Abstract:
Cardiac electrical heterogeneity information may be used to determine whether one or more His bundle paced settings for His bundle pacing therapy are acceptable for His bundle pacing. Cardiac electrical heterogeneity information may be generated during His bundle pacing, and the evaluation against baseline information and/or other information to determine whether the His bundle paced settings are acceptable.
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:
A method, system and device for implanting an electrode assembly of an implantable medical device in a patient's heart. Positioning one or more radiopaque markers in a coronary sinus of the patient's heart. Positioning, by using the one or more positioned radiopaque markers as a fluoroscopic visual reference, a distal tip of a delivery catheter within a right atrium of the patient's heart so that a distal opening of a lumen of the catheter is against a septal wall of the heart at a location between the ostium of the coronary sinus and the A-V nodal area of the right atrium, and so that the tip of the catheter is generally directed toward a left ventricle of the patient's heart. Advancing the electrode assembly through the lumen of the catheter and into the septal wall.
Abstract:
A transseptal catheter delivery system includes an elongate first tubular member and an elongate second tubular member receivable within the first tubular member. The first tubular member includes an adjustable portion adjacent a distal end. The second tubular member is adapted to receive an instrument to be placed in the left ventricle, and includes a curved portion adjacent its distal end in a relaxed state. The adjustable portion is deflectable toward the atrial septum to guide a puncturing tool and/or guide insertion of the second tubular member through a septal puncture into the left atrium. Within the left atrium, the curved portion is oriented toward the left ventricle to guide insertion of a guide wire, and subsequently the second tubular member, into the left ventricle. Methods of transvenously accessing a left ventricle are also provided.
Abstract:
An implantable medical lead having an elongated lead body extending from a proximal end to a distal end, at least one conductor extending within the lead body from the proximal end to the distal end, and a fixation member having a proximal end and a distal end, the proximal end of the electrode configured to be electrically coupled to the distal end of the lead body. The fixation member includes a first delivery port and a second delivery port for releasing a therapeutic agent from the fixation member to tissue of a patient, wherein the first delivery port is positioned along the proximal end of the fixation member to deliver the therapeutic agent to endothelial cells along an endothelial layer of tissue, and the second delivery port is positioned along the distal end of the fixation member and spaced a distance from the first delivery port to deliver the therapeutic agent to myocardial tissue within a myocardial layer of the tissue, and wherein no delivery ports are positioned within the distance that the second delivery port is spaced from the first delivery port.
Abstract:
A fixation member of an electrode assembly for an implantable medical device includes a tissue engaging portion extending along a circular path, between a piercing distal tip thereof and a fixed end of the member. The circular path extends around a longitudinal axis of the assembly. A helical structure of the assembly, which includes an electrode surface formed thereon and a piercing distal tip, also extends around the longitudinal axis and is located within a perimeter of the circular path. The tissue engaging portion of the fixation member extends from the distal tip thereof in a direction along the circular path that is the same as that in which the helical structure extends from the distal tip thereof. The electrode assembly may include a pair of the fixation members, wherein each tissue engaging portion may extend approximately one half turn along the circular path.
Abstract:
Method and systems of determining adequacy of fixation of a medical lead type having a fixation helix are disclosed. The lead of the medical lead type is placed at a desired location within a patient's body and the fixation helix is screwed into tissue at that location. One or more parameters, associated with the lead, are measured at the location. Based upon the measured one or more parameters, determining a number of turns that the helix is embedded into the tissue at the location.
Abstract:
A fixation member of an electrode assembly for an implantable medical device includes a tissue engaging portion extending along a circular path, between a piercing distal tip thereof and a fixed end of the member. The circular path extends around a longitudinal axis of the assembly. A helical structure of the assembly, which includes an electrode surface formed thereon and a piercing distal tip, also extends around the longitudinal axis and is located within a perimeter of the circular path. The tissue engaging portion of the fixation member extends from the distal tip thereof in a direction along the circular path that is the same as that in which the helical structure extends from the distal tip thereof. The electrode assembly may include a pair of the fixation members, wherein each tissue engaging portion may extend approximately one half turn along the circular path.
Abstract:
An implantable lead system may include an adjustable lead assembly. The lead assembly may include a fixation member and an implantable lead slidably coupled to and rotatable relative to the fixation member. The implantable lead system may include a telescoping delivery system. The delivery system may include an outer catheter and an inner catheter slidably coupled to and rotatable relative to the outer catheter. The lead assembly may be implanted in a cardiac septal wall through the delivery assembly.
Abstract:
A method, system and device for implanting an electrode assembly of an implantable medical device in a patient's heart. Positioning one or more radiopaque markers in a coronary sinus of the patient's heart. Positioning, by using the one or more positioned radiopaque markers as a fluoroscopic visual reference, a distal tip of a delivery catheter within a right atrium of the patient's heart so that a distal opening of a lumen of the catheter is against a septal wall of the heart at a location between the ostium of the coronary sinus and the A-V nodal area of the right atrium, and so that the tip of the catheter is generally directed toward a left ventricle of the patient's heart. Advancing the electrode assembly through the lumen of the catheter and into the septal wall.