КАТЕТЕР И МЕДИЦИНСКАЯ УСТАНОВКА

... 1. Катетер (6), содержащий: ! разъем (65, 66) с проксимальной стороны катетера для соединения катетера с внешним блоком (10) передачи/приема сигналов для передачи и/или приема сигналов, ! электрод (63, 64) с дистальной стороны катетера, ! электрическое соединение, включающее в себя электрический провод (61, 62) для электрического соединения электрода и разъема для передачи сигналов между электродом и разъемом, при этом электрическое соединение имеет высокое электрическое сопротивление, по меньшей мере, 1 кОм, в частности, по меньшей мере, 5 кОм, и ! блок (69, 70, R2) токового считывания для замера величины электрического тока, протекающего в электрическом соединении с дистальной стороны катетера и для передачи сигнала считывания, указывающего считанный ток, во внешний блок (13) регулирования тока. ! 2. Катетер по п.1, ! в котором провод (61, 62) имеет электрическое сопротивление, по меньшей мере, 1 кОм/м, в частности, по меньшей мере, 5 кОм. ! 3. Катетер по п.1, ! в котором электрическое ...

ЧУВСТВИТЕЛЬНЫЙ К ДАВЛЕНИЮ ЗОНД С ВЫСОКОЙ ЧУВСТВИТЕЛЬНОСТЬЮ

... 1. Медицинский зонд, содержащий: ! вводимую трубку, имеющую продольную ось и имеющую дистальный конец; ! дистальный кончик, который расположен на дистальном конце вводимой трубки и сконфигурирован для введения в контакт с тканью тела; ! стык, который соединяет дистальный кончик с дистальным концом вводимой трубки; и ! датчик стыка, заключенный внутри зонда, для распознавания положения дистального кончика относительно дистального конца вводимой трубки, причем датчик стыка содержит первый и второй подузлы, которые расположены внутри зонда на противоположных соответствующих сторонах стыка, и каждый подузел содержит один или более магнитных измерительных преобразователей. ! 2. Зонд по п.1, в котором магнитный измерительный преобразователь содержит катушки, и где первый подузел содержит первую катушку, имеющую ось первой катушки, параллельную продольной оси вводимой трубки, и где второй подузел содержит две или более вторых катушек в разных соответствующих радиальных местоположениях в пределах ...

Electrode connection arrangement for a medical implant, especially a pacemaker, whereby a branched electrode comprises first and second electrode sections with the second section having at additional third electrode

Electrode connection (10) for a medical implant has a near end (12) with a two-pole plug (20) for connection to a heart pacemaker and a distal section with first and second electrode sections (14, 16). The first electrode section has a first electrode that is connected to a single pole (22, 24) of the two pole plug. The second electrode section has second and third electrodes. The second electrode is connected to the second pole, while the third electrode can be switched to connect to the first pole. An Independent claim is made for a medical implant and electrode connection therefore.

ZUFÜHRSYSTEM FÜR MEDIZINISCHE VORRICHTUNGEN

Electrode e.g. nuero-stimulation electrode, for intervention purposes, has casing surrounding supply line, where materials of pole and casing are made such that materials contain conductive particles in concentration embedded in matrix

The electrode has a longitudinally elongated electrode body with distal and proximal ends. An electrode pole is provided in an area of the distal end for delivering an intervention pulse. A supply line runs in the electrode body in an isolated manner to the electrode pole that exhibits a material. An electrode casing made of another material surrounds the supply line. The materials are made such that the materials contain conductive particles in a concentration embedded in a polymer matrix, where the concentration is larger or equal to a percolation beam. An independent claim is also included for a method for manufacturing an electrode.

Katheter mit Punktionssensor

Herzschrittmacher mit einer bipolaren Sensorelektrode

ELECTRODES FOR CARDIAC PACEMAKERS

Elektrische Leitung für medizinische Zwecke und System zur Einführung derselben

Elektrische Leitung für medizinische Anwendungen und Einführsystem. Die Leitung ist eine Einpassagen-Doppelkammer-Leitung, welche in einer Ausführungsform eine Herzvorhof-Spitze aufweist. Das Einführsystem ist speziell für das Einführen einer Einpassagen-Doppelkammer-Leitung, welche eine Herzvorhof-Spitze aufweist, gestaltet. Das Einführsystem erleichtert das Einführen einer solchen Leitung in das Herz eines Patienten, während es die Spitze vor Schäden durch Verknicken bzw. Verdrehen während des Positionierens der Leitung bewahrt. Die Leitung ist eine Einpassagen-Leitung, die eine Herzvorhof-Spitze aufweist, während das Einführsystem speziell für das Einführen einer solchen Leitung in das Herz eines Patienten gestaltet ist, um so die Spitze vor Schäden durch ein Verknicken oder Verdrehen während des Positionierens der Leitung zu bewahren. Die Leitung ist so gestaltet, daß sie sowohl an den Herzvorhof als auch die Herzkammern des Herzens elektrisch ankoppelt. Die Leitung weist allgemein ...

ANORDNUNG FÜR SEQUENTIELLES MESSEN BIOLOGISCHER EREIGNISSE

Vorrichtung zum Implantieren einer Herzschrittmacher - und/oder Defibrillations-Elektrode

Vorrichtung (1) zum Implantieren einer Herzschrittmacher- und/oder Defibrillations-Elektrode in ein Blutgefäß oder eine Vene mit einer über einen Führungsdraht in das Blutgefäß einführbaren Einführhülse (3) und mit einer am proximalen Ende dieser Einführhülse (3) angeordneten Abdichtvorrichtung (5), die wenigstens eine Dichtung (8) aufweist, welche in Gebrauchsstellung die Herzschrittmacher- und/oder Defibrillations-Elektrode außenseitig gegen einen Blutaustritt aus der Einführhülse (3) abdichtet, dadurch gekennzeichnet, dass die Abdichtvorrichtung (5) und ihre Dichtung (8) wenigstens einmal unterteilt und die dadurch gebildeten Teile der Abdichtvorrichtung (5) und der Dichtung (8) soweit voneinander wegbewegbar sind, dass die Herzschrittmacher- und/oder Defibrillations-Elektrode zwischen diese Teile passt und einführbar ist, dass die Unterteilung der Dichtung (8) quer zum Verlauf der Herzschrittmacher- und/oder Defibrillations-Elektrode angeordnet ist und dass die Dichtung (8) mit den ...

Führungsdrahteinheit

VORRICHTUNG ZUM ELEKTRISCHEN ANREGEN DES HERZENS

Elektrode für medizinische Anwendungen, System mit einer Elektrode und Verfahren zur Herstellung einer Elektrode

Elektrode für medizinische Anwendungen zur Neuromodulation und/oder Nervenstimulation und/oder neurologischen Signalerfassung, die zur Einfuhr in ein Hohlorgan eines Körpers komprimierbar und expandierbar ist und mit einer Stromversorgung gekoppelt oder koppelbar ist, und eine komprimierbare und expandierbare Gitterstruktur (10) aus Gitterstegen (11) aufweist, die Zellen (22) bilden, wobei die Gitterstruktur (10) mit der Stromversorgung gekoppelt oder koppelbar ist und wenigstens einen elektrisch leitenden Bereich (12) und wenigstens einen elektrisch isolierten Bereich (13) bildet, dadurch gekennzeichnet, dass die Gitterstruktur (10) eine Tragschicht (14), wenigstens eine Isolierschicht (15) und wenigstens eine elektrisch leitende Schicht (16) aufweist.

ELEKTRODE FUER EINE IMPLANTIERBARE LEITUNG

Apparatus for artificial cardiac stimulation and method of using the same

Pacing unit

Artificial cardiac stimulation apparatus

Artificial stimulation apparatus comprising a controller 8 comprising a receiver for receiving signal data, a processor 22 for processing received signal data, and a transmitter for transmitting signal data; a sensing stent for location in the proximal coronary sinus of the subject comprising a sensing electrode assembly for sensing atrial and/or ventricular signals from the heart of the subject and a transmitting assembly for transmitting signal data 6 to the receiver of the controller; and at least one stimulation stent (10, 12, 14, 16, 18) for location in at least one vein of the subject distal of the sensing stent comprising a receiver for receiving signal data 20 from the transmitter of the controller and an electrode assembly for providing a stimulating electrical signal to the heart of the subject in response to the data received. A stent assembly for providing stimulation to heart tissue at a target site comprises a stent body of a size to be implanted and retained in the position ...

PROBES FOR USE WITHIN BODY CAVITIES AND DEVICES USING SUCH PROBES

... 1401477 Probes, pacing electrodes ELECTRO-CATHETER CORP 20 Sept 1972 [20 April 1972] 43553/72 Heading A5R An elongated tubular assembly for insertion into body cavities has at its forward end a probe 16 including spaced proximal and distal members 38, 40 and inflatable means 70 interconnecting the members for inhibiting the transfer of forces therebetween, the rearward end of the asembly being formed with means communicating with the forward end and receiving a fluid for inflating the inflatable means 70. The assembly may be used with a heart pacemaker machine, an annular electrode 54 being secured to member 38 and a cupshaped electrode 56 secured by solder 60 to distal member 40. The members 38, 40 are connected by a balloon. The probe is con nected by tubing 12 to an adaptor 14 having a branch 22 receiving electrical conductors 24, 26 for coupling to the electrode connectors 68, 62. A syringe 36 vented to atmosphere is attached to adaptor 14 and provides means for inflating the balloon ...

Characterisation of cardiac dyssynchrony and dyssynergy

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

CONNECTING TERMINAL FOR MEDICAL DEVICES

EXPRESSION OF PROTECTION ANTIGENS IN TRANSGENEN CHLOROPLASTEN AND PRODUCTION OF IMPROVED VACCINES

EXPANDABLE GUIDANCE AIR-LOCK AND EQUIPMENT

CATHETER AND MEDICAL BUILDING GROUP

TACHY LINE SYSTEM FOR THE SEPTUM PLACEMENT

EQUIPMENT FOR SUBKUTANEN THE INTRODUCTION OF AN ELECTRODE

TRANS SEPTALE KARDIALE ELECTRODE LINE

CONTROLLABLE ONE ONE IN IT FOR A MEDICAL IMPLANTIERBARE LINE AND MANUFACTURING PROCESS FOR IT

MOUNTING OF HOSES IN A HEART LINE

IMPLANTIERBARE ELECTRODE LEAD

CONTROLLABLE CATHETER FOR THE LOCALIZATION OF THE CORONARY SINE

IN KORONARVENEN IMPLANTIERBARE LINE FOR HEART STIMULATION OR FOR DETECTING HEART EVENTS

FORECOURT DEFIBRILLATOR WITH LEITUNGSYSTEM

CARDIAC PACEMAKER PROBE WITH ADDITIONAL STIMULATION POLE.

PROCEDURE AND PROBE FOR THE DETERMINATION OF THE DISCHARGE POSITION OF VENTRICULAEREN TACHYCARDIAS.

TWO-CHAMBER SINGLE PASSPORT ELECTRODE ARRANGEMENT

ELECTRODES FOR THE PRODUCTION OF CERTAIN SAMPLES OF PATHOLOGICALLY CHANGED FABRIC

A-V INLET WITH UNIQUE PASSAGE AS PACESETTERS FOR THE RIGHTS VENTRIKULÄRE LEAKING OUT COURSE

DEVICES AND METHODS FOR THE SUGGESTION OF THERAPEUTIC ANGIOGENESE FOR ISCHÄMIE AND HEART FAILURE

LOCALLY FLEXIBLE ONE DILATORHÜLSE

ELECTRODE LINE FROM A INTRINSISCH CONDUCTIVE ONE POLYMER

IMPLANTIERBARE ELECTRODE LINE

FLEXIBLE ELECTRODE STRUCTURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

PROCEDURE AND EQUIPMENT FOR THE MEASUREMENT THE LINKSVENTRIKULÄREN OF THE PRESSURE

BRAID ELECTRODE LEADS AND CATHETERS AND METHODS FOR USING THE SAME

System and method for stimulating a heart having undergone cardiac myoplasty using a single-chamber pacemaker

Treatments for a patient with congestive heart failure

Modular catheter assembly

A modular catheter assembly (10) includes a holder (12) having a proximal end (14) and a distal end (16). An electrode sheath carrier (20) is mounted on the distal end (16) of the holder (12). A shape imparting element carrier is removably mountable to an end of the holder (12) and is accessible externally of the holder (12) with at least the shape imparting element carrier being replaceably mounted to the holder (12).

MRI-safe high impedance lead systems and related methods

Some embodiments are directed to MRI/RF compatible medical interventional devices. A plurality of spaced apart high impedance circuit segments are configured to have a high impedance at a high range of radiofrequencies and a low impedance at a low range of frequencies The high impedance circuit segments may comprise co-wound coiled inductors and can reduce, block or inhibit RJ- transmission along the lead system (20) during exposure to RF associated with a high-Held magnet MRI systems, while permuting passage of low frequency physiologic signals, treatments and/or stimuli The devices can include at least one electrode ...

Apparatus and method for subcutaneous electrode insertion

System and method for detection of metal disturbance based on mutual inductance measurement

Apparatus and method for detecting metal disturbance during a medical procedure includes a probe having an insertion tube, a joint, and a joint sensor for sensing a position of the insertion tube. The joint sensor comprises first and second subassemblies having coils. A processor is used for measuring force using the joint sensor, and having a pre-established baseline value stored therein. The processor detects changes in a position of the insertion tube by applying current to one coil and measures a signal output by a remainder of the other coils. The signal output by a remainder of the coils defines a pickup value, wherein the processor compares the pickup value to the pre-established baseline value and identifies presence of metal when the pickup value is outside of a range of the pre established baseline value.

CARDIAC IMPLANT DEVICE

INTRAVENOUS CHANNEL CARDIAC ELECTRODE AND LEAD ASSEMBLY AND METHOD

Left ventricular access lead for heart failure pacing

Systems and methods for facilitating selection of one or more vectors in a medical device

Systems and methods may facilitate selection of a vector for delivering electrical stimulation to a patients heart. One illustrative method may include delivering electrical stimulation at a first voltage to each vector in a first set of two or more vectors of a multi-vector medical system, determining whether the delivered electrical stimulation at the first voltage resulted in capture for each of the vectors in the first set of two or more vectors, identifying those vectors of the first set of two or more vectors that were determined to result in capture as a second set of vectors, delivering electrical stimulation at a second voltage that is lower than the first voltage to each vector in the second set of vectors, and determining whether the delivered electrical stimulation at the second voltage resulted in capture for each of the vectors in the second set of vectors ...

Cardiac modulation facilitation methods and systems

A method of facilitating therapeutic neuromodulation of a heart of a patient includes positioning an electrode in a pulmonary artery, positioning a sensor in vasculature, delivering via a stimulation system first and second electrical signals of a series of electrical signals to the electrode. The second electrical signal differs from the first electrical signal by a magnitude of a first parameter of a plurality of parameters. The method includes determining, via the sensor, sensor data indicative of one or more heart activity properties in response to the delivery of the series of electrical signals, and delivering a therapeutic neuromodulation signal to the pulmonary artery using selected electrical parameters. The selected electrical parameters include a selected magnitude of the first parameter. The selected magnitude of the first parameter is based at least partially on the sensor data. The therapeutic neuromodulation signal increases heart contractility.

Medical device hybrid polymeric structures and coatings with improved lubricity and durability

A method for making a tubular medical device having a hybrid polymeric structure includes forming a first layer comprising a non-woven fibrous matrix made of a first polymeric material and forming a second layer comprising a second polymeric material about the first layer such that at least a portion of the second polymeric material of the second layer embeds into at least a portion of the first polymeric material of the first layer.

