Having built one of the strongest medical device franchises in its pacemaker and implantable defibrillator businesses, Medtronic is leveraging its expertise in cardiac rhythm management to tackle two related cardiac problems of similarly enormous potential.

Development’s more expensive, markets are smaller, investors are meaner. But alliances aren’t the answer. Or at least not the answer anyone wants to hear. It's time to rethink the anti-alliance logic, which may require a new approach to starting up device companies.