Methods and devices are disclosed for puncturing tissue, comprising a puncture device for puncturing tissue and a supporting member for supporting the puncture device. The puncture device is capable of being insertable within the supporting member and being selectively usable in co-operation therewith during a portion of a procedure for puncturing tissue and wherein the puncture device is usable independently therefrom during another portion of the procedure. The puncture device comprises visual or tactile markers for determining the relative positioning between puncture device and supporting member.

A device for providing fractional treatment of a body orifice includes a source of fractionated energy and a source of electrical muscle (EMS) energy. A programmed controller controls the application of fractionated and/or EMS energy. A probe is inserted by its distal end into the body orifice. The source of fractionated energy is positioned for transmitting fractionated energy from the source of fractionated energy through the probe to tissue in the vicinity around the body orifice; and, the source of EMS is positioned for transmitting EMS energy from the source of EMS energy through the probe to tissue in the vicinity around the body orifice. The programmed controller is configured to control the activation of fractionated energy and EMS energy one of simultaneously or sequentially.

Methods and devices are disclosed for puncturing tissue, comprising an assembly for puncturing a target tissue. The puncture device of the assembly has a distal tip configured to puncture the target tissue and at least one proximal marker, formed on the proximal portion of the puncture device. The supporting member of the assembly includes a proximal end, a distal end, and a lumen for receiving the puncture device. The puncture device is configured to enable advancement and withdrawal of the supporting member overtop of the puncture device. Alignment of the proximal end of the supporting member and the at least one proximal marker of the puncture device occurs when the distal tip of the puncture device protrudes from the distal end of the supporting member.

Described herein is a system including a catheter, an optical circuit, a pulsed field ablation energy source, and a processing device. The catheter includes a proximal section, a distal section, and a shaft coupled between the proximal section and the distal section. The optical circuit is configured to transport light at least partially from the proximal section to the distal section and back. The pulsed field ablation energy source is coupled to the catheter and configured to transmit pulsed electrical signals to a tissue sample. The processing device is configured to analyze one or more optical signals received from the optical circuit to determine changes in polarization or phase retardation of light reflected or scattered by the tissue sample, and determine changes in a birefringence of the tissue sample based on the changes in polarization or phase retardation.

Disclosed embodiments include apparatuses, systems, and methods for positioning electrodes within a body. In an illustrative embodiment, an apparatus for slidably moving multiple features relative to a sheath insertable into a body and positionable relative to a reference point includes a primary actuator configured to move a primary electrode to a first position. A secondary actuator is configured to move a secondary electrode to a second position. A shrouding device is configured to selectively prevent access to the secondary actuator until the primary actuator has been manipulated to extend the primary electrode to the first position.

A device, system, and method for delivering energy to tissue. In particular, the present invention relates to a system and method for enhancing lesion formation without arrhythmogenic effects within relatively thick target tissues, such as the ventricles of the heart. In one embodiment, charge-neutral pulses and non-charge-neutral pulses may be delivered to induce the formation of electrolytic compounds that enhance cell death at the treatment site. Additionally or alternatively, tissue at the treatment site may be heated to sub-lethal temperature before ablating the tissue.

A method includes receiving: (i) a position of a target tissue intended to be ablated in an organ of a patient and having a predefined pattern, and (ii) an energy level of an ablation signal intended to be applied to the target tissue. One or more selected ablation electrodes that, when applying the ablation signal, produce together a lesion having a shape that covers the predefined pattern, are selected in a catheter that is inserted into the organ and has an array of ablation electrodes. In response to verifying that: (i) the one or more selected ablation electrodes are positioned on the target tissue, and (ii) a contact force between the one or more selected ablation electrode and the target tissue is larger than a force threshold, the ablation signal is applied to the target tissue using the one or more selected ablation electrodes.

A medical device system for the delivery of energy to a region of a patient's anatomy is provided. An introducer tube defines a lumen therein and bears a first electrode. A second electrode is movable within the lumen between a retracted position and an extended position. In the retracted position, the second electrode is substantially disposed within the lumen. In the extended position, the second electrode extends at least partially beyond the distal end of the introducer tube. In one form, the introducer tube is configured to substantially hold the second electrode within the lumen in a predetermined orientation in the extended position, and the introducer tube prevents the second electrode from substantially rotating within the lumen of the introducer tube during movement into the extended position. In one form, the introducer tube is more flexible in a first plane than in a second plane.

Systems, apparatus, and methods are described for treatment of varicocele and associated conditions. In some embodiments, systems, apparatus, and methods described herein can include forming one or more fluid connections or fistulas between blood vessels such as a gonadal vein (e.g., spermatic vein, ovarian vein) and surrounding veins. In some embodiments, systems, apparatus, and methods described herein can include occluding one or more blood vessels such as a gonadal vein (e.g., spermatic vein, ovarian vein). In some embodiments, systems, apparatus and methods described herein relate to flow diverters, replacement valves, etc., e.g., for treatment of varicocele and associated conditions.

An apparatus includes an elongated medical dilator including a cautery device configured to selectively form, by cauterization, a tissue passage through a tissue portion of a living body. The elongated medical dilator also includes a dilation device configured to dilate the tissue passage once the cautery device selectively formed the tissue passage.