Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Embodiments of medical devices and methods are disclosed. The medical devices typically comprise a flexible elongate member defining a lumen, and a support spine affixed to the distal end and extending proximally therefrom within the elongate member lumen. In some embodiments, the support spine is pre-shaped such that the support spine biases the distal region of the elongate member to adopt a straight configuration, or the support spine biases at least a portion of the distal region of the elongate member to adopt a curved shape to form a curved portion. Some embodiments include apertures at or near the distal end for enabling fluid communication between the lumen and the outside environment. In some embodiments, the support wire extends proximally from the distal end within a distal portion of the lumen such that a proximal portion of the lumen is substantially unobstructed.

The disclosed technology includes a catheter comprising an elongated deflectable element extending along a longitudinal axis from a proximal end to a distal end, a position electrode attached to the elongated deflectable element proximate the distal end and configured for impedance-based position tracking, and a covering at least partially enclosing the position electrode. The covering can comprise a plurality of apertures such that a portion of a conductive surface of the position electrode is exposed through each aperture of the plurality of apertures.

Electrosurgery blades including electrosurgery blade assemblies having argon beam capability. The electrosurgery blade includes a thin conductive member having a lead sharp cutting end and an opposite noon-cutting end and a non-conductive coating covering the thin conductive member such that at least a portion of the lead cutting end and at least a portion of the opposite non-cutting end of the thin conductive member remain exposed. An electrosurgery blade assembly having argon beam capability includes the previously described electrosurgery blade, a non-conductive tube member having a hollow tubular shaped opening positioned on top of the electrosurgery blade, and a conductive hollow tubular member contained within at least a portion of the non-conductive tube member.

An end effector for an electrosurgical instrument is disclosed which includes a first jaw, a first energy delivery surface, a first distal end, and a first proximal end. A second jaw of the end effector includes a second energy delivery surface, a second distal end, and a second proximal end. The end effector also includes an electrically conductive gap setting member which defines a distal gap distance between the first and second energy delivery surfaces. At least one pivot is fixed to one of the jaws to set a proximal gap distance between the first and second energy delivery surfaces. A method for making an end effector and a method for assembling an end effector for an electrosurgical instrument are also disclosed.

An end effector includes a first and second jaw member each comprising a first and second electrode. The first and second jaw members are movable relative to the other between an open position and a closed position. An electrically conductive member is located at the distal end of the first jaw member. The electrically conductive member is sized and configured to define a minimum distance between the first and second electrodes along the length of the first and second electrodes. An electrically insulative member is located on one of the first jaw member or the second jaw member. The electrically insulative member is sized and configured to engage tissue and has a dimension extending from one of the first jaw member or the second jaw member. The dimension is less than the minimum distance.

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site.

An ultrapolar electrosurgery blade includes top and bottom thin elongated conductive members in vertical alignment and spaced apart from one another along their lengths, a non-conductive coating covering both the top and bottom thin elongated conductive members and the space located between them to create opposing non-conductive sides of the blade with conductive cutting and ends and conductive non-cutting ends exposed, and both return and active contact layers located on each of the opposing non-conductive sides of the blade. An ultrapolar electrosurgery blade assembly having argon beam capability further includes a non-conductive tube member having a slot positioned over the top of the ultrapolar electrosurgery blade and a conductive hollow tubular member contained within at least a portion of the non-conductive tube member.

An electrosurgical instrument includes an end effector having first and second jaws defining an electrically conductive gap setting member configured to maintain a gap between energy delivery surfaces of the first and second jaws. The first jaw comprises a first energy delivery surface, a first body, a first distal end, a first proximal end, and a first electrically conductive member protruding from the first body at the first distal end. The second jaw comprises a second energy delivery surface further comprising an aperture, a second body, a second distal end, a second proximal end, and a second electrically conductive member protruding from the second body at the second distal end. The second jaw further comprises an electrically insulative member extending through the aperture. At least one electrically conductive gap setting member is configured to maintain a gap between energy delivery surfaces of the first and second jaw.

A device for cold plasma endoscopy may include a cold plasma generating system, a catheter and electrically conductive means. The cold plasma generating system includes a gas source, an electrical source, a dielectric chamber, a first electrode surrounding the dielectric chamber and electrically connected to the electrical source. The catheter has a first lumen for carrying the cold plasma fluidly connected to the dielectric chamber at a proximal end and having an opening at a distal end for delivering the cold plasma. The electrically conductive means extend inside the first lumen. The electrical source is configured to apply a pulsed excitation signal to the first electrode. The device includes remotely actuated deployable confinement means for creating a confined space, wherein the opening of the first lumen is arranged in the confined space, the deployable confinement means allowing for confining the plasma substantially within the confined space.