Abstract: A leadless cardiac pacemaker device is configured to provide HIS bundle pacing and contains a housing having a tip, a first electrode arranged on the housing in the vicinity of the tip, the first electrode being configured to engage with intra-cardiac tissue, and a second electrode arranged on the housing at a distance from the tip of the housing. A processor is enclosed in the housing and operatively connected to the first electrode and the second electrode. The processor is configured to process a reception signal received by at least one of the first electrode and the second electrode and to generate a pacing signal to be emitted using at least one of the first electrode and the second electrode.

Abstract: A device for performing intervention procedures includes an elongated body having a first end and a second end. The elongated body includes a hollow tool channel extending through the elongated body from the first end to the second end. The tool channel is configured to receive an intervention tool and a length-adjusting element disposed at the first end or the second end of the elongated body. The length-adjusting element is configured to enable a length of the elongated body to be adjusted. The elongated body includes an angle-adjusting element disposed along the length of the elongated body. The angle-adjusting element is configured to enable the elongated body to be bent. The device includes an imaging system disposed at the first end or the second end of the elongated body. The imaging system includes an imaging device and an illumination device.

Abstract: Systems, methods, and devices to facilitate insertion of certain leads with electrode(s) into patients are described. Leads can be implanted to work in conjunction with a cardiac pacemaker or cardiac defibrillator. A lead for cardiac therapy may be inserted into an intercostal space associated with the cardiac notch of a patient. Devices for delivery may include, for example, a delivery system coupled with an electrical lead and having a handle, a component advancer and insertion tips. The handle is configured to be actuated by an operator and the component advancer is configured to advance an electrical lead into the patient. The insertion tips can be configured to close around the electrical lead within the component advancer, to push through biological tissue, and to open to enable the lead to advance into the patient. The electrical lead can also be maintained in a particular orientation during the advancement into the patient.

Abstract: An implant system includes an electrode portion comprising plural electrodes to perform nerve stimulation and nerve sensing, an impedance controller configured to selectively connect the plural electrodes between a stimulator to perform nerve stimulation and a sensor to perform nerve sensing based on a control signal, and set an impedance of each of the plural electrodes, and a processor configured to control a contact impedance by the plural electrodes by generating the control signal to control at least one of plural switches connected respectively to the plural electrodes, or variable resistors connected respectively to the plural electrodes, based on at least one of a selectively set purpose of the plural electrodes or a position of an electrode to which nerve stimulation is to be provided.

Abstract: The invention relates to an ablation catheter for treatment of a patient's tissue, for example for a PVI procedure on a patient's heart, comprising an elongated catheter shaft and an ablation portion being arranged at a distal end of the catheter shaft with a plurality of electrodes accommodated along the ablation portion, wherein the ablation portion comprises at least two loop sections forming a three-dimensional spiral. In order to increase safety of ablation treatment, spare adjacent tissue (e.g. nerves, vessels, esophagus) and shorten ablation time, a pitch, or clearance of two neighboring loop sections is greater than an ionization threshold of the medium around the distal section, for example blood or gases resulted from electrolysis. The invention further relates to an operation method of such ablation catheter.

Abstract: Systems, methods, and devices allow intravascular or percutaneous mapping, orientation and/or ablation, in bodily cavities or lumens. A device includes elongate members, moveable between an unexpanded configuration and an expanded or fanned configuration. The elongate members form a stack in the unexpanded configuration to fit through a catheter sheath. The elongate members follow respective arcuate or curvilinear paths as advanced from the sheath into the bent or coiled stack configuration, adopting volute, scroll or rho shapes, and may be nested. The elongated members are fanned or radially spaced circumferentially with respect to one another into the expanded or fanned configuration. Transducer elements carried by elongate members sense various physiological characteristics of or proximate tissue, and/or may apply energy to or proximate tissue. The elongate members are rotatable in groups or as a group in the expanded configuration. The device is retractable.

Abstract: A lead system and method of use for treating breathing disorders by the transvenous stimulation of the phrenic nerve.

Abstract: Devices and methods for the treatment of heart conditions, and other medical purposes, include cardiac pacing systems. For example, this document describes temporary transvenous endocardial pacemaker systems and devices for deploying such systems without the need for conventional imaging procedures.

