Medical dilator, and systems, methods, and kits for medical dilation

1 . A medical dilator, comprising:

an elongate member having a proximal end portion, an opposed distal end portion, and a lumen extending through the elongate member from the proximal end portion to the distal end portion;

a dilating tip at the distal end portion, the dilating tip having a first end of enlarged cross- sectional area and tapering going in the distal direction to a second end of reduced cross-sectional area;

a first electrode associated with the dilating tip;

the dilating tip including a proximal piece having a distal-facing shoulder surface and a neck extending distally from the shoulder surface;

the dilating tip further including a distal piece received on the neck distal to and abutting the first electrode;

the first electrode having an annular shape and being positioned on the neck and abutting the distal-facing shoulder surface; and

an electrical conductor electrically connected to the first electrode and extending proximally from the first electrode towards the proximal end portion for electrical connection with an electroanatomical mapping system.

2 . The medical dilator of claim 1 , wherein the first electrode has an electrode outer surface, and the first electrode outer surface is flush with a dilating tip circumferential outer surface.

3 . The medical dilator of claim 1 , wherein the dilating tip has a tip circumferential outer surface, a tip circumferential inner surface, and a tip sidewall extending between the tip circumferential inner surface and the tip circumferential outer surface, and the electrical conductor extends from the first electrode through the tip sidewall and into the lumen.

4 . The medical dilator of claim 1 , wherein the elongate member has a circumferential outer surface, a circumferential inner surface, and a sidewall extending along the length of the elongate member between the circumferential inner surface and the circumferential outer surface, and the electrical conductor is embedded in the sidewall and extends from the first electrode to the proximal end portion.

5 . The medical dilator of claim 4 , wherein the circumferential outer surface has a longitudinal groove defined therein and extending from the first electrode to the proximal end portion, and wherein the electrical conductor is seated in the longitudinal groove.

6 . The medical dilator of claim 4 , wherein the elongate member comprises an outer tube defining the circumferential outer surface, and an inner liner within the outer tube and defining the circumferential inner surface, and wherein the electrical conductor is positioned between the outer tube and the inner liner.

7 . The medical dilator of claim 6 , wherein the electrical conductor is a tubular braid.

8 . The medical dilator of claim 1 , wherein the first electrode is removable from the elongate member.

9 . The medical dilator of claim 1 , further comprising a second electrode mounted to the elongate member and spaced from the first electrode.

10 . The medical dilator of claim 1 , wherein the first electrode is radiopaque.

11 . The medical dilator of claim 10 , wherein the first electrode comprises platinum-iridium.

12 . The medical dilator of claim 1 , wherein the first electrode has an echogenic profile.

13 . The medical dilator of claim 12 , wherein the first electrode comprises a coil.

14 . A kit of parts for medical perforation system, the kit of parts comprising:

a medical dilator comprising an elongate member having a proximal end portion, an opposed distal end portion, and a lumen extending through the elongate member from the proximal end portion to the distal end portion; a dilating tip at the distal end portion, the dilating tip having first end of enlarged cross-sectional area and tapering going in the distal direction to a second end of reduced cross-sectional area; the dilating tip including a proximal piece having a distal-facing shoulder surface and a neck extending distally from the shoulder surface; the dilating tip further including a distal piece received on the neck; at least a first electrode associated with the dilating tip, the first electrode having an annular shape and being positioned on the neck and abutting the distal-facing shoulder surface; an electrical conductor electrically connected to the first electrode and extending proximally from the first electrode to the proximal end portion for electrical connection with an electroanatomical mapping system, wherein the electrical conductor is electrically insulated between the first electrode and the electroanatomical mapping system;

a sheath for receiving the medical dilator; and

a perforation device receivable in the lumen.

15 . The kit of parts of claim 14 , further comprising at least a second electrode, the second electrode secured to the sheath.

16 . The kit of parts of claim 14 , further comprising at least a second electrode, the second electrode secured to the elongate member.

17 . The kit of parts of claim 14 , further comprising at least a second electrode, the second electrode secured to the perforation device.

18 . A medical dilation system, comprising:

a medical dilator comprising an elongate member having a proximal end portion, an opposed distal end portion, and a lumen extending through the elongate member from the proximal end portion to the distal end portion; a dilating tip at the distal end portion, the dilating tip having first end of enlarged cross-sectional area and tapering going in the distal direction to a second end of reduced cross-sectional area; the dilating tip including a proximal piece having a distal-facing shoulder surface and a neck extending distally from the shoulder surface; the dilating tip further including a distal piece received on the neck; at least a first electrode associated with the dilating tip, the first electrode having an annular shape and being positioned on the neck and abutting the distal-facing shoulder surface;

and an electrical conductor electrically connected to the first electrode and extending proximally from the first electrode to the proximal end portion; and

an electroanatomical mapping system electrically connectable to the electrical conductor and configured to receive an electroanatomical mapping signal from the first electrode and determine a location of the dilating tip based on the electroanatomical mapping signal.