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: An electrode lead of a pacemaker includes a metal conductive core and a carbon nanotube film. The metal conductive core defines an extending direction. The carbon nanotube film wraps around the metal conductive core. The carbon nanotube film includes a plurality of carbon nanotubes extending substantially along the extending direction of the metal conductive core. A bared part is defined at one end of the electrode lead. A pacemaker using the above mentioned electrode lead is also disclosed.

Abstract: The present invention provides for a safer and less traumatic chronically implanted device and methods for removing same from a patient. One embodiment of the invention provides for a medical device comprising an implantable diagnostic or therapeutic lead having a distal end, a proximal end, a longitudinal axis and an outer surface, and a tubular cover attached to the diagnostic or therapeutic lead, preferably near the distal end, and positioned to cover a substantial portion of the outer surface of the diagnostic or therapeutic lead. The tubular cover is configured to evert upon application of a longitudinal force to extract the diagnostic or therapeutic lead.

Abstract: Exemplary lead assemblies include a lead body having a plurality of conductor wires embedded therein, a plurality of electrode contacts at least partially disposed on an outer surface of the lead body, and a plurality of switching networks each configured to control an operation of one or more of the plurality of electrode contacts.

Abstract: According to some method embodiments, a left pulmonary artery electrode is positioned in a left pulmonary artery, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation. According to some method embodiments, a right pulmonary artery electrode is positioned in a right pulmonary artery and a left pulmonary artery electrode is positioned in a left pulmonary artery, the right pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation.

Abstract: A method of placing an electrical lead of an implantable cardiac device inside a heart of a patient. The method includes securing a tool to an atrial appendage of the heart to hold onto the atrial appendage, piercing the atrial appendage, and creating an aperture in the atrial appendage while holding the atrial appendage with the tool. The method also includes moving a distal end of the electrical lead into the heart through the aperture in the atrial appendage and into a ventricle of the heart. Furthermore, the method includes coupling the distal end of the electrical lead to cardiac tissue in the ventricle and delivering an electrical signal to the cardiac tissue in the ventricle of the heart to maintain a predetermined heartbeat of the heart.

Abstract: An implantable medical device (IMD) can include a cardiac pacemaker or an implantable cardiac defibrillator (ICD). Various portions of the IMD, such as a case or device body, the lead body, or the lead tip, can be provided to reduce or dissipate a heat production due to a current induced by various external environmental factors. According to various embodiments, features or portions can be incorporated into the lead body, the lead tip, or the IMD body to reduce the creation of an induced current, or dissipate or increase the area of dissipation of thermal energy created due to an induced current in the lead.

Abstract: A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathoracic blood vessels and for providing anti-tachycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-tachycardia pacing energy for delivery to the patient's heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-tachycardia pacing energy to the capacitor subsystem.

Abstract: A method for treating patients after a myocardial infarction which includes pacing therapy is disclosed. A cardiac rhythm management device is configured to deliver pre-excitation pacing to one or more sites in proximity to an infarcted region of the ventricular myocardium. Such pacing acts to minimize the remodeling process to which the heart is especially vulnerable immediately after a myocardial infarction.

Abstract: A system for therapeutically stimulating a His bundle includes an implantable pulse generator and a multi-polar medical electrical lead. The generator is configured for subcutaneous implantation and to generate a pacing stimulus. The lead includes a connector assembly, a flexible tubular body, a distal tip assembly and coil conductors. The body extends intravascularly from the generator to a location proximate the His bundle and includes a proximal end, a distal end, and a longitudinal lumen. The tip assembly includes an electrode, a fixation helix, and a shank portion. The helix extends to a location proximate the His bundle and is operable as an electrically isolated electrode. The shank portion extends within the lumen and includes a receptacle for receiving a stylet tip. The conductors extend longitudinally through the lumen and are coupled to the electrode and the helix. One or both of the conductors defines a stylet lumen.

Abstract: Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein.

Abstract: An implantable lead includes a lead body having a plurality of electrodes disposed on a distal end of the lead body, a plurality of terminals disposed on a proximal end of the lead body, and a plurality of conductors disposed along the lead body such that each conductor electrically couples at least one of the electrodes to at least one of the terminals. At least one of the electrodes or terminals includes a multi-element contact assembly. The multi-element contact assembly includes at least one conductive inner element and at least one conductive outer element disposed over the inner element. At least one of the plurality of conductors is electrically coupled to one of the multi-element contact assemblies such that the conductor is positioned against the at least one inner element. The at least one outer element includes a region that is in contact with the at least one inner element.