RF shield for an implantable lead

Various embodiments concern shielding an implantable lead from RF energy associated with MRI scans. The lead can include a distal region, a proximal region, an intermediate region between the distal region and the proximal region, at least one electrode disposed on the distal region, and at least one conductor extending from the proximal region to the at least one electrode. Implanting of the lead can include coiling a portion of the intermediate region to define one or more loops and selectively shielding the one or more loops of the lead with a RF shield. The RF shield can comprise metallic material and can be configured to reduce RF signal coupling to the at least one conductor along the one or more loops.

HIGH DENSITY ELECTRODE STRUCTURE

Electrode cabling, including a core and n wires coiled on the core in an arrangement topologically equivalent to an n-start thread configuration, wherein n is an integer greater than one. The cabling also includes a sheath covering the n wires and an electrode attached through the sheath to a given wire selected from the n wires. .m ded C)~ C~j 00 uJU CC~i CC~i ...

Lead with an inner conductor provided with a textured insulative layer

Described is a medical device lead (14) including a lead body (36) having a conductor lumen (44, 46, 48) including an inner surface. The lead also includes a conductor assembly (38, 40, 42) extending through the conductor lumen, the conductor assembly comprising a conductor member (50, 54, 56) and an outer insulative layer (52, 58, 60), and an electrode coupled to the conductor cable. The outer insulative layer includes a textured external surface (62, 64, 66) that reduces the coefficient of friction between the outer insulative layer and the inner surface of the conductor lumen through which the conductor assembly extends. Methods of forming the conductor assembly are also described.

DEVICE FOR PREPARING AN IMPLANTED MEDICAL APPARATUS FOR EXTRACTION

A device for preparing an elongated implanted medical apparatus, such as a cardiac lead, for extraction from the body of a patient. The device includes a first handle and a second handle. At least the first handle has a surface for receiving the implanted apparatus therealong. A wire member having a first end and a second end is positioned to span a distance between the surface of the first handle, and the second handle. The wire member first end is removably engaged with the first handle, and the wire member second end is removably engaged with the second handle. The wire member is sized and arranged to enable the wire member to be wound around a length of the implanted apparatus to facilitate extraction of the apparatus with a lead extraction device. co~ (N N( V-D ...

Shockwave valvuloplasty catheter system

Cardiac modulation facilitation methods and systems

A method of facilitating therapeutic neuromodulation of a heart of a patient includes positioning an electrode in a pulmonary artery, positioning a sensor in vasculature, delivering via a stimulation system first and second electrical signals of a series of electrical signals to the electrode. The second electrical signal differs from the first electrical signal by a magnitude of a first parameter of a plurality of parameters. The method includes determining, via the sensor, sensor data indicative of one or more heart activity properties in response to the delivery of the series of electrical signals, and delivering a therapeutic neuromodulation signal to the pulmonary artery using selected electrical parameters. The selected electrical parameters include a selected magnitude of the first parameter. The selected magnitude of the first parameter is based at least partially on the sensor data. The therapeutic neuromodulation signal increases heart contractility.

Pacemaker lead for sensing a physiologic parameter of the body

Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode

Medical catheters for ablation and detection

Cardiac tissue ablation device

Silicone insulated extendable/retractable screw-in pacing lead with high-efficiency torque transfer

Method to detect and electrosurgically treat aberrant myoelectric activity

METHODS AND DEVICES FOR ABLATION

An ablating device (522) has a cover (460) which holds an interface material such as a gel. The cover (460) contains the interface material during initial placement of the device (522). The ablating device (522) may also have a removable tip or a membrane (520) filled with fluid. In still another aspect the ablating device (522) may be submerged in liquid during operation.

APPARATUS AND METHOD FOR SUBCUTANEOUS ELECTRODE INSERTION

DUAL-PURPOSE LASSO CATHETER WITH IRRIGATION

Cardiac catheters, including a lasso catheter, are provided for use in a system for electrical mapping of the heart has an array of raised, perforated electrodes, which are in fluid communication with an irrigating lumen. There are position sensors on a distal loop section and on a proximal base section of the catheter. The electrodes are sensing electrodes that may be adapted for pacing or ablation. The raised electrodes securely contact cardiac tissue, forming electrical connections having little resistance.

DRUG ELUTING COMPOSITE

The present invention relates to materials having therapeutic compositions releasably contained within the materials. The materials are configured to release therapeutic compositions at a desired rate. The present invention also relates to devices incorporating the materials.

APPARATUS FOR REMOVING AN ELONGATED STRUCTURE INPLANTED IN BIOLOGICAL TISSUE

ELECTRONIC SYSTEMS FOR GENERATING CURRENT PULSES FOR CARDIAC AND RELATED APPLICATIONS

ELECTRODE FOR USE IN IMPLANTING IN A LIVING BODY

The present invention relates to an electrode which is implanted in a living body, and which is used as an electrical stimulation system for the functional training or restoration of paralyzed muscles, and for the measurement of electrical signals of the living body, and the like. The electrode comprises: a core comprising a plurality of infinitesimal stainless steel wires of over 180 kg/mm2 in tensile strength and under 25 microns in diameter; and a resin coat provided on the surface of the core, made of a resin compatible with the living body. According to one aspect of the invention, the diameter of the electrode is under 0.3 mm; the electrode is provided with a spirally coiled part along its longitudinal direction; the core is stranded in one direction; and above mentioned coiled part is coiled in the direction opposite to the stranding direction of the core.

RING ELECTRODE FOR MULTICONDUCTOR PACING LEADS

RING ELECTRODE FOR MULTICONDUCTOR PACING LEADS A cardiac pacing lead having a plurality of individually insulated conductors arranged as a multifilar coil. The lead includes a connector assembly and a ring electrode assembly, each of which are optimized for use in conjunction with conductors arranged in the form of a multifilar coil. The connector assembly takes the form of an in-line connector having a plurality of linearly arranged connecting surfaces, each coupled to one of the conductors in the multifilar coil. The ring electrode assembly is constructed such that it displays the same outer diameter as the pacing lead. In both assemblies, conductors are coupled by means of welds, rather than by crimping or swaging.

ENHANCED CHRONIC LEAD REMOVAL

An implantable medical device, perhaps a pacemaker lead, has a medical unit and a casing at least partially enclosing the medical unit. The casing is formed of a base polymer having surface modifying pendant groups formed of an acrylamide polymer or an acrylamide copolymer, perhaps polyisopropyl acrylamide. The base polymer may be a polyurethane, polyimide, fluoropolymer or polyolefin, for example.

ELECTRICAL TISSUE STIMULATION APPARATUS AND METHOD

An implantable lead for electrical stimulation of tissue has wire-like extendable members whose tips curl back upon themselves in open tissue spaces to form 2- or 3-dimensional electrodes. The electrodes may be positioned axially or in other directions from the lead body. Traction on the lead body or extendable members allows easy withdrawal as the member tip electrodes uncurl, allowing removal without major surgery. This apparatus and method is useful for minimally invasive insertion of electrodes or electrode arrays, especially through a narrow body lumen or Tuohy needle, providing therapeutic stimulation of nervous tissue, muscle or organs.

METHOD AND APPARATUS FOR SHUNTING INDUCED CURRENTS IN AN ELECTRICAL LEAD

An electrical lead end cap includes a body defining a bore therein capable of receiving and retaining an end of an electrical lead and a connector capable of electrically coupling conductors leading to at least two electrodes. A method includes routing an electrical current induced in an electrical lead conductor disposed within body tissue to a plurality of electrodes, electrically coupled with the body tissue, via a circuit within an end cap attached to the electrical lead.

INSULATING MEMBER FOR A MEDICAL ELECTRICAL LEAD

A medical electrical lead that includes a lead body (12) having a lead body lumen (102), an electrode head assembly (113) fixedly engaged with the lead body and having an electrode head assembly lumen (104) communicating with the lead body lumen (102), and a conductor (26) extending within the lead body lumen and the electrode head assembly lumen. An insulating member (120) extends through the electrode head assembly lumen and the lead body lumen to electrically isolate the conductor.

MEDICAL LEAD ADAPTOR

A medical electrical lead includes an electrode, a connector terminal and an auxiliary connector port, which includes a connector contact adapted to electrically couple an electrode of a second lead. A first connector element of the connector terminal is coupled to the electrode via a first insulated conductor, and a second connector element of the connector terminal is coupled, via a second insulated conductor, to the connector contact included in the auxiliary port.

MEDICAL DEVICES WITH AROMATIC POLYIMIDE COATING

Medical devices that include on at least some portion thereof an aromatic polyimide of the structure: (I) wherein R is a tetravalent aromatic radical, preferably containing at least one ring of six carbon atoms, said ring characterized by benzenoid unsaturation, the four carbonyl groups being attached directly to separate carbon atoms in a ring and each pair of carbonyl groups being attached to adjacent carbon atoms in a ring of the R radical; and wherein R~ is a divalent benzenoid radical selected from the group consisting of (a) and (b) wherein R~~ is selected from the group consisting of an alkylene chain having 1-3 carbon atoms, wherein R~~~ and R~~~~ are selected from the group consisting of alkyl and aryl. In one embodiment the medical device is a coated lead body. Coated guide wires are a further embodiment. Methods of application are a further embodiment.

System and method for manipulating insertion pathways for accessing target sites

A method for accessing a target site in the body by transferring a guidewire from an initial insertion site on the body to a different insertion site on the body is provided. In one aspect, a method for transferring a medical device or component, such as a sensor lead, from an initial insertion site to another insertion site is also provided. A guidewire of sufficient length, pliancy and deformability to perform a transfer from one insertion site to another insertion site is provided. In one aspect, the guidewire comprises a removable core mandrel to increase rigidity, facilitate insertion and/or improve steerability. A kit or system, comprising introducers, guidewires and catheters for performing a guidewire or device transfer is also provided.

Layered electrode for an implantable medical device lead

A medical device lead includes an insulative lead body, a conductor extending through the lead body from a proximal end to a distal end, and an electrode electrically connected to the conductor. The proximal end is adapted to be electrically connected to a pulse generator. The electrode includes a plurality of electrode modules mechanically coupled in a stack of electrode modules. Each electrode module includes a plurality of layers that define substantially similar sized pores such that the stack of electrode modules includes an array of the substantially similar sized pores.

Drug eluting coatings for a medical lead and method

A medical electrical lead includes a drug eluting coating provided over at least a portion of the lead body. The drug eluting coating can be provided over at least a portion of the lead body and adjacent to at least one electrode located on the lead body. The drug eluting coating can include at least one matrix polymer layer including a polymer admixed with a therapeutic agent. The therapeutic agent, for example, can be an anti-proliferative agent or an anti-inflammatory agent. The matrix polymer can include a medical adhesive. The rate of elution of the drug from the matrix polymer layer is affected by the drug to polymer ratio of the drug in the matrix polymer layer.

Electrode catheter, in particular for cardiac therapy

An electrode catheter, in particular for cardiac therapy, includes an elongate, tubular catheter body, an electrode for delivering or measuring an electrical signal, in particular an electrocardiac signal, via its external electrode contact surface, at least one first supply line for the electrical connection of the electrode, at least one second supply line for the electrical connection of a further electrode, a plug terminal connection between the at least one first supply line and the electrode, and an insulated passage of the at least one second supply line through the electrode.

Implantable leads having coiled conductors to reduce rf-induced current

An implantable lead assembly includes an outer jacket, first and second coiled conductors, and first and second electrodes. The outer jacket is elongated along a center axis and includes a body that radially extends between opposite interior and exterior surfaces. The interior surface defines an elongated lumen. The coiled conductors are held within the body of the outer jacket between the interior and exterior surfaces of the outer jacket and are wrapped around the lumen and the center axis. The electrodes are coupled with the outer jacket and electrically coupled to the coiled conductors in order to at least one of deliver stimulus pulses or sense electrical activity.

Insulative structure for mri compatible leads

A medical device lead includes a proximal connector, an insulative lead body extending distally from the proximal connector. The proximal connector is configured to couple the lead to a pulse generator. A first conductive coil is coupled to the proximal connector and extends through the lead body. The first conductive coil is coupled to a first electrode at a distal end of the first conductive coil. A first magnetically impregnated polymer layer is adjacent the first conductive coil.

Implantable lead including a spark gap to reduce heating in mri environments

A medical device lead includes a proximal connector configured to couple the lead to a pulse generator, and an insulative lead body extending distally from the proximal connector. The first lead conductor is coupled to the proximal connector and extends through the lead body. The medical device lead also includes a distal defibrillation electrode. A first spark gap is connected between the first lead conductor and the distal defibrillation electrode and has a breakdown voltage that prevents transmission of magnetic resonance imaging (MRI) induced signals from the first lead conductor to the distal defibrillation electrode in an MRI environment and allows transmission of therapy signals to the distal defibrillation electrode.

Lead having a conductive polymer conductor

A medical electrical lead includes a conductive polymer conductor fabricated from a conductor-filled polyisobutylene urethane, urea or urethane/urea copolymer.

Medical electrical lead having biological surface and methods of making and using same

An implantable electrical lead suitable for left sided cardiac placement, the implantable medical electrical lead having an external blood contacting surface having an external coating including a monolayer of at least one biological agent that promotes endothelialization covalently attached to a polymeric lead surface.

Polymer coating comprising 2- methoxyethyl acrylate units synthesized by surface-initiated atom transfer radical polymerization

The present invention relates to preparation of a polymer coating comprising or consisting of polymer chains comprising or consisting of units of 2-methoxyethyl acrylate synthesized by Surface-Initiated Atom Transfer Radical Polymerization (SI ATRP) such as ARGET SI ATRP or AGET SI ATRP and uses of said polymer coating.

Nerve stimulator

A nerve stimulation electrode implantation system includes: an introduction portion that has a cylindrical main body which has an internal cavity, and an incision component which has a blunt dissection portion that bluntly dissects biological tissue, and which is formed so as to be transparent, and which is attached to a distal end portion of the main body; an observation portion that is inserted into the introduction portion such that it is able to observe the periphery of the incision component through the incision component; and a peeling portion that is positioned such that it is able to rotate around its own axis and is able to move relatively in this axial direction relative to the introduction portion, and that removes peripheral tissue from the periphery of the nerve tissue.

Method for fabricating an implantable lead for applying electrical pulses to tissue of a patient and system for fabrication thereof

In one embodiment, a method of fabrication an implantable lead for providing electrical pulses to tissue of a patient, the method comprises: (i) providing a sheath of transparent insulative material, wherein the sheath comprises a plurality of lumens; (ii) scanning across the sheath with a confocal displacement meter to generate displacement data; (iii) processing the displacement data, in software executed on a computer system, to generate a representation of an exterior surface and lumens of the sheath; (iv) automatically selecting locations, in software executed on a computer system, on the exterior surface of application of laser pulses to create apertures in the sheath that provide access to respective lumens of the sheath; and (v) applying laser pulses according to the sheath to create the apertures.

Automatic baroreflex modulation responsive to adverse event

A system for providing baroreflex stimulation comprises a sensor to detect a parameter and provide a signal indicative of the parameter and a baroreflex stimulator. The baroreflex stimulator includes a driver to provide a control signal adapted to deliver a baroreflex therapy and a controller to receive the signal indicative of the parameter and modulate the control signal based on the signal indicative of the parameter to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

Pacing and Stimulation Apparatus and Methods

System, device and method of variable pacing and stimulation are provided. In one example device, one or more lead integrated circuits may programmably control one or more variability parameters. One or more electrodes may provide electrical stimulation. Each electrode may be individually addressable by at least one of the lead integrated circuits and controlled by at least one variability parameter. Electrodes may be intentionally shorted together during time intervals that fall between times of stimulus, so as to dissipate potentials that might otherwise persist and cause electrode degradation.

