Systems and methods provide interface to a patient's autonomic nerves via an interior lumen wall of a blood vessel. Systems can include a probe having at least one electrode for receiving electrical signals from the interior of the lumen wall. The system can include processing components for extracting the signals from noise within the patient's body. Systems can include stimulation electrodes for providing stimulation and eliciting action potentials within the patient and destructive processes for destroying nervous function. The effect of nerve destruction on the propagation of action potentials can be effectively used as a feedback mechanism for determining the amount of nervous function destruction in the patient.

A device, system, and method for treating an area of tissue and evaluating lesion formation and quality. The system may include a medical device having a plurality of mapping electrodes on a treatment element, the plurality of mapping electrodes being configured to record from the area of tissue at least one of unipolar impedance measurements, bipolar impedance measurements, local electrical activity, and pace threshold measurements before, during, and after circulation of the cryogenic fluid within the treatment element. These measurements may be transmitted to a control unit having processing circuitry configured to compare pre-treatment measurements, in-treatment measurements, and/or post-treatment measurements to each other and/or to threshold values to determine occlusion and/or lesion quality, such as lesion transmurality.

A microcatheter with a guidewire therein can be steered to target tissue, then the target tissue can be punctured with the guidewire to create a transseptal puncture. The microcatheter can have a diameter substantially smaller than known sheaths which are typically used to guide a needle to a target puncture site in known transseptal puncture treatments. The guidewire can have an atraumatic, electrically conductive distal end that can be electrically energized to puncture the target tissue. Once the guide wire is across, ancillary devices such as a dilator and sheath can be delivered over the guide wire across the transseptal puncture. The microcatheter can include one or more location sensors. A navigation module can use the electrically conductive distal end as a reference electrode to the location sensor(s) of the microcatheter.

A medical laser system for outputting laser pulses includes at least one laser cavity, a rotating mirror, a user interface, and a controller. The controller is configured to receive at least one laser parameter associated with a laser pulse output by the system. The controller is configured to determine an average power level of the laser pulse based on the at least one laser parameter associated with the laser pulse. The controller is configured to determine a pulse width modulation (PWM) control signal based on at least one laser parameter. The controller is configured to generate the laser pulse based on the average power level and the PWM control signal, the laser pulse comprising at least one of a first shape, a second shape, or a third shape. Each of the first shape, the second shape, and the third shape of the laser pulse includes different pulse widths.

Medical devices and methods for making and using medical devices are disclosed. An example electrophysiology medical device may include a catheter shaft including a distal end portion and a sensing assembly having three or more terminals. The sensing assembly includes one or more current-carrying electrodes and one or more sensing electrodes. The one or more current-carrying electrodes, the one or more sensing electrodes, or both includes a mini-electrode. The mini-electrode is disposed on one of the other electrodes. The medical device may also include a controller coupled to the sensing assembly.

A method and apparatus that utilizes a force-time integral for real time estimation of steam pop in catheter-based ablation systems. The apparatus measures the force exerted by a contact ablation probe on a target tissue and an energization parameter delivered to the ablation probe. The exerted force and energization parameter can be utilized to provide an estimation of the probability of steam pop. In one embodiment, the force and energization metrics can be used as feedback to establish a desired contact force and energization level combination to prevent steam popping.

A system for controlling operation of a radiofrequency treatment device to apply radiofrequency energy to tissue to heat tissue to create lesions without ablating the tissue. The system includes a first treatment device having at least one electrode for applying radiofrequency energy to tissue, a controller including a connector to which a first treatment device is coupled for use, and a generator for applying radiofrequency energy to the electrodes. The controller controls application of energy so that the tissue is thermally treated to create lesions but preventing thermal treatment beyond a threshold which would ablate the tissue.

A treatment system comprises a power supply device and a treatment tool configured to communicate electrically with the power supply device so as to perform an operation on a treatment target. The treatment tool includes a sheath and an end effector configured to detachably attach to the sheath and being capable of bending with respect to the sheath. The end effector includes an electric element used to apply a treatment energy to the treatment target using an electric energy. The power supply device includes a processor. The processor sets to increase an output of the electric energy to be supplied to the electric element at in a second state. The sheath and the end effector are bent at a predetermined angle with respect to one another, compared with a first state where the sheath and the end effector are disposed straight in line with one another.

A method for controlling an operation of an ultrasonic blade of an ultrasonic electromechanical system is disclosed. The method includes providing an ultrasonic electromechanical system comprising an ultrasonic transducer coupled to an ultrasonic blade via an ultrasonic waveguide; applying, by an energy source, a power level to the ultrasonic transducer; determining, by a control circuit coupled to a memory, a mechanical property of the ultrasonic electromechanical system; comparing, by the control circuit, the mechanical property with a reference mechanical property stored in the memory; and adjusting, by the control circuit, the power level applied to the ultrasonic transducer based on the comparison of the mechanical property with the reference mechanical property.

A catheter ablation system includes: a catheter probe having distal end including: a temperature sensor; a plurality of irrigation holes; and an ablating electrode; a radiofrequency (RF) heating controller coupled to the catheter probe and configured to supply RF energy to the ablating electrode to control the ablating electrode to emit heat at a target power; an irrigation controller coupled to the catheter probe and configured to supply an irrigation fluid at a continuously adjustable irrigation flow rate through the catheter probe to exit through the irrigation holes; and an operating console having a processor and memory, the memory storing instructions that, when executed by the processor, cause the processor to control the irrigation controller to set the irrigation flow rate based on the target power and a target average temperature.