Abstract: Described embodiments include an apparatus that includes a flexible electrically-insulating substrate, including an inner surface and an outer surface, and shaped to define (i) multiple narrower channels passing between the inner surface and the outer surface, and (ii) one or more wider channels passing between the inner surface and the outer surface. The apparatus further includes an outer layer of an electrically-conducting metal covering at least part of the outer surface, an inner layer of the electrically-conducting metal covering at least part of the inner surface, a plating layer of the electrically-conducting metal that plates the wider channels such as to connect the outer layer to the inner layer, and respective columns of the electrically-conducting metal that fill the narrower channels such as to connect the outer layer to the inner layer. Other embodiments are also described.

Abstract: Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

Abstract: A catheter including a loop member adjustment mechanism for adjusting a diameter of a loop member is provided. The catheter further includes a longitudinally-extending catheter shaft including a proximal end portion and a distal end deflectable portion, wherein the distal end deflectable portion includes the loop member. The loop adjustment mechanism includes a loop member pull wire, wherein a distal end of the loop member pull wire is attached to the loop member, and a sliding member, located within the handle, wherein the sliding member is configured to translate within the handle, and wherein a proximal end of the pull wire is attached to the sliding member.

Abstract: Electrode assemblies include segmented electrodes disposed on a catheter. The segmented electrodes can be constructed at the tip of the catheter or more proximally located. Tip electrodes can be constructed from an electrically-insulative substrate covered with a conductive material. The conductive material can be deposited on the electrically-insulative substrate to form a single tip electrode or multiple segmented electrodes. In some embodiments the tip electrode can include irrigation flow holes for irrigation. A method of manufacturing a tip electrode comprising a thin layer of conductive material deposited on an electrically-insulative substrate is disclosed. Segmented ring electrodes can be constructed from segmented ring electrodes that can be equally separated around a circumference of a catheter. The segmented ring electrodes can be formed into segmented electrode subassemblies that can then be joined to a catheter shaft.

Abstract: Provided herein are ablation systems having an ablation component with an ablation chamber and an insulation chamber, wherein the ablation chamber comprises a plurality of channels defined there. Other embodiments include ablation systems having a substrate source, a cooling component, and an ablation component. Certain systems are closed-loop systems that reuse the cooling substrate.

Abstract: Described embodiments include a catheter tip that includes an outer layer of a thermally-conducting metal; an inner layer of a thermally-conducting metal; a polymer layer between the inner and outer layer; and a plurality of thermal bridges selectively positioned between the inner and outer layers and through the polymer layer thereby significantly increasing the heat transfer of the catheter tip through the polymer layer. Other embodiments are also described.

Abstract: An energy treatment system and a output control method thereof according to embodiments of the present invention perform treatment by energy supply in which ultrasonic energy and high frequency energy are combined, stop or suppress discharge by reducing the output of high frequency energy within a set period when a state in which discharge is likely to occur during treatment is detected, and change the output of ultrasonic energy. In addition, in order for a user to continue treatment without feeling uncomfortable and to ensure incision performance, each output is controlled so that the set period is as short as possible or is supplemented, and also, the set period expires, and control is performed so as to reduce the possibility of discharge even at the time of returning.

Abstract: Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

Abstract: There is disclosed a method of treating affected external or surface tissue comprising the steps of providing a source of affected external or surface tissue; generating a source of microwave energy; transmitting said microwave energy into said affected external or surface tissues; exposing said affected external and surface tissues to said microwave energy to raise the local temperature to thereby ablate, remove, coagulate or otherwise alter said affected external and surface tissues.

Abstract: A cardiac pacing and irreversible electroporation (IRE) apparatus includes a pulse generator and a shaping circuit. The pulse generator is configured to generate IRE pulses of prespecified shape and repetition rate. The shaping circuit is configured to convert some of the IRE pulses into pacing pulses of prespecified frequency and amplitude, to generate an output signal including ones of the IRE pulses interleaved with ones of the pacing pulses, and to output the output signal to a probe in a heart of a patient for applying the output signal to cardiac tissue.

