An apparatus includes a tube, a support element, multiple spines proximally coupled to the tube, and multiple electrodes coupled to the spines. The spines include respective expandable superelastic elements, and respective polymeric elements extending from respective distal ends of the superelastic elements and coupled to a surface of the support element by virtue of being bent proximally, into alignment with the surface, at a distal end of the support element. Other examples are also described.

A system for use with multiple electrodes coupled to respective spines of a probe includes multiple switches connected to the electrodes and configured to short different respective first subsets of the electrodes to each other and different respective second subsets of the electrodes to each other per different respective settings of the switches. The system further includes a processor configured to control the switches so as to alternate through the settings and, for each of the settings, cause a power generator to apply a voltage between the shorted first subset and the shorted second subset while the probe is deployed within a body of a subject. Other examples are also described.

Systems, methods, and devices allow percutaneous mapping, orientation and/or ablation in bodily cavities or lumens. Such may include a structure that is percutaneously positionable in a cavity, such as an intra-cardiac cavity of a heart. Transducers carried by the structure are responsive to blood flow. For example, the transducers may sense temperature, temperature being related to convective cooling caused by blood flow. A controller discerns positional information or location, based on signals from the transducers. For example, blood flow may be greater and/or faster proximate a port in cardiac tissue than proximate tissue spaced from the port. Position information may allow precise ablation of selected tissue, for example tissue surround a port in the intra-cardiac cavity.

Devices, methods, and systems for the treatment of tissue using energy delivery. Specifically, certain embodiments may be used for the treatment of lung tissue, such as lung nodules, using RF ablation, via a catheter provided with a first electrode attached to a distal end of the catheter, wherein the first electrode is hollow, wherein the first electrode comprises a piercing tip configured to pierce through an airway wall and a second electrode received in a movable manner within the first electrode, wherein the second electrode is extendable from the first electrode to form a first extended configuration.

Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

A system for assessing occlusion of a region to blood flow includes a catheter with an inflatable member, a first electrode configured for placement upstream of the inflatable member and the second electrodes configured for placement downstream of the inflatable member, the inflatable member configured for inflation to occlude the blood flow through the region. The system further includes a current/voltage source, a resistor and a voltmeter, wherein these components along with the first and second electrodes are configured to form an impedance measuring circuit configured to detect a change in impedance for indicating occlusion of the region to the blood flow.

According to various embodiments, systems, devices and methods for modulating targeted nerve fibers (e.g., hepatic neuromodulation) or other tissue are provided. Systems, devices and methods for cooling energy delivery members are also provided. The systems may be configured to access tortuous anatomy of or adjacent hepatic vasculature. The systems may be configured to target nerves surrounding (e.g., within adventitia of or within perivascular space of) an artery or other blood vessel, such as the common hepatic artery.

Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Medical devices and methods for making and using the same are disclosed. An example medical device may include a medical device for renal nerve ablation. The medical device may include an elongate shaft having a distal region. An expandable member may be coupled to the distal region. A plurality of electrodes may be coupled to the expandable member and a single conductive member may be coupled to each electrode. Where one of the plurality of electrodes is active, the remaining electrodes may be inactive and act as ground or return electrodes. The electrode of the plurality of electrodes that is active may change over time.

A probe generates location signals, and has an electrode at a distal end that acquires from heart chamber surface positions electrical signals due to a conduction wave traversing the surface. A processor derives LATs from the electrical signals, calculates a first time difference between LATs at a first pair of positions and a second time difference between LATs at a second pair of positions. The processor calculates first and second LAT-derived distances as products of the first and second time differences with a conduction wave velocity, identifies an arrhythmia origin at a surface location where a first difference in distances from the location to the first pair of the positions is equal to the first LAT-derived distance, and a second difference in distances from the location to the second pair of the positions is equal to the second LAT-derived distance, and marks the origin on a surface representation.