Abstract: An inner surface of a coupling component sidewall forms first and second portions of a cavity of the coupling component. A conductive coupling between an electrode and a conductor of a medical electrical lead may be formed by inserting a segment of the conductor into the first portion of the cavity, crimping the sidewall of the coupling component around the inserted segment, inserting a segment of the electrode into the second portion of the cavity, and welding an edge of the sidewall to the inserted electrode segment. The edge of the sidewall may define a slot, extending between first and second portions of the cavity, or a hole extending through the sidewall. The electrode may be part of an electrode assembly, mounted around an inner insulation layer of the lead, and the conductor may be part of a conductor assembly extending between inner and outer insulation layers of the lead.

Abstract: A cardiac rhythm management device that can comprise a lead and a pulse generator. The lead can comprise lead body, a composite conductor, a stylet guide, two or more electrodes and a proximal connector. The composite conductor can comprise two or more conductors which can electrically couple the electrodes to the proximal connector. The electrodes can be disposed on a distal portion of the lead body and can be longitudinally spaced from one another. The proximal connector can be configured to couple to the pulse generator.

Abstract: A cardiac lead adapted for fixation at least partially within a cardiac vessel. The lead includes, in one embodiment, an elongate lead body defining a proximal region and a distal region including a distal end region having at least one electrode and a distal tip. The distal end region is configured such that the electrode and the distal tip can be implanted in the cardiac vessel. Stiffening structures in the distal region of the lead are adapted to stiffen selected portions of the lead for fixation of the electrode within the cardiac vessel. In some embodiments, the stiffening structures include an implantable member adapted to be implanted in a lumen of the lead. In other embodiments, the stiffening structures include a sheath adapted to be deployed over the lead body. In still other embodiments, the stiffening structures are integral to the lead and/or the lead body.

Abstract: An implantable electrode lead for tissue stimulation adapted to be attached to an implantable tissue stimulator provided with a pulse generator, has at least two stimulation electrodes to apply stimulation pulses to said tissue and arranged close to the distal end of the electrode lead, and at least two electrical conductors to connect said electrodes to said pulse generator. The electrode lead further has a switching unit arranged close to the distal end of the electrode lead and adapted to switch the electrode lead between a local pacing mode and a normal pacing mode, the switching unit being controlled by a mode control signal. Further, a pacing module is arranged close to the distal end of the electrode lead and in relation to the switching unit and being connectable to said at least two stimulation electrodes, the pacing module includes a pulse generating unit to generate stimulating pulses to be applied to the tissue by the stimulation electrodes.

Abstract: A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle.

Abstract: An internally connected interconnect for an electrode and method for forming same.

Abstract: This invention provides a bypass bridge comprising a tract of gap junction-coupled cells having a first end and a second end, both ends capable of being attached to two selected sites in a heart so as to allow the conduction of a pacemaker and/or electrical signal/current across the tract between the two sites, wherein the cells functionally express a sodium channel. The invention also provides related methods of making the bypass bridge, methods of implanting same in a heart, and methods of treating a disorder associated with an impaired conduction in a subject's heart.

Abstract: A lead system for an implantable medical device and applications for the lead system. Also includes therapeutic systems, devices, and processes for detecting and treating disordered breathing and treating cardiac and breathing issues together with an implantable device.

Abstract: A leadless cardiac pacemaker configured for implantation in electrical contact with a left ventricular cardiac chamber and configured for leadless triggered left-ventricular pacing for cardiac resynchronization therapy (CRT) in response to conducted signals from a pulse generator.

Abstract: Treating the physiological electric conduction of the heart includes methods that involve guiding an electrode to a location, near the His bundle of the heart, that is determined by pacing the heart and sensing signals in response thereto, and electrically bypassing a conduction abnormality of the heart by presenting extrinsic pacing signals to the location near the His bundle of the heart. The pacing electrode may then be fixed at the location, near the His bundle, to provide subsequent pacing of the heart such that the subsequent pacing exhibits electrical bypassing of the conduction abnormality.

