Abstract: This invention relates to implantable heart sack that can be equipped with pacemaker leads and/or defibrillation leads for the treatment of cardiomyopathy, hypertrophic cardiomyopathy, tachycardia, bradycardia, ventricular fibrillation, atrial fibrillation etc. The heart sack was prepared from biocompatible, biostable, implantable polyetherurethane, polycarbonateurethane, silicone, polysiloxaneurethane, polyfluoroethylene, or hydrogenated poly(styrene-butadiene) copolymer. The heart sack is equipped with attached sutures to make it easier to attach onto the heart. The heart sack can be made semipermeable or perforated to have numerous holes. The heart sack can be reinforced with fiber or filament. Ordinary pacemaker leads can be attached to the inner side of the heart sack.

Abstract: Epicardial electrode lead (1) for minimally invasive implantation and anchoring to the epicardium, with an elongated supply lead (3) and an electrode head (5) distally attached thereto and substantially concentric therewith, wherein the electrode head comprises a fixation-hook section (7.1) that projects beyond its outer surface and is oriented substantially tangential to the electrode head, at an acute angle.

Abstract: A device for treating cardiac disease of a heart includes a jacket of flexible material defining a volume between an open upper end and a lower end. The jacket is dimensioned for an apex of the heart to be inserted into the volume through the open upper end and for the jacket to be slipped over the heart. The jacket is adapted to be secured to the heart with the jacket having portions disposed on opposite sides of the heart. The jacket is adjustable to snugly conform to an external geometry of the heart and to constrain circumferential expansion of the heart during diastole and permit substantially unimpeded contraction of the heart during systole. A first and a second grid of electrodes are carried on the jacket. The grids are disposed to be in overlying relation to individual ones of the opposite sides of the heart when the jacket is secured to the heart. The first and second grids are connectable to a source of a defibrillating waveform.

Abstract: A device for treating cardiac disease is provided. The device includes biologically compatible material, an electrotherapy instrument, and a placement apparatus capable of capable of releasably securing a lead of the electrotherapy instrument to the biologically compatible material. In one embodiment, the biologically compatible material is a patch that is configured to be secured to the epicardial surface of the heart. In an alternate embodiment, the biologically compatible material is constructed as a jacket of flexible material designed to be secured to the heart. Examples of electrotherapy instruments include a cardiac pacing device and a defibrillating device.

Abstract: A temporary cardiac electrical stimulating lead is disclosed having a stimulating electrode mounted in or on an electrode mounting pad disposed at a distal end of the lead, the pad having a biodegradable adhesive disposed thereon and/or therewithin. The adhesive, and preferably also the electrode mounting pad, are capable of biodegradably dissolving over time in human body fluids. The adhesive permits the electrode mounting pad to be attached to a patient's epicardium without the use of sutures, or with fewer sutures than have heretofore been required to suitably affix an electrode mounting pad to a patient's heart. In a preferred embodiment, when the lead body is pulled away from the electrode mounting pad and removed from a patient, any portion of the electrode mounting pad and the adhesive remaining within the patient dissolves over time and disappears.

Abstract: There is provided in one aspect of the present invention an assembly for subcutaneous implantation in a patient including a lead electrode assembly having an opening and an introducer disposed within the opening of the housing. Another aspect of the invention is an extractor for extracting a lead electrode assembly subcutaneously implanted in a patient, including an insertion portion for insertion into an opening in the lead electrode assembly, and a handle assembly connected to the insertion portion.

Abstract: An apparatus and method for Cardiac Resuscitation of an arrested heart, for Percutaneous Internal Direct Epicardial Defibrillation, Cardioversion and Pacing with electrodes placeable directly into the chest cavity onto the epicardium via a device entering the chest in a specific area of the anterior chest wall via blunt dissection rapidly creating a passage of negligible size in the chest wall for the introduction of the electrodes, without the need for thoracotomy or for sternotomy and without requiring the use of sharp surgical instruments and without causing pneumothorax. Due to its rapidity of implementation, its safety and simplicity of application, the device can be used by Paramedics in the field at the scene of a cardiac arrest, where the resuscitation efforts are more likely to succeed, for internal direct epicardial defibrillation, cardioversion and pacing.

