Abstract: A modular terminal assembly, which may be a connector assembly, for a medical electrical lead includes at least one contact conductor extending therefrom that may or may not be coupled to a lead body conductor. A lead body assembly, for the medical electrical lead that includes the lead body conductor may be selected from a group of different lead body assemblies.

Abstract: A virtual control system for an operating room establishes virtual control devices to control surgical equipment and patient monitoring equipment and to display control, status and functionality information concerning the surgical equipment and condition information of the patient. The virtual control devices permit direct interaction by the surgeon while maintaining a sterile field, and avoid the use of actual physical devices and electrical cables connecting them to the surgical equipment.

Abstract: A virtual control panel controls the functionality of an electrosurgical generator in response to interrogating, preferably optically, an object, such as a user's finger, interacting with a control panel image as an act of control input over the functionality of the generator. The control panel image is presented, preferably by optical projection, on a display surface of a display surface structure. The control panel image may include, in addition to a contact control area where interaction with the object is interrogated, a display area where information describing the functionality of the generator is presented, preferably by optical projection. A virtual pad can be used with the virtual control panel to divide and separate control and display functionality.

Abstract: A cardiac stimulation assembly includes an energy source coupled to an energy emitter that extends form a delivery member into a region of tissue in the heart. An array of the emitters are adapted to extend from a delivery assembly and into unique locations along the region of tissue, such as by use of extendable, pre-shaped needles. A volume of conductive agent is delivered into the region and enhances stimulation of the region with the energy emitter. The agent may be an injectable preparation of living cells that express production of connexin, e.g. connexin 43, and may be genetically modified to over-express such production. The agent may include a non-living material, such as conductive polymer or metal or combination thereof. The combination of energy emitters and conductive agent enhances stimulation of the region. Delivering the stimulation assembly and conductive agent into the interventricular septum allows for improved biventricular septal pacing.

Abstract: An intra-cardiac mapping system is based on locating the ports through which blood flows in or out the heart chambers. For many procedures, such as ablation to cure atrial fibrillation, locating the pulmonary veins and the mitral valve accurately allows to perform a Maze procedure. The location of the ports and valves is based on using the convective cooling effect of the blood flow. The mapping can be performed by a catheter-deployed expandable net or a scanning catheter. The same net or catheter can also perform the ablation procedure.

Abstract: A catheter apparatus is provided for use in the treatment of heart arrhythmia having a catheter shaft, a mapping and ablation catheter disposed within the shaft, and a control mechanism coupled to both the shaft and catheter. The catheter shaft includes a main body and a coaxial tip section joined to the main body. The tip section can be rotated about a central axis and curved away from the central axis in a controlled manner. The mapping and ablation catheter can be extended outward from the catheter shaft where it is able to take the form of a pre-stressed curve. The control mechanism controls axial rotation of the tip section, the degree of deflection of the tip section and longitudinal movement of the mapping and ablation catheter with respect to the catheter shaft. Preferably, the mapping and ablation catheter forms a pre-stressed loop when it is fully extended from the catheter shaft.

Abstract: A left ventricular lead is provided for placement in a branch vessel of the coronary sinus, the vessel having a vessel wall and an adjacent myocardium. The lead includes a lead body having a central lumen extending therethrough, at least a first electrode on the lead body and at least a first orientation feature protruding from the lead body for orienting one or more of the electrodes into contact with the myocardium. The lead may also include a pre-shaped curvature. The orientation feature may also aid in steering the lead into a selected branch vessel of the coronary sinus and in fixing the lead within the branch vessel.

Abstract: Medical electrical leads are provided including fixation features for acute and chronic fixation of a portion of the respective leads within the cardiac venous system. The medical electrical lead includes an elongate body having proximal and distal regions. Tissue contacting portions are selectively located in the distal region to contact an inner surface of the cardiac vessel when the lead is in an implanted position. The tissue contacting portion(s) include fixation features adapted to frictionally engage the inner surface of the cardiac vessel and promote tissue in-growth for chronic fixation. In some embodiments, the fixation features are detachable from the lead such that the lead can be extracted from its implanted position after tissue in-growth occurs.

