Abstract: An introducer configured with a first curve having a first angle that traverses space of an atrial appendage, a central atrium, caudad to the coronary sinus, and a second curve that has an angle sufficient to align the introducer with an intrinsic curvature of the coronary sinus of a subject.

Abstract: A medical device comprising a cannula probe for insertion into a patient with a proximal end and a distal end, a lumen extending between the proximal and distal ends, and a portion of the cannula probe configured with a contour customized to a patient's anatomy. The distal end of the cannula probe is disposed at a substantially right angle, with at least the distal tip of the cannula probe formed of a rigid material sufficient to maintain the substantially right angle orientation.

Abstract: Techniques for biventricular pacing include a rigid shaped stylet approximating curves of a coronary sinus and branch vein. Some techniques include a parasternal coronary sinus cannula comprising an outer sheath and an obturator. The obturator is removeably disposed inside the outer sheath from a device end of the hollow shaft. The obturator includes a flexible stem that fits snugly inside the hollow shaft, a malleable core disposed inside the flexible stem, a tapered tip that extends beyond a cardiac end of the shaft when the obturator is disposed inside the outer sheath, and a sensor for determining properties of the subject in a vicinity of the tapered tip. An optional pressure-seal, such as a tent, connected to suction maintains negative intrepleural pressure for insertion under local anesthesia.

Abstract: The invention is directed to methods and devices for optimization of biventricular pacing in subjects suffering from heart failure. The invention provides for a method for selection of optimal parameters for permanent pacing, the method comprising: positioning one or more arrays of lead wires in the posterior pericardium of a subject, wherein the arrays are connected to a multiplexing switch, wherein the switch is connected to a computer processor and a biventricular pacemaker; from the computer processor, generating a randomized sequence of: (i) pacing sites (VPS), (ii) right ventricular-left ventricular delays (RLDs), (iii) heart rates (HR); (iv) atrioventricular delays (AVDs), (v) or any combination or permutation thereof; and determining cardiac output in real time, using aortic flow velocity, thereby allowing selection of optimal parameters for permanent pacing.

Abstract: Techniques for biventricular pacing include a rigid shaped stylet approximating curves of a coronary sinus and branch vein. Some techniques include a parasternal coronary sinus cannula comprising an outer sheath and an obturator. The obturator is removeably disposed inside the outer sheath from a device end of the hollow shaft. The obturator includes a flexible stem that fits snugly inside the hollow shaft, a malleable core disposed inside the flexible stem, a tapered tip that extends beyond a cardiac end of the shaft when the obturator is disposed inside the outer sheath, and a sensor for determining properties of the subject in a vicinity of the tapered tip. An optional pressure-seal, such as a tent, connected to suction maintains negative intrepleural pressure for insertion under local anesthesia.

Abstract: The invention is directed to methods and devices for optimization of biventricular pacing in subjects suffering from heart failure. The invention provides for a method for selection of optimal parameters for permanent pacing, the method comprising: positioning one or more arrays of lead wires in the posterior pericardium of a subject, wherein the arrays are connected to a multiplexing switch, wherein the switch is connected to a computer processor and a biventricular pacemaker, from the computer processor, generating a randomized sequence of: (i) pacing sites (VPS), (ii) right ventricular-left ventricular delays (RLDs), (iii) heart rates (HR); (iv) atrioventricular delays (AVDs), (v) or any combination or permutation thereof; and determining cardiac output in real time, using aortic flow velocity, thereby allowing selection of optimal parameters for permanent pacing.

Abstract: A surgical cutting device according to the invention which permits the precise slitting of a human vein in situ. The cutting device is supported and guided over the centerline of the vein to be slit by two generally opposing guides which serve to precisely orient the knife along the centerline of the vein. The cutting device can comprise a blade or a functionally equivalent cutting edge or surface and is useful to cut other human vessels such as arteries or ducts.