Abstract: The apparatus for performing diagnostic and/or therapeutical heart interventions comprises a catheter (1) which contains a guided catheter (2), a guiding catheter (3) surrounding the guided catheter and a guide wire (4) extending within a lumen (20) of the guided catheter. Means (7) are provided which permit a controlled change of position of the guide wire in a chamber of the heart. The catheter is a first catheter (1) whose guide wire is in connection with the distal end (30') of a second catheter (1') or can be connected thereto respectively. The second catheter can be positioned in the heart in such a manner that its distal end takes on a stationary position independent of the change in position of the guide wire.

Abstract: A catheter which can be utilized for mapping and/or for ablation in the chamber or chambers of a heart or another body organ has a flexible sheath the distal end of which can be advanced through a blood vessel or another body passage into a selected chamber. A wire-like guide has a distal end portion affixed to the distal end of the sheath and is slidable in a lumen of the sheath so as to form a loop adjacent to and located externally of the distal end of the sheath. The guide and its loop are used as a device for steering the distal end portion of a tubular conductor assembly to any one of a number of different positions relative to the surface surrounding the chamber. The size of the loop is reduced prior to introduction of the distal end of the sheath into and prior to extraction of such distal end from a selected chamber.

Abstract: An endoscope has an elongated flexible guide the distal end of which can be introduced into a selected chamber of a human or other animal heart or into the internal space of another body organ. The tube confines a major portion of an elongated flexible sheath the distal end of which carries an inflatable balloon for the distal end portions of elongated flexible optical conductors some of which serve to illuminate selected portions of a surface bounding an internal space. The remaining conductors serve to transmit images of the illuminated portions of the surface toward the proximal end of the tube. When inflated, the ballon shields the distal ends of the conductors from contact with the body fluid in the internal space. A three-dimensional frame is provided to maintain the inflated balloon in any one of a number of different positions in a body cavity.

Abstract: A catheter for introduction into blood vessels or other passages in a patient's body has an elongated flexible tubular member with a readily flexible distal end portion, a less flexible intermediate portion and a proximal end portion. The distal end portion can be bent relative to the intermediate portion by a wire-, filament- or strip-shaped flexing element which extends through a lumen of the intermediate portion and through an extension of such lumen in the distal end portion and has a distal end affixed to the tip of the distal end portion. The intermediate portion is made stiffer than the distal end portion of the tubular member by appropriate shaping of the cross-sectional area of the intermediate portion and/or by resorting to one or more stiffening elements, such as a sleeve-like guide surrounding the flexing element in the respective lumen of the intermediate portion of the tubular member.

Abstract: A cardiac pacemaker lead wherein the helical fixation element and its pointed tip extend beyond the distal end of the insulating sheath for the conductor during implantation into the heart of a patient. In order to prevent damage to tissue during advancement of the fixation element and its tip through blood vessels and into the heart, the tip and preferably a portion of the adjacent convolution of the fixation element are confined in a deformable jacket in the course of the implanting step. The jacket is thereupon extracted by a length of wire or cord, either along the external surface of the sheath or through the axial passageway of the conductor, when the implanting step is completed. The jacket can be made of flexible sheet material or it can consist of closely adjacent convolutions one of which is of one piece with the wire or cord.

Abstract: A cardiac pacemaker lead wherein a tubular catheter has a proximal end connected to a pacemaker and a distal end provided with an electrode which can be anchored in or otherwise connected with a wall in the heart of a patient. The lead can be extracted from the body of the patient by resorting to an elongated flexible wire-like stylet having a front end receivable in an internal chamber of the distal end of the catheter. The front end of the stylet constitutes or includes a first coupling element and the chamber confines or is defined by a second coupling element which can be engaged by the first coupling element, e.g., in response to rotation of the fully inserted stylet relative to the catheter or in response to heating of the first coupling element. The coupling prevents tearing of the flexible portion of the catheter and/or separation of the flexible portion from the distal end during extraction of the stylet.

Abstract: A multipolar cardiac pacemaker lead wherein the distal end carries a first electrode and at least one sleeve-like additional electrode is provided between the first electrode and the proximal end. Each additional electrode is positively connected with a corresponding helically wound wire-like conductor of the lead by a tubular conductor within an insulating sheath of the lead and by one or more flexible metallic bands each of which has a distal portion soldered or welded to the internal surface of the respective additional electrode, a second portion soldered or welded to the respective tubular conductor, and an S-shaped or Z-shaped intermediate portion extending between and contacting the adjacent convolutions of the respective wire-like conductor. Each tubular conductor is welded or soldered to at least one adjacent convolution of the corresponding wire-like conductor. The wire-like conductors are electrically insulated from each other.

Abstract: Apparatus for eliminating or reducing occlusions or stenoses in veins and other body cavities has an elongated catheter with an ellipsoidal distal end having an internal anvil cooperating with a reciprocable hammer at the distal end of a flexible probe to drive the distal end of the catheter into an occlusion or into a stenoses. The proximal end of the probe is connected to the output element of a reciprocating unit which can be combined with a device for rotating the probe and/or the catheter. The distal end of the probe can be provided with an extension which projects beyond the hammer and beyond the distal end of the catheter to act upon a stenosis or upon an occlusion ahead of the distal end of the catheter.

