The disclosure relates to a multipolar, detection/stimulation endovascular lead intended to be implanted in the coronary venous network. The lead comprises a lead body with in proximal portion a connector to a cardiac pacemaker/defibrillator generator, and in a distal portion a first branch and a second branch extending beyond a bifurcation. The distal ends of the branches are free ends carrying an array of electrodes connected to the connector. Each of the branches comprises at its free end an outlet in the distal direction, able to receive an implantation guide wire inserted therein and to guide the implantation guide wire in an axial direction parallel to the main axis of the lead body.

A leadless pacemaker device for providing an intra-cardiac pacing includes processing circuitry configured to generate ventricular pacing signals for stimulating ventricular activity at a ventricular pacing rate, a first sensor configuration receiving a first sense signal, and a second sensor configuration receiving a second sense signal. The processing circuitry derives, in a first sensing state, atrial events from the first sense signal for controlling the ventricular pacing rate based on the atrial events. The processing circuitry switches, based on at least one switching criterion, from the first sensing state to a second sensing state in which the processing circuitry derives atrial events from the second sense signal. The second sense signal is received by the second sensor configuration for detection of atrial events and the second sensor configuration is a motion sensor or a sound sensor. A method for operating the pacemaker device is also provided.

A pacing system includes a signal generator and an electromechanical switch. The signal generator is configured to generate a pacing signal. The electromechanical switch has a plurality of outputs that are configured to be coupled to a plurality of electrodes inserted into a heart of a patient, each output configured to deliver the pacing signal to a respective electrode. The electromechanical switch is configured to route the pacing signal to no more than a single selected one of the outputs at any given time, so as to pace the heart using no more than a single selected one of the electrodes.

This disclosure is directed to a curvilinear medical electrical lead. For example, a medical electrical lead includes a lead body, a high voltage electrode positioned on the lead body, the high voltage electrode comprising a proximal coated portion, a distal coated portion, and an uncoated portion. Additionally, the medical electrical lead includes a first low voltage electrode and a second low voltage electrode distal to the first low voltage electrode, wherein a first line passes through the first low voltage electrode and the second low voltage electrode, wherein a second line passes through the first low voltage electrode and the uncoated portion, the second line forming a first angle with the first line, and wherein a third line passes through the second low voltage electrode and the uncoated portion, the third line forming a second angle with the first line.

Methods of treating acute heart failure in a patient in need thereof. Methods include inserting a therapy delivery device into a pulmonary artery of the patient and applying a therapy signal to autonomic cardiopulmonary fibers surrounding the pulmonary artery. The therapy signal affects heart contractility more than heart rate. Specifically, the application of the therapy signal increases heart contractility and treats the acute heart failure in the patient. The therapy signal can include electrical or chemical modulation.

Implantable lead having an electrode body with a free end and an inner part axially movable or rotatably movable with respect to it and an end on which means of fixation are extendable out of the free end by axially displacing the inner part, the inner periphery of the electrode body having an elastically deformable, peripheral, ring or ring segment-shaped, sealing/resistance element fixed to it. The outer periphery of the inner part having a section whose diameter changes (decreases) in the axial direction; this section passes the sealing/resistance element when the inner part is axially displaced. The inner periphery of the electrode body having a section whose diameter changes (decreases) in the axial direction; this section placed so that the sealing/resistance element passes this section when the inner part is axially displaced, the sealing/resistance element increasingly deformed during axial displacement of the inner part and counteracting movement thereof.

A method of pacing a His bundle of a patient heart using a stimulation system including a memory, a pulse generator, a stimulating electrode and at least one sensing electrode includes applying a plurality of impulses through the stimulating electrode to induce a plurality of responses from the patient heart. Each impulse of the plurality of impulses is delivered at a different impulse energy corresponding to a respective output setting of the stimulation system. The response characteristics for each of the plurality of responses are measured and each impulse is assigned a classification based on whether the respective response characteristics indicate capture of one or both of the His bundle and a ventricle of the patient heart. The output setting and classification for each impulse is then stored in the memory.

Methods, systems and devices are provided which transmit energy to a body lumen or passageway in the form of pulsed electric fields (PEFs) and in a manner which provides focal therapy. In some embodiments, PEFs are delivered through independent electrically active electrodes of an energy delivery body, typically in a monopolar fashion. Such delivery concentrates the electrical energy over a smaller surface area, resulting in stronger effects than delivery through an electrode extending circumferentially around the lumen or passageway. It also forces the electrical energy to be delivered in a staged regional approach, mitigating the effect of preferential current pathways through the surrounding tissue. Focal delivery of PEFs can provide increased tissue lethality by employing precise timing and sequencing of energy delivery to the electrodes.

An electrode (10) for treating organic tissue by means of direct current, comprising an electrode holder (20), at least one electrically conductive electrode surface (30), which is let into the electrode holder (20), wherein the at least one electrode surface (30) is connected to at least one control element (400) and wherein the at least one control element (400) is connected to a control and energy supply unit by way of electrical lines (60, 70), wherein the at least one control element (400) is configured in such a way that each individual electrode surface (30) is actuable by the at least one control element (400) in such a way that a current density (J) provided within a predetermined interval for each one of the at least one electrode surfaces (30) can be maintained or that a current density (J) for each one of the at least one electrode surfaces (30) can be maintained around a predetermined value.

Systems and methods may monitor electrical activity of a patient's heart using electrodes during delivery of cardiac therapy and determine a degree of posterior left bundle branch engagement based on the monitored electrical activity. The systems and methods may adjust the cardiac therapy based on the degree of posterior left bundle branch engagement.