Disclosed is a coupling for use in a looped medical device, such as a loop catheter. A sleeve is fitted onto a distal portion of an activation wire and a shape-memory wire is positioned alongside the sleeved activation wire. The sleeve is welded onto the activation wire to hold the sleeve onto the activation wire and is also welded onto the shape-memory wire that is positioned alongside the activation wire, thereby affixing the activation wire to the shape-memory wire. Also disclosed is an activation wire for use in a catheter. The activation wire includes a proximal section, and a distal section having at least a partial loop. The activation wire includes a connection section on the distal section, where the connection section is linear, and where the external surface of the connection section has a higher coefficient of friction than at least some of the remaining portion of the actuation wire that is housed within the catheter shaft.

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.

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.

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 lead receptacle having a lumen configured to traverse from an outer side of an outermost intercostal muscle to an inner side of an innermost intercostal muscle of an intercostal space of a patient and to support a lead traversing through the lumen. The lumen being configured to support one or more cardiac leads traversing through the intercostal space.

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.

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.

Extravascular implant tools that utilize a bore-in mechanism to safely access extravascular locations and implant techniques utilizing these tools are described. The bore-in mechanism may include a handle and a helix extending from the handle. The bore-in mechanism is used, for example, in conjunction with a tunneling tool to traverse the diaphragmatic attachments to access a substernal location. The tunneling tool may be an open channel tunneling tool or a conventional tunneling tool (e.g., metal rod).

Introducers for implanting a lead having a fixation element distal to an electrode include a window, electrode, or conductive member alignable with the electrode of the lead while maintaining the fixation element in a retracted configuration. The window, electrode or conductive member of the introducer provide a mechanism for applying test stimulation signals to determine whether the lead is properly positioned in a patient without deploying the fixation element.

A lead receptacle having a lumen configured to traverse from an outer side of an outermost intercostal muscle to an inner side of an innermost intercostal muscle of an intercostal space of a patient and to support a lead traversing through the lumen. The lumen being configured to support one or more cardiac leads traversing through the intercostal space.