An atraumatic detection/stimulation lead is disclosed. The lead includes at least one microcable having a core cable comprising a plurality of elementary metal strands. One of the microcables has provided at its distal end an atraumatic protection device. The atraumatic protection device includes a protective coating on the distal ends of the elementary strands of the microcable, and the protective coating is covered by a protective cap of deformable material. The protective cap may be a conical distal end adapted to deform and axially flatten out. The microcable may have an overall diameter less than or equal to 1.5 French (0.50 mm).

The present disclosure relates generally to pacing of the cardiac conduction system of a patient, and more particularly, to providing adaptive cardiac conducting system pacing therapy and to determining selective or non-selective capture of the cardiac conduction system by cardiac conduction system pacing therapy. The adaptive cardiac conduction system pacing therapy may adjust AV delay and VV delay based on various signals and metrics and may switch between cardiac conduction system pacing therapy exclusively and cardiac conduction system pacing therapy in combination with traditional left ventricular pacing therapy.

An implantable medical system includes an implantable catheter advanceable into a coronary sinus of a patient's heart. A guide element and an implantable lead receivable in the side lumen is advanceable through an angled opening of the catheter to be deflected laterally away from the catheter at the deflection angle to position the at least one testing electrode or at least one pacing electrode, respectively, in a myocardium of the patient's heart when the distal portion of the catheter is positioned in the coronary sinus.

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.

A pacing lead for a left cavity of the heart, implanted in the coronary system. The lead includes a lead body with a hollow sheath of deformable material, having a central lumen open at both ends, and at least one telescopic microcable of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end thereof. The part emerging beyond the distal end is an active free part comprising a plurality of distinct bare areas, intended to come into contact with the wall of a target vein of the coronary system, so as to form a network of stimulation electrodes electrically connected together in parallel. The microcable further comprises, proximally, a connector to a generator of active implantable medical device such as a pacemaker or a resynchronizer.

Lead electrodes having an asymmetrically distributed current density and methods for imparting current density directionality in lead electrodes are described. An implantable medical lead includes a lead body having a proximal section that connects to another implantable device and a distal section having a pre-biased shape configured to secure the lead to an inner wall of a body vessel. An electrode coupled to the distal section of the lead body includes a conductor mass having an asymmetrically distributed current density that imparts a directionality to one or more active portions of the electrode.

Coronary access and delivery systems are provided. A coronary access system can include a coronary sinus guide and a first core. A lateral vein delivery system can include a lateral vein introducer and a second core. The coronary sinus guide, the lateral vein introducer, and the first and second cores may be designed or shaped to access a predetermined position within a heart of a subject. For example, the coronary sinus guide, the lateral vein introducer, and/or the first and second cores can be used in combination to access the predetermined position within the heart of the subject.

An intracardiac defibrillation catheter has improved operability when a distal end portion of the catheter having a first DC electrode group is inserted into a coronary sinus. The defibrillation catheter includes an insulating tube member having a distal end side tube and a proximal end side tube, a handle connected to a proximal end of the tube member, a first DC electrode group having a plurality of electrodes mounted at the distal end side tube, and a second DC electrode group having a plurality electrodes spaced apart toward a proximal end side from the first DC electrode group and mounted at the distal end side tube. The catheter performs defibrillation in a cardiac cavity by applying voltages having polarities that differ from each other to the first DC electrode group and the second DC electrode group. Bending rigidities of a catheter shaft increases stepwise from the distal end to the proximal end.

Disclosed herein are implantable medical devices (IMDs) including a receiver and a battery, and methods for use therewith. The receiver includes first and second differential amplifiers, each of which monitors for a predetermined signal within a frequency range and drains power from the battery while enabled, and while not enabled drains substantially no power from the battery. To remove undesirable input offset voltages, each of the differential amplifiers, while enabled, is selectively put into an offset correction phase during which time the predetermined signal is not detectable by the differential amplifier. At any given time at least one of the first and second differential amplifiers is enabled without being in the offset correction phase so that at least one of the differential amplifiers is always monitoring for the predetermined signal. In this manner, the receiver is never blind to signals, including the predetermined signals, sent by another IMD.

A method and implantable medical device system for delivering a cardiac pacing therapy that includes suspending delivery of the LV cardiac pacing therapy and sensing far-field cardiac signals via one or more far-field sensing vectors formed between a plurality of electrodes positioned on a single-pass coronary sinus lead. Far-field signal features are determined in response to the sensed far-field cardiac signals, a first offset interval and a second offset interval are determined in response to the determined far-field signal features, and an AV delay of the LV cardiac pacing therapy is adjusted in response to the determined first offset interval and second offset interval. Delivery of the LV cardiac pacing therapy having the adjusted AV delay is subsequently resumed.