Ventricular assist device cannula and ventricular assist device including the same

Provided is a ventricular assist device cannula, and more particularly, a ventricular assist device cannula with electrodes. An exemplary embodiment of the present invention provides a ventricular assist device cannula with electrodes, including: a connecting tube connecting an incision of a body tissue and a ventricular assist device so that blood can flow; and electrodes connected with the connecting tube and contacting the incision of the body tissue to transfer an electric signal to the body tissue.

Method and Apparatus to Perform Electrode Combination Selection

Approaches for selecting an electrode combination of multi-electrode pacing devices are described. Electrode combination parameters that support cardiac function consistent with a prescribed therapy are evaluated for each of a plurality of electrode combinations. Electrode combination parameters that do not support cardiac function are evaluated for each of the plurality of electrode combinations. An order is determined for the electrode combinations based on the parameter evaluations. An electrode combination is selected based on the order, and therapy is delivered using the selected electrode combination.

Device, system, and method for modulating cardiac function

A therapy delivery device for modulating cardiac function in a subject includes a counterpulsation component, an endovascular lead, and at least one electrode that is physically coupled with the endovascular lead. Each of the counterpulsation component and the endovascular lead includes a proximal end and a distal end. The proximal end of the endovascular lead is physically connected to the distal end of the counterpulsation component.

Lead for implantable cardiac prosthesis with integrated protection against the effects of mri fields

A lead for an implantable cardiac prosthesis, having an integrated protection against the effects of magnetic resonance imaging (“MRI”) fields. A protection circuit ( 26 ), placed at the distal end of the lead comprises a resistive component ( 28 ) interposed between the electrode (E 1, E 2 ) and the distal end of the conductor ( 22, 24 ) associated with this electrode. A normally-open controlled active switch ( 34, 36 ), allows in its closed state to short-circuit the resistive component. A control stage. ( 32 ) is coupled to the conductors and detects the voltage of a stimulation pulse applied on the conductor(s), and selectively controls by this voltage the closing of the active switch for a duration at least equal to the duration of detected stimulation pulse.

Method for coating devices using electrospinng and melt blowing

A medical electrical lead may include an insulative lead body, a conductor disposed within the insulative lead body, an electrode disposed on the insulative lead body and in electrical contact with the conductor and a fibrous matrix disposed at least partially over the electrode. The fibrous matrix may be formed from a non-conductive polymer.

Multi-Area Pacing Lead For A Left Cavity Of The Heart, Implantable In The Coronary Network

A multi-area pacing lead implantable in a target vein of the coronary network for stimulating a left cavity of the heart, comprising an electrically conductive microcable ( 12 ), an electrically insulating outer coating, and carrying at its distal end a free active portion containing a plurality of separate denuded areas forming a network of active stimulation electrodes ( 14, 16 ), intended to contact the wall of target veins. The active free portion has a proximal corrugated portion carrying a first set of electrodes ( 14 ), a distal corrugated portion carrying a second series of electrodes ( 16 ) and an intermediate portion ( 20 ) that traverses an anastomosis ( 22 ) connecting the ends of two veins (VA, VPL). Both sets of electrodes ( 14, 16 ) can thus be placed in two different veins, defining two remote stimulation areas.

Electrode lead of pacemaker and pacemaker using the same

An electrode lead of a pacemaker includes at least one lead wire including at least one composite conductive core. The at least one composite conductive core includes at least one conductive core and at least one carbon nanotube yarn spirally wound on an outer surface of the at least one conductive core. The at least one carbon nanotube yarn includes a number of carbon nanotubes joined end to end by van der Waals attractive forces. The pacemaker includes a pulse generator and the electrode lead electrically connected to the pulse generator.

Implantable medical device lead including inner coil reverse-wound relative to shocking coil

A medical device lead includes a proximal connector configured to couple the lead to a pulse generator and an insulative lead body extending distally from the proximal connector. The lead also includes an inner conductor and one or more cable conductors coupled to the proximal connector at a proximal end and extending through the lead body. The lead further includes one or more defibrillation coil electrodes coupled to a distal end of the one or more cable conductors. The one or more defibrillation coil electrodes are disposed around and electrically isolated from the inner conductor. The one or more defibrillation coil electrodes have a first winding direction and the inner conductor has a second winding direction opposite the first winding direction.

POLYISOBUTYLENE URETHANE, UREA AND URETHANE/UREA COPOLYMERS AND MEDICAL LEADS CONTAINING THE SAME

The present invention provides medical devices that contain polyisobutylene urethane copolymers, polyisobutylene urea copolymers and polyisobutylene urethane/urea copolymers. More particularly, the present invention provides medical leads that contain such copolymer. 1. An implantable medical lead comprising: wherein the elongated polymeric component comprises a polyisobutylene-based urethane copolymer having a weight ratio of soft segments to hard segments ranging from 90:10 to 50:50, and wherein the elongated polymeric component further comprises:', 'a main lead portion ranging from about 5 cm to about 125 cm in length and having a Shore hardness ranging from about 75 A to about 100 A; and', 'a distal tip portion positioned distal to the main lead portion, the distal tip portion ranging from about 1 cm to about 12 cm in length and having a lower Shore hardness than the main lead body ranging from about 30 A to 80 A., 'an elongated polymeric component disposed over at least one electrical conductor,'}2. The implantable medical lead of claim 1 , wherein the weight ratio of the soft segments to the hard segments ranges from 80:20 to 60:40.3. The implantable medical lead of claim 1 , wherein the soft segments comprise polyisobutylene and the hard segments comprise a diisocyanate residue.4. The implantable medical lead of claim 3 , wherein the soft segments further comprise residue of a polyether diol.5. The implantable medical lead of claim 3 , wherein the soft segments further comprise residue of a polytetramethylene oxide diol.6. The implantable medical lead of claim 1 , wherein the elongated polymeric component comprises an inner lumen and an inner surface of the inner lumen comprises the polyisobutylene-based urethane copolymer.7. The implantable medical lead of claim 1 , wherein the elongated polymeric component comprises a proximal portion that is positioned proximal to the main lead portion claim 1 , the proximal portion ranging from about 10 to about 15 cm in ...

Method of joining dissimilar materials

A method of forming a wire includes providing a first wire segment and a second wire segment. The first and second wire segments are inserted into opposite ends of a coupling segment. The coupling segment is laser welded such that the laser creates an indent in the coupling segment that penetrates into at least one of the first and second wire segments.

Pacemakers and pacemaker electrodes

A pacemaker is provided. The pacemaker includes an electrode line having a lead and an electrode. The electrode includes a carbon nanotube composite structure having a matrix and at least one carbon nanotube structure located in the matrix. A first end of each carbon nanotube structure protrudes out of a first surface of the matrix for stimulating the human tissue, and a second end of each carbon nanotube structure protrudes out of a second surface of the matrix to electrically connect to the lead.

Hemostasis valve and guidewire pacing system

Systems and methods for temporarily pacing a patient's heart are provided. One system includes a hemostasis valve with an adjustable electrical connection, the adjustable electrical connection having one or more adjustable contacts. The adjustable contacts have a first, radially expanded configuration and a second, radially constricted configuration. In the radially constricted configuration, the adjustable contacts are configured to pierce through a layer of an elongate medical device that is disposed in the hemostasis valve. The elongate medical device has a distal electrode and a conductor extending along a portion of the elongate medical device. The adjustable contacts pierce through a make contact with the conductor, providing an electrical pathway to the distal electrode. Also provided are vascular access systems including a hemostasis valve and a guide catheter, guide wire torquers with adjustable contacts and methods of temporarily pacing a patient's heart.

METHODS AND SYSTEMS FOR TREATING ACUTE HEART FAILURE BY NEUROMODULATION

Methods of treating acute heart failure in a patient in need thereof. Methods include inserting a therapy delivery device into a pulmonary artery of the patient and applying a therapy signal to autonomic cardiopulmonary fibers surrounding the pulmonary artery. The therapy signal affects heart contractility more than heart rate. Specifically, the application of the therapy signal increases heart contractility and treats the acute heart failure in the patient. The therapy signal can include electrical or chemical modulation. 1. A method of treating acute heart failure in a patient in need thereof comprising:inserting a therapy delivery device into a pulmonary artery of the patient; andapplying a therapy signal to autonomic cardiopulmonary fibers surrounding the pulmonary artery, the therapy signal affecting heart contractility more than heart rate, wherein the application of the therapy signal increases heart contractility and treats the acute heart failure in the patient.2. The method of claim 1 , wherein the therapy delivery device is an electrode.3. The method of claim 1 , wherein the therapy delivery device is a catheter.4. The method of claim 1 , wherein the therapy signal is applied to a pulmonary trunk of the pulmonary artery.5. The method of claim 1 , further comprising sensing a parameter associated with cardiac function; generating a sensor signal; and adjusting the therapy signal in response to the sensor signal to treat the acute heart failure.6. The method of claim 5 , wherein the sensed parameter is chosen from the group consisting of arterial blood pressure claim 5 , central venous pressure claim 5 , capillary pressure claim 5 , systolic pressure variation claim 5 , arterial blood gases claim 5 , cardiac output claim 5 , systemic vascular resistance claim 5 , pulmonary artery wedge pressure claim 5 , and mixed venous oxygen saturation. This application is a continuation of U.S. application Ser. No. 12/185,473, filed on Aug. 4, 2008, which is a ...

Electrophysiological endocardiology tool

Apparatus and methods for pacing the heart. The apparatus may include, and the methods may involve, an elongated member having: a delivery lumen that is configured to traverse the heart wall, the lumen having a proximal opening for receiving the instrument and a distal opening for deploying the instrument; and an electrically conductive member that is configured to deliver to the heart wall a current that modifies a contraction frequency. The apparatus may include an access opening closure device that has: a distal end that is configured to be disposed interior the heart and contact endocardial tissue adjacent the access opening; and a proximal end that is configured to be disposed exterior the heart and contact heart tissue adjacent the access opening; and an electrode that is configured to discharge electrical energy into the heart wall to change the frequency. The apparatus may include an injectable needle pacing electrode.

Electrode for medical applications, system having an electrode, and method for producing an electrode

An electrode for medical applications for neuromodulation and/or nerve stimulation and/or neurological signal detection, which electrode can be compressed and expanded in order to insert same into a hollow organ of a body and is or can be coupled to a current supply. The electrode has a compressible and expandable lattice structure including lattice webs, which form cells, wherein the lattice structure is or can be coupled to the current supply and forms at least one electrically conductive region and at least one electrically insulated region.

Electromagnetic shield for a passive electronic component in an active medical device implantable lead

A shielded component or network for an active medical device (AMD) implantable lead includes (1) an implantable lead having a length extending from a proximal end to a distal end, all external of an AMD housing, (2) a passive component or network disposed somewhere along the length of the implantable lead, the passive component or network including at least one inductive component having a first inductive value, and (3) an electromagnetic shield substantially surrounding the inductive component or the passive network. The first inductive value of the inductive component is adjusted to a account for a shift in its inductance to a second inductive value when shielded.

Lead header and manufacture thereof

A lead header for an implantable medical lead is in the form of a metal sheet bent to form a metal tube having a lumen. The metal sheet has a protruding portion that extends radially inwardly into the lumen. The protruding portion may be lip arranged in connection with one of the longitudinal sides of the metal sheet that is bent to protrude radially inwardly into the lumen, or it may be a dent formed in the metal sheet. In either case, the protruding portion is configured to transform a rotation of a helical fixation element of the medial lead that is at least partly present in the lumen into a longitudinal movement of the helical fixation element relative to the lead header.

Steroid eluting collar undermold

Methods of manufacturing implantable medical devices with one or more undermolded features are disclosed. An example method includes injection molding an annular-shaped member onto an inner surface of a sacrificial mold insert, and then undermolding an elongate medical device body directly to the member. The member is directly coupled to the device body without the use of adhesives or bonding agents, thus eliminating the presence of gaps or surface irregularities that can affect device performance.

Electrode spacing in a subcutaneous implantable cardiac stimulus device

Methods and implantable cardiac stimulus devices that include leads designed to avoid post-shock afterpotentials. Some examples are directed toward lead-electrode designs that reduce the impact of an applied stimulus on sensing attributes. These examples may find particular use in systems that provide both sensing and therapy delivery from subcutaneous location

Implantable medical device lead including a unifilar coiled cable

A medical device lead includes a flexible body having a proximal region with a proximal end, and a distal region with a distal end. A connector is coupled to the proximal end of the flexible body of the lead to electrically and mechanically connect the lead to an implantable pulse generator. The medical device lead also includes an electrode in the distal region of the flexible body, and a cable conductor having a proximal end electrically coupled to the connector and a distal end electrically coupled to the electrode. The cable conductor consists of a single helically coiled filar including a plurality of co-radial turns and having an outer diameter of less than about 0.020 inch (0.508 mm).

Capture threshold and lead condition analysis

An exemplary method includes performing a capture threshold assessment using a bipolar electrode configuration, deciding if capture occurred for a maximum energy value of the capture threshold assessment and, if capture did not occur, then performing a lead impedance test for the lead associated with the bipolar electrode configuration. Such a test may aim to detect an insulation defect and/or a conductor defect. Other exemplary methods, devices, systems, etc., are also disclosed.

INTRAVASCULAR ELECTRODE ARRAYS FOR NEUROMODULATION

A neuromodulation catheter is positionable in a blood vessel having a wall for use in delivering therapeutic energy to targets external to the blood vessel. An electrically insulative substrate such as an elongate finger is carried at a distal end of the catheter body. The substrate has a first face carrying a plurality of electrodes, and a second face on an opposite side of the substrate from the first face. The finger is biased such that when expanded within the blood vessel, it forms a spiral configuration with the first face facing outwardly to bias the electrodes in contact with the blood vessel wall. 1. A neuromodulation catheter positionable in a blood vessel having a wall , comprising:a catheter body having a longitudinal axis;an electrically insulative substrate comprising at least one elongate finger carried at a distal end of the catheter body, the substrate having a first face and a second face on an opposite side of the substrate from the first face, the finger biased to form a spiral configuration with the first face facing outwardly and the second face facing inwardly;a plurality of electrodes on the first face of the finger.2. The neuromodulation catheter of claim 1 , wherein the finger comprises a strip of planar claim 1 , flexible claim 1 , substrate.3. The neuromodulation catheter of claim 2 , wherein the substrate is selected from the group consisting of polyimide claim 2 , polyurethane claim 2 , polyethylene claim 2 , silicone claim 2 , fluoropolymer claim 2 , stainless steel claim 2 , platinum-iridium claim 2 , MP35N claim 2 , titanium or flex circuit.4. The neuromodulation catheter of claim 1 , wherein claim 1 , when flattened against its bias claim 1 , the finger extends angularly from the longitudinal axis.5. The neuromodulation catheter of claim 1 , wherein the substrate comprises a pair of parallel fingers claim 1 , each biased to form a spiral configuration with the first face facing outwardly and the second face facing inwardly claim 1 , ...

