Abstract: Various aspects of the present disclosure are directed towards apparatuses, systems and methods that may include a cardiac ablation catheter. The cardiac ablation catheter may include a handle, an elongated shaft, and a distal assembly including a tip electrode, a ring electrode, and an insulator preform.

Abstract: A retention device for use with an implantable medical device (IMD) may comprise an elongate body including a configured to receive the lead of the IMD. The retention device may also include securing mechanisms coupled to the elongate body and configured to push against tissue of a patient. The securing mechanisms may also include linking elements coupled to the elongate body and a portion of the securing mechanisms.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include an implantable lead having a terminal pin, a conductor member configured to rotate in response to rotation of the terminal pin and a coupler arranged within configured to interface with the conductor member and having a rear bearing surface contacting the inner wall of a housing.

Abstract: An implantable medical electrical lead connectable to an electrical header of an implantable medical device includes a lead body extending from a proximal end to a distal end, a lead terminal disposed at the proximal end of the lead body and configured to couple the lead to the electrical header, and a lead boot disposed at the lead terminal. The lead boot includes a strain relief portion and a seal portion. The strain relief portion is formed of a first elastic polymer and the seal portion is formed of a second elastic polymer. The first elastic polymer is different from the second elastic polymer.

Abstract: A catheter for delivering a medical electrical lead to a bundle of His from within a right atrium of a heart. The catheter includes a straight portion and a hook portion projecting from a distal end of the straight portion. The hook portion includes a first curved portion, a second curved portion, and a third curved portion. The straight portion and the first curved portion define a plane. The second curved portion extends from a distal end of the first curved portion. The second curved portion curves away from the plane. The third curved portion extends from a distal end of the second curved portion. The third curved portion curves toward the plane. The catheter forms a lumen extending from a proximal end of the straight portion to an opening at a distal end of the third curved portion.

Abstract: Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Abstract: Various aspects of the present disclosure are directed towards apparatuses, systems and methods that may include an electroporation ablation device. The electroporation ablation device may include a shaft defining a longitudinal axis and an electrode assembly including a first pair of electrodes having a first electrode and a second electrode, and a second pair of electrodes disposed adjacent to the first pair of electrodes and having a third and a fourth electrode. In some embodiments, the first electrode has a first edge portion, and a first side view of the first edge portion along the longitudinal axis is rounded at a first corner.

Abstract: A catheter for delivering a medical electrical lead to a bundle of His from within a right atrium of a heart. The catheter includes a straight portion and a hook portion projecting from a distal end of the straight portion. The hook portion includes a first curved portion, a second curved portion, and a third curved portion. The straight portion and the first curved portion define a plane. The second curved portion extends from a distal end of the first curved portion. The second curved portion curves away from the plane. The third curved portion extends from a distal end of the second curved portion. The third curved portion curves toward the plane. The catheter forms a lumen extending from a proximal end of the straight portion to an opening at a distal end of the third curved portion.

Abstract: A terminal tool includes a main body, an electrical connector body, and an electrical connector. The main body includes a distal clamping section and a shaft. The shaft includes a window and a first lumen extending through the shaft for receiving a terminal end of an implantable lead. The electrical connector body includes a second lumen and is independently rotatable with respect to the main body. The shaft at least partially extends through the second lumen. The electrical connector is coupled to the electrical connector body and extends at least partially through the window of the shaft.

Abstract: Methods and tool kits for implanting a lead subcutaneously. Examples include tool kits and methods for establishing first and second subcutaneous tunnels at an angle relative to one another to facilitate introduction of a lead to the subcutaneous space. In an example, a tunneling tool and lead assembly are advanced simultaneously into the subcutaneous space. The tunneling tool may include a curved region configured to transition the tool from the first subcutaneous tunnel to the second subcutaneous tunnel with the use of a single incision.

Abstract: A retention device for use with an implantable medical device (IMD) are disclosed. An illustrative retention device may comprise an elongate body including a configured to receive the lead of the IMD. The retention device may also include securing mechanisms coupled to the elongate body and configured to push against tissue of a patient. The securing mechanisms may also include linking elements coupled to the elongate body and a portion of the securing mechanisms.

