Abstract: Systems and methods are described herein for tracking an elongate instrument or other medical instrument in an image.

Abstract: Stomach tissue is manipulated and fastened with a tissue grasper and a tissue shaper to form folds in the stomach. The tissue grasper and the tissue shaper rotate and translate relative to one another. The tissue grasper has a plurality of vacuum orifices to adhere the tissue grasper to tissue.

Abstract: A method is provided, comprising: (1) making a transapical puncture into a left ventricle of the heart; (2) making a transseptal fenestration in the heart; (3) delivering a prosthetic valve via the transapical puncture and implanting the prosthetic valve at a mitral valve of the heart; and (4) subsequently to delivering the prosthetic valve and making the transseptal fenestration, closing the transapical puncture. Other embodiments are also described.

Abstract: The sinus venosus atrial septal defect (“ASD”) treatment device includes has a generally tubular or funnel shaped configuration. A first end of the device can have a diameter that is less than a diameter of a second end of the device. The device can be inserted in the right upper right pulmonary vein PV. The second end of the device is configured to expand in a skirt-like configuration once the device is positioned in the right upper right pulmonary vein PV. In this manner, the device closes the upper sinus venosus hole and diverts anomalous pulmonary venous drainage into the left atrium.

Abstract: Multiple vascular wall penetrations are formed and sealed in a single blood vessel, typically a vein, for performing cardiac and other catheter-based procedures. Access sheaths are placed in two or more tissue tracts each having a vascular wall penetration at a distal end and into a lumen of the blood vessel. A catheter is advanced though each of the access sheaths to perform a therapeutic or diagnostic procedure. A vascular closure device is introduced through each access sheath, typically sequentially, and an occlusion element at a distal end of the device is deployed against an inner wall of the blood vessel in a manner so that the adjacent access sheath does not interfere or overlap with the deployed occlusion element. The vascular penetration at the distal end in that tissue tract may then be sealed prior to using another vascular closure device to seal a caudally adjacent vascular wall penetration.

Abstract: Improved methods and devices for performing an endoscopic surgery including a system for performing minimally invasive procedures including a flexible catheter having a working space expanding system positioned at a distal portion, the working space expanding system movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body lumen. A tissue retractor having an inner member positioned within an outer member has a plurality of closed loops at a distal portion forming a petal-like structure. The loops are positioned in a collapsed position within the outer member and are movable to an expanded position when exposed from the outer member.

Abstract: A multi-functional soft tissue wound protective sleeve includes: a waste collection bag including a bottom patch and a surface patch connected to form a cavity; a bottom ring to be inserted into a human body, to push away human tissues surrounding the bottom ring to form a surgery space; a flip ring located above the waste collection bag and having an adjustable distance with the bottom ring, to prevent waste from touching a surgical surface; a medical inner membrane connecting the bottom ring to the flip ring and defining a surgery channel to the surgery space; a positioning ring sealed with a hole edge of the surgery through-hole on the bottom patch; and a medical outer membrane connecting the positioning ring to the flip ring so as to guide waste escaping the surgery channel over the flip ring to flow into the waste collection bag.

Abstract: A method of anchoring a suture into a pilot hole in bone utilizing a suture anchor. A lumen-defining circular soft wall, having a first and second end, is slidably engaged to a piece of suture, a first length of which extends from the first end of the wall and is threaded through the lumen from the second end, and a second length of which extends from the second end and is threaded through the lumen from the first end. The suture anchor is introduced into the pilot hole so that the first length and second length of suture material extend out of the pilot hole. The first length and second length are pulled on alternately, thereby permitting the suture anchor structure to slide on the piece of suture material, and to be compacted evenly by the pulling, until the suture anchor is set in the pilot hole.

Abstract: Embodiments of the present disclosure are directed to prosthetic heart valves and methods of use thereof. In one implementation, a prosthetic heart valve may include an annular spacer having a spacer opening therein and a disc-shaped wall configured to obstruct blood flow. The annular spacer may be configured for engaging with a native heart valve opening, such as the orifice of a mitral valve. The spacer opening may be sized to be smaller than the native heart valve opening. The prosthetic heart valve may also include a central valve section configured for disposal within the spacer opening. The central valve section may be separate from the annular spacer and may include one or more prosthetic valve leaflets.

