A system for modulating bladder function is disclosed. A system for evaluating the electrophysiological function of a bladder is disclosed. Methods for performing a controlled surgical procedure on a bladder are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. An implantable device for monitoring and/or performing a neuromodulation procedure on a bladder is disclosed.

Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft. An expandable member may be coupled to the catheter shaft. The expandable member may be capable of shifting between a folded configuration and an expanded configuration. A plurality of flexible elements may be attached to the expandable member, with a plurality of electrode assemblies disposed on the flexible elements. The flexible elements may have a grooved substrate.

An electrosurgical apparatus and method for performing thermal treatment in the gastrointestinal tract, e.g. to ablate duodenal mucosal tissue. The apparatus comprises an instrument having a flexible cable and an applicator suitable for use with a gastroscope, which can be deployed within a patient to delivery energy in a targeted or otherwise controllable manner. The applicator can deliver microwave energy by radiation. The direct and depth-limited nature of microwave energy can be make it more effective than treatments that rely on thermal conduction. The applicator may include a radially extendable portion arranged to move an microwave energy delivery structure into contact with duodenal mucosal tissue at the treatment region. The applicator may comprise any of a balloon, bipolar radiator, movable paddle, and rotatable roller element.

A catheter system (100) for treating one or more treatment sites (106) within or adjacent to a vessel wall (108) or a heart valve includes an energy source (124), an energy guide (122A), and a plasma generator (133). The energy source (124) is configured to generate (i) an energizing pulse, and (ii) a conditioning pulse that alternately generates a lower energy than the energizing pulse. The energy source (124) includes a source adjuster (224A) that conditions the energy source (124). The energy guide (122A) is configured to selectively receive energy. The energy guide (122A) includes a guide proximal end (122P) and a guide distal end (122D). The energy source (124) is coupled to the guide proximal end (122P). The plasma generator (133) is coupled to the guide distal end (122D). The plasma generator (133) includes a generator target (233T) having a target surface (233S).

Device and method for selectively ablating a submucosal layer of a duodenal wall and/or of sensory neurons therein, including a laser transmitting element coupled with the catheter body and configured to transmit a laser beam having a spot diameter of less than 200 microns and to provide an ablative dose of 0.5-2.5 J/mm; wherein the laser beam is configured to selectively ablate an area of the submucosal layer that is at least twice the size of the spot diameter, while essentially preventing damage of the surrounding mucosal, muscularis and/or serosal layers of the duodenal wall; and an expandable member configured to stretch the duodenal wall and to generate a fixed distance between the catheter's laser transmitting element and the duodenal wall.

A method for ablating a patient, consisting of ascertaining a CHA.sub.2DS.sub.2-VASc score for the patient and inserting a probe into the patient, so as to contact a pulmonary vein of the patient. The method further includes applying energy via the probe so as to ablate the pulmonary vein until pulmonary vein isolation (PVI) is achieved. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is less than a preset value, ablation of the pulmonary vein is ceased. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is greater than or equal to the preset value, energy is applied to perform a further ablation.

A method and system for determining a target location for a medical device having complex geometry relative to an anatomical feature, and for navigating and positioning the medical device at the target location. The system may include a medical device including a treatment element having a centroid, one or more navigation electrodes, and a longitudinal axis and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to define a plane that approximates a surface of the anatomical feature, define a centroid of the anatomical feature, define a vector that is normal to the plane and extends away from the centroid of the anatomical feature, and determine a target location for the treatment element of the medical device based on the vector to assist the user in placing the device for treatment.

A tissue treatment system and method of using the tissue treatment system determines a size of a body lumen, or a neuromodulation parameter corresponding to the size of the body lumen. The tissue treatment system fills a balloon with a fluid when the balloon is within a body lumen. A fluid parameter of the fluid is detected over a period of time. A parameter curve of the fluid parameter is determined. The parameter curve includes the fluid parameter versus an independent variable over the period of time. The system compares the parameter curve of the fluid parameter to a reference curve and, based on the comparison, determine the body lumen size or the neuromodulation parameter. Other embodiments are also described and claimed.

The disclosed invention provides a transseptal insertion device which is suitable for facilitating precise and safe transseptal puncture of a cardiac interatrial septum. The transseptal insertion device includes a sheath that defines at least one lumen therein, one or more positioning balloons that are connected to a distal end of the sheath, a puncture member movably positioned within the at least one lumen, and a puncture member balloon located on the puncture member. The sheath has one or more deflation ports to deflate the one or more positioning balloons. The puncture member balloon, when inflated, is capable of sealing the one or more deflation ports in the sheath, permitting the inflation of the one or more positioning balloons. When the puncture member moves toward fossa ovalis, the inflated puncture member balloon moves away from the deflation ports, allowing the positioning balloons to be deflated.

Systems and methods for visualizing ablated tissue are disclosed. In some embodiments, a system for imaging tissue comprising: a catheter having a distal end and a proximal end; an inflatable balloon disposed about the distal end of the catheter; and an optical housing extending from the distal end of the catheter into the balloon, the optical housing being configured to position inside the balloon a light source for illuminating a tissue outside the balloon and a camera for imaging the illuminated tissue.