Abstract: A temporary cardiac electrical stimulating lead comprises a stimulating electrode mounted in or on a biodegradable electrode mounting pad disposed at a distal end of the lead. The electrode mounting pad is capable of biodegradably dissolving over time in human body fluids and is loaded with a drug for therapeutically treating a medical condition of a patient's heart. The electrode mounting pad may be loaded with any of a variety of different drugs, such anti-arrhythmia or anti-inflammatory drugs. When the lead body is pulled away from the electrode mounting pad and removed from the patient, any portion of the electrode mounting pad remaining within the patient dissolves over time and disappears.

Abstract: One embodiment of the present invention provides a lead electrode assembly for subcutaneous implantation including an electrode; a riser coupled to the electrode; and a head coupled to the riser.

Abstract: A medical device, and related method, use epicardial ablators and detectors for intraoperative epicardial approaches to ablation therapy of cardiac conduction pathways. An epicardial gripper is sized to grasp the cardiac circumference or smaller structures on the epicardial surface of the heart. Ablators are disposed on the arms of the gripper for epicardial ablation of cardiac conduction tissue. In another embodiment of the invention, an electrode system includes a flexible, adjustable probe forming a loop for epicardial ablation. Ablators are provided on one or multiple surfaces of the probe for epicardial ablation of cardiac conduction tissue. In yet another embodiment of the invention, an endocardial ablator detection system provides an indicator adjacent an ablator on an endocardial catheter, and a detector on an epicardial probe.

Abstract: An electrode device intended for medical equipment and arranged to be attached to a tissue of a body part of a patient, the electrode device including a clamping member, wherein the clamping member also includes a relatively thin metal sheet to be brought into an electrical connection with the body part, and is also configured and arranged to connect an electric conductive cable member to the clamping member for establishing an electric connection with the medical equipment, the connection being provided in such a way that the cable member is releasably connected to the clamping member, wherein the metal sheet forms a clip, which is arranged to be clamped to the body part by plastic deformation of the metal sheet without extending through the tissue and in such a way that electric signals are transferable between the medical equipment and the body part.

Abstract: A temporary cardiac electrical stimulating lead is disclosed where the lead body thereof may be removed from inside a patient through the application of a simple pulling force exerted on its proximal end. An electrode mounting pad is located at the distal end of the lead and has a stimulating electrode mounted thereon or therein. A distal end of the electrical conductor may serve as the stimulating electrode. The electrode mounting pad is preferably capable of biodegradably dissolving or otherwise dissociating over time in human body fluids. Thus, the lead body may be detached from the electrode mounting pad through the application of a simple pulling force and removed from the patient while the electrode mounting pad remains within the patient and dissolves or otherwise dissociates over time.

Abstract: An epicardial pacer wires shield comprising a base element with a pair of spools mounted to the base element. Each of spool of the pair of spools has a slit in a top surface thereof for securing the epicardial pacer wires to the spool. A cover element is configured to be secured to the base element, and has an adhesive layer on a back surface. A tab is mounted on an edge of the cover element for removing the cover element from the base element when the cover element and base element are secured together.

Abstract: A pacing electrode arrangement for stimulating the heart by means of an implantable pacemaker, comprising a first pacing electrode arranged in the vena cava superior and a second pacing electrode arranged in either the atrium, or a blood vessel near the heart other than the vena cava superior, or arranged at a distance from the heart, whereby the first and the second pacing electrode essentially enclose between them a predetermined, central region of the cardiac stimulus generating and conduction system.

