Abstract: Delivery systems for and methods of delivering ion channel protein genetic material to cardiac cells in areas adjacent to where an electrode is to be positioned in a patient's heart to improve or correct the signal to noise ratio of cardiac signals, such as the P-wave, is described herein. More specifically, there is provided a system and method for delivering sodium ion channel proteins or nucleic acid molecules encoding sodium ion channel proteins to a site in the heart adjacent to an electrode to increase the expression of the same, thereby enhancing the cardiac signal amplitude and enabling improved sensing of cardiac signals by an implanted pacemaker.

Abstract: A cardiac lead is disclosed which includes an elongated lead body having opposed proximal and distal ends, a tip electrode operatively associated with the distal end of the elongated lead body, a connector operatively associated with the proximal end of the elongated lead body and electrically connected to the tip electrode, and a cylindrical eluting ring disposed proximate the tip electrode and formed from a compound including an elastomer and about 15% to 25% by weight medicament.

Abstract: A drug delivery catheter suited for cardiac procedures including transmyocardial revascularization. The catheter includes a distal helical coil or other fixation and penetrating element, which can be operated from the proximal end of the catheter to engage and penetrate the myocardium. Once delivered to the inside of the heart, the catheter can be used to created several helical wounds in the myocardium, and also inject small doses of therapeutic agents to the wounds. The TMR accomplished by the procedure provides for large wound to penetration ratio, and limits the potential of perforating the heart wall.

Abstract: Methods and systems for treatment of coronary artery disease (CAD) include implantation of the discharge portion(s) of a catheter and, optionally, electrodes on a lead, near the tissue(s) to be stimulated. Stimulation pulses, i.e., drug infusion pulses and optional electrical pulses, are supplied by a stimulator implanted remotely, and through the catheter or lead, which is tunneled subcutaneously between the stimulator and stimulation site. Stimulation sites include the coronary arteries, the aorta, the left ventricle, the left atrium, and/or the pulmonary veins, among other locations. Disclosed treatments include drugs used for acute treatment of CAD, for chronic treatment of CAD, to promote angiogenesis, and/or as AGE Crosslink Breakers, among other drugs. For instance, the systems and methods reduce or eliminate the incidence of CAD and related morbidities, improve symptoms resulting from CAD, and/or improve cardiac blood flow, cardiac function, and patient quality of life.

Abstract: Implantable cardiac drug delivery systems. The systems are installed endocardially into a chamber in the heart, and are variously capable of delivering anti-arrhythmia agents into the heart wall, and into the epicardial space outside the heart, and into other chambers in the heart through the septa of the heart.

Abstract: Disclosed is a device for delivering a therapeutic or diagnostic agent to an anatomic position, such as a heart. The device includes a flexible catheter having a proximal end and a distal end, a guide wire lumen that extends longitudinally through the catheter, and a delivery lumen that extends longitudinally at least partially through the catheter. The delivery lumen communicates with a side port adjacent a distal end of the catheter, through which side port a therapeutic or diagnostic agent may be delivered. The device also may include a guide wire, and the catheter may be advanced along the guide wire via the guide wire lumen. The device also may include a secondary catheter capable of sliding through the delivery lumen and capable of delivering a liquid, solid, or radiant agent to a desired anatomic location; thus, the secondary catheter may be considered a delivery catheter. The device may be used to deliver a therapeutic agent to a particular body location in a subject suffering a disease.

Abstract: An apparatus for elution of drugs and radiographic visualization that is formed from a polymeric material mixed with a drug and a radiopaque material. The drug and radiopaque material are dispersed through the polymer and the combination is formed into a solid shape having structural integrity.

Abstract: A method of treating the heart and other body tissues by injecting a compound comprised of microsphere encapsulated macromolecule therapeutic agents into the myocardium, such that the microsphere size inhibits capillary transport of the compound but may permit lymphatic transport of the compound, and the compound releases therapeutic agents upon degradation of the microsphere. The compounds may be used in a method of treating the coronary arteries in which lymphatic transportable therapeutic agents are injected into the myocardium at a location distal to a target site in the coronary artery, after which they are taken up by the lymphatic vessels and transported proximally relative to the coronary artery, and migrate from the lymphatic vessel to the coronary blood vessel.