Abstract: A pacing lead (20) having a lead body (22) with a central lumen and provided with structure for retaining the lead body to a wall of the coronary network, and a hollow tubular extension (26), bearing an active region of the lead and also traversed by a central lumen (28) communicating with the inner lumen of the lead body, so as to allow implantation by an over the wire technique. The hollow tubular extension has an outside diameter of between 2 and 3 French (0.66 and 1 mm) to allow implantation deep in the coronary sinus network, and it comprises on its outer surface an electrically insulated peripheral conductor, except for denuded areas intended to come into contact with the wall of a target vein and form a network of stimulation electrodes (32, 34) electrically connected together.

Abstract: Devices, systems, and methods for leadlessly stimulating the heart. Through a magnetic signal generator positioned outside or inside the thoracic cavity, a magnetic signal is transmitted through the chest to stimulate electrical activity within the myocardial muscles. The magnetic signal may function as a pacemaker, cardioverter or defibrillator. Advantages of magnetic stimulation include, without limitation, non invasiveness, a reduction or even elimination in pain, and access to tissues covered by poorly conductive structures.

Abstract: Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing.

Abstract: To provide radio-frequency (RF) bandstop filtering within an implantable lead for use in reducing lead heating during magnetic resonance imaging (MRI) procedures, parallel inductive-capacitive (LC) filters are provided within the lead. In one example, the ring electrode of the lead is configured to function as one of the capacitive elements of the parallel LC filter to help provide LC bandstop filtering along the ring conductor of the lead. In another example, capacitive plates are provided that sandwich an inductor mounted near the tip of the lead to provide parallel LC bandstop filtering along the tip conductor of the lead.

Abstract: A lead includes a plurality of electrodes disposed on the distal end of the lead, a plurality of contact terminals disposed on the proximal end of the lead, a plurality of conductor wires extending along the lead to couple the electrodes electrically to the contact terminals, a central lumen defined by the lead and extending from the proximal end of the lead towards the distal end of the lead, and a tubular stiffener disposed in the proximal end of the central lumen. The tubular stiffener is configured and arranged to facilitate insertion of the proximal end of the lead into a connector.

Abstract: An implantable lead may have a distal assembly including a coupler, a fixation helix secured to the coupler and a housing in which the fixation helix and the coupler are disposed. The distal assembly may include an annular seal that is disposed between the coupler and the housing and that provides an at least substantially fluid-tight seal between the coupler and the housing.

Abstract: An implantable electrical lead having a flexible body and including a multi-layer coil conductor extending within the longitudinal body lumen from the connector assembly to at least the electrode, the multi-layer coil conductor including a first coil layer a second coil layer disposed about the first coil layer, wherein at least one parameter of the first and the second coil layer is configured such that the lead exhibits a predetermined axial stiffness or bending stiffness.

Abstract: An electrode for interventional purposes, such as a cardiac pacemaker, neurostimulation, or ICD electrode, comprises an elongate electrode body (6), at least one electrode pole (5) in the area of the distal end (4) of the electrode body (6) for delivering an intervention pulse, at least one supply line (7) running in the electrode body (6) to the at least one electrode pole (5), and an electrode sheath (8) for insulating the supply line (7). The first and/or second material is produced in such a way that it contains conductive particles embedded in a polymer matrix in a concentration which is greater than or equal to the percolation threshold.

Abstract: This disclosure describes implantable medical leads that include a lead body and an electrode. A width of the electrode as measured along a longitudinal direction of the lead varies about the perimeter of the lead. The uneven width of the electrode may bias a stimulation field in a particular direction, e.g., a radial or transverse direction relative to the longitudinal axis of the lead. Electrodes with an uneven width may be useful for controlling the direction of propagation of the stimulation field in order to, for example, avoid phrenic nerve stimulation during LV pacing or neck muscle stimulation during vagal neurostimulation.

