Abstract: Implantable medical device with at least one long extended electrical conductor that is insulated from the surrounding material by a dielectric. The implantable medical device includes an electrode pole that emits therapy signals or detects diagnostic signals, at least one first longitudinal section of a first characteristic impedance between a proximal end and the electrode pole; and at least one second longitudinal section adjacent to the at least one first longitudinal section. The at least one second longitudinal section includes a second characteristic impedance and is shorter than the first longitudinal section. The second characteristic impedance is either larger or smaller than a load characteristic impedance.

Abstract: A multizone epicardial pacing lead (10) having a lead body (12) with a proximal connector (14) for coupling to a generator of an active implantable medical device and, distally, an anchor to an epicardium wall and an active part comprising a plurality of stimulation electrodes, coming into contact with, or penetrating, the epicardium wall. This active part comprises a distributor housing (16) and a network of flexible microcables (18) radiating from the housing. Each microcable is formed of an electrically insulated conductor comprising at least one denuded area (20), each of these areas forming a stimulation electrode.

Abstract: A family of minimally-invasive surgical (MIS) cardiac interventional tools with tactile feedback based upon cardiac mechanical data and physiologic parameters derived from sensors positioned upon the tools are configurable for optimal placement of an end-effector to provide acute cardiac resuscitation and/or remote cardiovascular intervention for a subject. A haptic interface (e.g., a haptic handle, haptic glove or a simulated haptic heart) provides a clinician with real, not virtual, interaction with the cardiovascular anatomy (including intrathoracic organs) of the subject to optimize end-effector placement. The MIS tools optionally include webbed blade portions for exploration of extracardiac or intrathoracic spaces.

Abstract: A method includes providing a mold defining a mold cavity for receiving material to be molded into a molded part, positioning an insert at least partially in the mold such that a portion of the insert defines a portion of the mold cavity, and injecting the material into the mold cavity to substantially fill the mold cavity to form the molded part. The molded par can then be removed from the mold and the insert can be removed from the molded part. The mold can include silicone and the insert can include polyoxymethylene.

Abstract: An intravascular electrode device for use in neuromodulation includes an anchor expandable from a radially compressed position to a radially expanded position. A lead extends from the anchor and has at least one conductor extending through it. A flex circuit is coupled to the anchor and comprises a flexible insulative substrate, a plurality of electrodes carried by the substrate, and a plurality of conductive traces carried by the substrate, each trace electrically coupled to an electrode and a conductor. Expansion of the anchor within a blood vessel biases the electrodes into contact with the surrounding blood vessel wall. An exemplary anchor includes a first portion having expansion forces sufficient to bias the electrodes against the vessel wall for mapping and chronic stimulation, and a second portion having greater radial expansion forces sufficient to chronically engage the vessel wall once an optimal electrode location has been selected.

Abstract: A medical implantable lead comprising a core formed of a bare conductive wire formed from a biocompatible, corrosion-resistant conductive material, loosely wrapped in a fibrous material formed of shaped flattened ribbon filaments of a valve metal, and surrounded by a biocompatible insulation material.

Abstract: Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.

Abstract: A lead for an implantable cardiac prosthesis is disclosed. The lead has integrated protection against the effects of magnetic resonance imaging (“MRI”) fields. A protection circuit (26) may be placed at the distal end of the lead comprises a resistive component (28) interposed between the electrode (E1, E2) and the distal end of the conductor (22, 24) associated with this electrode. A normally-open controlled active switch (34, 36) may allow in its closed state to short-circuit the resistive component. A control stage (32) may be coupled to the conductors and detect the voltage of a stimulation pulse applied on the conductor(s), and selectively control by this voltage the closing of the active switch for a duration at least equal to the duration of detected stimulation pulse.

Abstract: A lead assembly includes a ring component having mechanical coupling features, and at least one polymer component mechanically coupled with the mechanical coupling features of the ring component. Elongate tubing is disposed over the polymer component and is secured with the polymer component.

Abstract: A method for forming a lead or lead extension having an arrangement of elongated conductors disposed in a body of a lead or lead extension includes ablating a plurality of spaced-apart channels in proximity to at least one of the proximal end or the distal end of the body to expose at least part of at least one of the conductors. A C-shaped contact is disposed into each of a different one of the transverse channels. Each C-shaped contact is electrically coupled to at least one of the conductors. Each C-shaped contact is closed so that opposing ends of the C-shaped contact are adjacent to one another and aligned over one of the elongated conductors. The two opposing ends of each C-shaped contact is coupled together such that each C-shaped contact forms a continuous path around the arrangement within the transverse channel in which the C-shaped contact is disposed.

