<SUBMISSION>
<ACCESSION-NUMBER>0001047469-05-026800
<TYPE>SC 14D9/A
<PUBLIC-DOCUMENT-COUNT>2
<FILING-DATE>20051114
<DATE-OF-FILING-DATE-CHANGE>20051114
<SUBJECT-COMPANY>
<COMPANY-DATA>
<CONFORMED-NAME>ADVANCED NEUROMODULATION SYSTEMS INC
<CIK>0000351721
<ASSIGNED-SIC>3841
<IRS-NUMBER>751646002
<STATE-OF-INCORPORATION>TX
<FISCAL-YEAR-END>1231
</COMPANY-DATA>
<FILING-VALUES>
<FORM-TYPE>SC 14D9/A
<ACT>34
<FILE-NUMBER>005-33902
<FILM-NUMBER>051196475
</FILING-VALUES>
<BUSINESS-ADDRESS>
<STREET1>6901 PRESTON RD.
<CITY>PLANO
<STATE>TX
<ZIP>75024
<PHONE>9723098000
</BUSINESS-ADDRESS>
<MAIL-ADDRESS>
<STREET1>6901 PRESTON RD.
<CITY>PLANO
<STATE>TX
<ZIP>75024
</MAIL-ADDRESS>
<FORMER-COMPANY>
<FORMER-CONFORMED-NAME>QUEST MEDICAL INC
<DATE-CHANGED>19920703
</FORMER-COMPANY>
</SUBJECT-COMPANY>
<FILED-BY>
<COMPANY-DATA>
<CONFORMED-NAME>ADVANCED NEUROMODULATION SYSTEMS INC
<CIK>0000351721
<ASSIGNED-SIC>3841
<IRS-NUMBER>751646002
<STATE-OF-INCORPORATION>TX
<FISCAL-YEAR-END>1231
</COMPANY-DATA>
<FILING-VALUES>
<FORM-TYPE>SC 14D9/A
</FILING-VALUES>
<BUSINESS-ADDRESS>
<STREET1>6901 PRESTON RD.
<CITY>PLANO
<STATE>TX
<ZIP>75024
<PHONE>9723098000
</BUSINESS-ADDRESS>
<MAIL-ADDRESS>
<STREET1>6901 PRESTON RD.
<CITY>PLANO
<STATE>TX
<ZIP>75024
</MAIL-ADDRESS>
<FORMER-COMPANY>
<FORMER-CONFORMED-NAME>QUEST MEDICAL INC
<DATE-CHANGED>19920703
</FORMER-COMPANY>
</FILED-BY>
<DOCUMENT>
<TYPE>SC 14D9/A
<SEQUENCE>1
<FILENAME>a2164785zsc14d9a.htm
<DESCRIPTION>SC 14D9/A
<TEXT>
<HTML>
<HEAD>
</HEAD>
<BODY BGCOLOR="#FFFFFF" LINK=BLUE  VLINK=PURPLE>
<BR>

<P><FONT SIZE=2>
<hr noshade width=100% align=left size=4>
<hr noshade width=100% align=left size=1> </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=5><B>SECURITIES AND EXCHANGE COMMISSION<BR>  </B></FONT><FONT SIZE=2><B>WASHINGTON, D.C. 20549  </B></FONT></P>

<HR NOSHADE ALIGN="CENTER" WIDTH="120">
<P ALIGN="CENTER">


<FONT SIZE=5><B>SCHEDULE 14D-9<BR>
(RULE 14d-101)<BR>  </B></FONT><FONT SIZE=4><B>SOLICITATION/RECOMMENDATION STATEMENT<BR>
UNDER SECTION 14(d)(4) OF THE SECURITIES EXCHANGE ACT OF 1934<BR>
(Amendment No. 4)

  </B></FONT>

</P>

<HR NOSHADE ALIGN="CENTER" WIDTH="120">
<P ALIGN="CENTER"><FONT SIZE=4><B> Advanced Neuromodulation Systems,&nbsp;Inc.<BR>  </B></FONT><FONT SIZE=2>(Name of Subject Company) </FONT></P>