Abstract: A device for treating cardiac disease of a heart includes a jacket of flexible material defining a volume between an open upper end and a lower end. The jacket is dimensioned for an apex of the heart to be inserted into the volume through the open upper end and for the jacket to be slipped over the heart. The jacket is adapted to be secured to the heart with the jacket having portions disposed on opposite sides of the heart. The jacket is adjustable to snugly conform to an external geometry of the heart and to constrain circumferential expansion of the heart during diastole and permit substantially unimpeded contraction of the heart during systole. A first and a second grid of electrodes are carried on the jacket. The grids are disposed to be in overlying relation to individual ones of the opposite sides of the heart when the jacket is secured to the heart. The first and second grids are connectable to a source of a defibrillating waveform.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: Apparatus and method for the treatment of congestive heart failure are disclosed that utilize a cuff that surrounds the heart and constrains cardiac dilation, while electrodes embedded in the cuff stimulate the myocardium to contractile function. An EKG signal can be processed to create an optimal pattern of selective stimulation of different areas of the heart at different times. An implantable circuit contains a power source and stimulation circuits. In some embodiments, a telemetry unit and an EKG collection circuit are also included. In accordance with the present disclosure, cuff limits the dilation of the heart and the stimulation electrodes enhance ventricular function by optimizing ventricular contractility.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is proved with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by he body of the pacemaker.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: An apparatus and method for Cardiac Resuscitation of an arrested heart, for Percutaneous Internal Direct Epicardial Defibrillation, Cardioversion and Pacing with electrodes placeable directly into the chest cavity onto the epicardium via a device entering the chest in a specific area of the anterior chest wall via blunt dissection rapidly creating a passage of negligible size in the chest wall for the introduction of the electrodes, without the need for thoracotomy or for sternotomy and without requiring the use of sharp surgical instruments and without causing pneumothorax. Due to its rapidity of implementation, its safety and simplicity of application, the device can be used by Paramedics in the field at the scene of a cardiac arrest, where the resuscitation efforts are more likely to succeed, for internal direct epicardial defibrillation, cardioversion and pacing.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: The defibrillation electrode is intended for a temporary and epicardial use after heart operations. For the purpose of local stimulation of the surface of the heart the electrode comprises at its distal end a wire having a distal end which can be drawn out of an anchoring position. The stimulation wire or a plurality of stimulation wires is or are preformed in such a manner that it or they fractally covers or cover a global surface of influence largely uniformly and with relatively large radii of curvature. The surface of influence has a largely iso-diametral form.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: Methods and apparatus for thoracoscopic defibrillation of a patient's heart. The technique involves introducing a first electrode (10) through a percutaneous intercostal penetration, positioning the first electrode against the heart surface (H) and positioning a second electrode (10') against the patient's body. A voltage is then applied through the percutaneous intercostal penetration to the first electrode and to a second electrode to deliver electrical energy to the first electrode, through at least a portion of the patient's heart, and to the second electrode. The electrical energy applies an electric charge to the patient's heart to defibrillate the heart muscle or restart the heart during, for example, cardiac procedures that involve arresting the heart.

Abstract: The invention includes an implantable epicardial defibrillator lead with a linear assembly of sensors and coils that is formed into a loop upon implanting in a patient and a method for implanting this lead on a diaphragmatic surface of the pericardium.

Abstract: A temporary atrial defibrillation lead featuring a pad fashioned of a pliant biocompatible material in which three parallel stainless steel defibrillation wire electrodes are mounted. The pad contains holes which expose the electrode wires in a discontinuous fashion. The three electrode wires are merged into one polyurethane insulated lead body, proximal to the pad. At the proximal end of the lead body a stainless steel connector pin with break away needle is mounted, for percutaneous exteriorization of the lead pin, in an area separated from the surgical incision. The break away needle can be broken off to make the connector pin suitable to patient cable connection. The pad is permanently implanted on the atria and remains implanted after removal of the temporary electrode sections. The temporary electrode sections may be removed by gently pulling them at their proximal end. In a preferred embodiment the pad is fashioned of PTFE felt.

Abstract: An electrode terminal is described for delivering a stimulation pulse to the heart or other tissues containing a linear array of fibers. The electrode terminal is elongated and adapted for orientation in a direction parallel to the tissue fibers. The device of the present invention further includes a power source for electrically energizing the terminal such that the energization of the terminal reduces the nonuniformity of the transmembrane voltage change in the tissue proximate the electrode which is produced during the stimulation pulse. Nonuniform transmembrane voltage changes are associated with arrhythmic conditions. The linear electrode of the present invention can be used for cardiac pacing, defibrillation, and the termination of tachycardia.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is proved with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by he body of the pacemaker.

