Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: An ultrasonic surgical device is disclosed including a surgical tool including a proximal transducer mounting portion defining a surface, a distal end effector end, and a waveguide disposed therebetween, the waveguide extending along a longitudinal axis. The ultrasonic surgical device further includes a transducer is in mechanical communication with the surface of the transducer mounting portion. The transducer is configured to operate in a D31 mode with respect to the longitudinal axis of the waveguide. Upon activation by an electrical signal having a predetermined frequency component, the transducer is configured to induce a standing wave in the surgical tool to cause the end effector to vibrate, the standing wave having a wavelength proportional to the predetermined frequency component of the electrical signal.

Abstract: A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

Abstract: Implementations described and claimed herein provide controlled access into the intra-pericardial space. In one implementation, a medical device comprises an outer sheath, an inner sheath, and a nose shaft. The outer sheath comprises a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The inner sheath extends through the lumen of the outer sheath and comprises a distal portion adapted to pierce the pericardial sac. The nose shaft is adapted to displace relative to a distal edge of the distal portion of the inner sheath. Displacing the distal portion of the inner sheath relative to the outer sheath until the nose shaft displaces relative to the distal edge provides controlled penetration into the intra-pericardial space.

Abstract: Implementations described and claimed herein provide controlled access into the intra-pericardial space. In one implementation, a medical device comprises an outer sheath, an inner sheath, and a nose shaft. The outer sheath comprises a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The inner sheath extends through the lumen of the outer sheath and comprises a distal portion adapted to pierce the pericardial sac. The nose shaft is adapted to displace relative to a distal edge of the distal portion of the inner sheath. Displacing the distal portion of the inner sheath relative to the outer sheath until the nose shaft displaces relative to the distal edge provides controlled penetration into the intra-pericardial space.

Abstract: Implementations described and claimed herein provide controlled access into the intra-pericardial space. In one implementation, a medical device comprises an outer sheath, an inner sheath, and a nose shaft. The outer sheath comprises a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The inner sheath extends through the lumen of the outer sheath and comprises a distal portion adapted to pierce the pericardial sac. The nose shaft is adapted to displace relative to a distal edge of the distal portion of the inner sheath. Displacing the distal portion of the inner sheath relative to the outer sheath until the nose shaft displaces relative to the distal edge provides controlled penetration into the intra-pericardial space.

Abstract: A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

Abstract: Implementations described and claimed herein provide controlled access into the intra-pericardial space. In one implementation, a medical device comprises an outer sheath, an inner sheath, and a nose shaft. The outer sheath comprises a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The inner sheath extends through the lumen of the outer sheath and comprises a distal portion adapted to pierce the pericardial sac. The nose shaft is adapted to displace relative to a distal edge of the distal portion of the inner sheath. Displacing the distal portion of the inner sheath relative to the outer sheath until the nose shaft displaces relative to the distal edge provides controlled penetration into the intra-pericardial space.

Abstract: A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

Abstract: A first cardiac signal associated with an activity of a first implant site of a heart during a cardiac cycle is sensed. A second cardiac signal is sensed using an intrapericardial lead located on an epicardial surface proximate a second implant site of the heart. The second cardiac signal is associated with an activity of the second implant site during the cardiac cycle. A timing delay between the activity of the first implant site and the activity of the second implant site is obtained and analyzed to determine if the intrapericardial lead location is appropriate. The preceding is repeated until an appropriate intrapericardial lead location is determined. Other measurements obtained during implant determine whether the intrapericardial lead location is at or near slow conduction zone and whether the intrapericardial lead is placed at the location having the greatest mechanical delay. Post implant measurements determine whether the intrapericardial lead has migrated.

Abstract: The intrapericardial lead includes a lead body having a proximal portion and a flexible, pre-curved distal end portion. The distal end portion carries at least one electrode assembly containing an electrode adapted to engage pericardial tissue. The distal end portion further carries a pre-curved flexible wire member having ends attached to spaced apart points along the distal end portion of the lead body, the flexible wire member having a normally expanded state wherein an intermediate portion of the wire member is spaced apart from the distal end portion, and a generally straightened state wherein the wire member and the distal end portion are disposed in a more parallel, adjacent relationship so as to present a small frontal area to facilitate delivery into the pericardial space. The wire member re-expands to its normal state after delivery into the pericardial space to anchor the distal end portion of the lead body relative to the pericardial tissue.