Abstract: A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

Abstract: Time delays between a feature of a signal indicative of electrical activity of a patient's heart and a feature of a plethysmograph signal indicative of changes in arterial blood volume are used to arrange the operation of an implantable device, such as a pacemaker. Shorter time delays between the feature of the signal indicative of electrical activity of a patient's heart and the feature of the plethysmograph signal indicative of changes in arterial blood volume are indicative of larger cardiac stroke volumes. The time delay can be used to select a pacing site or combination of pacing sites and/or to select a pacing interval set.

Abstract: Various aspects of the present subject matter provide devices and methods to treat AV-conducted ventricular tachyarrhythmia (AVCVT). According to various embodiments of the method, an AVCVT is sensed, an IVC-LA fat pad is stimulated when the AVCVT is sensed to block AV conduction, and bradycardia support pacing is provided while the IVC-LA fat pad is stimulated. Other aspects and embodiments are provided herein.

Abstract: An exemplary method includes positioning a lead in a patient where the lead has a longitudinal axis that extends from a proximal end to a distal end and where the lead includes an electrode with an electrical center offset from the longitudinal axis of the lead body; measuring electrical potential in a three-dimensional potential field using the electrode; and based on the measuring and the offset of the electrical center, determining lead roll about the longitudinal axis of the lead body where lead roll may be used for correction of field heterogeneity, placement or navigation of the lead or physiological monitoring (e.g., cardiac function, respiration, etc.). Various other methods, devices, systems, etc., are also disclosed.

Abstract: A lead anchor includes a core housing defining a cavity; a swivel anchor disposed in the cavity and having a tubular portion and a locking portion; at least two locking members; and at least two sleeves with a portion of each of the sleeves and each of the locking members disposed within the cavity at a periphery of the cavity. The tubular portion is adapted to receive an external tool to rotate the swivel anchor within the cavity. The lead anchor has an unlocked configuration, in which the swivel anchor can rotate within the cavity of the core housing without compressing the sleeves, and a locked configuration, in which opposing ends of the locking portion of the swivel anchor each lie between one of the sleeves and one of the locking members and compress the sleeves and any lead disposed within the sleeves to hold that lead in place.

Abstract: Substernal implantable cardioveter-defibrillator (ICD) systems and methods for providing substernal electrical stimulation therapy to treat malignant tachyarrhythmia, e.g., ventricular tachycardia (VT) and ventricular fibrillation (VF) are described. In one example, an implantable cardioveter-defibrillator (ICD) system includes an ICD implanted in a patient and an implantable medical electrical lead. The lead includes an elongated lead body having a proximal end and a distal portion, a connector at the proximal end of the lead body configured to couple to the ICD, and one or more electrodes along the distal portion of the elongated lead body. The distal portion of the elongated lead body of the lead is implanted substantially within an anterior mediastinum of the patient and the ICD is configured to deliver electrical stimulation to a heart of the patient using the one or more electrodes.

Abstract: A fixation member of an electrode assembly for an implantable medical device includes a tissue engaging portion extending along a circular path, between a piercing distal tip thereof and a fixed end of the member. The circular path extends around a longitudinal axis of the assembly. A helical structure of the assembly, which includes an electrode surface formed thereon and a piercing distal tip, also extends around the longitudinal axis and is located within a perimeter of the circular path. The tissue engaging portion of the fixation member extends from the distal tip thereof in a direction along the circular path that is the same as that in which the helical structure extends from the distal tip thereof. The electrode assembly may include a pair of the fixation members, wherein each tissue engaging portion may extend approximately one half turn along the circular path.

Abstract: Implantable devices containing extracellular matrix and methods of using the devices are provided.

Abstract: A pacemaker lead includes a body and an insulation layer. The body includes at least one carbon nanotube yarn. The at least one carbon nanotube yarn includes a plurality of carbon nanotubes. The carbon nanotubes are interconnected along an axis of the body by van der Waals force. The insulation layer covers an outer surface of the body.

Abstract: An implantable nerve stimulation device has a sensor system, a data processor in communication with the sensor system, and a nerve stimulation system in communication with the data processor and constructed to provide electrical stimulation to at least one branch of at least one vestibulocochlear nerve. The nerve stimulation system includes an electrode array that has a first plurality of electrodes structured to be surgically implanted in electrical communication with a superior branch of the vestibular nerve, a second plurality of electrodes structured to be surgically implanted in electrical communication with a horizontal branch of the vestibular nerve, a third plurality of electrodes structured to be surgically implanted in electrical communication with a posterior branch of the vestibular nerve, and a common erus reference electrode structured to be surgically implanted into a common eras of the vestibular labyrinth.