Abstract: A cautery safety controller can include a first input to receive a cautery power signal; a first output coupled to a nerve stimulator system; a second input coupled to receive a nerve detected signal; a zero-crossing detector coupled to receive the cautery power signal via the first input and output a nerve sense enable signal via the first output to the nerve stimulator system in response to detecting a zero crossing of the cautery power signal; and a nerve detection decision unit coupled to receive the nerve detected signal via the second input, generate a stop operation signal, and output the stop operation signal via a second output. A cauterizing pencil can be provided with a tap line for providing the cautery power signal. Alternatively, a cautery pad can be provided with a sense electrode for providing the cautery power signal.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Abstract: Devices, systems and methods for controlling the temperature of all or part of the body of a human or animal subject.

Abstract: A vapor ablation handpiece for assisting a physician perform vapor ablation with a vapor ablation catheter includes a vapor generating element arranged in a coil shape. A mandrel seated in the body of the handpiece affixes the vapor generating element in the coiled arrangement. A voltage difference is supplied across the length of the vapor generating element when activated, causing the vapor generating element to heat liquid therein converting the liquid to vapor. The heated condensable vapor is delivered to a target tissue through the catheter.

Abstract: The invention relates to a device for producing a cold atmospheric pressure plasma for the treatment of human and/or animal surfaces, comprising a flexible, planar multilayer system with a side facing the surface to be treated and a side facing away from the surface to be treated, wherein the multilayer system comprises the following layers, namely a first electrode layer on the facing away side of the multilayer system, second electrode layer on the facing side of the multilayer system, wherein the electrode layer has a plurality of recesses or is formed in a grid-like or meander-shaped fashion, a dielectric layer arranged between the first electrode layer and the second electrode layer, and a spacer layer arranged adjacent the second electrode layer on the facing side of the multilayer system. In addition, the invention relates to a cable, a generator unit for providing a high voltage, and a system.

Abstract: A medical device for directionally focusing energy to a treatment site, the medical device including a shaft having an elongated body defining a proximal portion and a distal portion opposite the proximal portion, the distal portion including at least one electrode having a contact portion and a permeable sheath at least partially surrounding the at least one electrode, the permeable sheath and the at least one electrode defining an insulation cavity, the permeable sheath being impermeable to an insulation material introduced to the insulation cavity from a fluid source configured to be coupled to the shaft.

Abstract: In one embodiment, the present disclosure relates to an electrosurgical device that includes an outer body, an inner body disposed partially within the outer body, three plates and an insulator. A first plate of the three plates includes a plurality of apertures and is positioned so that each of two projections extending from the inner body extend through a respective aperture of the plurality of apertures of the first plate. A second plate and a third plate of the three plates are both disposed on the first plate such that each of the two projections extends through an aperture of the second plate or the third plate, the second and third plates being fixed to a respective projection. The insulator is disposed around the inner body and is attached to the outer body at a first end and abuts the first plate at a second end opposite the first end.

Abstract: A forceps includes a first portion and a second portion. The first portion includes a shaft, an end effector assembly disposed at a distal end of the shaft, and a drive assembly including a drive bar. The end effector assembly includes jaw members movable between spaced-apart and approximated positions. The drive bar is slidably disposed within the shaft and coupled to the end effector assembly such that translation of the drive bar relative to the shaft moves the jaw members between the spaced-apart and approximated positions. The second portion includes a housing (or portion thereof) and a handle assembly including a movable handle that is coupled to the housing and movable relative thereto between first and second positions. The first and second portions are releasably couplable with one another to operably couple the movable handle with the drive bar such that moving the movable handle actuates the jaw members.

Abstract: Method and devices for delivering pulsed RF ablation energy to enable the creation of lesions in tissue are disclosed. The delivery of RF energy is controlled such that the generator power setting remains sufficiently high to form adequate lesions while mitigating against overheating of tissue. An ablation catheter tip having high-thermal-sensitivity comprises a thermally-insulative ablation tip insert supporting at least one temperature sensor and encapsulated, or essentially encapsulated, by a conductive shell. A system for delivering pulsed RF energy to a catheter during catheter ablation comprises an RF generator and a pulse control box operatively connected to the generator and configured to control delivery of pulsatile RF energy to an ablation catheter comprising at least one temperature sensor mounted in its tip. Also disclose is a method of controlling the temperature of an ablation catheter tip while creating a desired lesion using pulsatile delivery of RF energy.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.