Abstract: A pacing lead (20) having a lead body (22) with a central lumen and provided with structure for retaining the lead body to a wall of the coronary network, and a hollow tubular extension (26), bearing an active region of the lead and also traversed by a central lumen (28) communicating with the inner lumen of the lead body, so as to allow implantation by an over the wire technique. The hollow tubular extension has an outside diameter of between 2 and 3 French (0.66 and 1 mm) to allow implantation deep in the coronary sinus network, and it comprises on its outer surface an electrically insulated peripheral conductor, except for denuded areas intended to come into contact with the wall of a target vein and form a network of stimulation electrodes (32, 34) electrically connected together.

Abstract: A multi-area pacing lead implantable in a target vein of the coronary network for stimulating a left cavity of the heart, comprising an electrically conductive microcable (12), an electrically insulating outer coating, and carrying at its distal end a free active portion containing a plurality of separate denuded areas forming a network of active stimulation electrodes (14, 16), intended to contact the wall of target veins. The active free portion has a proximal corrugated portion carrying a first set of electrodes (14), a distal corrugated portion carrying a second series of electrodes (16) and an intermediate portion (20) that traverses an anastomosis (22) connecting the ends of two veins (VA, VPL). Both sets of electrodes (14, 16) can thus be placed in two different veins, defining two remote stimulation areas.

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: 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).

Abstract: A lead for active implantable medical devices comprising a chip, notably for electrode multiplexing. The lead (10) includes an insulating supporting tube (20) interposed in a flexible elongated tube, with a central bore (22) coaxial with the lumen of the lead. The supporting tube comprises on its surface at least one crossing conductive strip (28) extending in the axial direction. A chip (18) on a flexible substrate is disposed with a bent or curved conformation in a receptacle of the supporting tube isolated from the conductive strip. An electrode, e.g., for cardiac sensing/pacing, (16) on the supporting tube (20) is electrically connected to an outer conductive pad (24) of the chip. The conductive strip is connected (i) at each end (28b), face to face to a conductive connection (12), housed in the sheath, and (ii) in a central region (28a), to an inner conductive pad (26) of the chip.

Abstract: A system for stimulation/defibrillation of the left ventricle endocardially or from a vein in the coronary system including: a lead body (10) having a lumen, a distal end (12) with an anchor (14) connectable to a wall of a heart chamber or of a vein of the coronary system, and a proximal side with a connector (22) having a first terminal (26). The lumen of the lead houses a microcable (28) with an active free part (30) that emerges from the distal end. An insert (38) formed on the lead body includes a first electrical connection to the first terminal (26) of the connector, and a coupler selectively movable between (i) a released position wherein the microcable is free to slide in lumen of the lead body, and (ii) a closed position, wherein the microcable is both mechanically immobilized in the lead body and electrically connected to first electrical connection.

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 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 probe including at its distal extremity a tubular flexible sheath core supporting at least a winding forming a shock electrode and connected to a electrical conductor of connection extending in a internal lumen of the sheath core. In a way characteristic 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 the 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 tool for cutting or slitting the tubular sheath of a guide-catheter in the presence of a lead placed in this sheath. The tool (10) has a flattened, substantially planar blade holder body (12) with a cutting area (14) and a prehension area (16). The cutting area has a blade (18) and a tubular guide (22) receiving the lead for isolating it from the guide-catheter. The prehension area (16) has on a first side (30) an area for receiving the thumb and a lead holding pathway (68) spreading in the continuation of the tubular guide following an overall orientation forming an angle with this guide. The thumb reception area has a concave footprint (34) crossed through and through by the lead holding pathway (68), which spreads in the prehension area following an “S” shaped curve having a first curved area (74) and a second counter-curved area (76). The minimal distance between the blade (18) and the contour of the first footprint (34) is to the most equal to 15-20 mm.

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: An epicardial screw lead for stimulation/defibrillation implantable by a guide-catheter inserted into the pericardial space is described. The lead is a monodiameter lead with a helical anchoring screw extending axially of the lead body. The guide-catheter (24) has a pre-shaped tube having, in the absence of stress, a first bend (26) for supporting the lead body on the outer wall of the pericardial space (38), and a second bend (28) for orienting the end of the guide-catheter tube in the direction of the outer wall of the myocardium (34) and keeping the axis of the anchoring screw (14) in that same direction during a combined movement of screwing and insertion of the lead head.

