Abstract: A joint between an insulative sidewall of a medical electrical lead subassembly and an underlying fluoropolymer layer includes an interfacial layer. A first section of the interfacial layer is bonded to the fluoropolymer layer and is formed by a thermoplastic fluoropolymer; a second section of the interfacial layer extends adjacent the first section and is bonded to the insulative sidewall. The insulative sidewall, of the subassembly, and the second section, of the interfacial layer, are each formed from a material that is not a fluoropolymer. A recess is formed in the first section of the interfacial layer and the second section of the interfacial layer extends within the recess.

Abstract: A medical device lead. The lead includes one or more jacketed conductive elements. The jacket comprises one or more covers. A first cover of polytetrafluoroethylene (PTFE) is in direct contact with the at least one conductive element. The at least one conductive element and the PTFE cover are coiled. The coiled conductive element can substantially retain its original coiled shape.

Abstract: This disclosure provides various embodiments of implant tools and implant techniques utilizing those tools. In one embodiment, an implant tool comprises a handle and a shaft. The shaft includes a proximal end adjacent the handle, a distal end, an open channel that extends from near the proximal end to the distal end, and at least one lumen that extends from a proximal end of the shaft to a location near the distal end of the shaft. The implant tool may also include a coupler configured to connect to a fluid delivery device. In one example, the fluid delivery device may be a syringe. In some instances, the handle of the implant tool may include a compartment or a recess configured to receive the fluid delivery device.

Abstract: Extravascular implant tools that utilize a bore-in mechanism to safely access extravascular locations and implant techniques utilizing these tools are described. The bore-in mechanism may include a handle and a helix extending from the handle. The bore-in mechanism is used, for example, in conjunction with a tunneling tool to traverse the diaphragmatic attachments to access a substernal location. The tunneling tool may be an open channel tunneling tool or a conventional tunneling tool (e.g., metal rod).

Abstract: This disclosure describes an implantable medical electrical lead and an ICD system utilizing the lead. The lead includes a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration. The lead includes a defibrillation electrode that includes a plurality of defibrillation electrode segments disposed along the undulating configuration spaced apart from one another by a distance. The lead also includes at least one electrode disposed between adjacent sections of the plurality of defibrillation sections. The at least one electrode is configured to deliver a pacing pulse to the heart and/or sense cardiac electrical activity of the heart.

Abstract: This disclosure provides various embodiments of implant tools and implant techniques utilizing those tools to implant components within extravascular locations. In one example, an implant tool for implanting a component within an extravascular location of a patient comprise a handle and a shaft adjacent the handle. The shaft has a proximal end, a distal end, and a body formed to define an open channel that extends from near the proximal end to the distal end. The open channel has a first width. The body has at least one flexible portion that defines an opening via which the open channel is accessed. The opening has a second width that is less than the first width. In another example, a sheath with an opening having the second width may be placed on the shaft of the implant tool instead of the implant tool having the at least one flexible portion.

Abstract: A lead body having a defibrillation electrode positioned along a distal portion of the lead body is described. The defibrillation electrode includes a plurality of electrode segments spaced a distance apart from each other. At least one of the plurality of defibrillation electrode segments includes at least one coated portion and at least one uncoated portion. The at least one coated portion is coated with an electrically insulating material configured to prevent transmission of a low voltage signal (e.g., a pacing pulse) while allowing transmission of a high voltage signal (e.g., a cardioversion defibrillation shock). The at least one uncoated portion is configured to transmit both low voltage and high voltage signals. The lead may also include one or more discrete electrodes proximal, distal or between the defibrillation electrode segments.

Abstract: The disclosure describes implantable medical systems that respond to occurrence of a lead-related condition by utilizing an elongated coil electrode in defining an alternative pacing therapy vector to maintain optimal drain of an IMD power supply. An exemplary system includes a medical electrical lead having an elongated electrode and an improved sensing and therapy delivery circuitry to provide the alternative pacing therapy vector responsive to the lead-related conditions. The system reconfigures the operation of the sensing and therapy delivery circuitry triggered by the switch to the alternative pacing therapy vector.

Abstract: An implantable medical therapy delivery device includes a non-conductive filament extending along a length of an outer surface of an insulative body of the device, wherein the filament includes a plurality of fixation projections and is secured to the outer surface of the insulative body such that the projections protrude outward from the outer surface and are spaced apart from one another along the length of the outer surface. The filament may be wound about the length with an open pitch. In some cases, the insulative body includes an open-work member forming at least a portion of the outer surface thereof, and the filament may be interlaced with the open-work member. In these cases, the filament may be bioabsorbable, for example, to provide only acute fixation via the projections thereof, while the open-work member provides a structure for tissue ingrowth and, thus, more permanent or chronic fixation.

Abstract: This disclosure provides a medical lead assembly that includes a lead body having a proximal end configured to couple to an implantable medical device and a distal end. The lead assembly further includes an electrode assembly located at the distal end of the lead body, the electrode assembly including a tip electrode, a conductive electrode shaft that is electrically coupled to the tip electrode and an energy dissipating structure that is coupled to at least a portion of the conductive electrode shaft at high frequencies to redirect at least a portion of the current induced in the lead by a high frequency signal from the tip electrode to the energy dissipating structure.