Abstract: A lead includes a conductor having a distal end and a proximal end and a resonant circuit connected to the conductor. The resonant circuit has a resonance frequency approximately equal to an excitation signal's frequency of a magnetic resonance imaging scanner or a resonance frequency not tuned to an excitation signal's frequency of a magnetic resonance imaging scanner so as to reduce the current flow through a tissue area, thereby reducing tissue damage. The resonant circuit may be included in an adapter that provides an electrical bridge between a lead a medical device such as an electrode, sensor, or signal generator. The resonant circuit may also be included directly in the housing of a medical device.

Abstract: An implantable electrode for electrical stimulation of a body, for example, being a component of an implantable medical electrical lead, is preferably in the form of a coiled conductor wire, wherein the wire is formed by a tantalum (Ta) core directly overlaid with a platinum-iridium (Pt—Ir) cladding. When a maximum thickness of the Pt—Ir cladding defines a cladded zone between an outer, exposed surface of the electrode and the Ta core, a surface of the Ta core encroaches into the cladded zone by no more than approximately 50 micro-inches. The tantalum core may be cold worked to improve surface quality or formed from a sintered and, preferably, grain stabilized tantalum.

Abstract: Apparatus (20) is provided, including a bifurcation stent (50) comprising one or more electrodes (32), the stent (50) configured to be placed in a primary passage (52) and a secondary passage (54) of a blood vessel (30), and a control unit (34), configured to drive the electrodes (32) to apply a signal to a wall (36) of the blood vessel (30), and to configure the signal to increase nitric oxide (NO) secretion by the wall (36). Other embodiments are also described.

Abstract: Leadless pacemaker, including a hermetic housing, a pacing electrode on a distal portion of the housing, an electronics package in the housing and configured to generate/deliver pacing pulses to the electrode, and a fixation mechanism on the housing distal portion. The fixation mechanism includes at least one deformable hook-shaped thin fixation wire having an attachment portion fixedly attached at the distal portion of the housing and a free end portion which is angled or bent with respect to the attachment portion such that it extends essentially in conformity, but with a small spacing, to a neighbored surface portion of the housing such that the free end portion engages with heart tissue onto which the distal portion is pressed upon rotation of the pacemaker in the direction in which the free end portion extends from the attachment portion, and disengages upon rotation of the pacemaker in the opposite direction.

Abstract: The embodiments herein relate to a conductor cable for use in a lead and more specifically to methods and devices related to laser consolidation of the cable. The various conductor cable embodiments and methods provide for at least one end of the cable having a weld mass created by a laser welding process.

Abstract: A delivery system for implanting a biostimulation device comprising a stylet extending along an axis from knob end to a threaded end configured to engage an internally threaded nut of the biostimulation device and a catheter tube configured to axially contain the stylet. The catheter tube comprises a feature that engages a corresponding feature on the biostimulation device whereby the stylet can be rotated relative to the catheter tube for disengagement of the stylet threaded end from the biostimulation device threaded end.

Abstract: An implantable medical device for electrical stimulation or sensing includes a body supporting at least one flexible elongate conductor element. The body includes an insulating structure that protects the flexible conductor element(s). The insulating structure is realized from multiple polymer layers wherein at least one of the polymer layers is formed from a polymer blend of a thermoplastic polyurethane material and an isobutylene block copolymer. In one particular embodiment, the insulating structure of the body includes at least a first polymer layer, a second polymer layer and a third polymer layer, where the second polymer layer covers and interfaces to the first polymer layer, and the third polymer layer covers and interfaces to the second polymer layer. The first polymer layer is formed from a thermoplastic polyurethane material. The third polymer layer is formed from an isobutylene block copolymer.

Abstract: Detects external noise using a motion sensor signal for example to increase the specificity of arrhythmia detections based on active muscle noise detection. Whenever a motion signal is present that is below or above a certain frequency, for example 5 Hz, or within a certain frequency range, for example 1 to 10 Hz, and/or above a certain amplitude, for example greater than 1 mg, or close to a known motion pattern, then the detection of fast ventricular arrhythmia is suspended. For the detection of slow arrhythmia, for example asystole or syncope, an episode is confirmed when a short lasting motion sensor signal occurs. Uses a motion sensor based signal, for example as obtained from an accelerometer on an implantable electrode lead and/or implantable device.