Abstract: An electrophysiology catheter and method of use for mapping and ablation procedures. The catheter includes a braided conductive member at its distal end that can be radially expanded. The catheter can be used in endocardial and epicardial mapping and ablation procedures.

Abstract: A cardiac lead adapted for fixation at least partially within a cardiac vessel. The lead includes, in one embodiment, an elongate lead body defining a proximal region and a distal region including a distal end region having at least one electrode and a distal tip. The distal end region is configured such that the electrode and the distal tip can be implanted in the cardiac vessel. Stiffening structures in the distal region of the lead are adapted to stiffen selected portions of the lead for fixation of the electrode within the cardiac vessel. In some embodiments, the stiffening structures include an implantable member adapted to be implanted in a lumen of the lead. In other embodiments, the stiffening structures include a sheath adapted to be deployed over the lead body. In still other embodiments, the stiffening structures are integral to the lead and/or the lead body.

Abstract: A medical electrical lead adapted to be at least partially implanted in a cardiac vessel includes a fixation feature operable to change from an undeployed configuration to a deployed configuration in which the fixation feature is adapted to engage an inner surface of the cardiac vessel. A tendon is disposed within a lumen of the lead and is operatively connected to the fixation feature and adapted to cause the fixation feature to change from the undeployed configuration to the deployed configuration for acute and/or chronic fixation of the lead. In one embodiment, the fixation feature includes a deflectable region of the lead which in the deployed configuration causes a surface of the lead body to engage the inner surface of the cardiac vessel. In another embodiment, the fixation feature includes a radially expandable structure for engaging the inner surface of the vessel in the deployed configuration.

Abstract: A proximal end of a lead body carries a connector assembly. A first electrical conductor within the lead body electrically connects a tip electrode to a first electrical contact on the connector assembly. A collar electrode is carried by a distal end portion of the lead body. A second electrical conductor within the lead body electrically connects the collar electrode to a second electrical contact on the connector assembly. A ring electrode, carried by the distal end portion of the lead body, is disposed proximally of the collar electrode in spaced-apart relationship thereto and is connected through a switching device to a node point along the first conductor. The switching device has a first state permitting an electrical current to be conducted between the ring electrode and the node point and a second state in which the ring electrode is electrically isolated from the node point. Preferably, the switching device comprises a diode.

Abstract: An improved catheter is provided that is particularly useful for mapping the Purkinje fibers for potential diagnosis of ventricular fibrillation. The catheter comprises an elongated catheter body having proximal and distal ends and at least one lumen extending longitudinally therethrough. Mounted at the distal end of the catheter body is a mapping assembly having at least two spines, each having a proximal end attached at the distal end of the catheter body and a free distal end. Each spine comprises at least one electrode, preferably a tip electrode and at least one ring electrode. An irrigation tube extends through the catheter body and has an open distal end that is in communication with the outside of the distal end of the catheter body. The spines may be arranged in an expanded arrangement wherein each spine extends radially outwardly from the catheter body or in a collapsed arrangement wherein each spine is disposed generally along the longitudinal axis of the catheter body.

Abstract: Catheters for mapping and/or ablation are disclosed. In one embodiment, the catheter comprises a handle, a flexible shaft, a tip assembly, and a cable. The handle includes an actuator and is attached, at its distal end, to the proximal end of the flexible shaft. The flexible shaft has a longitudinal axis that extends along a length of the shaft. The proximal end of the tip assembly is attached to the distal end of the shaft and includes a fixed bend of approximatley ninety degrees relative to the longitudinal axis of the shaft. The distal end of the tip assembly includes an arcuate curve having a diameter. The arcuate curve is oriented in a plane that is approximatley perpendicular to the longitudinal axis of the shaft. The cable is attached to the actuator and the distal end of the tip assembly, and extends through the shaft. The cable is adapted to change the diameter of the arcuate curve in response to movement of the actuator.