Abstract: Methods and apparatus of embodiments of the invention are adapted to treat tissue inside a patient's body. Aspects of the invention can be used in a wide variety of applications, but certain embodiments provide minimally invasive alternatives for treating atrial fibrillation by delivering a tissue-damaging agent to selected areas of the heart. One exemplary embodiment of the invention provides a method of treating cardiac arrhythmia. This method includes positioning a distal tissue-contacting portion of a body in surface contact with a tissue surface of cardiac tissue; detecting the surface contact between the tissue-contacting portion and the tissue surface; and thereafter, injecting a tissue-ablating agent into the cardiac tissue through the tissue-contacting portion of the body.

Abstract: A drug delivery catheter suited for cardiac procedures. The catheter includes a distal helical coil or other fixation and penetrating element which can be operated from the proximal end of the catheter to engage and penetrate the myocardium. Once delivered to the inside of the heart, the catheter can be used to inject small doses of therapeutic agents to the myocardium. The drug delivery system of the catheter allows for precise control of the dose injected into the heart wall.

Abstract: Catheter systems and methods for implanting helical or dart-like implants into the myocardium or other body tissue. The catheter system includes a helix for fixing the distal end of the catheter to the myocardium, an implant held by the helix, mechanisms for driving the fixation helix into the myocardium, and mechanisms for driving the implant into the myocardium, removing the fixation helix and leaving the implant behind. The implant may be coated, filled, or made of a drug or drug eluting compound, or drug delivery matrix of any composition.

Abstract: A medical electrical lead or indwelling catheter comprising an elongated body having a tissue-contacting surface that includes a polymer in intimate contact with a steroidal anti-inflammatory agent.

Abstract: A surgical apparatus for delivering fluid to treat a lesion comprising a housing, an elongated member extending from the housing, and a plurality of tines positioned in the housing. Each of the tines has a lumen and at least one opening communicating with the lumen for delivering fluid to the lesion. An actuator is operatively associated with the tines and actuable to a first position to move the plurality of tines from a retracted position substantially within the elongated member to a first deployed position extending from the elongated member and actuable to a second position to move the plurality of tines from the first position to a second deployed position.

Abstract: A drug delivery catheter suited for cardiac procedures. The catheter includes a distal helical coil or other fixation and penetrating element which can be operated from the proximal end of the catheter to engage and penetrate the myocardium. Once delivered to the inside of the heart, the catheter can be used to inject small doses of therapeutic agents to the myocardium. The drug delivery system of the catheter allows for precise control of the dose injected into the heart wall.

Abstract: The present invention provides for a catheter assembly for implanting cellular pellets into diseased or damaged heart muscle tissue. A guiding catheter is accurately positioned within either the left or right ventricle by means of an anchor wire so that a seeding catheter can distribute a pattern of cellular pellets into the diseased heart muscle tissue to stimulate heart muscle growth or angiogenesis.

Abstract: A passive fixation, body implantable lead assembly has a cylindrical tip electrode whose outer side surface is covered with a thin dielectric insulating layer so as to mask an active, disk-shaped electrode surface at the distal extremity of the tip electrode. The active electrode surface preferably has an area less than about 1 mm2. An MCRD, in the form of a collar, may be carried by a proximal portion of the tip electrode. Supplementing a set of main tines projecting from the distal end portion of an insulating sheath housing the lead assembly is a set of nubby auxiliary tines extending from the sheath immediately adjacent the distal extremity thereof.