Method for blood pressure modulation using electrical stimulation of the coronary baroreceptors

An apparatus comprises a first stimulation circuit and a control circuit. The stimulation circuit is configured to be electrically coupled to a first electrode assembly that is configured to deliver electrical sub-myocardial activation stimulation to a coronary baroreceptor from a location within a left atrial appendage of a heart. The stimulation circuit is further configured to generate the electrical stimulation for delivery to the coronary baroreceptor via the first electrode assembly. The control circuit is wirelessly or conductively coupled to the first stimulation circuit and is configured to control delivery of the electrical stimulation.

Method for detecting and treating insulation lead-to-housing failures

Disclosed is a method for the diagnosis of conductor anomalies, such as an insulation failure resulting in a short circuit, in an implantable medical device, such as an implantable cardioverter defibrillator (ICD). Upon determining if a specific defibrillation pathway is shorted, the method excludes the one electrode from the defibrillation circuit, delivering defibrillation current only between functioning defibrillation electrodes. Protection can be provided against a short in the right-ventricular coil-CAN defibrillation pathway of a pectoral, transvenous ICD with a dual-coil defibrillation lead. If a short caused by an in-pocket abrasion is present, the CAN is excluded from the defibrillation circuit, delivering defibrillation current only between the right-ventricular and superior vena cava defibrillation coils. Determination that the defibrillation pathway is shorted may be made by conventional low current measurements or delivery of high current extremely short test pulses.

Pacing lead for a left cavity of the heart, implanted in the coronary system

A pacing lead for a left cavity of the heart, implanted in the coronary system. This lead ( 24 ) includes a lead body with a hollow sheath ( 26, 28 ) of deformable material, having a central lumen open at both ends, and at least one telescopic microcable ( 42 ) of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end ( 32 ) thereof. The party emerging beyond the distal end is an active free part ( 34 ) comprising a plurality of distinct bare areas ( 36, 38, 50, 50′, 50 ″), intended to come into contact ( 40 ) with the wall of a target vein ( 22 ) of the coronary system ( 14 - 22 ), so as to form a network of stimulation electrodes electrically connected together in parallel. The microcable further comprises, proximally, a connector to a generator of active implantable medical device such as a pacemaker or a resynchronizer.

Method and Apparatus for a Right-Sided Short Sheath

An introducer sheath comprising a curved shape that follows the right sided vasculature when introduced through the right side subclavian vein and which stops far short of the coronary ostium in the right atrium. No attempt is made to access the coronary sinus through the sheath. The sheath establishes a fulcrum point on the upper lateral wall of the superior vena cava and comprises the ability to be removed from the implanted pacemaker lead without flipping the distal end of the sheath to cause a pull back of the pacemaker lead. The more proximal portions of the sheath extend through the superior vena cava and provide a force which biases the sheath against the lateral wall of the lower portion of the superior vena cava to establish a fulcrum or pivot point which positions the distal end of sheath at the desired location.

Enhancing perfusion by contraction

Apparatus and methods are described including a mechanical support element that is placed inside a first vein of a subject. At least one electrode disposed on the mechanical support element is placed inside the first vein, in a vicinity of a site upstream of a bifurcation with a second vein of the subject. A control unit enhances downstream blood flow from the first vein by driving the at least one electrode to divert blood downstream into the second vein by constricting the first vein at the upstream site, by driving the at least one electrode to apply a current to the vicinity of the site. The mechanical support element prevents the first vein from collapsing by providing mechanical support to the vein. Other embodiments are also described.

Leads with high surface resistance

Implantable medical leads having resistance characteristics adapted to dissipate radio frequency (RF) electromagnetic energy during medical procedures such as magnetic resonance imaging (MRI) are disclosed. An illustrative medical device includes a lead having an inner electrical conductor operatively coupled to an electrode and a pulse generator, and one or more outer resistive shields that radially surround the inner conductor and dissipate RF energy into the surrounding body tissue along the length of the lead.

MEDICAL IMPLANTABLE LEAD AND METHOD FOR MANUFACTURING OF SUCH A LEAD

A medical implantable lead has a header in a distal end, a fixation arrangement and an electrode arranged in the header. The lead also has a connector in a proximal end that includes a connector pin and is adapted to be connected to a monitoring and/or controlling device, and an inner coil, which extends inside an outer casing of the lead and is adapted to transmit electrical signals between the monitoring and/or controlling device and the electrode. The inner coil is attached to the connector pin. The inner coil extends through a bore inside the connector pin and is attached to the connector pin in its proximal end. A method for manufacturing such a lead is also provided. 1. A method to manufacture an implantable medical lead having a lead body with a distal end and a proximal end and a hollow interior proceeding between the distal end and the proximal end , the method comprising:manufacturing a connector pin with a configuration to mechanically and electrically attach the distal end of the lead body to an electronic device, and with an inner bore proceeding through the connector pin;attaching the connector pin to the distal end of the lead body;introducing an inner coil from the distal end of the lead body through the inner bore of the connector pin, and leaving the inner coil so that the inner coil protrudes a distance beyond a proximal end of the connector pin;cutting the inner coil to a selected length at the proximal end of the connector pin; andattaching a proximal end of the inner coil to the proximal end of the connector pin.2. The method as claimed in claim 1 , further comprising:forming a first sub-assembly by attaching a header, containing a fixation arrangement to the inner coil;assembling a second sub-assembly comprising an outer casing of the lead body and the connector;assembling the first and second sub-assemblies by introducing the proximal end of the inner coil into a distal end of the outer casing to cause the proximal end of the inner coil to ...

VENTRICULAR ASSIST DEVICE CANNULA AND VENTRICULAR ASSIST DEVICE INCLUDING THE SAME

Provided is a ventricular assist device cannula, and more particularly, a ventricular assist device cannula with electrodes. An exemplary embodiment of the present invention provides a ventricular assist device cannula with electrodes, including: a connecting tube connecting an incision of a body tissue and a ventricular assist device so that blood can flow; and electrodes connected with the connecting tube and contacting the incision of the body tissue to transfer an electric signal to the body tissue. The ventricular assist device cannula with electrodes according to the exemplary embodiment of the present invention has effects as follows. First, a bio-signal of a patient wearing the ventricular assist device through the electrode attached to the conduit can be easily measured without a separate electrode implant and an electric stimulus can also be measured. Second, since the electric stimulus can be directly applied to a cardiac muscle, it is possible to improve stability and efficiency of an electric treatment such as a cardiac pacemaking, a ventricular defibrillation, and the like of the patient wearing the ventricular assist device. 1. A ventricular assist device cannula with electrodes , comprising:a connecting tube connecting an incision of a body tissue and a ventricular assist device so that blood can flow; andelectrodes connected with the connecting tube and contacting the incision of the body tissue to transfer an electric signal to the body tissue.2. The ventricular assist device cannula with electrodes of claim 1 , wherein:the electrode isa conductive sheet attached to the surface of the connecting tube.3. The ventricular assist device cannula with electrodes of claim 1 , wherein:the electrode isa hollow electrode which has a hollow space into which the connecting tube is inserted at the inside thereof and is closely contacted to the incision of the body tissue at the outside thereof.4. The ventricular assist device cannula with electrodes of claim 3 ...

VENTRICULAR ASSIST DEVICE CANNULA AND VENTRICULAR ASSIST DEVICE INCLUDING THE SAME

Provided is a ventricular assist device cannula, and more particularly, a ventricular assist device cannula with electrodes. An exemplary embodiment of the present invention provides a ventricular assist device cannula with electrodes, including: a connecting tube connecting an incision of a body tissue and a ventricular assist device so that blood can flow; and electrodes connected with the connecting tube and contacting the incision of the body tissue to transfer an electric signal to the body tissue. The ventricular assist device cannula with electrodes according to the exemplary embodiment of the present invention has effects as follows. First, a bio-signal of a patient wearing the ventricular assist device through the electrode attached to the conduit can be easily measured without a separate electrode implant and an electric stimulus can also be measured. Second, since the electric stimulus can be directly applied to a cardiac muscle, it is possible to improve stability and efficiency of an electric treatment such as a cardiac pacemaking, a ventricular defibrillation, and the like of the patient wearing the ventricular assist device. 1. A ventricular assist device including a defibrillator , comprising:in the ventricular assist device including a blood pump pumping the blood,at least a pair of conduits including a connecting tube connecting an incision of a body tissue and the blood pump so that the blood can flow and electrodes connected with the connecting tube and contacting the incision of the body tissue to transfer an electric signal to the body tissue;a detecting device detecting an abnormality of heart beat or not;a defibrillator applying an electric stimulus to the heart by applying a defibrillation pulse to the electrode; anda control device receiving a signal from the detecting device to control the blood pump and the defibrillator.2. The ventricular assist device including a defibrillator of claim 1 , wherein:the detecting device includesa pressure ...

Neuromodulation Systems and Methods for Treating Acute Heart Failure Syndromes

A neuromodulation system for treating acute heart failure syndromes includes a first catheter having a parasympathetic therapy element adapted for positioning within a first blood vessel such as a superior vena cava, and a second catheter sympathetic therapy element adapted for positioning with a second, different, blood vessel such as the pulmonary artery. The catheters comprise a system in which one of catheters is slidably disposed over the other of the catheters. The system may further be slidably disposed over a third elongate element such as a Swan-Ganz catheter positionable within a pulmonary artery, such that the Swan-Ganz may be used for monitoring parameters such as blood pressure and cardiac output during neuromodulation therapy. The parasympathetic therapy element is energized to deliver neuromodulation therapy to a parasympathetic nerve fiber such as a vagus nerve, while the sympathetic therapy element is energized to deliver neuromodulation therapy to a sympathetic nerve fiber such as a sympathetic cardiac nerve fiber. For treatment of acute heart failure syndromes, the neuromodulation therapy may be used to lower heart rate and increase cardiac inotropy. 1. A neuromodulation system for treating a patient , comprising:a first catheter having a parasympathetic therapy element adapted for positioning within a first blood vessel;a second catheter sympathetic therapy element adapted for positioning with a second blood vessel different than the first blood vessel, wherein one of the first and second catheters is slidably disposed within a second one of the first and second blood vessels;a stimulator configured to (a) energize the parasympathetic therapy element within the first blood vessel to deliver parasympathetic therapy to a parasympathetic nerve fiber disposed external to the first blood vessel and (b) energize the sympathetic therapy element within the second blood vessel to deliver sympathetic therapy to a sympathetic nerve fiber disposed external ...

Compound-shaped stylet for torque transmission

A medical stylet for guiding a lead includes a first elongate member for attachment of the lead to the target tissue, a second elongate member to reshape the lead. The first elongate member of the medical stylet includes a proximal end portion, and a distal end portion wherein the distal end portion of the first elongate member includes a tip feature configured to engage the lead on application of torque externally. The second elongate member defines a lumen along its length. The lumen of the second elongate member can be configured to enclose at least a portion of the first elongate member. The second elongate member can have a pre defined shape. The pre defined shape of the second elongate member allows the lead to be reshaped when inserted into the lead, this reshaped lead now can be guided to an anatomical pass way.

Systems and methods for improving rf compatibility of electrical stimulation leads

An implantable lead for stimulating patient tissue includes a lead body. A jacket is disposed over at least a portion of a length of the lead body. The jacket has an outer surface and an opposing inner surface. At least a portion of the outer surface of the jacket forms at least a portion of an outer surface of the lead. At least a portion of the inner surface of the jacket is open to the lead body. The jacket defines apertures each extending completely through the jacket. Electrodes are disposed along a distal end of the lead body. Terminals are disposed along a proximal end of the lead body. Conductors electrically couple the electrodes to the terminals. Conductor insulation is disposed over each of the conductors. At least a portion of the conductor insulation is in fluid communication with the local environment external to the lead via the apertures.

MRI COMPATIBLE LEAD COIL

Various embodiments concern leads having low peak MRI heating for improved MRI compatibility. Various leads include a lead body having at least one lumen, a proximal end configured to interface with an implantable medical device, and a distal end. Such leads can further include a conductor extending along at least a portion of the lead body within the at least one lumen and a defibrillation coil extending along an exterior portion of the lead body and in electrical connection with the conductor, wherein at least a section of the defibrillation coil is under longitudinal compression. The longitudinal compression can lower peak MRI heating along the defibrillation coil. The longitudinal compression may maintain circumferential contact between adjacent turns of the section of the defibrillation coil. 1. A lead having low peak MRI heating , the lead comprising:a lead body having at least one lumen, a proximal end configured to interface with an implantable medical device, and a distal end;a cable conductor extending along at least a portion of the lead body within the at least one lumen;a coil extending along a portion of the distal end of the lead body, at least a section of coil exposed along the portion of the lead body and configured to deliver electrical stimulation therapy, the section of the coil under longitudinal compression to lower peak MRI heating along the section of the coil; andat least two couplings mechanically and electrically connecting the cable conductor to the coil, where the at least two couplings maintain longitudinal compression of the section of the coil.2. The lead of claim 1 , wherein the section of the coil is between the at least two couplings.3. The lead of claim 1 , wherein the cable conductor is in tension between the at least two couplings claim 1 , the tension in the cable conductor maintaining the longitudinal compression within the coil.4. The lead of claim 1 , wherein the longitudinal compression forces each turn of the section of ...

Leads incorporating a laser processed electrode

Medical devices may include an electrode that has been processed to increase its surface area. In some cases, an electrode may be processed using an ultrafast laser to produce an electrode surface that includes macrostructures formed within the electrode surface and nanostructures formed on the macrostructures. The nanostructures may be formed of material that was removed from the electrode surface in forming the macrostructures.

NON-LINEAR FILTERING FOR THE RECONSTRUCTION OF A SURFACE ELECTROCARDIOGRAM FROM AN ENDOCARDIAL ELECTROGRAM

An active medical device using non-linear filtering for the reconstruction of a surface electrocardiogram (ECG) from an endocardial electrogram (EGM) is disclosed. The device for the reconstruction of the surface ECG comprises: a plurality of inputs, receiving a corresponding plurality of EGM signals from endocardial or epicardial electrogram (x[n], x[n]), each collected on a respective EGM derivation of a plurality of EGM derivations, and at least one output delivering a reconstructed surface ECG electrocardiogram signal (y[n]), related to an ECG derivation, and a non-linear digital filter () with a transfer function that determines the reconstructed ECG signal based on said plurality of input EGM signals. The non-linear digital filter includes a Volterra filter type (″) whose transfer function includes a linear term (h1) and at least one quadratic (h2) and/or cubic (h3) term(s). 1. A device for processing signals representative of a cardiac potential of depolarization of the myocardium for reconstruction of a surface electrocardiogram (ECG) , comprising:{'sub': 1', '2', 'Q, 'b': '10', 'a plurality of inputs, corresponding to a plurality of EGM signals from endocardial or epicardial electrogram (x, x. . . x,) each acquired on a respective EGM derivation of a plurality of EGM derivations ();'}{'b': '16', 'at least one output delivering a reconstructed surface electrocardiogram ECG signal (yj), relative to an ECG () derivation; and'}{'sub': 1', '2', 'Q', '1', '2', '3, 'b': 12', '14', '12', '12', '14', '12', '52, 'a non-linear digital filter including a Volterra type filter (F, F. . . F) (, , ′, ″, , , ) with a transfer function that reconstructs said ECG signal derivation based on said plurality of inputs, said transfer function including a linear term (h) and at least one quadratic (h) and/or cubic (h) term(s).'}2. The device of claim 1 , wherein the transfer function of the non-linear digital filter further comprises at least a finite time delay (z).3. The device ...

Tissue slitting methods and systems

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Medical implantable lead and manufacture thereof

A medical implantable lead comprising a core formed of a conductive wire formed from a biocompatible, corrosion-resistant conductive material, wrapped in a fibrous material formed of a valve metal, and surrounded by a biocompatible insulation material.