<HR NOSHADE ALIGN="CENTER" WIDTH="120">
<P ALIGN="CENTER"><FONT SIZE=4><B>Advanced Neuromodulation Systems,&nbsp;Inc.<BR>  </B></FONT><FONT SIZE=2>(Name of Person Filing Statement) </FONT></P>

<HR NOSHADE ALIGN="CENTER" WIDTH="120">
<P ALIGN="CENTER"><FONT SIZE=2><B>COMMON STOCK, PAR VALUE $.05 PER SHARE<BR>
(INCLUDING THE ASSOCIATED COMMON STOCK PURCHASE RIGHTS)<BR>  </B></FONT><FONT SIZE=2>(Title of Class of Securities) </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=2><B>00757T101<BR>  </B></FONT><FONT SIZE=2>(CUSIP Number of Class of Securities) </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=2><B>Christopher G. Chavez<BR>
President and Chief Executive Officer<BR>
Advanced Neuromodulation Systems,&nbsp;Inc.<BR>
6901 Preston Road<BR>
Plano, Texas 75024<BR>
(972)&nbsp;309-8000<BR>  </B></FONT><FONT SIZE=2>(Name, Address and Telephone Number of Person Authorized to<BR>
Receive Notice and Communications on Behalf of the Person(s) Filing Statement) </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=2>With
copies to each of: </FONT></P>

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<TD WIDTH="49%" ALIGN="CENTER"><FONT SIZE=2><B>Kenneth G. Hawari<BR>
General Counsel and Executive Vice President<BR>
Advanced Neuromodulation Systems, Inc.<BR>
6901 Preston Road<BR>
Plano, Texas 75024-2508<BR>
(972) 309-8000</B></FONT></TD>
<TD WIDTH="2%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="49%" ALIGN="CENTER"><FONT SIZE=2><B>Joseph Cialone, II<BR>
Baker Botts L.L.P.<BR>
One Shell Plaza<BR>
910 Louisiana<BR>
Houston, TX 77002-4995<BR>
(713) 229-1234</B></FONT></TD>
</TR>
</TABLE>
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<DL compact>
<DT style='margin-bottom:-11pt;'><FONT SIZE=2><FONT FACE="WINGDINGS">&#111;</FONT></FONT></DT><DD><FONT SIZE=2>Check
the box if the filing relates solely to preliminary communications made before the commencement of a tender offer. </FONT></DD></DL>
<BR>

<P><FONT SIZE=2><hr
noshade width=100% align=left size=1>
<hr noshade width=100% align=left size=4> </FONT></P>

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<P><FONT SIZE=2><A
NAME="page_ja1391_1_1"> </A> </FONT> <FONT SIZE=2>


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;This Amendment No.&nbsp;4 (this "Amendment") further amends and supplements the Solicitation/Recommendation Statement on Schedule&nbsp;14D-9, as amended through the date hereof (the
"Statement"), originally filed with the Securities and Exchange Commission on October&nbsp;19, 2005, by Advanced Neuromodulation Systems, Inc., a Texas corporation (the "Company"), relating to the
third-party tender offer by Apollo Merger Corp., a Texas corporation (the "Purchaser") and a wholly-owned subsidiary of St. Jude Medical, Inc., a Minnesota corporation ("Parent"), to purchase all of
the issued and outstanding shares of common stock of the Company, par value $.05 per share (together with the associated rights issued pursuant to the Rights Agreement dated August&nbsp;30, 1996
between Quest Medical, Inc. and KeyCorp Shareholder Services, Inc., as rights agent, as amended by the Amendment to Rights Agreement dated January&nbsp;25, 2002 between the Company and Computershare
Investor Services LLC and the Second Amendment to Rights Agreement dated October&nbsp;14, 2005 between the Company and Computershare Investor Services LLC (as so amended, the "Rights Plan")) (the
"Shares"), at a purchase price of $61.25 per share, net to the seller in cash, without interest thereon, upon the terms and subject to the conditions set forth in the Offer to Purchase, dated
October&nbsp;18, 2005 (the "Offer to Purchase") and in the related Letter of Transmittal (the "Letter of Transmittal") (which, together with the Offer to Purchase and any amendments or supplements
thereto, are referred to herein collectively as the "Offer"). The Offer to Purchase and the Letter of Transmittal are filed as Exhibits&nbsp;(a)(2) and (a)(3) this Statement, respectively.
Capitalized terms used and not otherwise defined in this Amendment shall have the meanings assigned to such terms in the Statement. The purpose of this Amendment is to attach a press release filed by
St.&nbsp;Jude Medical on November&nbsp;11, 2005.

