Abstract: A guiding accessory, for use in conjunction with a guidewire and a catheter of an implant system, facilitates passage of an elongate and flexible conductor of a relatively compact therapy delivery device to an implant site, for example, within the cardiac venous system, when a therapy generator of the device is held within a distal portion of the catheter, and the catheter, device and guiding accessory are advanced along the guidewire. The guiding accessory includes a helically extending wall that forms a lumen within which the device conductor and guidewire extend. After advancing the catheter, guiding accessory and device to the implant site, the helically extending wall is unwound from around the device conductor, for removal, preferably, by pulling proximally on a tension line, which is attached to a proximal end of the wall.

Abstract: A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module.

Abstract: A device includes a signal generator module, a processing module, and a housing. The signal generator module is configured to deliver pacing pulses to an atrium. The processing module is configured to detect a ventricular activation event and determine a length of an interval between the ventricular activation event and a previous atrial event that preceded the ventricular activation event. The processing module is further configured to schedule a time at which to deliver a pacing pulse to the atrium based on the length of the interval and control the signal generator module to deliver the pacing pulse at the scheduled time. The housing is configured for implantation within the atrium. The housing encloses the stimulation generator and the processing module.

Abstract: An instrument including an elongated shaft and a non-conductive handle is disclosed. The shaft defines a proximal section and a distal section. The distal section forms an electrically conductive tip. Further, the shaft is adapted to be transitionable from a straight state to a first bent state. The shaft is capable of independently maintaining the distinct shapes associated with the straight state and the first bent state. The handle is rigidly coupled to the proximal section of the shaft. The instrument is useful for epicardial pacing and/or mapping of the heart for temporary pacing on a beating heart, for optimizing the placement of ventricular leads for the treatment of patients with congestive heart failure and ventricular dysynchrony and/or for use in surgical ablation procedures.

Abstract: A holding member for an implantable cardiac device facilitates tether attachment and removal, at time of implant, and snaring, or otherwise capturing, for subsequent explant. Preferably located in proximity to a proximal end wall of a shell of the device, the holding member includes a strut portion, being spaced proximally apart from the proximal end wall, a waist portion, defining a recess, and an engagement section, extending between the strut portion and the waist portion and overhanging the recess. The waist portion may either extend between the strut portion and the proximal end wall, or be formed in the shell, distal to the proximal end wall. Alternately, the holding member includes a loop element and an engagement element coupled thereto, between first and second segments thereof. The segments are initially formed to give the loop element an opening, and have a flexibility to be compressed together.

Abstract: Disclosed techniques include monitoring a physiological characteristic of a patient with a sensor that is mounted to an inner wall of a thoracic cavity of the patient, and sending a signal based on the monitored physiological characteristic from the sensor to a remote device.

Abstract: Embodiments of the invention provide a vessel support system and a method of vessel harvesting. The system can include a cutting device, a catheter adapted to be inserted into a section of the vessel in order to support the vessel as the cutting device is advanced over the vessel, and a cannula adapted to be coupled to the vessel and adapted to receive the catheter as the catheter is inserted into the section of the vessel. The method can include orienting a cutting device coaxially with the cannula and the catheter and advancing the cutting device over the cannula, the catheter, and the section of the vessel in order to core out the section of the vessel and a portion of the surrounding tissue.

Abstract: The invention provides a system and method for harvesting a vessel section. The system comprises a vessel support member, a handle, and a tubular cutting device. The vessel support member is introduced into the vessel section to be harvested. The tubular cutting device may comprise an outer tubular member or an outer and an inner tubular member. The outer tubular member carries at least one cutting element. The tubular member or members are advanced over the vessel section and vessel support member to core out the vessel section and tissue adjoining the vessel section.

Abstract: A holding member for an implantable cardiac device facilitates tether attachment and removal, at time of implant, and snaring, or otherwise capturing, for subsequent explant. Preferably located in proximity to a proximal end wall of a shell of the device, the holding member includes a strut portion, being spaced proximally apart from the proximal end wall, a waist portion, defining a recess, and an engagement section, extending between the strut portion and the waist portion and overhanging the recess. The waist portion may either extend between the strut portion and the proximal end wall, or be formed in the shell, distal to the proximal end wall. Alternately, the holding member includes a loop element and an engagement element coupled thereto, between first and second segments thereof. The segments are initially formed to give the loop element an opening, and have a flexibility to be compressed together.

Abstract: A guiding accessory, for use in conjunction with a guidewire and a catheter of an implant system, facilitates passage of an elongate and flexible conductor of a relatively compact therapy delivery device to an implant site, for example, within the cardiac venous system, when a therapy generator of the device is held within a distal portion of the catheter, and the catheter, device and guiding accessory are advanced along the guidewire. The guiding accessory includes a helically extending wall that forms a lumen within which the device conductor and guidewire extend. After advancing the catheter, guiding accessory and device to the implant site, the helically extending wall is unwound from around the device conductor, for removal, preferably, by pulling proximally on a tension line, which is attached to a proximal end of the wall.

