Methods and apparatuses for detecting tension on a tendon and/or mechanical deformation (e.g., breakage) of one or more steering tendon of a steerable and flexible articulating device. Theses apparatuses may have one or more tendons that are each electrically conductive and configured to steer the apparatus when tension is applied to the proximal end of the tendon. Tension and/or breakage (or other deformation) of one or more of these tendons may be detected by monitoring the electrical resistance of the tendons.

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.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

Tumor ablation devices and related systems and methods are disclosed. Some tumor ablation devices include an RF energy delivery probe with two conductors and one or more thermocouples. The thermocouple measures a temperature at a location on one of the conductors. A generator can produce a current to be conducted between the first conductor and the second conductor via tissue within a desired ablation region. The ablation regions created by the RF energy delivery probe are symmetric about poles of the first conductor and the second conductor. A distal portion of the RF energy delivery probe may articulate, enabling a user to position the RF energy delivery probe in a proper position to ablate the tumor. The thermocouples may be disposed on a flexible or wired thermocouple circuit that is disposed between insulators.

An in-ear stimulation device for administering caloric stimulation to the ear canal of a subject includes (a) first and second earpieces configured to be insertable into the ear canals of the subject; (b) at least first and second thermoelectric devices thermally coupled to respective ones of the first and second earpieces; (c) a first heat sink thermally coupled to the first thermoelectric device opposite the first earpiece and a second heat sink thermally coupled to the second thermoelectric device opposite the second earpiece; and (d) a controller comprising a waveform generator in communication with the first and second thermoelectric devices, the waveform generator configured to generate a first control signal to control a first caloric output to the first thermoelectric device and a second control signal to control a second caloric output to the second caloric device.

A return pad of an electrosurgical system is disclosed. The return pad includes a plurality of conductive members and a plurality of sensing devices. The conductive members are configured to receive radio frequency current applied to a patient. The sensing devices are configured to detect at least one of the following: a nerve control signal applied to the patient; and a movement of an anatomical feature of the patient resulting from application of the nerve control signal.

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.

Disclosed herein are devices, systems, and methods for monitoring a formation of an iceball at a cryoablation needle. An example method includes receiving an impedance from at least one electrode in an electrode arrangement that is disposed at a cryoablation needle distal portion. The electrode arrangement is configured to engage the iceball as the iceball is formed over the cryoablation needle distal portion so as to cause a change in the impedance. The example method includes determining one or more physical attributes of the iceball based on a rate of the change in the impedance.

Systems and methods for controlled sympathectomy procedures for neuromodulation are disclosed. A system for controlled micro ablation procedures is disclosed. A guidewire including one or more sensors or electrodes for accessing and recording physiologic information from one or more anatomical sites within the parenchyma of an organ as part of a physiologic monitoring session, a diagnostic test, or a neuromodulation procedure is disclosed. A guidewire including one or more sensors and/or a means for energy delivery, for performing a neuromodulation procedure within a small vessel within a body is disclosed.

A catheter device for renal denervation ablation includes a flexible catheter shaft having an electrically insulating expandable member in its distal portion with at least one electrode located proximal to the member, at least one electrode located distal to the member, and with openings in the distal shaft with at least one opening proximal to the proximal electrode and one opening distal to the distal electrode of said electrode pair, said openings connected through an inner lumen in the catheter that provides a path for blood to flow through the expandable member. In one embodiment, the device comprises a flexible catheter shaft with a multiplicity of recessed paired electrodes disposed in recessed spaces in its distal portion, such that an electrically conducting portion of each electrode is exposed to the exterior of the catheter within a recessed space, and with an electrical insulator separating the electrodes of each pair.