Abstract: A cardiac stimulation system for implantation in a patient is disclosed. The cardiac stimulation system comprises first and second electrodes configured for positioning in a bifocal arrangement. A first lead system is adapted for carrying the first and second electrodes in the right ventricle in accordance with the bifocal arrangement and along the high basal region of the heart proximate the septum. A third electrode is adapted for positioning outside the right ventricle. The system further comprises a power supply and a controller. The controller is coupled to the power supply and operates to activate the first, second and third electrodes to deliver pulse therapy to the heart according to predetermined criteria.

Abstract: A conductor assembly and methods for mechanically and electrically coupling a small diameter conductor to a lead component having a relatively larger sized conductor bore is provided. The assembly includes a sizing member sized to fit securely around a relatively small diameter conductor and to further fit within a conductor bore so that temporary compression (e.g., crimping, crushing, or staking) of a discrete portion of the conductor bore mechanically couples, and establishes electrical communication between, the conductor and the lead component. Alternately, a conductive sleeve member having a relatively large diameter conductor bore is adapted to receive a sizing unit to downsize one side of the sleeve member in a manner similar to the foregoing. In this case, a relatively smaller diameter one of a pair of different diameter elongated conductors is firmly mechanically coupled and in electrical communication with a relatively larger diameter conductor.

Abstract: A medical electrical lead containing a pyroelectric material is provided. The pyroelectric material is capable of dissipating heat generated in the lead due to radio frequency energy. The pyroelectric material may be a polymeric material, such as polyvinylidene fluoride (PVDF).

Abstract: A catheter body includes a proximal portion, an intermediate portion extending from the proximal portion and defining a longitudinal axis, and a distal portion extending from the intermediate portion and terminated by a distal end of the catheter body; the distal portion forms a coil about a central loop axis, which is substantially parallel to the longitudinal axis. A first lumen extends through the proximal and intermediate portions of the catheter body and is terminated at an opening proximal to an ablation section, which is formed along the coil.

Abstract: An implantable medical lead includes an adaptor coupled to a body of the lead. The adaptor holds a sensor capsule between a first portion and a second portion of the lead body.

Abstract: A device and associated method for performing ablation procedures on anatomical structures accessible from within the chambers of the heart to form lesions that electrically isolate the tissue.

Abstract: A lead stabilization and extension wire that enables the withdrawal of a guide catheter over an electrical medical lead body without dislodging an electrode or sensor from an implantation site or detaching the fixation mechanism and methods of use and a kit are disclosed. The lead stabilizer and retraction wire comprises a wire sheath and an elongated core wire insertable within a sheath lumen. The sheath is insertable within a lead body lumen and includes a movable lead clamp that can engage with a lead connector element and a friction element frictionally engaging the core wire to maintain the extension wire length. The lead stabilizer and retraction wire is insertable into the lead body lumen enabling retraction of the guide catheter over the lead stabilization and extension wire while force is applied through the lead stabilization and extension wire to maintain the distal electrode at the implantation site.

Abstract: For use in an implantable medical device, there is provided a biocompatible, biostable, corrosion-resistant wire strand comprising a core comprising a plurality of electrically conductive, low electrical resistance filaments embedded in an electrically conductive matrix, and a low electrical resistance, substantially chemically inactive cladding.

Abstract: Side-port sheaths for catheter placement and translation are disclosed. The sheaths include a side-port opening through which a gliding catheter may be deployed during diagnosis or treatment of tissue. The side-port sheath may include a suspension ribbon used to deploy, or that aids in the deployment of, the embedded gliding catheter. The suspension ribbon may be slideably or fixably engaged with an outer surface of the sheath of the gliding catheter.

Abstract: A cardiac transvenous defibrillation lead has a continuous coil conductor within a layer of insulation. A portion of the coil conductor is exposed as a defibrillation electrode. In order to enhance fluoroscopic visualization of the exposed electrode during implant, the end of the exposed electrode is marked with a radiopaque element. The element may be in the form of an adhesive filled with radiopaque material that is used to backfill under the layer of insulation. Alternatively, a tube made of radiopaque material may be installed between the layer of insulation and the coil conductor.