Abstract: A post-surgical atrial cardioverting, atrial pacing, and ventricular pacing system and lead system provides for cardioverting the atria, pacing the atria, and/or pacing the ventricles of the heart of a post-surgical heart patient. The system includes a first lead and a second lead providing a pair of atrial cardioverting electrodes, an atrial pacing electrode, and a ventricular pacing electrode. The electrodes are electrically isolated from each other. The system further includes at least one anchor releasably disposing the electrodes beneath the skin of the patient with each atrial cardioverting electrode electrically contacting a respective given one of the atria, the atrial pacing electrode electrically contacting one of the atria, and the ventricular pacing electrode electrically contacting a ventricle.

Abstract: A temporary atrial defibrillation lead featuring a polytetraflouroethylene ("TEFLON") felt pad in which three parallel stainless steel defibrillation wire electrodes are mounted. The pad contains holes which expose the electrode wires in a discontinuous fashion. The three electrode wires are merged into one polyurethane insulated lead body, proximal to the pad. At the proximal end of the lead body a stainless steel connector pin with break away needle are mounted, for percutaneous exteriorization of the lead pin, in an area separated from the surgical incision. The break away needle can be broken off to make the connector pin suitable to patient cable connection. The polytetraflouroethylene ("TEFLON") pad is permanently implanted on the atria and remains implanted after removal of the temporary electrode sections. The temporary electrode sections may be removed by gently pulling them at their proximal end.

Abstract: A method of rolling a defibrillator electrode inserts one side of a defibrillator electrode within a recess of a first handle, the recess located at one end of the first handle, inserts an opposite side of the defibrillator electrode within a recess of a second handle, the recess located at one end of the second handle, wherein the first and second handles are then rotated toward each other about their respective axes. An apparatus for rolling a defibrillator electrode includes a first handle having a recess at one of its ends operative to slidably grasp one side of a defibrillator electrode, and a second handle, the second handle having a recess at one of its ends operative to slidably grasp an opposite side of the defibrillator electrode.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: An implantable defibrillation system with an intercardial or subcutaneous defibrillation electrode is provided wherein the defibrillation electrode includes portions with a porous surface coating having an active surface area substantially larger than a surface area resulting from the basic geometrical shape of the electrode.

Abstract: Improved implantable defibrillator electrodes and methods of implanting such electrodes are disclosed. One embodiment of the defibrillator electrodes includes a flexible conductive mesh and non-conductive mesh. Another embodiment of the defibrillator electrodes includes a flexible conductive mesh, a non-conductive mesh and an insulator therebetween. A third embodiment of the defibrillator electrode compensates for the shape of a human heart.Methods for implanting the defibrillator electrodes include rolling an electrode and inserting the rolled electrode into a subxiphoid opening while thorascopically observing the insertion and manipulation of the defibrillator electrode.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: A pacemaker system adapted to deliver pacing pulses in the presence of fibrillation. The pacing pulses are delivered via large surface area electrodes of the type normally used to accomplish defibrillation or cardioversion using high voltage pulses. An extended pulse train is delivered in order to gradually entrain greater portions of heart tissue, until a sufficient percentage of tissue is entrained to interrupt fibrillation. The invention is believed most applicable to treatment of atrial fibrillation.

Abstract: In an implantable defibrillator electrode having a large surfaced electrode in the form of a netting, a spiral, or a fabric of electronically conductive material or having an intracardial electrode in the form of a coil of electronically conductive material, the electrode is completely embedded in a biocompatible, hydrophilic, electrolytically conductive polymer or is covered by such a polymer.

Abstract: Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart.