Abstract: A fitting which serves to connect the bare proximal end of the conductor in an implanted or implantable lead with a cardiac pacemaker has a deformable tubular socket with a proximal end insertable into a pacemaker and a distal end received in the proximal end of an insulating sleeve the distal end of which contains the tubular liner of an extractible guide serving to facilitate insertion of proximal end of the insulating tube for the conductor. The bare proximal end of the conductor is first slipped onto the tip of a stylet which extends through the axial passage of the socket as well as through the axial hole of the sleeve, and the proximal end of the conductor is then introduced into and through the sleeve and the socket until the front end face of the proximal end of the insulating tube strikes an internal shoulder of the sleeve.

Abstract: Apparatus for implanting surgical electrodes or catheters into human hearts or other hollow body organs has one or more flexible guide wires defining one or more tracks for a streamlined carriage the rear end of which is formed with a cavity for reception of the leading end of a catheter or electrode. The carriage can be pushed along the guide wire or wires by the electrode or catheter, and the leading end of thus implanted object is thereupon extracted from or expelled laterally from or beyond the cavity in the carriage while the carriage is held against forward and/or rearward movement with reference to the guide wire or wires. The carriage can be extracted from the body by the guide wire or wires or by means of a cord or hose. The carriage serves as a shield in front of the leading end of an electrode or catheter during introduction of the latter by way of an artery, a vein or another body cavity.

Abstract: The output or outputs of the subcutaneously implanted pulse generator of a cardiac pacemaker are accessible by introducing a cannula or the wire of a stylet through the skin and thereupon through a silicone membrane which is implanted beneath the skin and surrounds a portion of a chamber which contains the output or outputs or affords access to the output or outputs through a conduit or conductor. The cannula or the wire of the sylet can be used to test the pulse generator, the lead or leads and/or the connection or connections between the lead or leads and the pulse generator as well as to admit medicaments and/or to facilitate or carry out adjustments or repairs.

Abstract: A surgical electrode wherein the terminal portion of a lead wire which extends from the thorax of a patient is connectable with a cardiac pacing or monitoring instrument by a rod-shaped electrically conductive male connector in cooperation with an insulating sleeve-like female connector which is slidable longitudinally of the male connector. The latter has a transverse slot or hole remote from one end of the male connector, and the terminal portion of the wire extends from the one end of the male connector, through the slot or hole, and back to the one end of the male connector. The female connector normally surrounds two legs of the terminal portion as well as the hole or that part of the slot which is nearer to the one end of the male connector but leaves the male connector exposed between that part of the wire which extends through the hole or slot and the other end of the male connector so that the exposed portion of the male connector can be inserted into the socket of a pacing or monitoring instrument.

Abstract: Apparatus for implanting pacemaker electrodes whose proximal ends have enlarged plugs for attachment to pacemakers has a one-piece unslotted and unweakened tubular introducer of somewhat flexible material whose front end portion is inserted into the subclavian vein of the patient with assistance from a guide wire and a dilator. The dilator and the guide wire are thereupon extracted from the introducer so that the latter provides an unobstructed passage for implantation of a pacemaker electrode. The exposed section of the implanted electrode between the rear end of the introducer and the plug is then engaged by the trough-shaped elastically deformable portion of a severing device whose knife extends radially of the exposed section of the electrode and severs the introducer longitudinally while the latter is being pulled in a direction to extract its front end portion from the vein.

Abstract: A surgical electrode which can be used as a temporary lead for cardiac pacing or monitoring purposes has two elongated conductors whose distal ends are provided with spaced-apart poles and are implanted in a single operation by means of a surgical needle which is separably secured to the distal end of one of the conductors. The proximal ends of the conductors are connected to an elongated extension which passes through and outwardly from the thorax to be connected to a pacemaker or to an instrument which makes electrocardiograms. The conductors are insulated from each other and that pole which is nearer to the needle is defined by one or more bare strands which have a zig-zag, undulate, helical and/or other shape allowing the strands to reduce the width of the respective pole during penetration into the heart wall.

Abstract: An intravenously implantable electrode lead has a conductor whose rear end portion is connected to the casing of a cardiac pacemaker and whose front end has a stimulation surface. A sleeve-like screw surrounds the conductor immediately behind the stimulation surface and has a soft thread made of silicone rubber or polyurethane. The thread can yield during advancement of the screw through the openings of the trabecular network in the heart, and thereupon expand to reliably hold the stimulation surface in contact with a selected portion of the heart. The thread is continuous or discontinuous and tapers radially outwardly, and its height increases gradually from that end which is nearer to the stimulation surface toward the other end.

Abstract: A connector for connecting the broken ends of a helical conducting element has an outer sleeve of synthetic plastic material which is surrounded by an insulating coating. A pair of insulating tubular extensions having outer diameters smaller than the outer diameter of the insulating coating project from the latter in axial direction of the connector. The outer sleeve accommodates a compressible, electrically conductive helix having an inner diameter sufficiently large to receive the broken ends of the helical conducting element. The helix and helical conducting element have approximately the same pitch. The outer sleeve is provided with threaded holes which mesh with grub screws bearing upon the external surface of the helix. The insulating coating which surrounds the outer sleeve has openings which register with the holes in the outer sleeve to thereby permit the grub screws to be inserted in the holes.