Abstract: Devices, systems, and methods facilitate modification of renal sympathetic nerve activity using a force generating arrangement. A device for mechanically modifying renal sympathetic nerve activity includes a contact arrangement having a shape that generally conforms to a portion of a renal artery wall and is configured for placement at the renal artery wall portion. A compression arrangement is configured to cooperate with the contact arrangement to place the wall portion of the renal artery in compression sufficient to achieve a desired reduction in renal sympathetic nerve activity. The compression arrangement and the contact arrangement are preferably configured to cooperatively place the wall portion of the renal artery in compression sufficient to irreversibly terminate renal sympathetic nerve activity.

Abstract: Acoustic energy is delivered to innervated vascular that contributes to renal sympathetic nerve activity, such as innervated tissue of the renal artery and abdominal aorta. Focused acoustic energy is delivered via an intravascular device of sufficient power to ablate innervated renal or aortal tissue. Focused acoustic energy may be delivered via an intravascular or extracorporeal device to image and locate target innervated renal or aortal tissue. Intravascular, extravascular, or transvascular focused ultrasound devices provide for high precision denervation of innervated vascular to terminate renal sympathetic nerve activity.

Abstract: Apparatuses and methods facilitate delivery of optical or photoacoustic energy to innervated vascular that contributes to renal sympathetic nerve activity. The optical energy delivered may be of sufficient power to scan or image innervated renal or aortal tissue. The optical energy delivered may be of sufficient power to ablate innervated renal or aortal tissue, such as by thermal laser ablation or photoacoustic laser ablation. A catheter for intravascular or extravascular deployment supports an optical fiber arrangement comprising a coupling for receiving light from a laser light source. An optics arrangement is supported by the catheter and coupled to the optical fiber arrangement. The optics arrangement includes one or more optical elements arranged to receive the laser light and direct optical energy to target innervated tissue or a water source from which a cavitation bubble may be created and launched for acoustically shocking the target innervated tissue.

Abstract: Remote ischemic conditioning is applied during a revascularization procedure to prevent and/or reduce myocardial injury associated with myocardial infarction (MI) and the revascularization procedure such as percutaneous transluminal coronary angioplasty (PTCA). A percutaneous transluminal vascular intervention (PTVI) device used for the revascularization procedure, such as an introducer sheath or a guide catheter, includes an adjustable balloon to be positioned at a vascular site remote from the heart. The remote ischemic conditioning is applied by inflating and deflating the adjustable balloon, thereby causing temporary ischemia in the vascular site to activate the patient's intrinsic cardioprotective mechanism.

Abstract: An apparatus for locally controlling smooth muscle tone includes a first electrode for insertion into an artery; a barrier for preventing the first electrode from contacting an arterial wall; a second electrode; a power supply; and a controller for coupling the power supply to the electrodes. The controller is configured to cause the electrode to maintain a waveform for controlling polarization of smooth muscle tone.

Abstract: A stent assembly includes a stent, a covering on at least a portion of the stent, and a string encircling at least a portion of the covering. The string is releasably engaged to the covering or stent or both the covering and the stent. The string can be adhered to the stent, or the stent assembly, to the covering of the stent assembly, or both the covering and the stent. The string can be wrapped around the stent or covering in an interwoven loop or knit pattern. The covering can be made to overlap a perforation in a body lumen such as an artery or blood vessel and prevent bleeding.

Abstract: An implantable cardiorenal stimulator delivers cardiorenal stimulation in response to detection of decompensation associated with heart failure. The cardiorenal stimulation includes delivering renal stimulation pulses to promote diuresis and/or natriuresis and delivering cardiac stimulation pulses to enhance the diuretic and/or natriuretic effects of the renal stimulation pulses.

Abstract: Some embodiments of an electrical stimulation system employ wireless electrode assemblies to provide pacing therapy, defibrillation therapy, or other stimulation therapy. In certain embodiments, the wireless electrode assemblies may include a guide wire channel so that each electrode assembly can be advanced over a guide wire instrument through the endocardium. For example, a distal tip portion of a guide wire instrument can penetrate through the endocardium and into the myocardial wall of a heart chamber, and the electrode assembly may then be advanced over the guide wire and into the heart chamber wall. In such circumstances, the guide wire instrument (and other portions of the delivery system) can be retracted from the heart chamber wall, thereby leaving the electrode assembly embedded in the heart tissue.