NEURAL STIMULATION SYSTEM FOR CARDIAC FAT PADS

Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein. 113-. (canceled)14. A method , comprising:implanting a lead comprising at least two electrodes;stimulating, via at least one of the at least two electrodes, an IVC-LA cardiac fat pad associated with an atrioventricular (AV) node to change the AV conduction time of the heart without changing the sinus rate, the IVC-LA cardiac fat pad being located proximate to a junction between an inferior vena cava and a left atrium; anddelivering, via another one of the at least two electrodes, myocardial pacing.15. The method of claim 14 , wherein implanting the lead includes implanting an epicardial lead.16. The method of claim 14 , wherein implanting the lead includes implanting an intravascular lead for transvascular stimulation of the IVC-LA fat pad.17. The method of claim 14 , wherein implanting the lead includes implanting an intravascular lead for puncturing a vessel to place the at least one of the at least two electrodes outside of the vessel proximate to the IVC-LA fat pad.1820-. (canceled)21. A method claim 14 , comprising: stimulating the IVC-LA fat pad using at least one of the at least two electrodes; and', 'delivering myocardial pacing using another one of the at least two electrodes on the lead., ' ...

Implantable therapy lead with conductor configuration enhancing abrasion resistance

An implantable therapy lead employs electrical conductors configured to enhance the abrasion resistance of the lead. Specifically, conductors are configured to create a surface contact area with walls of a wall lumen of a tubular body that is greater than would otherwise be possible with traditional conductors that have a circular transverse cross-section. As a result, the abrasion pressure of the conductors against the lumen walls is decreased for the conductors disclosed herein as compared to that of traditional conductors.

SYSTEM AND METHODS FOR SENSING VECTOR SELECTION

Systems and methods for evaluating multiple candidate sensing vectors for use in sensing electrical activity of a heart are disclosed. The system can sense physiologic signals using each of a plurality of candidate sensing vectors, and generate respective signal intensity indicators and interference indicators using the physiologic signals sensed by using the respective sensing vectors. The system can also receive electrode information of each of the candidate sensing vectors, including information about sensing electrodes that are also used for delivering cardiac electrostimulation. The system can rank at least some of the plurality of candidate sensing vectors according to the signal intensity indicators, the interference indicators, and the electrode information. The system can also include a user interface for displaying the ranked sensing vectors, and allowing the user to select at least one sensing vector for use in sensing the cardiac electrical activity. 1. A system for evaluating a plurality of candidate sensing vectors for use in sensing electrical activity of a heart , the system comprising:a sensing circuit configured to sense one or more physiologic signals indicative of target cardiac electrical activity according to a specified sensing vector involving first and second electrodes;a signal processor circuit, configured to generate a signal intensity indicator and an interference indicator using the one or more physiologic signals, the signal intensity indicator indicative of the strength of the sensed one or more physiologic signals, the interference indicator indicative of presence or degree of interference produced by an activity other than the target cardiac electrical activity; and for the plurality of candidate sensing vectors, receive respective signal intensity indicators and respective interference indicators;', 'for the plurality of candidate sensing vectors, receive respective electrode information about first and second electrodes of the ...

Devices and Methods for Endovascular Electrography

A method for positioning an endovascular device in or near the heart using electrocardiogram (ECG) signals. The method includes receiving an endovascular ECG signal including a plurality of waveforms, processing the endovascular ECG signal to calculate a P-wave amplitude and a spectral power for each predetermined time period, determining a maximum P-wave amplitude and an associated maximum spectral power, associating the maximum P-wave amplitude and the maximum spectral power with a predetermined location in or near the heart, calculating a location based on a ratio of the P-wave amplitude to the maximum P-wave amplitude and a ratio of the spectral power to the maximum spectral power, and displaying the location to a user. 1. A computer-based method for positioning an endovascular device in or near the heart using electrocardiogram (ECG) signals , comprising:receiving an endovascular ECG signal, associated with an endovascular device, including a plurality of waveforms, each waveform having at least a P-wave component;processing the endovascular ECG signal, over a plurality of predetermined time periods, to calculate a P-wave amplitude and a spectral power for each predetermined time period;determining a maximum P-wave amplitude from the plurality of P-wave amplitudes, and an associated maximum spectral power from the plurality of spectral powers;associating the maximum P-wave amplitude and the maximum spectral power with a predetermined location in or near the heart;calculating a location of the endovascular device, for each predetermined time period, based on a ratio of the P-wave amplitude to the maximum P-wave amplitude and a ratio of the spectral power to the maximum spectral power; anddisplaying the location of the endovascular device to a user.2. The computer-based method according to claim 1 , wherein the P-wave amplitude is a peak-to-peak value claim 1 , and the maximum P-wave amplitude is a peak-to-peak value.3. The computer-based method according to ...

TELESCOPING CATHETER DELIVERY SYSTEM FOR LEFT HEART ENDOCARDIAL DEVICE PLACEMENT

A transseptal catheter delivery system includes an elongate first tubular member and an elongate second tubular member receivable within the first tubular member. The first tubular member includes an adjustable portion adjacent a distal end. The second tubular member is adapted to receive an instrument to be placed in the left ventricle, and includes a curved portion adjacent its distal end in a relaxed state. The adjustable portion is deflectable toward the atrial septum to guide a puncturing tool and/or guide insertion of the second tubular member through a septal puncture into the left atrium. Within the left atrium, the curved portion is oriented toward the left ventricle to guide insertion of a guide wire, and subsequently the second tubular member, into the left ventricle. Methods of transvenously accessing a left ventricle are also provided. 1. A transseptal delivery system for a heart , comprising:an elongate first tubular member defining a first lumen extending between a proximal end and a distal end of the first tubular member, the first tubular member having an adjustable portion adjacent its distal end; andan elongate second tubular member receivable within the first tubular member, the second tubular member defining a lumen extending between a proximal end and a distal end of the second tubular member, the lumen adapted to receive a puncturing tool and an instrument to be placed in the heart, the second tubular member having a curved portion adjacent its distal end in a relaxed state;wherein, with the first tubular member extending through a superior entry point into a right atrium of the heart, the adjustable portion of the first tubular member is deflectable toward an atrial septum of the heart thereby providing an outlet at its distal end to i) guide the puncturing tool toward the atrial septum for creating a septal puncture, and ii) guide insertion of the second tubular member through the septal puncture into a left atrium of the heart;wherein, with ...

METHODS AND APPARATUS FOR DELIVERING A PROSTHETIC VALVE TO A BEATING HEART

A method for delivering a prosthetic valve to a patient's heart having a native valve with a plurality of valve leaflets includes providing a delivery device with a prosthetic valve, advancing the delivery device toward the native valve, and expanding a portion of the prosthetic valve to form a flanged region that is upstream of the valve leaflets. One or more tabs on the prosthetic valve are released so that they expand outward to a position that is transverse to the longitudinal axis of the prosthetic valve. The position of the prosthetic valve is adjusted relative to the valve leaflets and rapid pacing is applied to the patient's heart so that the valve leaflets move inward toward the prosthetic valve or the delivery device. The tabs are further released to allow the tabs to move into their final positions. 1rapidly pacing the patient's heart; andanchoring the prosthetic valve by releasing one or more tabs.. A method for delivering a prosthetic valve to a patient's heart having a native valve with a plurality of valve leaflets, said method comprising: The present application is a continuation of U.S. application Ser. No. 14/242,661 (Attorney Docket No. 42194-710.201), filed Apr. 1, 2014, now U.S. patent Ser. No. ______, which claims the benefit of U.S. Provisional Patent Application No. 61/808,473 (Attorney Docket No. 42194-710.101), filed Apr. 4, 2013; the entire contents of which are incorporated herein by reference.The present application is related to the following U.S. patent application Ser. No. 13/096,572 (now U.S. Pat. No. 8,579,964); Ser. Nos. 14/046,606; 13/679,920; 13/762,671; and 14/195,576; the entire contents of which are incorporated herein by reference.The present invention generally relates to medical devices and methods, and more particularly relates to the treatment of valve insufficiency, such as mitral insufficiency, also referred to as mitral regurgitation. The use of prosthetic valves delivered by traditional surgical implantation methods, ...

MEDICAL DEVICE WITH A STRUCTURED COATING

A medical device includes a tubular body having a distal end and a proximal end, a lumen extending through the tubular body from the distal end to the proximal end, a wire extending through the lumen from the distal end to the proximal end, and a polymeric coating. The wire has an outer surface. The polymeric coating is on at least a portion of the outer surface of the wire. The coating comprises a bulk material and a plurality of flexible microstructures disposed on the bulk material. The microstructures extend outwardly from a surface of the polymeric coating. 1. A medical device comprising:a catheter having a distal end and a proximal end;a lumen extending through the catheter from the distal end to the proximal end;a drive shaft extending through the lumen from the distal end to the proximal end, wherein the drive shaft is a helically coiled wire having an outer surface; anda polymeric coating on at least a portion of the outer surface of the drive shaft, wherein the coating comprises a bulk material and a plurality of flexible microstructures disposed on the bulk material, wherein the microstructures extend outwardly from a surface of the polymeric coating.2. The medical device of claim 1 , wherein the flexible microstructures include a first end and a second end claim 1 , and the distance from the first end to the second end is from 5 micrometers to 100 micrometers.3. The medical device of claim 1 , wherein the microstructures are integral with the polymeric coating.4. The medical device of claim 1 , wherein the coating includes at least one member selected from the group consisting of ethylene tetrafluoroethylene (ETFE) and polyethylene terephthalate (PET).5. The medical device of claim 1 , and further comprising a protective coating on at least a portion of the flexible microstructures.6. The medical device of claim 5 , wherein the protective coating has a thickness of 3 nanometers to 30 nanometers.7. The medical device of claim 5 , wherein the protective ...

DELIVERY CATHETER APPARATUS AND METHODS

A catheter has a shaft that defines a delivery lumen, for example, to deliver an elongate medical device therethrough; a proximal section of the catheter includes a seal zone portion, a handle portion and a proximal port portion. A relatively thin wall section of the proximal port portion extends between the seal zone portion and a proximal edge that defines part of a perimeter of a proximal opening of the delivery lumen. The handle portion projects laterally from the seal zone portion, generally opposite the relatively thin wall section. An inflation subassembly of the catheter includes a compliant sleeve member and an inflation lumen extending from the sleeve member, proximally along the shaft, and into a connector port formed in the handle portion. The inflation lumen may be formed by fusing a section of a tube to the shaft and molding the handle portion around another section of the tube. 1. A method for delivering an implantable medical electrical lead into the coronary vasculature of a patient via a catheter , the catheter including a delivery lumen , an inflation lumen , and a compliant sleeve member extending around an exterior surface of a shaft of the catheter such that an inflatable section of the sleeve is in fluid communication with the inflation lumen , the catheter having been advanced into a body of the patient such that a distal tip thereof canulates a coronary vein , the compliant sleeve member being located in proximity to the distal tip , and the distal tip surrounding a distal opening of the delivery lumen; and the method comprising:coupling an inflation fluid source to a connector port of the catheter, the connector port being formed in a handle portion of the catheter and in fluid communication with the inflation lumen;pressurizing the coupled inflation fluid source to inflate and maintain inflation of the inflatable section of the sleeve;injecting a radiopaque dye from a syringe, the syringe having a tip inserted into a proximal port portion ...

ENDOCARDIAL LEAD CUTTING APPARATUS

In some embodiments, without limitation, the invention comprises an apparatus for cutting an endocardial lead within a patient. The apparatus comprises a generally flexible tubular member having a proximal end and distal end. At least one blade or cutting surface is affixed to the distal end of the tubular member. The apparatus optionally includes an adjustment mechanism adapted to adjust the blade or cutting surface between an extended position and a retracted position. The blade or cutting surface engages the endocardial lead to cut the lead. Various embodiments include a v-shaped groove defining the cutting surfaces. Other embodiments may comprise a rotatable blade of an inner shaft rotating within the tubular member and cutting the lead received within the v-shaped groove, and blades or cutting surfaces functioning like guillotines or scissors retracting into a distal end of the tubular member. 1. An endocardial lead cutting apparatus for cutting a lead implanted within a patient , said apparatus comprising:a flexible shaft having a proximal end and a distal tip;a groove for relieving the lead positioned at said distal tip of said shaft, said groove being generally V-shaped and defining at least one cutting surface for cutting the lead,wherein motion or other energy is applied through the shaft to cut the lead.2. The apparatus claim 1 , further including a shroud positioned about said shaft.3. The apparatus of claim 2 , wherein said shroud is pliable.4. The apparatus of claim 1 , wherein said proximal end of said shaft includes a handle.5. The apparatus of claim 1 , wherein said at least one cutting surface is comprised of a hardened material.6. The apparatus of claim 1 , further including a laser generating device to cut the lead by applying radiation to the lead.7. The apparatus of claim 6 , wherein said shaft includes an optical fiber to transmit the radiation to said distal tip.8. The apparatus of claim 1 , further including an ultrasonic device to cut the ...

Automatic vector selection for multi-site pacing

Systems and methods for evaluating multiple candidate electrostimulation vectors for use in therapeutic cardiac stimulation are disclosed. The system can include a programmable electrostimulator circuit for delivering electrostimulation to one or more sites of a heart according to multiple candidate electrostimulation vectors. One or more physiologic sensors can detect resulting physiologic responses to the electrostimulation. A processor circuit can generate categories of indicators including therapy efficacy indicators, battery longevity indicators, or complication indicators using the sensed physiologic responses. The candidate electrostimulation vectors can be ranked according to the categories of indicators in specified orders. The system can include a user interface for displaying the ranked candidate electrostimulation vectors, and allowing the user to select one or more electrostimulation vectors and programming the electrostimulator circuit to deliver therapeutic electrostimulation to at least one site of the heart using the selected electrostimulation vectors.

CARDIAC OR CEREBRAL VESSEL MICROLEAD WITH ELECTRODE RING

A method of manufacturing a detection/stimulation lead for implantation into a venous, arterial, or lymphatic network is shown and described. The method includes providing a microcable comprising a sheath of insulating material covering an electrically conductive core. The method further includes surrounding a portion of the microcable with an electrically conductive metal ring. The method also includes crimping the ring such that the thickness of the sheath is penetrated by a portion of the metal ring and such that an electrical connection is formed between the metal ring and the electrically conductive core. 1. A metal ring for installation as an electrode on a microcable , comprising:an elongated ring having an internal lumen;a middle portion partially collapsed into the internal lumen and adapted to puncture a sheath of the microcable when the middle portion is crimped around the microcable; andtwo end portions surrounding the middle portion.2. The metal ring of claim 1 , wherein an interior surface of the middle portion of the ring comprises a plurality of helically oriented ribs.3. The metal ring of claim 1 , wherein an interior surface of the middle portion of the ring comprises a plurality of straight ribs.4. The metal ring of claim 1 , wherein the two end portions extend in a longitudinal direction perpendicular to the elongated axis of the lead claim 1 , wherein the two end portions are on either side of the middle portion claim 1 , wherein the end portions do not directly contact the conductor and are in direct contact with the sheath.5. The metal ring of claim 1 , wherein the two end portions of the ring are straight and cylindrical.6. The metal ring of claim 1 , wherein the ring includes an interior relief defining an area at which the ring is adapted to puncture the sheath.7. The metal ring of claim 6 , wherein the relief comprises a longitudinal profile positioned to share an elongated axis with the microcable.8. The metal ring of claim 6 , wherein ...