Abstract: The present invention provides systems and methods for determining the coordinates of a location element mounted on a medical probe. First and second signals are transmitted between the location element and a first and second reference transducers, which may be arranged in a reference array that can be attached to a patient's skin. A transit time difference between the first and second signals is determined, e.g., using a thresholding or correlation technique. A distance difference between a first distance extending from the location element to the first reference element and a second distance extending from the location element to the second reference element is then determined based on the transit time difference. An angle between the reference array and the location element can then be determined based on the determined distance difference and a known distance between the first and second reference transducers.

Abstract: A diagnostic catheter with a steering device to direct the distal end of the catheter while it is inserted in a vessel. The catheter may include either a bi-directional steering mechanism, or a unidirectional steering mechanism. Pre-formed catheters with no steering means are also provided. The catheter bodies include a plurality of ring electrodes used for sensing the intracardial electrogram signal during operation of the catheter. The ring electrodes are placed in ohmic contact with their corresponding signal wires by a solderless connection. In addition, the catheter may be embodied as a basket catheter including a plurality of splines. After the catheter is inserted into the vessel or organ to be examined (typically the heart), the splines may be expanded from an at-rest position to form the basket. A central retractable and steerable member is included to provide the expansion force. The expansion force can also be provided by moving the proximal portion of the catheter relative to the central member.

Abstract: In one embodiment, the present invention provides a bipolar ablation device with multiple needle electrodes that penetrate a desired target tissue. These electrodes may be arranged in a variety of therapeutically effective arrangements, such as a comb-like shape, a multi-needle wheel, or an expanding bow design. By contacting and preferably penetrating the cardiac tissue with bipolar electrodes, a user can more precisely create ablation-induced scarring and thus electrical block at desired target locations without causing unwanted damage and related complications.

Abstract: A catheter based implantable wireless pressure sensor and associated electronic circuitry for transmission of hemodynamic status of a subject.

Abstract: Methods and systems for securing tissues, e.g., cardiovascular tissues, are disclosed. A method in accordance with one embodiment of the invention includes inserting a portion of a catheter into an opening between a first portion of cardiovascular tissue and a second portion of cardiovascular tissue. The method can further include drawing the first and second portions of the cardiovascular tissue into contact with each other by drawing a vacuum in a region adjacent to the first and second portions of cardiovascular tissue via the catheter while the catheter is positioned between the first and second portions. The tissue portions can be fused by heating the tissue from within the opening, e.g., via radio frequency energy. This technique, and associated catheter system, can be used to close a patent foramen ovale or other openings in cardiovascular tissue.

Abstract: A lead assembly includes a flexible lead body extending from a proximal end to a distal end, and the lead body includes two or more conductors disposed therein. The second conductor is disposed within the first conductor, and the second conductor has a coating of insulation on the second conductor. In another option, a sleeve of insulative material is disposed between the first conductor and the second conductor.

Abstract: An electrophysiology catheter and method of use for mapping and ablation procedures. The catheter includes a braided conductive member at its distal end that can be radially expanded.

Abstract: A catheter is provided that has a basket-shaped electrode assembly with an improved mechanism for expanding and contracting the electrode array. The expansion mechanism is designed to permit reproducible reintroduction of the catheter into the heart. The catheter comprises an elongated catheter body having at least one lumen therethrough. A basket-shaped electrode assembly is mounted at the distal end of the catheter body. The basket assembly comprises a plurality of spines connected at their proximal and distal ends, each of which comprises at least one electrode. The basket assembly has an expanded arrangement wherein the spines bow radially outwardly and a collapsed arrangement wherein the spines are arranged generally along the axis of the catheter body. An expander is attached at or near its distal end to the distal ends of the spines and extends through the catheter body. The expander has a proximal end that extends out the proximal end of the catheter body a lumen extending therethrough.

Abstract: A guiding introducer system for use in the treatment of arrhythmia associated with the left ventricle from the ventricular side comprising an inner guiding introducer and an outer guiding introducer wherein the inner guiding introducer is comprised of a first and second section and the outer guiding introducer is comprised of a first and second sections. The guiding introducer system is for use in sensing, pacing, and ablating procedures in the left ventricle.