 </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=2>1</FONT></P>

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<P><FONT SIZE=2><B>Item 9.&nbsp;&nbsp;&nbsp;&nbsp;Exhibits.  </B></FONT></P>

<P><FONT SIZE=2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;The following Exhibits are attached hereto: </FONT></P>




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<TR VALIGN="BOTTOM">
<TH WIDTH="11%" ALIGN="CENTER"><FONT SIZE=1><B>Exhibit Number</B></FONT><HR NOSHADE></TH>
<TH WIDTH="3%"><FONT SIZE=1>&nbsp;</FONT></TH>
<TH WIDTH="86%" ALIGN="CENTER"><FONT SIZE=1><B>Description</B></FONT><HR NOSHADE></TH>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2>(a)(1)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2>Letter to the shareholders of the Company, dated October&nbsp;18, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(2)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Offer to Purchase, dated October&nbsp;18, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(3)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Form of Letter of Transmittal.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(4)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Opinion of Piper Jaffray &amp; Co., dated as of October&nbsp;14, 2005 (included as Annex A to this Statement).*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(i)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Joint Press Release issued by the Company and St. Jude Medical on October&nbsp;16, 2005 (incorporated by reference to Exhibit&nbsp;99.1 of the Current Report on Form 8-K filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(ii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Letter to employees of the subject company dated October&nbsp;17, 2005 with attached fact sheet (incorporated by reference to Exhibit&nbsp;99.1 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on
October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(iii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Employee Questions and Annswers, dated October&nbsp;17, 2005 (incorporated by reference to Exhibit&nbsp;99.2 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(iv)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Subject company fact sheet (incorporated by reference to Exhibit&nbsp;99.3 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(v)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Customer Letter, dated October&nbsp;17, 2005 (incorporated by reference to Exhibit&nbsp;99.4 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(vi)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Form of Clinical Studies Letter, dated October&nbsp;17, 2005 (incorporated by reference to Exhibit&nbsp;99.5 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(vii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Form of Supplier Letter, dated October&nbsp;17, 2005 (incorporated by reference to Exhibit&nbsp;99.6 of the pre-commencement Solicitation/Recommendation Statement on Form 14D-9 filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(viii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Form of letter to employees of the Company dated October&nbsp;19, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(ix)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
International Customer Letter dated October&nbsp;27, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(x)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Press Release issued by the Company on October&nbsp;27, 2005 (incorporated by reference to Exhibit&nbsp;99.1 of the Current Report on Form&nbsp;8-K filed by the Company on October&nbsp;27, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(xi)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Employee Questions and Answers, Part II, dated October 27, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(xii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Press Release issued by St.&nbsp;Jude Medical on November&nbsp;4, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(5)(xiii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Press Release issued by St.&nbsp;Jude Medical on November&nbsp;11, 2005.</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(6)(i)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Part 13 of the Texas Business Corporation Act.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(a)(6)(ii)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Articles 5.11, 5.12, 5.13 and 5.16(E) of the Texas Business Corporation Act.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(1)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Agreement and Plan of Merger, dated as of October&nbsp;15, 2005, among St. Jude Medical, the Purchaser and the Company (incorporated by reference to Exhibit&nbsp;2.1 to the Form 8-K filed by the Company on October&nbsp;17, 2005).</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2>&nbsp;</FONT></TD>
</TR>
</TABLE>