Abstract: Provided is a curable silicone composition, a cured product thereof, a laminate body, a manufacturing method thereof, and an optical device or optical display exhibiting excellent performance for use as a member where transparency is required such as for an optical display, a touch panel, or the like. A curable silicone composition, comprises: (A) an organopolysiloxane having in a molecule at least 2 alkenyl groups with 2 to 12 carbon atoms; (B) an organohydrogenpolysiloxane having at least 2 silicon-bonded hydrogen atoms per molecule; and (C) a hydrosilylation reaction catalyst. Component (B) is present in an amount such that the silicon-bonded hydrogen atoms in component (B) are 0.5 to 2 mol per mol of aliphatic unsaturated carbon-carbon bonds in component (A), and 2 to 17.5 mol % of the silicon-bonded organic groups in the curable silicone composition are aryl groups.

Abstract: A pacemaker lead for cerclage pacing includes a lead fixing part including a fixing tip whose diameter becomes gradually smaller toward an end of a distal part thereof, a plurality of bipolar electrodes that come into close contact with heart muscle, in an outer circumference of the lead fixing part, and a guide wire insertion through hole through which a guide wire can be inserted thereinto, a lead body part configured to be extended to the lead fixing part, having a stylet insertion through hole formed therein, and a body fixing part formed in a bent shape so as to be fixed to an inner wall of the coronary sinus, and a stylet inserted into the stylet insertion through hole, enabling the pacemaker lead for cerclage pacing to be easily moved within the body of the patient.

Abstract: The invention relates to a method for manufacturing an insertion tube of an endoscope from a tubular element, wherein the insertion tube includes a proximal passive flexible portion and a distal deflecting portion, wherein, in the proximal passive flexible portion, cuts are provided to enable the proximal passive flexible portion to be bent. In the method, the cuts are configured in the proximal passive flexible portion such that adjacent cuts do not have the same distance. The invention further relates to an endoscope including such insertion tube.

Abstract: A catheter has a multifunctional “virtual” tip electrode with a porous substrate and a multitude of surface microelectrodes. The surface microelectrodes are in close proximity to each other and in a variety of configurations so as to sense tissue for highly localized intracardiac signal detection, and high density local electrograms and mapping. The porous substrate allows for flow of conductive fluid for ablating tissue. The surface microelectrodes can be formed via a metallization process that allows for any shape or size and close proximity, and the fluid “weeping” from the porous substrate provides more uniform irrigation in the form of a thin layer of saline. The delivery of RF power to the catheter tip is based on the principle of “virtual electrode,” where the conductive saline flowing through the porous tip acts as the electrical connection between the tip electrode and the heart surface.

Abstract: Disclosed herein shock wave catheters comprising one or more shock wave electrodes for cracking calcifications located within blood vessels. In some variations, a shock wave catheter has first and second shock wave electrodes each circumferentially disposed over the outer surface of the catheter. In certain variations, the first electrode has a recess and the second electrode has a protrusion that is received by the recess and a spark gap is located along the separation between the recess and the protrusion. The second electrode can also have a recess that receives a protrusion from a third shock wave electrode, where the separation between the second and third electrodes along the separation between the recess and the protrusion forms a second spark gap. A shock wave can be initiated across these spark gaps when a voltage is applied over the electrodes.

Abstract: A surgical instrument includes a shaft, an end effector, and a wrist coupling the end effector to the shaft. The wrist has a central channel extending along a length of the wrist. An insert guide member is positioned in the central channel. The insert guide member has an exterior lateral wall extending between a first end and a second end of the insert guide member and an interior lateral wall extending between the first end and the second end. A passage extends from the first end of the insert guide member to the second end of the insert guide member. The passage can include a first portion extending through the insert guide member between an interior lateral wall of the insert guide member and the exterior lateral wall of the insert guide member, and a second portion intersecting the exterior lateral wall of the insert guide member.