Abstract: An electromagnetic interference immune defibrillator lead has a first electromagnetic insulating layer. A first layer is formed on the first electromagnetic insulating layer, the first layer having a plurality of first conductive rings composed of first conductive material, each first conductive ring being separated by first insulating material. A second electromagnetic insulating layer is formed on the first layer. A second layer is, formed on the second electromagnetic insulating layer, the second layer having a plurality of second conductive rings composed of second conductive material, each second conductive ring being separated by second insulating material. A third electromagnetic insulating layer is formed on the second layer. The second conductive rings of second conductive material are positioned such that a second conductive ring overlaps a portion of a first conductive ring and overlaps a portion of a second conductive ring, the second conductive ring being adjacent to the first conductive ring.

Abstract: Disclosed are several embodiments of a battery-less piezo-electric defibrillation system (2) comprising external piezo-electric defibrillator (4) and at least one electrode (5) connected thereto. The system includes a piezo-electric generator (6) connected to direct cardiac access-(5), or indirect subcutaneous electrode assemblies (30). The piezo-electric generator (6) is energized by a spring-driven striker element (8) and produces electrical pulse for defibrillation. The direct cardiac access electrodes (5) engage the heart muscle directly via the intercostal space. Alternatively, indirect subcutaneous electrodes (34a) are positioned under patient's skin.

Abstract: Several embodiments of a battlefield defibrillation system (2) comprising external defibrillator (6) and at least one electrode (8) connected thereto are described. The system includes direct cardiac access-(8), or indirect subcutaneous electrodes (30). The direct cardiac access electrodes (26) engage the heart muscle directly via the intercostal space. Indirect subcutaneous electrodes are positioned under patient's skin. Several design features are implemented to aid precise electrode positioning and facilitate system operation by an untrained personnel.

Abstract: A connecting device for an electromedical implant having a housing, the connecting device including a feedthrough and a header. The feedthrough and the header are formed in one piece so as to reduce the cost of the production process.

Abstract: Devices or methods such as for stimulating excitable tissue or sensing physiologic response or other signals that can use separate fixation mechanism is described. An implantable apparatus can include a modular electrostimulation electrode assembly that can include a first module and a second module that can be end user-attachable to each other and end user-detached from each other. The first module can include an electrostimulation electrode fixation support member that can be laid flat against or otherwise conform to a surface of a heart, and can define a centrally located open portal such as for permitting electrode access to the surface of the heart. The second module can include an electrostimulation electrode that can be inserted through the portal of the fixation support member such as to contact the surface of the heart such as to deliver chronic electrostimulation to the heart.

Abstract: A system is provided to determine whether an insulating layer of an implanted lead is damaged.

Abstract: The present disclosure provides methods and techniques associated with a planar transformer for an apparatus. The planar transformers include a substrate carrying electronic components and a continuous core that is formed by distributing the encapsulant material uniformly around the substrate unit to define a consistent cross-sectional area for the magnetic path. The electronic components include primary windings and secondary windings associated with the transformer. In some embodiments, the encapsulant material is molded to seals air gaps to the substrate unit.

Abstract: An implantable medical lead may include a longitudinally extending body, an electrical conductor, an electrical component, and a weld. The longitudinally extending body includes a distal end and a proximal end. The electrical conductor extends through the body between the proximal end and the distal end. The electrical component is on the body and includes a sacrificial feature defined in a wall of the electrical component. The sacrificial feature includes a region that continues from the wall of the electrical component and a side that is isolated from the wall of the electrical component via a void defined in the wall of the electrical component. The weld is formed at least in part from at least a portion of the sacrificial feature. The weld operably couples the electrical component to the electrical conductor.

Abstract: Implantable object, comprising a layer, comprising a copolymer that contains an aptamer, wherein bonds in the copolymer can be broken in accordance with a binding event at the aptamer, such that the copolymer degrades.

Abstract: This document describes an apparatus including an implantable medical device having a printed circuit board. The apparatus can include a connector block for a lead terminal of the implantable medical device mounted directly to the printed circuit board.

Abstract: A device and method for cardiac pacing is disclosed in which anodal pacing of the left ventricle is provided. Anodal pacing occurs when an anodal surface area is sufficiently small to create an area of hyper-polarization of the myocardial cell membrane. This creates a virtual cathode at a location remote from the anode. The virtual cathode results in depolarization of the heart in a manner similar to the virtual cathode at the true fixed cathode. In addition a device and method for summation anodal pacing is provided in which one anode is common between two or more cathodes. This results in hyperpolarization of a larger segment of the myocardium as compared to non-summation anodal pacing and thereby forms a larger virtual electrode to enable capture of localized, discrete cardiac structures such as the bundle of His or the very proximal portions of the right and left bundles.