Abstract: A cardiac rhythm management system includes a lead assembly for intracardiac mapping, pacing, and drug delivery. The lead assembly includes an implantable endocardial lead having a proximal end for connection to an implantable cardiac rhythm management device and a distal end for disposal in an intracardiac region. The lead includes a pacing-sensing electrode and a drug delivery device, both located at or near the distal end. A lumen is within and extends throughout the lead, with an opening at or near the proximal end and another opening at or near the distal end. The lumen provides for access to the intracardiac region by a steerable stylet and a hollow needle, one at a time. The steerable stylet allows for electrophysiological mapping of the intracardiac region. The hollow needle allows for delivery of chemical, biochemical, and/or biological substance to the intracardiac region.

Abstract: Terminating supraventricular arrhythmias through parasympathetic nerve stimulation. The method comprises detecting a supraventricular arrhythmia, stimulating a parasympathetic nerve and determining whether the supraventricular arrhythmia terminated or worsened. Various exemplary methods include delivering one or more stimulation pulses during postinspiration and/or in response to one or more cardiac events.

Abstract: An adaptor couples multiple high-voltage connector elements included on a plurality of medical electrical lead connectors to a single connector port of an implantable medical device thereby facilitating alternative high-voltage therapy vectors.

Abstract: A catheter system includes a mapping catheter having an open lumen and a mapping arrangement provided at a distal end of the mapping catheter. A balloon catheter is movably disposed within the open lumen of the mapping catheter. The balloon catheter has an open lumen dimensioned to receive a lead. A balloon arrangement is provided at a distal end of the balloon catheter and inflatable with an inflation mechanism provided at a proximal end of the balloon catheter. The balloon arrangement is dimensioned to prevent movement of the lead upon inflation of the balloon arrangement, and to permit movement of the lead within the open lumen of the balloon catheter upon deflation of the balloon arrangement.

Abstract: A medical balloon catheter assembly includes a balloon having a permeable region and a non-permeable region. The balloon is constructed at least in part from a fluid permeable tube such that the permeable region is formed from a porous material which allows a volume of pressurized fluid to pass from within a chamber formed by the balloon and into the permeable region sufficiently such that the fluid may be ablatively coupled to tissue engaged by the permeable region. The non-permeable region is adapted to substantially block the pressurized fluid from passing from within the chamber and outwardly from the balloon. The porous material may be a porous fluoropolymer, such as porous polytetrafluoroethylene, and the pores may be created by voids that are inherently formed between an interlocking node-fibril network that makes up the fluoropolymer. Such voids may be created according to one mode by expanding the fluoropolymer.

Abstract: A lead assembly includes an outer insulative body, a conductor, and at least one electrode electrically coupled with the at least one conductor. The outer insulative body extends from a proximal end to a distal end and has an intermediate portion therebetween. A flexible portion for example having a bellows portion is disposed along the lead body.

Abstract: An assembly is provided for an implantable medical lead. The assembly includes a first lead body comprising one or more electrical leads, and a hermetic encasement. The encasement comprises a housing having first and second openings and interior walls, an interior space defined by the interior walls, an electronic network housed within the interior space, and a circuit board extending through the first and second openings. The circuit board comprises a plurality of layers into which the electronic network is at least partially integrated, a first set of one or more terminals electrically coupling the electronic network to the first lead body, and a second set of one or more terminals electrically coupled to the electronic network for external electrical engagement.

Abstract: A connector for connecting to an energy source such as a pulse generator for a cardiac stimulator system. The connector assembly includes a pin, at least one ring and a sleeve composed of an insulative hard polymer molded between the pin and ring such that the sleeve provides electrical insulation between the pin and ring and mechanically couples the pin and ring.

Abstract: An improved catheter is provided that is particularly useful for mapping the Purkinje fibers for potential diagnosis of ventricular fibrillation. The catheter comprises an elongated catheter body having proximal and distal ends and at least one lumen extending longitudinally therethrough. Mounted at the distal end of the catheter body is a mapping assembly having at least two spines, each having a proximal end attached at the distal end of the catheter body and a free distal end. Each spine comprises at least one electrode, preferably a tip electrode and at least one ring electrode. An irrigation tube extends through the catheter body and has an open distal end that is in communication with the outside of the distal end of the catheter body. The spines may be arranged in an expanded arrangement wherein each spine extends radially outwardly from the catheter body or in a collapsed arrangement wherein each spine is disposed generally along the longitudinal axis of the catheter body.

