Abstract: An implantable medical device (IMD) comprises a plurality of deep tines configured to be advanced into a septum of a heart of a patient in different directions that are not parallel to a longitudinal axis of the implantable medical device, wherein each deep tine of the plurality of deep tines is configured to deliver cardiac pacing to cardiac tissue distal to a chamber of the heart in which the IMD is implanted, and one or more shallow electrodes engageable with the septum, wherein the one or more shallow electrodes are configured to deliver cardiac pacing to the chamber of the heart in which the IMD is implanted.

Abstract: An implantable medical lead comprising one or more tines configured to extend and/or retract from a lead body. The implantable medical lead includes a torque member within the implantable medical lead and configured to rotate a drive shaft within the implantable medical lead. The drive shaft is threadably engaged with an interior surface of the implantable medical lead and configured to convert the rotation into a lateral translation of the drive shaft. The one or more tines are configured such that the lateral translation of the torque member laterally translates the one or more tines. The one or more tines are each electrically connected to a conductor extending through a lumen of the implantable medical lead and electrically isolated from each other.

Abstract: An implantable medical lead includes a lead body, an electrode, a lead electrical connector, and a rotational electrical coupling. The lead electrical connector is configured to establish electrical communication between a test device and the electrode. The rotational electrical coupling includes a first conductive component electrically connected to the electrode and a second conductive component electrically connected to the first conductive component. The second conductive component is configured to establish electrical communication with the test device. The rotational electrical coupling is configured to facilitate rotation of the first conductive component relative to the second conductive component.

Abstract: A system for delivery of a leadless pacemaker. The system includes a catheter with an elongate flexible tubular body with a proximal end and a distal end, wherein the distal end of the tubular body includes a delivery cup with an external surface having an inflatable compliant balloon; and a pacing capsule of the leadless pacemaker releasably retained in the delivery cup. The pacing capsule includes an arrangement of tines configured to deploy and pierce a target tissue at a desired pacing capsule implant site in a coronary sinus of a patient. The balloon, when at least partially inflated, is configured to urge the delivery cup against the target tissue during deployment of the pacing capsule.

Abstract: In some examples, an implantable medical device (IMD) includes a housing defined in part by a longitudinal axis, a header at a distal end of the housing, the header defining a header plane, the header plane disposed at an angle relative to a reference plane, where the reference plane is perpendicular to the longitudinal axis, a fixation mechanism extending from the header, the fixation mechanism configured to be advanced into tissue of a heart of a patient to fix at least a portion of the IMD to the heart, one or more electrodes that extend from the header and are configured to engage with the septum, and circuitry within the housing, wherein the circuitry is configured to deliver cardiac pacing to the heart via the one or more electrodes.

Abstract: An implantable medical device (IMD) including a fixation mechanism and a leadlet supporting an electrode. The leadlet includes a shape memory material configured to urge a leadlet body of the leadlet toward a preset orientation relative to a device body of the IMD. The leadlet is configured to establish a radial displacement between the device body and a distal end of the leadlet when the shape memory material urges the leadlet toward the preset orientation. The leadlet may be configured to cause the electrode to contact tissues of the heart when the fixation mechanism attaches to tissue of the heart and the shape memory material urges the leadlet toward the preset orientation.

Abstract: A medical system includes an implantable medical device configured to be positioned within an atrium of a heart. The implantable medical device includes a housing carrying a return electrode, a first leadlet, a second leadlet, and a fixation device. The medical system may be configured to deliver a variety of therapies, including one or more of ventricle-from-atrium cardiac therapy (“VfA therapy”), left bundle branch pacing therapy (“LBB therapy”), or cardiac resynchronization therapy (“CRT”).