Abstract: Exemplary lead assemblies include a lead body having a plurality of conductor wires embedded therein, a plurality of electrode contacts at least partially disposed on an outer surface of the lead body, and a plurality of switching networks each configured to control an operation of one or more of the plurality of electrode contacts.

Abstract: A biomimetic electrode material including a fibrous matrix including a conductive polymer and an ion conducting polymeric material is described. The biomimetic electrode material may be used in a number of body-implantable applications including cardiac and neuro-stimulation applications. The biomimetic electrode material can be formed using electrospinning and other related processes. The biomimetic electrode may facilitate efficient charge transport from ionically conductive tissue to the electronically conductive electrode, and may induce surrounding tissue to attach or interface directly to the implanted device, increasing the biocompatibility of the device.

Abstract: A method and apparatus permit sensing one or more forces exerted by one or more portions of a heart. A force transducer and displacement sensor are disclosed. A movement of one or more portions of a heart can be translated into one or more signals indicative of force. These signals can be used to provide information such as to diagnose or treat one or more conditions.

Abstract: An embodiment of an open-irrigated catheter system comprises a tip section, a distal insert, and mapping electrodes. The tip section has an exterior wall that defines an open interior region within the tip section. The exterior wall includes mapping electrode openings and irrigation ports. The exterior wall is conductive for delivering radio frequency (RF) energy for an RF ablation procedure. The irrigation ports are in fluid communication with the open interior region to allow fluid to flow from the open interior region through the irrigation ports. The distal insert is positioned within the tip section to separate the open region into a distal fluid reservoir and a proximal fluid reservoir. The mapping electrodes are positioned in the mapping electrode openings in the tip section.

Abstract: An implantable medical device (IMD) can include a cardiac pacemaker or an implantable cardiac defibrillator (ICD). Various portions of the IMD, such as a case or device body, the lead body, or the lead tip, can be provided to reduce or dissipate a heat production due to a current induced by various external environmental factors. According to various embodiments, features or portions can be incorporated into the lead body, the lead tip, or the IMD body to reduce the creation of an induced current, or dissipate or increase the area of dissipation of thermal energy created due to an induced current in the lead.

Abstract: A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathoracic blood vessels and for providing anti-tachycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-tachycardia pacing energy for delivery to the patient's heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-tachycardia pacing energy to the capacitor subsystem.

Abstract: A method of placing an electrical lead of an implantable cardiac device inside a heart of a patient. The method includes securing a tool to an atrial appendage of the heart to hold onto the atrial appendage, piercing the atrial appendage, and creating an aperture in the atrial appendage while holding the atrial appendage with the tool. The method also includes moving a distal end of the electrical lead into the heart through the aperture in the atrial appendage and into a ventricle of the heart. Furthermore, the method includes coupling the distal end of the electrical lead to cardiac tissue in the ventricle and delivering an electrical signal to the cardiac tissue in the ventricle of the heart to maintain a predetermined heartbeat of the heart.

Abstract: The present invention is a device localization system that uses one or more ultrasound reference catheters to establish a fixed three-dimensional coordinate system within a patient's heart using principles of triangulation. The coordinate system is represented graphically in three-dimensions on a video monitor and aids the clinician in guiding other medical devices, which are provided with ultrasound transducers, through the body to locations at which they are needed to perform clinical procedures. In one embodiment of a system according to the present invention, the system is used in the heart to help the physician guide mapping catheters for measuring electrical activity, and ablation catheters for ablating selected regions of cardiac tissue, to desired locations within the heart.

Abstract: A neurostimulating lead having a stent-like anchor is described. A distal portion of the lead is mounted to an exterior of an expandable, stent-like lead anchor. The stent-like lead anchor is formed from a superelastic material and is adapted to transition from a collapsed configuration to an expanded configuration upon deployment in a vessel. In the expanded configuration, the lead anchor presses the distal portion of the lead against at least one vessel wall of a vessel in which the lead is deployed securing and stabilizing the distal portion of the lead within the vessel.