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 a electrical conductor of connection extending in a internal lumen of the sheath core. 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 the 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 system implantable in the coronary venous system, including a pacing lead with an anchoring screw is disclosed. The system includes a stimulation lead (10) for stimulating a left heart cavity of a patient, and a removable catheter (26) for implanting the lead. The lead (10) has at least one stimulation electrode having an anchoring screw (14) that penetrates into the epicardial tissue of the patient. The catheter tube (26) is a pre-shaped tube with two curvatures in the absence of stress. The two curvatures are inscribed in two separate surfaces (38, 40) for self-orientating the distal end of the catheter tube into the target vein and maintaining the axis of the anchoring screw towards the epicardial wall during the screwing of the lead head.

Abstract: A retractable screw-type stimulation or defibrillation intracardiac lead is disclosed. According to one embodiment, the lead comprises a flexible hollow sheath (12) having at its distal end a lead head (10) and a connector (66) at its proximal end. The connector comprises a pin (62) connected to a lead head electrode (18). The lead head comprises a tubular body (28), at least one electrode (18, 20) for stimulation or defibrillation, a moving element translationally and rotationally moving within the tubular body in a helical motion, and an anchoring screw (24) axially moving with respect to the tubular body, and a deployment mechanism (22) to deploy the anchoring screw out of the tubular body (28).

Abstract: Preformed guiding stylet for introducing a septal lead in contact with the septum or other intra-corporal device in contact with body tissue. This stylet include a flexible wire (10), to be introduced by its distal end in a central lumen of the lead, and a control handle (18). The wire is elastically deformable in bending and has sufficient rigidity in torsion to enable transmission by the handle rotation of a rotational movement over the entire length of the wire. In the unstressed status, the wire comprises successively in its distal part (12), a first curvilinear portion (C1), a first straight portion (D1), a second curvilinear portion (C2) and optionally a second straight portion (D2). The first and second curvilinear portions extend in respective planes (P1, P2) making an angle (?3) between them defining a dihedral (?) which axis (?) comprises the first straight portion (D1).

Abstract: A kit for penetrating the cardiac septum and for the placement of a trans-septal device, in particular of a stimulation probe, in a left heart cavity. This kit includes a penetration guide (16), a handling stylet, a piercing stylet (38) and a guiding stylet (46). The penetration guide (16) comprises a probe body with a flexible hollow sheath (22) successively receiving these stylets, and a probe-head (18, 24) having an extendable helicoid screw (20) for anchoring to the wall of the septum (10). The piercing stylet (38) presents a sharp distal extremity (44) emerging from the frontal face, through the anchor (20), over a distance at least equal to the local thickness of the septum (10), so as to traverse through the septum. A guiding stylet will be then introduced into the sheath to form, after withdrawal of the penetration guide (16), an axial guide traversing the septum, for the introduction therethrough of a trans-septal device.

Abstract: A tool for cutting or slitting the tubular sheath of a guide-catheter in the presence of a lead placed in this sheath. The tool (10) has a flattened, substantially planar blade holder body (12) with a cutting area (14) and a prehension area (16). The cutting area has a blade (18) and a tubular guide (22) receiving the lead for isolating it from the guide-catheter. The prehension area (16) has on a first side (30) an area for receiving the thumb and a lead holding pathway (68) spreading in the continuation of the tubular guide following an overall orientation forming an angle with this guide. The thumb reception area has a concave footprint (34) crossed through and through by the lead holding pathway (68), which spreads in the prehension area following an “S” shaped curve having a first curved area (74) and a second counter-curved area (76). The minimal distance between the blade (18) and the contour of the first footprint (34) is to the most equal to 15-20 mm.

Abstract: A coronary probe for stimulation of the heart having a sophisticated retention structure. The probe is intended to be implanted in a vein of the coronary network for the stimulation of a left cavity of the heart by an active implantable medical device. It includes a flexible hollow sheath (10) including an internal conductor, an intermediate element (12) with a cylindrical body (24) bearing retention structure, and an end forming a probe-head (14) that is equipped with at least one stimulation electrode (20). The retention structure includes at least one relief (28) formed on the cylindrical body (24) and presenting, as seen from the end, an overall circular contour so as to have locally an increased diameter compared to the diameter of the cylindrical body. This contour is eccentric compared to the axis (D) of cylindrical body.

Abstract: A modular electric terminal connector, in particular for a monobody defibrillation probe. This terminal includes a stacking of elementary cylindrical parts, alternatively conducting and insulating, each of which includes a central cavity receiving the sheath of a cable comprising several connection wires. An axial pin, placed on a casing at the free extremity of stacking, is connected to a respective connection wire to form an axial contact of the terminal. Rods passing through homologous borings formed in each part ensure axial and angular alignment of the various parts of stacking. The unit is solidarized by injection of an adhesive under pressure. Suitable openings make it possible to connect by laser welding the conducting elementary parts to the wires located in the sheath to form the annular contacts of the terminal.