Abstract: Thin conductive metal coatings suitable for flexible nonmetal fine wires and leads are described. Polymer clad silica fiber cores are produced by plasma coating with single or dual layers of metals such as silver, gold or titanium to provide micro thin leads such as those used for pacemakers and fracture resistant aircraft wires that are both conductive and resistant to flexing breakage. The metal surfaces can be used to transmit analog signals while the nonmetal cores can be designed to transmit digital signals. Select deposition conditions can produce nanorough metal coating surfaces which promote cell adhesion so that tissue scarring in vivo is greatly reduced.

Abstract: The present disclosure provides an apparatus and method of optimizing a pacing heart rate. The method can include obtaining a preload-frequency relation and a force-frequency relation from histogram data for a patient condition and determining an optimal pacing heart rate for the patient condition. The optimal pacing heart rate can be substantially between a first heart rate corresponding to a minimum preload condition based on the preload-frequency relation and a second heart rate corresponding to a sustained ionotropic reserve condition based on the force-frequency relation.

Abstract: An implantable lead includes an elongated member. A plurality of electrodes are disposed on a distal end of the elongated member. A plurality of terminals are disposed on a proximal end of the elongated member. Each of a plurality of conductors electrically couples at least one of the electrodes to at least one of the terminals. The plurality of conductors are disposed in the elongated member in a coiled configuration and have an end portion. Each of a plurality of constraining elements is disposed over at least one of the plurality of conductors such that the underlying at least one of the plurality of conductors is maintained in the coiled configuration. At least one of the plurality of electrodes or terminals is disposed over the constraining element and electrically coupled to at least one of the plurality of conductors.

Abstract: A cardiac pacemaker, other CRT device or neurostimulator has one or more fine wire leads. Formed of a glass, silica, sapphire or crystalline quartz fiber with a metal buffer cladding, a unipolar lead can have an outer diameter as small as about 300 microns or even smaller. The buffered fibers are extremely durable, can be bent through small radii and will not fatigue even from millions of iterations of flexing. Bipolar leads can include several conductors side by side within a glass/silica fiber, or can be concentric metal coatings in a structure including several fiber layers. An outer protective sheath of a flexible polymer material can be included.

Abstract: An implantable medical device and associated method classify therapy outcomes and heart rhythms in association with therapy outcome. A therapy success time interval is started in response to delivering an arrhythmia therapy. If normal sinus rhythm is detected after the therapy success time interval expires, the delivered therapy is classified as unsuccessful and the detected arrhythmia is classified as a self-terminating rhythm.

Abstract: Lead electrode assemblies for use with an implantable cardioverter-defibrillator subcutaneously implanted outside the ribcage between the third and twelfth ribs comprising the electrode. Example assemblies include appendages of various types for use during implantation including fins, pinholes, loops, tubes, openings and other means for attachment to an implant tool. Several embodiments include first and second faces on the electrodes such that a first face is configured to be implanted facing the ribcage of the patient and the second face has the appendage.

Abstract: A neurostimulation lead is configured to be implanted into a patient's body and has at least one distal electrode. The lead comprises at least one conductive filer electrically coupled to the distal electrode, a jacket for housing the conductive filer and a shield surrounding at least a portion of the filer for reducing electromagnetic coupling to the filer.

Abstract: A lead assembly includes a lead with a distal end and a proximal end. The lead includes a plurality of electrodes disposed at the distal end and a plurality of terminals disposed at the proximal end. The lead also defines at least one central lumen and a plurality of outer lumens. The central and outer lumens extend from the proximal end to the distal end such that the plurality of outer lumens extend laterally from the at least one central lumen. The lead further includes a plurality of conductive wires. Each conductive wire couples at least one of the plurality of electrodes electrically to at least one of the plurality of terminals. At least two conductive wires are disposed in each of the plurality of outer lumens.

Abstract: An implantable connector comprises an electrically insulative housing including an outer wall, an interior cavity surrounded by the outer wall, a port through which the lead body portion can be introduced into the interior cavity, and a pair of first apertures disposed through the outer wall on a first side of the housing. The connector further comprises an electrical spring clip contact mounted to the housing. The contact includes a common portion and a pair of legs extending from opposite ends of the common portion. The legs respectively extend through the first apertures into the interior cavity, such that the legs firmly engage the electrical terminal therebetween when the lead body portion is introduced into the interior cavity.

