Abstract: A distal electrode of an electrode assembly, for example, employed by an implantable medical electrical lead device, extends distally from a distal terminal end of a sleeve of the assembly; and the sleeve, which defines a longitudinal axis of the assembly, includes a plurality of channels that provide fluid communication between a steroid eluting component, which is seated in an external groove of the sleeve, and an area distal to the distal terminal end of the sleeve. Floors of some or all of the sleeve channels may angle toward the longitudinal axis of the assembly, being closer to the axis at the distal terminal end of the sleeve. The assembly may further include a proximal electrode secured to a proximal end of the sleeve, wherein the proximal electrode may be mounted around an outer surface of the sleeve or coupled to the sleeve by means of a coupling component.

Abstract: A method and system for employing a medical device is disclosed. The medical device includes a housing, a processor disposed within the housing, a connector module, and a medical electrical epicardial lead connected to the processor through the connector module. The epicardial lead is used to sense a cardiac signal from tissue of a patient. The lead comprises an insulative lead body that includes a proximal end and a distal end, at least one conductor disposed in the lead body, and a side helical fixation member, disposed a distance from the distal end, the side helical fixation member. The side helical fixation member comprises a set of windings configured to wrap around the lead body circumference. The side helical fixation member includes a distal tip comprising a sharpened elongated flat free end that is perpendicular to the lead body and angled toward an inside of the set of windings.

Abstract: This disclosure is directed to a curvilinear medical electrical lead. For example, a medical electrical lead includes a lead body, a high voltage electrode positioned on the lead body, the high voltage electrode comprising a proximal coated portion, a distal coated portion, and an uncoated portion. Additionally, the medical electrical lead includes a first low voltage electrode and a second low voltage electrode distal to the first low voltage electrode, wherein a first line passes through the first low voltage electrode and the second low voltage electrode, wherein a second line passes through the first low voltage electrode and the uncoated portion, the second line forming a first angle with the first line, and wherein a third line passes through the second low voltage electrode and the uncoated portion, the third line forming a second angle with the first line.

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: A medical access tool includes a needle member extending along a longitudinal axis, and a coiled wire extending around the axis. An inner surface of the coiled wire, along a proximal segment thereof, is spaced radially apart from an outer surface of the needle member, and a distal segment of the coiled wire extends distally to a tissue-engaging tip of the coiled wire, a piercing distal tip of the needle member being recessed proximally from the tissue-engaging tip at a fixed distance. An operator may rotate the coiled wire to engage tissue, for example, that of a pericardial sac or a diaphragmatic attachment, which then travels proximally along the coiled wire and into contact with the needle member's distal tip, to be pierced through thereby. At least one lumen of the needle member provides a passageway through which the operator may advance a guide wire and/or inject a fluid.

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: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

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: 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: An extra-cardiovascular implantable cardioverter defibrillator (ICD) having a low voltage therapy module and a high voltage therapy module is configured to select, by a control module of the ICD, a pacing output configuration from at least a low-voltage pacing output configuration of the low voltage therapy module and a high-voltage pacing output configuration of the high voltage therapy module. The high voltage therapy module includes a high voltage capacitor having a first capacitance and the low voltage therapy module includes a plurality of low voltage capacitors each having up to a second capacitance that is less than the first capacitance. The ICD control module controls a respective one of the low voltage therapy module or the high voltage therapy module to deliver extra-cardiovascular pacing pulses in the selected pacing output configuration via extra-cardiovascular electrodes coupled to the ICD.

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract: In some examples, an implantable medical device (IMD) that includes a pulse generator comprising a housing, electrodes, and circuitry configured to deliver cardiac pacing via the electrodes. The IMD may further include a lead including at least one of the electrodes, an elongate body, a fixation helix, and a connector segment. A width of the helix transverse to a longitudinal axis of the lead is greatest at a distal end of the helix. A proximal end of the elongate body may be connected to a distal end of the pulse generator, and the helix may be attached to a distal end of the elongate body. The pulse generator may include a first connector tab. A distal end of the connector segment may be configured to receive the proximal end of the elongate body and a proximal end of the connector segment may include at least one second connector member configured to engage the first connector tab.

Abstract: An implantable medical device is configured to control a therapy module to couple a capacitor array comprising a plurality of capacitors to a plurality of extra-cardiovascular electrodes and control the therapy module to deliver a composite pacing pulse to a patient's heart via the plurality of extra-cardiovascular electrodes by sequentially discharging at least a portion of the plurality capacitors to produce a series of at least two individual pulses that define the composite pacing pulse.

