Abstract: Aspects of the present disclosure are directed to flexible catheters for both electrophysiology mapping and ablation using a high-density array of electrodes. These catheters may be used to detect electrophysiological characteristics of tissue in contact with the electrodes, and conduct monopolar and bipolar ablations of the tissue.

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.

Abstract: A method includes positioning an expandable balloon, coupled to a distal end of a catheter, at a target location within an organ of a patient, the expandable balloon including multiple electrodes and one or more sensors in proximity to each electrode, wherein the one or more sensors are configured each to measure a characteristic of blood. The expandable balloon is expanded at the target location. A fluid is flowed through an inner lumen of the catheter and into the blood in a vicinity of each electrode. A dependence of the characteristic of blood on time is measured, via the one or more sensors, in proximity to each electrode. Using a processor, it is determined whether or not each electrode is in physical contact with tissue, based on the measured dependence of the characteristic of blood. An indication of whether or not each electrode is in physical contact with tissue is outputted to a user.

Abstract: A medical system includes a medical device and an analysis system. The medical device includes a perforation device having a shaft. The shaft has a proximal portion, and an opposed distal portion. A perforating tip is associated with the distal portion. At least a first light emitter is associated with the distal portion and is positioned proximate the perforating tip for illuminating a region surrounding the perforating tip. The analysis system is for analyzing returned light that is returned towards the shaft from the region surrounding the perforating tip. The analysis system includes a light sensor configured to detect one or more parameters of the returned light, a processor configured to perform an analysis of the one or more parameters, and an alert system connected to the processor for alerting a user to a result of the analysis.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

Abstract: A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

Abstract: A tissue segmentation device, controller, and methods therefore are disclosed. The device has an active electrode, a return electrode, a mechanical force application mechanism, voltage and current sensors, and a controller. The controller has a processing component, configured to assign a circuit status to a circuit comprising the at least one electrode. IF (PF?0) and ((Vrms/Irms)?T), THEN the circuit status is “open”. IF (PF?0) and ((Vrms/Irms)<T), THEN the circuit status is “short”. PF is a power factor of power applied to the electrosurgical device. T is a threshold value.

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.

Abstract: Ablation catheters and systems include coaxial catheter shafts with an inner lumen for delivering an ablative agent and an outer lumen for circulation of a cooling element about the catheter. Induction heating is used to heat a chamber and vaporize a fluid within by wrapping a coil about a ferromagnetic chamber and providing an alternating current to the coil. A magnetic field is created in the area surrounding the chamber which induces electric current flow in the chamber, heating the chamber and vaporizing the fluid inside. Positioning elements help maintain the device in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues.

Abstract: A surgical apparatus system for minimally invasive surgery (MIS) which includes a wrist assembly. The wrist assembly includes a first jaw, a first actuation hub, and a cable redirecting hub operably coupled to the first actuation hub, a second jaw, a second actuation hub, a housing for the first and second jaws, a first cable, a second cable, a third cable, rotational position sensors, and a control system. The first and second jaws of the wrist assembly are movably opposed, and the cables are configured such that applying tensions upon them cables produces rotation about a jaw axis. The wrist assembly may further include a hinge-rotary assembly to configured to provide rotation about a pitch axis and/or a roll axis. The wrist assembly may further include a fourth cable configured such that applying tensions upon the fourth cable and the opposing cable produces rotation about a pitch axis.

Abstract: An electrosurgical instrument comprising an end effector is disclosed. The end effector comprises a first jaw and a second jaw. The first jaw comprises a first electrode. The end effector is movable from an open configuration to a closed configuration to grasp tissue. The second jaw comprises a second electrode configured to deliver a first monopolar energy to the tissue, a third electrode, and a conductive circuit selectively transitionable between a connected configuration with the third electrode and a disconnected configuration with the third electrode. In the connected configuration, the third electrode is configured to cooperate with the first electrode to deliver bipolar energy to the tissue. The conductive circuit defines a return path for the bipolar energy. In the disconnected configuration, the first electrode is configured to deliver a second monopolar energy to the tissue.

