Abstract: An apparatus for deflecting a catheter or lead, for example a deflectable stylet or guidewire. The device includes an outer tubular member, a tension member mounted within the outer tubular member and coupled to the outer member and a handle mounted at the proximal end of the tubular member. The handle includes a major handle portion which has a rotatable knob located at its distal end, surrounding a proximal portion of the outer tubular member and provided with inwardly directed threading and an inner slider member provided with outwardly directed threading engaging the inwardly directed threading of the knob. The slider is advanced or retracted longitudinally within the handle by rotation of the knob but is rotationally fixed with regard to the major handle portion.

Abstract: A method of interconnecting a core, a stranded conductor such as a wire rope or cable and a component of a medical electrical lead provided with a internal lumen. At least one of the core and the internal lumen of the component is provided with a textured surface, such as threading. The conductor is located alongside said textured surface and the core is advanced into the lumen of said component, such that the textured surface engages the conductor and retains the conductor as the core is advanced into the lumen, and the conductor is compressed between the core and the inner lumen of the component.

Abstract: A cardiac pacing lead for pacing the atria and a method of its use. The lead is provided with a mechanism for maintaining an atrial pacing electrode adjacent stimulable tissue in a patient's superior vena cava and an additional electrode locatable in the right ventricle or elsewhere when the atrial electrode is so located. One such mechanism for maintaining the atrial electrode's position may be a lead body displaying pre-formed laterally extending curves sized to span a patient's superior vena cava, with the atrial electrode located thereon.

Abstract: An implantable lead which has an increased resistance to fracture and has the capability of continued function after fracture of a conductor. The lead is provided with a coiled conductor which may be monofilar or multifilar and which extends along the length of the lead, running from an electrical connector at the proximal end of the lead to an electrode at or near the distal end of the lead. In addition, the lead is provided with a stranded conductor which is electrically coupled to the coiled conductor at point along the lead body located proximal to the point of expected breakage of the coiled conductor and at a point along the lead body located distal to the point of expected breakage. The proximal and distal ends of the stranded conductor in some embodiments are also mechanically coupled to the coiled conductor.

Abstract: An ablation catheter and a method of performing cardiac ablation. The catheter is provided with a hollow, helical electrode, which is screwed into cardiac tissue at a desired ablation site and connected to a source of R-F electrical energy to ablate the tissue adjacent the electrode. Prior to ablation, a conductive fluid may be injected through the hollow needle, both to provide for cooling of the tissue adjacent the needle and to increase the conductivity of the tissue in the area of the electrode.

Abstract: An implantable electrical lead of the type which has an insulative rigid electrode head carrying an advanceable helical electrode. The electrode head is mounted toan elongated insulative lead body which is less rigid than the electrode head and which carries an extensible conductor coupled to the helical electrode and an inextensible conductor coupled to the proximal end of the lead body. A second electrode is mounted to said lead body adjacent the electrode head and is coupled to the inextensible conductor by a conductive sleeve which is mechanically coupled to electrode head so that proximally directed traction forces applied to the lead body are applied by the inextensible conductor directly to the electrode head.

Abstract: A tool for implanting a pacing lead of the type having a fixation helix. The tool is provided a curved, elongated shaft with rotatable tongs mounted at its distal end. The tongs extend distally from the shaft and angle radially outward and slide against a bearing located in a distal portion of the shaft. A cable, rotatable and longitudinally movable relative to the shaft, extends through the shaft and is coupled to the tongs. A handle is mounted at a proximal end of the shaft and includes a mechanism for rotating the cable mechanism relative to the shaft and for moving the cable longitudinally relative to the shaft, so that the tons may grip rotate and release the tongs.

Abstract: An implantable device which stores information indicative of events occurring within a patient's body and related to operation of the device for transmission to an external device in response to a request from the external device. The implanted device is provided with a mechanism for retaining information as to the state of the information stored in the device at the time of a preceding request or interrogation from the external device and for storing cumulative information indicative of the operation of the device or events occurring within the patient's body over a time frame spanning multiple interrogations or requests from the external device. The two types of stored information together may be employed by the implanted device or the external device to derive information indicative only of events occurring since a preceding interrogation of the implanted device by the external device.

Abstract: An atrial lead system and a method of employing it to provide a single electrode bi-atrial pacing. The system includes an atrial pacing lead having an electrode located on a distal portion thereof and a guide catheter having a longitudinal lumen and a lateral aperture open to the longitudinal lumen of the catheter proximal to a distal end of the catheter through which the distal portion of the lead may be advanced. The electrode is preferably an active fixation electrode or is associated with an active fixation device. The system is employed by first advancing the guide catheter to the ostium of a patient's coronary sinus and inserting the distal end of the guide catheter into the coronary sinus such that the lateral aperture of the catheter is located in the patient's right atrium. The atrial pacing lead is then advanced through the lumen of the guide catheter such that the electrode exits the lateral aperture of the guide catheter and the electrode is affixed to the tissue of the atrial septum.

Abstract: A system for connecting electrical leads having connector assemblies carrying electrical connectors to an implantable electrical device having a device housing containing electrical circuitry, including a first connector module fixedly mounted to the device housing, with a first set of electrical connectors coupled to the circuitry within the device housing and a second connector module, with a second set of electrical connectors engageable with the first set of connectors and a second set of connectors electrically coupled to the second set of connectors and engageable with the connectors on the electrical leads and a mechanism for retaining the second module on an outer surface of the device housing adjacent the first module while the second set of connectors engages the first set of connectors.