Implantable medical devices and methods for making and delivering implantable medical devices

Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead.

LEAD FOR IMPLANTABLE CARDIAC PROSTHESIS WITH INTEGRATED PROTECTION AGAINST THE EFFECTS OF MRI FIELDS

A lead for an implantable cardiac prosthesis is disclosed. The lead has integrated protection against the effects of magnetic resonance imaging (“MRI”) fields. A protection circuit () may be placed at the distal end of the lead comprises a resistive component () interposed between the electrode (E, E) and the distal end of the conductor () associated with this electrode. A normally-open controlled active switch () may allow in its closed state to short-circuit the resistive component. A control stage () may be coupled to the conductors and detect the voltage of a stimulation pulse applied on the conductor(s), and selectively control by this voltage the closing of the active switch for a duration at least equal to the duration of detected stimulation pulse. 1. A lead for an implantable medical device , comprising:at least one electrode;at least one conductor;a resistive component positioned between the at least one electrode and at least one conductor and configured to protect against a current induced by a magnetic field during an MRI procedure;one or more switching components having a first configuration and a second configuration, wherein, in the first configuration, the one or more switching components are configured to provide a short circuit across the resistive component and provide a path for current to flow from the at least one conductor to the at least one electrode around the resistive component, and wherein, in the second configuration, the one or more switching components are configured to open the short circuit, such that the only path for current to flow from the at least one conductor to the at least one electrode is through the resistive component;a control circuit configured to control the one or more switching components to place the one or more switching components in the first configuration or the second configuration, wherein the control circuit is configured to detect a stimulation pulse based on a voltage of the stimulation pulse and to place ...

Method and Apparatus for Implantable Cardiac Lead Integrity Analysis

Scientific and medical system circuitry for diagnosis of implantable cardioverter defibrillator (ICD) lead conductor anomalies, in particular conductor migration and externalization within an ICD implantable cardiac lead. The system determines an “imaginary” component of the high frequency transmission line impedance having certain spectral changes that correspond to radially outward movements or local externalization of a conductor within a lead body allowing for the detection of conductor migration and small insulation failures. 1. A method to determine the integrity of an implantable cardiac lead implanted in a patient , comprising:determining a length of the implantable cardiac lead;calculating a test frequency based on the length;using a frequency signal source to apply a set of test signals to the implantable cardiac lead at frequencies within a predetermined range of the test frequency, each test signal including a phase shifted signal;measuring an imaginary component of a transmission line impedance of the implantable cardiac lead in response to the each test signal;determining an imaginary impedance for each test signal based on the imaginary component of the transmission line impedance; andcomparing changes in the imaginary impedance for each test signal to a predetermined threshold to determine whether the implantable cardiac lead has a potential lead integrity issue.2. The method of wherein the method further comprises:reporting the potential lead integrity issue for the patient to a medical professional.3. The method of wherein the method further comprises:extracting the implantable cardiac lead based upon determination of the potential lead integrity issue.4. The method of wherein:using the frequency signal source to apply the set of test signals includes generating a high frequency signal and delivering the high frequency signal across a sampling resistor to a selected conductor in the implantable cardiac lead;measuring the imaginary component of the ...

Apparatus for testing a cardiac catheter utilizing live cardiac cells

A medical tool testing apparatus comprising a vessel. The vessel comprises a scaffold formed from biomaterial, live cardiac tissue, generated from cardiac cells, proliferating on the scaffold, the live cardiac tissue configured to generate electrical activity. The vessel also comprises a medical tool, in contact with live cardiac tissue, used for a medical procedure within patient anatomy. Operational features of the medical tool are determined by a visually perceptible condition of the live cardiac tissue.

USER INTERFACE SYSTEM FOR USE WITH MULTIPOLAR PACING LEADS

An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device. 1. A method comprising:providing to a user an interactive representation of a first set of electrostimulation electrodes or vectors;receiving a first selection of an electrostimulation electrode or vector;providing a visual indication of the first selection using the interactive representation; and providing, using the interactive representation, a second set of electrostimulation electrodes or vectors that is available for use with the first selection;', 'displaying, using the interactive representation, information indicative of a parameter test result for an electrostimulation electrode combination or vector associated with the first selection; or', 'performing, using the interactive representation, interactive user-controllable parameter testing using the first selection., 'interactively using the first selection, wherein interactively using the first selection comprises performing at least one of2. The method of claim 1 , wherein interactively using the first selection comprises providing a second set of electrostimulation electrodes or vectors that is available for use with the first selection.3. The method of claim 1 , ...

APPARATUS AND METHODS FOR OPTIMIZING INTRA-CARDIAC PRESSURES FOR IMPROVED EXERCISE CAPACITY

Systems and methods are provided for optimizing hemodynamics within a patient's heart, e.g., to improve the patient's exercise capacity. In one embodiment, a system is configured to be implanted in a patient's body to monitor and/or treat the patient that includes at least one sensor configured to provide sensor data that corresponds to a blood pressure within or near the patient's heart; at least one component designed to cause dyssynchrony of the right ventricle, and a controller configured for adjusting the function of the at least one component based at least in part on sensor data from the at least one sensor. 1. A system configured to be implanted in a patient's body to monitor and/or adjust electrical activation of the patient's heart , the system comprising:at least one sensor acquiring signals corresponding to patient activity or movement;at least one pacing component positioned adjacent a free wall of a right ventricle of the heart, whereby stimulation of the at least one pacing component is designed to compromise function of the right ventricle; anda controller coupled to the at least one sensor and at least one pacing component for adjusting the function of the at least one pacing component based at least in part on the signals from the at least one sensor.2. The system of claim 1 , further comprising an additional sensor measuring sensor data corresponding to a blood pressure.3. A system for monitoring and/or treating a heart of a patient to increase the patient's capacity for physical activity claim 1 , comprising:a blood pressure sensor implantable within a region of the heart;an adjustable component configured to affect contractility of a right ventricle of the heart;an activity sensor implantable within the patient's body;at least one pacing component sized for introduction into a region of the heart; anda processor operatively coupled to the pressure sensor, the adjustable component, the activity sensor, and the at least one pacing component to: ...

LEADLESS PACEMAKER HAVING ATTACHMENT FEATURE

A leadless biostimulator including an attachment feature to facilitate precise manipulation during delivery or retrieval is described. The attachment feature can be monolithically formed from a rigid material, and includes a base, a button, and a stem interconnecting the base to the button. The stem is a single post having a transverse profile extending around a central axis. The transverse profile can be annular and can surround the central axis. The leadless biostimulator includes a battery assembly having a cell can that includes an end boss. A tether recess in the end boss is axially aligned with a face port in the button to receive tethers of a delivery or retrieval system through an inner lumen of the stem. The attachment feature can be mounted on and welded to the cell can at a thickened transition region around the end boss. Other embodiments are also described and claimed. 19-. (canceled)10. A battery assembly for a leadless biostimulator , comprising:an electrolyte; anda cell can containing the electrolyte, wherein the cell can includes an annular wall extending proximally along a central axis, and an end boss extending from the annular wall to a proximal face, and wherein the end boss includes a tether recess extending into the proximal face along the central axis.11. The battery assembly of claim 10 , wherein the cell can includes a transition region between the annular wall and the end boss claim 10 , and wherein a wall thickness of the annular wall is less than a transition thickness of the transition region.12. The battery assembly of claim 10 , wherein the end boss includes an outer surface extending longitudinally from the annular wall claim 10 , and a tapered surface tapering radially inward from the outer surface to the proximal face.13. The battery assembly of further comprising a separator containing the electrolyte claim 10 , wherein an inner surface of the annular wall is in contact with the separator.14. The battery assembly of claim 13 , ...

Active implantable medical device for detecting a remodeling or reverse remodeling phenomenon of the patient

According to some embodiments, a device operates by comparative morphological analysis of depolarization signals collected in spontaneous rhythm on separate respective channels, with two temporal components combined into a single 2D parametric VGM vectogram characteristic. Similarity quantification methods evaluate a variation over time of a descriptor parameter of a current VGM compared to a stored previous reference VGM. This variation is compared with predetermined thresholds to diagnose an occurrence of remodeling or reverse remodeling in a patient, and/or to detect a lead failure or an occurrence of ischemia. The descriptor parameter is a function of a velocity vector of the VGM, a comparison relating to a correlation coefficient between respective magnitudes of a current VGM velocity vector and of a reference VGM velocity vector, and an average angle between these respective velocity vectors.

Active implantable medical device for the diagnosis of cardiac decompensation

The disclosure relates to a device including a plurality of electrodes for stimulation of both ventricles with application of an atrioventricular delay and of an interventricular delay, a processor configured to multidimensionally measure an interventricular conduction delay, and monitor the evolution of a patient's condition. For the multidimensional measurement of the interventricular conduction delay, the device produces stimulation of one of the ventricles and collects, in the other ventricle, two endocardial electrogram signals on separate respective channels, giving two respective temporal components. Both temporal components are combined in one single parametric 2D characteristic representative of the cardiac cycle, and a comparison is made with reference descriptors for deriving an index representative of the evolution of the patient's condition.

Patient screening and ecg belt for brady therapy tuning

Cardiac electrical activity is monitored from tissue of the patient using the plurality of external electrodes. One or more cardiac metrics of the patient are generated based on the monitored electrical activity. It is determined whether the patient is a candidate for a cardiac resynchronization therapy (CRT) device based on a first global dyssynchrony metric using the one or more cardiac metrics if the patient has a right bundle branch block. It is determined whether the patient is a candidate for a cardiac resynchronization therapy (CRT) device based on a second global dyssynchrony metric using the one or more cardiac metrics if the patient does not have a right bundle branch block.

CATHETERS WITH ENHANCED FLEXIBILITY AND ASSOCIATED DEVICES, SYSTEMS, AND METHODS

A neuromodulation catheter includes an elongate shaft and a neuromodulation element. The shaft includes two or more first cut shapes and two or more second cut shapes along a helical path extending around a longitudinal axis of the shaft. The first cut shapes are configured to at least partially resist deformation in response to longitudinal compression and tension on the shaft and torsion on the shaft in a first circumferential direction. The second cut shapes are configured to at least partially resist deformation in response to longitudinal compression on the shaft and torsion on the shaft in both first and second opposite circumferential directions. 139-. (canceled)40. A catheter comprising:a first helically wound elongate member;a second helically wound elongate member, the first helically wound elongate member being disposed within the second helically wound elongate member, at least one of the first helically wound elongate member or the second helically wound elongate member comprising a plurality of filaments wound in parallel, and the second helically wound elongate member being counter-wound relative to the first helically wound elongate member; andan outer jacket positioned over at least one of the first or second helically wound elongate members.41. The catheter of claim 40 , wherein the second helically wound elongate member comprises the plurality of filaments wound in parallel.42. The catheter of claim 41 , wherein the second helically wound elongate member is openly wound.43. The catheter of claim 42 , wherein the second helically wound elongate member comprises gaps between at least some adjacent windings of the plurality of filaments.44. The catheter of claim 40 , wherein at least one of the first helically wound elongate member or the second helically wound elongate member is openly wound.45. The catheter of claim 44 , wherein the at least one of the first helically wound elongate member or the second helically wound elongate member comprises ...

BODY AREA NETWORK COMMUNICATION COLLISION AVOIDANCE CONCEPT FOR MEDICAL SYSTEMS

A medical system, comprising a plurality of devices forming nodes of a network, each device of said plurality of devices is configured to communicate with another device in a wireless fashion by receiving a message from another device in the network or by transmitting a message to another device in the network. A priority is assigned to each device, wherein as long as no other transmission of a message is ongoing in the network, each device is configured to initiate a transmission of a message by transmitting a start signal, wherein the higher the priority of the respective device, the higher the duration of the start signal allocated to the respective device. In case several devices in the network simultaneously initiate a transmission of a message by transmitting a start signal, a permission to transmit a message is automatically granted to the device in the network with the highest priority. 1. A medical system , comprising a plurality of devices forming nodes of a network , wherein each device of said plurality of devices is configured to communicate with another device of the network in a wireless fashion by receiving a message from another device in the network or by transmitting a message to another device in the network , and wherein a priority is assigned to each device , wherein as long as no other transmission of a message is ongoing in the network , each device is configured to initiate a transmission of a message by transmitting a start signal , wherein the higher the priority of the respective device , the higher the duration of the start signal allocated to the respective device , and wherein in case several devices in the network simultaneously initiate a transmission of a message by transmitting a start signal , a permission to transmit a message is automatically granted to the device in the network with the highest priority.2. The medical system according to claim 1 , wherein the network is a body area network.3. The medical system according to ...

CORONARY SINUS CONDUCTION SYSTEM PACING AND DELIVERY

An implantable medical system includes an implantable catheter advanceable into a coronary sinus of a patient's heart. A guide element and an implantable lead receivable in the side lumen is advanceable through an angled opening of the catheter to be deflected laterally away from the catheter at the deflection angle to position the at least one testing electrode or at least one pacing electrode, respectively, in a myocardium of the patient's heart when the distal portion of the catheter is positioned in the coronary sinus. 1. An implantable medical system comprising:an implantable catheter advanceable into a coronary sinus of a patient's heart, the catheter comprising a sheath body extending between a proximal portion and a distal portion, the catheter comprising a side lumen and an angled opening proximal to the distal portion in fluid communication with the side lumen, wherein the side lumen and the angled opening define a deflection angle;a guide element receivable in the side lumen, the guide element extending from a proximal portion to a distal portion, wherein the distal portion includes at least one testing electrode, wherein the guide element is advanceable through the angled opening to be deflected laterally away from the catheter at the deflection angle to position the at least one testing electrode in a myocardium of the patient's heart when the distal portion of the catheter is positioned in the coronary sinus; andan implantable lead receivable in the side lumen, the lead comprising a lead body extending from a proximal portion to a distal portion, wherein the implantable lead comprises an anchoring element disposed along the lead body and at least one pacing electrode disposed along the distal portion, wherein the lead is advanceable through the angled opening to be deflected laterally away from the catheter at the deflection angle to implant the at least one pacing electrode in the myocardium to pace a conduction system of the patient's heart.2. The ...

APPARATUS AND METHODS FOR OPTIMIZING VOLUME STATUS AND CARDIAC OUTPUT

Systems and methods are provided for optimizing hemodynamics within a patient. Specifically, the system incorporates invasive sensor data (e.g., pressure measurements) combined with mechanisms to dynamically change the loading conditions of the heart and/or heart rate, in order to understand hemodynamic parameters. Computational analyses on dynamic sensor data are used to understand and guide heart rate, filling pressures, and/or volume resuscitation in critically ill patients. By pacing the heart or inducing tricuspid regurgitation, the system may cause dynamic changes in sensor data to understand optimal loading conditions and heart rates. While determining optimal hemodynamic parameters, the system may then automatically optimize the heart rate and/or filling pressures in critically ill patients. 1. A system for monitoring and/or treating a patient , comprising:an elongate member comprising a distal portion designed to be inserted into a patient's heart and advanced into a pulmonary artery of the heart;at least one sensor on the distal portion for measuring blood pressure;an electrode structure on the distal portion carrying one or more electrodes, the electrode structure configured to extend the one or more electrodes outwardly away from the distal portion to contact myocardial tissue for the purposes of sensing and pacing the heart; andan external processor that performs computational analyses on sensed parameters in order to estimate volume responsiveness and/or optimal heart rates.2. The system of claim 1 , further comprising a regurgitation structure on the distal portion comprising a radially expandable portion configured to hold open leaflets of a tricuspid valve of the heart to induce tricuspid regurgitation in a controllable manner.3. The system of claim 2 , further comprising one or more sensors for measuring sensor data corresponding to blood flow through one of a right ventricle or pulmonary artery of the heart.4. The system of claim 3 , wherein the ...