Abstract: A connector assembly of an implantable medical electrical lead includes insulation and conductor segments, which may be formed together in a molded subassembly. The insulation segment includes at least one sealing surface, and the conductor segment includes at least one contact surface and a shank electrically common therewith. The shank has a smaller diameter than a uniform outer diameter of the assembly, which is defined by the sealing and contact surfaces, and the smaller diameter is sized to receive a coiled proximal end of a lead conductor mounted thereabout. The connector assembly may include another conductor segment that has a third contact surface, active or inactive, extending between third and fourth sealing surfaces of another insulation segment of the assembly; if active, a distal shank of the segment is electrically common with the third contact surface, and sized to receive a coiled proximal end of another lead conductor mounted thereabout.

Abstract: A medical electrical lead may include a conductive electrode shaft located near the distal end within the lead body, a coiled conductor extending within the lead body from the proximal end and coupled to a first end of the conductive electrode shaft, and an electrode located near the distal end of the lead body and coupled to an opposite end of the conductive electrode shaft as the coiled conductor. The lead may also include an energy dissipating structure located near the distal end of the lead body and defining a lumen through which a portion of the coiled conductor extends. The energy dissipating structure may include a region having one or more protrusions extending toward a central axis of the lumen to push the coiled conductor off center relative to the central axis of the lumen.

Abstract: The disclosure describes implantable medical systems that respond to occurrence of a lead-related condition by utilizing an elongated coil electrode in defining an alternative pacing therapy vector to maintain optimal drain of an IMD power supply. An exemplary system includes a medical electrical lead having an elongated electrode and an improved sensing and therapy delivery circuitry to provide the alternative pacing therapy vector responsive to the lead-related conditions. The system reconfigures the operation of the sensing and therapy delivery circuitry triggered by the switch to the alternative pacing therapy vector.

Abstract: A connector assembly of an implantable medical electrical lead includes insulation and conductor segments, which may be formed together in a molded subassembly. The insulation segment includes at least one sealing surface, and the conductor segment includes at least one contact surface and a shank electrically common therewith. The shank has a smaller diameter than a uniform outer diameter of the assembly, which is defined by the sealing and contact surfaces, and the smaller diameter is sized to receive a coiled proximal end of a lead conductor mounted thereabout. The connector assembly may include another conductor segment that has a third contact surface, active or inactive, extending between third and fourth sealing surfaces of another insulation segment of the assembly; if active, a distal shank of the segment is electrically common with the third contact surface, and sized to receive a coiled proximal end of another lead conductor mounted thereabout.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An example implant tool for implanting a medical lead includes a rod having a handle and a shaft, and a sheath configured to be placed on the shaft of the rod. The sheath includes a body having proximal end and a distal, a channel formed by the body, the channel extending from the proximal end to the distal end of the body, and an opening that extends along the body of the sheath from the proximal end to the distal end, wherein the channel is accessible via the opening.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An implant tool for implanting a medical lead may include a handle and a shaft adjacent the handle. The shaft has a proximal end, a distal end, and an open channel that extends from near the proximal end to the distal end, the open channel having a width that is greater than or equal to an outer diameter of the implantable medical lead.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An implant tool for implanting a medical lead may include a shaft having a proximal end, a distal end, an open channel that extends from near the proximal end to the distal end, and an attachment feature configured to couple to the medical lead. Such an implant tool provides a user with the versatility to use the same implant tool to either pull the lead through a tunnel formed via the implant tool or push the lead through the tunnel via the open channel in the implant tool.

Abstract: Implant tools and techniques for implantation of a medical lead, catheter or other implantable component are provided. The implant tools and techniques are particularly useful in implanting medical electrical leads in extravascular locations, including subcutaneous locations. An example implant tool for implanting a medical lead includes a rod and a sheath configured to be placed on the rod. The rod includes a handle, a shaft having a proximal end adjacent to the handle and a distal end, and an attachment feature toward the distal end of the shaft, the attachment feature configured to couple to the medical lead. The sheath is configured to be placed in multiple positions along the rod including a first position in which the sheath does not interact with the attachment feature and second position in which the sheath does interact with the attachment feature.

Abstract: A medical device lead is presented that includes an electrode assembly having a first electrode located near a distal end of the electrode assembly and a second electrode located near a proximal end of the electrode assembly. The electrode assembly also includes a conductive elongated coupler that is electrically coupled to the first electrode and capacitively coupled to the second electrode. At low frequencies and DC (e.g., during delivery of stimulation therapy), the capacitive coupling between the conductive elongated coupler and the second electrode presents a high impedance allowing little current to be redirected from the first electrode to the second electrode. However, at high frequencies (e.g., during an MRI scan) the capacitive coupling between the conductive elongated coupler and the second electrode presents a low impedance, resulting in a significant amount of induced current being redirected to the second electrode and dissipated into bodily fluid surrounding the second electrode.

Abstract: The disclosure describes implantable medical systems that respond to occurrence of a lead-related condition by utilizing an elongated coil electrode in defining an alternative pacing therapy vector to maintain optimal drain of an IMD power supply. An exemplary system includes a medical electrical lead having an elongated electrode and an improved sensing and therapy delivery circuitry to provide the alternative pacing therapy vector responsive to the lead-related conditions. The system includes circuitry for recognition of the lead type in order to respond to the occurrence of the lead-related condition.