic voltage pulse 602C) and a second plurality of biphasic voltage pulses (e.g., including at least biphasic voltage pulse 602B and biphasic voltage pulse 602D), each biphasic voltage pulse in the first plurality of biphasic voltage pulses having a sequence of a first particular monophasic voltage pulse (e.g., monophasic voltage pulse 604A in the case of biphasic voltage pulse 602A) of the first polarity followed by a second particular monophasic voltage pulse (e.g., monophasic voltage pulse 605A in the case of biphasic voltage pulse 602A) of the second polarity, and each biphasic voltage pulse in the second plurality of biphasic voltage pulses having a sequence of a third particular monophasic voltage pulse (e.g., monophasic voltage pulse 605B in the case of biphasic voltage pulse 602B) of the second polarity followed by a fourth particular monophasic voltage pulse (e.g., monophasic voltage pulse 604B in the case of biphasic voltage pulse 602B) of the first polarity.

[0185] Pulsed field ablation systems may employ a transformer for various reasons, for example, to provide a PFA system with voltage gain capabilities. For example, U.S. Patent Application Publication No. 2022 / 0047319, published February 17, 2022 describes a high voltage pulse generation circuit employing a transformer in a pulsed field ablation system. A transformer having a 1 :N turns ratio provides a voltage gain of N. This allows use of lower voltage power supplies and control circuitry on the primary (i.e., non-patient) side of the transformer, which can make design easier. A transformer may also be employed to provide a PFA system with electrical isolation / safety capabilities. A transformer blocks direct current (DC), and as such, may be employed to ensure that hardware failures in the primary side control circuitry do not result in application of a DC voltage to the patient, which could otherwise result in electric shock. Transformers intended for this purpose must meet requirements from standards (e.g., IEC 60601-1) related to characteristics such as minimum spacings, minimum insulation thickness, dielectric strength, etc.

[0186] A transformer transfers energy from one circuit to another by means of electromagnetic induction. A transformer typically includes multiple coils that are wound around a ferromagnetic core. One of the fundamental factors that affects the performance of a transformer is the magnetic flux density within the core. Transformer cores typically have a limit on magnetic flux density (i.e., magnetic flux per unit cross-sectional area). Exceeding that limit can cause transformer saturation, which may have negative effects (e.g., inability to continue to provide voltage gain, overcurrent conditions in the driving circuitry, waveform distortion, lower efficiency, etc.). It is noted that saturation may refer to complete saturation of a transformer core, where a further increase in magnetizing force results in negligible change in flux, or to “soft” saturation, where further increases in magnetizing force result in proportionately less increase in flux than prior increases in magnetizing force (i.e., the magnetic permeability of the core is reduced, potentially significantly relative to its value when not saturated). Depending on the material properties of its core, a transformer may transition relatively rapidly from normal operation to complete saturation, or may transition from normal operation through varying degrees of “soft” saturation, prior to complete saturation. In any case, the aforementioned negative effects may occur, potentially to varying degrees.

[0187] Since the transformer core cross-sectional area is essentially constant over time, the limit on magnetic flux density can also be considered as a limit on magnetic flux. The magnetic flux within the core is proportional to the integral of the applied voltage with respect to time and, in an ideal system, alternating current (e.g., utilizing biphasic pulses) may be employed to balance the time and voltage of one polarity pulse with an equal time and voltage pulse of the opposite polarity so as to produce a net magnetic flux of zero during the provision of the two opposing polarity pulses. However, in a real-world system, the net magnetic flux generated during the provision of the biphasic pulse may not be zero due to various factors. This non-zero net magnetic flux may be considered a residual magnetic flux. Continued application of a sequence of biphasic pulses, each resulting in a non-zero net magnetic flux of the same sign, may eventually cause the magnetic flux limit of the transformer core to be exceeded, causing saturation of the transformer.

[0188] FIG. 7A models the magnetic flux from a provided biphasic voltage pulse 702 having a constituent first monophasic voltage pulse 704 having a first polarity and a constituent second monophasic voltage pulse 705 having a second polarity opposite the first polarity. The biphasic voltage pulse 702 shown in FIG. 7A also includes a particular delay between its respective opposing polarity monophasic pulses (704, 705), the particular delay (e.g., an intra-biphasic- pulse delay 713 described in detail below) intended to be a period during which zero voltage is applied to the transformer primary so as to not generate additional magnetic flux and so as to not generate an output voltage. The magnetic flux 718 is modeled as a dashed line in a superimposed manner with the biphasic voltage pulse.

[0189] The magnetic flux 718 is proportional to the integral over time of the voltage applied to the transformer. Therefore, while the first monophasic voltage pulse 704 of the biphasic voltage pulse 702 is delivered, the magnetic flux 718 increases linearly based on the applied voltage. As the magnetic flux accumulates, there is a larger voltage drop across the transistors used to apply the voltage to the transformer. During the intra-biphasic-pulse delay 713 in FIG. 7 A, the voltage applied to the transformer is nominally set to zero volts. However, the accumulated magnetic flux results in a magnetizing current that continues to flow in the primary side of the transformer during the intra-biphasic-pulse delay. The magnetizing current passes through transistors used to apply the short-circuit to the transformer primary (e.g., to apply as close to zero volts as possible to the transformer primary) during the intra-biphasic-pulse delay 713. There is a resulting voltage drop that appears across the transformer, and this voltage drop (i.e., indicated as AV in FIG. 7 A) is in the opposite polarity to the voltage of the first monophasic voltage pulse 704. Due to the non-zero voltage across the transformer primary, the magnetic flux decreases during the intra-biphasic-pulse delay 713, albeit by a small amount.

[0190] Provision of the second monophasic voltage pulse 705 of the biphasic voltage pulse 702 causes the magnetic flux 718 to decrease linearly based on the applied opposite polarity voltage. Even in the case where the first monophasic voltage pulse 704 and the second monophasic voltage pulse 705 have identical durations and amplitudes, the magnetic flux 718 will decrease and cross through zero (better seen in FIG. 7B, which is an enlarged view of region A-A in FIG. 7 A) and have a negative value at the end of the biphasic pulse due to the change in magnetic flux that occurred during the intra-biphasic-pulse delay, as described above.

[0191] Another source of residual magnetic flux results from natural variance in the pulses due to the non-ideal characteristics of real circuit components. Real circuit components have non- ideal properties in the form of resistance, parasitic capacitance, lead inductance, etc. These nonideal properties result in small deviations in the pulses, resulting in a difference in the integral over time of the constituent positive voltage pulse versus the constituent negative voltage pulse applied to the transformer during the provision of a biphasic voltage pulse. Therefore, a residual magnetic flux will exist that is proportional to the difference in the integral over time of the constituent positive voltage pulse versus the constituent negative voltage pulse in a biphasic voltage pulse.

[0192] Accordingly, the residual magnetic flux can continue to accumulate with the provision of additional pulses in a pulse train and may lead to transformer saturation. Flipping the polarity order of the constituent monophasic voltage pulses in each successive biphasic voltage pulse 602 e.g., as described above with respect to FIG. 6A according to some embodiments) may at least help reduce any residual magnetic flux that may accumulate over time.

[0193] According to various embodiments, the first biphasic voltage pulse 602A and the second biphasic voltage pulse 602B may include other biphasic waveform characteristics that may be different or the same as one another. For example, although FIG. 6A shows same monophasic pulse durations, in some embodiments, as shown in FIG. 6E, (a) the first monophasic voltage pulse (corresponding to pulse 604X in the example of FIG. 6E) and the second monophasic voltage pulse (corresponding to pulse 605X in the example of FIG. 6E) may have different pulse durations (e.g., different pulse durations 609X1 and 609X2, respectively, in the example of FIG. 6E), (b) the third monophasic voltage pulse (corresponding to pulse 605Y in the example of FIG. 6E) and the fourth monophasic voltage pulse (corresponding to pulse 604Y in the example of FIG. 6E) may have different pulse durations (e.g., different pulse durations 609X3 and 609X4, respectively, in the example of FIG. 6E), or (a) and (b). In some embodiments, the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse may have a different pulse duration than the respective pulse duration of each of the other monophasic voltage pulses of the first monophasic voltage pulse 604A, the second monophasic voltage pulse 605A, the third monophasic voltage pulse 605B, and the fourth monophasic voltage pulse 604B. For instance, in the example of FIG. 6E, the pulse durations 609X1, 609X2, 609X3, and 609X4 are all different. Although the example of FIG. 6E shows what may be relatively large proportional differences in pulse durations for ease of visual differentiation in some embodiments, other embodiments may have variations in pulse durations that are less pronounced. Further, although all the pulses in FIG. 6E are shown with the same pulse amplitude according to some embodiments, different pulse amplitudes may also be employed according to other embodiments. For example, the voltage of each pulse may be adjusted such that the product of voltage and pulse duration is nominally equal for each of the pulses, according to some embodiments.

[0194] Returning to the example of FIG. 6A, in some embodiments, (a) the first monophasic voltage pulse 604A and the second monophasic voltage pulse 605 A have a same pulse duration, (b) the third monophasic voltage pulse 605B and the fourth monophasic voltage pulse 604B may have a same pulse duration, or (a) and (b). In some embodiments, the first monophasic voltage pulse 604A, the second monophasic voltage pulse 605 A, the third monophasic voltage pulse 605B, and the fourth monophasic voltage pulse 604B all have the same pulse duration (e.g., as exemplified in FIG.6A). It is noted that according to some embodiments, the same pulse durations described above may be associated with the same nominal or intended values. It is understood, however, that the various pulses may have variations within the tolerances associated with these same nominal values, and as such, embodiments of the present invention may also be employed to minimize systematic effects that may be accentuated by these deviations of the pulse durations from their nominal values.

[0195] In a similar manner, other biphasic voltage pulse waveform characteristics including rise time, fall time, pulse amplitude, and general pulse shape may be the same or different nominally, but will typically exhibit differences, and various embodiments of the present invention are configured to help alleviate systematic effects that may be accentuated by these differences.

[0196] According to some embodiments associated at least with FIG. 6A, the first biphasic voltage pulse 602A may include a first intra-biphasic-pulse delay 613A between the first monophasic voltage pulse 604A and the second monophasic voltage pulse 605 A. In some embodiments, the second biphasic voltage pulse 602B may include a second intra-biphasic-pulse delay 613B between the third monophasic voltage pulse 605B and the fourth monophasic voltage pulse 604B. In some embodiments, a duration of the first intra-biphasic-pulse delay 613A may be the same as a duration of the second intra-biphasic-pulse delay 613B (e.g., as shown in FIG. 6A). In some embodiments, a duration of the first intra-biphasic-pulse delay 613A may be different than a duration of the second intra-biphasic-pulse delay 613B.

[0197] According to some embodiments, an inter-biphasic-pulse delay 603 A, shown in FIG. 6A, spaces or separates the second biphasic voltage pulse 602B from the first biphasic voltage pulse 602A. In some embodiments, the inter-biphasic-pulse delay 603A is longer in duration than each of the first and the second intra-biphasic-pulse delays 613A, 613B.

[0198] In some embodiments, a duration of each of the first and the second intra-biphasic-pulse delays 613A, 613B is between 0 and 8 microseconds, and the inter-biphasic-pulse delay 603A is between 300 microseconds and 1000 microseconds. In some embodiments, a duration of each of the first and the second intra-biphasic-pulse delays 613A, 613B is between 0 and 8 microseconds, and the inter-biphasic-pulse delay 603 A is between 0.5 milliseconds and 15 milliseconds. In some embodiments, a duration of each of the first and the second intra- biphasic-pulse delays 613A, 613B is between 0 and 8 microseconds, and the inter-biphasic-pulse delay 603A is between 15 milliseconds and 30 milliseconds. In some embodiments, a duration of each of the first and the second intra-biphasic-pulse delays 613A, 613B is between 0 and 8 microseconds, and the inter-biphasic-pulse delay 603 A is between 30 milliseconds and 100 milliseconds. In some embodiments, a duration of each of the first and the second intra- biphasic-pulse delays 613A, 613B is between 0 and 8 microseconds, and the inter-biphasic-pulse delay 603 A is at least 100 milliseconds. In some embodiments, the inter-biphasic-pulse delay 603A is at least 100 milliseconds with an upper bound limited, e.g., in some embodiments, by clinical speed requirements (e.g., to reduce procedure time). For example, in some embodiments, the 1.5 seconds upper bound may be associated with delivering at least 400 pulses while keeping treatment time at 10 minutes or less. In other embodiments, the upper bound of the inter-biphasic-pulse delay may be associated with a heart rate. For instance, in some embodiments, such as embodiments associated with delivery of pulses synchronously with the cardiac cycle, the inter-biphasic-pulse delay 603A is between 100 milliseconds and 1.5 seconds, which, in some contexts for example, may correspond to a heart rate of 40 bpm, where an electrophysiology (“EP”) technician may start pacing or at which the EP technician may have a pacemaker set during the treatment procedure (e.g., in order to avoid an unacceptably low heart rate). It is noted that although the pulse train in FIG. 6A shows multiple inter-biphasic-pulse delays 603, each having a same duration according to various embodiments, multiple inter- biphasic-pulse delays 603 having different durations may be employed in other embodiments, as described below in this disclosure.

