Abstract: A transseptal guidewire and methods for perforating the intra-atrial septum of the heart are disclosed. The transseptal guidewire has an elongated body with an end section and a tapered distal section. At least a portion of the end section has a first dimension in a first direction transverse to a longitudinal axis of the elongated body. The first dimension is larger than a second dimension of the portion of the end section in a second direction transverse to the longitudinal axis.

Abstract: The invention is defined as a precurved coronary sinus guiding introducer for use in a cardiomyopathic heart comprising a flexible elongated member with a proximal and distal end. The elongated member comprises a generally straight, proximal portion and a precurved distal portion. In one embodiment the proximal portion and distal portion are formed to lie is a common plane. In another embodiment the portions are angulated with respect to each other in different planes. The precurved distal portion comprises at least one curved subportion and at least one curved or straight subportion. The precurved distal subportion curves through a generally circular arc away and is defined by a chord of predetermined length. The precurved distal subportion has a predetermined height above the chord. The curved or straight subportion is the distal section of the precurved distal portion.

Abstract: A class of introducers is comprised of a plurality of straight sections and at least two curved sections with a pre-determined sense of curvature preceded, separated and followed by the straight sections, which introducer is adapted by its shape to access the septal wall or apex of a heart. One of the plurality of straight sections is a distal-most straight section. The straight and curved sections define a predetermined three dimensional shape by means of the distal straight section lying out of plane with respect to the remaining curved and straight sections.

Abstract: An introducer system is used for implantation of pacemaker leads into the venous system of the human heart through the coronary sinus. The system is comprised of three telescopic components, an inner telescoping core, a precurved inner telescoping sheath, and an outer telescoping sheath, introducer, guide or catheter. In an embodiment where a core is used it is torsionally stiff. In an embodiment where no core is used, the inner sheath is torsionally stiff. In either case, the member which is torsionally stiff is torqueable. In general, the inner sheath and outer guide will be both laterally and torsionally flexible, while the core will be torsionally stiff. The core and inner sheath, when curved together in the venous system and proximally coupled, will be sufficiently bound to each other that proximal rotation of the core will be coupled to and cause distal rotation of the inner sheath.

Abstract: A sheath is composed of a biocompatible material which has a stiffness and moldability such that it can easily be deformed by hand by the physician prior to implantation, or by means of a guiding or shaping tool such as the dilator, stylet and or guide wire during placement within the body cavity. Similarly, it has a suppleness such that it may be molded by its disposition within the body cavity without trauma to the tissues. Yet, it has sufficient stiffness and moldability such that it retains a shape which has been imparted to it by a shaping tool when in the body cavity, even when left unsupported or unconfined in a body cavity or subject to normal bodily fluid, blood or air flow. However, once the shaping or forming tool has been removed, the sheath will tend to stay in its molded shape in a body cavity without generating a resilient force or displacement which returns it to its original shape.

Abstract: Reprogramming of implanted pacemakers is made more reliable and secure by utilizing a pad having an adhesive surface provided on its upper and lower contacting layers. In the illustrated embodiment, the pad is generally circular with a central circular hole. The pad is placed over the implanted pacemaker at a predetermined position utilizing the central aperture hole for alignment of the pad on the site of pacemaker implantation. An auxiliary cardiac device, such as a programming head, is then disposed on the upper adhesive of the circular pad. The shape of the pad inherently induces the medical technician to appropriately register the auxiliary device relative to the pacemaker. The double adhesive layers of the pad provide temporary affixation of the auxiliary device relative to the pacemaker during the reprogramming or other pacemaker manipulation so that inadvertent relative movement of the auxiliary device relative to the programmable pacemaker is avoided.

Abstract: A therapeutic device for providing cold treatments to cardiac pacemaker implantation patients is comprised of a bilobed chest pad having an elastic chest strap connected thereto. The chest strap is fixed at one end to the lower lobe of the chest pad and is wrapped around the torso of the patient under tension and temporarily is coupled to the opposing portion of the lower lobe of the chest pad. The cold compress, which is placed behind the chest pad over the incision site, is thereby firmly kept in contact with the incision site. A shoulder strap is slidingly coupled at one end to the chest strap and is positioned on the back of the patient and wrapped under tension behind the back and over the shoulder of the patient, which shoulder is adjacent to the incision site. The end of the shoulder strap is then temporarily coupled to the upper lobe of the chest pad.