Abstract: An active anvil assembly for use in forming a looped suture is provided. The active anvil assembly includes an anvil member, a first sensor operably connected to the anvil member, and a control assembly. The first sensor is configured for measuring at least one of force, torque, and distance feedback. Also provided are systems and methods for forming a looped suture including an active anvil assembly.

Abstract: A surgical end effector for use with a surgical instrument that includes an elongate shaft assembly that includes a rotary output drive shaft is disclosed. An elongate channel is attached to the elongate shaft assembly. An anvil frame that comprises a proximal end and a distal end is selectively movable between open and closed positions relative to the elongate channel. An anvil concentric drive member is rotatably supported by the anvil frame and is configured to receive rotary drive motions from the rotary output drive shaft of the surgical instrument when the anvil frame is in the closed position. A firing member is in driving engagement with the anvil concentric drive member for linear travel through the end effector.

Abstract: Systems and methods are provided for delivering and mechanically detaching embolic coils. The systems disclosed herein comprise a mechanical detachment mechanism to intravascularly release an embolic coil. The methods disclosed herein comprise a various triggering mechanisms to detach embolic coils.

Abstract: In a system and method for deployment of an implant device, the implant device includes a first loop at its proximal end, and a deployment tool has a second loop attached at its distal end. A release wire slidably disposed within the deployment tool has a distal end extending through the first and second loops to releasably couple the implant device to the deployment tool, and a proximal portion extending from a proximal end of the deployment tool, which is held in a retraction device. The retraction device is operable to hold the proximal end of the deployment tool and to pull the release wire proximally through the deployment tool until the distal end of the release wire is withdrawn from the first and second loops to decouple the implant device from the deployment tool.

Abstract: An atrial appendage closure device is provided that includes an insertion rod having a first end and a second end. An occluding member having an outer surface and an inner surface is connected to the first end of the insertion rod. The occluding member is moveable between a retracted position and a deployed position such that, in the deployed position, the occluding member is configured to provide a seal between a left atrial appendage and a left atrium of a heart. An anchoring member is further connected to the insertion rod and is configured to slide along the insertion rod to secure the device to a wall of a left atrial appendage. Methods for occluding a left atrial appendage that make use of the closure devices are also provided.

Abstract: Clamping devices for occluding a blood vessel comprise a pair of jaws for receiving the blood vessel therebetween, one or more inflatable membranes within the jaws and at least one handle coupled to the pair of jaws via a hollow arm. The at least one handle comprises an actuator coupled to the one or more inflatable membranes via the hollow arm for inflating the one or more inflatable membranes to occlude the blood vessel.

Abstract: Microfracture apparatuses with a cannula and a penetrator. The cannula has a first end, a second end, and a channel extending between the first end and the second end through which a penetrator can move between a retracted and an extended position substantially without rotation of the penetrator. The cannula has a primary portion and a distal portion between the primary portion and the second end, with the distal portion configured such that the distal portion and/or the second end of the channel is disposed at a nonparallel angle relative to the primary portion, for example, with a curve between the primary portion and the distal portion. The penetrator is configured to flex around such a curve and/or to flex to align with the angle of the send end of the channel and/or the distal portion of the cannula.

Abstract: A target apparatus for aligning a surgical drilling instrument that includes a pointer mechanism for arranging at a location on a bone where a drilled hole that is to be formed is intended to emerge, a guide mechanism for guiding the surgical drilling instrument, and an adjustable connection mechanism with a first end, which is connected to the guide mechanism, and a second end, which is connected to the pointer mechanism. The adjustable connection mechanism comprises a first component, a second component and a locking mechanism. The second component is movable relative to the first component along a predetermined path. The first component is elastically deformable by the locking mechanism such that the second component can be locked relative to the first component by clamping.