METHOD AND APPARATUS FOR IMPLANTATION OF A PACING ELECTRODE

A medical device system is configured to guide implantation of a pacing electrode for left bundle branch pacing. The system includes a medical device having a processor configured to receive at least one cardiac electrical signal, determine a feature of the cardiac electrical signal, compare the feature to left bundle branch signal criteria, and determine a left bundle branch signal in response to the feature meeting the left bundle branch signal criteria. The system includes a display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal. 1. A medical device , comprising: receive a first cardiac electrical signal;', 'determine at least one feature of the first cardiac electrical signal;', 'compare the at least one feature to left bundle branch signal criteria; and', 'determine a left bundle branch signal in response to the at least one feature meeting the left bundle branch signal criteria; and, 'a processor configured toa display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal.2. The medical device of claim 1 , wherein the processor is configured to determine the at least one feature from the first cardiac electrical signal during an intrinsic ventricular rhythm.3. The medical device of claim 2 , wherein the processor is configured to determine the at least one feature by detecting at least one of a left bundle branch potential signal or an injury current following the left bundle branch potential signal.4. The medical device of claim 1 , further comprising a pulse generator configured to generate pacing pulses deliverable via the pacing electrode;wherein the processor is configured to determine the at least one feature from the first cardiac ...

METHOD AND APPARATUS FOR IMPLANTATION OF A PACING ELECTRODE

A medical device system is configured to guide implantation of a pacing electrode for left bundle branch pacing. The system includes a medical device having a processor configured to receive at least one cardiac electrical signal, determine a feature of the cardiac electrical signal, compare the feature to left bundle branch signal criteria, and determine a left bundle branch signal in response to the feature meeting the left bundle branch signal criteria. The system includes a display unit configured to generate a user feedback signal indicating advancement of a pacing electrode into a left portion of a ventricular septum in response to the processor determining the left bundle branch signal. 1. A medical device comprising: receive imaging data corresponding to a cardiac image comprising a ventricular septum;', 'generate a boundary line corresponding to a cardiac landmark based on the cardiac image;', 'generate a marker based on the boundary line and the cardiac image, the marker representing a target entry region along the ventricular septum for a pacing electrode; and, 'a processor configured toa memory configured to store the imaging data with the boundary line and the marker for display by a display unit.2. The medical device of claim 1 , wherein the processor is configured to:generate a user feedback signal based on the marker to prompt advancement of the pacing electrode into the target entry region represented by the marker.3. The medical device of claim 1 , wherein the processor is configured to:generate the boundary line by generating a septal boundary line along the ventricular septum of the cardiac image; and generating a plurality of section lines superimposed on the cardiac image that divide the ventricular septum into a plurality of sections; and', 'generating the marker representing the target entry region based on least one of the plurality of section lines., 'generate the marker by4. The medical device of claim 3 , wherein the processor is ...

SINGLE CONDUIT MULTI-ELECTRODE CARDIAC PACEMAKER AND METHODS OF USING THEREOF

A device and method for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit are provided. The method includes providing a single conduit with multiple electrodes, positioning electrodes in the target zone of a heart, selecting acceptable electrodes as active based on a predetermined criteria and providing cardiac stimulation for multiple chambers of the heart from a single location. 19-. (canceled)10. A method of providing cardiac pacing comprising the steps of:a. providing a flexible single conduit housing a plurality of individual wires extending therethrough and positioned alongside each other at least in a portion of said single conduit, said plurality of individual wires terminating with a plurality of corresponding individual electrodes located at a distal end of said single conduit,b. advancing said single conduit to position said distal end thereof near a cardiac tissue target area while said plurality of individual electrodes are held in a collapsed position next to a center of said distal end of said single conduit,c. expanding said plurality of individual electrodes to an expanded position forming an expanded scattered pattern of said plurality of individual electrodes about and away from said center of said distal end of said single conduit,d. implanting said individual electrodes into said cardiac tissue target area while in said expanded scattered pattern,e. interrogating each individual electrode of said plurality of individual electrodes to determine a subset of said plurality of individual electrodes meeting a predetermined acceptance criteria for capturing of and pacing the heart, andf. initiating cardiac capture and pacing using at least some of individual electrodes of said subset of individual electrodes meeting said predetermined acceptance criteria, said at least some individual electrode connected via corresponding individual wires of said single conduit to a pacemaker ...

IMPLANTABLE LEAD ASSEMBLY

An implantable lead assembly is provided that comprises a lead body having a proximal end portion and a distal end portion, and having a length extending there between. A plurality of electrodes are disposed along the lead body. A plurality of cable conductors are contained within the lead body, the conductors extending from the electrodes to the proximal end portion. A lead connector is provided at the proximal end portion. The lead connector includes a connector pin configured to mate with a corresponding header contact; a first termination pin coupled to one of the plurality of cable conductors; a collar coupler securely and electrically coupling the connector pin and first termination pin in an axially offset alignment with one another; and a body segment that is elongated along a longitudinal axis and extends between a header mating face and a lead mating end. The body segment is over-molded about the connector pin, the first termination pin and the collar coupler, the connector pin extending from the header mating face, the first termination pin extending from the lead mating end. 1. A method of manufacturing a lead assembly , comprising:providing a lead connector by: over molding a body segment about the connector pin, the first termination pin and the collar coupler, the body segment being elongated along a longitudinal axis and extending between a header mating face and a lead mating end, the connector pin positioned along the longitudinal axis and extending from the header mating face, the first termination pin positioned axially offset from the longitudinal axis and extending from the lead mating end;', 'attaching the lead connector to a proximal end portion of a lead body having a plurality of electrodes disposed along the lead body, the lead body including a plurality of cable conductors; and', 'joining the first termination pin to a proximal end of a first conductor from the plurality of cable conductors., 'coupling a connector pin to a first ...

LEAD EXTRACTION METHODS AND APPARATUS

According to one aspect, a device for assisting in removing an implanted lead is provided. The device comprises a body portion having a center adapted to accommodate the lead, a cutting component coupled to the body portion to assist in separating tissue from the lead, and at least one anchoring component disposed at least partially within the body portion, the at least one anchoring component capable of providing pressure on the lead that resists movement of at least part of the body portion along the lead at least in part by applying fluid pressure. 1. A method for assisting in removing an implanted electrical lead using a device adapted to accommodate the implanted electrical lead , the method comprising:advancing the device along the lead to where the device encounters tissue adhered to the lead;applying fluid pressure to a proximal anchoring component of the device to anchor a proximal portion of the device to the lead at a first location along the lead proximate the tissue;applying fluid pressure to an expansion component comprising a piston mechanism having a piston, the expansion component coupled to a separating component, wherein applying the fluid pressure to the expansion component forces the piston forward to cause the separating component to separate at least some of the tissue from the lead; andapplying fluid pressure to a distal anchoring component arranged on a distal side of the expansion component to anchor a distal portion of the device to the lead.2. The method of claim 1 , further comprising releasing fluid pressure from the proximal anchoring component subsequent to applying fluid pressure to the distal anchoring component to allow the proximal portion of the device to advance along the lead.3. The method of claim 2 , further comprising releasing fluid pressure from the expansion component.4. The method of claim 3 , wherein applying fluid pressure to the expansion component stretches a spring claim 3 , and wherein releasing the fluid pressure ...

LEAD REMOVAL SLEEVE

Methods and systems for removing an object, such as a lead, from formed tissue are provided. Specifically, a lead removal sleeve is configured to engage patient formed tissue at a dilation engagement point. The lead removal sleeve is configured to dilate the formed tissue around a lead, while providing an inner lumen with clearance for the lead to move within the sleeve. It is an object of the lead removal sleeve to support the formed tissue, and even forces of the formed tissue, with a structure of the sleeve as the lead is removed from a patient. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures. 1. A lead removal apparatus comprising:a shaft, wherein the shaft is flexible, the shaft having at least one outer surface, a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal to the distal end to receive at least one of an implanted object and a mechanical traction device; anda tissue dilating tip disposed adjacent to the distal end of the shaft, wherein the tissue dilating tip is configured to passively wedge into an area between a tissue growth and the implanted object, and wherein the at least one outer surface of the lead removal apparatus is configured to dilate the tissue growth about an area of the implanted object.229-. (canceled) The present application claims the benefit of and priority, under 35 U.S.C. §119(e), to U.S. Provisional Application Ser. No. 61/701,520, filed Sep. 14, 2012, entitled “TISSUE SEPARATING METHODS AND SYSTEMS,” which is hereby incorporated herein by reference in its entirety for all that it teaches and for all purposes.This application is also related to U.S. patent application Ser. Nos. ______/______,______, filed on Mar. 14, 2013, entitled, “Tissue Slitting Methods and Systems” (Attorney Docket No. 6593-208); ______/______,______, filed on Mar. 14, 2013, entitled, “Tissue Slitting Methods and Systems” (Attorney Docket No. 6593-251); ...

Medical electrical lead with biostable pvdf-based materials

A medical electrical lead includes an insulative lead body extending from a distal region to a proximal region, a conductor disposed within the insulative lead body and extending from the proximal region to the distal region, an electrode disposed on the insulative lead body and in electrical contact with the conductor, and a fibrous matrix disposed on at least part of the electrode. The fibrous matrix includes fibers. The fibers include a polyvinylidene fluoride-based (PVDF-based) polymer and a crystal-modifying additive. The PVDF-based polymer includes an amorphous PVDF phase and a crystalline PVDF phase. The crystalline PVDF phase includes a beta form crystalline structure in an amount exceeding any other crystalline structure form in the crystalline PVDF phase.

LEADS FOR SELECTIVE SENSING AND VIRTUAL ELECTRODES

Selective sensing implantable medical leads include pulsing and sensing portions and pulsing and not sensing portion. Leads and electrodes may be used in defibrillation and as integrated bipolar defibrillation electrodes. An entire electrode can pass charge while a valve metal or valve metal oxide portion of the electrode prevents the entire electrode from sensing, effectively rejecting unwanted signals. Differential conduction pathways, due to the valve metal and/or oxides thereof, cause the portions of the electrodes to conduct differently when used anodically and cathodically. Complex intracardiac electrical gradient can be formed along with a number of virtual electrodes within the tissue. Reentrant loops can thereby be pinned following defibrillation shock. 1. An implantable medical lead comprising:an elongated lead body having a distal end and a proximal end;a connector at the proximal end of the elongated body; a first portion configured to provide a defibrillation pulse and sense cardiac electrical signals; and', 'a second portion configured to provide the defibrillation pulse and not sense cardiac electrical signals; and, 'an electrode toward the distal end of the elongated body, the electrode comprisinga conductor that extends from the connector to the electrode.2. The implantable medical lead of claim 1 , wherein the electrode comprises a conductive metal partially coated with a second material claim 1 , the first portion being one or more portions of the conductive metal not coated with the second material and the second portion being one or more portions of the conductive metal covered with the second material.3. The implantable medical lead to claim 2 , wherein the second material comprises tantalum pentoxide.4. The implantable medical lead of claim 3 , wherein the conductive metal comprises one of platinum claim 3 , platinum iridium (Pt/Ir) or titanium.5. The implantable medical lead of claim 2 , wherein the second material comprises a valve metal.6. ...

METHOD AND SYSTEM FOR DETERMINING PACE TIMING IN A LEADLESS CARDIAC PACEMAKER SYSTEM

A leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP may include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine a pace time for a cardiac cycle based at least in part upon a signal from the pressure sensor. 1. A leadless cardiac pacemaker (LCP) configured to sense cardiac activity and to pace a patient's heart , the LCP disposable within a ventricle of the patient's heart , the LCP comprising:a housing;a first electrode secured relative to the housing;a second electrode secured relative to the housing, the second electrode spaced from the first electrode;a controller disposed within the housing and operably coupled to the first electrode and the second electrode;a pressure sensor disposed relative to the housing and operably coupled to the controller, the controller configured to receive a pressure signal from the pressure sensor;the controller configured to determine a pace time for a cardiac cycle for delivering a ventricle pacing pulse to the ventricle of the patient's heart, the controller determining the pace time based at least in part on the received pressure signal; andthe controller configured to generate and deliver a ventricle pacing pulse at the pace time.2. The LCP of claim 1 , further comprising:an accelerometer secured relative to the housing and operably coupled to the controller, the controller configured to receive an accelerometer signal from the accelerometer;wherein the controller is configured to determine the pace ...

METHOD AND SYSTEM FOR DETERMINING A CARDIAC CYCLE PACE TIME IN ACCORDANCE WITH METABOLIC DEMAND IN A LEADLESS CARDIAC PACEMAKER SYSTEM

A leadless cardiac pacemaker (LCP) is configured to sense cardiac activity and to pace a patient's heart and is disposable within a ventricle of the patient's heart. The LCP MAY include a housing, a first electrode and a second electrode that are secured relative to the housing and are spaced apart. A controller is disposed within the housing and is operably coupled to the first electrode and the second electrode such that the controller is capable of receiving, via the first electrode and the second electrode, electrical cardiac signals of the heart. The LCP may include a pressure sensor and/or an accelerometer. The controller may determine a pace time within a cardiac cycle based at least in part upon an indication of metabolic demand. 1. A leadless cardiac pacemaker (LCP) configured to sense cardiac activity and to pace a patient's heart , the LCP disposable within a ventricle of the patient's heart , the LCP comprising:a housing;a first electrode secured relative to the housing;a second electrode secured relative to the housing, the second electrode spaced from the first electrode;a controller disposed within the housing and operably coupled to the first electrode and the second electrode such that the controller is capable of receiving an electrical cardiac signal from the patient's heart via the first electrode and the second electrode;a first sensor disposed relative to the housing and operably coupled to the controller, the controller configured to receive a first sensor signal from the first sensor, wherein the first sensor signal is responsive to an atrial contraction of the patient's heart;a second sensor disposed relative to the housing and operably coupled to the controller, the controller configured to receive a second sensor signal from the second sensor, wherein the second sensor signal is responsive to an atrial contraction of the patient's heart;the controller configured to determine a ventricle pace time for delivering a ventricle pacing pulse to ...

LEADLESS CARDIAC PACEMAKER FOR GENERATING CARDIAC PRESSURE VOLUME LOOP

A leadless cardiac pacemaker (LCP) configured to sense cardiac activity and to pace a patient's heart. The LCP may include a housing, a first electrode secured relative to the housing, a second electrode secured relative to the housing, and a pressure sensor secured relative to the housing and coupled to the environment outside of the housing. The LCP may further include circuitry in the housing in communication with the first electrode, the second electrode, and the pressure sensor. The circuitry may be configured to determine and store a plurality of impedance-pressure data pairs, from which a representation of a pressure-volume loop may be determined. 1. A leadless cardiac pacemaker (LCP) configured to sense cardiac activity and to pace a patient's heart , the LCP comprising:a housing;a first electrode secured relative to the housing and exposed to the environment outside of the housing;a second electrode secured relative to the housing and exposed to the environment outside of the housing, the second electrode is spaced from the first electrode;a pressure sensor secured relative to the housing and is coupled to the environment outside of the housing; andcircuitry in the housing in communication with the first electrode, the second electrode, and the pressure sensor, the circuitry configured to determine, at a first time during a cardiac cycle, a first impedance between the first electrode and the second electrode and also a corresponding first pressure via the pressure sensor, resulting in a first impedance-pressure data pair.2. The LCP of claim 1 , wherein the circuitry is configured to wirelessly transmit the first impedance-pressure data pair to a remote device.3. The LCP of claim 1 , wherein the circuitry is configured to determine claim 1 , at a second time during the cardiac cycle claim 1 , a second impedance between the first electrode and the second electrode and also a second pressure via the pressure sensor claim 1 , resulting in a second impedance- ...