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<TABLE WIDTH="77%" BORDER=0 CELLSPACING=0 CELLPADDING=0>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(2)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Information Statement of the Company, dated October&nbsp;18, 2005 (included as Annex B hereto).*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(3)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Confidentiality Agreement dated July 28, 2005 between the Company and St. Jude Medical.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(4)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Christopher G. Chavez, President and Chief Executive Officer, dated as of April&nbsp;1, 2002.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(5)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;Kenneth G. Hawari, General Counsel, Executive Vice President&#151;Corporate Development and Secretary, dated as of April 1, 2002.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(6)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;Scott F. Drees, Executive Vice President&#151;Operations, dated as of May 25, 2001.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(7)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;F. Robert Merrill, III, Chief Financial Officer, dated as of May&nbsp;25, 2001.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(8)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;James P. Calhoun, Vice President&#151;Human Resources, dated as of May&nbsp;25, 2001.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(9)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;John H. Erickson, Vice President&#151;Research &amp; Development, dated as of May&nbsp;25, 2001.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(10)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Special Termination Agreement between the Company and Mr.&nbsp;Stuart B. Johnson, Vice President&#151;Manufacturing, dated as of May 25, 2001.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(e)(11)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Second Amendment to Rights Agreement, dated as of October&nbsp;14, 2005.*</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="11%" ALIGN="CENTER"><FONT SIZE=2><BR>
(g)</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2><BR>&nbsp;</FONT></TD>
<TD WIDTH="86%"><FONT SIZE=2><BR>
Not applicable.</FONT></TD>
</TR>
</TABLE>


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<DL compact>
<DT style='margin-bottom:-11pt;'><FONT SIZE=2>*</FONT></DT><DD><FONT SIZE=2>Previously
filed. </FONT></DD></DL>
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<P style='page-break-before:always'></p>
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<DOCUMENT>
<TYPE>EX-99.(A)(5)(XIII)
<SEQUENCE>2
<FILENAME>a2165128zex-99_a5xiii.htm
<DESCRIPTION>EXHIBIT 99.(A)(5)(XIII)
<TEXT>
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<BR>
<P ALIGN="RIGHT"><FONT SIZE=2><A
NAME="page_re1391_1_1"> </A> </FONT> <FONT SIZE=2><B>Exhibit&nbsp;(a)(5)(xiii)  </B></FONT></P>

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<TD WIDTH="10%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=1>St. Jude Medical<BR>
One Lillehei Plaza<BR>
St. Paul, Minnesota 55117<BR>
(651) 483.2000<BR>
www.sjm.com</FONT></TD>
</TR>
<TR VALIGN="TOP">
<TD WIDTH="10%"><FONT SIZE=2><B>Contacts</B></FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=2>Laura Merriam<BR>
Investor Relations<BR>
(651) 766-3029</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=2>Angela Craig<BR>
Media Relations<BR>
(651) 481-7789</FONT></TD>
<TD WIDTH="3%"><FONT SIZE=2>&nbsp;</FONT></TD>
<TD WIDTH="27%"><FONT SIZE=2>&nbsp;</FONT></TD>
</TR>
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<P ALIGN="CENTER"><FONT SIZE=2><B>St. Jude Medical Obtains Foreign Antitrust Clearance to Acquire<BR>
Advanced Neuromodulation Systems  </B></FONT></P>

<P><FONT SIZE=2>ST.
PAUL, MN, November&nbsp;11, 2005&#151;St. Jude Medical,&nbsp;Inc. (NYSE:STJ) announced today that the German Federal Cartel Office confirmed that the acquisition of Advanced
Neuromodulation Systems,&nbsp;Inc. (NASDAQ:ANSI) by St. Jude Medical may be completed. This approval, together with the previously announced expiration of the waiting period under the
Hart-Scott-Rodino Antitrust Improvements Act of 1976, satisfies the antitrust approval condition set forth in the parties' merger agreement. No other regulatory approvals are required for
the merger. </FONT></P>

<P><FONT SIZE=2>As
previously reported, on October&nbsp;18, 2005, St. Jude Medical commenced an all-cash tender offer for all of the outstanding shares of ANS common stock, at a price of $61.25 per
share. The tender offer is being made pursuant to the definitive merger agreement unanimously approved by the Boards of Directors of both companies and announced on October&nbsp;16, 2005. The ANS
Board of Directors has unanimously recommended that ANS shareholders tender their shares into the offer. </FONT></P>