Abstract: A temporary cardiac electrical stimulating lead comprises a stimulating electrode mounted in or on a biodegradable electrode mounting pad disposed at a distal end of the lead. The electrode mounting pad is capable of biodegradably dissolving over time in human body fluids and is loaded with a drug for therapeutically treating a medical condition of a patient's heart. The electrode mounting pad may be loaded with any of a variety of different drugs, such anti-arrhythmia or anti-inflammatory drugs. When the lead body is pulled away from the electrode mounting pad and removed from the patient, any portion of the electrode mounting pad remaining within the patient dissolves over time and disappears.

Abstract: Device and method are disclosed in which leads with pacing and defibrillating electrodes are implanted into both the right and left ventricles of a patient's heart to enable simultaneous pacing of both ventricles to reduce the width of the QRS complex of the patient's cardiac activity to a more normal duration, and, when appropriate, to apply electrical shock waveforms to both ventricles simultaneously for lower energy defibrillation of the ventricles. In applying the defibrillation therapy, the defibrillating electrode in the left ventricle may be used as the anode and the defibrillating electrode in the right ventricle may be used as the cathode, or both ventricular defibrillating electrodes may be the anode and the metal case in which the shock waveform generator is implanted may be the cathode.

Abstract: A medical electrical lead having an elongated insulative sheath carrying an elongated electrical conductor therein and having a drug-dispensing electrode assembly coupled to a distal end of the elongated conductor. The electrode assembly takes the form of a conductive electrode member having a distal electrode portion exposed exterior to the elongated sheath and a shank portion extending proximally from the distal portion and coupled to the elongated conductor. A drug release device is mounted around the shank proximal to the distal portion of the electrode member and the electrode member is provided with at least one bore extending from a surface of the release device to a surface of the distal portion of the electrode member.

Abstract: A lead having an electrode assembly has a high impedance electrode. The high impedance electrode includes a partially insulated sleeve electrode or a wire filament. The high impedance electrode includes an exposed surface of less than 1.2 MM2. One or more eluting drugs are disposed adjacent to the high impedance electrode.

Abstract: A temporary cardiac electrical stimulating lead is disclosed having a stimulating electrode mounted in or on a biodegradable electrode mounting pad disposed at a distal end of the lead. The electrode mounting pad is capable of biodegradably dissolving over time in human body fluids and is loaded with a drug for therapeutically treating a medical condition of a patient's heart. The electrode mounting pad may be loaded with any of a variety of different drugs, such anti-arrhythmia or anti-inflammatory drugs. When the lead body is pulled away from the electrode mounting pad and removed from the patient, any portion of the electrode mounting pad remaining within the patient dissolves over time and disappears.

Abstract: A system is disclosed, for administering a therapeutic agent locally and to a depth within cardiac tissue. An elongate, flexible catheter contains a flexible electric conductor and supports at its distal end an implantable electrode incorporating a penetrating element, typically a fixation helix or a linear needle that penetrates cardiac tissue as the electrode is implanted. A therapeutic agent is delivered through the electrode, to the cardiac tissue surrounding the penetrating element. The electrode acts as a sensor, electrically coupled through the flexible conductor, and monitors an electrical condition of the surrounding cardiac tissue. A controller is coupled to the sensor and to a pump or reservoir containing the therapeutic agent, to control delivery of the agent responsive to the sensed electrical condition. The implanted electrode further can be used to deliver RF current to ablate the surrounding tissue.

Abstract: A helical element for insertion into tissue comprises a helical element having an insertion end, a protruding end and an open central area within the wire, rods, filaments, cables or the like that form the helix. The helical element has at least its insertion end covered by a cap of a water-soluble or water-dispersible composition. The composition of the cap comprises a water-soluble or water dispersible component having a hydrogel mixed therein. In one embodiment, there is either a hollow area within the composition within the open central area or the material is more porous than the remaining material. The helical element preferably comprises an electrical lead, such as a positive endocardial lead, with an electrode at the protruding or distal end of the lead. The helical element may comprise any biocompatable material with sufficient structural integrity to provide a secure attachment to tissue in a patient.