Abstract: Systems and methods for performing and assessing neuromodulation therapy are disclosed herein. One method for assessing the efficacy of neuromodulation therapy includes positioning a neuromodulation catheter at a target site within a renal blood vessel of a human patient and delivering neuromodulation energy at the target site with the neuromodulation catheter. The method can further include obtaining a measurement related to a blood flow rate through the renal blood vessel via the neuromodulation catheter. The measurement can be compared to a baseline measurement related to the blood flow rate through the renal blood vessel to assess the efficacy of the neuromodulation therapy. In some embodiments, the baseline and post-neuromodulation measurements are obtained by injecting an indicator fluid into the renal blood vessel upstream of the target site and detecting a transient change in vessel impedance caused by the indicator fluid.

Abstract: Apparatuses, systems and methods are provided for treating pulmonary tissues via delivery of energy, generally characterized by high voltage pulses, to target tissue using a pulmonary tissue modification system (e.g., an energy delivery catheter system). Example pulmonary tissues include, without cells), lamina propria, submucosa, submucosal glands, basement membrane, smooth muscle, cartilage, nerves, pathogens resident near or within the tissue, or a combination of any of these. The system may be used to treat a variety of pulmonary diseases or disorders such as or associated with COPD (e.g., chronic bronchitis, emphysema), asthma, interstitial pulmonary fibrosis, cystic fibrosis, bronchiectasis, primary ciliary dyskinesia (PCD), acute bronchitis and/or other pulmonary diseases or disorders.

Abstract: Systems, such as an electrosurgical unit, and method for use with an active electrode and a plurality of return electrodes are disclosure. An electrosurgical treatment is provided to tissue via the active electrode at a treatment site and a first return electrode of the plurality of return electrodes at the treatment site. An impedance measurement is received or determined of an impedance in the tissue between the active electrode at the treatment site and a second return electrode of the plurality of return electrodes at a site remote from the treatment site.

Abstract: A method and apparatus for controlling output of radio frequency ablation power, and a radio frequency ablation system.

Abstract: Disclosed herein is a vapor therapy device for producing intra-uterine tissue effects. The device can include a shaft, including a proximal portion and a distal portion, a fluid-expandable medium, near the distal portion of the shaft, a fluid-delivery conduit, extending between the proximal portion and the distal portion of the shaft, the fluid-delivery conduit comprising an outlet, near the distal portion of the shaft, for delivery of the fluid toward the medium, and an in vivo heat generator, near the distal portion of the shaft, to heat the fluid. A method of treating a patient for menorrhagia with the device can include introducing a medium, in a contracted state, into a patient, delivering a fluid toward the medium to expand the medium in vivo; generating heat in vivo on or near the medium to vaporize the fluid, and exposing a treatment site to the vaporized fluid.

Abstract: The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

Abstract: Tissue treatment systems include an actuator handle assembly coupled with a clamp assembly having a first jaw mechanism and a second jaw mechanism. A first jaw mechanism includes a first flexible boot, a first flexible ablation member coupled with the first flexible boot, and a first rotatable jawbone disposed within the first flexible boot. A second jaw mechanism comprises a second flexible boot, a second flexible ablation member coupled with the second flexible boot, and a second rotatable jawbone disposed within the second flexible boot.

Abstract: Disclosed is a surgical instrument with an end-effector adapted and configured to deliver a plurality of energy modalities to tissue at a distal end thereof. The energy modalities may be applied simultaneously, independently, or sequentially. A generator is electrically coupled to the surgical instrument and is configured to supply a plurality of energy modalities to the end-effector. In one aspect, the generator is configured to supply electrosurgical energy (e.g., monopolar or bipolar radio frequency (RF) energy) and ultrasonic energy to the end-effector to allow the end-effector to interact with the tissue. The energy modalities may be supplied to the end-effector by a single generator or multiple generators.

Abstract: Catheter systems include direction-sensitive, multi-polar tip electrode assemblies for electroporation-mediated therapy, electroporation-induced primary necrosis therapy and electric field-induced apoptosis therapy, including configurations for producing narrow, linear lesions as well as distributed, wide area lesions. A monitoring system for electroporation therapy includes a mechanism for delivering electrochromic dyes to a tissue site as well as a fiber optic arrangement to optically monitor the progress of the therapy as well as to confirm success post-therapy. A fiber optic temperature sensing electrode catheter includes a tip electrode having a cavity whose inner surface is impregnated or coated with thermochromic/thermotropic material that changes color with changes in temperature. An optic fiber/detector arrangement monitors the thermochromic or thermotropic materials, acquiring a light signal and generating an output signal indicative of the spectrum of the light signal.