Abstract: A cardiac medical device and associated method control delivery of dual chamber burst pacing pulses in response to detecting tachycardia. A number of cardiac cycles occurring in a first cardiac chamber are identified subsequent to the dual chamber pacing pulses. The number of sensed intrinsic events occurring in a second cardiac chamber during the first chamber cardiac cycles is determined as a number of second chamber events. The tachycardia episode is classified in response to the number of second chamber events.

Abstract: A subcutaneous implantable cardioverter-defibrillator is disclosed which has an electrically active canister which houses a source of electrical energy, a capacitor, and operational circuitry that senses the presence of potentially fatal heart rhythms. At least one subcutaneous electrode that serves as the opposite electrode from the canister is attached to the canister via a lead system. Cardioversion-defibrillation energy is delivered when the operational circuitry senses a potentially fatal heart rhythm. There are no transvenous, intracardiac, or epicardial electrodes. A method of subcutaneously implanting the cardioverter-defibrillator is also disclosed as well as a kit for conducting the method.

Abstract: A medical device lead includes a flexible body having a proximal region with a proximal end, and a distal region with a distal end. A connector is coupled to the proximal end of the flexible body of the lead to electrically and mechanically connect the lead to an implantable pulse generator. The medical device lead also includes an electrode in the distal region of the flexible body, and a cable conductor having a proximal end electrically coupled to the connector and a distal end electrically coupled to the electrode. The cable conductor consists of a single helically coiled filar including a plurality of co-radial turns and having an outer diameter of less than about 0.020 inch (0.508 mm).

Abstract: An electrode lead of a pacemaker includes a lead wire. The lead wire includes at least one sub-lead wire and an electrode head electrically connected with the lead wire. The sub-lead wire includes a core wire structure and a carbon nanotube composite structure wound around the core wire structure. The pacemaker includes a pulse generator and the electrode lead electrically connected to the pulse generator.

Abstract: A medical device lead includes an insulated lead body including at least one electrode, a helically coiled conductor electrically coupled to the at least one electrode, and one or more polymer coils formed coaxially with the helically coiled conductor. The helically coiled conductor includes a plurality of turns having a conductive coil pitch and including one or more conductive filars each having a conductive filar diameter. The one or more polymer coils provide at least about 25 ?N·m of torque transmitting capacity along a length of the medical device lead.

Abstract: A multi-conductor medical electrical lead comprises a connector located at a proximal end of the lead, one or more electrodes located at a distal end of the lead and a co-radial multi-conductor coil connecting the connector with the electrode(s), wherein the coil has a lead body region with co-radially wound conductors and has an inductance greater than or equal to approximately 1.5 ?H.

Abstract: Implantable element having an elongate main body, a functional conductor which extends in the longitudinal direction of the main body or forms it, and which acts to implement a medical function of the element and has an inductive section, and magnetic flux generation means for generating a magnetic flux in the surroundings of the functional conductor, in particular of its inductive section, which are magnetically coupled to the functional conductor in such a way that the magnetic flux generated upon a current flux through the functional conductor is counteracted and the current flux density through the functional conductor is thus reduced.

Abstract: An internal paddle electrode includes: an electrode which is to be in contact with a living body to apply a voltage; a cable which includes a voltage supply path that extends between a voltage supply source and the electrode; a handle which includes: a first portion that supports the electrode and is hermetically sealed with the electrode; and a second portion that is connected to the cable and is hermetically sealed with the cable; and a gas passage through which a gas in the handle communicates with external air that is outside the handle.

Abstract: Certain embodiments of the present disclosure are directed toward devices, methods and systems for controlling depolarization in cardiac cells. One such device includes one or more circuits that are configured and arranged to generate an electrical stimulus at a high frequency. The circuit is configured to provide electrical stimulus over a period of time sufficient to depolarize the cardiac cells. An electrode arrangement is configured and arranged to deliver the high frequency electrical stimulus to cardiac cells and depolarize the cardiac cells.

Abstract: An implantable lead connector configured for long term implantation and to electrically interconnect multiple medical devices and to channel electrical signals between said interconnected devices and a target organ, comprising: a first port adapted to receive a first signal suitable to stimulate a target tissue, a second port adapted to receive a second signal suitable to stimulate a target tissue, and a third port configured to connect to a target organ, wherein at least one of said first and second ports is configured to connect to a signal generator not integrated with said connector.

Abstract: A medical lead is configured to be implanted into a patient's body and comprises a lead body, and an electrode coupled to the lead body. The electrode comprises a first section configured to contact the patient's body, and a second section electrically coupled to the first section and configured to be capacitively coupled to the patient's body.