Abstract: An assembly including an autonomous capsule having an anchoring member adapted to penetrate tissue of the heart and an accessory for implantation of the capsule. The accessory includes a steerable catheter with an inner lumen, having at its distal end a tubular protection tip defining a volume for housing the capsule. The accessory also includes a disconnectable attachment mechanism for supporting and guiding the capsule to an implantation site and a sub-catheter housed within the lumen of the steerable catheter, moveable in translation and in rotation relative to the steerable catheter. The sub-catheter and the capsule are movable between a refracted position and a position wherein the capsule is deployed out of the protection tip. The sub-catheter and the capsule are provided with a first fastening mechanism for fastening the two in translation and in mutual rotation, which is disconnectable under a rotation applied to the sub-catheter.

Abstract: A lead for an implantable cardiac prosthesis, with protection against the thermal effects of MRI fields by terminating the lead head (10) with an electrically insulating tubular outer housing (28) and an anchoring mechanism. The tubular housing (28) carries an electrically isolated thermally conductive solid part in the outer region of its distal end forming a heat sink. The heat sink thermally conductive material is for example titanium, associated with an electrically insulating coating such as a diamond deposition. The anchor may be a projecting helical anchoring screw (20), axially extending the tubular housing, which is an electrically conductive active screw on at least one end portion.

Abstract: This system includes a conductor microcable and an insulating microcatheter, including a hollow tube housing the microcable with the possibility of relative axial translation therebetween. The microcatheter is suitable for permanent implantation. The microcatheter, in its distal portion, includes at least one lateral window formed by a through orifice formed on the wall of the hollow tube. The window forms a stimulation site defined on the wall of the target vein facing the window of the microcatheter, and provides for a region of the microcable surface located at the window to form a stimulation electrode. In its distal portion, the microcable is not isolated at least in the region of the window of the microcatheter. The microcatheter is telescopically moveable on the microcable, so as to modify the position of the stimulation site of the target vein.

Abstract: A system and method for implantation of an autonomous intracardiac capsule. The autonomous capsule includes a cylindrical body with an anchoring screw for penetrating a tissue wall, and at least one coupling finger radially projecting outwards. An implantation accessory includes a lead body and a helical guide, for guiding and driving by rotation the capsule. This helical guide is integral with the lead body, and its inner diameter is sufficient to contain that cylindrical body of the capsule therein. The helix direction of the helical guide is opposite to that of the anchoring screw such that continued rotational motion imparted on the lead body drives the anchoring screw into the target tissue and then emerges the capsule from the helical guide. The helical guide is resiliently compressible in axial direction, and its helix pitch is increased in the free distal end portion.

Abstract: A kit for penetrating the cardiac septum and for implanting a transeptal lead, including a lead for the detection/stimulation of a left heart cavity. This kit includes a screw lead (16) and a radio-frequency puncture generator (32). The lead includes: a lead body with a deformable sheath (18); a proximal end having an electrical connector (20) for coupling to an implanted medical device housing; a distal end having a lead head (22) with an electrode including a projecting conductive helical screw (24) for penetrating into the septum (10) due to a screw movement applied from the proximal end of the lead, and a conductor (26) connecting the electrode to the electrical connector, the electrode including the screw.

Abstract: A microlead implantable in a patient's venous, arterial or lymphatic networks for the detection and/or stimulation of tissue. The microlead has a diameter at most equal to 2 French (0.66 mm) and comprises at least one microcable (40) comprising a core cable (11) and an insulation layer (20) partially surrounding the core. The core is formed of a plurality of strands, and has a composite structure comprising a structuring material having high fatigue resistance, and a radiopaque material. A denuded area (30) is formed in the isolation layer (20) so as to form at least one electrode for stimulation detection. The microlead is shaped at the electrodes (30) according to at least one electrical contact and mechanical stabilization preshape, and has a gradual decrease of rigidity along the microlead between its proximal portion and its distal portion.