Abstract: Apparatus for intracardiac drug administration, including a catheter which is inserted into a chamber of the heart and brought into engagement with a site in the heart wall. The catheter includes at least one position sensor, which generates signals responsive to the position of the catheter within the heart, and a drug delivery device, which administers a desired dose of a therapeutic drug at the site determined responsive to the signals from the position sensor.

Abstract: Apparatus for intracardiac drug administration, including a catheter which is inserted into a chamber of the heart and brought into engagement with a site in the heart wall. The catheter includes at least one position sensor, which generates signals responsive to the position of the catheter within the heart, and a drug delivery device, which administers a desired dose of a therapeutic drug at the site determined responsive to the signals from the position sensor.

Abstract: A cardiac rhythm management system provides an endocardial cardiac rhythm management lead with an at least partially dissolvable coating at least partially on insulating portions of the lead body at or near its distal end. Upon dissolution, the coating promotes tissue ingrowth to secure the lead in place within fragile vascular structures or elsewhere. Dissolution of one such coating releases a therapeutic agent, such as a steroid that modifies the fibrotic scar tissue content of tissue ingrowth, such that the resulting bond between the tissue and the lead is weak, so that the lead can be easily extracted if desired. One such lead includes an insulating elongate body carrying at least. The lead also includes an at least partially dissolvable coating on an insulating portion of the peripheral distal lead surface. The coating provides one or more of a rough surface, a porous surface, or a swollen surface after being exposed to an aqueous substance.

Abstract: An implantable lead, being either a fixed or retractable/extendable lead, having a distal tip electrode is adapted for implantation on or about the heart and for connection to a system for monitoring or stimulating cardiac activity. The electrode includes a mechanical fastener such as a fixation helix for securing the electrode to cardiac tissue, which may or may not be electrically active.

Abstract: An ionically conductive polymeric composition for coating a hot can defibrillator electrode. A polymeric coating, such as polyethylene oxide containing NaCl or a similar ionic medium, coats and fills the pores of a high surface area electrode to provide a continuous ionic network from the can to the adjacent body tissue. In certain embodiments, the underlying high surface area, porous electrode is made by chemically etching a smooth electrode surface, such as that of a conventional titanium housing, followed by applying a thin coating of a noble metal such as platinum. In other embodiments, a noble metal or an oxide thereof, such as platinum black or iridium oxide, is applied to a titanium housing to form a porous, high surface area electrode. The conductive polymeric coating is then applied over the porous noble metal or metal oxide.

Abstract: An apparatus for treating an infection which may occur in the biofilm which surrounds an implanted cardiac stimulation device, e.g., a cardioverter-defibrillator (ICD) or pacemaker. Such infections are relatively untreatable by conventional antibiotics treatments. Thus, explanting of the implanted devices may be required. Accordingly, the present apparatus provides an electrical treatment that enables a biocide, i.e., an antibiotic, to successfully treat the infection within the biofilm and thus avoid the necessity to explant the device. Furthermore, the present invention provides this electrical treatment in a manner to not interfere with the stimulation pulses of the cardiac stimulation device by alternatively delivering current pulses during atrial and ventricular refractory periods or a high frequency square wave at a frequency that exceeds the frequency response of the heart muscle.

Abstract: An electrode assembly for a body implantable lead comprises a longitudinally extending dispenser housing having an internal cavity with opposed longitudinally extending openings for storing a drug to be dispensed. A tip electrode integral and axially aligned with the dispenser housing has a face adapted for positioning adjacent the desired body site, a transverse channel formed into and transversely across its face, and an orifice extending between the channel and the internal cavity for elution of the drug to the desired body site. A weld sleeve integral and axially aligned with the dispenser housing distant from the tip electrode has an outer peripheral surface for engageably receiving one end of an elongated electrical conductor, and a collar spaced from the dispenser housing. The electrical conductor is welded to the collar to obtain a welded connection for electrical continuity between the tip electrode and the electrical conductor.

