Abstract: Electrical medical leads having active fixation electrodes, particularly helix electrodes intended to be screwed into body tissue, e.g., the heart, are disclosed having selectively applied insulation to optimize exposed electrode surface area and dispose the exposed electrode surface area toward tissue that is less traumatized by injury caused by screwing in the fixation helix. In a preferred fabrication method, an outer helical surface is masked by contact with a masking tube while a dielectric coating is applied to the inner helical surface of the coil turns of the helix, and the masking tube is removed when the dielectric coating has set. In one variation, at least one aperture is formed through the masking tube sidewall exposing an area of the outer helical surface thereby interrupting the uninsulated outer helical electrode.

Abstract: A method for adjusting delivery of a therapeutic fluid to a patient suffering from or at risk of pulmonary arterial hypertension includes introducing the therapeutic fluid to a patient via a catheter at a predetermined rate. The catheter is positioned to deliver the fluid to the right ventricle or the pulmonary artery. The catheter a one-way valve configured to allow the fluid to flow from the catheter to the target location. The method further includes monitoring pressure of the target location by monitoring internal catheter pressure, and adjusting the rate at which the therapeutic fluid is introduced to the catheter based on the monitored pressure. The rate at which the fluid is introduced to the catheter is increased if internal catheter pressure increases, and the rate at which the fluid is introduced to the catheter is decreased if the internal catheter pressure decreases.

Abstract: The present invention includes methods, systems, uses, and means for the delivery of one or more anti-fibrotic agents into the pericardial space for the treatment and prevention of heart failure (HF).

Abstract: Heart pacing systems include at least one electronic or biological pacemaker as a primary pacemaker, and at least one electronic or biological pacemaker as a backup pacemaker. When implanted, the primary pacemaker(s) produce primary pacing stimuli that modulate cardiac function. The backup pacemaker(s) provide backup pacing stimuli when the electronic pacemaker is unable to modulate cardiac function at the predetermined pacing rate. The heart pacing systems are implemented by implantation in regions where they can provide pacing stimuli to cardiac tissue.

Abstract: In general, the invention is directed to techniques for delivering macromolecules to a tissue site via electroporation. Particularly, a catheter detects contact between a distal end of the catheter and a target tissue site via a sensing electrode at the distal end of the catheter. The catheter delivers a fluid containing macromolecules to the tissue site upon detecting contact between the tissue site and the catheter. Concurrently or soon after delivery of the fluid, an electrical stimulus is applied to the tissue site. The electrical stimulus can be applied by the catheter or directly from a power supply, such as an implanted pulse generator. The electrical stimulus causes membranes of cells within the tissue site to destabilize, in turn, forming pores through which the macromolecules migrate into the cells of the tissue site.

Abstract: Electrical medical leads having active fixation electrodes, particularly helix electrodes intended to be screwed into body tissue, e.g., the heart, are disclosed having selectively applied insulation to optimize exposed electrode surface area and dispose the exposed electrode surface area toward tissue that is less traumatized by injury caused by screwing in the fixation helix. In a preferred fabrication method, an outer helical surface is masked by contact with a masking tube while a dielectric coating is applied to the inner helical surface of the coil turns of the helix, and the masking tube is removed when the dielectric coating has set. In one variation, at least one aperture is formed through the masking tube sidewall exposing an area of the outer helical surface thereby interrupting the uninsulated outer helical electrode.

Abstract: A cardiac ischemic protection system and method for conditioning a patient's heart is provided. The method can include detecting acute myocardial infarction, angina pectoris, silent ischemia, or stunning and providing closed-loop dyssynchronous pacing to the patient's heart to precondition and/or postcondition the patient's heart in order to reduce ischemic damage.

Abstract: A composition for implantation into cardiac tissue includes a biological pacemaker that, when implanted, expresses an effective amount of a mutated hyperpolarization-activated and cyclic nucleotide-gated (HCN) isoform to modify Ih when compared with wild-type HCN. Methods for implementing each of the biological pacemakers include implanting each of biological pacemakers into cardiac tissue.

Abstract: A sympatholytic cardiovascular agent delivered by a drug delivery pump to a central nervous system site to alleviate symptoms of acute or chronic cardiac insult or impaired cardiac performance. The drug delivery pump can be external or implantable infusion pump (IIP) coupled with a drug infusion catheter extending to the site. A patient activator can command delivery of a dosage and/or an implantable heart monitor (IHM) coupled with a sensor can detect physiologic parameters associated with cardiac insult or impaired cardiac performance and trigger dosage delivery. The IIP and IHM can be combined into a single implantable medical device (IMD) or can constitute separate IMDs that communicate by any of known communication mechanisms. The sympatholytic cardiovascular agent is one of the group consisting of an alpha-adrenergic agonist and an alpha2-adrenergic agonist (e.g.