Abstract: A tubing assembly for electronic catheter guidance systems is provided and can include a catheter, an internal acoustic transducer and an external acoustic transducer. The catheter extends in a longitudinal direction and has proximal and distal ends that define a lumen therebetween. Further, the catheter is configured for placement within a patient's digestive or respiratory tract. The internal acoustic transducer can be located within the catheter's lumen, and the external acoustic transducer can be located on or outside the patient's body. The transducers can transmit and/or receive acoustic signals as directed by a processor and communicate with the processor to deliver sound data to a display device. The frequency response and/or attenuation of the signals can indicate placement of the catheter in the digestive tract compared to the respiratory tract. A catheter guidance system and method for accurately placing a catheter in the digestive or respiratory tract are also provided.

Abstract: A Percutaneous Coronary Intervention (PCI) guidewire and method of use includes at least two pairs of small surface area, closely spaced electrodes spaced axially along the length of the guidewire to allow one electrode pair to be positioned on each side of a coronary stenosis. The electrodes can sense electrical signals from the myocardium immediately adjacent to the electrodes, enabling the guidewire to record and analyze an Intra-Coronary Electrogram (ICEG) and heart pacing, and, therefore, facilitate more accurately diagnosis of an individual patient's stenosis and provide a more patient specific diagnosis of clinical need.

Abstract: A Percutaneous Coronary Intervention (PCI) guidewire and method of use includes at least two pairs of small surface area, closely spaced electrodes spaced axially along the length of the guidewire to allow one electrode pair to be positioned on each side of a coronary stenosis. The electrodes can sense electrical signals from the myocardium immediately adjacent to the electrodes, enabling the guidewire to record and analyze an Intra-Coronary Electrogram (ICEG) and heart pacing, and, therefore, facilitate more accurately diagnosis of an individual patient's stenosis and provide a more patient specific diagnosis of clinical need.

Abstract: A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

Abstract: A method of navigating a catheter to a target location in an anatomical structure of a patient includes inserting a portion of a catheter into the patient. The catheter includes an elongate shaft having a proximal and a distal end, and a loop subassembly coupled to the distal end. The loop subassembly includes a loop coupled to the distal end and positioned parallel to the elongate shaft, and electrodes disposed on the loop. The method includes positioning one of a portion of the loop subassembly and a portion of the distal end of the elongate shaft in contact with a surface of the anatomical structure a distance from the target location, and translating the loop subassembly toward the target location with the one of the portion of the loop subassembly and the portion of the distal end of the elongate shaft in contact with the surface of the anatomical structure.

Abstract: The present invention relates to an implantable lead comprising at least one conductive wire and one electrical connector, the electrical connector configured to be connected to an implantable medical device such as a cardiac stimulation, defibrillation and/or neuromodulation device, wherein the electrical connection between the conductive wire and the connector is effected by a first hypotube welded to the conductive wire and welded to a second hypotube of the electrical connector. The present invention also relates to a method for electrically connecting the at least one conductive wire of the implantable lead to the electrical connector.

Abstract: A flexible electronic circuit includes a plurality of leaves having a proximal section, a distal section, and an intermediate section. The plurality of leaves are bonded to each other within the distal section and loose within the intermediate section. The intermediate section also includes conductive connector pads for a wiring harness. A plurality of test connector pads are disposed on the plurality of leaves within the proximal section. The leaves within the proximal section may also be bonded to each other, for example in a ribbon or stepped configuration, in order to facilitate connection to testing apparatus. Once the circuit is tested, the proximal section can be severed from the intermediate section prior to installation of the circuit into a medical device, such as an intracardiac echocardiography catheter.

Abstract: Various embodiments relate to a microserpentine including a plurality of u-bends, each having a degree of completeness (?), in which an ? value of 0° corresponds to a semi-circular shape, and in which an ? value of +90° corresponds to a complete circle and ?90° corresponds to a straight shape. Each of the plurality of u-bends may have an ? value of from about ?35° to about 45°. The microserpentine may include a core coated with a conductive coating. The core may include a polymeric material. Various embodiments relate to microelectronic devices and methods of producing the same. The microelectronic devices may include but are not limited to a microelectrode array, a microelectronics packaging, an interconnect, a stretchable sensor, a wearable sensor, a wearable actuator, an in vitro sensor, an in vivo sensor, and combinations thereof.

Abstract: A bending and extending device 1 comprises an elastic hollow guide unit 2 and a movable part 3 to be movably inserted into the guide unit 2. The movable part 3 is constituted, either partially or entirely, of a plurality of belt-like flexible parts 30a and 30b, which extend in the axial direction of the guide unit 2 and the flexible parts 30a and 30b are connected at distal ends.