Abstract: A medical system comprises a plurality of electrodes; at least one sensor configured to output at least one signal based on at least one physiological parameter of a patient; and a processor. The processor is configured to control delivery of stimulation to the patient using a plurality of electrode configurations. Each of the electrode configurations comprises at least one of the plurality of electrodes. For each of the electrode configurations, the processor is configured to determine a first response of target tissue to the stimulation based on the signals, and a second response of non-target tissue to the stimulation based on the signals. The processor is also configured to select at least one of the electrode configurations for delivery of stimulation to the patient based on the first and second responses for the electrode configurations. As examples, the target tissue may be a left ventricle or vagus nerve.

Abstract: Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing.

Abstract: A leadless autonomous intracardiac implantable medical device having a releasable fastener system. This autonomous intracorporeal active medical device has two distinct elements connectable together and reversibly separable from one another, with a sealed capsule body (100) housing electronic circuitry (110), and a base (200) comprising a plate (202) having an outer face and an anchoring system on said outer face to anchor the base to a wall of an organ of a patient, and an inner face forming a support for the capsule body and having a fastening system to couple releasably the capsule body to the base. The capsule body comprises on its face turned towards the base at least one projection support (108) on an electrode surface for coming into contact with the wall of the organ of the patient when the capsule body is mounted on the base.

Abstract: Various configurations of systems that employ leadless electrodes to provide pacing therapy are provided. In one example, a system that provides multiple sites for pacing of myocardium of a heart includes wireless pacing electrode assemblies that are implantable at sites proximate the myocardium using a percutaneous, transluminal, catheter delivery system. Also disclosed are various configurations of such systems, wireless electrode assemblies, and delivery catheters for delivering and implanting the electrode assemblies.

Abstract: Implantable medical leads having resistance characteristics adapted to dissipate radio frequency (RF) electromagnetic energy during medical procedures such as magnetic resonance imaging (MRI) are disclosed. An illustrative medical device includes a lead having an inner electrical conductor operatively coupled to an electrode and a pulse generator, and one or more outer resistive shields that radially surround the inner conductor and dissipate RF energy into the surrounding body tissue along the length of the lead.

Abstract: An implantable medical device lead includes an insulative lead body, an outer conductive coil extending through the lead body, and an inner conductive coil extending coaxially with the outer conductive coil. The outer conductive coil, which is coupled to a proximal electrode at a distal end of the outer conductive coil, has a first outer conductive coil diameter. The inner conductive coil is coupled to a distal electrode at a distal end of the inner conductive coil. The inner conductive coil includes a filar having a filar diameter and a coil pitch that is about one to one and a half times the filar diameter. The inner conductive coil transitions from a first inner conductive coil diameter to a larger second inner conductive coil diameter between the proximal electrode and the distal electrode.

Abstract: A conductor assembly for a medical device lead includes a helically coiled conductor including a plurality of turns having a coil pitch and an outer diameter and consisting of one filar having a filar diameter. The coil pitch and outer diameter are selected based on the filar diameter to minimize heating of the helically coiled conductor in the presence of an MRI field. A polymer sheath is formed about the helically coiled conductor such that the coil pitch of the unifilar helically coiled conductor is maintained. The polymer sheath is configured to increase a torque transmitting capacity of the helically coiled conductor.

Abstract: A multi-lead system includes a first lead and a second lead. The first lead includes a distal end and a first plurality of electrodes disposed along the distal end of the first lead. The first plurality of electrodes are configured and arranged in a first electrode axis. The second lead includes a distal end and a proximal end. A second plurality of electrodes is disposed along the distal end of the second lead. The second plurality of electrodes are configured and arranged in a second electrode axis. The second lead also includes at least one bend between the distal end and the proximal end to allow for linear alignment of the first electrode axis with the second electrode axis to form a combination electrode axis when the first lead and the second lead are implanted.

Abstract: Devices and methods are disclosed for implanting, positioning, removing, replacing and operating intra-aortic balloon pumps.

Abstract: An implantable device for the atraumatic removal of chronically implanted medical devices.

Abstract: Devices and methods are disclosed for implanting, positioning, removing, replacing and operating intra-aortic balloon pumps.

