Abstract: Systems, devices and methods of determining orientation of a distal end of a medical instrument (e.g., electrode-tissue orientation of an RF ablation catheter) are described herein. One or more processors may be configured to receive temperature measurements from each of a plurality of temperature-measurement devices distributed along a length of the distal end of the medical instrument and determine the orientation from a group of two or more possible orientation options based on whether temperature measurement values or characteristics of temperature response determined from the temperature measurement values satisfy one or more orientation criteria.

Abstract: Apparatuses and methods for treating a heart failure patient by ablating a nerve of the thoracic splanchnic sympathetic nervous system to increase venous capacitance and reduce pulmonary blood pressure. A method comprising: inserting a catheter into a vein adjacent the nerve, applying stimulation energy and observing hemodynamic effects, applying ablation energy and observing hemodynamic effects, applying stimulation energy after the ablation and observing hemodynamic effects and monitoring for presence of the lung in the ablation zone. An alternative method comprising: inserting a catheter into a vein adjacent the nerve, detecting that lung tissue is a safe distance from an ablation zone, and delivering ablation energy to the target nerve when lung tissue is a safe distance from the ablation zone.

Abstract: According to some embodiments, a medical instrument (for example, an ablation device) comprises an elongate body having a proximal end and a distal end, an energy delivery member positioned at the distal end of the elongate body, a first plurality of temperature-measurement devices carried by or positioned within the energy delivery member, the first plurality of temperature-measurement devices being thermally insulated from the energy delivery member, and a second plurality of temperature-measurement devices positioned proximal to a proximal end of the energy delivery member, the second plurality of temperature-measurement devices being thermally insulated from the energy delivery member.

Abstract: Methods and apparatuses, including devices and systems, for remote and detection and/or diagnosis of acute myocardial infarction (AMI). In particular, described herein are handheld and adhesive devices having an electrode configuration capable of recording three orthogonal ECG lead signals in an orientation-specific manner, and transmitting these signals to a processor. The processor may be remote or local, and it may automatically or semi-automatically detect AMI, atrial fibrillation or other heart disorders based on the analyses of the deviation of the recorded 3 cardiac signals with respect to previously stored baseline recordings.

Abstract: Methods and apparatuses, including devices and systems, for remote and detection and/or diagnosis of acute myocardial infarction (AMI). In particular, described herein are handheld and adhesive devices having an electrode configuration capable of recording three orthogonal ECG lead signals in an orientation-specific manner, and transmitting these signals to a processor. The processor may be remote or local, and it may automatically or semi-automatically detect AMI, atrial fibrillation or other heart disorders based on the analyses of the deviation of the recorded 3 cardiac signals with respect to previously stored baseline recordings.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue are disclosed herein. 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 method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Abstract: An ablation catheter configured to ablate tissue in a lung of a patient including: a flexible shaft that advances endobronchially into an airway of the lung and has an outer diameter of 2.0 mm or less; an ablation electrode attached to a distal portion of the flexible shaft and to deliver radiofrequency (RF) electrical current to the tissue and conductively connectable to an RF electrical energy source external to the patient; wherein an outer diameter of an assembly of the flexible shaft and the ablation electrode is no greater than 2.0 mm; a liquid outlet on the distal portion and configured to be in fluid communication with a source of hypertonic saline solution; and a first occluder attached to the flexible shaft proximal to the ablation electrode and proximal to the liquid outlet, wherein the first occluder is configured to expand to occlude the airway.

Abstract: A medical system comprises a memory for receiving intraoperative external image data for at least a portion of a patient anatomy. The memory further receives intraoperative pose data for a medical instrument of the medical system. The medical system further comprises a processor configured for generating a first model of the patient anatomy. The processor is further configured for, based on the intraoperative external image data, intraoperatively generating an updated model of the patient anatomy that is different from the first model. The updated model includes an anatomical structure that is not present in the first model.

Abstract: A system for treatment of a target region of lung tissue including: a flow regulator configured to be interposed between a conductive fluid source and a conductive fluid outlet positionable at or in proximity of the target region of lung tissue, the flow regulator being further configured for controlling a flow rate or a bolus quantity of conductive fluid coming from the fluid source and delivered to the conductive fluid outlet; and a controller communicatively connectable with said flow regulator and with at least one sensor, with the at least one sensor being configured for detecting values taken by at least one control parameter representative of a physical property, wherein the physical property is one of temperature (T), pressure (p), electric impedance (Z), or electric conductivity (C) of material present at or in proximity of the target region of lung tissue.

Abstract: An apparatus (150) for ablating a tumor in a lung including: an elongate shaft (149); an obturator (152) positioned at a distal region of the elongate shaft, a suction lumen (166) extending through the elongate shaft and exiting the shaft distal to the obturator, wherein the suction lumen is configured to remove air or fluid from the portion of the lung, an ablation catheter delivery lumen (153) extending through the elongate shaft and exiting the shaft distal to the obturator, and an ablation catheter (155, 154) comprising an RF electrode (156, 157).