Abstract: An illustrative anchoring mechanism is provided for attachment to an implantable subcutaneous lead to facilitate anchoring at the distal tip of the lead. The anchoring mechanism is attached to an opening in a distal portion of a subcutaneous lead prior to implantation. The anchoring mechanism may be designed to avoid covering the sensing electrode of the subcutaneous lead, to prevent interference with sensing. Use of such an apparatus may reduce the number of incisions needed to perform implantation.

Abstract: Disclosed herein are apparatus, systems, and methods for ablating tissue in a patient by electroporation. Embodiments generally include an ablation catheter having a hand, a shaft, and an electroporation electrode arrangement. The shaft has a distal end and defines a longitudinal axis of the ablation catheter. The electroporation electrode arrangement is at the distal end of the shaft and is configured to generate a multidirectional electric field when at least one pulse sequence is delivered thereto. The multidirectional electric field includes at least two of the following directions relative to the longitudinal axis: generally axial, circumferential, and transverse. The electroporation electrode arrangement is configured to operatively couple to an electroporation generator that is configured to generate the at least one pulse sequence and is configured to receive the at least one pulse sequence from the electroporation generator.

Abstract: A catheter for focal cardiac ablation by irreversible electroporation includes a flexible catheter body, a plurality of tines disposed at a distal end of the catheter body, a flexible shaft, a return electrode, and an electrical conductor. The plurality of tines are formed of an electrically conductive material and configured to deploy from a lumen at the distal end of the catheter body. Each tine of the plurality of tines is configured to self-bias from a linear configuration within the lumen to a curved configuration when deployed from the lumen. The shaft is mechanically and electrically coupled to the plurality of tines. The shaft is configured to deploy the tines from the lumen when the shaft is moved toward the distal end of the catheter body. The return electrode is disposed on an outer surface of the catheter body. The electrical conductor is electrically coupled to the return electrode.

Abstract: Retention devices for use with an implantable medical device (IMD) are disclosed. An illustrative retention device may comprise an elongate body including a hollow lumen configured to receive a lead of the IMD and an outer surface configured to receive a suture. The retention device may also include a securing mechanism configured to push against tissue of a patient.

Abstract: A subcutaneous implantable cardioverter-defibrillator (S-ICD) comprising shocking electrodes configured to reduce the defibrillation threshold. The S-ICD may include a canister housing a source of electrical energy, a capacitor, and operational circuitry that senses heart rhythms and an electrode and lead assembly. The electrode and lead assembly may comprise a lead, at least one sensing electrode, and at least one shocking electrode. The at least one shocking electrode may extend over a length in the range of 50 to 110 millimeters and a width in the range of 1 to 40 millimeters.

Abstract: A retention device for use with an implantable medical device (IMD) are disclosed. An illustrative retention device may comprise an elongate body including a configured to receive the lead of the IMD. The retention device may also include securing mechanisms coupled to the elongate body and configured to push against tissue of a patient. The securing mechanisms may also include linking elements coupled to the elongate body and a portion of the securing mechanisms.

Abstract: A system for ablation by electroporation including a catheter having electrodes, a display, and a controller. The controller is to generate, based on models of electric fields, graphical representations of the electric fields that can be produced using the electrodes, and overlay, on the display, the graphical representations of the electric fields and an anatomical map of a patient to aid in planning the ablation by electroporation, prior to delivering energy.

Abstract: Retainer devices and methods are configured for securing medical devices subcutaneously in a patient. The retainer device may include first and second arms connected by a bridge, the retainer clip configured to move between a first orientation in which lower surfaces of the first and second arms face each other, and a second orientation in which the first and second arms extend laterally from opposite sides of the bridge, wherein the clip is biased in the second orientation. Another example includes a coil and delivery device in which the delivery device holds the coil in a general straight configuration until release; when released the coil wraps about a medical device and holds the device to the subcutaneous tissue.

Abstract: Retention devices for use with an implantable medical device (IMD) are disclosed. An illustrative retention device may comprise an elongate body including a bore configured to receive and substantially surround an implantable lead of the IMD and an outer surface configured to receive a suture. The retention device may also include a securing mechanism configured to push against tissue of the patient.