Abstract: A method is provided, including identifying that a subject is at risk of suffering from atrial fibrillation (AF). Responsively to the identifying, a risk of an occurrence of an episode of the AF is reduced by coupling an electrode device to a site of a subject containing parasympathetic nervous tissue; driving, by a control unit, the electrode device to apply an electrical current to the site not responsively to any physiological parameters sensed by any device directly or indirectly coupled to the control unit; and configuring the current to stimulate autonomic nervous tissue in the site. Other embodiments are also described.

Abstract: This document discusses, among other things, a system capable of resolving interactions between programmable parameters for operation of a medical device. Programming these devices is a difficult task when many parameters are involved. The disclosed systems and methods attempt to reduce and minimize constraint violations between interdependent parameters using an initial set of parameter values supplied by user (typically a physician) input or calculated automatically, and constraint violations describing invalid parameter values. If possible, a set of parameter values with less egregious constraint violations is generated and may be displayed to the user. A user is prompted to accept the set of parameter values and program the medical device.

Abstract: A composition of matter includes a substrate material (M) having a bulk portion and an outer surface integrated to the bulk portion. The outer surface includes a modified surface layer. The modified surface layer extends to a depth from the outer surface of at least 1 nm. The modified surface layer includes M and at least one other material (X) which is a metal or metal alloy. The modified surface layer has a 25° C. electrical conductivity which is at least 2.5% above or below a 25° C. electrical conductivity in the bulk portion of M. The composition of matter can be an article that includes a frequency selective surface-based metamaterial, and the plurality of modified surface portions can be a plurality of periodic surface elements that provide a resonant frequency.

Abstract: An exemplary implantable medical device includes an electrode lead connector having at least one electrical contact for connection of an electrode lead, and an analyzing unit which is connected to the electrode lead connector and is designed to detect and evaluate a response signal present at the at least one electrical connector in response to known electromagnetic irradiation. The analyzing unit may compare a signal modulation resulting from an electromagnetic irradiation of the electrode lead with a reference signal modulation. The electrode lead may be classified as defective if the deviation exceeds a threshold deviation. If a second antenna is available, the analyzing unit may compare response signals resulting from electromagnetic irradiation of the electrode lead and the second antenna. If the ratio of response signals exceeds a threshold, the electrode lead may be classified as defective.

Abstract: A connector for an implantable medical lead that is electrically and mechanically connectable to an implantable medical device, has a connector pin made of a first conducting material. A tubular insulator made of an insulating material concentrically surrounds at least a portion of the pin. A connector ring made of a second conducting material is concentrically positioned around at least a portion of the insulator. The insulator is connected to the connector ring by spark plasma sintering in the case of an active fixation lead, and is connected to the ring and the pin by spark plasma sintering in the case of a passive fixation lead.

Abstract: A cardio electrotherapy lead is disclosed herein. In one embodiment, the lead includes a tubular body, a conductor cable and an electrode. The conductor cable longitudinally extends through the tubular body and includes a distal end. The electrode is located on the tubular body and includes an attachment mechanism mechanically coupling the lead distal end to the electrode.

Abstract: A lead assembly of an implantable medical device includes an elongated body, electrodes on the body, and a tracking sensor located in the body. The body extends between a connector end and a leading end and has conductors disposed in the body. The connector end of the body includes terminals coupled with the conductors. The electrodes disposed on the body can be located at or near an anatomy of interest in a patient and are conductively coupled with the terminals of the body by the conductors. The electrodes are configured to sense electric activity of the anatomy of interest and/or deliver stimulus pulses to the anatomy of interest. The tracking sensor is conductively coupled with the terminals of the body by the conductors. The tracking sensor generates an electric position signal representative of a position of the tracking sensor in the heart when the body is in the patient.

Abstract: A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Abstract: An implantable lead for a medical device with a coplanar coupling for connecting a conductor to a contact reduces conductor bending moments to improve lead reliability. The implantable lead comprises a lead body having a proximal end and a distal end, at least one conductor, at least one contact carried on the proximal end, at least one contact carried on the distal end, and at least one coupling. The lead body has an exterior surface. The conductor is contained in the lead body and extends from the lead proximal end to the distal end. The conductor is also electrically insulated. The contact carried on the proximal end is electrically connected to the conductor. The coupling has a conductor coupling and a contact coupling. The conductor coupling is placed over the conductor and attached to the conductor. The contact coupling exits the lead body and has a weld to connect the contact coupling to the contact.