Abstract: A delivery apparatus for accessing the pericardial space of a heart including an elongated body defining a lumen and a piercing member that extends from a distal portion of the elongated body for piercing tissue of the heart. A spring expands from a distal end of the piercing member in response to the distal end of the piercing member passing through the tissue and into the pericardial space. An electrode located on the spring in order to sense signals indicative of a distal end of the spring passing through the tissue and into the pericardial space.

Abstract: Disclosed herein is an implantable medical lead. In one embodiment, the lead includes a ring electrode, a tip electrode, first and second helically wound coaxial conductor coils, and a distal coil transition. The coils extend between the proximal and distal ends of the lead. The distal coil transition is proximal to the ring electrode and near the distal end and is where the first coil transitions from being outside the second coil proximal of the distal coil transition to being inside the second coil distal of the distal coil transition.

Abstract: An implantable medical lead is disclosed herein wherein the lead employs a helical distal tip anchor having improved fixation capabilities. The implantable medical lead may include a body and a helical anchor. The body may include a distal end and a proximal end. The helical anchor may be at least one of extending and extendable from the distal end. The helical anchor may include at least one loop including first and second straight sides that intersect at a first corner.

Abstract: Disclosed herein is a system for monitoring a motion of a cardiac tissue. The system includes a motion sensor configured to operably couple to the cardiac tissue. The motion sensor includes an electroactive polymer and is further configured to result in a deflection in the electroactive polymer when the cardiac tissue undergoes the motion. The deflection in the electroactive polymer generates an electrical event.

Abstract: An implantable medical lead configured for improved MRI safety and heating reduction performance is disclosed herein. In one embodiment, the lead includes a tubular body having a proximal end and a distal end with a lead connector near the proximal end. In this embodiment the lead further includes a conductor extending longitudinally within the tubular body and having a proximal end that is electrically coupled to the connector and a distal end electrically coupled to a contact pin. The lead in this embodiment further includes a filter element electrically coupled to a distal end of the contact pin and a flange electrically coupled between a proximal end of the filter element and a proximal portion of an electrode. In this embodiment the flange and the proximal portion of the electrode form at least a first part of a hermetic chamber enclosing the filter element.

Abstract: An introducer sheath is disclosed herein. The sheath includes a tubular body. The tubular body has a proximal zone, an intermediate zone and a distal zone. The proximal zone is generally straight. The intermediate zone extends from a distal end of the proximal zone and curves in a first direction. The distal zone extends from a distal end of the intermediate zone and curves in a second direction different from the first direction.

Abstract: A biocompatible inductor for an implantable medical lead is disclosed herein. In one embodiment the biocompatible inductor may include a biocompatible bobbin and a wire wound about a barrel of the biocompatible bobbin to form a coil. The wire may include an electrically conductive core, an electrically conductive biocompatible jacket extending over the core, and a coating of high dielectric strength insulation material extending over the jacket. Additionally, the biocompatible inductor may include medical adhesive located in gaps within the coil and a polyester shrink tube covering the coil.

Abstract: Embodiments include electrical leads and methods of using electrical leads that may be used for delivering both cardioversion/defibrillation signals and pacing signals and sensing to target tissue. Some of these embodiments may also be used to sense and transmit electrical signals from target tissue. Some electrical lead embodiments are configured to be delivered into a patient's intrapericardial space by non-invasive methods.

Abstract: The intrapericardial lead includes a lead body having a proximal portion and a flexible, pre-curved distal end portion. The distal end portion carries at least one electrode assembly containing an electrode adapted to engage pericardial tissue. The distal end portion further carries a pre-curved flexible wire member having ends attached to spaced apart points along the distal end portion of the lead body, the flexible wire member having a normally expanded state wherein an intermediate portion of the wire member is spaced apart from the distal end portion, and a generally straightened state wherein the wire member and the distal end portion are disposed in a more parallel, adjacent relationship so as to present a small frontal area to facilitate delivery into the pericardial space. The wire member re-expands to its normal state after delivery into the pericardial space to anchor the distal end portion of the lead body relative to the pericardial tissue.