[0199] In some embodiments, each of the first monophasic voltage pulse 604A, the second monophasic voltage pulse 605 A, the third monophasic voltage pulse 605B, and the fourth monophasic voltage pulse 604B has a pulse duration between 1 microsecond and 8 microseconds. In some embodiments, each of the first monophasic voltage pulse 604A, the second monophasic voltage pulse 605 A, the third monophasic voltage pulse 605B, and the fourth monophasic voltage pulse 604B has a pulse duration between 0.01 microseconds and 1 microsecond. In some embodiments, each of the first monophasic voltage pulse 604A, the second monophasic voltage pulse 605 A, the third monophasic voltage pulse 605B, and the fourth monophasic voltage pulse 604B has a pulse amplitude between 200 V and 3000 V. The provision of the at least one pulse train in accordance with block 502 of method 500 may, in some embodiments, be represented as block 502b in FIG. 5C. According to some embodiments associated with block 502b, each pulse train of the at least one pulse train that is provided includes a plurality of first monophasic voltage pulses (e.g., first monophasic pulses 604 in FIG. 6A). According to some embodiments, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses has a same first polarity (e.g., the first monophasic pulses 604 in FIG. 6A have a same first polarity). According to some embodiments, the plurality of first monophasic voltage pulses includes at least four successive pairs of first monophasic voltage pulses in the pulse train. For example, in FIG. 6A, the pulse train 610 includes four successive pairs of first monophasic voltage pulses 604 including a first pair made up of first monophasic voltage pulses 604A and 604B, a second pair made up of first monophasic voltage pulses 604B and 604C, a third pair of first monophasic voltage pulses made up first monophasic voltage pulses 604C and 604D, and a fourth pair made up of first monophasic voltage pulses 604D and 604E. According to various embodiments, the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses are spaced or separated from one another by a respective first inter-monophasic-pulse delay (e.g., the respective first inter-monophasic-pulse delays 606 shown in FIG.6A).

[0200] According to some embodiments, the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train has a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train. For example, in FIG. 6A, the respective first inter-monophasic-pulse delay 606C, which is between the first monophasic voltage pulses 604C and 604D that make up the third pair of the four successive pairs of first monophasic voltage pulses 604 exemplified in FIG. 6 A, has a different duration (e.g., longer in this example embodiment) as compared with (i) the respective first inter-monophasic-pulse delay 606B between the first monophasic voltage pulses 604B and 604C that form the pair of the successive first monophasic voltage pulses that sequentially precedes the third pair of the four successive pairs of first monophasic voltage pulses 604, and (ii) the respective first inter-monophasic-pulse delay 606D between the first monophasic voltage pulses 604D and 604E that form the pair of the successive first monophasic voltage pulses that sequentially succeeds the third pair of the four successive pairs of first monophasic voltage pulses 604. The same situation occurs with the respective first inter- monophasic-pulse delay 606B between the first monophasic voltage pulses 604B and 604C that make up the second pair of the four successive pairs of first monophasic voltage pulses 604 exemplified in FIG. 6A, as the respective first inter-monophasic-pulse delay 606B has a different duration (e.g., shorter in this example embodiment) as compared with (iii) the respective first inter-monophasic-pulse delay 606A between the first monophasic voltage pulses 604A and 604B that form the pair of the successive first monophasic voltage pulses that sequentially precedes the second pair of the four successive pairs of first monophasic voltage pulses 604, and (iv) the respective first inter-monophasic-pulse delay 606C between the first monophasic voltage pulses 604C and 604D that form the pair of the successive first monophasic voltage pulses that sequentially succeeds the second pair of the four successive pairs of first monophasic voltage pulses 604. The first pair of first monophasic voltage pulses 604A and 604B is the initial pair of successive first monophasic voltage pulses 604 in the pulse train 610, and, as such, no preceding pair of successive first monophasic voltage pulses 604 is present in the pulse train 610. However, the first pair of successive first monophasic voltage pulses 604 A and 604B is sequentially succeeded by the second pair of successive first monophasic voltage pulses 604B and 604C whose respective first inter-monophasic-pulse delay 606B has a duration that is different (e.g., shorter) than the first inter-monophasic-pulse delay 606A. The fourth pair of successive first monophasic voltage pulses 604D and 604E has a respective first inter- monophasic-pulse delay 606D that is different in duration than the respective first inter- monophasic-pulse delay 606 of each of the pair of successive first monophasic voltage pulses 604 that sequentially precedes the fourth pair of successive first monophasic voltage pulses 604D and 604E and the pair of successive first monophasic voltage pulses 604 that sequentially succeeds the fourth pair of successive first monophasic voltage pulses 604D and 604E as shown in FIG. 6A, according to various embodiments.

[0201] Although the embodiment described above with respect to FIG. 6A is described as the four successive pairs of first monophasic voltage pulses 604 in the pulse train 610 including the initial first monophasic pulse 604A, it is understood that in other embodiments, the initial first monophasic voltage pulse in the pulse train need not be included in the four successive pairs of first monophasic voltage pulses 604. In some embodiments, the four successive pairs of first monophasic voltage pulses 604 in the pulse train 610 may exclude the initial monophasic pulse 604A having the first polarity in the pulse train and the last monophasic pulse 604END having the first polarity in the pulse train. The differences in inter-monophasic pulse delays described above with respect to FIG. 6 A, for example, may, in some embodiments, be caused by the flipping of the polarities of successive biphasic voltage pulses 602, as shown in FIG. 6A, in an attempt to reduce accumulated magnetic flux in a transformer of the energy source device system circuit 340, as described above. The differences in inter-monophasic pulse delays described above with respect to FIG. 6A may also provide benefits in a purely monophasic pulse train, for instance, by allowing improved control over pulse timings, which may facilitate control over balancing therapeutic tissue treatment and allowing cardiovascular recovery following pulse-induced cardiac stimulation between pulse set deliveries.

[0202] In some embodiments, each pulse train 610 of the at least one pulse train per block 502 includes a sequence of the respective first inter-monophasic-pulse delays (e.g., first inter- monophasic pulse delays 606 in FIG. 6A), and successive respective first inter-monophasic- pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration, the second duration different than the first duration. In some embodiments, the four successive pairs of first monophasic voltage pulses 604 in the pulse train 610 include a sequence of the respective first inter-monophasic-pulse delays 606, and the successive respective first inter-monophasic-pulse delays 606 in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration. For example, in some embodiments associated at least with FIG. 6A, the sequence of successive respective first inter-monophasic-pulse delays 606 A, 606B, 606C, and 606D are associated with the four successive pairs of first monophasic voltage pulses 604 in the pulse train 610. In this regard, the respective first inter-monophasic-pulse delays cycle between a relatively longer first duration (e.g., as exemplified by the respective first inter-monophasic-pulse delays 606A and 606C in the example of FIG. 6A) and a relatively shorter second duration (e.g., as exemplified by the respective first inter-monophasic-pulse delays 606B and 606D), according to some embodiments.

[0203] In some embodiments, each pulse train 610 of the at least one pulse train may include a particular monophasic voltage pulse having a particular pulse width, and the first duration is longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, the first duration is longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse. For example, according to some embodiments associated at least with FIG. 6A, the first duration (e.g., as exemplified by the duration of the first inter- monophasic-pulse delay 606A) is longer than the second duration (e.g., as exemplified by the duration of the first inter-monophasic-pulse delay 606B) by at least twice the particular pulse width (e.g., pulse width 609P in FIG. 6A) of a particular one of the first monophasic voltage pulses 604. The particular monophasic pulse need not have the same polarity as the first polarity of the first monophasic voltage pulses 604 in some embodiments. For example, according to some embodiments associated at least with FIG. 6A, the first duration (e.g., as exemplified by the duration of the first inter-monophasic-pulse delay 606A) is longer than the second duration (e.g., as exemplified by the duration of the first inter-monophasic-pulse delay 606B) by at least twice the particular pulse width (e.g., pulse width 609N in FIG. 6A) of one of the second monophasic voltage pulses 605 described in further detail below that has a second polarity that is opposite the first polarity of the first monophasic voltage pulses 604.

[0204] In some embodiments, each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first monophasic voltage pulses has a pulse amplitude between 200 V and 3000 V.

[0205] In some embodiments, the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses have a same duration (e.g., as shown in FIG. 6A).

[0206] In some embodiments, each pulse train 610 of the at least one pulse train may include a plurality of second monophasic voltage pulses. In this regard, the provision of the at least one pulse train in accordance with block 502 of method 500 may, in some embodiments, be represented as block 502c in FIG. 5D. According to some embodiments associated with block 502c, each pulse train of the at least one pulse train that is provided includes a plurality of first monophasic voltage pulses (e.g., first monophasic voltage pulses 604 in FIG. 6A) and a plurality of second monophasic voltage pulses (e.g., second monophasic voltage pulses 605 in FIG. 6A). In some embodiments, each second monophasic voltage pulse of the plurality of second monophasic voltage pulses may have a same second polarity that is opposite the first polarity of the first monophasic voltage pulses 604 of the plurality of first monophasic voltage pulses. For example, in FIG. 6A, each second monophasic voltage pulse of the plurality of second monophasic voltage pulses 605 has a second polarity that is opposite the first polarity of each first monophasic voltage pulse 604.

[0207] In some embodiments, the plurality of second monophasic voltage pulses may include at least four successive pairs of second monophasic voltage pulses in the pulse train. For example, in FIG. 6A, the pulse train 610 includes four successive pairs of second monophasic voltage pulses 605 including a first pair made up of second monophasic voltage pulses 605A and 605B, a second pair made up of second monophasic voltage pulses 605B and 605C, a third pair of second monophasic voltage pulses made up of second monophasic voltage pulses 605 C and 605D, and a fourth pair made up of second monophasic voltage pulses 605D and 605E. According to various embodiments, the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses are spaced or separated from one another by a respective second inter-monophasic-pulse delay (e.g., the respective second inter-monophasic- pulse delays 607 shown in FIG.6A).

[0208] According to some embodiments, the respective second inter-monophasic-pulse delay 607 between the second monophasic voltage pulses of each pair of the four successive pairs of second monophasic voltage pulses 605 in the pulse train 610 has a different duration as compared with the respective second inter-monophasic-pulse delay 607 between the second monophasic voltage pulses 605 of (c) a sequentially preceding pair of the successive second monophasic voltage pulses 605 in the pulse train 610, if present in the at least four successive pairs of second monophasic voltage pulses 605 in the pulse train 610, and (d) a sequentially succeeding pair of the successive second monophasic voltage pulses 605 in the pulse train 610, if present in the at least four successive pairs of second monophasic voltage pulses 605 in the pulse train 610. For example, in FIG. 6A, the respective second inter-monophasic-pulse delay 607C, which is between the second monophasic voltage pulses 605C and 605D that make up the third pair of the four successive pairs of second monophasic voltage pulses 605 exemplified in FIG. 6A, has a different duration (e.g., shorter in this example embodiment) as compared with (i) the respective second inter-monophasic-pulse delay 607B between the second monophasic voltage pulses 605B and 605C that form the pair of the successive second monophasic voltage pulses that sequentially precedes the third pair of the four successive pairs of second monophasic voltage pulses 605, and (ii) the respective second inter-monophasic-pulse delay 607D between the second monophasic voltage pulses 605D and 605E that form the pair of the successive second monophasic voltage pulses that sequentially succeeds the third pair of the four successive pairs of second monophasic voltage pulses 605. The same situation occurs with the respective second inter-monophasic-pulse delay 607B, which is between the second monophasic voltage pulses 605B and 605C that make up the second pair of the four successive pairs of second monophasic voltage pulses 605 exemplified in FIG. 6A, and which has a different duration (e.g., longer in this example embodiment) as compared with (iii) the respective second inter-monophasic-pulse delay 607A between the second monophasic voltage pulses 605A and 605B that form the pair of the successive second monophasic voltage pulses that sequentially precedes the second pair of the four successive pairs of second monophasic voltage pulses 605, and (iv) the respective second inter-monophasic-pulse delay 607C between the second monophasic voltage pulses 605C and 605D that form the pair of the successive second monophasic voltage pulses that sequentially succeeds the second pair of the four successive pairs of second monophasic voltage pulses 605. The first pair of second monophasic voltage pulses 605A and 605B is the initial pair of successive second monophasic voltage pulses 605 in the pulse train 610, and, as such, no preceding pair of successive second monophasic voltage pulses 605 is present in the pulse train 610. However, the first pair of successive second monophasic voltage pulses 605A and 605B is sequentially succeeded by the second pair of successive second monophasic voltage pulses 605B and 605C whose respective second inter- monophasic-pulse delay 607B has a duration that is different (e.g., longer) than the second inter- monophasic-pulse delay 607 A. The fourth pair of successive second monophasic voltage pulses 605D and 605E has a respective first inter-monophasic-pulse delay 607D that is different in duration than the respective second inter-monophasic-pulse delay 607 of each of the pair of successive second monophasic voltage pulses 605 that sequentially precedes the fourth pair of successive second monophasic voltage pulses 605D and 605E and the pair of successive second monophasic voltage pulses 605 that sequentially succeeds the fourth pair of successive second monophasic voltage pulses 605D and 605E, as shown in FIG. 6A, according to various embodiments.

[0209] Although the embodiment described above with respect to FIG. 6A is described as the four successive pairs of second monophasic voltage pulses 605 in the pulse train 610 including the initial second monophasic pulse 605 A, it is understood that in other embodiments, the initial second monophasic voltage pulse in the pulse train need not be included in the four successive pairs of second monophasic voltage pulses 605. In some embodiments, the four successive pairs of second monophasic voltage pulses 605 in the pulse train 610 may exclude the initial monophasic pulse 605A having the second polarity in the pulse train and the last monophasic pulse 605END having the second polarity in the pulse train.

[0210] According to some embodiments, each pulse train 610 of the at least one pulse train per block 502 (e.g., at least block 502c) may include a sequence of the respective second inter- monophasic-pulse delays (e.g., second inter-monophasic-pulse delays 607 in FIG. 6A), and the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays may cycle between a first duration and a second duration, the second duration different than the first duration. In some embodiments, the four successive pairs of second monophasic voltage pulses 605 in the pulse train 610 include a sequence of the respective second inter-monophasic-pulse delays 607, and the successive respective second inter-monophasic-pulse delays 607 in the sequence of the respective second inter-monophasic- pulse delays cycle between a first duration and a second duration, the second duration different than the first duration. For example, in some embodiments associated at least with FIG. 6A, the sequence of successive respective second inter-monophasic-pulse delays 607 A, 607B, 607C, and 607D are associated with the four successive pairs of second monophasic voltage pulses 605 shown in the pulse train 610. In this regard, the respective second inter-monophasic-pulse delays 607 cycle between a relatively shorter duration (e.g., as exemplified by the respective second inter-monophasic-pulse delays 607A and 607C) and a relatively longer second duration (e.g., as exemplified by the respective second inter-monophasic-pulse delays 607B and 607D), according to some embodiments.

