Abstract: An apparatus for and method of measuring pressure through a septum in a patient's heart is disclosed. A lead inserted into the right side of a heart is routed through the septum to gain access to the left side of the heart. The lead includes an attachment structure that secures the lead to one or both of the septal walls. The attachment structure may include at least one protruding tine, membrane, inflatable balloon, involuted spiral or J-lead that engage one or more sides of the septum. The lead also includes one or more sensors for measuring cardiac pressure on the left side of the heart and, as necessary, the right side of the heart.

Abstract: The lead body of a medical lead comprises a distal end portion carrying at least one electrode for placement in the pericardial sac of a human heart. The distal end portion of the lead body includes a multi-turn section having opposed ends, opposing forces applied to the ends tending to flatten the multi-turn section, the multi-turn section being thereby adapted to be retained within the pericardial sac. The turns of the multi-turn section may become progressively smaller from one end of the section to the other end of the section. The multi-turn section may have, in a relaxed state thereof, a generally conical, helical configuration. The at least one electrode may be carried adjacent to the end of the multi-turn section having the larger turns. Alternatively, the at least one electrode may be carried adjacent to the end of the multi-turn section having the smaller turns.

Abstract: An introducer system for use with a pacemaker lead includes a plastic sheath compatible for insertion within a body, a first end configured for insertion into the body with a second end extending out of the body. A central lumen of the sheath is configured to permit introduction of the lead and includes a flexible, kink-resistant section smooth on its outer surface with a helical pleat defining a helical groove enabling a conductor extending from the mapping probe to the pacing system analyzer to be received in the helical groove of the sheath. A mapping probe at the first end of the sheath is connectable to a pacing system analyzer for seeking a location on the myocardial surface of the heart or an endocardial location at which optimal pacing parameters can be achieved prior to implantation of the lead.

Abstract: A medical electrical lead to conduct electrical stimulation and/or signals between an electrical stimulator and a heart site includes an elongated lead body extending to a proximal connector for attachment to the electrical stimulator. An electrode head at the distal end includes an electrode tip member for fixation to the heart and an electrode backing member fixed to the lead body is releasably attachable to the electrode tip member for transmission of electrical signals between the heart and the electrical stimulator. The electrode tip member may include a first non-conductive base with an outwardly projecting tip electrode and a first mounting member projecting oppositely away from the non-conductive base. The electrode backing member includes a second non-conductive base and a second mounting member thereon adapted for mounting engagement with the first mounting member for selectively releasably but firmly integrating the electrode tip member and the electrode backing member.

Abstract: An omnidirectionally steerable obturator facilitates the delivery of the distal tip of an introducer sheath into the coronary sinus of a heart. The steerable obturator comprises an obturator body extending longitudinally along a central axis, the obturator body being configured to be received by the introducer sheath. The obturator body further has a flexible, deflectable distal end section terminating in a rounded distal tip. An actuator, controllable from a proximal end of the obturator body, is operatively associated with the flexible distal end section of the obturator body to cause deflection of the flexible distal end section of the obturator body in at least one selected direction to facilitate passage of the distal end section of the obturator body and the distal tip of the introducer sheath into the coronary sinus of the heart. The obturator body is preferably configured to be received in a close fit within at least the tip of the introducer sheath.

Abstract: An implantable single-pass cardiac stimulation lead provides for placement of electrodes into electrical contact with two chambers of a patient's heart. The lead includes an inner lead body having at least one electrode at its distal end and an outer lead body having at least one electrode at its distal end. The outer lead body has an internal lumen that slidingly receives the inner lead body. The inner lead body is extendable from the outer lead body at a point proximal to the distal end of the outer lead body. The sliding of the inner lead body relative to the outer lead body enables the inner lead body distal electrode to have a varying distance from the outer lead body distal electrode and enables the inner lead body to extend into the coronary sinus region of the heart to place the inner lead body electrode into electrical contact with the left ventricle.

Abstract: An implantable lead for electrical stimulation of the body includes an elongated multi-lumen proximal tube composed of a first material having a first lumen for freely receiving a guidewire therethrough, a cable conductor extending between proximal and distal ends and received in a second lumen of the proximal tube, an elongated distal tube composed of a second material extending between proximal and distal ends having at least one lumen therein, a distal tip electrode attached to the distal end of the distal tube, a coil conductor received in the lumen of the distal tube extending between the proximal end thereof and the distal end thereof and being joined at the distal end to the distal tip electrode, and a joint assembly for electrically and mechanically connecting the distal end of the cable conductor to the proximal end of the coil conductor.

