Abstract: A system implantable in the coronary venous system, including a pacing lead with an anchoring screw is disclosed. The system includes a stimulation lead (10) for stimulating a left heart cavity of a patient, and a removable catheter (26) for implanting the lead. The lead (10) has at least one stimulation electrode having an anchoring screw (14) that penetrates into the epicardial tissue of the patient. The catheter tube (26) is a pre-shaped tube with two curvatures in the absence of stress. The two curvatures are inscribed in two separate surfaces (38, 40) for self-orientating the distal end of the catheter tube into the target vein and maintaining the axis of the anchoring screw towards the epicardial wall during the screwing of the lead head.

Abstract: A torque limiting mechanism between a medical device and an implantation accessory is disclosed. In a particular embodiment, a delivery system for a leadless active implantable medical device includes a delivery catheter and a torque shaft disposed within the delivery catheter. The delivery system also includes a docking cap having a distal end for engaging an attachment mechanism of the leadless active implantable medical device. The delivery system also includes a torque limiting component coupled to a distal end of the torque shaft and a proximal end of the docking cap.

Abstract: A retractable screw-type stimulation or defibrillation intracardiac lead is disclosed. According to one embodiment, the lead comprises a flexible hollow sheath (12) having at its distal end a lead head (10) and a connector (66) at its proximal end. The connector comprises a pin (62) connected to a lead head electrode (18). The lead head comprises a tubular body (28), at least one electrode (18, 20) for stimulation or defibrillation, a moving element translationally and rotationally moving within the tubular body in a helical motion, and an anchoring screw (24) axially moving with respect to the tubular body, and a deployment mechanism (22) to deploy the anchoring screw out of the tubular body (28).

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. The lead includes a lead body with a hollow sheath of deformable material, having a central lumen open at both ends, and at least one telescopic microcable of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end thereof. The part emerging beyond the distal end is an active free part comprising a plurality of distinct bare areas, intended to come into contact with the wall of a target vein of the coronary system, 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.

Abstract: An intracardiac capsule comprises a cylindrical body having an atraumatic rounded surface and a helical anchoring screw integral with the cylindrical body. The helical anchoring screw is able to penetrate tissue of a wall of the heart and is configured to provide temporary attachment, in rotation and in translation, of the capsule to an implantation site. The helical anchoring screw surrounds at least a portion of the length of the cylindrical body forming a contact region intended to come into contact with the wall of the cavity of the heart. Over the length of the contact region, the external diameter of the cylindrical body is less than the inner diameter of the helical anchoring screw, so as to leave a free gap there between. The helical anchoring screw is secured to the cylindrical body near the proximal end of the contact region, and extends freely to the opposite distal end.

Abstract: An epicardial stimulation lead includes a lead body having a connector at a proximal end for coupling the lead to a generator of an active implantable medical device. The lead also includes a distributor housing at a distal end of the lead body and means for anchoring the distal end of the lead body to the epicardium. The lead also includes an active part having a plurality of microcable conductors, the proximal ends being coupled to the distributor housing, the distal ends being free. Each microcable has a diameter of at most equal to 2 French. Each microcable includes at least one denuded area in the insulating coating forming a stimulation electrode adapted to contact or penetrate an epicardium wall. Each microcable also includes a transverse elongated member extending at an angle relative to the main direction of the microcable for penetrating into the epicardial wall.

Abstract: A sensing/pacing lead including a microcable having a diameter of at most 2 French (0.66 mm). The microcable includes an electrically conductive core cable including a plurality of strands and a composite structure formed from at least a structuring material and a radiopaque material, the radiopaque material constituting at least about 0.008 mm2 of the core cable cross section. The plurality of strands of the core cable comprises a first set of individual strands formed from the structuring material and a second set of individual strands formed from the radiopaque material, or a plurality of strands each comprising a first and second layer, one of which is the structuring material and the other the radiopaque material. The microcable further includes a polymer insulation layer at least partially surrounding the core cable and at least one electrode.

Abstract: The invention relates to an implantable capsule, particularly an autonomous capsule of cardiac stimulation, including a tubular body provided at the distal end of an anchoring element with a helical screw adapted to penetrate tissue a wall of an organ of a patient, the body housing a set of functional elements of the capsule. It includes, in an annular area surrounding the base of the screw recessed arrangements defining a set of flush tips oriented in a circumferential direction opposite to that of the screwing, to avoid the unscrewing of the capsule.

Abstract: An intracardiac capsule comprises a cylindrical body having an atraumatic rounded surface and a helical anchoring screw integral with the cylindrical body. The helical anchoring screw is able to penetrate tissue of a wall of the heart and is configured to provide temporary attachment, in rotation and in translation, of the capsule to an implantation site. The helical anchoring screw surrounds at least a portion of the length of the cylindrical body forming a contact region intended to come into contact with the wall of the cavity of the heart. Over the length of the contact region, the external diameter of the cylindrical body is less than the inner diameter of the helical anchoring screw, so as to leave a free gap there between. The helical anchoring screw is secured to the cylindrical body near the proximal end of the contact region, and extends freely to the opposite distal end.