Abstract: An implantable medical device for treatment of cardiovascular disorders by stimulating a selective nerve, the device including an implantable pulse generator, an implantable electrode body and a reservoir. The electrode body includes an electrode electrically connected to the pulse generator. Further, the electrode body is configured to sustain long-term contact between the electrode and the nerve. The reservoir maintains a nerve stimulating drug, such as a veratrum alkaloid, and defines a delivery surface through which the drug is released from the reservoir. Finally, the reservoir is operatively associated with the electrode body to deliver the nerve stimulating drug directly to the nerve. During use, the electrode and the delivered drug stimulate the nerve to effect control over the cardiovascular system of the patient.

Abstract: A device for preventing an anchoring element disposed at the distal end of an implantable electrode cable from coming into contact, during introduction of the cable into a body cavity, with a cavity wall and thereby damaging the cavity wall, as a protection element which either projects beyond the distal tip of the helical anchoring element, or has the distal tip of the helical anchoring element embedded therein. The protection element is composed of a porous, resilient, spongy material which is compressible. The protection element has interstices which are at least partially filled with medication, and the protection element is compressible during affixing of the anchoring element in the heart wall, so as to express the medication from the interstices.

Abstract: A cardiac stimulator lead is provided that includes a connector for connecting to a cardiac stimulator and an insulating sleeve that has a first end coupled to the connector and a second end. The second end has an opening therein. An electrode is positioned in the insulating sleeve and has a piercing member. The electrode is moveable axially from a retracted position to an extended position wherein the piercing member projects from the opening. A conductor wire is disposed in the sleeve and coupled between the connector and the electrode for transmitting electric signals between the cardiac stimulator and the electrode. A lubricant is provided inside the insulating sleeve for lubricating the movement of the electrode. The lubricant reduces the potential for sticking, particularly for silicone lead sleeves.

Abstract: A system is disclosed, for administering a therapeutic agent locally and to a depth within cardiac tissue. An elongate, flexible catheter contains a flexible electric conductor and supports at its distal end an implantable electrode incorporating a penetrating element, typically a fixation helix or a linear needle that penetrates cardiac tissue as the electrode is implanted. A therapeutic agent is delivered through the electrode, to the cardiac tissue surrounding the penetrating element. The electrode acts as a sensor, electrically coupled through the flexible conductor, and monitors an electrical condition of the surrounding cardiac tissue. A controller is coupled to the sensor and to a pump or reservoir containing the therapeutic agent, to control delivery of the agent responsive to the sensed electrical condition. The implanted electrode further can be used to deliver RF current to ablate the surrounding tissue.

Abstract: An implantable cardiac stimulation lead comprises an elongated electrical conductor with an electrode configured to deliver a tiered level of drug therapy to a patient. An insulative electrical sheath covers the electrical conductor and an electrical connector is coupled to the proximal end of the electrical conductor, adapted for connection with the pulse generator. An electrically conductive electrode is located at a distal end of the electrical conductor whose proximal end is adapted for connection to an implantable stimulation device, the electrode having an interior cavity and an axial bore extending between an exterior surface and the interior cavity. A matrix member, preferably composed of silicon rubber, is received within the interior cavity and contains a therapeutic drug.

Abstract: An iontophoretic drug delivery device includes a controller normally being in an off or low power consumption state, and a patch including electrodes, a reservoir containing an ionizable drug for transcutaneous delivery to a patient and a return reservoir. The patch is removably and electrically connectable to the controller, and delivers the drug to patient when the patch is on the patient's skin and when the controller is switched from the off or low power consumption state to an operational state. This occurs when the patch is inserted into the controller. This feature preserves the battery of the controller. Upon patch insertion, the controller periodically changes from a non-current delivery state to a current delivery state for the predetermined period of time to deliver a pulse of current to the inserted patch. A current sensor within the controller measures the current delivered to the patch.