Abstract: An image diagnosis support apparatus includes a shape information acquiring unit that acquires shape information including a size of a diameter and a route of a coronary vein for at least one coronary vein from a three-dimensional image including a heart, a distal position acquiring unit that acquires a most distal position into which an electrode lead wire having a plurality of electrodes arranged at predetermined electrode intervals is able to be inserted based on the shape information, and information indicating a size of a diameter of the electrode lead wire, and a candidate position acquiring unit that acquires at least one piece of information indicating candidate positions of the plurality of electrodes which are candidates for positioning the plurality of electrodes in the coronary vein based on the distal position and positional information indicating arrangement positions of the plurality of electrodes.

Abstract: A catheter is described with an end effector having densely arrayed electrodes on three loops which are arrayed in various planar configurations when the end effector is unconstrained. The end effector has first, second and third loop members, each loop member includes two spines and a connector that connects the two spines to define a loop extending away from a tubular member of the catheter such that the first, second and third loop members are configured so that each connector of each of the first, second and third loop members is in contact with only one connector of the adjacent loop member.

Abstract: A system and method of implanting pacing lead in a patient's heart. The system may include a catheter configured to by inserted through the coronary sinus ostium such that the distal end region of the catheter is positioned past the anterolateral vein and proximate at least one septal perforating vein. The catheter is configured to inject contrast proximate the septal perforating vein to identify an implant region for a pacing lead. Further, a controller is configured to deliver pacing therapy to the implant region.

Abstract: Methods and systems for position determination of an intrabody probe, targets of an intrabody probe, and or actions to be performed using an intrabody probe are described. In some embodiments, an anatomy being navigated and/or mapped is described by a rule-based schema relating different anatomically identified structures to one another according to their ability to help identify and/or locate one another. Additionally, in some embodiments, data recorded from the intrabody probe is processed according to schema rules in order to provide anatomical identification of the anatomical region which the intrabody probe is sampling, optionally without performing detailed mapping, and/or prior to the availability of detailed mapping of anatomical geometry.

Abstract: Devices and techniques for continuously monitoring pressure and simultaneously monitoring changes in blood flow, vascular resistance, and/or vascular behavior are provided. The techniques are employed in measuring intracranial pressure (ICP), while simultaneously measuring cerebral blood flow and/or cerebrovascular resistance or behavior. A sensor device includes an optical and piezoelectric sensing assembly integrated into a deployable ICP monitoring device.

Abstract: Leads for use with implantable medical devices may be implanted in the venous, arterial, or lymphatic networks. The diameter of a microlead may be at most equal to 1.5 French (0.5 mm), and it may include a plurality of micro-cables each including: an electrically conductive core cable for connection to one pole of a multipolar generator of an active implantable medical device, and a polymer insulation layer surrounding the core cable. At least one exposed area may be formed in the insulation layer to form a detection/stimulation electrode.

Abstract: A device and method consisting of conductive, non-conductive, and support materials. These materials when dispensed or extruded onto a multitude of temporary structures will create an implantable conductive and non-conductive structure suitable for neurological electrical stimulation and neurological electrical recording. This structure may also be suitable for delivering fluid and/or contain optical structures suitable for physiological sensing.

Abstract: A radiofrequency guidewire includes a core wire configured to be coupled to a radiofrequency generator. The core wire includes a proximal end and a distal end with respect to the radiofrequency generator. A tip structure is coupled to the core wire proximate the distal end. The tip structure includes one or more edge surfaces. The one or more edge surfaces provide an area of reduced curvature radius on the tip structure. The area of reduced curvature radius generates a higher electric field than other areas of the tip structure during a delivery of radiofrequency energy on the tip structure. A method of ablating an occlusion utilizing the radiofrequency guidewire is also disclosed.

Abstract: Methods for forming an implantable layer onto a staple cartridge are disclosed.