Abstract: An injection needle comprises an elongated body having an outer surface and an inner surface defining a longitudinal channel through the tubular body. The elongated body further comprises a distal end and at least one lateral delivery port extending from the inner surface to the outer surface proximate the distal end and fluidly coupled to the longitudinal channel. A distal tip is coupled to the distal end and comprises a radio-opaque material.

Abstract: A sympatholytic cardiovascular agent delivered by a drug delivery pump to a central nervous system site to alleviate symptoms of acute or chronic cardiac insult or impaired cardiac performance. The drug delivery pump can be external or implantable infusion pump (IIP) coupled with a drug infusion catheter extending to the site. A patient activator can command delivery of a dosage and/or an implantable heart monitor (IHM) coupled with a sensor can detect physiologic parameters associated with cardiac insult or impaired cardiac performance and trigger dosage delivery. The IIP and IHM can be combined into a single implantable medical device (IMD) or can constitute separate IMDs that communicate by any of known communication mechanisms. The sympatholytic cardiovascular agent is one of the group consisting of an alpha-adrenergic agonist and an alpha2-adrenergic agonist (e.g.

Abstract: Heart pacing systems include at least one electronic or biological pacemaker as a primary pacemaker, and at least one electronic or biological pacemaker as a backup pacemaker. When implanted, the primary pacemaker(s) produce primary pacing stimuli that modulate cardiac function. The backup pacemaker(s) provide backup pacing stimuli when the electronic pacemaker is unable to modulate cardiac function at the predetermined pacing rate. The heart pacing systems are implemented by implantation in regions where they can provide pacing stimuli to cardiac tissue.

Abstract: A medical fluid delivery system includes an implantable medical lead including a fixation element adapted to secure the lead to a tissue site and a fluid delivery device including a tissue piercing distal tip; the device is adapted to pass through a proximal port, a lumen and a distal port of the lead. The system further includes means for adjusting a position of the device distal tip with respect to the lead distal port.

Abstract: A sympatholytic cardiovascular agent delivered by a drug delivery pump to a central nervous system site to alleviate symptoms and otherwise treat heart failure (HF) and pathologies associated with HF. The drug delivery pump can be external or implantable infusion pump (IIP) coupled with a drug infusion catheter extending to the site. A patient activator can command delivery of a dosage and/or an implantable heart monitor (IHM) coupled with a sensor can detect physiologic parameters associated with HF (or pathologies associated with HF) and trigger dosage delivery. The IIP and IHM can be combined into a single implantable medical device (IMD) or can constitute separate IMDs that communicate by any of known communication mechanisms. The sympatholytic cardiovascular agent is one of the group consisting of an alpha-adrenergic agonist and an alpha2-adrenergic agonist, e.g.

Abstract: A medical fluid delivery system includes an implantable medical lead and a fluid delivery device; the device is adapted to pass through a proximal port, a lumen and a distal port of the lead. The fluid delivery device includes a tissue piercing distal tip and a pre-formed curve in proximity to the distal tip such that the tip is directed away from a lead fixation element after passing beyond the distal port of the lead.

Abstract: A medical system incorporating fluid delivery and lead delivery lumens dispense fluid into a volume of tissue. The fluid comprises or contains a pharmacologic, genetic, or biologic agent. The fluid may be dispensed initially during implantation or later using a minimally invasive medical procedure.

Abstract: An implantable lead system includes an elongated device slideably engaged within a lumen of a lead body. A distal portion of the elongated device is slidable through a helix tip coupled to a distal end of the lead body by passing through a pierceable fluid-tight seal disposed in proximity to the distal end of the lead body; the seal prevents ingress of bodily fluid into the lumen of the lead body.

Abstract: A medical fluid delivery system includes an implantable medical lead including a fixation element adapted to secure the lead to a tissue site and a fluid delivery device including a tissue piercing distal tip; the device is adapted to pass through a proximal port, a lumen and a distal port of the lead. The system further includes means for adjusting a position of the device distal tip with respect to the lead distal port.

Abstract: A medical fluid delivery system includes an implantable medical lead and a fluid delivery device; the device is adapted to pass through a proximal port, a lumen and a distal port of the lead. The fluid delivery device includes a tissue piercing distal tip and a pre-formed curve in proximity to the distal tip such that the tip is directed away from a lead fixation element after passing beyond the distal port of the lead.

Abstract: An implantable lead system includes an elongated device slideably engaged within a lumen of a lead body. A distal portion of the elongated device is slidable through a helix tip coupled to a distal end of the lead body by passing through a pierceable fluid-tight seal disposed in proximity to the distal end of the lead body; the seal prevents ingress of bodily fluid into the lumen of the lead body.