Device companies finished 2013 strong, raising $1.2 billion in Q4, the highest quarter total of the year. CVS Caremark’s $2.1 billion buy of Apria’s infusion therapy business was the largest M&A of the year, and late-stage venture rounds dominated the $423 million total in diagnostics funding.

St. Jude announces the first post-approval implant of the Nanostim leadless pacemaker in the U.K. Gore launches a feasibility study of the TAG thoracic branch endoprosthesis for the treatment of aortic aneurysms requiring coverage of the left subclavian artery.

To stave off the sluggish growth in established markets, multinational medtechs not only are finding new business in countries with booming health care industries but they’re also forging new ways to serve customers. Device companies now are pushing into services, such as disease management, and angling to compete more aggressively on pricing.

Derived from Strategic Transactions, Elsevier Business Intelligence’s premium source for tracking life sciences deal activity, the Medical Device Deals Update column is a survey of recent medtech M&A, alliance, and financing activity. This month’s column covers deals announced October-November 2013.