Abstract: A lead-in-lead system may include a first implantable lead having a first electrode and a second implantable lead having a second electrode guided by the first implantable lead to an implantation site. The second electrode may be implanted in a patient's heart distal to the first electrode at the same implantation site or at a second implantation site. Various methods may be used to deliver the lead-in-lead system to one or more implantation sites including at the triangle of Koch for ventricle-from-atrium (VfA) therapy, at the right ventricular septal wall for dual bundle-branch pacing, or in the coronary vasculature for left side sensing and pacing.

Abstract: Apparatus, systems, and methods for achieving thermally-induced renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a thermal element to a renal artery via an intravascular path. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

Abstract: A partially-masked electrode includes a conductive material and an insulated coating having an outer surface. The insulated coating defines a contoured opening that exposes or reveals an area of the conductive material, wherein the contoured opening has an upper perimeter at the outer surface of the insulated coating. When the upper perimeter of the insulated surface coating is placed in contact with a tissue of interest, wherein the tissue of interest is proximate a blood pool, the insulated coating creates a seal between the blood pool and the contoured opening so that no blood in the blood pool can contact the conductive material. This seal reduces or eliminates the reception of far field effects in the blood pool by the electrode, making it easier to locate and diagnose unhealthy tissue.

Abstract: A device, system and method for temperature-based lesion formation assessment and mapping functionality using an accessory usable with an over-the-wire balloon catheter. The device may include a first annular element, a plurality of wires coupled to the first annular element, and a second annular element, the plurality of wires passing from the first annular element through the second annular element and into an elongate wire conduit coupled to the second annular element. At least one of the plurality of wires may include at least one temperature sensor and/or at least one mapping electrode. The first annular element coupled to an outer surface of a sheath. As a balloon catheter is advanced out of the sheath lumen, the distal tip of the catheter engages the second annular element and pushes the wires out of the sheath lumen, everting them over the balloon of the catheter.

Abstract: One aspect relates to a method for a ring electrode, including: providing an outer element with an outer tube and providing a first inner element with a first inner tube having a first core made of a sacrificial material. A material of the outer element and a material of the first inner element have a similar microstructure. A second inner element is provided with a second core made of a sacrificial material; A connection tube is formed by arranging the first inner element and the second inner element within the outer element. The first inner element and the second inner element are arranged concentrically. The composite tube is drawn in a longitudinal direction of the composite tube. The material of the outer element and the material of the first inner element maintain a simialar microstructure. A connection tube disc is seperated from the connection tube.

Abstract: In various examples, a medical device is configured to be at least partially insertable within a patient. The medical device includes a first elongate member including a sidewall surrounding and defining a lumen extending through the first elongate member between a first proximal end and a first distal end. A second elongate member is sized and shaped to fit within the lumen of the first elongate member. A coil is disposed within the sidewall of the first elongate member, wherein the coil is configured to sense a position of the second elongate member with respect to the coil. In some examples, the first elongate member includes a catheter, and the second elongate member includes a guidewire.

Abstract: Systems and methods for implanting a lead. The system includes an active guidewire having proximal and distal ends. The distal end includes a guidewire anchor that is configured to be attached to a target SOI. The active guidewire is configured to be utilized to electrically map the target SOI by at least one of delivering stimulation energy through the active guide wire to the target SOI or sensing an evoked response at the target SOI from the guidewire. The system also includes a lead having a lead body with proximal and distal ends and with a lumen extending between the proximal and distal ends. The distal end of the lead body is configured to receive the proximal end of the active guidewire. The lumen is configured to permit the lead body to be advanced over the active guidewire.

Abstract: Systems and methods are provided for implanting a medical device. An implantable lead comprises a lead body, with electrodes positioned at the distal end and a lead connector positioned at the proximal end. The lead body has a body outer envelope configured to fit within a lumen of an introducer sheath and the lead connector has a connector outer envelope configured to fit within the lumen of the introducer sheath. A lead adaptor is configured to interconnect the implantable lead and the pulse generator. The lead adaptor has an insertable connector that includes mating contacts and an adaptor cavity that includes cavity contacts. The cavity contacts are positioned to engage the lead contacts of the lead connector when the lead connector is inserted into the adaptor cavity. The insertable connector is configured to be inserted into the connector cavity of the pulse generator.