Abstract: A system for treating a patient's heart which comprises a means to form channels in the heart wall and a means to deliver a therapeutic or diagnostic agent into the channels. Additionally, the system may comprise a means to retain the agent within the channels for a useful period of time. The system may be configured to be introduced percutaneously or intraoperatively. The system generally comprises an elongated, flexible lasing transmission means having a laser radiation emitting means and an delivery lumen opening at the distal end. Practice of the invention comprises forming channels in the heart wall and delivering a therapeutic or diagnostic agent into the channel. Gene therapy agents of this invention comprise vectors for transferring genetic information to the heart tissue in vivo or harvested cells which have been genetically engineered in vitro. Additionally, the invention may comprise retaining the agent within the channels, for example, by incorporating the agent in a viscous carrier.

Abstract: A medical electrical lead having a drug which is no more than sparingly soluble in water applied to the electrode surface. In the preferred embodiment the lead of the present invention possesses an electrode treated with a very slightly soluble in water steroid, such as beclomethasone dipropionate anhydrous. Preferably the steroid is applied to the surface of the electrode which contacts tissue when implanted. A method of manufacturing such a lead is also disclosed. Through such a design, a high impedance, low threshold lead which is simple and easy to manufacture is disclosed.

Abstract: A pacing lead, and system for pacing, where the lead has an improved distal tip designed to provide reliable chronic fixation of the electrode-heart interface, while also providing low pacing threshold. The distal end of the lead has a standard surface, of roughly hemispherical shape, made of a porous material. In one embodiment, the tip surface is suitably about 6-8 square mm, and there is a smaller surface of about 1.5-2.0 square mm which is electrically isolated from the remainder of the porous surface; the smaller surface acts as a high impedance electrode, providing low threshold, while the larger porous surface provides the stable fixation. A steroid source is housed in the distal end of the lead, so as to provide an eluted steroid to the electrode surface area, as well as at least part of the remaining porous surface, whereby the overall porous surface and the eluted steroid minimizes the resulting capsule of non-excitable tissue around the electrode, providing for a stable reduced threshold.

Abstract: A continuous sheath of open-celled porous plastic, preferably ePTFE, is used on the outside of a medical lead, extending along the lead body and the electrodes. Because the plastic is open-celled, when the pores are filled with saline, the lead can deliver electrical energy through the pores in the plastic. Pore size is chosen to discourage tissue ingrowth while allowing for defibrillation energy delivery and electrical signals through it. The porous plastic has a biocompatible wetting agent applied to it to speed the process of filling the pores with saline.

Abstract: An improved catheter system, having at least one rollable electrode at its tip section, can be used in ablating the arrhythmogenic point of a patient. A catheter suitable for radiofrequency ablation of cardiac tissues comprises a catheter shaft having a distal section, a distal end, a proximal end, and at least one lumen extending therebetween, wherein at least a rollable electrode is disposed at the tip section of the said catheter. In one embodiment, the ablation catheter has a temperature sensor and a close-loop temperature control mechanism. In another embodiment, the ablation catheter has fluid infusion and irrigation means at its distal tip section for creating a deep and large lesion by applying radiofrequency energy and cooled fluid to the said electrode.

Abstract: An apparatus and method for delivering a drug selectively and locally to internal body tissue with a catheter using electric current/voltage controlled in conjunction with active pacing of cardiac activity.

Abstract: An iontophoretic drug delivery device includes a controller normally being in an off or low power consumption state, and a patch including electrodes, a reservoir containing an ionizable drug for transcutaneous delivery to a patient and a return reservoir. The patch is removably and electrically connectable to the controller, and delivers the drug to patient when the patch is on the patient's skin and when the controller is switched from the off or low power consumption state to an operational state. This occurs when the patch is inserted into the controller. This feature preserves the battery of the controller. Upon patch insertion, the controller periodically changes from a non-current delivery state to a current delivery state for the predetermined period of time to deliver a pulse of current to the inserted patch. A current sensor within the controller measures the current delivered to the patch.