Abstract: A probe including at its distal extremity a tubular flexible sheath core supporting at least a winding forming a shock electrode and connected to an electrical conductor of connection extending in an internal lumen of the sheath core. In one embodiment of the invention, the sheath core extends axially without a solution of continuity in the area supporting the winding. In particular, the sheath core comprises cavities to receive and hold conducting inserts, of homologous size with cavities formed locally close to the ends of the winding, the insert being connected to the interior side to the electrical conductor, and on the external side to the corresponding extremity of winding. A longitudinal slit connects two cavities and allows, by elastic deformation of the sheath core, the introduction into the cavities and in the internal lumen of the unit formed by the final extremity of the electrical conductor beforehand equipped with its two inserts.

Abstract: A stimulation lead is disclosed. This lead comprises a lead body having a lumen housing an inner conductor, the conductor being axially and rotationally movable within the lumen, and coupled to a generator of an active implantable medical device. The lead also has a helical anchoring screw extending from a distal end configured to penetrate target tissue, and a stimulation needle electrically coupled to the conductor and comprising at its distal end an active free portion with at least one stimulation electrode for application of pacing pulses to the target tissue. The stimulation needle is axially movable between a retracted position inside the tubular body, and a deployed position with the active free portion of the needle emerging out of the tubular body, utilizing an actuating mechanism for moving the needle from its retracted position to its deployed position under the effect of rotary movement relative to the lead body.

Abstract: An implantable cardiac stimulation lead for implantation along the septal wall and/or the free wall of the left ventricular is disclosed. The lead is a microlead formed in its distal portion by a microcable with an active portion comprising a series of exposed areas forming the stimulation electrodes. This lead is implanted by an accessory with a needle having a puncture pointed free end and an opposite end mounted on a gripping end tip, and a releasable device for holding the microcable along the length of the needle. The microlead is introduced by injection of the microcable with penetration of the needle into the wall thickness of the interventricular septum or in the thickness of the free wall of the left ventricle, below the surface and along this wall between the apex region the atrial region.

Abstract: A system and method for implantation of an autonomous intracardiac capsule. The autonomous capsule includes a cylindrical body with an anchoring screw for penetrating a tissue wall, and at least one coupling finger radially projecting outwards. An implantation accessory includes a lead body and a helical guide, for guiding and driving by rotation the capsule. This helical guide is integral with the lead body, and its inner diameter is sufficient to contain that cylindrical body of the capsule therein. The helix direction of the helical guide is opposite to that of the anchoring screw such that continued rotational motion imparted on the lead body drives the anchoring screw into the target tissue and then emerges the capsule from the helical guide. The helical guide is resiliently compressible in axial direction, and its helix pitch is increased in the free distal end portion.

Abstract: This implantable microcatheter includes a hollow tube with a central lumen extending throughout the length of the tube from a proximal region to a distal region. The bending stiffness of the proximal region is greater than the bending stiffness of the distal region, and the tube has a transition region having a decreasing stiffness gradient from the proximal region to the distal region. The tube wall is free of shielding or armor at least in the distal region, and the catheter is made of biocompatible material(s) suitable for a permanent implantation in venous, arterial or lymphatic networks.

Abstract: One embodiment of the invention relates to a multipolar lead for implantation in a venous, arterial, or lymphatic network, and for use with an electric stimulation or detection device. The invention includes at least two microcables, each having a central conductor for connection to the electric stimulation or detection device. The invention further includes a first ring having at least two lumens, each sized to receive a microcable of the at least two microcables, wherein one of the at least two lumens is a connection lumen which receives a first microcable of the at least two microcables. The ring further includes a connection element movable into the connection lumen to pierce a sheath of the first microcable and to press into the central conductor of the first microcable received by the connection lumen, electrically connecting at least a portion of the first ring to the central conductor.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. This lead (24) includes a lead body with a hollow sheath (26, 28) of deformable material, having a central lumen open at both ends, and at least one telescopic microcable (42) of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end (32) thereof. The party emerging beyond the distal end is an active free part (34) comprising a plurality of distinct bare areas (36, 38, 50, 50?, 50?), intended to come into contact (40) with the wall of a target vein (22) of the coronary system (14-22), so as to form a network of stimulation electrodes electrically connected together in parallel. The microcable further comprises, proximally, a connector to a generator of active implantable medical device such as a pacemaker or a resynchronizer.

