The present invention includes devices and methods for pacing contact, lead, conduit or other medical fixture placement in tissues or organs. The invention features an articulating multiple suction foot device, comprising an inner vacuum conduit and foot slidingly contained within an outer vacuum conduit and foot, with the inner vacuum conduit and foot configured to extend beyond the outer vacuum suction foot, and to be further articulated once extended; as well as a separate tissue or waste removal vacuum assembly that extends within the inner vacuum conduit to the inner vacuum foot to remove cut tissue prior to its advancement beyond the outer vacuum suction foot. The device is configured to permit the placement foot, such as a suction foot, to articulate to a desired position with respect to the target tissue, while the pacing contact, lead, fluid conduit or other medical fixture is releasably attached to the placement foot to permit it to be released from the placement foot after stabilization on the target tissue site.

An operator advances a delivery catheter through a guiding catheter, after positioning an inflatable sleeve of the guiding catheter in proximity to a target implant site on an epicardial surface. By inflating the positioned sleeve, the operator displaces the epicardial surface to create a gap that accommodates a reach of the delivery catheter. With the delivery catheter extending distally from the guiding catheter, the operator can activate the reach of the delivery catheter within the gap, and then advance the lead out through a distal-most opening of the delivery catheter. The reach may orient a fixation member of the advanced lead relative to the epicardial surface so the operator can secure the lead to the surface. The sleeve of the guiding catheter is preferably non-compliant and has a maximum diameter of at least twice the reach of the delivery catheter, when inflated.

Disclosed herein is a screw-in lead implantable in the pericardium of a patient heart and a system for delivering such leads to an implantation location. The leads include a helical tip electrode and a curate body including a defibrillator coil with improved contact between the defibrillator coil and the patient heart. The delivery system includes a delivery catheter and lead receiving sheath disposed within the catheter. A fixation tine is disposed on one of the delivery catheter and the lead receiving sheath such that the delivery system may be anchored into the pericardium during fixation of the screw-in lead. In certain implementations, an implantable sleeve receives the leads to bias the defibrillator coil against the patient heart.

Delivery tools of interventional medical systems facilitate deployment of relatively compact implantable medical devices that include extensions, for example, cardiac pacing devices that include an extension for atrial sensing, wherein an entirety of the device is contained within the delivery tool while a distal-most portion of the tool is navigated to a target implant site. Once at the implant site, a device fixation member may be exposed out from a distal opening of the tool, for initial deployment, while the extension remains contained within the delivery tool. The tool includes a grasping mechanism, operable, within and without a lumen of the tool, to alternately grip and release the device extension, for example, to position a distal end of the extension after the tool has been withdrawn from over an entirety of the initially deployed device.

A cardiac pacing system that includes an implantable pulse generator and electrical leads that include a lead body portion having a distal end and a proximal end, a connector configured to electrically connect the proximal end of the lead body to the pulse generator, and at least one electrode disposed at the distal end of the lead body for delivering electrical stimulation to a patient's heart, wherein the distal end of the lead body is configured to terminate within the mediastinum of the thoracic cavity of the patient, proximate to the heart.

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.

A catheter assembly includes a cap and a spring-biased tethering member coupled thereto. The cap includes first and second portions, and a transition zone extending therebetween. A girth of the first portion is sized to fit within a distal-most opening of the catheter assembly; and a girth of the second portion tapers from a first size at the transition zone, which is too large to fit within the distal-most opening, to a smaller size at a distal end of the cap. The spring-biased tethering member holds the cap in open and closed positions, when the cap first portion extends within the distal-most opening, and when the cap is separated from the distal-most opening, respectively. At the closed position, the first portion is approximately concentric with the distal-most opening, and at the open position, an entirety of the cap is laterally offset from the distal-most opening.

An apparatus for securing a sensor at the heart is formed based on a modified, branched, pacemaker lead to provide a heart anchor lead where two anchors are coupled to a single main lead rather than there being just a single anchor. Thus, the proposed heart anchor lead comprises a single main lead, a sensor included within the main lead, in which the sensor has a distal end and a proximal end, a first anchor coupled to the distal end of the sensor and extending outward from the distal end of the sensor, and a second anchor coupled to the proximal end of the sensor and extending outward from the proximal end of the sensor in a direction that forms an angle with the first anchor. The heart anchor lead can optionally also have a pacemaking function.

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.

A delivery device for installing a medical device in a patient comprising a body portion having a proximal end and a distal end, the distal end having a chisel shaped tip, a receptacle disposed in the distal end of the body portion for receiving a medical device for implanting in the patient, a handle disposed at the proximal end of the body portion for facilitating advancement of the proximal end of the body portion into the patient.