Abstract: One example includes an implantable lead with an elongate lead body including a proximal portion and a distal portion. The lead includes a coupler configured to be coupled to an implantable medical device, a conductor, extending through the coupler, a first electrode, and a first electrostimulation capacitor located at the distal portion of the lead body, the first electrostimulation capacitor including a capacitance value that is large enough to store an electrostimulation charge of an electrostimulation energy that is large enough to perform electrostimulation of tissue. The lead includes a first switch located at the distal portion of the lead body and coupled to the conductor, the first switch configured to selectively couple the first electrostimulation capacitor to the first electrode during a stimulating state and to selectively couple the first electrostimulation capacitor to the conductor during a charging state.

Abstract: A system for therapeutically stimulating a His bundle includes an implantable pulse generator and a multi-polar medical electrical lead. The generator is configured for subcutaneous implantation and to generate a pacing stimulus. The lead includes a connector assembly, a flexible tubular body, a distal tip assembly and coil conductors. The body extends intravascularly from the generator to a location proximate the His bundle and includes a proximal end, a distal end, and a longitudinal lumen. The tip assembly includes an electrode, a fixation helix, and a shank portion. The helix extends to a location proximate the His bundle and is operable as an electrically isolated electrode. The shank portion extends within the lumen and includes a receptacle for receiving a stylet tip. The conductors extend longitudinally through the lumen and are coupled to the electrode and the helix. One or both of the conductors defines a stylet lumen.

Abstract: A steerable multi-linked device. The device includes a first multi-linked mechanism and a second multi-linked mechanism. At least one of the first and second multi-linked mechanisms is steerable and includes a modular link assembly at an end thereof. The modular link assembly includes a base, and a tip removably connected to the base.

Abstract: A method of delivering a payload to a destination vessel branching from a coronary sinus of a patient's heart. The method comprises inserting a catheter assembly into a right atrium of the patient's heart. The catheter assembly comprises an outer catheter and an inner catheter movably disposed within the open lumen of the outer catheter. The inner and outer catheters are operable to be rotated and translated relative to one another such that the distal end of the outer catheter can assume a selectable plurality of shapes appropriate for accessing the coronary sinus. The method further comprises locating and cannulating the patient's coronary sinus by adjusting a relative orientation or longitudinal position of the inner catheter relative to the outer catheter, longitudinally sliding the outer catheter over the distal end of the inner catheter to deep seat the outer catheter within the patient's coronary sinus, and delivering a payload to the destination vessel through the outer catheter or the inner catheter.

Abstract: An elongate body of a medical electrical lead includes at least one conductor formed into a coil that includes a first portion and a second portion, wherein the first portion extends within an outer insulation sheath and the second portion extends outside the outer insulation sheath to be exposed to an environment external to the lead body as an energy dissipating shunt.

Abstract: A lead assembly includes an elongate body having a conductor electrically coupled with an electrode coupled to the elongate body. The lead assembly includes a push tube extending along at least a portion of the elongate body. A distal tip is coupled to the elongate body substantially adjacent to the distal end of the elongate body. The distal tip is sized and shaped to couple with a push tube distal end. In one option, the distal tip includes a seat to receive the push tube distal end. In another option, the seat is a side rail seat and a guide wire extends along the elongate body and is slidably coupled with the side rail seat. The lead assembly includes, optionally, an active fixation device slidably coupled with a portion of the elongate body, and the active fixation device is sized and shaped to couple with the push tube.

