Abstract: A transvenous lead system for cardiac stimulation with a pacemaker or implantable defibrillator having automatic activation of a passive fixation system. The lead includes an insulative lead body such as silicone rubber and has a proximal end with a connector for coupling the lead to the pacemaker or defibrillator. At least one conductor extends through the lead body for connection to a lead electrode. The lead further includes a plurality of flexible tines. In a first position, the tines are folded back along the lead body and exhibit a minimal profile. A hydrophilic material such as a hydrogel is disposed on the under side of each tine either as part of the tine or between the tine and the lead body. Upon exposure to body fluids when the lead is implanted, the hydrogel absorbs liquid and expands. This expansion forces the tines into a second, deployed position where the tines can engage trabeculae of the heart chambers to anchor the lead in place.

Abstract: An implantable defibrillator lead comprises a flexible core onto which is wound helically wound coils to form an electrode. These electrode coils are partially encapsulated by a flexible matrix which holds them in their wrapped position around the core. Due to its coiled coil structure, this electrode provides improved flexibility, and can be used endocardially, intravascularly, epicardially, or subcutaneously. The electrode may function alternately as a defibrillation electrode and as a sensing electrode in a lead with a separate pacing electrode.

Abstract: A defibrillator having a housing for enclosing and containing defibrillation pulse generator circuitry, particularly adapted to allow for ease of manufacture and use. At least one surface of the housing is electrically conductive and connected to the defibrillation pulse generator circuitry for delivering defibrillating energy to the heart. The defibrillator is provided with a case-activating lead connector cavity having two isolated conductive elements. By tightening a first setscrew onto a lead connector pin, an electrode of the lead becomes active. Tightening a second setscrew activates the can. Tightening both setscrews onto a plug pin activates the can alone. To use neither a lead in the case-activating port, nor an active can, only one setscrew may be tightened onto a conductive or nonconductive pin to plug the cavity without activating the can. By using this system, various electrode configurations can be used as required to provide the optimum system for a given patient.

Abstract: An implantable defibrillator lead having an improved integrated bipolar defibrillation electrode is disclosed. The defibrillation electrode is electrically connected to the lead conductor at the distal end, and has an increased surface area portion at the distal end, for bipolar sensing with a right ventricular pacing electrode.

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: A defibrillation insulating device insulates the heart from the body. This forces 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.

Abstract: A body implantable electrode with rate controlled drug delivery is disclosed. A body implantable lead is provided for the delivery of stimulation energy to a desired body site includes a drug dispenser carried by the lead which retains a drug to be dispensed at least adjacent the desired body stimulation site. The drug may be one which is intended to counter thrombus formation, fibrosis, inflammation or arrhythmias, for example. The drug may be in liquid or powder form retained in a reservoir carried by the lead. The reservoir is formed as a pump which controls dispensing of the drug using a fluid drawing agent such as a salt.

Abstract: A method for electrically attaching electrode wire to a conductor in a defibrillation lead is disclosed. The method comprises melting the end of the wire with a hydrogen torch to form a ball of metal, then crimping or welding the ball to the conductor or to a joining piece attached to the conductor. Also, a hydrogen torch (water welder) may be used to join two or more electrode wires to each other.

Abstract: A terminal for detachably connecting an electrical lead connector pin to an electrical device is disclosed. The terminal includes an outer sleeve and a movable collet for movement between first and second positions relative to the outer sleeve. The collet has a plurality of fingers thereon that are movable relatively toward and away from one another between a first spaced apart position less than the diameter of the electrical lead connector pin and a second spaced apart position greater than the diameter of the electrical lead connector pin for receiving and releasing the lead in the second spaced apart position and for gripping the lead in the first spaced apart position. The terminal further includes a spring and a push button release means for moving the collet between its first and second positions.

Abstract: An implantable lead conductor comprises at least one helical coil formed from at least one electrical cable. Each cable is formed from several wires twisted in a ropelike configuration with at least some of the wires being helically wound around a central axis of the cable. Each wire is a composite comprising a core of a first material and a coveting of a second material, with all adjacent wires belonging to the same cable in uninsulated contact with each other. Preferably, the core material is highly conductive, and the covering material is strong and biocompatible. The helical coil has a lumen for insertion of a stylet to facilitate insertion through a vein.

Abstract: A lead system for use with an implantable cardioverter/defibrillator is disclosed. The lead system includes a fixation hook positioned approximately half-way between the distal tip of the lead and the tricuspid valve. The distal tip of the lead is positioned at the apex of the right ventricle and may or may not be secured there by a second fixation means such as a screw tip or tines. The fixation hook allows the defibrillation electrode to be accurately positioned by the patient's surgeon and maintained in contact with the septum wall of the patient's heart. By providing such intimate contact between the defibrillation electrode and the septum wall, defibrillation thresholds are reduced.

Abstract: A lead for use with an implantable cardioverter/defibrillator system is disclosed. In the preferred embodiment, the lead combines a right ventricular endocardial electrode, a superior vena cava electrode and one or more atrial sensing electrodes on a single catheter lead. The distal end of the lead is transvenously implanted, typically through an incision in the cephalic or subclavian vein. The proximal end of the lead is then tunneled below the fascia to the location of the pulse generator. Ventricular sensing and/or pacing electrode(s) may also be included at the distal end of the combined lead to provide ventricular intracardiac electrogram sensing and bradycardia pacing.

Abstract: An implantable defibrillator lead comprises a flexible core onto which is wound helically wound coils to form an electrode. These electrode coils are partially encapsulated by a flexible matrix which holds them in their wrapped position around the core. Due to its coiled coil structure, this electrode provides improved flexibility, and can be used endocardially, intravascularly, epicardially, or subcutaneously. The electrode may function alternately as a defibrillation electrode and as a sensing electrode in a lead with a separate pacing electrode.

Abstract: An electronic connector pin adapter comprises a forward connector pin portion and a rear end portion. The rear end portion comprises a plurality of longitudinally extending retaining fingers carried in electrically connected relation with the connector pin portion and spaced about an open bore for connecting with and retaining an electronic connector pin, typically of different dimension from that of the forward connector pin portion.

Abstract: An implantable cardiac therapy device collects patient ECG and device status information, including cardiac event interval information, why therapy was or was not applied, and patient response to therapy, in connection with an arrhythmic episode and correlates such information in a data frame that may be stored for later telemetric transmission to an external instrument or that may be transmitted in real time to the external instrument. The data frame is decoded by the external instrument for presentation to an attending physician in a time correlated format.

Abstract: An implantable cardiac defibrillation lead is provided in which surface modification and deposition techniques are utilized to provide improved electrical and mechanical characteristics. The surface of an electrode can thereby be matched to the heart tissue for biocompatibility while at the same time providing for the appropriate electrical and mechanical characteristics of the electrode material.

Abstract: An improved endocardial lead for electrocardial stimulation includes a sleeve that has a face surface. A conductor fitted into the sleeve, such that a distal end of the conductor passes completely through the sleeve, past the face surface, is electrically and mechanically connected to the face surface of the sleeve by mechanical means, e.g. crimping, and/or through the application of heat, e.g. welding or brazing. An electrode is integrated with the sleeve along an outer sleeve surface. A highly reliable, redundant joint is thereby provided between the sleeve and the conductor that secures the conductor against movement and therefore minimizes stress placed on the conductor, preventing fatigue to the conductor at the joint.