Abstract: Methods and devices are disclosed herein that allow for infusion and aspiration through a single device. The device can be used to treat a stroke by delivering the device to the site of a blood clot and simultaneously or sequentially infusing a thrombolytic or other drug into the clot and aspirating the dissolving clot from the patient. The methods and devices can advantageously permit more efficient thrombolytic infusion and clot aspiration. Modular systems are also disclosed, as are methods of treating subdural hematoma or other conditions.

Abstract: A thrombectomy removal system includes a catheter having a distal end and defining a lumen filled with a liquid column having a proximal portion and a distal portion, a vacuum source, a vent liquid source, and a vacuum and vent control system configured to cyclically connect or disconnect the vacuum source and the vent liquid source to change a level of vacuum at the distal end and substantially prevent forward flow. The vacuum source and the vent source are respectively fluidically connected to the vacuum and vent valves. A manifold connects the proximal portion to the vacuum and vent sources through the valves. Control of the valves prevents forward flow of the distal portion out from the distal end during each cycle. Each cycle can have states including vacuum-only, first double-closed, vent-only, and second double-closed. A time of the double-closed states can be no greater than 30 ms.

Abstract: A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

Abstract: A medical retrieval tool including a sheath; and a basket device connected to the sheath. The basket device includes a shaft and a basket located at a distal end of the shaft. The shaft is movably located in the sheath. The basket includes a first basket cage section and a second basket cage section. The first basket cage section is located in front of the second basket cage section. The basket is configured to be extended from a distal end of the sheath in a plurality of deployment modes including a first deployment mode where the first basket cage section is deployed in a first fully expanded shape and the second basket cage section is located in the sheath; and a second deployment mode where both the first basket cage section and the second basket cage section are deployed out of the distal end of the sheath.

Abstract: An inflatable device for insertion into a user's nose for controlling nasal exudation has an elongated shaft including at least one lumen for accommodating a fluid; an inflatable balloon connected to the shaft, the balloon being in fluid connection to the lumen; and an absorber for absorbing nasal exudates, the absorber being disposed at an outer circumference of the shaft and/or at a distal tip portion of the device. Another inflatable device for insertion into a user's nose for controlling nasal exudation has an elongated shaft including at least one lumen for accommodating a fluid; and an inflatable balloon connected to the shaft, the balloon being in fluid connection to the lumen; the balloon containing a cooling agent, wherein the cooling agent is configured to cool the balloon when coming into contact with the fluid.

Abstract: A surgical instrument comprising an end effector configured to grasp tissue. The end effector comprises at least one sensor configured to measure a parameter corresponding to a thickness of the grasped tissue. The surgical instrument further includes a firing member movable during a firing stroke to cause a motion at the end effector and a motor configured to drive the firing member. A feedback indicator or display is configured to display the speed of the firing member according to one of a plurality of zones of speed, such as the relative speed of the firing member.

Abstract: A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Abstract: A releasably attached surgical scissor spray shield is mounted immediately proximate to the scissor blade. The shield controls the spray at the source thus shielding not only the user, but all personnel in the vicinity when an umbilical cord or the like is cut. The mounting mechanisms for the shield releasably, yet securely attaches the spray shield to the scissors so the shield remains immediately proximate to the scissor blades and umbilical cord yet does not restrict the opening of the scissor shear blades. The shield is mounted in close proximity to the cutting operation of the scissors to thereby deflect blood spray immediately adjacent to the source of the spray. The shield does not restrict the operational movement of the scissor blades and arms during the cutting operation.