Abstract: Devices and methods utilizing a catheter to remodel soft tissue of a patient and, in a preferred embodiment, to reduce the volume of the left ventricle of a heart. In some embodiments, one or more sutures are passed through a wall of the ventricle. The ends of the one suture and, more preferably, the multiples sutures are drawn together to draw tissue portions towards one another. In some embodiments, a tissue remodeling clip is implanted into a wall of the ventricle. Ends of the clip are resiliently biased to move relative to one another to draw tissue portions towards one another. In some embodiments, a tissue remodeling anchor includes a base and a plurality of legs attached to the base. The legs of the tissue anchor are implanted into a wall of the ventricle and moved toward one another to draw tissue portions toward one another.

Abstract: An implantable lead may have a distal assembly including a coupler, a fixation helix secured to the coupler and a housing in which the fixation helix and the coupler are disposed. The distal assembly may include an annular seal that is disposed between the coupler and the housing and that provides an at least substantially fluid-tight seal between the coupler and the housing.

Abstract: A device and method for providing stimulation to an inferior nodal extension of a heart. The method includes providing a lead comprising an electrode, positioning the electrode proximate an inferior nodal extension of a heart, and effecting at least one of activation, deactivation, or modulation of the electrode to provide stimulation to the inferior nodal extension.

Abstract: An implantable lead for a medical device with an isolated contact connection for connecting a conductor to a contact reduces the opportunity for conductor material to migrate to a contact or into a patient. The implantable lead comprises a lead body having a proximal end and a distal end, at least one conductor, at least one contact carried on the proximal end, at least one contact carried on the distal end, at least one coupling. The lead has an exterior surface. The conductor is contained in the lead body and extends from the lead proximal end to the distal end. The conductor is electrically insulated. The contact carried on the proximal end is electrically connected to the conductor. The coupling has a conductor coupling and a contact coupling. The conductor coupling is placed over the conductor and attached to the conductor. The contact coupling exits the lead body and has a weld to connect the contact coupling to the contact.

Abstract: 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.

Abstract: An implantable medical lead has at least one electric conductor running along a lead body and electrically interconnecting at least one electrode at the distal portion of the lead with at least one lead terminal at the proximal portion of the lead. The lead also has at least one closed channel running along at least a portion of the lead body. The closed channel contains an extracorporeally detectable detection substance. A rupture to the lead will cause the detection substance to leak out of the channel and outside of the lead body. Lead damage can be confirmed by the absence of or a reduced amount of said detection substance inside the lead.

Abstract: A coronary sinus lead is disclosed that includes a lead body having opposed proximal and distal end portions, and an open-ended cavity formed in the distal end portion of the lead body for temporarily receiving an angioplasty balloon. The lead is configured for connection with a pacing device. A method of implanting the lead is also disclosed, which includes passing a coronary angioplasty balloon catheter over a length of guide wire extending through the coronary sinus, coronary veins, and collaterals so that the balloon is externalized. The method further includes inserting the balloon into an open cavity of the lead, inflating the balloon within the open cavity to temporarily engage a distal end portion of the lead to the catheter, and pulling the distal end portion of the lead though the coronary sinus and into a coronary vein by at least partially withdrawing the catheter from the coronary sinus.

Abstract: A lead assembly includes a lead with a distal end and a proximal end. The lead includes a plurality of electrodes disposed at the distal end and a plurality of terminals disposed at the proximal end. The lead also defines at least one central lumen and a plurality of outer lumens. The central and outer lumens extend from the proximal end to the distal end such that the plurality of outer lumens extend laterally from the at least one central lumen. The lead further includes a plurality of conductive wires. Each conductive wire couples at least one of the plurality of electrodes electrically to at least one of the plurality of terminals. At least two conductive wires are disposed in each of the plurality of outer lumens.

Abstract: A lead assembly includes a ring component having mechanical coupling features, and at least one polymer component mechanically coupled with the mechanical coupling features of the ring component. Elongate tubing is disposed over the polymer component and is secured with the polymer component.

Abstract: Implantable medical devices and methods use an intravascular implantable medical device having an elongated housing module to contain one or more circuitry components. An opening is defined through the elongated housing module. A lead, including at least one electrode, is coupled towards the distal end of the elongated housing module and at least a portion of the at least one electrode is in a stowed position within the opening defined through the elongated housing module during implant of the implantable medical device. The at least one electrode is advanceable from the stowed position to a location distal of the distal end of the elongated housing module.