Abstract: An ablation catheter configured to ablate tissue in a lung of a patient including: a flexible shaft that advances endobronchially into an airway of the lung and has an outer diameter of 2.0 mm or less; an ablation electrode attached to a distal portion of the flexible shaft and to deliver radiofrequency (RF) electrical current to the tissue and conductively connectable to an RF electrical energy source external to the patient; wherein an outer diameter of an assembly of the flexible shaft and the ablation electrode is no greater than 2.0 mm; a liquid outlet on the distal portion and configured to be in fluid communication with a source of hypertonic saline solution; and a first occluder attached to the flexible shaft proximal to the ablation electrode and proximal to the liquid outlet, wherein the first occluder is configured to expand to occlude the airway.

Abstract: A medical robotic system comprises a memory for receiving intraoperative external image data for at least a portion of a patient anatomy. The portion of the patient anatomy includes a target anatomy, and the intraoperative external image data includes image data for the target anatomy and for an effect of a substance on the target anatomy. The system further includes a processor configured for at least semi-automatically controlling a medical instrument of the medical robotic system based on the intraoperative external image data to deliver the substance to the target anatomy through the medical instrument. The processor is further configured for determining the effect of the substance on the target anatomy. The processor is further configured for, using the determined effect, adjusting a control parameter for delivering the substance to the target anatomy.

Abstract: A minimally invasive system comprises an elongate medical instrument including a flexible body. The flexible body includes a wall including a channel, and the channel includes a groove. The flexible body further includes a lumen defined by an interior surface of the wall and a curved distal tip portion. The elongate medical instrument further includes a shape sensor coupled to the flexible body. The shape sensor is at least partially positioned within the groove, and the shape sensor is configured to detect shape characteristics of at least a portion of the flexible body. The system further includes an actuator for manipulating the elongate medical instrument.

Abstract: According to some embodiments, a medical instrument (for example, an ablation device) comprises an elongate body having a proximal end and a distal end, an energy delivery member positioned at the distal end of the elongate body, a first plurality of temperature-measurement devices carried by or positioned within the energy delivery member, the first plurality of temperature-measurement devices being thermally insulated from the energy delivery member, and a second plurality of temperature-measurement devices positioned proximal to a proximal end of the energy delivery member, the second plurality of temperature-measurement devices being thermally insulated from the energy delivery member.

Abstract: According to some embodiments, a medical instrument (for example, an ablation device) comprises an elongate body having a proximal end and a distal end, an energy delivery member positioned at the distal end of the elongate body, a first plurality of temperature-measurement devices carried by or positioned within the energy delivery member, the first plurality of temperature-measurement devices being thermally insulated from the energy delivery member, and a second plurality of temperature-measurement devices positioned proximal to a proximal end of the energy delivery member, the second plurality of temperature-measurement devices being thermally insulated from the energy delivery member.

Abstract: According to some embodiments, a medical instrument comprises an elongate body having a proximal end and a distal end and a pair of electrodes or electrode portions (for example, a split-tip electrode assembly). Systems and methods are described herein that perform contact sensing and/or ablation confirmation based on electrical measurements obtained while energy of different frequencies are applied to the pair of electrodes or electrode portions. The contact sensing systems and methods may calibrate network parameter measurements to compensate for a hardware unit in a network parameter measurement circuit or to account for differences in cables, instrumentation or hardware used.

Abstract: A method of deploying an interventional instrument is performed by a processing system. The method comprises receiving an image of an anatomic structure from an imaging probe. The image has an image frame of reference. The imaging probe is extendable distally beyond a distal end of a guide catheter. The distal end of the guide catheter has a catheter frame of reference. The method further includes receiving location data associated with a target structure identified in the image. The received location data is in the image frame of reference. The method further comprises transforming the location data associated with the target structure from the image frame of reference to the catheter frame of reference.

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 method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Abstract: Apparatuses and methods for treating a heart failure patient by ablating a nerve of the thoracic splanchnic sympathetic nervous system to increase venous capacitance and reduce pulmonary blood pressure. A method comprising: inserting a catheter into a vein adjacent the nerve, applying stimulation energy and observing hemodynamic effects, applying ablation energy and observing hemodynamic effects, applying stimulation energy after the ablation and observing hemodynamic effects and monitoring for presence of the lung in the ablation zone. An alternative method comprising: inserting a catheter into a vein adjacent the nerve, detecting that lung tissue is a safe distance from an ablation zone, and delivering ablation energy to the target nerve when lung tissue is a safe distance from the ablation zone.

Abstract: According to some embodiments, a medical instrument comprises an elongate body having a proximal end and a distal end and a pair of electrodes or electrode portions (for example, a split-tip electrode assembly). Systems and methods are described herein that perform contact sensing and/or ablation confirmation based on electrical measurements obtained while energy of different frequencies are applied to the pair of electrodes or electrode portions. The contact sensing systems and methods may calibrate network parameter measurements to compensate for a hardware unit in a network parameter measurement circuit or to account for differences in cables, instrumentation or hardware used.