[0211] In some embodiments, each pulse train of the at least one pulse train may include a sequence of the respective first inter-monophasic-pulse delays, with the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic- pulse delays cycling between a first duration and a second duration. In some embodiments, each pulse train of the at least one pulse train may further include a sequence of the respective second inter-monophasic-pulse delays, with the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycling between the first duration and the second duration. For example, in FIG. 6A, the respective first inter- monophasic-pulse delays 606 cycle between a first duration as exemplified by the duration of each of the respective first inter-monophasic-pulse delays 606A and 606C, and a second duration as exemplified by the duration of each of the respective first inter-monophasic-pulse delays 606B and 606D. The respective second inter-monophasic-pulse delays 607 cycle between a first duration as exemplified by the duration of each of the respective second inter- monophasic-pulse delays 607B and 607D, and a second duration as exemplified by the duration of each of the respective second inter-monophasic-pulse delays 607A and 607C. According to various embodiments, these two first durations have the same duration, and these two second durations have the same duration. In some embodiments, each of the first duration and the second duration is between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first duration and the second duration is between 30 milliseconds and 100 milliseconds. In some embodiments, each of the first duration and the second duration is at least 100 milliseconds. In some embodiments, each of the first duration and the second duration is between 100 milliseconds and 1.5 seconds. In some embodiments, a duration of each of the first inter- monophasic-pulse delays 606 and the second inter-monophasic-pulse delays 607 is between 300 microseconds and 1000 microseconds. In some embodiments, a duration of each of the first inter-monophasic-pulse delays 606 and the second inter-monophasic-pulse delays 607 is between 0.5 milliseconds and 15 milliseconds. In some embodiments, a duration of each of the first inter-monophasic-pulse delays 606 and the second inter-monophasic-pulse delays 607 is between 15 milliseconds and 30 milliseconds. In some embodiments, a duration of each of the first inter-monophasic-pulse delays 606 and the second inter-monophasic-pulse delays 607 is between 30 milliseconds and 100 milliseconds. In some embodiments, a duration of each of the first inter-monophasic pulse delays 606 and the second inter-monophasic pulse delays 607 is at least 100 milliseconds. In some embodiments, a duration of each of the first inter-monophasic pulse delays 606 and the second inter-monophasic pulse delays 607 is at least 100 milliseconds with an upper bound limited, e.g., in some embodiments, by clinical speed requirements (e.g., to reduce procedure time). For example, in some embodiments, the 1.5 seconds upper bound may be associated with delivering at least 400 pulses while keeping treatment time at 10 minutes or less. In other embodiments, the upper bound of the inter-biphasic-pulse delay may be associated with a heart rate. For instance, in some embodiments, such as embodiments associated with delivery of pulses synchronously with the cardiac cycle, a duration of each of the first inter- monophasic pulse delays 606 and the second inter-monophasic pulse delays 607 is between 100 milliseconds and 1.5 seconds, which, in some contexts for example, may correspond to a heart rate of 40 bpm, where an electrophysiology (“EP”) technician may start pacing or at which the EP technician may have a pacemaker set during the treatment procedure (e.g., in order to avoid an unacceptably low heart rate). In some embodiments, each first monophasic voltage pulse 604 and each second monophasic voltage pulse 605 has a pulse amplitude between 200 V and 3000 V.

[0212] In some embodiments, the four successive pairs of first monophasic voltage pulses 604 in the pulse train 610 may include a sequence of the respective first inter-monophasic-pulse delays 606, with the successive respective first inter-monophasic-pulse delays 606 in the sequence of the respective first inter-monophasic-pulse delays 606 cycling between a first duration and a second duration. In some embodiments, the four successive pairs of second monophasic voltage pulses 605 in the pulse train may include a sequence of the respective second inter-monophasic-pulse delays 607, and the successive respective second inter- monophasic-pulse delays 607 in the sequence of the respective second inter-monophasic-pulse delays 607 may cycle between the first duration and the second duration (e.g., as described above in this disclosure). In some embodiments, the respective second inter-monophasic-pulse delay 607 between the second monophasic voltage pulses 605 of a particular pair of successive second monophasic voltage pulses in the plurality of second monophasic voltage pulses 605 has a duration that is different than a duration of the respective first inter-monophasic-pulse delay 606 between the first monophasic voltage pulses 604 of a particular pair of successive first monophasic voltage pulses in the plurality of first monophasic voltage pulses 604. For example, in some embodiments associated at least with FIG. 6A, the respective second inter-monophasic-pulse delay 607C between the particular pair of second monophasic voltage pulses 605 C and 605D has a duration that is different than a duration of the respective first inter-monophasic-pulse delay 606C between the particular pair of first monophasic voltage pulses 604C and 604D. According to some embodiments, the respective second inter-monophasic-pulse delay 607C between the particular pair of second monophasic voltage pulses 605C and 605D occurs during the respective first inter-monophasic-pulse delay 606C between the particular pair of first monophasic voltage pulses 604C and 604D. In some embodiments, the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses have a same first duration, and the second monophasic voltage pulses 605 in the plurality of second monophasic voltage pulses have a same second duration (e.g., as shown in FIG. 6A). In some embodiments, the second duration is equal to the first duration (e.g., as shown in FIG. 6A). In some embodiments, (i) each of the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses 605 in the plurality of second monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

[0213] Referring back to block 502c in FIG. 5D, the provision of the at least one pulse train in accordance with block 502 of method 500 may, in some embodiments, be represented as block 502c in FIG. 5D in which each pulse train of the at least one pulse train that is provided includes a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses. According to various embodiments, each first monophasic voltage pulse has a same first polarity (e.g., first monophasic voltage pulses 604 in FIG. 6A), and each second monophasic voltage pulse has a same second polarity (e.g., second monophasic voltage pulses 605 in FIG. 6A), the second polarity opposite the first polarity. In some embodiments, the first monophasic voltage pulses 604 are successively arranged in the pulse train 610 with the first monophasic voltage pulses 604 of each pair of successive first monophasic voltage pulses in the pulse train spaced or separated from one another by a respective first inter-monophasic-pulse delay 606. According to some embodiments, the data processing device system 110, 310 is configured by the program at least to cause provision of each pulse train 610 of the at least one pulse train such that multiple ones of the second monophasic voltage pulses 605 are provided in the pulse train 610 during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses 604 of a first pair of successive ones of the first monophasic voltage pulses 604 in the pulse train 610. For example, in FIG. 6A, multiple second monophasic voltage pulses (605C and 605D in this example) are provided in the pulse train 610 during the respective first inter-monophasic-pulse delay 606C between the first monophasic voltage pulses 604C and 604D that form a first pair of successive ones of the first monophasic voltage pulses 604.

[0214] In some embodiments, the data processing device system 110, 310 may be configured by the program at least to cause provision of each pulse train 610 of the at least one pulse train such that the pulse train 610 exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays 606 between the first monophasic voltage pulses 604 of at least two pairs of successive ones of the first monophasic voltage pulses 604 in the pulse train 610. For example, in FIG. 6A, two pairs of successive ones of the first monophasic voltage pulses 604 include one particular successive pair made up of first monophasic voltage pulses 604C and 604D spaced or separated from one another by respective first inter-monophasic-pulse delay 606C, and another particular successive pair made up of first monophasic voltage pulses 604D and 604E spaced or separated from one another by respective first inter-monophasic-pulse delay 606D. Two second monophasic voltage pulses 605 are provided during the respective first inter-monophasic-pulse delay 606C, while zero second monophasic voltage pulses 605 are provided during the respective first inter-monophasic-pulse delay 606D. It is noted that, in this particular illustrated example embodiment, the pairs of the at least two pairs of successive ones of the first monophasic voltage pulses 604 in the pulse train 610 are successive pairs. In some embodiments, the pairs of the at least two pairs of successive ones of the first monophasic voltage pulses 604 in the pulse train 610 are not successive pairs.

[0215] In some embodiments, the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses may have a same duration (e.g., as shown in FIG. 6A). In some embodiments, the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses may have a same first duration, and the second monophasic voltage pulses 605 in the plurality of second of monophasic voltage pulses have a same second duration (e.g., as shown in FIG. 6A). In some embodiments, the second duration may be equal to the first duration (e.g., as shown in FIG. 6 A). In some embodiments, (i) each of the first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses 605 in the plurality of second monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

[0216] According to some embodiments, each pulse train 610 of the at least one pulse train includes a sequence of the respective first inter-monophasic-pulse delays 606, and the successive respective first inter-monophasic-pulse delays 606 in the sequence of the respective first inter- monophasic-pulse delays 606 cycle between a first duration and a second duration. For example, in FIG. 6A, the durations of the respective first-inter-monophasic-pulse delays 606 cycle between a relatively longer duration (e.g., as indicated by each of respective first-inter- monophasic-pulse delays 606A and 606C) and a relatively shorter duration (e.g., as indicated by each of respective first-inter-monophasic-pulse delays 606B and 606D). In some embodiments, each of the first duration and the second duration may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first duration and the second duration may be between 30 milliseconds and 100 milliseconds. In some embodiments, each of the first duration and the second duration may be at least 100 milliseconds. In some embodiments, each of the first duration and the second duration may be at least 100 milliseconds with an upper bound limited, e.g., in some embodiments, by clinical speed requirements (e.g., to reduce procedure time). For example, in some embodiments, the 1.5 seconds upper bound may be associated with delivering at least 400 pulses while keeping treatment time at 10 minutes or less. In other embodiments, the upper bound of the inter-biphasic-pulse delay may be associated with a heart rate. For instance, in some embodiments, such as embodiments associated with delivery of pulses synchronously with the cardiac cycle, each of the first duration and the second duration may be between 100 milliseconds and 1.5 seconds, which, in some contexts for example, may correspond to a heart rate of 40 bpm, where an electrophysiology (“EP”) technician may start pacing or at which the EP technician may have a pacemaker set during the treatment procedure (e.g., in order to avoid an unacceptably low heart rate). In some embodiments, each pulse train 610 of the at least one pulse train includes a particular monophasic voltage pulse having a particular pulse width, and the first duration may be longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse. In some embodiments, the first duration may be longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse. For example, in some embodiments associated at least with FIG. 6A, a first duration of the first inter-monophasic-pulse delay 606A is longer than a second duration of the first inter-monophasic-pulse delay 606B by at least twice a pulse width of any of the provided first monophasic voltage pulses 604 or a pulse width of any of the provided second monophasic voltage pulses 605. In some embodiments, each first monophasic voltage pulse 604 and each second monophasic voltage pulse 605 has a pulse amplitude between 200 V and 3000 V.

[0217] According to some embodiments, each pulse train 610 of the at least one pulse train is provided such that the pulse train 610 exhibits the different numbers of the second monophasic voltage pulses 605 during the respective first inter-monophasic-pulse delay 606 between the monophasic voltage pulses of at least four pairs of successive ones of the first monophasic voltage pulses 604 in the pulse train. In some embodiments, the different numbers of second monophasic voltage pulses 605 cycle between a first number of second monophasic voltage pulses 605 and a second number of second monophasic voltage pulses 605, and the second number of second monophasic voltage pulses is different than the first number of second monophasic voltage pulses. For example, in some embodiments associated at least with FIG. 6 A, the first number of second monophasic pulses 605 is zero and the second number of monophasic pulses 605 is an integer greater than or equal to two (e.g., two in FIG. 6 A).

[0218] To elaborate, for example, in FIG. 6 A, four pairs of successive ones of the first monophasic voltage pulses 604 include a first pair of first monophasic voltage pulses 604A and 604B having respective first inter-monophasic-pulse delay 606 A therebetween, a second pair of first monophasic voltage pulses 604B and 604C having respective first inter-monophasic-pulse delay 606B therebetween, a third pair of first monophasic voltage pulses 604C and 604D having respective first inter-monophasic-pulse delay 606C therebetween, and a fourth pair of first monophasic voltage pulses 604D and 604E having respective first inter-monophasic-pulse delay 606D therebetween are shown. Two second monophasic voltage pulses 605 are provided during each of first inter-monophasic-pulse delays 606A and 606C, while zero second monophasic pulses 605 are provided during each of first inter-monophasic-pulse delays 606B and 606D in a cyclic manner according to various embodiments. For instance, in FIG. 6A, it is illustrated that the first inter-monophasic-pulse delays 606 alternate between the first inter-monophasic-pulse delays 606A, 606C, 606E and the first inter-monophasic-pulse delays 606B, 606D, such that in at least the illustrated part of the pulse train 610, second monophasic voltage pulses 605 cycle between two of such pulses 605 being within each of the first inter-monophasic-pulse delays 606 A, 606C, 606E and zero of such pulses 605 being within each of the first inter-monophasic- pulse delays 606B, 606D, according to some embodiments. In some embodiments, for each pulse train 610 of the at least one pulse train, the second monophasic voltage pulses 605 are successively arranged in the pulse train 610 with the second monophasic voltage pulses 610 of each pair of successive second monophasic voltage pulses spaced or separated from one another by a respective second inter-monophasic-pulse delay 607. According to some embodiments, the data processing device system 110, 310 is configured by the program at least to cause provision of each pulse train 610 of the at least one pulse train, such that multiple first monophasic voltage pulses 604 are provided during the respective second inter-monophasic-pulse delay 607 between the second monophasic voltage pulses 605 of a first pair of successive second monophasic voltage pulses in the pulse train 610. For example, in FIG. 6A, multiple first monophasic voltage pulses 604 (e.g., first monophasic voltage pulses 604D, 604E) are provided during the respective second inter-monophasic-pulse delay 607D between the second monophasic voltage pulses 605D, 605E of a first pair of successive second monophasic voltage pulses 605.