Abstract: An optical-signal vestibular-nerve stimulation device and method that provides different nerve stimulation signals to a plurality of different vestibular nerves, including at least some of the three semicircular canal nerves and the two otolith organ nerves. In some embodiments, balance conditions of the person are sensed by the implanted device, and based on the sensed balance conditions, varying infrared (IR) nerve-stimulation signals are sent to a plurality of the different vestibular nerves.

Abstract: An implantable connector comprises an electrically insulative housing including an outer wall, an interior cavity surrounded by the outer wall, a port through which the lead body portion can be introduced into the interior cavity, and a pair of first apertures disposed through the outer wall on a first side of the housing. The connector further comprises an electrical spring clip contact mounted to the housing. The contact includes a common portion and a pair of legs extending from opposite ends of the common portion. The legs respectively extend through the first apertures into the interior cavity, such that the legs firmly engage the electrical terminal therebetween when the lead body portion is introduced into the interior cavity.

Abstract: A system and method for determining on a continuous, real-time basis the proximity of the esophagus to an endocardial catheter during mapping, ablation or other endocardial catheter-based procedures, comprising an esophagus probe catheter and an endocardial catheter adapted for proximal signal transmission between each other. A signal processing unit is included to process and compare a characteristic of the proximity signal that is changes or attenuates with distance between the two catheters, such as impedance, amplitude and/or phase. Audio and/or optical outputs are provided to alert an operator when the distance between the catheters changes or is below a baseline measurement to avoid damage to the esophagus by the endocardial catheter. The system and method may include adaptations of the catheters with location sensor, and a mapping/navigational system for nonfluoroscopic location determination of the catheters.

Abstract: A lead system has an elongate body, an active fixation assembly movable relative to the elongate lead body, including a non-stationary electrode. The lead system further includes a non-stationary electrode member and an electrical interconnect electrically connected between the non-stationary electrode member and the stationary electrode member. The electrical interconnect provides a reliable electrical interconnection between the stationary electrode and the non-stationary electrode, while allowing the non-stationary electrode to move relative to the stationary electrode.

Abstract: A pacemaker is disclosed which reestablishes or keeps the physiological electric conduction of the heart and a method of application. The pacemaker is a pulse generator, it has a ventricular output including at least two superimposed monopolar pulsewaves of reversed polarity between each other, with programmable configuration, with respect to a neutral which can be the pacemaker's metallic box or a third electrode in the case of a tripolar catheter. The catheter can have a deflectable sheath, with an electrode on its distal tip. The invention consists of a new pacemaker, and a method of application in the right ventricular septum, being able to use in order to facilitate the implantation and to avoid the connection and the disconnection, a sheath to check a proper place and then screw the catheter in said place.

Abstract: Systems and methods for treating disc herniation include surgical and endoscopic access and removal of disc tissue. The tissue removal devices that may be used include flexible elongate members, such as a cable, that may be inserted into a vertebral disc and rotated to pulverize the disc material and facilitate its removal.

Abstract: An implantable medical system for detecting incipient edema has an implantable medical lead including an optical sensor having a light source and a light detector. The medical system further has an edema detection circuit that activates the light source to emit light, the light being directed into lung tissue of a patient and that obtains a light intensity value corresponding to an intensity of light received by the light detector, and that evaluates the light intensity value to detect a consistency with incipient edema.

Abstract: A method and apparatus for creating and accessing an anatomic space between a heart and a pericardial sac. The apparatus includes a catheter having a cryoadhesion member situated on the distal tip of the catheter. The cryoadhesion member is utilized to adhere to the pericardial sac and to retract the sac to create a tent like structure. The catheter allows introduction of an instrument to access the pericardial sac by puncture. The access to the pericardial sac allows delivery of a device, a drug, a biologic or other substance to the heart or the space around the heart.