Abstract: A device for introduction into a body vessel includes a shaft, a balloon positioned at the distal end of the shaft, a guidewire disposed longitudinally within the shaft to receive a guidewire during use, a balloon disposed at the distal end of the shaft, and longitudinal scoring wires to score a vascular lesion attached to the distal end of the shaft. The scoring wires are disposed over the balloon and disposed within the shaft. The proximal ends are welded or otherwise affixed to a spring mounted in the handle. The balloon expands when fluid is delivered to the balloon through the inflation lumen. This expansion pushes the scoring wires against the vascular lesion. The scoring wires attach to a source of vibrations. The scoring wires are made of a helical coil.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: The disclosure provides examples of a surgical needle for entering a joint space through tissue, such as the hip joint. The surgical needle includes a stylet movable within a hollow body. The hollow body has at one end, a tip of a bevel for cutting tissue and at another end, a feedback member providing a surgeon with tactile feedback. The stylet has at one end, a resistance reducing member that when positioned a preset distance from the bevel reduces the resistance of the surgical needle through tissue. At the other end of the stylet is a stylet hub. In some examples of the surgical needle, the stylet hub includes a proximal stop, stylet locking member and/or locking member. The surgical needle advantageously provides tactile feedback, reduces resistance, and minimizes or prevents damage to delicate structures.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An example implant tool for implanting a medical lead includes a rod having a handle and a shaft, and a sheath configured to be placed on the shaft of the rod. The sheath includes a body having proximal end and a distal, a channel formed by the body, the channel extending from the proximal end to the distal end of the body, and an opening that extends along the body of the sheath from the proximal end to the distal end, wherein the channel is accessible via the opening.

Abstract: Method and system for treating a patient using a compressible, pressure-attenuating device. According to one embodiment, the system is used to treat urinary tract disorders and comprises an access device, a delivery device, a pressure-attenuating device, and a removal device. The access device may be used to create a passageway to an anatomical structure, such as the patient's bladder. The delivery device may be inserted through the passageway created by the access device and may be used to deliver the pressure-attenuating device to the anatomical structure. The removal device may be inserted through the passageway created by the access device and may be used to view the bladder and/or to capture, to deflate and to remove the pressure-attenuating device.

Abstract: Systems, methods, and kits for performing endoscopic fusion with neuromonitoring. The endoscopic fusion may be performed, for example, through a cannula providing a portal to the disc space. Throughout various steps in the procedure, neuromonitoring may occur to minimize the possibility of injuring or contacting a nerve.

Abstract: Described herein are external fixation systems for correcting bone deformities in adjacent bones or fragments thereof. The systems herein include first and second elongate tubes that translate with respect to one another via rotation of an actuation member at an end of one of the rods. At least one housing member is coupled along a length of one of the tubes. The housing member includes at least clamping portion for clamping a portion of a fixation pin therein. When the housing member is in an unlocked state, the clamping portions can move in a variety of directions. When in a locked state, the housing member cannot move with respect to the tube that it is coupled to. The position and orientation of the fixation pin is also set. The locked and unlocked state of the housing member is determined by the positioning of a locking pin coupled to the housing member.

Abstract: An apparatus and related method for controlling a load on a human ankle joint during normal gait while preserving motion. The approach is intended to treat osteoarthritis and pain of the ankle without substantially resisting an angular displacement associated with full mobility of the ankle joint. In one particular embodiment, the device includes a first load transmission support, a second load transmission support and an implantable compressible absorber.

Abstract: A sacroiliac fixation implant comprising a one-piece anchoring component supporting a connecting element of the linking rod and provided with three orifices for the passage of anchoring screws, where the anchoring component comprises: an elongated main wall in which are formed two orifices, where the connecting element is interposed between the two orifices; and a secondary wall protruding from the main wall at the level of one end so that the anchoring component has a general «L» shape, a third orifice being formed on said secondary wall; wherein each orifice is internally delimited by a spherical shaped bearing face extended by a truncated-cone shaped flared face centered on a central axis, and wherein the orientations of the central axes and the taper angles of the flared faces are shaped so as to enable an arrangement of the screwing axes of the three anchoring screws.

Abstract: A combination of an implant (100) like a bone screw together with an augmentation sleeve (200) is suggested. The bone screw may comprise a trailing end portion with a plurality of lateral bores (120). The augmentation sleeve may comprise a leading end portion which is adapted to be coupled to the trailing end portion of the bone screw, and a lateral opening (220) at the leading end. The augmentation sleeve may be adapted to guide an augmentation tool to the trailing end portion of the bone screw and to the leading end portion of the augmentation sleeve so that the trailing end portion of the bone screw may be augmented by pressing augmentation material through the plurality of lateral bores at the trailing end portion of the bone screw and further through the lateral opening of the augmentation sleeve into the bone at the trailing end of the bone screw, or other implant. After the augmentation of the trailing end portion of the bone screw, the augmentation sleeve may be removed.

