Abstract: A steerable or deflectable distal tip of a cardiac instrument is provided by creating a differential tension in a distal portion, causing the distal portion either to curve if originally straight, or to straighten if originally curved. The differential tension can be created by a pull or push wire disposed in a longitudinal lumen of the instrument, which wire is attached at its distal end to the instrument. In another embodiment, the differential tension is created by thermoelectrically heated by metallic strip which is disposed within a lumen within the instrument in the form of a stylet. In another embodiment, the stylet is deformed by virtue of differential tension being applied between a pair of strips comprising the stylet.

Abstract: A therapeutic device for providing cold treatments to cardiac pacemaker implantation patients is comprised of a bilobed chest pad having an elastic chest strap connected thereto. The chest strap is fixed at one end to the lower lobe of the chest pad and is wrapped around the torso of the patient under tension and temporarily is coupled to the opposing portion of the lower lobe of the chest pad. The cold compress, which is placed behind the chest pad over the incision site, is thereby firmly kept in contact with the incision site. A shoulder strap is slidingly coupled at one end to the chest strap and is positioned on the back of the patient and wrapped under tension behind the back and over the shoulder of the patient, which shoulder is adjacent to the incision site. The end of the shoulder strap is then temporarily coupled to the upper lobe of the chest pad.