Abstract: An implantable lead including a lead body including an outer surface, a proximal end, a distal end, and at least one electrode; an electrically insulating member that extends axially over a first portion of the outer surface of the lead body between the proximal end and distal end, the electrically insulating member defining at least one aperture that exposes a first portion of the at least one electrode when in a first position over the lead body; and a reinforcement member formed at least partially of a different material than the insulating member and coupled to the insulating member, the reinforcement member extending axially over the outer surface of the lead body between the insulating member and proximal end.

Abstract: A cardiac rhythm management system comprises a medical electrical lead, a pressure sensing element, and an implantable pulse generator. The lead is sized to be advanced through the right atrium and coronary sinus into a coronary vein adjacent to the left ventricle. The lead includes an opening intermediate its proximal and distal ends, and a lumen extending longitudinally within the body in communication with the opening. The pressure sensing element is movably disposed in lead lumen and is dimensioned to extend through the opening in the lead, and includes a flexible, elongated conductive member having a distal end, and a pressure transducer coupled to the distal end of the conductive member. The pulse generator is configured to receive cardiac rhythm signals from the electrode and fluid pressure signals from the pressure transducer.

Abstract: A transseptal cannula assembly for directing blood from the heart of a patient and a minimally invasive method of implanting the same. The transseptal cannula assembly includes a flexible cannula body having proximal and distal portions with a lumen therebetween, a tip coupled to the distal portion of the flexible cannula body, and first and second anchors coupled to the tip. The anchors can be configured to be deployed from a contracted state to an expanded state and are configured to engage opposite sides of the heart tissue when in the expanded state. The anchors resist movement of the cannula assembly along a lengthwise central axis of the flexible cannula body.

Abstract: An implantable lead for a medical device includes a lead body having a proximal end and a distal end, an electrical connector coupled to the proximal end of the lead body, an electrode coupled to the distal end of the lead body, and electrically conductive conductor coil extending between the proximal and the distal end of the lead body, the conductor coil wound in a first winding direction under tension. The lead body also includes a plastic ribbon wound around the conductor coil in a second winding direction opposite to the first winding direction without releasing the tension of the conductor coil.

Abstract: A multi-lead system includes a first lead and a second lead. The first lead includes a distal end and a first plurality of electrodes disposed along the distal end of the first lead. The first plurality of electrodes are configured and arranged in a first electrode axis. The second lead includes a distal end and a proximal end. A second plurality of electrodes is disposed along the distal end of the second lead. The second plurality of electrodes are configured and arranged in a second electrode axis. The second lead also includes at least one bend between the distal end and the proximal end to allow for linear alignment of the first electrode axis with the second electrode axis to form a combination electrode axis when the first lead and the second lead are implanted.

Abstract: A conductor assembly for a medical device lead includes a helically coiled conductor including a plurality of turns having a coil pitch and an outer diameter and consisting of one filar having a filar diameter. The coil pitch and outer diameter are selected based on the filar diameter to minimize heating of the helically coiled conductor in the presence of an MRI field. A polymer sheath is formed about the helically coiled conductor such that the coil pitch of the unifilar helically coiled conductor is maintained. The polymer sheath is configured to increase a torque transmitting capacity of the helically coiled conductor.

Abstract: The present application includes treatment systems having delivery-activated inflatable members, and associated systems and methods for treating the spinal cord and other tissues. A treatment system in accordance with one embodiment includes a lead body having an opening, an inner surface position around the opening, and an inflatable member carried by the lead body, with at least one of the inflatable member and the lead body including a frangible portion accessible from the opening. The inflatable member can have an expandable interior volume bounded at least in part by the frangible portion. The system can further include a delivery device received in the opening of the lead body and positioned to open a passage through the frangible portions between the interior volume of the inflatable member and the opening of the lead body when the delivery device is removed from the opening of the lead body.