Abstract: A temporary atrial defibrillation lead featuring a polytetraflouroethylene ("TEFLON") felt pad in which three parallel stainless steel defibrillation wire electrodes are mounted. The pad contains holes which expose the electrode wires in a discontinuous fashion. The three electrode wires are merged into one polyurethane insulated lead body, proximal to the pad. At the proximal end of the lead body a stainless steel connector pin with break away needle are mounted, for percutaneous exteriorization of the lead pin, in an area separated from the surgical incision. The break away needle can be broken off to make the connector pin suitable to patient cable connection. The (polytetraflouroethylene ("TEFLON") pad is permanently implanted on the atria and remains implanted after removal of the temporary electrode sections. The temporary electrode sections may be removed by gently pulling them at their proximal end.

Abstract: A joint for cardiac stimulation lead has a sleeve that joins a conductor to an electrode. The conductor and electrode are inserted into passages formed through the sleeve and are bonded at least to the sleeve surface by laser welding, crimping, or resistance welding. The distal end of the conductor is attached to the sleeve and either the proximal end or the distal end of the electrode may be attached to the sleeve. The number, size, shape and positioning of passages in the sleeve are varied according to the desired lead configuration to allow passage of additional conductors through the joint.

Abstract: An epicardial defibrillation electrode having a wide insulating border which insulates the heart from the body is disclosed. The wide insulating border forces defibrillation current to flow through the heart without passing through surrounding tissues, thus increasing the current density throughout the heart, to depolarize the majority of the cardiac tissue with a minimum of energy. By increasing defibrillation efficacy in this way, the conductive surface area of each electrode can be decreased, thus allowing room for implantation of a plurality of conductive electrode portions for controlling energy delivery to the heart both spatially and temporally.

Abstract: Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

Abstract: A chronic myocardial pacing lead for the delivery of stimulation energy to and the sensing of electrical signals from the myocardium of a human heart. In one embodiment the lead is bipolar, having a sleeve electrode implanted into the myocardium and a pad electrode positioned on the epicardium. The lead includes a drug for delivery through the sleeve electrode to the myocardium. The disclosed lead is highly flexible to minimize tissue reaction, this permits the lead to offer relatively low pacing thresholds, high impedance, and excellent sensing in a configuration which is relatively easy to implant.

Abstract: An intelligent patch electrode having a plurality of sensor electrodes for use with an implantable defibrillator. The sensor electrodes are disposed in an array and connected to a microcircuit to sense a depolarization wave as it propagates through the ventricular tissue. The timing, direction of propagation, and point of initiation of successive depolarization waves can also be monitored.

Abstract: Improved implantable defibrillator electrodes and methods of implanting such electrodes are disclosed. One embodiment of the defibrillator electrodes includes a flexible conductive mesh and non-conductive mesh. Another embodiment of the defibrillator electrodes includes a flexible conductive mesh, a non-conductive mesh and an insulator therebetween. A third embodiment of the defibrillator electrode compensates for the shape of a human heart. Methods for implanting the defibrillator electrodes include rolling an electrode and inserting the rolled electrode into a subxiphoid opening while thorascopically observing the insertion and manipulation of the defibrillator electrode.

Abstract: A defibrillation pulse generator and lead system particularly adapted to allow for implant in a single incision and subcutaneous pocket. The electrode system consists of a right ventricular electrode and a combined, subcutaneously implanted pulse generator housing and flexible periprerally extending electrode. The flexible electrode extends in a generally co-planar relation with respect to the major surfaces of the device housing and may comprise a plurality of electrode segments electrically connected in common with the device housing and distributed over a flexible electrode pad.

Abstract: An electrical lead has a cardioverting/defibrillating electrode composed of a multiplicity of tiny flexible elongate metallic fibers, for implantation in a patient. One embodiment of the lead is implanted by puncturing the chest/abdominal wall of the patient and inserting the lead, fiber electrode first, into the body through the puncture site followed by maneuvering the lead by endoscopy to position the electrode adjacent the epicardium of the heart for electrical interaction with the ventricles. The fibers may be interwoven to form a thin tube prestressed to assume a flat spiral shape to permit it to be straightened with a stiffening wire for maneuvering to return to its flat spiral shape after proper positioning and removal of the wire. In other embodiments, the lead has multiple conductors electrically connected to respective electrodes arranged on the lead for positioning transvenously relative to selected regions of the heart.