Abstract: A multizone epicardial pacing lead (10) having a lead body (12) with a proximal connector (14) for coupling to a generator of an active implantable medical device and, distally, an anchor to an epicardium wall and an active part comprising a plurality of stimulation electrodes, coming into contact with, or penetrating, the epicardium wall. This active part comprises a distributor housing (16) and a network of flexible microcables (18) radiating from the housing. Each microcable is formed of an electrically insulated conductor comprising at least one denuded area (20), each of these areas forming a stimulation electrode.

Abstract: A method of manufacturing a detection/stimulation lead for implantation into a venous, arterial, or lymphatic network is shown and described. The method includes providing a microcable comprising a sheath of insulating material covering an electrically conductive core. The method further includes surrounding a portion of the microcable with an electrically conductive metal ring. The method also includes crimping the ring such that the thickness of the sheath is penetrated by a portion of the metal ring and such that an electrical connection is formed between the metal ring and the electrically conductive core.

Abstract: A system of an autonomous intracardiac capsule and its implantation accessory. The autonomous capsule (10) includes a tubular body (12) with an anchoring screw (14) for penetrating the wall of a cavity of the heart, and at least one coupling finger (20, 22) radially projecting outwards. The implantation accessory (26) includes a lead body (28) with a sheath (30, 32) of deformable material supporting on the distal side a helical guide (36, 52), for guiding and driving by rotation the capsule. This helical guide is integral with the lead body, and its inner diameter is homologous to the outer diameter of the cylindrical body of the capsule so the latter can be housed it in, the coupling fingers protruding between the coils of the guide. The helix direction of the helical guide (36) is opposite to that of the anchoring screw (14). The helical guide is resiliently compressible in axial direction, and its helix pitch (38) is increased in the free distal end portion (40).

Abstract: A system for the endocardial stimulation/defibrillation of the left ventricle. This system includes a generator (60) and an endocardial lead having a distal end (30) which extends into the right ventricle (14). The lead includes anchor (32) for coupling the distal end to the interventricular septum (20). The lead body carries on it a stimulating and/or defibrillation electrode (38) (64, 66). A microcable (42) extends into the lead body and beyond, with an intermediate portion (56) crossing from one side of the interventricular septum (20) to the other, and an active free portion (58) that emerges in the left ventricle (16). The microcable is coupled to the generator, to produce an electric field (62) between, on one hand, the stimulation electrode (38) or defibrillation electrode (64, 66) of the lead body and, on the other hand, a bare region of the active free portion (58) of microcable (42).

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. One lead includes a telescopic microcable including multiple distinct bare areas that form a network of stimulation electrodes. The microcable includes a diameter providing for insertion of the microcable within smaller portions of the coronary vein system. The diameter may be selected from between 0.5 and 2 French. The microcable includes multiple strands twisted together. At least some strands incorporate either a core of radiopaque material wrapped by a sheath of mechanically durable material, or vice-versa. The bare areas that form the network of stimulation electrodes are provided on outward-facing portions of at least some of the strands.

Abstract: A microlead implantable in a patient's venous, arterial or lymphatic networks for the detection and/or stimulation of tissue. The microlead has a diameter at most equal to 2 French (0.66 mm) and comprises at least one microcable (40) comprising a core cable (11) and an insulation layer (20) partially surrounding the core. The core is formed of a plurality of strands, and has a composite structure comprising a structuring material having high fatigue resistance, and a radiopaque material. A denuded area (30) is formed in the isolation layer (20) so as to form at least one electrode for stimulation detection. The microlead is shaped at the electrodes (30) according to at least one electrical contact and mechanical stabilization preshape, and has a gradual decrease of rigidity along the microlead between its proximal portion and its distal portion.

Abstract: A system for the endocardial stimulation/defibrillation of the left ventricle. This system includes a generator (60) and an endocardial lead. The lead includes a lead body (26) whose distal end (30) extends into the right ventricle (14) and is provided with a mechanism to anchor (32) the distal end to the interventricular septum (20). The lead body carries on it a stimulating and/or defibrillation electrode (38) (64, 66). A microcable (42) extends into the lead body and beyond, with an intermediate portion (56) crossing from one side of the interventricular septum (20) to the other, and an active free portion (58) that emerges in the left ventricle (16). The microcable is coupled to the generator, to produce an electric field (62) between, on one hand, the stimulation electrode (38) or defibrillation electrode (64, 66) of the lead body and, on the other hand, a bare region of the active free portion (58) of microcable (42).