Abstract: A physiologic rate responsive pacer which alters the pacer's escape interval in response to the patient's respiratory minute ventilation derived from the electromyogram of selected respiratory muscle groups. The directly detected electromyogram (EMG) signal is amplified and band passed filtered, processed to remove any electrocardiogram (ECG) or pacing impulse signal, full-wave rectified, processed to develop a moving time average signal from which the peak, the maximal slope, and the average slope of the EMG moving time average may be calculated and processed in conjunction with the inspiratory and expiratory times between successive slope detections of the moving time average EMG to develop a rate control signal representative of minute ventilation.

Abstract: A lead extraction device which utilizes laser light to separate an implanted object, such as a pacemaker lead, from fibrous scar tissue and thereby permit the implanted object to be extracted from a body. The extraction device features a catheter having a central lumen. The lumen is preferably dimensioned so a pacemaker lead will fit within. The catheter is thereby guided by the lead. The catheter has at least one optical fiber to emit laser light from the distal end and thereby separate the lead from fibrous scar tissue. Disclosed embodiments include catheters which emit light parallel as well as inwardly perpendicular to the catheter and the lead. Through such catheters the lead may be separated along its length, as well as separated at its distal end from fibrous scar tissue, thereby permitting the lead to be readily extracted from the body.

Abstract: An implantable cardioversion or defibrillation lead provided with a large surface, carbon fiber electrode. The lead takes the form of an elongated tubular braid of carbon fiber, provided with a central core of insulating plastic. Over the majority of the braid's length, it is covered by an outer sheath of insulating plastic as well, serving as a lead conductor. At its distal end, the braid is not covered, and the exposed portion of the braid serves as the electrode.

Abstract: An implantable active fixation lead system which connects a source of electrical energy, such as a pacemaker, to the cardiac tissue. The lead system includes a lead, an introducer and a guide catheter. The lead has a small diameter lead body, and an active fixation device for engaging the cardiac tissue. The lead body has an overall straight, uncoiled configuration, and an outer diameter of about 13 mils. The lead body includes a plurality of infinitesimal, bio-compatible, bio-stable electrically conductive strands which are tightly bundled together in a cable-like fashion to form a single conductor. A dielectric bio-compatible insulation coating surrounds the conductor to provide an insulation layer between the conductor and the body environment. The fixation device includes a crank portion which engages the introducer.The introducer is assembled to the lead and includes a coupler which engages the crank portion of the lead fixation device.

Abstract: An epicardial defibrillation electrode employing an elongated, coil electrode embedded in the surface of a flexible electrode pad. The coil electrode provides increased flexibility and superior electrode flex life. The arrangement of the coil electrode provides uniform current distribution.

Abstract: An endocardial defibrillation electrode system as provided, including a coronary sinus lead, a ventricular lead, and a subcutaneous plate. The coronary sinus lead includes an elongated electrode adapted for location in the coronary sinus, extending into the great vein, and termination in the vicinity of the left atrial appendage. The right ventricular eletrode may be located either in the right ventricular apex, or may extend from the right ventricular apex to the vicinity of the tricuspid valve. This subcutaneous electrode preferably is a large surface electrode, adapted for implant in the vicinity of the heart. A variety of defibrillation pulse regimes are disclosed, optimized for use with the defibrillation electrode system, and with subgroupings of the disclosed electrodes.

Abstract: An epicardial defibrillation electrode employing an elongated, coil electrode embedded in the surface of a flexible electrode pad. The coil electrode provides increased flexibility and superior electrode flex life. The arrangement of the coil electrode provides uniform current distribution. The electrode takes the form of a space wound coil following a tortuous path over the surface of the electrode pad to provide a large surface area to reduce current density. In some embodiments, an insulative core is located within the lumen of the coil.

Abstract: A transvenous pacing lead having a stylet including a longitudinal stylet wire, a handle affixed to the proximal end of the stylet wire, a taper of a predetermined length formed adjacent to or on the distal end of the stylet wire, and a ball affixed to the end of the stylet wire where the ball has a diameter substantially equal to the diameter of the stylet wire. The taper at the distal end of the stylet provides strain relief, least rigidity of the stylet wire and complies with the curvature bends of the transvenous pacing lead. The tapered end of the stylet wire can also be referred to as a soft tip stylet wire.

Abstract: A single pass atrial-ventricular transvenous pacing lead wherein the atrial branch has a positive fixation device. The proximal end of the lead has a standard electrical connector for coupling both atrial and ventricular electrodes to an implantable pulse generator. The lead is bifurcated at a point near or above the superior vena cava during normal transvenous insertion. The atrial and ventricular branches are of a fixed length from the point of bifurcation to the distal tip. The ventricular branch preferably employs a passive fixation device such as tines to maintain the ventricular electrode within the right ventricular apex. The atrial branch is positioned in the normal manner under control of a stylet to obtain optimal sensing and stimulation thresholds. This position is maintained using an active fixation device. Preferably the active fixation device is a helix which is screwed into the atrial wall by rotating the atrial connector pin and conductor coil.

Abstract: A lead or heart wire for use in temporary electrical stimulation or monitoring of epicardial tissue. Positive fixation is accomplished by suturing the electrode to the tissue using an attached length of surgical thread and a curved needle. The heart wire is a tightly wound helix of wire insulated by a sheath. A needle, used for electrical connection to external equipment, is attached to the proximal end. Near the distal end, the conductor is bent into an "C" shape. The electrode is attached about midway along the top of the "C" shaped length of conductor. The length of surgical thread is attached to the proximal end of the conductor and exits the sheath through an aperture proximal to the "C" shape. The curved needle is attached to the distal end of the surgical thread. The heart wire may be readily removed after use by removing the surgical thread. The heart wire may be readily removed after use by removing the surgical thread, which is retracted into the conductor by pulling at its proximal end.