Abstract: This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

Abstract: Apparatus and methods for injecting biological agents into tissue. Devices are provided having elongate shafts and distal injection heads for transversely driving needles into tissue and injecting medical agents into the tissue through the needles. A longitudinal force directed along the shaft can be translated to a needle driving force transverse to the shaft. Some devices provide controllably variable needle penetration depth. Devices include mechanical needle drivers utilizing four link pantographs, rack and pinions, and drive yokes for driving a first needle bearing body toward a second tissue contacting body. Other devices include inflatable members for driving and retracting needles. Still other devices include magnets for biasing the needles in extended and/or retracted positions. The invention includes minimally invasive methods for epicardially injecting cardiocyte precursor cells into infarct myocardial tissue.

Abstract: Various fixation techniques for implantable medical device (IMDs) are described. In one example, an assembly comprises an IMD; and a set of active fixation tines attached to the IMD. The active fixation tines in the set are deployable from a spring-loaded position in which distal ends of the active fixation tines point away from the IMD to a hooked position in which the active fixation tines bend back towards the IMD. The active fixation tines are configured to secure the IMD to a patient tissue when deployed while the distal ends of the active fixation tines are positioned adjacent to the patient tissue.

Abstract: An assembly includes an implantable medical device (IMD) including a conductive housing, and a fixation element assembly attached to the IMD. The fixation element assembly includes a set of active fixation tines and an insulator to electrically isolate the set of active fixation tines from the conductive housing of the implantable medical device. The active fixation tines in the set are deployable from a spring-loaded position in which distal ends of the active fixation tines point away from the implantable medical device to a hooked position in which the active fixation tines bend back towards the implantable medical device. The active fixation tines are configured to secure the implantable medical device to a patient tissue when deployed while the distal ends of the active fixation tines are positioned adjacent to the patient tissue.

Abstract: System and method for extracting an implantable medical device. An implantable medical device has a fixation member operatively coupled to the housing having an engaged state configured to engage tissue of a patient, the medical device being magnetically attractable. A catheter has a lumen and a distal portion configured for insertion in proximity of the implantable medical device. A magnetic element is configured to pass through the lumen of the catheter and to magnetically engage the implantable medical device when inserted toward the distal portion of the catheter.

Abstract: System and method for implanting an implantable medical device. A catheter has a lumen and a distal portion configured for insertion in proximity of tissue of a patient. An implantable medical device has a fixation member operatively coupled to the housing having an unengaged state when in the lumen of the catheter and an engaged state configured to engage tissue of a patient when outside of the lumen of the catheter, the medical device being magnetically attractable. A magnetic element is configured to magnetically engage the implantable medical device and to pass through the lumen of the catheter.

Abstract: Embodiments of the invention provide a cutting device and method of vessel harvesting. The cutting device can include at least one tubular member, a cutting element, and a centering member. The cutting device can include at least one tubular member with a flexible section and a cutting element. The method of vessel harvesting can include spacing a cutting element of the cutting device from the vessel as the cutting element is advanced over the vessel.

Abstract: Apparatus and methods for injecting biological agents into tissue. Devices are provided having elongate shafts and distal injection heads for transversely driving needles into tissue and injecting medical agents into the tissue through the needles. A longitudinal force directed along the shaft can be translated to a needle driving force transverse to the shaft. Some devices provide controllably variable needle penetration depth. Devices include mechanical needle drivers utilizing four link pantographs, rack and pinions, and drive yokes for driving a first needle bearing body toward a second tissue contacting body. Other devices include inflatable members for driving and retracting needles. Still other devices include magnets for biasing the needles in extended and/or retracted positions. The invention includes minimally invasive methods for epicardially injecting cardiocyte precursor cells into infarct myocardial tissue.

Abstract: The current invention discloses a method for treating infracted/ischemic injury to a myocardium by injecting a substance into the myocardium. The injected substance helps to prevent negative adaptive remodeling by providing mechanical reinforcement or mechanical reinforcement combined with biological therapy. A number of substances for injection are disclosed, including multi component substances such as platelet gel, and other substances. The substances disclosed may contain additives to augment/enhance the desired effects of the injection. The invention also discloses devices used to inject the substances. The devices can include means for ensuring needles do not penetrate beyond a desired depth into the myocardium. The devices can also include needles having multiple lumens such that the components of the platelet gel will be combined at the injection site and begin polymerization in the myocardium.

Abstract: Embodiments of the invention provide a vessel support system and a method of vessel harvesting. The system can include a cutting device, a catheter adapted to be inserted into a section of the vessel in order to support the vessel as the cutting device is advanced over the vessel, and a cannula adapted to be coupled to the vessel and adapted to receive the catheter as the catheter is inserted into the section of the vessel. The method can include orienting a cutting device coaxially with the cannula and the catheter and advancing the cutting device over the cannula, the catheter, and the section of the vessel in order to core out the section of the vessel and a portion of the surrounding tissue.