Abstract: A system for treating a patient's heart which comprises a means to form channels in the heart wall and a means to deliver a therapeutic or diagnostic agent into the channels. Additionally, the system may comprise a way to retain the agent within the channels for a useful period of time. The system may be configured to be introduced percutaneously or intraoperatively. The system generally comprises an elongated, flexible lasing transmission catheter that emits laser radiation and has delivery lumen opening at the distal end. Practice of the invention comprises forming channels in the heart wall and delivering a therapeutic or diagnostic agent into the channel. Gene therapy agents of this invention comprise vectors for transferring genetic information to the heart tissue in vivo or harvested cells which have been genetically engineered in vitro. Additionally, the invention may comprise retaining the agent within the channels, for example, by incorporating the agent in a viscous carrier.

Abstract: A pacing lead having a stylet introduced anti-inflammatory drug delivery element advanceable from the distal tip electrode. The element is preferably formed as a moldable biocompatible composite material. The element has a biocompatible matrix material which may be combined with drugs and therapeutic agents to deliver the drugs and agents by co-dissolution or diffusion to the point of either passive or active fixation. The drug delivery element may be rigid and serve to center an active fixation mechanism, preferably a helix, which penetrates the myocardium.

Abstract: A catheter system suitable for electrophysiology mapping and radiofrequency ablation of cardiac tissue comprises a catheter shaft having a distal end, a proximal handle, and at least a lumen extending therebetween, wherein a distal section of the shaft is either a fixed curve or deflectable; and safety anchoring means being provided to maintain the integrity of the catheter by holding the tip electrode in place. In one embodiment, the safety means is a tip electrode with safety anchoring pins. In another embodiment, the safety means is a tip electrode with extended flexible stem having open slots on said stem.

Abstract: A medical electrical lead having a fixation helix which is surface treated along at least a portion to have a relatively high microscopic area along with a relatively low macroscopic area. In the preferred embodiment, such a surface treated portion is accomplished with a porous platinized construction. The surface treated portion further has a bioabsorbable coating in order to permit the helix to be inserted into the heart tissue without causing damage to the heart tissue through the engagement of the surface treated portion with heart tissue during insertion. In the preferred embodiment the bioabsorbable material is mannitol, although other bioabsorbable materials may also be used, such as a material which is no more than sparingly soluble in water, for example, the steroid beclomethasone dipropionate anhydrous. Through such a construction the helix may be inserted into tissue while the coating of absorbable materials provides a smooth surface between the surface treated portion of the helix and the tissue.

Abstract: Intravenous cardiac leads having at least one electrode intended to be implanted within the coronary veins are disclosed. Also disclosed are structures and techniques for advancing such leads through the atrium and coronary sinus into the coronary veins overlaying the left ventricle.

Abstract: A porous electrode assembly includes a wall having a surface capable of contacting tissue. The wall peripherally surrounds an interior area. The assembly also includes a lumen to convey a medium containing ions into the interior area, as well as an electrically conductive element, which couples the medium within the interior area to a source of electrical energy. At least a portion of the wall comprises a porous material, which is sized to pass ions contained in the medium, to thereby enable ionic transport of electrical energy through the porous material to tissue contacting the wall. An imaging element is located in the interior area, which is coupled to a source of visualizing energy for visualizing tissue. At least a portion of the wall is generally transparent to the visualizing energy.

Abstract: An implantable devices for the effective elimination of an arrhythmogenic site from the myocardium is presented. By inserting small biocompatible conductors and/or insulators into the heart tissue at the arrhythmogenic site, it is possible to effectively eliminate a portion of the tissue from the electric field and current paths within the heart. The device would act as an alternative to the standard techniques for the removal of tissue from the effective contribution to the hearts electrical action which require the destruction of tissue via energy transfer (RF, microwave, cryogenic, etc.). This device is a significant improvement in the state of the art in that it does not require tissue necrosis. In one preferred embodiment the device is a non conductive helix that is permanently implanted into the heart wall around the arrhythmogenic site.