Abstract: A delivery system and method for delivering a right ventricular lead into a right ventricle includes a delivery device having an inflatable balloon at a distal end. The device is inserted into the venous system, the balloon is inflated and the device is floated along a blood flow path within the venous system through the heart and into the pulmonary artery. The lead is delivered into the right ventricle using the device. In one embodiment, the device is a catheter that facilitates placement of a guide wire into the right ventricle for delivery of the lead. The catheter is then removed and the lead is inserted into the right ventricle over the guide wire.

Abstract: A medical electrical lead adapted to be at least partially implanted in a cardiac vessel includes a fixation feature operable to change from an undeployed configuration to a deployed configuration in which the fixation feature is adapted to engage an inner surface of the cardiac vessel. A tendon is disposed within a lumen of the lead and is operatively connected to the fixation feature and adapted to cause the fixation feature to change from the undeployed configuration to the deployed configuration for acute and/or chronic fixation of the lead. In one embodiment, the fixation feature includes a deflectable region of the lead which in the deployed configuration causes a surface of the lead body to engage the inner surface of the cardiac vessel. In another embodiment, the fixation feature includes a radially expandable structure for engaging the inner surface of the vessel in the deployed configuration.

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: A medical electrical lead adapted to be at least partially implanted in a cardiac vessel includes a fixation feature operable to change from an undeployed configuration to a deployed configuration in which the fixation feature is adapted to engage an inner surface of the cardiac vessel. A tendon is disposed within a lumen of the lead and is operatively connected to the fixation feature and adapted to cause the fixation feature to change from the undeployed configuration to the deployed configuration for acute and/or chronic fixation of the lead. In one embodiment, the fixation feature includes a deflectable region of the lead which in the deployed configuration causes a surface of the lead body to engage the inner surface of the cardiac vessel. In another embodiment, the fixation feature includes a radially expandable structure for engaging the inner surface of the vessel in the deployed configuration.

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 apparatus includes a lead body extending from a proximal end to a distal end and having an intermediate portion therebetween. The lead body includes two or more individually insulated conductors, where a first conductor traverses along less than an entire length of the lead body and a second conductor traverses from the proximal end to the distal end of the lead body. Optionally, the first conductor has a different material than the second conductor, for instance having differing electrical properties and/or differing stiffnesses. A method includes varying the stiffness of a coiled conductor assembly including winding a plurality of conductors to form the coiled conductor assembly, and pulling at least one loop of a first conductor away from the coiled conductor assembly.

Abstract: The present invention is a medical assembly comprising an elongated flexible medical device, such as a cardiac lead, and a torquing member, such as a stylet, slidably receivable inside the medical device. The device and member are coupled at their distal ends by a corresponding set of opposing curves. This coupling allows more precise rotational control of the assembly when it is manipulated at its proximal end. In one embodiment, the assembly has a open curvature at its distal end. In another embodiment, the distal end has a closed curvature.

Abstract: A lead for sensing and pacing a left ventricle of the heart includes a lead body having a proximal portion and a distal portion, a lumen extending through the lead body, a conductor extending through the lead body from the proximal end to the distal end and an electrode disposed on the distal portion of the lead body and electrically coupled to the conductor. A distal tip of the lead body is continuously deflectable upon advancement and withdrawal of a stylet through the lumen at the distal portion to access a selected branch of the coronary sinus. The distal tip of the lead body may be offset before or after continuously deflecting the distal tip.

Abstract: According to one embodiment, the present invention includes an elongate implantable medical lead having a distal portion that is relatively flexible, a proximal portion that is relatively stiff, and a transition portion which has a variable transition stiffness. The transition stiffness varies over the length of the transition portion that generally decreases in a distal direction. The relatively stiff proximal portion of the lead gives the lead steerability while the gradual change in stiffness in the transition portion reduces the likelihood that the lead will prolapse when it is guided into a branch vein. The distal stiffness is less than the proximal stiffness giving the lead a safe end that is unlikely to puncture vascular walls and is able to maneuver around various tortuosities when the lead is implanted into a patient.

Abstract: An apparatus includes a lead body extending from a proximal end to a distal end and having an intermediate portion therebetween. The lead body includes two or more individually insulated conductors, where a first conductor traverses along less than an entire length of the lead body and a second conductor traverses from the proximal end to the distal end of the lead body. Optionally, the first conductor has a different material than the second conductor, for instance having differing electrical properties and/or differing stiffnesses. A method includes varying the stiffness of a coiled conductor assembly including winding a plurality of conductors to form the coiled conductor assembly, and pulling at least one loop of a first conductor away from the coiled conductor assembly.

Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall.

Abstract: A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing.

Abstract: A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing.

Abstract: A system and method facilitates inserting a cardiac lead into a patient's vasculature. The cardiac lead system includes a cardiac lead having a lumen, and a guide member displaceable within the lumen. The guide member includes a guide wire extension that extends distal to the elongated body of the guide member. The guide wire extension is dimensioned to pass through an external distal opening of the cardiac lead lumen. Engagement of stop features or a stop mechanism of the cardiac lead system provides a push point for advancing the cardiac lead system through the patient's anatomy.

Abstract: A device and method for accessing a pericardial space of the heart includes a shaft having a cavity at a distal end, a suction lumen terminating in a distal port within the cavity and a hollow needle having a distal tip extending into the cavity. The cavity may be a recess in the shaft into which the distal tip of the needle fixedly protrudes. In other embodiments, the cavity is formed by an inflatable member positioned at the distal end of the shaft and the needle is slidable relative to the shaft. Suction is applied at the cavity to draw a pericardial bleb. The needle pierces the pericardial bleb for accessing the pericardial space and also facilitates delivery of payloads into the pericardial space.

Abstract: The present invention is device for delivering an electrode into a lateral vein of the coronary sinus. The device includes a support structure, a stent, a tether coupled to the stent and a removable sheath disposed about the stent. The stent is carried on the support structure and is deployable from a first collapsed configuration to a second expanded configuration for engaging the inner walls of the selected vessel. The sheath is sized to retain the stent in the first collapsed configuration. The electrode is carried on the stent or on a lead threaded over the tether.

Abstract: A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart.

Abstract: A method for allowing cardiac signals to be sensed and pacing pulse vectors to be delivered between two or more electrodes. In one embodiment, cardiac signals are sensed and pacing pulse vectors are delivered between least one of a first left ventricular electrode and a second left ventricular electrode. Alternatively, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrodes and a first supraventricular electrode. In addition, cardiac signals are sensed and pacing pulse vectors are delivered between different combinations of the first and second left ventricular electrode, the first supraventricular electrode and a conductive housing. In an additional embodiment, a first right ventricular electrode is used to sense cardiac signals and provide pacing pulses with different combinations of the first and second left ventricular electrodes, the first supraventricular electrode and the housing.

Abstract: In one embodiment, the present invention provides a cardiac lead device including a fixation mechanism slidably attached to the lead such that when the fixation mechanism is expanded into contact with a body lumen, the lead may be moved relative to the fixation mechanism if desired. Such lead movement may be limited by complimentary structure on the lead body and the fixation mechanism that prevents the lead from moving unless sufficient force is applied to the lead.

Abstract: The present invention provides a cardiac vascular occlusion system which includes inner and outer guide catheters and an occluding member disposed on the inner catheter. The occluding member may be deployed from a compressed to an expanded position to limit retrograde blood flow in a body lumen. The occluding member may be used when injecting a contrast agent into the body lumen.