Abstract: This accessory comprises a remotely steerable catheter (40) extended by a tip (50) comprising a base (52) to which the catheter (40) connects to and a cylindrical portion (54) defining a volume (56) suitable for housing the capsule (10). A sub-catheter (30) and the capsule are telescopically extendable with respect to the catheter between i) a retracted position and a deployed position wherein the capsule is removed from the connector and is carried by the distal end of the sub-catheter, and the distal end of sub-catheter and the proximal region (18) of the capsule being provided with disconnectable means of attachment (20, 36). The tip presents, between its base (52) and its cylindrical portion (54), a flexible portion (58) providing, between the base and the cylindrical portion, an elastic deformability in bending and compression.

Abstract: The invention relates to an implantable capsule, particularly an autonomous capsule of cardiac stimulation, comprising a tubular body provided at the distal end of an anchoring element with a helical screw adapted to penetrate tissue a wall of an organ of a patient, the body housing a set of functional elements of the capsule. It comprises an annular support integral with the body and coaxial therewith, said support surrounding the base of the anchoring element and comprising a series of openings radially extending. The base of the anchoring element comprises a series of rods or tubes projecting in a generally radial direction, and engaged in said openings to thereby secure the anchoring element to the support.

Abstract: An epicardial screw lead for stimulation/defibrillation implantable by a guide-catheter inserted into the pericardial space is described. The lead is a monodiameter lead with a helical anchoring screw extending axially of the lead body. The guide-catheter (24) has a pre-shaped tube having, in the absence of stress, a first bend (26) for supporting the lead body on the outer wall of the pericardial space (38), and a second bend (28) for orienting the end of the guide-catheter tube in the direction of the outer wall of the myocardium (34) and keeping the axis of the anchoring screw (14) in that same direction during a combined movement of screwing and insertion of the lead head.

Abstract: A pacing lead having a lead body comprising a hollow sheath by a first lumen and an extension body extending from the lead body, the extension body having a proximal end and a distal end, the distal end having an active lead region. The extension is traversed by a second lumen, the second lumen communicating with the first lumen of the lead body so as to receive a guide wire for the implantation of the lead. The extension has an outside diameter of between 1 and 3 French. The extension distal end comprises at least one electrically isolated peripheral conductor electrically insulated except for at least two denuded areas on an outer surface of the conductor to contact a wall of a target vein, so as to form a network of stimulation electrodes electrically connected together. The lead body proximal end includes an electrical connection for the peripheral conductor.

Abstract: 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.

Abstract: A system for stimulation/defibrillation of the left ventricle endocardially or from a vein in the coronary system including: a lead body (10) having a lumen, a distal end (12) with an anchor (14) connectable to a wall of a heart chamber or of a vein of the coronary system, and a proximal side with a connector (22) having a first terminal (26). The lumen of the lead houses a microcable (28) with an active free part (30) that emerges from the distal end. An insert (38) formed on the lead body includes a first electrical connection to the first terminal (26) of the connector, and a coupler selectively movable between (i) a released position wherein the microcable is free to slide in lumen of the lead body, and (ii) a closed position, wherein the microcable is both mechanically immobilized in the lead body and electrically connected to first electrical connection.

Abstract: This implantable microcatheter includes a hollow tube with a central lumen extending throughout the length of the tube from a proximal region to a distal region. The bending stiffness of the proximal region is greater than the bending stiffness of the distal region, and the tube has a transition region having a decreasing stiffness gradient from the proximal region to the distal region. The tube wall is free of shielding or armor at least in the distal region, and the catheter is made of biocompatible material(s) suitable for a permanent implantation in venous, arterial or lymphatic networks.

Abstract: A stimulation lead is disclosed. This lead comprises a lead body having a lumen housing an inner conductor, the conductor being axially and rotationally movable within the lumen, and coupled to a generator of an active implantable medical device. The lead also has a helical anchoring screw extending from a distal end configured to penetrate target tissue, and a stimulation needle electrically coupled to the conductor and comprising at its distal end an active free portion with at least one stimulation electrode for application of pacing pulses to the target tissue. The stimulation needle is axially movable between a retracted position inside the tubular body, and a deployed position with the active free portion of the needle emerging out of the tubular body, utilizing an actuating mechanism for moving the needle from its retracted position to its deployed position under the effect of rotary movement relative to the lead body.

Abstract: An explantation accessory includes a catheter with a steerable head carrying a tubular receptacle adapted to accommodate the proximal portion of the capsule. The explantation accessory further includes a lasso having a flexible wire extending along the catheter to and forming at its distal end a deformable loop. One end of the deformable loop is mobile so as to allow tightening of the loop under the effect of a traction exerted on the flexible wire along the catheter. The free end edge of the tubular receptacle comprises a protruding anterior portion, an axially recessed posterior portion with respect to the anterior portion and located diametrically opposite to the protruding anterior portion, and two beveled edges connecting the protruding anterior portion to the recessed posterior portion.

Abstract: 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.

Abstract: The invention relates to an implantable capsule, particularly an autonomous capsule of cardiac stimulation, including a tubular body provided at the distal end of an anchoring element with a helical screw adapted to penetrate tissue a wall of an organ of a patient, the body housing a set of functional elements of the capsule. It includes, in an annular area surrounding the base of the screw recessed arrangements defining a set of flush tips oriented in a circumferential direction opposite to that of the screwing, to avoid the unscrewing of the capsule.