Abstract: Elongated medical instruments adapted to be permanently or temporarily implanted in the mammalian body or used to access a site in the body to facilitate introduction of a further medical device, and methods and apparatus for deflecting the distal end and imparting curves in distal segments of such medical instruments within the body by manipulation of a proximal segment of the instrument outside the body are disclosed. Multiple portions of distal segments of a single one or distal segments of coaxially arranged distal segments of deflectable coiled wires are formed each having a line of spacers each functioning as a backbone along a side of the wire coil and formed in a variety of ways. One or more elongated movable wire extends through a coil lumen to one or more attachment point distal to each portion that can be pushed to widen and/or pulled to narrow the spacing of coil turns across the coil diameter from the line to induce a bend in all more proximal portions.

Abstract: A medical instrument including a body extending between proximal and distal ends and enclosing an elongated, inelastic, pull wire extending between a pull wire proximal end affixed at a point at or near the proximal end and a pull wire distal end affixed at or near the distal end. The wire extends through a lumen off-set from the instrument axis and through a distal segment of the body that is to be curved for deflection at the distal end. A proximal segment of the instrument axially stretches when tension is applied to increase the length of the proximal segment from a relaxed length. A hand-held tool engages the proximal and distal ends of the proximal segment and manually applies a selective amount of tension that stretches the proximal segment from its relaxed length.

Abstract: A medical electrical lead and introducer system. The lead is a single pass, dual chamber lead, which features in one embodiment an atrial tine. The introducer system is particularly designed for introduction of single pass, dual chamber lead which has an atrial tine. The introducer system facilitates the introduction of a such lead into a patient's heart while safeguarding the tine from damage due to kinking during lead positioning. The lead is a single pass lead which features an atrial tine while the introducer system is particularly designed for introduction of a such lead into a patient's heart so as to safeguard the tine from damage due to kinking during lead positioning. The lead is designed so as to electrically couple both the atrium and the ventricular chambers of the heart. The lead generally features several lengths each having differing stiffness as well as a pre-formed bend. The lead also features a atrial tine having an electrode at the tip.

Abstract: The present invention provides a pacing system with a lead having a fixation element for providing stable fixation relative to the junction of the left and right brachiocephalic veins of the patient. In a first embodiment, a short tine element is provided for engaging the brachiocephalic junction. The present invention also provides a pacing system with a lead having a fixation element for providing stable fixation relative to the atrium and the SVC of the patient. In another embodiment, a three-pronged tine is provided for engaging the portion of the atrium adjacent the SVC.

Abstract: The present invention provides a pacing system with a lead having a fixation element for providing stable fixation relative to the patient's SVC, preferably providing for positioning of the atrial electrodes near the sinus node. In a first embodiment, an adjustable loop is provided for engaging the inside wall of the SVC so as to obtain fixation of the lead just above the sinus node. Other embodiments utilize tine arrangements for providing the fixation relative to the SVC.

Abstract: The present invention provides a cardiac pacing system with a DDD lead with pre-stressed curvilinear portions, the lead being able to adapt to heart movement and size so as to provide more stable positioning with respect to the atrium. The lead has at least three such pre-stressed curvilinear portions positioned to adapt to the patient's heart and to absorb movement due to contractions so as to maintain atrial electrodes in a stable position with respect to the atrial wall.