Abstract: An electro-stimulation device includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat. The electro-stimulation device both electrically arrests the heartbeat and stimulates the heartbeat. A pair of electrodes are provided for connection to at least one location in the body that affects or regulates the heartbeat. The pair of electrodes may be connected to an intravenous catheter for transvenous stimulation of the appropriate nerve. A first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment any natural stimuli to the heart and thereby stop the heart from beating. A second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate heartbeating.

Abstract: A cardiac pacing lead for use in the coronary sinus and coronary veins. The lead is provided with a lead body configured to exhibit a curved configuration along a distal portion thereof, induced to maintain a portion of the curved configuration solely by a portion of a polyurethane lead body formed to display the curved configuration and wherein the lead conductor is freely mounted within the segment The curved configuration includes first and second arcuate segments together providing a single-plane curvature of approximately 180 degrees, separated by a generally straight segment, the first segment having a greater length and greater arc of curvature than the second segment.

Abstract: An implantable antiarrhythmia device which detects and classifies arrhythmias of the human heart, and delivers appropriate therapy. The device employs a method of arrhythmia classification based on a set of prioritized rules, each of the rules defining a plurality of criteria based upon characteristics of sensed depolarizations of heart tissue, each rule being met when the criteria associated with the rule are met. Some rules, when met, trigger delivery of antiarrhythmia therapy. Other rules, when met, inhibit delivery of antiarrhythmia therapy. The rules may be met simultaneously, and if so, the highest priority rule governs the behavior of the device.

Abstract: An implantable anti-arrhythmia device such as a defibrillator or anti-tachycardia pacemaker with an associated patient activator. In response to the patient activation signal, the implanted device notifies the activator whether an atrial rhythm requiring treatment is present and whether a therapy is available for delivery in response to the patient's request. After the patient is notified that a therapy is pending, the implanted device charges its output capacitors and thereafter determines whether opportunities for prompt synchronization are present with a desired frequency, over a preceding series of depolarizations. If both conditions are met, the likelihood that a defibrillation or cardioversion pulse can be delivered quickly following a patient initiated retrigger signal is high, and the device notifies the patient's activator that it will await receipt of a patient retrigger signal, as a prerequisite for a delivery of the cardioversion or defibrillation pulse.

Abstract: An ablation catheter and a method of performing cardiac ablation. The catheter is provided with a hollow, helical electrode, which is screwed into cardiac tissue at a desired ablation site and connected to a source of R-F electrical energy to ablate the tissue adjacent the electrode. Prior to ablation, a conductive fluid may be injected through the hollow needle, both to provide for cooling of the tissue adjacent the needle and to increase the conductivity of the tissue in the area of the electrode.

Abstract: A method of providing biocompatible surface texturing on a metal component of an implantable device and the device so produced. The coating is provided by applying particles of metal falling substantially entirely in the range of 1 to 5 microns to a surface of said component to provide a layer of generally uniform thickness and sintering said particles to one another and to said component to provide a generally continuous external surface having surface texturing in the form of projections formed from said sintered particles. The particles are preferably applied to a depth of 1 to 25 microns. In a preferred embodiment particles of titanium are applied to a surface of a titanium component.

Abstract: An implantable medical device which senses atrial electrograms, detects atrial tachyarrhythmias and delivers atrial cardioversion/defibrillation pulses in response thereto, which employ a correlation analysis to assist in detection of arrhythmias and/or timing of delivery of cardioversion/defibrillation shocks. The device includes an electrogram recorder which stores atrial electrogram segments associated with R--R intervals extending over multiple atrial depolarizations and a correlator which measures correlation of successive stored atrial electrogram segments. The device may use the measured corellation meeting a defined threshold value to detect the occurrence of a defined tachyarrhythmia such as atrial fibrillation or allow delivery of a cardioversion/defibrillation pulse.

Abstract: A pacing lead of the type having a hollow lead body with a conductor linking the electrode at one end with the connector at the other end has a guide wire or stylet either connected to a mechanical vibrator or carrying an ultrasonic transducer in order to cause the guidewire to move within the body to facilitate the display of the catheter position on external ultrasonic monitoring equipment.

Abstract: An implantable electrical lead having an elongated insulative lead body carrying a cardioversion/defibrillation electrode and a sensing electrode spaced from the cardioversion/defibrillation electrode. A diode enclosure is mounted in the lead body between the cardioversion/defibrillation electrode and the sensing electrode, the diode enclosure having conductive end walls and including a diode or diodes therein coupled between the conductive end walls. The enclosure is also provided with a feedthrough tube extending through said enclosure, passing through the end walls. An elongated conductor extends through the lead body and through the feedthrough tube of said enclosure and is electrically coupled to the sensing electrode. The cardioversion/defibrillation electrode and the sensing electrode are each electrically coupled to one of the conductive end walls of the diode enclosure.

Abstract: A medical electrical lead having an elongated lead body carrying a conductor therein, the lead body being formed of an inner sleeve of a first, relatively more rigid plastic and an outer sheath of a second, relatively less rigid plastic, the inner sleeve having a tubular portion and having outwardly extending helical ridges extending along its length, the ridges having lateral wall surfaces extending radially from the tubular portion and an outer sheath over the inner sleeve and in contact with the lateral wall surfaces of the inner sleeve. A fixation helix may be mounted at the distal end of the lead body and a conductor, which is also rotatable relative to the lead body may be located within the inner, tubular sleeve. Conductors may also be located between the ridges of the inner sleeve, embedded in the outer sheath.