CATHETER SYSTEM AND METHODS OF MEDICAL USES OF SAME, INCLUDING DIAGNOSTIC AND TREATMENT USES FOR THE HEART

The present invention includes systems, devices and methods for treating and/or diagnosing a heart arrhythmia, such as atrial fibrillation. Specifically, the present invention provides a system including a diagnostic catheter and an ablation catheter. The diagnostic catheter includes a shaft, multiple dipole mapping electrodes and multiple ultrasound transducers. The ablation catheter is slidingly received by the diagnostic catheter shaft. 1. (canceled)2. A catheter system , comprising: an elongate shaft comprising a distal end;', 'an expandable assembly mounted to the elongate shaft, the expandable assembly comprising multiple splines and configured to transition from a compacted state to an expanded state;', 'a plurality of electrodes coupled to the multiple splines of the expandable assembly, each electrode configured to emit electric signals and record electric signals; and', 'a plurality of ultrasound transducers coupled to the multiple splines of the expandable assembly;, 'a diagnostic catheter comprisinga distance measurement assembly configured to drive the plurality of ultrasound transducers to produce anatomical geometry data, and including data representing a distance between each ultrasound transducer of the plurality of ultrasound transducers and a tissue surface orthogonal to each ultrasound transducer; and measure spacing between two or more of the electrodes based on the recorded electric signals and to determine a geometric configuration of one or more of the multiple splines based on the measured electrode spacing; and', 'create a three-dimensional anatomical map based on the produced anatomical geometry data, create electrical information based on the recorded electric signals, and display the electrical information in relation to the three-dimensional anatomical map,', the electrical information is further based on the determined geometric configuration of the one or more of the multiple splines, and/or', 'the anatomical geometry data is based on ...

SYSTEMS AND METHODS FOR AUTOMATED CAPTURE THRESHOLD TESTING AND ASSOCIATED HIS BUNDLE PACING

A method of pacing a His bundle of a patient heart using a stimulation system including a memory, a pulse generator, a stimulating electrode and at least one sensing electrode includes applying a plurality of impulses through the stimulating electrode to induce a plurality of responses from the patient heart. Each impulse of the plurality of impulses is delivered at a different impulse energy corresponding to a respective output setting of the stimulation system. The response characteristics for each of the plurality of responses are measured and each impulse is assigned a classification based on whether the respective response characteristics indicate capture of one or both of the His bundle and a ventricle of the patient heart. The output setting and classification for each impulse is then stored in the memory. 1. A method of pacing a His bundle of a patient heart using a stimulation system , the stimulation system having a memory , a pulse generator a stimulating electrode disposed in proximity to the His bundle , and at least one sensing electrode adapted to sense electrical activity of the patient heart , the method comprising:applying, using the pulse generator, a plurality of impulses through the stimulating electrode to induce a plurality of responses from the patient heart, each impulse of the plurality of impulses having a different impulse energy corresponding to a respective output setting of the stimulation system;measuring, using the sensing electrode, response characteristics for each of the plurality of responses;assigning each impulse a classification based on whether the respective response characteristics indicate capture of one or both of the His bundle and a ventricle of the patient heart; andfor each impulse, storing each of the output setting and the classification associated with the impulse in the memory.2. The method of claim 1 , wherein the response characteristics include each of a QRS complex duration and an evoked response delay.3. The ...

System and methods for chronic fixation of medical devices

Devices or methods such as for stimulating excitable tissue or sensing physiologic response or other signals that can use chronic fixation mechanism are described. An implantable apparatus can comprise an electrostimulation electrode assembly that can include a primary fixation member and a secondary fixation member. The primary fixation member can be actively engaged or affixed to a target tissue of a patient, and the second fixation member can be biased against the target tissue, collapsed or compressed against the target tissue when the primary fixation member is affixed to the target tissue. The electrostimulation electrode assembly can also include at least one electrode such as to contact heart or other excitable tissue such as to deliver chronic electrostimulation or sensing physiologic responses.

CATHETERS WITH LUBRICIOUS LININGS AND METHODS FOR MAKING AND USING THEM

Apparatus and methods are provided for creating tubular devices, e.g., as components for catheters, sheaths, and or other devices sized for introduction into a patient. In one embodiment, a method is provided for making a tubular device using a sheet of material including a coated first surface. The sheet is rolled around a mandrel until longitudinal edges of the sheet are disposed near or adjacent one another, e.g., without attaching the longitudinal edges together. A tubular braid is positioned over the sheet-wrapped mandrel, one or more tubular segments are positioned over the tubular braid, and heat shrink tubing is positioned over the tubular segments. The resulting assembly is heated to cause the tubular segments to at least partially reflow and/or otherwise laminate the tubular segments to the tubular braid and sheet. The heat shrink tubing and mandrel are then removed to create the tubular device. 1. A tubular device , comprising a proximal end , a distal end sized for introduction into a body lumen , and a lumen extending between the proximal and distal ends , the tubular device comprising:an inner liner comprising longitudinal edges extending substantially axially between the proximal and distal ends and a coating on an inner surface thereof, the coating imparting one or more predetermined properties to a wall of the lumen, the longitudinal edges being disposed adjacent one another;a braid surrounding at least a portion of the liner; andan outer layer surrounding the braid and liner,wherein the inner surface of the liner at least partially defines a lumen of the tubular device, and wherein material of the inner surface has a reduced bond angle selected to resist air bubbles sticking to the liner when the lumen is flushed.2. The tubular device of claim 1 , wherein the liner comprises hydrophobic material claim 1 , the tubular device further comprising a temporary coating on the inner surface to provide the reduced bond angle.3. The tubular device of claim 2 ...

RETENTION MECHANISM FOR AN IMPLANTABLE LEAD

A retention device for use with an implantable medical device (IMD) are disclosed. An illustrative retention device may comprise an elongate body including a configured to receive the lead of the IMD. The retention device may also include securing mechanisms coupled to the elongate body and configured to push against tissue of a patient. The securing mechanisms may also include linking elements coupled to the elongate body and a portion of the securing mechanisms. 1. A retention device for use with an implantable medical device (IMD) having a lead , the lead having a proximal end for coupling to a canister and a distal end , the retention device comprising:an elongate body having a proximal end, a distal end, and a hollow lumen extending from the proximal end to the distal end configured to receive the lead; and a first end coupled to the elongate body;', 'a second end configured to push against tissue of a patient; and', 'an intermediate portion extending between the first and second ends; and, 'one or more securing mechanisms havingone or more first linking elements having a first end coupled to the elongate body and a second end coupled to the intermediate portion of one of the securing mechanisms.2. The retention device of having at least two securing mechanisms claim 1 , further comprising one or more second linking elements claim 1 , the one or more second linking elements having a first end coupled to a first one of the securing mechanisms and a second end coupled to a second one of the securing mechanisms.3. The retention device of wherein the at least two securing mechanisms are circumferentially spaced about the elongate body and the second linking elements link together adjacent ones of the securing mechanisms.4. The retention device of any of claim 1 , wherein the first linking elements are configured to prevent prolapse of the securing mechanisms.5. The retention device of wherein the first linking elements are configured to limit the extension of the ...

LEAD ASSEMBLY AND RELATED METHODS

Defibrillator lead designs and methods for manufacturing a lead having attachment between a fibrosis-limiting material covering, a shocking coil electrode, and an implantable lead body are disclosed herein. An electrode coil fitting is disposed within the shocking coil electrode. In an option, the fibrosis limiting material extends past the ends of the electrode coil, and is wrapped between the coil electrode and the electrode coil member. 1. A method comprising:forming a lead assembly including coating an external portion of at least one electrode coil with a coating of fibrosis limiting material, where the coating of fibrosis limiting material extends past end portions of the electrode coil;disposing the electrode coil over an electrode coil fitting and anchoring the fibrosis limiting material between the electrode coil and the electrode coil fitting;coupling the at least one electrode coil with at least one conductor; anddisposing insulative lead body over at least a portion of the at least one conductor and adjacent to the electrode coil and coating.2. The method as recited in claim 1 , wherein anchoring the fibrosis limiting material includes disposing coating end portions of the coating of fibrosis limiting material within the electrode coil.3. The method as recited in claim 1 , further comprising forming at least one through hole through the coil electrode fitting.4. The method as recited in claim 3 , further comprising contacting tubing external to the electrode coil fitting with internal tubing through the at least one through hole.5. The method as recited in claim 1 , further comprising forming one or more tethers along one or more end portions of the fibrosis limiting coating claim 1 , and disposing the one or more tethers between an exterior surface of the at least one coil electrode fitting and an interior portion of the at least one electrode coil.6. The method as recited in claim 1 , further comprising welding the electrode coil.7. The method as ...

LEAD ASSEMBLY WITH POROUS POLYETHYLENE COVER

This document discusses, among other things, a lead assembly including a porous polyethylene cover. In an example, the cover includes sections that have differing pore sizes. In an example, a section of the cover near a distal end portion of a lead assembly includes pores that are large enough to allow tissue ingrowth. In another example, a lead assembly includes two or more polyethylene covers having different porosities. 1. A method comprising:wrapping a porous polyethylene material around a portion of a lead assembly under tension such that adjacent portions of the porous polyethylene material form a spirally overlapping cover around the lead assembly;controlling pore sizes in the porous polyethylene material by varying the tension during wrapping such that pore size in a first section of the porous polyethylene material is larger than pore size in a second section of the porous polyethylene material;fusing the adjacent portions of the porous polyethylene material together by applying heat.2. The method of claim 1 , wherein controlling the pore sizes further comprises applying a first tension in controlling pore sizes in the first section of the porous polyethylene material and applying a second tension in controlling pore sizes in the second section of the porous polyethylene material claim 1 , the first tension being higher than the second tension.3. The method of claim 2 , wherein controlling the pore sizes further comprises controlling pore size in the first section in the first piece of the polyethylene material to allow tissue ingrowth claim 2 , and controlling pore size in the second section in the first piece of the polyethylene material having pores that inhibit tissue ingrowth.4. The method of claim 1 , wherein fusing the first portion of the first piece of polyethylene material to the second portion of the first piece of polyethylene material comprises heating the polyethylene material to between 80 and 150 degrees.5. The method of claim 4 , wherein ...

Blood glucose reduction

A method for use with a blood-glucose-reduction device is provided. The method includes using a sensor, sensing a parameter indicative of a level of skeletomotor activity of a subject, and generating a signal in response thereto. In response to the signal from the sensor indicating that the level of skeletomotor activity exceeds a skeletomotor-activity threshold, reduction of blood glucose of the subject is reduced by the blood-glucose-reduction device.

DELIVERY OF BI-VENTRICULAR PACING THERAPY IN A CARDIAC MEDICAL DEVICE AND MEDICAL DEVICE SYSTEM

An implantable medical device and medical device system for delivering a bi-ventricular pacing therapy that includes a plurality of electrodes to sense a cardiac signal, an emitting device to emit a trigger signal to control delivery of the bi-ventricular pacing, and a processor configured to compare the sensed cardiac signal associated with the delivered bi-ventricular pacing to at least one of an intrinsic beat template and an RV template associated with a morphology of RV-only pacing therapy, determine whether an offset interval associated with the bi-ventricular pacing therapy is set to a maximum offset interval level in response to the comparing, adjust the offset interval in response to the offset interval not being set to the maximum offset interval level, and generate the trigger signal to be emitted by the emitting device to subsequently deliver the bi-ventricular pacing therapy having the adjusted offset interval. 1. A medical device system for delivering a bi-ventricular pacing therapy , comprising:a leadless pacing device capable of being positioned within a left ventricle of a patient's heart and comprising electrodes to deliver the bi-ventricular pacing therapy;an implantable medical device comprising a plurality of electrodes and capable of being positioned within a right ventricle of the heart to deliver the bi-ventricular pacing therapy and to sense a cardiac signal;an emitting device to emit a trigger signal to control delivery of the bi-ventricular pacing therapy; anda processor configured to compare the sensed cardiac signal associated with the delivered bi-ventricular pacing to at least one of an intrinsic beat template and an RV template associated with a morphology of RV-only pacing therapy, determine whether an offset interval associated with the bi-ventricular pacing therapy is set to a maximum offset interval level in response to the comparing, adjust the offset interval in response to the offset interval not being set to the maximum offset ...

IMPLANTED LEAD ANALYSIS SYSTEM AND METHOD

Implanted medical device data is received, where the data was sensed by a first lead portion and a sensor over a time period. The number of detected noise events sensed by the first lead portion is counted based on applying first noise detection criteria to the data sensed by the first lead portion. The number of detected noise events over the sensor is counted based on applying second noise detection criteria to the data sensed by the sensor. The mean number of detected noise events is calculated for the first lead portion and sensor based on the number of noise events sensed by the first lead portion and the number of noise events sensed by the sensor. Potential lead failure in the first lead is recorded if the number of detected noise events over the first lead is greater than the mean number of noise events by at least 5%. 1. A method comprising:receiving implanted medical device data, wherein the medical device data was sensed by a first lead portion and a sensor over a period of time of at least one day;applying first noise detection criteria to the medical device data sensed by the first lead portion;counting the number of detected noise events sensed by the first lead portion over the time period based on the first noise detection criteria;applying second noise detection criteria to the medical device data sensed by the sensor;counting the number of detected noise events over the sensor over the time period based on the second noise detection criteria;calculating the mean number of detected noise events over the time period, wherein at least the number of detected noise events sensed by the first lead portion and the number of detected noise events sensed by the sensor are included in the mean calculation; andrecording a determination of potential lead failure in the first lead if the number of detected noise events over the first lead over the time period is greater than the mean number of noise events by at least 5%.2. The method of claim 16 , further ...

INJECTABLE SUBCUTANEOUS STRING HEART DEVICE

A method for subcutaneously implanting a heart device in a patient using an implantation device involves making a first incision in the vicinity of the sternum of the patient and a second incision in the lumbar region of the patient posterior to the vertebral column of the patient. The implantation device is inserted through the first incision to the second incision, and a guidewire is placed through the implantation device via the second incision to the first incision. An end of the guidewire is coupled to the heart device, and the guidewire is pulled through the implantation device until the guidewire is placed within the patient. The guidewire then is detached from the heart device, and the implantation device is removed. The first and second incisions are sutured such that the heart device is left positioned completely subcutaneously around the heart and outside of the ribcage of the patient. 1. Method for subcutaneously implanting a heart device in a patient , said heart device comprising a plurality of similarly shaped linked structures having a spine-like shape providing said heart device with flexibility in at least three directions and having a substantially symmetric circular cross-section , using an implantation device comprising a hollow elongated cylindrical shape , said implantation device having a diameter smaller than a diameter of said heart device , said implantation device further comprising a gap , running along a length of said elongated cylindrical shape , comprising the procedures of:making a first incision in the vicinity of the sternum of said patient and making a second incision in the lumbar region of said patient posterior to the vertebral column of said patient;inserting said implantation device through said first incision to said second incision;guiding a guidewire through said implantation device via said second incision to said first incision;coupling said heart device with an end of said guidewire;pulling said guidewire through said ...