Abstract: An implantable stimulation lead is disclosed for placement in the coronary sinus region and its associated coronary vessels overlying the left side of a patient's heart. The lead comprises at least one proximal connector; at least one tissue stimulation electrode; at least one conductor coupled between the at least one proximal connector and the at least one stimulation electrode; and a lead body including a housing of insulating material enclosing the at least one conductor, the lead body having a relatively flexible distal portion of, for example, silicone rubber, having a length corresponding to the coronary sinus region of the heart, and a stiffer proximal portion of, for example, polyurethane. A robust transition joint comprising telescoped sections of the distal and proximal portions of the lead body couples the two portions of the lead body. Also provided is a versatile lead delivery system including a stylet stop disposed within the distal portion of the lead body.

Abstract: A stylet unit for implanting a removable lead system for a cardiac stimulation device includes an elongated main body having an enlarged feature at the distal end of the main body with a rounded blunt tip end, a width greater than the width of the distal end of the main body, and a length greater than the width. A finger grip is provided at a proximal extremity of the elongated main body for manipulating the stylet unit. Lead system includes an elongated tubular lead body containing an elongated coil conductor with a plurality of coil windings defining a passageway extending the length of the coil conductor and having inner surfaces facing toward the passageway. The enlarged feature of the stylet is sufficiently long to assure that it advances along the passageway in slidable engagement with the inner surfaces of the coil conductor but without thrusting between adjoining coils.

Abstract: An implantable lead is provided for delivering electrical therapy. The lead, suitable for placement and passive anchoring in a vessel within the coronary sinus region of a patient's heart, comprises a lead body having a distal end carrying at least one electrode electrically connected to a terminal contact on a proximal end of the lead body, the lead body further including an insulative, tubular housing. A longitudinally extending coil member is contained within the housing, the housing and the coil member having distal ends provided with corresponding, substantially matching preformed bends, the distal end of the housing being thereby adapted to exert a sufficient bias against the inner wall of the vessel within which the lead is placed to stabilize the lead in said vessel.

Abstract: An implantable endocardial lead intended for use with a cardiac stimulation device includes an elongated lead body of flexible resilient material, for example, silicone rubber or polyurethane, having a longitudinally extending lumen defined by a plurality of longitudinally extending side wall surfaces, adjacent pairs of the side wall surfaces lying in angularly disposed planes and intersecting at an energy absorbing corner ridge. An electrical conductor is located loosely within and extends longitudinally along the lumen between proximal and distal ends. With this construction, forces imposed laterally on the lead body by the conductor engaging the side wall surfaces of the lumen upon bending of the lead body are absorbed without damaging the lead body by reason of engagement of the conductor with a corner ridge causing the corner ridge thereby engaged to recede toward a condition of being coplanar with its subtended pair of side wall surfaces.

Abstract: An implantable stimulation lead is disclosed for placement in the coronary sinus region and its associated coronary vessels overlying the left side of a patient's heart. The lead comprises at least one proximal connector; at least one tissue stimulation electrode; at least one conductor coupled between the at least one proximal connector and the at least one stimulation electrode; and a lead body including a housing of insulating material enclosing the at least one conductor, the lead body having a relatively flexible distal portion of, for example, silicone rubber, having a length corresponding to the coronary sinus region of the heart, and a stiffer proximal portion of, for example, polyurethane. A robust transition joint comprising telescoped sections of the distal and proximal portions of the lead body couples the two portions of the lead body.

Abstract: Devices and methods are described that permit simple correction of a fiber optic polarity reversal problem. An adapter is described having receptacles to receive a connector on a first end, or user end, and on a second end, or contractor end. Both the receptacles provide keying arrangements so that the connectors can be received only when correctly oriented with respect to the adapter. The keying arrangement on the contractor end, however, is reversable so that the connector may be inserted in one of two predetermined orientations, at the behest of the contractor or installer. Adapters are also described that receive connectors only in a physically reversed orientation to counteract a reverse polarity condition. In addition, a jumper is described that can be interposed between a connector and adapter to correct a reverse polarity condition.

Abstract: An implantable lead for electrical stimulation of the body includes an elongated multi-lumen proximal tube composed of a first material having a first lumen for freely receiving a guidewire therethrough, a cable conductor extending between proximal and distal ends and received in a second lumen of the proximal tube, an elongated distal tube composed of a second material extending between proximal and distal ends having at least one lumen therein, a distal tip electrode attached to the distal end of the distal tube, a coil conductor received in the lumen of the distal tube extending between the proximal end thereof and the distal end thereof and being joined at the distal end to the distal tip electrode, and a joint assembly for electrically and mechanically connecting the distal end of the cable conductor to the proximal end of the coil conductor.