Abstract: A medical electrical lead includes an electrode, a connector terminal and an auxiliary connector port, which includes a connector contact adapted to electrically couple an electrode of a second lead. A first connector element of the connector terminal is coupled to the electrode via a first insulated conductor, and a second connector element of the connector terminal is coupled, via a second insulated conductor, to the connector contact included in the auxiliary port.

Abstract: A pacing lead includes a first pacing cathode coupled to a first conductor, a second pacing cathode coupled to a second conductor, and a flexible anode coupled to a third conductor. The flexible anode has a length less than approximately 10 millimeters and is spaced apart from and proximal to the first pacing cathode and spaced apart from and distal to the second pacing cathode. The spacing between the anode and the first pacing cathode is approximately equal to the spacing between the anode and the second pacing cathode.

Abstract: An implantable lead for use with an implantable medical device includes a lead body with first and second electrical conductors extending between its proximal and distal ends. An electrical connector at the proximal end of the lead body includes terminals electrically connected to the first and second conductors. First and second coaxial active fixation helices are coupled to the lead body's distal end, one being an anode, the other an electrically isolated cathode. Each helix has an outer peripheral surface with alternating insulated and un-insulated portions along its length with about a half of the surface area being insulated. The un-insulated portions of the helices may be formed as a plurality of islands in the insulated portions, or as rings spaced by insulative rings, or as longitudinally extending strips spaced by longitudinally extending insulative strips.

Abstract: The present invention is an apparatus for treating a selected patient tissue or organ region, at the surface of such region. The apparatus has an accessing tool for accessing the patient region, the tool having a distal end, and a proximal end at which the tool can be manipulated to place the distal end adjacent to the patient region. The apparatus also has a probe carried on the distal end and defining a contact surface that may be urged against the patient region thereby creating contact pressure. A pressure transducer is operatively coupled to the probe and is capable of producing a measurable response to the contact pressure. A monitoring device is operatively connected to the pressure transducer, for determining the contact pressure. An effector is operatively disposed on the probe for producing a given effect on the patient region when the effector is activated, and an activator operatively connected to the effector, by which the effector can be activated.

Abstract: Various stimulation catheters are disclosed to lie along and stimulate tissue in the intrathecal space. The electrodes on the leads are various sizes to conserve the battery as well as allowing a more defined area of stimulation. It may also include multiple channels or passages for delivery of drugs, thermal or photonic energy. The sheath includes a fixing element configured to fix the electrode in place along the tissue.

Abstract: A catheter tip for mapping is provided. The medical probe tip includes a first mapping ring electrode and a second mapping ring electrode that is electrically insulated from the first mapping ring electrode. The second mapping ring electrode is located substantially concentric to the first mapping ring electrode, and is coaxially surrounding the first mapping ring electrode.

Abstract: An electrode having a substrate with a first layer covering at least a portion of the substrate, and a second layer covering at least a portion of the first layer is disclosed. The first layer includes a porous layer consisting of a carbide, nitride or carbonitride of at least one of the metals titanium, vanadium, zirconium, niobium, molybdenum, hafnium, tantalum or tungsten. The second layer includes iridium. In a method according to the present invention, a substrate is provided. A first layer is provided over at least a portion of the substrate, and a second layer is provided over at least a portion of the first layer. The first layer includes a layer consisting of a carbide, nitride or carbonitride of at least one of the metals titanium, vanadium, zirconium, niobium, molybdenum, hafnium, tantalum or tungsten. The second layer includes iridium.

Abstract: A medical electrical lead includes a first low voltage electrode adapted for intimate contact with tissue at an implant site, in order to provide pacing stimulation, and a second low voltage electrode positioned in proximity to the first electrode, isolated from the first electrode and adapted to function in conjunction with the first electrode to provide bipolar sensing of near-field signals. A porous layer is formed over the second electrode; the porous layer allows conduction therethrough while preventing contact between the second electrode and tissue in proximity to the implant site.