[0219] In some embodiments, the data processing device system 101, 310 is configured by the program at least to cause provision of each pulse train 610 of the at least one pulse train such that the pulse train 610 exhibits different numbers of first monophasic voltage pulses 604 during the respective second inter-monophasic-pulse delays between the second monophasic voltage pulses of at least two pairs of successive second monophasic voltage pulses in the pulse train. For example, in FIG. 6A, two pairs of successive ones of the second monophasic voltage pulses 605 include one particular successive pair made up of second monophasic voltage pulses 605C and 605D spaced or separated from one another by respective second inter-monophasic-pulse delay 607C, and another particular successive pair made up of second monophasic voltage pulses 605D and 605E spaced or separated from one another by respective second inter- monophasic-pulse delay 607D. Two first monophasic voltage pulses 604 are provided during the respective second inter-monophasic-pulse delay 607D, while zero first monophasic voltage pulses 604 are provided during the respective second inter-monophasic-pulse delay 607C. It is noted that, in this particular illustrated example embodiment, the pairs of the at least two pairs of successive ones of the second monophasic voltage pulses 605 in the pulse train 610 are successive pairs. In some embodiments, the pairs of the at least two pairs of successive ones of the second monophasic voltage pulses 605 in the pulse train 610 are not successive pairs.

[0220] In some embodiments, the data processing device system 110, 310 is configured by the program at least to cause provision of each pulse train 610 of the at least one pulse train, such that the pulse train 610 exhibits different numbers of first monophasic voltage pulses 604 during the respective second inter-monophasic-pulse delays 607 between the second monophasic voltage pulses 605 of at least four pairs of successive second monophasic voltage pulses in the pulse train 610. According to some embodiments, the different numbers of first monophasic voltage pulses 604 may cycle between a first number of first monophasic voltage pulses 604 and a second number of first monophasic voltage pulses 604 in the plurality of first monophasic voltage pulses of the pulse train 610.

[0221] According to various embodiments, the second number of first monophasic voltage pulses 604 is different than the first number of first monophasic voltage pulses 604. For example, in some embodiments associated at least with FIG. 6A, the first number of first monophasic pulses 604 is zero and the second number of first monophasic pulses 604 is an integer greater than or equal to two (e.g., two in FIG. 6A). For instance, in FIG. 6 A, four pairs of successive ones of the second monophasic voltage pulses 605 including a first pair of second monophasic voltage pulses 605A and 605B having respective second inter-monophasic-pulse delay 607A therebetween, a second pair of second monophasic voltage pulses 605B and 605C having respective second inter-monophasic-pulse delay 607B therebetween, a third pair of second monophasic voltage pulses 605C and 605D having respective second inter-monophasic- pulse delay 607C therebetween, and a fourth pair of second monophasic voltage pulses 605D and 605E having respective second inter-monophasic-pulse delay 607D therebetween are shown. Zero first monophasic voltage pulses 604 are provided during each of second inter- monophasic-pulse delays 607A and 607C, while two first monophasic pulses 604 are provided during each of second inter-monophasic-pulse delays 607B and 607D in a cyclic manner according to various embodiments. For instance, in FIG. 6A, it is illustrated that the second inter-monophasic-pulse delays 607 alternate between the second inter-monophasic-pulse delays 607B, 607D and the second inter-monophasic-pulse delays 607A, 607C, 607E, such that in at least the illustrated part of the pulse train 610, first monophasic voltage pulses 604 cycle between two of such pulses 604 being within each of the second inter-monophasic-pulse delays 607B, 607D and zero of such pulses 604 being within each of the second inter-monophasic- pulse delays 607A, 607C, 607E, according to some embodiments.

[0222] According to some embodiments, each pulse train 610 of the at least one pulse train includes a sequence of the respective second inter-monophasic-pulse delays 607, and the successive respective second inter-monophasic-pulse delays 607 in the sequence of the respective second inter-monophasic-pulse delays cycle between a first duration and a second duration. For example, in FIG. 6A, the durations of the respective second inter-monophasic- pulse delays 607 cycle between a relatively shorter duration (e.g., as indicated by each of respective second inter-monophasic-pulse delays 607A and 607C) and a relatively longer duration (e.g., as indicated by each of respective second inter-monophasic-pulse delays 607B and 607D). In some embodiments, each of the first duration and the second duration may be between 300 microseconds and 1000 microseconds. In some embodiments, each of the first duration and the second duration may be between 0.5 milliseconds and 15 milliseconds. In some embodiments, each of the first duration and the second duration may be between 15 milliseconds and 30 milliseconds. In some embodiments, each of the first duration and the second duration may be between 30 milliseconds and 100 milliseconds. In some embodiments, each of the first duration and the second duration is at least 100 milliseconds. In some embodiments, each of the first duration and the second duration is at least 100 milliseconds with an upper bound limited, e.g., in some embodiments, by clinical speed requirements (e.g., to reduce procedure time). For example, in some embodiments, the 1.5 seconds upper bound may be associated with delivering at least 400 pulses while keeping treatment time at 10 minutes or less. In other embodiments, the upper bound of the inter-biphasic-pulse delay may be associated with a heart rate. For instance, in some embodiments, such as embodiments associated with delivery of pulses synchronously with the cardiac cycle, each of the first duration and the second duration may be between 100 milliseconds and 1.5 seconds, which, in some contexts for example, may correspond to a heart rate of 40 bpm, where an electrophysiology (“EP”) technician may start pacing or at which the EP technician may have a pacemaker set during the treatment procedure (e.g., in order to avoid an unacceptably low heart rate).

[0223] In some embodiments, all or one or more portions of a pulse train provided in accordance with block 502 of method 500 may be provided to a same electrode set. For instance, in some embodiments, the sequence of biphasic pulses illustrated in FIG. 6A may be provided or delivered to a same electrode set (e.g., a pair or more of electrodes of transducers 220, 306, 406). In some embodiments, the data processing device system (e.g., 110, 310) may be configured at least by the program (e.g., including instructions associated with at least block 502) at least to cause, via the input-output device system (e.g., 120, 320) and via operation of at least the energy source device system circuit (e.g., energy source device system circuit 340), provision of at least one pulse train (e.g., pulse train 610 in FIG. 6A in some embodiments), where each pulse train of the at least one pulse train includes a plurality of biphasic voltage pulses. In some embodiments, the plurality of biphasic voltage pulses includes a first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in FIG. 6A) and a second biphasic voltage pulse (e.g., biphasic voltage pulse 602B in FIG. 6 A) that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic pulse and the second biphasic pulse. In some embodiments, each of the first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in FIG. 6A) and the second biphasic voltage pulse (e.g., biphasic voltage pulse 602B in FIG. 6A) is provided to a particular electrode set of at least some electrodes of a plurality of electrodes (e.g., electrodes 220, 306, 406) supported by a structure (e.g., 218, 308, 401) of a catheter (e.g., 200, 300, 400). For instance, in some embodiments in which consecutive biphasic voltage pulses (such as biphasic voltage pulses 602A, 602B) in a pulse train (e.g., pulse train 610 in FIG. 6A) are provided to a particular electrode set, there may be no other pulses of the pulse train 610 delivered between the consecutive biphasic pulses (e.g., no other pulses in the pulse train 610 exist between the biphasic voltage pulses 602A, 602B in this example). In some embodiments, these consecutive biphasic voltage pulses may be provided to a same particular electrode set (e.g., electrodes of transducers (e.g., 220, 306, 406)). In some embodiments, the first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in FIG. 6A in this example) includes a first monophasic voltage pulse (e.g., monophasic voltage pulse 604A) followed by a second monophasic voltage pulse (e.g., monophasic voltage pulse 605A), the first monophasic voltage pulse having a first polarity (e.g., a positive polarity for monophasic voltage pulse 604A in this example) and the second monophasic voltage pulse having a second polarity (e.g., a negative polarity for monophasic voltage pulse 605A in this example) opposite the first polarity. In some embodiments, the second biphasic voltage pulse (e.g., biphasic voltage pulse 602B in FIG. 6A in this example) includes a third monophasic voltage pulse (e.g., monophasic voltage pulse 605B) followed by a fourth monophasic voltage pulse (e.g., monophasic voltage pulse 604B), the third monophasic voltage pulse having the second polarity (e.g., a negative polarity for monophasic voltage pulse 605B in this example) and the fourth monophasic voltage pulse having the first polarity (e.g., a positive polarity for monophasic voltage pulse 604B in this example).

[0224] In some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the pulse train does not include any pulse (e.g., a high voltage or pulsed field ablative pulse) between the first and second monophasic voltage pulses of the first biphasic voltage pulse. For instance, in some embodiments in which a sequence of the biphasic voltage pulses (such as biphasic voltage pulses 602A, 602B in the example of FIG. 6A) in a pulse train (e.g., pulse train 610 in FIG. 6A) are provided to a particular electrode set, there may be no other pulses of the pulse train 610 delivered between the first monophasic voltage pulse (e.g., monophasic voltage pulse 604A in FIG. 6A) and the second monophasic voltage pulse (e.g., monophasic voltage pulse 605A in FIG. 6A) of the first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in FIG. 6A). Similarly, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the pulse train does not include any pulse (e.g., a high voltage or pulsed field ablative pulse) between the third and fourth monophasic voltage pulses of the second biphasic voltage pulse. For instance, in some embodiments in which consecutively or successively arranged biphasic voltage pulses (such as biphasic voltage pulses 602A, 602B in the example of FIG. 6A) in a pulse train (e.g., pulse train 610 in FIG. 6A) are provided to a particular electrode set, there may be no other pulses of the pulse train 610 delivered between the third monophasic voltage pulse (e.g., monophasic voltage pulse 605B in FIG. 6A) and the fourth monophasic voltage pulse (e.g., monophasic voltage pulse 604B in FIG. 6 A) of the second biphasic voltage pulse (e.g., biphasic voltage pulse 602B in FIG. 6A).

[0225] In some embodiments, the data processing device system (e.g., 110, 310) may be configured at least by the program (e.g., including instructions associated with at least block 502) at least to cause, via the input-output device system (e.g., 120, 320) and via operation of at least the energy source device system circuit (e.g., energy source device system circuit 340), provision of at least one pulse train (e.g., delivered according to some embodiments of block 502), where each pulse train of the at least one pulse train includes at least three biphasic voltage pulses. For instance, in the example of FIG. 6 A, the pulse train 610 includes at least three biphasic voltage pulses 602D, 602E, and 602F. In some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), each biphasic voltage pulse of the at least three biphasic voltage pulses includes a respective first monophasic voltage pulse (e.g., monophasic voltage pulse 605D in the case of biphasic voltage pulse 602D) and a respective second monophasic voltage pulse (e.g., monophasic voltage pulse 604D in the case of biphasic voltage pulse 602D) having a polarity opposite a polarity of the first monophasic voltage pulse (e.g., monophasic voltage pulse 605D in FIG. 6A is of negative polarity, whereas monophasic voltage pulse 604D is of positive polarity), where the respective second monophasic voltage pulse (e.g., pulse 604D in this example) follows the respective first monophasic voltage pulse (pulse 605D in this example) in the pulse train (e.g., pulse train 610 in FIG. 6A, in some embodiments). In this context, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the biphasic voltage pulses of the at least three biphasic voltage pulses (e.g., biphasic voltage pulses 602D, 602E, 602F in FIG. 6A in this example) are successively arranged in the pulse train (e.g., pulse train 610 in FIG. 6A) with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse (e.g., monophasic voltage pulse 604D) of a first biphasic voltage pulse (e.g., biphasic voltage pulse 602D) in the particular successive pair of biphasic voltage pulses has a same polarity (e.g., positive polarity in this example) as the respective first monophasic voltage pulse (e.g., monophasic voltage pulse 604E) of a second biphasic voltage pulse (e.g., biphasic voltage pulse 602E) that follows the first biphasic voltage pulse (e.g., biphasic voltage pulse 604D) in the particular successive pair of biphasic voltage pulses (e.g., the successive pair of biphasic voltage pulses 602D, 602E in this example instance).

[0226] Continuing with this example, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the pulse train may be considered to include at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes. In some embodiments, these at least two biphasic voltage pulses may be included in the above-discussed at least three biphasic voltage pulses (e.g., included in the above example of biphasic voltage pulses 602D, 602E, 602F, in some embodiments) or they may be other than the at least three biphasic voltage pulses (e.g., other than the biphasic voltage pulses 602D, 602E, 602F in the above example, in some embodiments). In this regard, as discussed above, all or one or more pulses of a pulse train may be delivered to the same electrode set. Accordingly, in some embodiments, these at least two biphasic voltage pulses may be provided to a same particular electrode set (e.g., electrodes of transducers (e.g., 220, 306, 406)). In some embodiments, these at least two biphasic voltage pulses provided to a same particular electrode set are consecutively or successively arranged in the pulse train. In some embodiments, these at least two biphasic voltage pulses provided to a same particular electrode set are not consecutively or not successively arranged in the pulse train. In some embodiments, these at least two biphasic voltage pulses are consecutive or successive biphasic voltage pulses in a sequence of biphasic voltage pulses provided to a same particular electrode set.

[0227] In some embodiments, these at least two biphasic voltage pulses may at least partially follow the flipped polarity sequencing shown at least in FIG. 6 A. For instance, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train includes a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse, the respective second particular monophasic voltage pulse following the respective first particular monophasic voltage pulse in the pulse train. In this regard, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train has a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses. For example, with respect to FIG. 6A, if the at least two biphasic voltage pulses are considered to include biphasic voltage pulses 602B and 602C, the respective second particular monophasic voltage pulse (e.g., monophasic voltage pulse 604B) of a first particular biphasic voltage pulse (e.g., biphasic voltage pulse 602B in this example) of the at least two biphasic voltage pulses in the pulse train has a same polarity as the respective first particular monophasic voltage pulse (e.g., monophasic voltage pulse 604C) of a second particular biphasic voltage pulse (e.g., biphasic voltage pulse 602C in this example) of the at least two biphasic voltage pulses. In some embodiments, the first particular biphasic voltage pulse and the second particular biphasic voltage pulse are consecutive or successive biphasic voltage pulses in a sequence of biphasic voltage pulses provided to a same particular electrode set.