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) having a low voltage therapy module and a high voltage therapy module is configured to select, by a control module of the ICD, a pacing output configuration from at least a low-voltage pacing output configuration of the low voltage therapy module and a high-voltage pacing output configuration of the high voltage therapy module. The high voltage therapy module includes a high voltage capacitor having a first capacitance and the low voltage therapy module includes a plurality of low voltage capacitors each having up to a second capacitance that is less than the first capacitance. The ICD control module controls a respective one of the low voltage therapy module or the high voltage therapy module to deliver extra-cardiovascular pacing pulses in the selected pacing output configuration via extra-cardiovascular electrodes coupled to the ICD.

Abstract: In some examples, a system includes a medical device comprising an elongate body configured to advance through layers of tissue of a patient, a lumen extending through the elongate body, a fluid line configured to supply fluid to the lumen, and a pressure sensor positioned within the lumen or the fluid line. The system may further include processing circuitry configured to receive, from the pressure sensor, a signal corresponding to the pressure of the fluid at each of a plurality of time points, determine, for each time point: a corresponding amplitude value of the signal, a difference between two amplitude values of the signal, an amplitude oscillation status of the signal, a position of the elongate body based on the difference and the amplitude oscillation status; and provide an indication of the position of the elongate body relative to the layers of tissue.

Abstract: An implantable medical lead may include an electrode at a distal portion of the lead that is configured to monitor or provide therapy to a target site. The lead may include a visible indicator that is visible to the naked eye of a clinician at a medial portion of the lead that is configured to indicate when the electrodes of the lead are longitudinally and radially aligned properly to monitor or treat the target site. A clinician may insert the lead into the patient using an introducer sheath inserted to a predetermined depth into the patient and subsequently aligning the distal portion of the lead by orienting the indicator at an entry port of the introducer sheath.

Abstract: An implantable medical device is configured to control a therapy module to couple a capacitor array comprising a plurality of capacitors to a plurality of extra-cardiovascular electrodes and control the therapy module to deliver a composite pacing pulse to a patient's heart via the plurality of extra-cardiovascular electrodes by sequentially discharging at least a portion of the plurality capacitors to produce a series of at least two individual pulses that define the composite pacing pulse.

Abstract: A distal electrode of an electrode assembly, for example, employed by an implantable medical electrical lead device, extends distally from a distal terminal end of a sleeve of the assembly; and the sleeve, which defines a longitudinal axis of the assembly, includes a plurality of channels that provide fluid communication between a steroid eluting component, which is seated in an external groove of the sleeve, and an area distal to the distal terminal end of the sleeve. Floors of some or all of the sleeve channels may angle toward the longitudinal axis of the assembly, being closer to the axis at the distal terminal end of the sleeve. The assembly may further include a proximal electrode secured to a proximal end of the sleeve, wherein the proximal electrode may be mounted around an outer surface of the sleeve or coupled to the sleeve by means of a coupling component.

Abstract: An implantable medical device (IMD) can include a cardiac pacemaker or an implantable cardioverter-defibrillator (ICD). Various portions of the IMD, such as a device body, a lead body, or a lead tip, can be provided to reduce or dissipate a current and heat induced by various external environmental factors. According to various embodiments, features can be incorporated into the lead body, the lead tip, or the IMD body to reduce the creation of an induced current, or dissipate the induced current and heat created due to an induced current in the lead. For example, an IMD can include at least one outer conductive member and a first electrode. The first electrode can be in electrical communication with the at least one outer conductive member. The first electrode can dissipate a current induced in the at least one outer conductive member via a first portion of the anatomical structure.

Abstract: A tool for inserting an elongate medical device into a body includes a track (e.g. defined by inner surfaces of a base wall and opposing sidewalls), and a deployment assembly for moving the device along the track. A retainer of the assembly, fitted in sliding engagement within the track and limited to move only along a portion of the track, grips a first portion of a proximal length of the device; a slider of the assembly, also fitted in sliding engagement within the track and detachably joined to the retainer, receives a second portion of the device proximal length. When detached from the retainer, the slider is free to move along a distal length of the device, and can be moved along a distal segment of the track to disengage therefrom by separating from a distal terminal end of the guide.