Abstract: Some embodiments of pacing systems employ wireless electrode assemblies to provide pacing therapy. The wireless electrode assemblies may wirelessly receive energy via an inductive coupling so as to provide electrical stimulation to the surrounding heart tissue. In certain embodiments, the wireless electrode assembly may be pivotable so that the proximal end of the wireless electrode assembly may be shifted to a position against the heart wall after the distal end has been secured to the heart wall.

Abstract: Some embodiments of an electrical stimulation system employ wireless electrode assemblies to provide pacing therapy, defibrillation therapy, or other stimulation therapy. In certain embodiments, the wireless electrode assemblies may include a guide wire channel so that each electrode assembly can be advanced over a guide wire instrument through the endocardium. For example, a distal tip portion of a guide wire instrument can penetrate through the endocardium and into the myocardial wall of a heart chamber, and the electrode assembly may then be advanced over the guide wire and into the heart chamber wall. In such circumstances, the guide wire instrument (and other portions of the delivery system) can be retracted from the heart chamber wall, thereby leaving the electrode assembly embedded in the heart tissue.

Abstract: Cardioprotective pacing is applied to prevent and/or reduce cardiac injury associated with myocardial infarction (MI) and revascularization procedure. Pacing pulses are generated from a flexible pacemaker circuit integrated with a percutaneous transluminal vascular intervention (PTVI) device and delivered through pacing electrodes incorporated onto the PTVI device during the revascularization procedure.

Abstract: Cardioprotective pacing is applied to prevent and/or reduce cardiac injury associated with myocardial infarction (MI) and revascularization procedure. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure. In one embodiment, at least one pacing electrode is constructed as, or incorporated onto, a stent at a distal end portion of a stent catheter.

Abstract: A system and method are described involving the use of a cell delivery catheter that incorporates a stimulating electrode to promote vasodilation prior to injection of cells at a target location within a blood vessel. The vasodilation may be produced locally and/or distally from the target location near the target organ. The technique may be applied not only to intra-coronary injection of cells to treat heart disease but to injection of cells in any blood vessel that feeds a target organ.

Abstract: An apparatus and method can receive wireless energy using a wireless electrostimulation electrode assembly. In certain examples, at least some of the received wireless energy can be delivered as an electrostimulation to a heart. In certain examples, the wireless electrostimulation electrode can be mechanically supported at least partially using a ring formed by an annulus of a mitral valve of the heart. In certain examples, the wireless electrostimulation electrode assembly can be configured to be intravascularly delivered to an implant location within a chamber of the heart at the annulus of the mitral valve of the heart, and can fit entirely within the heart.

Abstract: A wireless electrostimulation system can comprise a wireless energy transmission source, and an implantable cardiovascular wireless electrostimulation node. A receiver circuit comprising an inductive antenna can be configured to capture magnetic energy to generate a tissue electrostimulation. A tissue electrostimulation circuit, coupled to the receiver circuit, can be configured to deliver energy captured by the receiver circuit as a tissue electrostimulation waveform. Delivery of tissue electrostimulation can be initiated by a therapy control unit.

Abstract: Methods and systems of treating a patient with pancreatitis pain include providing a stimulator, configuring one or more stimulation parameters to control sphincter of Oddi function, programming the stimulator with the one or more stimulation parameters, generating a stimulus configured to control sphincter of Oddi function with the stimulator in accordance with the one or more stimulation parameters, and applying the stimulus with the stimulator to one or more stimulation sites in accordance with the one or more stimulation parameters.

Abstract: Methods and systems of treating a patient with pancreatitis pain include providing a stimulator, configuring one or more stimulation parameters to treat pancreatitis pain, programming the stimulator with the one or more stimulation parameters, generating a stimulus configured to treat pancreatitis pain with the stimulator in accordance with the one or more stimulation parameters, and applying the stimulus with the stimulator to one or more stimulation sites in accordance with the one or more stimulation parameters.

Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.

Abstract: A method of navigating the distal end of a medical device through an operating region in a subject's body includes displaying an x-ray image of the operating region, including the distal end of the medical device; determining the location of the distal end of the medical device in a reference frame translatable to the displayed x-ray image; and displaying an enhanced indication of the distal end of the medical device on the x-ray image to facilitate the navigation of the distal end of the device in the operating region.

Abstract: A method of turning a medical device, having a magnetically responsive element associated with its distal end, at an operating point within an operating region inside a patient's body from an initial direction to a desired final direction, through the movement of at least one external source magnet. The at least one external source magnet is moved in such a way as to change the direction of the distal end of the magnetic medical device from the initial direction to the desired final direction without substantial deviation from the plane containing the initial direction and the desired final direction.