Abstract: A housing is provided for interconnecting customer premises equipment with a digital subscriber line (DSL) at a location remote from a telephone company central office. The housing includes a base defining an interior cavity and at least one xDSL/POTS splitter positioned within the interior cavity. The splitter combines a POTS signal and a data signal from the central office into a combined signal on the DSL and separates a combined signal on the DSL from the customer premises equipment into the POTS signal and the data signal. In a particular embodiment, a back-plane circuit board having at least one card socket connector is positioned within the interior cavity and the splitter is mounted on a circuit card having a board edge connector. The board edge connector is received within the card socket connector to electrically connect the splitter to the back-plane circuit board.

Abstract: An implantable stimulation lead system comprises a lead including a lead body dimensioned for placement inside the coronary sinus region. The lead system further comprises a device dimensioned for insertion within a lumen in the lead, the device including a main body; a steering knob secured to a proximal extremity of the main body; and a flexible distal portion secured to a distal extremity of the main body. The main body has a length such that, with the main body of the device substantially completely advanced within the lead, the flexible distal portion of the device projects distally from the aperture in the distal tip of the lead body. The flexible distal portion of the device may comprise a proximal section and a distal section, the distal section being more flexible, and thus softer, than the proximal section.

Abstract: An implantable cardiac lead system suitable for placement in the coronary sinus region of the heart. The lead system comprises a lead having two or more non-helical bends in its distal portion. The two or more non-helical bends cooperate to prevent the lead from dislodgment or displacement inside the coronary sinus. The lead system may further comprise a stylet suitable for steering the lead into at least one of the coronary sinus vein, great cardiac vein, left marginal vein, left posterior ventricular vein, and small cardiac vein. The stylet is tapered in its distal portion to provide enhanced maneuverability and steerability inside the coronary sinus region. The lead system may also comprise an introducer which aids in introducing the lead into the heart.

Abstract: An electrode assembly including a tip electrode and a longitudinally extending axially aligned weld electrode egageably receiving a distal end of a coiled wire strand conductor at a proximal end. A connector member includes a fastener having an enlarged head and a threaded shank, the weld electrode includes an integral weld sleeve with an annular locking tab engageable with the enlarged head to prevent longitudinal movement while permitting rotational movement. The weld electrode has an internal bore for receiving an elongated stylet selectively engageable therewith for implanting and explanting the electrode assembly. The tip electrode includes an integral attachment sleeve having an outer peripheral surface extending in a direction away from the tip and having a longitudinally extending tapped bore for engagement with the threaded shank of the connector member. The weld sleeve and attachment sleeve are mutually stepped to prevent their relative rotation when in the locked position.

Abstract: A single chronic implantable cardiac lead for use in the coronary sinus region of the heart provides both atrial and ventricular pacing and defibrillation therapy. The lead includes an elongated lead body having a distal end and a proximal end, a first electrode assembly including a ventricular pacing electrode and a ventricular defibrillation at the distal end, a second electrode assembly proximal to the first electrode assembly including at least one atrial pacing electrode and an atrial defibrillation electrode, and a further defibrillation electrode proximal to the second electrode assembly. The electrode assemblies and further defibrillation electrode are spaced apart so that when the lead is implanted within the coronary sinus region of the heart with the first electrode assembly adjacent the left ventricle, the second electrode assembly is adjacent the left atrium and the further defibrillation electrode is within the right atrium and/or the superior vena cava.

Abstract: An electrode assembly for a body implantable lead provided for the delivery of stimulation energy to a desired body site includes a tip electrode having a face adapted for positioning at least adjacent the desired body site and a longitudinally extending axially aligned weld electrode engageably receiving a distal end of an electrical conductor at a proximal end. The electrical conductor is a coiled wire strand with an inner peripheral surface for fitting reception on an outer peripheral surface of the weld electrode. A connector member includes a fastener having an enlarged head and a threaded shank, the weld electrode includes an integral weld sleeve with an annular locking tab engageable with the enlarged head to prevent longitudinal movement while permitting rotational movement. The weld electrode has an internal bore for receiving an elongated stylet selectively engageable therewith for implanting the electrode assembly at a desired body site and for explanting the electrode assembly from that body site.