Abstract: A subcutaneous lead for an implantable cardiac device, in particular for a defibrillator or/and a pacemaker comprising a lead body, itself comprising at least one sensing electrode and an insulating sleeve into which the lead body is threaded so that the insulating sleeve and the lead body are movable relative to each other so as to at least partially cover the at least one sensing electrode with the insulating sleeve.

Abstract: Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

Abstract: A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.

Abstract: The present disclosure relates to a plasma treatment (under atmospheric conditions or under vacuum conditions) of a jacketed cable comprising a cable jacket and a heat shrink tubing. The plasma treatment improves retention properties of an optical fiber cable assembly by imparting a permanent change on a polymer surface of the cable jacket by cross-linking, leading to eventual graphitization, that can result in a diffusion barrier layer at an interface of the cable jacket and the heat shrink tubing, which prevents or minimizes plasticizer migration and results in an environmental seal (e.g., a long-term water tight seal).

Abstract: A shield located within an implantable medical lead may be terminated in various ways. The shield may be terminated by butt, scarf, lap, or other joints between insulation layers surrounding the lead and an insulation extension. For lap joints, a portion of an outer insulation layer may be removed and a replacement outer insulation layer is positioned in place of the removed outer insulation layer, where the replacement layer extends beyond an inner insulation layer and the shield. The replacement layer may also lap onto a portion of the insulation extension. The barbs may be located between the replacement layer and the inner insulation layer or the insulation extension. The shield wires have ends at the termination point that may be folded over individually or may be capped with a ring located within one of the insulation layers of the jacket.

Abstract: A medical lead includes a lead body, a proximal connector, a helix extending from a distal end of the lead body. The helix is configured to anchor to a patient tissue, and the helix forms a helical electrode. The medical lead further includes a distal ring electrode, and a cable within the lead body, the cable including a cable conductor, a cable electrode proximate a distal end of the cable conductor, and a blunt dissection tip at a distal end of the cable. The cable is slidable within the lead body to extend and retract the cable electrode along a trajectory extending from the distal end of the lead body. When the helix is anchored to the patient tissue, the blunt dissection tip is configured to blunt dissect the patient tissue along the trajectory extending from the distal end of the lead body through extension of the cable.

Abstract: A method, apparatus, and system for delivering an electrical current. Optical signals are sent through a group of optical fibers in a medium. Response optical signals occurring in response to the optical signals sent through the group of optical fibers are detected when the group of optical fibers is located in the medium. A group of parameters for the medium is determined using the response optical signals. A group of electrical currents is sent through a group of electrodes based on the group of parameters, wherein the group of electrodes emit the group of electrical currents.

Abstract: A navigation system or combination of navigation systems can be used to provide one or more navigation modalities to track a position and navigate a single instrument in a volume. For example, both an Electromagnetic (EM) and Electropotential (EP) navigation system can be used to navigate an instrument within the volume. The two navigation systems may be used separately to selectively individually navigate the single instrument in the volume. Disclosed are also systems and processes to determine a shape of the single instrument either alone or in combination with the position of the instrument. The instrument may be navigated with the addition of tracking devices or with native or inherent portions of the instrument.

Abstract: A valve bypass tool, and a biostimulator transport system having such a valve bypass tool, is described. The valve bypass tool includes an annular seal to seal against a protective sheath of the biostimulator transport system. The valve bypass tool is slidably mounted on the protective sheath and includes a bypass sheath to insert into an access introducer. The valve bypass tool can lock onto the access introducer by mating a locking tab of the valve bypass tool with a locking groove of the access introducer. The locking tab can have a decent that securely fastens the components to resist decoupling when the biostimulator transport system is advanced through the access introducer into a patient anatomy. Other embodiments are also described and claimed.

Abstract: A pacemaker lead for cerclage pacing includes a lead fixing part including a fixing tip whose diameter becomes gradually smaller toward an end of a distal part thereof, a plurality of bipolar electrodes that come into close contact with heart muscle, in an outer circumference of the lead fixing part, and a guide wire insertion through hole through which a guide wire can be inserted thereinto, a lead body part configured to be extended to the lead fixing part, having a stylet insertion through hole formed therein, and a body fixing part formed in a bent shape so as to be fixed to an inner wall of the coronary sinus, and a stylet inserted into the stylet insertion through hole, enabling the pacemaker lead for cerclage pacing to be easily moved within the body of the patient.