Abstract: A medical device that may include a main body and a plurality of hooks. The main body includes a length extending along an axis between first and second ends. The main body may be deformable such that the axis forms an arch shape corresponding to a shape of a mandibular jaw or a maxillary jaw. The main body may include a plurality of sections each having first and second edges defining a first width and a plurality of openings disposed between the first and second edges and extending through a thickness of the main body. The main body may include a plurality of recessed portions defining a second width disposed between adjacent ones of the sections. Each of the hooks may extend from a corresponding one of the sections.

Abstract: A self-adjustable pectus reconstruction system comprising: a pectus reconstruction bar having a first end and a first slot disposed on the first end; a first fixing unit having a first channel; and a first connector, wherein the first end of the pectus reconstruction bar is assembled on the first channel of the first fixing unit, the first connector passes through the first slot to combine the pectus reconstruction bar with the first fixing unit, and the first slot of the pectus reconstruction bar is capable of sliding back and forth around the first connector.

Abstract: A method and apparatus is provided for conducting percutaneous surgery using a cable passer device 200, a crimping device 100, a screwdriver device 120, a cable tensioning device 130, and a cutting device 300. The percutaneous cable passer device 200 is for inserting into an incision during percutaneous surgery having a cable 110 for making a loop around the bone. The crimping device 100 is for threading the tip of the cable 110 through an opening in crimping device 100. The cannulated screwdriver device 120 has a tip 126 for threading the tip of the cable 110 through the tip 126, and an exit port 124 for pulling the cable 110 while pushing said screwdriver device 120 towards the bone. The cable tensioning device 130 has an internal passage way 132 for threading the tip of the cable 110 through it. The screwdriver device 120 is rotatable while holding the cable tensioning device 130, thus deploying the crimping device 100.

Abstract: A system for inserting an anchor member into bone includes a receiving member and an anchor member receivable within the receiving member. The receiving member is elongate along a longitudinal axis and has a proximal end and a distal end spaced from the proximal end along the longitudinal axis. The receiving member has an internal surface that defines a transmission element. The anchor member includes an engagement element configured to rotatably engage the transmission element such that the transmission element is configured to drive the anchor member in a distal direction relative to the transmission element so as to rotatably decouple the engagement element from the transmission element. The distal direction extends from the proximal end to the distal end of the receiving member and is parallel with the longitudinal axis.

Abstract: A bone screw includes a main body having a proximal end and a distal end. The main body extends along a longitudinal axis. The main body has an externally threaded surface that includes at least one helically extending thread having a minor diameter and a major diameter, which major diameter is greater than the minor diameter. The thread includes at least two flank surfaces extending between the minor diameter and the major diameter. The minor diameter of the thread defines a central portion of the main body. The thread may include at least one aperture that extends along an aperture axis through the thread between the flank surfaces.

Abstract: A compression screw for applying compression at a bone joint. The compression screw includes an axial screw body extending from a distal end to a proximal end with the distal end including a series of bone engaging threads configured to be self-drilling and self-tapping and the proximal end including a head which defines a radially extending shoulder. At least one proximal rotary cutting structure is defined proximally of the bone engaging threads. The at least one proximal rotary cutting structure is configured to be self-drilling such that a proximal portion of the axial screw body cuts into and advances within a bone of the bone joint as the axial screw body is advanced. A method of inserting the compression screw is also provided.

Abstract: A medical vapor system and method is provided. The medical vapor system can include a fluid conduit having an inlet, an outlet and a heating section, the inlet being adapted and configured to be connected to a source of liquid water, a resistance heater disposed and configured to generate heat and conduct the heat to the heating section of the fluid conduit to vaporize liquid water flowing through the heating section, a power supply operatively connected to the heater, and a controller adapted to control production of water vapor by the system. Methods of use are also provided.