Abstract: An implantable medical device configured to deliver pacing therapy, the implantable medical device including a device body configured to position within a heart, where the device body comprises a proximal body portion and a distal body portion and defines a longitudinal axis extending through the proximal body portion and the distal body portion, the proximal body portion is configured to rotate around the longitudinal axis relative to distal body portion, and a leadlet mechanically coupled to the device body, where the leadlet mechanically supports an electrode configured to deliver pacing therapy, and where in response to the proximal body portion rotating relative to the distal body portion, the device body is configured to alter an extension length of the leadlet.

Abstract: A medical system includes an implantable medical device that carries a first electrode on a distal end of the implantable medical device and a return electrode. The implantable medical device is configured to be positioned within a heart. The implantable medical device further includes a leadlet including a proximal end and a distal end. The proximal end is attached to the implantable medical device, and the distal end is configured to penetrate tissue of the heart. The leadlet carries a second electrode, and a body of the leadlet between the proximal end and the distal end is configured to flex when the distal end is implanted in the tissue of the heart. The implantable medical device further includes a fixation device attached to the implantable medical device. The fixation device is configured to affix the distal end of the implantable medical device to the heart.

Abstract: A medical system including a device head configured to be positioned in an atrium of a heart, an implantable medical device configured to be positioned within a vena cava of the heart, and a lead extending from the device head to the implantable medical device. A fixation element coupled to the device head is configured to engage tissues within the atrium. The device head includes an electrode configured to deliver therapy and/or sensing signals to tissues within the atrium using stimulation signals received from processing circuitry within the implantable medical device. The medical system may include a delivery catheter configured to allow delivery of the device head to the atrium.

Abstract: A method includes locating the triangle of Koch region in the right atrium of a patient's heart; securing at least one electrode of an implantable lead or device to cardiac tissue from the triangle of Koch region to deliver ventricle-from-atrium (VfA) cardiac therapy; and testing the location or depth of the at least one electrode to configure VfA cardiac therapy. Locating the target implant region in the triangle of Koch region may include detecting an atrial slow pathway potential (ASP) or atrial pacing output.

Abstract: An implantable medical lead comprising a lead body defining a lumen. The lead body includes one or more tines substantially at a distal end of the lead body. An inner member extending within the lead body lumen is configured to rotate relative to the lead body and configured to cause a rotation of a dilator. The dilator is configured such that the rotation causes or enables a lateral translation of the dilator from a first position proximal to a lead body opening to a second position distal to the lead body opening. The implantable medical lead may include a probe wire configured to slidably translate through an inner lumen of the dilator.

Abstract: An implantable medical lead comprising one or more tines configured to extend and/or retract from a lead body. The implantable medical lead includes a torque member within the implantable medical lead and configured to rotate a drive shaft within the implantable medical lead. The drive shaft is threadably engaged with an interior surface of the implantable medical lead and configured to convert the rotation into a lateral translation of the drive shaft. The one or more tines are configured such that the lateral translation of the torque member laterally translates the one or more tines. The one or more tines are each electrically connected to a conductor extending through a lumen of the implantable medical lead and electrically isolated from each other.

Abstract: An implantable medical device (IMD) comprises a plurality of deep tines configured to be advanced into a septum of a heart of a patient in different directions that are not parallel to a longitudinal axis of the implantable medical device, wherein each deep tine of the plurality of deep tines is configured to deliver cardiac pacing to cardiac tissue distal to a chamber of the heart in which the IMD is implanted, and one or more shallow electrodes engageable with the septum, wherein the one or more shallow electrodes are configured to deliver cardiac pacing to the chamber of the heart in which the IMD is implanted.

Abstract: A method includes locating the triangle of Koch region in the right atrium of a patient's heart; securing at least one electrode of an implantable lead or device to cardiac tissue from the triangle of Koch region to deliver ventricle-from-atrium (VfA) cardiac therapy; and testing the location or depth of the at least one electrode to configure VfA cardiac therapy. Locating the target implant region in the triangle of Koch region may include detecting an atrial slow pathway potential (ASP) or atrial pacing output.