[0228] As discussed above, all or one or more pulses of a pulse train may be delivered to the same electrode set. In this regard, in some embodiments pulses or pulse sequences of a pulse train may be distributed among different electrode sets. Continuing with the previous example, in some embodiments, while the above-discussed at least two biphasic voltage pulses may be delivered to the same particular electrode set, each of at least some of the above-discussed at least three biphasic voltage pulses may be delivered to a respective electrode set. For instance, in some embodiments, the above-discussed at least three biphasic voltage pulses may include three biphasic pulses that are successively arranged in the pulse train. An example will be provided in this regard with respect to some embodiments of FIG. 6A. Accordingly, it should be noted that FIG. 6A pertains to various embodiments, some of which have all pulses in the pulse train 610 of FIG. 6A going to the same electrode set, at least according to examples provided above, and some of which distribute pulses of the pulse train 610 of FIG. 6A to multiple electrode sets (e.g., electrodes of transducers (e.g., 220, 306, 406)). In this regard, in some embodiments associated with FIG. 6A, if the three biphasic pulses mentioned earlier in this paragraph, which are successively arranged in the pulse train 610 in FIG. 6A, are considered to be biphasic voltage pulses 602A, 602B, and 602C, such pulses 602A, 602B, and 602C may respectively be provided to respective electrode sets. In some embodiments, such pattern of pulse distribution may be repeated for biphasic voltage pulses 602D, 602E, and 602F, such that biphasic voltage pulses 602A and 602D are provided to the same first electrode set, biphasic voltage pulses 602B and 602E are provided to the same second electrode set, and biphasic voltage pulses 602C and 602F are provided to the same third electrode set, where the first electrode set, the second electrode set, and the third electrode set are different electrode sets, according to some embodiments. In such a configuration, biphasic voltage pulses 602A and 602D may be considered an example of the above-discussed at least two biphasic voltage pulses that are provided to the same particular electrode set. Or, biphasic voltage pulses 602B and 602E may be considered an example of the above-discussed at least two biphasic voltage pulses that are provided to the same particular electrode set. Or, biphasic voltage pulses 602C and 602F may be considered an example of the above-discussed at least two biphasic voltage pulses that are provided to the same particular electrode set.

[0229] In this regard, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), three biphasic pulses of the at least three biphasic pulses may be successively arranged in the pulse train (e.g., as are biphasic voltage pulses 602A, 602B, 602C in the example of FIG. 6A), where each of the three biphasic pulses may be provided to a respective electrode set of a plurality of electrode sets (e.g., electrodes of transducers 220, 306, 406), and where each electrode set of the plurality of electrode sets includes at least one electrode not included in any other electrode set of the plurality of electrode sets.

[0230] In some embodiments, pulses in a pulse train may be distributed to different electrode sets in an interleaved manner, for instance, where one pulse set or sequence is distributed to one electrode set in between pulse sets or sequences delivered to another electrode set. Continuing with the previous example, in some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the at least two biphasic voltage pulses are provided to the same particular electrode set of the at least some electrodes of the plurality of electrodes according to a particular sequence, and for each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train, the second particular biphasic voltage pulse occurs immediately after the first particular biphasic voltage pulse in the particular sequence. For instance, with reference to the example of FIG. 6 A, according to some embodiments, the above-discussed at least two biphasic voltage pulses delivered to the same particular electrode set may be considered to be or include biphasic voltage pulse 602A and biphasic voltage pulse 602D, such that biphasic voltage pulses 602A, 602D may be considered to be a particular sequence of biphasic voltage pulses delivered to the same particular electrode set, such that, from the perspective of the same particular electrode set, biphasic voltage pulse 602D occurs immediately after biphasic voltage pulse 602A (e.g., at least if the time axis is considered such that pulses to the left are “newer” and “ahead-in-line”) with that particular electrode set delivering no other pulse between the biphasic voltage pulses 602A, 602D.

[0231] Accordingly, from the perspective of the pulse train (e.g., pulse train 610 in the example of FIG. 6A), the above-discussed interleaving may occur by delivering one or more pulses within that sequence of pulses to one or more other electrode sets. For instance, if the abovediscussed at least two biphasic voltage pulses delivered to the same particular electrode set is considered to be or include biphasic voltage pulse 602A and biphasic voltage pulse 602D in the example of FIG. 6A, then biphasic voltage pulses 602B, 602C of pulse train 610 may be delivered to one or more electrode sets other than the particular electrode set (e.g., two electrode sets other than the particular electrode set as described above). In some embodiments, for each pulse train of the at least one pulse train (e.g., delivered according to some embodiments of block 502), the pulse train may include at least one biphasic voltage pulse (e.g., biphasic voltage pulse 602B or 602C) provided to an electrode set other than the particular electrode set to which the at least two biphasic voltage pulses (e.g., biphasic voltage pulses 602A, 602D in this example) are provided, where the at least one biphasic voltage pulse (e.g., biphasic voltage pulse 602B, 602C) occurs between the first particular biphasic voltage pulse (e.g., biphasic voltage pulse 602A in this example) and the second particular biphasic voltage pulse (e.g., biphasic voltage pulse 602D in this example) in the pulse train (e.g., 610). In some embodiments, such electrode set, which is other than the particular electrode set, is mutually exclusive (i.e., shares no electrode) with the particular electrode set.

[0232] According to some embodiments, distributing biphasic pulses in a pulse train to different electrode sets may occur on a pulse set-by -pulse set basis, each pulse set containing multiple consecutive biphasic pulses in the pulse train. According to some embodiments, distributing biphasic pulses in a pulse train to different electrode sets may occur on a pulse-by -pulse basis. In some embodiments, the data processing device system (e.g., 110, 310) may be configured at least by the program (e.g., including instructions associated with at least block 502) at least to cause, via the input-output device system (e.g., 120, 320) and via operation of at least the energy source device system circuit (e.g., energy source device system circuit 340), provision of at least one pulse train (e.g., delivered according to some embodiments of block 502). In some embodiments, each pulse train of the at least one pulse train includes a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses including a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train. For instance, with respect to the example of FIG. 6A, the pulse train 610 includes a first biphasic voltage pulse 602A, a second biphasic voltage pulse 602B that sequentially follows the first biphasic voltage pulse 602A in the pulse train, and a third biphasic voltage pulse 602C that sequentially follows the second biphasic voltage pulse 602B in the pulse train 610 (e.g., at least if the time axis is considered such that pulses to the left are “newer” and “ahead-in-line”). In some embodiments, the first biphasic voltage pulse includes a first monophasic voltage pulse (e.g., monophasic voltage pulse 604A) followed by a second monophasic voltage pulse (e.g., monophasic voltage pulse 605 A), the first monophasic voltage pulse having a first polarity (e.g., a positive polarity in this example) and the second monophasic voltage pulse having a second polarity (e.g., a negative polarity in this example) opposite the first polarity. In some embodiments, the second biphasic voltage pulse includes a third monophasic voltage pulse (e.g., monophasic voltage pulse 605B) followed by a fourth monophasic voltage pulse (e.g., monophasic voltage pulse 604B), the third monophasic voltage pulse having the second (e.g., negative) polarity and the fourth monophasic voltage pulse having the first (e.g., positive) polarity. In some embodiments, the third biphasic voltage pulse includes a fifth monophasic voltage pulse (e.g., monophasic voltage pulse 604C) followed by a sixth monophasic voltage pulse (e.g., monophasic voltage pulse 605C), the fifth monophasic voltage pulse having the first (e.g., positive) polarity and the sixth monophasic voltage pulse having the second (e.g., negative) polarity. In some embodiments, each of the first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in FIG. 6A in this example), the second biphasic voltage pulse (e.g., biphasic voltage pulse 602B), and the third biphasic voltage pulse (e.g., biphasic voltage pulse 602C) are provided to a respective electrode set of a plurality of electrode sets (e.g., electrodes of transducers 220, 306, 406). In this regard, for example, each of the biphasic voltage pulses 602A, 602B, 602C may, in some embodiments, be delivered to a respective electrode set of a plurality of electrode sets. In some embodiments, each electrode set of the plurality of electrode sets includes at least one electrode not included in any other electrode set of the plurality of electrode sets. In some embodiments, each electrode in each respective electrode set of the plurality of electrode sets is not included in any other electrode set of the plurality of electrode sets.

[0233] In some embodiments, distributing biphasic pulses in a pulse train to different electrode sets may occur on a pulse-by-pulse basis with interleaving where, e.g., the distributing is repeated. Continuing with the previous example, in some embodiments, the first biphasic voltage pulse (e.g., biphasic voltage pulse 602A in the example of FIG. 6A), the second biphasic voltage pulse (e.g., biphasic voltage pulse 602B), and the third biphasic voltage pulse (e.g., biphasic voltage pulse 602C) are a first group of three sequential biphasic voltage pulses in the pulse train. In this regard, in some embodiments, the three sequential biphasic voltage pulses are repeated as a second group of three sequential biphasic voltage pulses (e.g., biphasic voltage pulses 602E, 602F, and the next subsequent biphasic voltage pulse that would follow biphasic voltage pulse 602F in FIG. 6A) in the pulse train (e.g., 610). In some embodiments, each biphasic voltage pulse in the second group of three sequential biphasic voltage pulses is provided to the same respective electrode set of the plurality of electrode sets to which the corresponding biphasic voltage pulses of the first group of three sequential biphasic voltage pulses is provided. For instance, continuing with the previous example, biphasic voltage pulses 602A and 602E may be delivered to a same electrode set, biphasic voltage pulses 602B and 602F may be delivered to a same electrode set, and biphasic voltage pulse 602C and the biphasic voltage pulse that would follow biphasic voltage pulse 602F in the pulse train 610 may be delivered to a same electrode set, according to some embodiments. In some embodiments, the pulse train includes at least one biphasic pulse between the first group of three sequential biphasic voltage pulses and the second group of three sequential biphasic voltage pulses. For instance, if the first group of three sequential biphasic voltage pulses is biphasic voltage pulses 602A, 602B, 602C in the example of FIG. 6A, and the second group of three sequential biphasic voltage pulses is bi...

Claims

WHAT IS CLAIMED IS:

1. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

2. The medical system of Claim 1, wherein the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse includes a second intra- biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse.

3. The medical system of Claim 2, wherein the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by an inter-biphasic-pulse delay, wherein the inter-biphasic- pulse delay is greater in duration than each of the first intra-biphasic-pulse delay and the secondintra-biphasic-pulse delay.

4. The medical system of Claim 3, wherein a duration of each of the first intra-biphasic- pulse delay and the second intra-biphasic-pulse delay is between 0 and 8 microseconds, and the inter-biphasic-pulse delay is between 300 microseconds and 1000 microseconds.

5. The medical system of Claim 3, wherein a duration of each of the first intra-biphasic- pulse delay and the second intra-biphasic-pulse delay is between 0 and 8 microseconds, and the inter-biphasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

6. The medical system of Claim 3, wherein a duration of each of the first intra-biphasic- pulse delay and the second intra-biphasic-pulse delay is between 0 and 8 microseconds, and the inter-biphasic-pulse delay is between 15 milliseconds and 30 milliseconds.

7. The medical system of Claim 3, wherein a duration of each of the first intra-biphasic- pulse delay and the second intra-biphasic-pulse delay is between 0 and 8 microseconds, and the inter-biphasic-pulse delay is between 100 milliseconds and 1.5 seconds.

8. The medical system of Claim 6, wherein each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a pulse duration between 1 microsecond and 8 microseconds.

9. The medical system of Claim 6, wherein each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a pulse duration between 0.01 microseconds and 1 microsecond.

10. The medical system of Claim 6, wherein each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a pulse amplitude between 200 V and 3000 V.

11. The medical system of Claim 1, wherein (a) each of the first monophasic voltage pulse and the second monophasic voltage pulse has a same pulse duration, (b) each of the third monophasic voltage pulse and the fourth monophasic voltage pulse has a same pulse duration, or (a) and (b).

12. The medical system of Claim 1, wherein (a) the first monophasic voltage pulse and the second monophasic voltage pulse have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse have different pulse durations, or (a) and (b).

13. The medical system of Claim 1, wherein the plurality of biphasic voltage pulses comprises (a) a first plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics as the first biphasic voltage pulse, and (b) a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the second plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics as the second biphasic voltage pulse, wherein the pulses of the first plurality of biphasic voltage pulses alternate with the pulses of the second plurality of biphasic voltage pulses.

14. The medical system of Claim 1, wherein the plurality of biphasic voltage pulses comprises an interleaving of a first plurality of biphasic voltage pulses and a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having a sequence of a first particular monophasic voltage pulse of the first polarity followed by a second particular monophasic voltage pulse of the second polarity, and each biphasic voltage pulse in the second plurality of biphasic voltage pulses having a sequence of a third particular monophasic voltage pulse of the second polarity followed by a fourth particular monophasic voltage pulse of the first polarity.

15. The medical system of Claim 1, wherein the energy source device system circuit is configured to generate each pulse train of the at least one pulse train.

16. The medical system of Claim 1, wherein the data processing device system is configured by the program at least to cause delivery of the at least one pulse train from an electrode set of the plurality of electrodes.

17. The medical system of Claim 1, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

18. The medical system of Claim 3, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), wherein each respective inter-pulse-train delay is greater in duration than the inter- biphasic-pulse delay.

19. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

20. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train,each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

21. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses of the plurality of first monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter-monophasic-pulse delay, wherein the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train has a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least foursuccessive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

22. The medical system of Claim 21, wherein the four successive pairs of first monophasic voltage pulses in the pulse train exclude the initial monophasic pulse having the first polarity in the pulse train and the last monophasic pulse having the first polarity in the pulse train.

23. The medical system of Claim 21, wherein each pulse train of the at least one pulse train comprises a sequence of the respective first inter-monophasic-pulse delays, and wherein the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration.

