In various examples, a system includes a steerable medical device including a handle including a longitudinal axis. An elongate shaft extends distally from the handle. The elongate shaft includes a distal tip and a lumen through the elongate shaft. At least four pullwires are disposed within the handle and extending to and anchored proximate the distal tip of the elongate shaft. At least two actuators are associated with the handle. The at least two actuators are operably coupled to the at least four pullwires with actuation of the first actuator causing tension in the first or second pullwire to deflect the distal tip in a first or second tip direction, respectively, and actuation of the second actuator causing tension in the third or fourth pullwire to deflect the distal tip in a third or fourth tip direction, respectively.