Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an implantable medical device. The implantable medical device may include an implantable pacing member having a housing and a lead input. A lead may be coupled to the lead input. The lead may be designed to extend along a pericardial space, epicardium, or both and engage a heart chamber. A passageway may be defined along a portion of the length of the lead.

Pacemakers and pacemaker delivery systems and methods are disclosed which use a modified cylindrical pacemaker body having a flat side which includes the anode/cathode and spikes to anchor the pacemaker in place within the pericardium.

A device for pacemaker lead placement is disclosed. The device has a device tip having a tissue bite area, ferrule holders, and needle tips. The device also has a lead end rest. The device also has a pacemaker lead end situated on the lead end rest, the pacemaker lead end having first and second anchor suture holes. The device further has an anchor suture with ferrules at respective ends of the anchor suture, wherein the ferrules of the anchor suture are passed through the anchor suture holes and into communication with the ferrule holders.

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.

Devices, systems, and methods for accessing the internal and external tissues of the heart are disclosed. At least some of the embodiments disclosed herein provide access to the external surface of the heart through the pericardial space for localized delivery of substances to the heart tissue. In addition, various disclosed embodiments provide access to the internal surface of the heart for aspiration and delivery of substances to a targeted region without disturbing or interfering with nearby structures or surfaces.

Medical devices are described for performing mapping, ablating, and/or pacing procedures on one or more layers of the cardiac wall via an epicardial approach in a minimally invasive (e.g., orthoscopic) surgical procedure. One of the medical devices described includes a main support member and one or more secondary support members extending outwardly from the main support member having electrodes configured to receive electrical impulses. The secondary support member may include a support pad configured to be removably attached to a corresponding area of the epicardium for holding the medical device in place during a procedure, such as through application of vacuum pressure via a containment dome provided on each secondary support member. Further, an ablating electrode may be slidably disposed along the main support member for transmitting energy to a target site proximate the electrode. Associated methods are also described.

A system and method enables delivery of an implantable medical lead to an implant location. A delivery tool of the system defines the delivery angle of the lead at the implant location. The delivery tool includes an elongate body having at least one lumen extending from a distal portion to a proximal portion. A suction cup is coupled to the distal portion of the elongate body. The suction cup may be configured to be collapsible in a first configuration, prior to deployment, and expandable in a second configuration. The system may include a suction source for drawing tissue at the implant location into the suction cup of the delivery tool that is disposed at the distal portion. The delivery angle of the lead tip is based on the interior cavity of the suction cup rather than the angle of insertion with the suctioned tissue.

Implantation of a cardiac stimulus system into the mediastinum using the ITV. Superior, intercostal, and inferior access methods are discussed and disclosed. Superior access may be performed using the brachiocephalic vein to access the ITV, with access to the brachiocephalic vein achieved using subclavian vein, using standard visualization techniques. Inferior access may be accomplished inferior to the lower rib margin via the superior epigastric vein. Intercostal access may include creating an opening in an intercostal space between two ribs and advancing a needle using ultrasound guidance.

Implantation of a cardiac stimulus system into the mediastinum using the ITV. Superior, intercostal, and inferior access methods are discussed and disclosed. Superior access may be performed using the brachiocephalic vein to access the ITV, with access to the brachiocephalic vein achieved using subclavian vein, using standard visualization techniques. Inferior access may be accomplished inferior to the lower rib margin via the superior epigastric vein. Intercostal access may include creating an opening in an intercostal space between two ribs and advancing a needle using ultrasound guidance. Once in the ITV, access is then made into the mediastinum for placement of at least a portion of a lead of the cardiac stimulus system therein.

Implantation of a cardiac stimulus system using parasternal access to the ITV is provided. Superior access may be achieved using parasternal locations in the upper ribcage to access the ITV. Inferior access may be achieved using parasternal locations in the lower ribcage to access the ITV. Parasternal access may include creating an opening in an intercostal space between two ribs and advancing a needle using ultrasound guidance.