24. The medical system of Claim 23, wherein each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds.

25. The medical system of Claim 23, wherein each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds.

26. The medical system of Claim 21, wherein the four successive pairs of first monophasic voltage pulses in the pulse train comprise a sequence of the respective first inter-monophasic-pulse delays, and wherein the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration.

27. The medical system of Claim 26, wherein each pulse train of the at least one pulse train comprises a particular monophasic voltage pulse having a particular pulse width, and wherein the first duration is longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse.

28. The medical system of Claim 26, wherein each pulse train of the at least one pulse train comprises a particular monophasic voltage pulse having a particular pulse width, and wherein the first duration is longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse.

29. The medical system of Claim 27 or Claim 28, wherein a polarity of the particular monophasic voltage pulse is opposite the first polarity of the first monophasic voltage pulses of the plurality of first monophasic voltage pulses.

30. The medical system of Claim 21, wherein each first monophasic voltage pulse of the plurality of first monophasic voltage pulses has a pulse amplitude between 200 V and 3000 V.

31. The medical system of Claim 21, wherein each pulse train of the at least one pulse train comprises a plurality of second monophasic voltage pulses, the plurality of second monophasic voltage pulses including at least four successive pairs of second monophasic voltage pulses in the pulse train, each second monophasic voltage pulse of the plurality of second monophasic voltage pulses having a same second polarity that is opposite the first polarity of the first monophasic voltage pulses of the plurality of first monophasic voltage pulses, and the second monophasic voltage pulses of the plurality of second monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay, and wherein the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of each pair of the four successive pairs of second monophasic voltage pulses in the pulse train has a different duration as compared with the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of (c) a sequentially preceding pair of the successive second monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of second monophasic voltage pulses in the pulse train, and (d) a sequentially succeeding pair of the successive second monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of second monophasic voltage pulses in the pulse train.

32. The medical system of Claim 31, wherein the four successive pairs of second monophasic voltage pulses in the pulse train exclude the initial monophasic pulse having thesecond polarity in the pulse train and the last monophasic pulse having the second polarity in the pulse train.

33. The medical system of Claim 31, wherein each pulse train of the at least one pulse train comprises a sequence of the respective second inter-monophasic-pulse delays, and wherein the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycle between a first duration and a second duration, the second duration different than the first duration.

34. The medical system of Claim 31, wherein the four successive pairs of second monophasic voltage pulses in the pulse train comprise a sequence of the respective second inter-monophasic-pulse delays, and wherein the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycle between a first duration and a second duration, the second duration different than the first duration.

35. The medical system of Claim 31, wherein: each pulse train of the at least one pulse train comprises a sequence of the respective first inter-monophasic-pulse delays, the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration, each pulse train of the at least one pulse train comprises a sequence of the respective second inter-monophasic-pulse delays, and the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycle between the first duration and the second duration.

36. The medical system of Claim 35, wherein each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds.

37. The medical system of Claim 35, wherein a duration of each of the respective first inter-monophasic-pulse delays and the respective second inter-monophasic-pulse delays is between 300 microseconds and 1000 microseconds.

38. The medical system of Claim 35, wherein each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds.

39. The medical system of Claim 35, wherein each first monophasic voltage pulse of the plurality of first monophasic voltage pulses and each second monophasic voltage pulse of the plurality of second monophasic voltage pulses has a pulse amplitude between 200 V and 3000 V.

40. The medical system of Claim 35, wherein a duration of each of the respective first inter-monophasic-pulse delays and the respective second inter-monophasic-pulse delays is between 100 milliseconds and 1.5 seconds.

41. The medical system of Claim 31, wherein the four successive pairs of first monophasic voltage pulses in the pulse train comprises a sequence of the respective first inter-monophasic-pulse delays, wherein the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration, wherein the four successive pairs of second monophasic voltage pulses in the pulse train comprises a sequence of the respective second inter-monophasic-pulse delays, and wherein the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycle between the first duration and the second duration.

42. The medical system of Claim 31, wherein the respective second inter-monophasic- pulse delay between the second monophasic voltage pulses of a particular pair of successive second monophasic voltage pulses in the plurality of second monophasic voltage pulses has a duration that is different than a duration of the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a particular pair of successive first monophasic voltage pulses in the plurality of first monophasic voltage pulses, the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of the particular pair of successive second monophasic voltage pulses in the plurality of second monophasic voltage pulses occurring during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of the particular pair of successive first monophasic voltage pulses in the plurality of first monophasic voltage pulses.

43. The medical system of Claim 21, wherein the first monophasic voltage pulses in the plurality of first monophasic voltage pulses have a same duration.

44. The medical system of Claim 31, wherein the first monophasic voltage pulses in the plurality of first monophasic voltage pulses have a same first duration, and the second monophasic voltage pulses in the plurality of second monophasic voltage pulses have a same second duration.

45. The medical system of Claim 44, wherein the second duration is equal to the first duration.

46. The medical system of Claim 31, wherein (i) each of the first monophasic voltage pulses in the plurality of first monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses in the plurality of second monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

47. The medical system of Claim 21, wherein the energy source device system circuit is configured to generate each pulse train of the at least one pulse train.

48. The medical system of Claim 21, wherein the data processing device system is configured by the program at least to cause delivery of the at least one pulse train from an electrode set of the plurality of electrodes.

49. The medical system of Claim 21, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

50. The medical system of Claim 21, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii), wherein each respective inter-pulse-train delay is greater in duration than each respective first inter-monophasic-pulse delay.

51. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses of the plurality of first monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter-monophasic-pulse delay, wherein the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train has a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

52. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, theinput-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses, the plurality of first monophasic voltage pulses including at least four successive pairs of first monophasic voltage pulses in the pulse train, each first monophasic voltage pulse of the plurality of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses of the plurality of first monophasic voltage pulses successively arranged in the pulse train with the monophasic voltage pulses of each pair of successive first monophasic voltage pulses spaced from one another by a respective first inter-monophasic-pulse delay, wherein the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of each pair of the four successive pairs of first monophasic voltage pulses in the pulse train has a different duration as compared with the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of (a) a sequentially preceding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train, and (b) a sequentially succeeding pair of the successive first monophasic voltage pulses in the pulse train, if present in the at least four successive pairs of first monophasic voltage pulses in the pulse train.

53. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses and a plurality of secondmonophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity, wherein the first monophasic voltage pulses are successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, wherein the data processing device system is configured by the program at least to cause provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter- monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train, and wherein the data processing device system is configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter- monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

54. The medical system of Claim 53, wherein each pulse train of the at least one pulse train is provided such that the pulse train exhibits the different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the monophasic voltage pulses of at least four pairs of successive ones of the first monophasic voltage pulses in the pulse train, and wherein the different numbers of second monophasic voltage pulses cycle between a first number of second monophasic voltage pulses and a second number of second monophasic voltage pulses, wherein the second number of second monophasic voltage pulses is different than the first number of second monophasic voltage pulses.

55. The medical system of Claim 54, wherein the first number of second monophasic voltage pulses is zero and the second number of monophasic voltage pulses is an integer greater than or equal to two.

56. The medical system of Claim 53,wherein, for each pulse train of the at least one pulse train, the second monophasic voltage pulses are successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay, wherein the data processing device system is configured by the program at least to cause provision of each pulse train of the at least one pulse train such that multiple first monophasic voltage pulses are provided during the respective second inter-monophasic-pulse delay between the second monophasic voltage pulses of a first pair of successive second monophasic voltage pulses in the pulse train.

57. The medical system of Claim 53, wherein, for each pulse train of the at least one pulse train, the second monophasic voltage pulses are successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay, and wherein the data processing device system is configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of first monophasic voltage pulses during the respective second inter- monophasic-pulse delays between the second monophasic voltage pulses of at least two pairs of successive second monophasic voltage pulses in the pulse train.

58. The medical system of Claim 53, wherein, for each pulse train of the at least one pulse train, the second monophasic voltage pulses are successively arranged in the pulse train with the second monophasic voltage pulses of each pair of successive second monophasic voltage pulses spaced from one another by a respective second inter-monophasic-pulse delay, wherein the data processing device system is configured by the program at least to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of first monophasic voltage pulses during the respective second inter- monophasic-pulse delays between the second monophasic voltage pulses of at least four pairs of successive second monophasic voltage pulses in the pulse train, wherein the different numbers of first monophasic voltage pulses cycle between a first number of first monophasic voltage pulses and a second number of first monophasic voltage pulses in the plurality of first monophasic voltage pulses of the pulse train, andwherein the second number of first monophasic voltage pulses is different than the first number of first monophasic voltage pulses.

59. The medical system of Claim 53, wherein one of the different numbers of second monophasic voltage pulses that is provided during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of the at least two pairs of successive first monophasic voltage pulses in the pulse train is zero.

60. The medical system of Claim 53, wherein each pulse train of the at least one pulse train comprises a sequence of the respective first inter-monophasic-pulse delays, and wherein the successive respective first inter-monophasic-pulse delays in the sequence of the respective first inter-monophasic-pulse delays cycle between a first duration and a second duration.

61. The medical system of Claim 60, wherein each of the first duration and the second duration is between 300 microseconds and 1000 microseconds.

62. The medical system of Claim 60, wherein each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds.

63. The medical system of Claim 60, wherein each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds.

64. The medical system of Claim 60, wherein each first monophasic voltage pulse and each second monophasic voltage pulse has a pulse amplitude between 200 V and 3000 V.

65. The medical system of Claim 60, wherein each of the first duration and the second duration is between 100 milliseconds and 1.5 seconds.

66. The medical system of Claim 60, wherein each pulse train of the at least one pulse train comprises a particular monophasic voltage pulse having a particular pulse width, and wherein the first duration is longer than the second duration by at least a duration of the particular pulse width of the particular monophasic voltage pulse.

67. The medical system of Claim 60, wherein each pulse train of the at least one pulse train comprises a particular monophasic voltage pulse having a particular pulse width, and wherein the first duration is longer than the second duration by at least twice a duration of the particular pulse width of the particular monophasic voltage pulse.

68. The medical system of Claim 66 or Claim 67, wherein the particular monophasic voltage pulse is from the plurality of second monophasic voltage pulses.

69. The medical system of Claim 56, wherein each pulse train of the at least one pulse train comprises a sequence of the respective second inter-monophasic-pulse delays, and wherein the successive respective second inter-monophasic-pulse delays in the sequence of the respective second inter-monophasic-pulse delays cycle between a first duration and a second duration.

70. The medical system of Claim 69, wherein each of the first duration and the second duration is between 300 microseconds and 1000 microseconds.

71. The medical system of Claim 69, wherein each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds.

72. The medical system of Claim 69, wherein each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds.

73. The medical system of Claim 69, wherein each of the first duration and the second duration is between 100 milliseconds and 1.5 seconds.

74. The medical system of Claim 53, wherein the first monophasic voltage pulses in the plurality of first monophasic voltage pulses have a same duration.

75. The medical system of Claim 53, wherein the first monophasic voltage pulses in the plurality of first monophasic voltage pulses have a same first duration, and the secondmonophasic voltage pulses in the plurality of second monophasic voltage pulses have a same second duration.

76. The medical system of Claim 75, wherein the second duration is equal to the first duration.

77. The medical system of Claim 53, wherein (i) each of the first monophasic voltage pulses in the plurality of first monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) each of the second monophasic voltage pulses in the plurality of second monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

78. The medical system of Claim 53, wherein the energy source device system circuit is configured to generate each pulse train of the at least one pulse train.

79. The medical system of Claim 53, wherein the data processing device system is configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes.

80. The medical system of Claim 53, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

81. The medical system of Claim 53, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii), wherein each respective inter-pulse-train delay is greater in duration than each respective first inter-monophasic-pulse delay.

82. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configuredto provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity, wherein the first monophasic voltage pulses are successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, wherein the method comprises causing provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train, and wherein the method comprises causing provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

83. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of first monophasic voltage pulses and a plurality of second monophasic voltage pulses, each first monophasic voltage pulse having a same first polarity, and each second monophasic voltage pulse having a same second polarity, the second polarity opposite the first polarity,wherein the first monophasic voltage pulses are successively arranged in the pulse train with the first monophasic voltage pulses of each pair of successive first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, wherein the provision instructions are configured to cause provision of each pulse train of the at least one pulse train such that multiple ones of the second monophasic voltage pulses are provided in the pulse train during the respective first inter-monophasic-pulse delay between the first monophasic voltage pulses of a first pair of successive ones of the first monophasic voltage pulses in the pulse train, and wherein the provision instructions are configured to cause provision of each pulse train of the at least one pulse train such that the pulse train exhibits different numbers of the second monophasic voltage pulses during the respective first inter-monophasic-pulse delays between the first monophasic voltage pulses of at least two pairs of successive ones of the first monophasic voltage pulses in the pulse train.

84. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising multiple groups of voltage pulses sequentially arranged in the pulse train, each group of voltage pulses of the multiple groups of voltage pulses comprising:(a) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omitsprovision of any voltage pulses in the pulse train having other than the first polarity, and(b) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter-monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses is provided after completion of the provision of the sequence of first monophasic voltage pulses, and wherein, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses is different than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

85. The medical system of Claim 84, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses is shorter than (i) a duration of each respective first inter- monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

86. The medical system of Claim 84 wherein a duration of each respective first inter- monophasic-pulse delay and each respective second inter-monophasic-pulse delay is between 300 microseconds and 1000 microseconds.

87. The medical system of Claim 84, wherein a duration of each respective first inter- monophasic-pulse delay and each respective second inter-monophasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

88. The medical system of Claim 84, wherein a duration of each respective first inter- monophasic-pulse delay and each respective second inter-monophasic-pulse delay is between 15 milliseconds and 30 milliseconds.

89. The medical system of Claim 84, wherein each first monophasic voltage pulse and each second monophasic voltage pulse has a pulse amplitude between 200 V and 3000 V.