<P><FONT SIZE=2>The
tender offer will expire at 12:00 midnight Eastern Time, on Tuesday, November&nbsp;15, 2005, unless extended. Following successful completion of the tender offer, holders of any remaining
outstanding shares of ANS will be entitled to receive cash of $61.25 per share of ANS common stock upon closing of the acquisition. </FONT></P>


<P><FONT SIZE=2>The
transaction is subject to customary closing conditions, as well as the valid tender of a majority of the outstanding shares of ANS common stock, on a fully-diluted basis. St. Jude Medical expects
the transaction to close by the end of the year. </FONT></P>

<P><FONT SIZE=2>The
complete terms and conditions of the tender offer are set forth in the Offer to Purchase and certain additional information is set forth in the Solicitation/Recommendation Statement of ANS, copies
of which are available by contacting MacKenzie Partners,&nbsp;Inc. (800)&nbsp;322-2885-toll free or (212)&nbsp;929-5500-collect, the Information
Agent for the tender offer. The Dealer Manager for the tender offer is Banc of America Securities LLC. </FONT></P>


<P><FONT SIZE=2><B>About St. Jude Medical</B></FONT><FONT SIZE=2><BR>
St. Jude Medical,&nbsp;Inc. (<U>www.sjm.com</U>) is dedicated to the design, manufacture and distribution of innovative medical devices of the highest quality, offering
physicians, patients and payers outstanding clinical performance and demonstrated economic value. </FONT></P>

<P><FONT SIZE=2><B>About ANS</B></FONT><FONT SIZE=2><BR>
ANS (<U>www.ANS-medical.com</U>) designs, develops, manufacturers and markets implantable systems used to manage chronic intractable pain and other disorders of the
central nervous system. </FONT></P>

<P ALIGN="CENTER"><FONT SIZE=2>1</FONT></P>

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<P><FONT SIZE=2><B>Forward-Looking Statements<BR>  </B></FONT><FONT SIZE=2><I>Any statements made regarding the proposed transaction between St. Jude Medical,&nbsp;Inc. and Advanced Neuromodulation Systems,&nbsp;Inc., the expected timetable for
completing the transaction, successful integration of the business, benefits of the transaction, potential clinical success, regulatory approvals, anticipated future product launches, revenues,
earnings, expected repayment of debt, market shares, market growth, market segment growth, new indications, and any other statements regarding St. Jude Medical's or ANS's future expectations, beliefs,
goals or prospects are forward-looking statements which are subject to risks and uncertainties, such as those described under or incorporated by reference in the Cautionary Statements section in Item
2 of St. Jude Medical's Quarterly Report on Form&nbsp;10-Q filed on November&nbsp;8, 2005 (see page 35), and in Item 8.01 of ANS's Current Report on Form&nbsp;8-K filed
on October&nbsp;17, 2005, and in the Outlook and Uncertainties section in ANS's Quarterly Report on Form&nbsp;10-Q for the quarter ended September&nbsp;30, 2005 (see page 26), and
ANS's Annual Report on Form&nbsp;10-K for the year ended December&nbsp;31, 2004 (see page 26). Actual results may differ materially from anticipated results.  </I></FONT></P>

<P><FONT SIZE=2><B>Additional Information<BR>  </B></FONT><FONT SIZE=2><I>This announcement is neither an offer to purchase nor a solicitation of an offer to sell shares of ANS. St. Jude Medical has filed a tender offer statement with the Securities
and Exchange Commission (SEC) and ANS has filed a solicitation/recommendation statement with respect to the offer. ANS shareholders are advised to read the tender offer statement regarding the
acquisition of ANS referenced in this news release, and the related solicitation/recommendation statement. The tender offer statement and the solicitation/recommendation statement contain important
information that should be read carefully before any decision is made with respect the offer. These documents are available at no charge on the SEC's web site at www.sec.gov. Shareholders may also
obtain copies of these documents without charge by requesting them from MacKenzie Partners,&nbsp;Inc., (800)&nbsp;322-2885 -toll free or
(212)&nbsp;929-5500- collect, the Information Agent for the tender offer.</I></FONT></P>

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