Abstract: A method of treating bowel diseases includes introducing a fluid into a portion of a patient's colon and applying energy thereto from an external energy source such that the fluid and the energy cooperate to treat tissue of the portion of the patient's colon in contact with the fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient's colon, introducing an electrically-conductive fluid thereto, and energizing an electrode disposed therein to treat tissue of the portion of the patient's colon in contact with the electrically-conductive fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient's colon and introducing a heated fluid at a temperature equal to or above 60° C. to treat tissue of the portion of the patient's colon in contact with the heated fluid.

Abstract: A method for heat treating biological tissues includes providing a pulsed energy source having energy parameters selected so as to raise a target temperature to a level to achieve a therapeutic effect, while the average temperature rise of the tissue over a prolonged period of time is maintained at or below a predetermined level so as not to permanently damage the target tissue. Application of the pulsed energy source to the target tissue induces a heat shock response and stimulates heat shock protein activation in the target tissue so as to therapeutically treat the target tissue.

Abstract: A treatment instrument includes a first treatment portion including a first member with a first contact surface and a second member with a second contact surface; a movement mechanism to switch between a closed position where the first and second contact surfaces are close to each other and an open position where the first and second contact surfaces are separated each other; and a second treatment portion juxtaposed to the first treatment portion. A distal end of the second treatment portion is located at a distal side in the longitudinal axis than a distal end of the first treatment portion on the closed position.

Abstract: A surgical device is disclosed including a surgical instrument and an outer sheath surrounding the surgical instrument. The surgical instruments includes an end effector including a first jaw member and a second jaw member. At least one of the first jaw member or the second jaw member is pivotable toward the other to grasp tissue. The outer sheath is slidable relative to the surgical instrument along a longitudinal axis between a first position, wherein the first jaw member and the second jaw member are positioned within the outer sheath proximal to a distal portion of the outer sheath, and a second positon, wherein the first iaw member and the second iaw member are positioned outside the outer sheath distal to the distal portion of the outer sheath. The distal portion of the outer sheath is configured to clamp tissue.

Abstract: A medical device that can perform plural actions by a single operation and is excellent in operability includes a catheter that is insertable into a living body, a sandwiching portion and a needle positioning portion that are disposed in the catheter so as to be able to advance and retract. A slide portion is operable such that the sandwiching portion and the needle positioning portion advance and retract simultaneously, and an action switching portion causes the sandwiching portion to advance and retract in tandem with or independently of the slide portion by the advance and retraction of the slide portion.

Abstract: Hysteroscopic system includes a hysteroscope having a main body coupled to an extension portion. The extension portion may be a shaft configured to extend transcervically to a patient's uterine cavity. First, second, and third channels extend from the main body to a distal end of the extension portion. A fluid source is coupleable to a proximal end of the first channel, and a pressure sensor is coupleable to a proximal end of the second channel. A tissue resecting probe is configured for introduction through the third channel. At least one resistance feature is included which is configured to provide a selected level of resistance to axial sliding of the probe through the third channel while permitting rotation of the probe within the third channel.

Abstract: A catheter includes a flexible shaft having a distal end dimensioned for deployment within a patient's renal artery. A number of elongated resilient members are mounted along a longitudinal length of the distal end of the shaft, and are extensible radially from the shaft at regions defined between longitudinally spaced-apart engagement locations. One or more electrodes are mounted on each of the resilient members at the radially extensible regions. A number of conductors are electrically coupled to the electrodes and extend along the shaft of the catheter. The elongated resilient members are collapsible when encompassed within a lumen of an outer sheath and extensible radially outward from the shaft at the regions defined between the longitudinally spaced-apart engagement locations when the catheter and the resilient members are axially extended beyond the distal tip of the sheath. RF energy is delivered to the electrodes for ablating perivascular renal nerves.

Abstract: A method for ablating tissue by applying at least one pulse train of pulsed-field energy. The method includes delivering a pulse train of energy having a predetermined frequency to cardiac tissue, the pulse train including at least 60 pulses, an inter-phase delay between 0 ?s and 5 ?s, an inter-pulse delay of at least 5 ?s, and a pulse width of 5 ?s.