90. The medical system of Claim 85, wherein a duration of each respective first inter- monophasic-pulse delay and each respective second inter-monophasic-pulse delay is between 100 milliseconds and 1.5 seconds.

91. The medical system of Claim 84, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, the monophasic voltage pulses in the sequence of first monophasic voltage pulses have a same duration.

92. The medical system of Claim 84, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, the monophasic voltage pulses in the sequence of second monophasic voltage pulses have a same duration.

93. The medical system of Claim 84, wherein, for each group of voltage pulses of the multiple groups of voltage pulses the monophasic voltage pulses in the sequence of first monophasic voltage pulses have a same first duration, and the monophasic voltage pulses in the sequence of second monophasic voltage pulses have a same second duration.

94. The medical system of Claim 93, wherein the second duration is equal to the first duration.

95. The medical system of Claim 84, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, (i) each of the monophasic voltage pulses in the sequence of first monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) each of the monophasic voltage pulses in the sequence of second monophasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

96. The medical system of Claim 84, wherein the energy source device system circuit is configured to generate each pulse train of the at least one pulse train.

97. The medical system of Claim 84, wherein the data processing device system is configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes.

98. The medical system of Claim 84, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

99. The medical system of Claim 84, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (i) and (ii), and wherein each respective inter-pulse-train delay is greater in duration than (iii) each respective first inter-monophasic-pulse delay, (iv) each respective second inter- monophasic-pulse delay, or each of (iii) and (iv).

100. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at leastone pulse train comprising multiple groups of voltage pulses sequentially arranged in the pulse train, each group of voltage pulses of the multiple groups of voltage pulses comprising:(c) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omits provision of any voltage pulses in the pulse train having other than the first polarity, and(d) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter-monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses is provided after completion of the provision of the sequence of first monophasic voltage pulses, and wherein, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses is different than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of second monophasic voltage pulses.

101. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device systemcircuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising multiple groups of voltage pulses sequentially arranged in the pulse train, each group of voltage pulses of the multiple groups of voltage pulses comprising:(a) a sequence of first monophasic voltage pulses, each first monophasic voltage pulse of the sequence of first monophasic voltage pulses having a same first polarity, and the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the pulse train spaced from one another by a respective first inter-monophasic-pulse delay, the sequence of first monophasic voltage pulses occupying a first period of time that omits provision of any voltage pulses in the pulse train having other than the first polarity, and(b) a sequence of second monophasic voltage pulses, each second monophasic voltage pulse of the sequence of second monophasic voltage pulses having a same second polarity opposite the first polarity, and the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the pulse train spaced from one another by a respective second inter-monophasic-pulse delay, the sequence of second monophasic voltage pulses occupying a second period of time that omits provision of any voltage pulses in the pulse train having other than the second polarity, wherein, for each group of voltage pulses of the multiple groups of voltage pulses, the sequence of second monophasic voltage pulses is provided after completion of the provision of the sequence of first monophasic voltage pulses, and wherein, for each group of voltage pulses of the multiple groups of voltage pulses, a duration between the completion of the provision of the sequence of first monophasic voltage pulses and a start of the provision of the sequence of second monophasic voltage pulses is different than (i) a duration of each respective first inter-monophasic-pulse delay between the first monophasic voltage pulses in each pair of successive ones of the first monophasic voltage pulses in the sequence of first monophasic voltage pulses, and (ii) a duration of each respective second inter-monophasic-pulse delay between the second monophasic voltage pulses in each pair of successive ones of the second monophasic voltage pulses in the sequence of secondmonophasic voltage pulses.

102. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, wherein each biphasic voltage pulse in the plurality of biphasic voltage pulses comprises a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity, the first monophasic voltage pulses of the biphasic voltage pulses having a same duration and the second monophasic voltage pulses of the biphasic voltage pulses having a same duration, wherein the biphasic voltage pulses are successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay, and wherein the respective inter-biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train is different than the respective inter-biphasic-pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present.

103. The medical system of Claim 102, wherein the pulse train comprises a sequence of the respective inter-biphasic-pulse delays, wherein the successive respective inter-biphasic-pulse delays in the sequence of the respective inter-biphasic-pulse delays cycle between a first duration and a second duration.

104. The medical system of Claim 103, wherein each of the first duration and the second duration is between 300 microseconds and 1000 microseconds.

105. The medical system of Claim 103, wherein each of the first duration and the second duration is between 0.5 milliseconds and 15 milliseconds.

106. The medical system of Claim 103, wherein each of the first duration and the second duration is between 15 milliseconds and 30 milliseconds.

107. The medical system of Claim 103, wherein each of the first duration and the second duration is between 100 milliseconds and 1.5 seconds.

108. The medical system of Claim 102, wherein a biphasic pulse width of each biphasic voltage pulse of the plurality of biphasic voltage pulses has a same duration.

109. The medical system of Claim 102, wherein (i) the first monophasic voltage pulse of each biphasic voltage pulse of the plurality of biphasic voltage pulses has a duration between 1 microsecond and 8 microseconds, (ii) the second monophasic voltage pulse of each biphasic voltage pulse of the plurality of biphasic voltage pulses has a duration between 1 microsecond and 8 microseconds, or both (i) and (ii).

110. The medical system of Claim 102, wherein (i) the first monophasic voltage pulse of each of at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses has a pulse amplitude between 200 V and 3000 V, (ii) the second monophasic voltage pulse of each of the at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses has a pulse amplitude between 200 V and 3000 V, or both (i) and (ii).

111. The medical system of Claim 102, wherein each of the biphasic voltage pulses of the plurality of biphasic voltage pulses comprises an intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and wherein the intra-biphasic-pulse delay of each particular biphasic voltage pulse of at least some of the biphasic voltage pulses in the plurality of biphasic voltage pulses has a duration that is less than a duration of the respective inter-biphasic-delay between any pair ofsuccessive biphasic voltage pulses in the pulse train.

112. The medical system of Claim 111, wherein the intra-biphasic-pulse delay of each of at least some of the biphasic voltage pulses of the plurality of biphasic voltage pulses has a duration between 0 and 8 microseconds.

113. The medical system of Claim 112, wherein each respective inter-biphasic-pulse delay has a duration between 300 microseconds and 1000 microseconds.

114. The medical system of Claim 112, wherein each respective inter-biphasic-pulse delay has a duration between 0.5 milliseconds and 15 milliseconds.

115. The medical system of Claim 112, wherein each respective inter-biphasic-pulse delay has a duration between 15 milliseconds and 30 milliseconds.

116. The medical system of Claim 112, wherein each respective inter-biphasic-pulse delay has a duration between 100 milliseconds and 1.5 seconds.

117. The medical system of Claim 102, wherein the energy source device system circuit is configured to generate each pulse train of the at least one pulse train.

118. The medical system of Claim 102, wherein the data processing device system is configured by the program at least to cause delivery of the at least one pulse train to or from an electrode set of the plurality of electrodes.

119. The medical system of Claim 102, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a regularly repeating sequence of pulse trains.

120. The medical system of Claim 102, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (i) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (ii) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of(i) and (ii), wherein each respective inter-pulse-train delay is greater in duration than each respective inter-biphasic-pulse delay.

121. The medical system of Claim 102, wherein the plurality of biphasic voltage pulses comprises (a) a first plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics, and (b) a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the second plurality of biphasic voltage pulses having the same biphasic pulse waveform characteristics, wherein the pulses of the first plurality of biphasic voltage pulses alternate with the pulses of the second plurality of biphasic voltage pulses.

122. The medical system of Claim 102, wherein the plurality of biphasic voltage pulses comprises an interleaving of a first plurality of biphasic voltage pulses and a second plurality of biphasic voltage pulses, each biphasic voltage pulse in the first plurality of biphasic voltage pulses having a sequence of a first particular monophasic voltage pulse of the first polarity followed by a second particular monophasic voltage pulse of the second polarity, and each biphasic voltage pulse in the second plurality of biphasic voltage pulses having a sequence of a third particular monophasic voltage pulse of the second polarity followed by a fourth particular monophasic voltage pulse of the first polarity.

123. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, wherein each biphasic voltage pulse in the plurality of biphasic voltage pulses comprises a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity, the first monophasic voltage pulses of the biphasic voltage pulses having a same duration and the second monophasic voltage pulses of the biphasic voltage pulses having a same duration,wherein the biphasic voltage pulses are successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay, and wherein the respective inter-biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train is different than the respective inter-biphasic-pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present.

124. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, wherein each biphasic voltage pulse in the plurality of biphasic voltage pulses comprises a first monophasic voltage pulse having a first polarity and a second monophasic voltage pulse having a second polarity opposite the first polarity, the first monophasic voltage pulses of the biphasic voltage pulses having a same duration and the second monophasic voltage pulses of the biphasic voltage pulses having a same duration, wherein the biphasic voltage pulses are successively arranged in the pulse train with the biphasic voltage pulses of each pair of successive biphasic voltage pulses in the pulse train spaced from one another by a respective inter-biphasic-pulse delay, and wherein the respective inter-biphasic-pulse delay between the biphasic voltage pulses of each pair of successive ones of the biphasic voltage pulses in the pulse train is different than the respective inter-biphasic-pulse delay between the biphasic voltage pulses of (a) an immediately preceding pair of successive ones of the biphasic voltage pulses in the pulse train, if present, and (b) an immediately succeeding pair of successive ones of the biphasic voltage pulses in the pulse train, if present.

125. A medical system comprising:a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity, wherein the third biphasic voltage pulse includes a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse, the fifth monophasic voltage pulse having the first polarity and the sixth monophasic voltage pulse having the second polarity, and wherein each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse are provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets.

126. The medical system of Claim 125, wherein each electrode in each respective electrode set of the plurality of electrode sets is not included in any other electrode set of the plurality of electrode sets.

127. The medical system of Claim 125, wherein the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse are a first group of three sequential biphasic voltage pulses in the pulse train, and wherein the three sequential biphasic voltage pulses are repeated as a second group of three sequential biphasic voltage pulses in the pulse train, each biphasic voltage pulse in the second group of three sequential biphasic voltage pulses provided to the same respective electrode set of the plurality of electrode sets to which the corresponding biphasic voltage pulse of the first group of three sequential biphasic voltage pulses is provided.

128. The medical system of Claim 127, wherein the pulse train includes at least one biphasic voltage pulse between the first group of three sequential biphasic voltage pulses and the second group of three sequential biphasic voltage pulses.

129. The medical system of Claim 125, wherein the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, the second biphasic voltage pulse includes a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, and the third biphasic voltage pulse includes a third intra-biphasic-pulse delay between the fifth monophasic voltage pulse and the sixth monophasic voltage pulse, wherein the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the third biphasic voltage pulse is spaced from the second biphasic voltage pulse by a second inter-biphasic-pulse delay, wherein the first inter-biphasic-pulse delay is greater in duration than each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay, and wherein the second inter-biphasic-pulse delay is greater in duration than each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay.

130. The medical system of Claim 129, wherein a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay is between 0 and 8 microseconds, and a respective duration of each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay is between 300 microseconds and 1000 microseconds.

131. The medical system of Claim 129, wherein a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay is between 0 and 8 microseconds, and a respective duration of each of the first inter- biphasic-pulse delay and the second inter-biphasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

132. The medical system of Claim 129, wherein a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay is between 0 and 8 microseconds, and a respective duration of each of the first inter- biphasic-pulse delay and the second inter-biphasic-pulse delay is between 15 milliseconds and 30 milliseconds.

133. The medical system of Claim 129, wherein a respective duration of each of the first intra-biphasic-pulse delay, the second intra-biphasic-pulse delay, and the third intra-biphasic- pulse delay is between 0 and 8 microseconds, and a respective duration of each of the first inter- biphasic-pulse delay and the second inter-biphasic-pulse delay is between 100 milliseconds and 1.5 seconds.

134. The medical system of Claim 129, wherein each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse has a respective pulse duration between 1 microsecond and 8 microseconds.

135. The medical system of Claim 129, wherein each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse has a respective pulse duration between 0.01 microseconds and 1 microsecond.

136. The medical system of Claim 129, wherein the second inter-biphasic-pulse delay has a different duration than the first inter-biphasic-pulse delay.

137. The medical system of Claim 129, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), and wherein each respective inter-pulse-train delay is greater in duration than each of the first inter-biphasic-pulse delay and the second inter-biphasic-pulse delay.

138. The medical system of Claim 125, wherein (a) the first monophasic voltage pulse and the second monophasic voltage pulse have different pulse durations, (b) the third monophasic voltage pulse and the fourth monophasic voltage pulse have different pulse durations, (c) the fifth monophasic voltage pulse and the sixth monophasic voltage pulse have different pulse durations, or (a) and (b), (a) and (c), (b) and (c), or (a), (b), and (c).

139. The medical system of Claim 125, wherein the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay of a first duration, wherein the third biphasic voltage pulse is spaced from the second biphasic voltage pulse by a second inter-biphasic-pulse delay of a second duration, and wherein the first duration is different than the second duration.

140. The medical system of Claim 125, wherein the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, the second biphasic voltage pulse includes a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, and the third biphasic voltage pulse includes a third intra-biphasic-pulse delay between the fifth monophasic voltage pulse and the sixth monophasic voltage pulse, and wherein each of the first intra-biphasic-pulse delay and the third intra-biphasic-pulse delay is of a first duration, and the second intra-biphasic-pulse delay is of a second duration.

141. The medical system of Claim 125, wherein each of the first monophasic voltagepulse, the second monophasic voltage pulse, the third monophasic voltage pulse, the fourth monophasic voltage pulse, the fifth monophasic voltage pulse, and the sixth monophasic voltage pulse has a duration between 1 microsecond and 8 microseconds.

142. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity, wherein the third biphasic voltage pulse includes a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse, the fifth monophasic voltage pulse having the first polarity and the sixth monophasic voltage pulse having the second polarity, and wherein each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse are provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets.

143. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system,the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse, a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train, and a third biphasic voltage pulse that sequentially follows the second biphasic voltage pulse in the pulse train, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity, wherein the third biphasic voltage pulse includes a fifth monophasic voltage pulse followed by a sixth monophasic voltage pulse, the fifth monophasic voltage pulse having the first polarity and the sixth monophasic voltage pulse having the second polarity, and wherein each of the first biphasic voltage pulse, the second biphasic voltage pulse, and the third biphasic voltage pulse are provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets.

144. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter, each electrode set of the plurality of electrode sets including at least one electrode that is not included in any other electrode set of the plurality of electrode sets; anda memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of sequences of biphasic voltage pulses, each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses including a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses, wherein, in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity, wherein each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses is provided to a respective electrode set of the plurality of electrode sets, and wherein the second biphasic voltage pulse in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses is sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided, the particular monophasic voltage pulse having the second polarity.

145. The medical system of Claim 144, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the particular monophasic voltage pulse in the pulse train is the second monophasic voltage pulse of the first biphasic voltage pulse of another sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses.

146. The medical system of Claim 144, wherein each electrode in each electrode set of the respective electrode sets of the plurality of electrode sets is other than any electrode in any other electrode set of the respective electrode sets of the plurality of electrode sets.

147. The medical system of Claim 144, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the pulse train does not include any pulse between the first and second monophasic voltage pulses of the first biphasic voltage pulse of the sequence of biphasic voltage pulses.

148. The medical system of Claim 147, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the pulse train does not include any pulse between the third and fourth monophasic voltage pulses of the second biphasic voltage pulse of the sequence of biphasic voltage pulses.

149. The medical system of Claim 144, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse includes a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the first inter-biphasic-pulse delay is greater in duration than each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay.

150. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 300 microseconds and 1000 microseconds.

151. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

152. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 15 milliseconds and 30 milliseconds.

153. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 100 milliseconds and 1.5 seconds.

154. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a respective pulse duration between 1 microsecond and 8 microseconds.

155. The medical system of Claim 149, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a respective pulse duration between 0.01 microseconds and 1 microsecond.

156. The medical system of Claim 149, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), and wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, each respective inter-pulse-train delay is greater in duration than the first inter-biphasic-pulse delay.

157. The medical system of Claim 144, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses:(a) the first monophasic voltage pulse and the second monophasic voltage pulse have different pulse durations,(b) the third monophasic voltage pulse and the fourth monophasic voltage pulse have different pulse durations, or(a) and (b).

158. The medical system of Claim 144, wherein, for each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a duration between 1 microsecond and 8 microseconds.

159. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter, each electrode set of the plurality of electrode sets including at least one electrode that is not included in any other electrode set of the plurality of electrode sets, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of sequences of biphasic voltage pulses, each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses including a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses, wherein, in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having thesecond polarity and the fourth monophasic voltage pulse having the first polarity, wherein each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses is provided to a respective electrode set of the plurality of electrode sets, and wherein the second biphasic voltage pulse in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses is sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided, the particular monophasic voltage pulse having the second polarity.

160. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to a plurality of electrode sets of a plurality of electrodes supported by a structure of a catheter, each electrode set of the plurality of electrode sets including at least one electrode that is not included in any other electrode set of the plurality of electrode sets, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of sequences of biphasic voltage pulses, each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses including a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the sequence of biphasic voltage pulses, wherein, in each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses, the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity, wherein each sequence of biphasic voltage pulses of the plurality of sequences of biphasic voltage pulses is provided to a respective electrode set of the plurality of electrode sets, and wherein the second biphasic voltage pulse in each sequence of biphasic voltage pulses ofthe plurality of sequences of biphasic voltage pulses is sequentially preceded in the pulse train by a particular monophasic voltage pulse that is not provided to the respective electrode set to which the sequence of biphasic voltage pulses is provided, the particular monophasic voltage pulse having the second polarity.

161. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising at least three biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses comprises a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse, the respective second monophasic voltage pulse following the respective first monophasic voltage pulse in the pulse train, wherein, for each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses are successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, the pulse train comprises at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse ofthe at least two biphasic voltage pulses in the pulse train comprises a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse, the respective second particular monophasic voltage pulse following the respective first particular monophasic voltage pulse in the pulse train, and wherein, for each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train has a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses.

162. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train, three biphasic pulses of the at least three biphasic voltage pulses are successively arranged in the pulse train, and wherein each of the three biphasic pulses is provided to a respective electrode set of a plurality of electrode sets of the plurality of electrodes, each electrode set of the plurality of electrode sets including at least one electrode not included in any other electrode set of the plurality of electrode sets.

163. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses in the pulse train are other than the at least three biphasic voltage pulses in the pulse train.

164. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses in the pulse train are included in the at least three biphasic voltage pulses in the pulse train.

165. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train, the at least two biphasic voltage pulses are provided to the particular electrode set of the at least some electrodes of the plurality of electrodes according to a particular sequence, and for each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train, the second particular biphasic voltage pulse occurs immediately after the first particular biphasic voltage pulse in the particular sequence.

166. The medical system of Claim 165, wherein, for each pulse train of the at least onepulse train, the pulse train includes at least one biphasic voltage pulse provided to an electrode set of the at least some electrodes of the plurality of electrodes, the electrode set other than the particular electrode set, and the at least one biphasic voltage pulse occurring between the first particular biphasic voltage pulse and the second particular biphasic voltage pulse in the pulse train.

167. The medical system of Claim 166, wherein the electrode set is mutually exclusive with the particular electrode set.

168. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the respective first monophasic voltage pulse and the respective second monophasic voltage pulse, and the second biphasic voltage pulse includes a second intra-biphasic-pulse delay between the respective first monophasic voltage pulse and the respective second monophasic voltage pulse, the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the first inter-biphasic-pulse delay is greater in duration than each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay.

169. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 300 microseconds and 1000 microseconds.

170. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

171. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 15 milliseconds and 30 milliseconds.

172. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 100 milliseconds and 1.5 seconds.

173. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse has a respective pulse duration between 1 microsecond and 8 microseconds, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse has a respective pulse duration between 1 microsecond and 8 microseconds.

174. The medical system of Claim 168, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse has a respective pulse duration between 0.01 microseconds and 1 microsecond, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse has a respective pulse duration between 0.01 microseconds and 1 microsecond.

175. The medical system of Claim 168, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), and wherein, for each pulse train of the plurality of pulse trains and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train, each respective inter-pulse-train delay is greater in duration than the first inter- biphasic-pulse delay.

176. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train:(a) the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse have different pulse durations,(b) the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse have different pulse durations, or(a) and (b).

177. The medical system of Claim 161, wherein, for each pulse train of the at least one pulse train and for each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses in the pulse train: each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the first biphasic voltage pulse has a duration between 1 microsecond and 8 microseconds, and each of the respective first monophasic voltage pulse and the respective second monophasic voltage pulse of the second biphasic voltage pulse has a duration between 1 microsecond and 8 microseconds.

178. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-outputdevice system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising at least three biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses comprises a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse, the respective second monophasic voltage pulse following the respective first monophasic voltage pulse in the pulse train, wherein, for each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses are successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, the pulse train comprises at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train comprises a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse, the respective second particular monophasic voltage pulse following the respective first particular monophasic voltage pulse in the pulse train, and wherein, for each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train has a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least two biphasic voltage pulses.

179. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising at least three biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least three biphasic voltage pulses comprises a respective first monophasic voltage pulse and a respective second monophasic voltage pulse having a polarity opposite a polarity of the first monophasic voltage pulse, the respective second monophasic voltage pulse following the respective first monophasic voltage pulse in the pulse train, wherein, for each pulse train of the at least one pulse train, the biphasic voltage pulses of the at least three biphasic voltage pulses are successively arranged in the pulse train with each particular successive pair of biphasic voltage pulses of the at least three biphasic voltage pulses configured such that the respective second monophasic voltage pulse of a first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses has a same polarity as the respective first monophasic voltage pulse of a second biphasic voltage pulse that follows the first biphasic voltage pulse in the particular successive pair of biphasic voltage pulses, wherein, for each pulse train of the at least one pulse train, the pulse train comprises at least two biphasic voltage pulses, each biphasic voltage pulse of the at least two biphasic voltage pulses provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein, for each pulse train of the at least one pulse train, each biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train comprises a respective first particular monophasic voltage pulse and a subsequent respective second particular monophasic voltage pulse having a polarity opposite a polarity of the first particular monophasic voltage pulse, the respective second particular monophasic voltage pulse following the respective first particular monophasic voltage pulse in the pulse train, and wherein, for each pulse train of the at least one pulse train, the respective second particular monophasic voltage pulse of a first particular biphasic voltage pulse of the at least two biphasic voltage pulses in the pulse train has a same polarity as the respective first particular monophasic voltage pulse of a second particular biphasic voltage pulse of the at least twobiphasic voltage pulses.

180. A medical system comprising: a data processing device system; an input-output device system communicatively connected to the data processing device system, the input-output device system communicatively connectable to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter; and a memory device system communicatively connected to the data processing device system and storing a program executable by the data processing device system, the data processing device system configured by the program at least to: cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse, and each of the first biphasic voltage pulse and the second biphasic voltage pulse provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

181. The medical system of Claim 180, wherein, for each pulse train of the at least one pulse train, the pulse train does not include any pulse between the first and second monophasic voltage pulses of the first biphasic voltage pulse.

182. The medical system of Claim 180, wherein, for each pulse train of the at least one pulse train, the pulse train does not include any pulse between the third and fourth monophasic voltage pulses of the second biphasic voltage pulse.

183. The medical system of Claim 180, wherein, for each pulse train of the at least one pulse train: the first biphasic voltage pulse includes a first intra-biphasic-pulse delay between the first monophasic voltage pulse and the second monophasic voltage pulse, and the second biphasic voltage pulse includes a second intra-biphasic-pulse delay between the third monophasic voltage pulse and the fourth monophasic voltage pulse, the second biphasic voltage pulse is spaced from the first biphasic voltage pulse by a first inter-biphasic-pulse delay, and the first inter-biphasic-pulse delay is greater in duration than each of the first intra- biphasic-pulse delay and the second intra-biphasic-pulse delay.

184. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 300 microseconds and 1000 microseconds.

185. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 0.5 milliseconds and 15 milliseconds.

186. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the first inter-biphasic-pulse delay is between 15 milliseconds and 30 milliseconds.

187. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: a respective duration of each of the first intra-biphasic-pulse delay and the second intra- biphasic-pulse delay is between 0 and 8 microseconds, and a respective duration of the firstinter-biphasic-pulse delay is between 100 milliseconds and 1.5 seconds.

188. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a respective pulse duration between 1 microsecond and 8 microseconds.

189. The medical system of Claim 183, wherein, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, the third monophasic voltage pulse, and the fourth monophasic voltage pulse has a respective pulse duration between 0.01 microseconds and 1 microsecond.

190. The medical system of Claim 183, wherein the at least one pulse train comprises a plurality of pulse trains arranged in a sequence of pulse trains, each pulse train in the sequence of pulse trains spaced (a) by a respective inter-pulse-train delay from an immediately preceding pulse train, if present in the sequence of pulse trains, (b) by a respective inter-pulse-train delay from an immediately succeeding pulse train, if present in the sequence of pulse trains, or each of (a) and (b), and wherein, for each pulse train of the at least one pulse train, each respective inter-pulsetrain delay is greater in duration than the first inter-biphasic-pulse delay.

191. The medical system of Claim 180, wherein, for each pulse train of the at least one pulse train:(a) the first monophasic voltage pulse and the second monophasic voltage pulse have different pulse durations,(b) the third monophasic voltage pulse and the fourth monophasic voltage pulse have different pulse durations, or(a) and (b).

192. The medical system of Claim 180, wherein, for each pulse train of the at least one pulse train: each of the first monophasic voltage pulse, the second monophasic voltage pulse, thethird monophasic voltage pulse, and the fourth monophasic voltage pulse has a duration between 1 microsecond and 8 microseconds.

193. A method executed by a data processing device system according to a program stored by a communicatively connected memory device system, the data processing device system also communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the method comprising: causing, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a second biphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse, and each of the first biphasic voltage pulse and the second biphasic voltage pulse provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

194. One or more computer-readable storage mediums storing a program executable by a data processing device system communicatively connected to an input-output device system, the input-output device system communicatively connected to an energy source device system circuit configured to provide pulsed field ablation energy to at least some electrodes of a plurality of electrodes supported by a structure of a catheter, and the program comprising: provision instructions configured to cause, via the input-output device system and via operation of at least the energy source device system circuit, provision of at least one pulse train, each pulse train of the at least one pulse train comprising a plurality of biphasic voltage pulses, the plurality of biphasic voltage pulses comprising a first biphasic voltage pulse and a secondbiphasic voltage pulse that sequentially follows the first biphasic voltage pulse in the pulse train with no other pulse in the pulse train located between the first biphasic voltage pulse and the second biphasic voltage pulse, and each of the first biphasic voltage pulse and the second biphasic voltage pulse provided to a particular electrode set of the at least some electrodes of the plurality of electrodes, wherein the first biphasic voltage pulse includes a first monophasic voltage pulse followed by a second monophasic voltage pulse, the first monophasic voltage pulse having a first polarity and the second monophasic voltage pulse having a second polarity opposite the first polarity, and wherein the second biphasic voltage pulse includes a third monophasic voltage pulse followed by a fourth monophasic voltage pulse, the third monophasic voltage pulse having the second polarity and the fourth monophasic voltage pulse having the first polarity.

195. A computer program product comprising program code portions for performing the steps of method Claim 19, Claim 51, Claim 82, Claim 100, Claim 123, Claim 142, Claim 159, Claim 178, or Claim 193 when the computer program product is executed by a computing device.

196. The computer program product of Claim 195, stored on one or more computer readable storage mediums.

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