Anchoring mechanisms for an implantable electrical medical lead that is positioned within a substernal space are disclosed. The anchoring mechanisms fixedly-position a distal portion of the lead, that is implanted in the substernal space.

A device includes a handle, an expandable structure including a plurality of splines extending from a proximal hub to a distal hub, a first electrode on a first spline of the plurality of splines, an outer tube extending from the handle to the proximal hub, and a shaft extending through the outer tube from the handle to the distal hub. The expandable structure has a collapsed state and a self-expanded state. The handle is configured to retract the shaft. Retracting the shaft may expand the expandable structure outward of the self-expanded state.

A pacing lead conversion tool and a method of using the pacing lead conversion tool to reversibly convert an extendable cardiac pacing lead into a fixed cardiac pacing lead. The pacing lead conversion tool includes a locking lumen configured to receive a pacing lead. The locking lumen includes a connector body segment to receive a connector body of the pacing lead in a first friction fit and a pin segment to receive a connector pin of the pacing lead in a second friction fit. The friction fits allow for relative rotation between a lead body of the pacing lead and the connector pin when the pacing lead conversion tool is twisted, and prevents relative rotation between the lead body and the connector pin when the cardiac pacing lead is burrowed through a target tissue. Other embodiments are also described and claimed.

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 lead anchor comprising a longitudinally extending anchor body and a retainer. The longitudinally extending anchor body having a lumen positioned to receive a spinal cord lead therethrough and having a retainer pocket intersecting the lumen. The retainer is positioned in the retainer pocket. The retainer comprises a first grip member having at least one first aperture, a second grip member having at least one second aperture, and at least one U-shaped resilient portion connecting the first and second grip members.

A pacemaker has a housing and a therapy delivery circuit enclosed by the housing for generating pacing pulses for delivery to a patient's heart. An electrically insulative distal member is coupled directly to the housing and at least one non-tissue piercing cathode electrode is coupled directly to the insulative distal member. A tissue piercing electrode extends away from the housing.

An implantable medical device includes a device housing, a fixation device, a first prong projecting from a proximal end of the device housing and a second prong projecting from the proximal end of the device housing. The second prong is spaced apart from the first prong. The first prong includes a first flange projecting away from a longitudinal axis of the device housing. The second prong includes a second flange projecting away from the longitudinal axis. The first prong and the second prong are configured to extend to a first flange diameter in a relaxed configuration and to extend to a second flange diameter in an expanded configuration.

A shield located within an implantable medical lead may be terminated in various ways. The shield may be terminated by butt, scarf, lap, or other joints between insulation layers surrounding the lead and an insulation extension. For lap joints, a portion of an outer insulation layer may be removed and a replacement outer insulation layer is positioned in place of the removed outer insulation layer, where the replacement layer extends beyond an inner insulation layer and the shield. The replacement layer may also lap onto a portion of the insulation extension. The barbs may be located between the replacement layer and the inner insulation layer or the insulation extension. The shield wires have ends at the termination point that may be folded over individually or may be capped with a ring located within one of the insulation layers of the jacket.

Anchoring mechanisms for an implantable electrical medical lead that is positioned within a substernal space are disclosed. The anchoring mechanisms fixedly-position a distal portion of the lead, that is implanted in the substernal space.

Disclosed herein is a medical leadless pacemaker delivery system adapted to engage and disengage with leadless pacemakers to allow for the repeated use of the leadless pacemaker delivery system in delivering and implanting multiple leadless pacemakers into a patient heart in a serial or repeated manner. The leadless pacemaker delivery system includes a handle, an attachment mechanism, a torque portion, and a rotation limiter. The handle includes a housing. The attachment mechanism is operably coupled to the housing and configured to actuate between a released state and an engaged state. The torque portion is operably coupled to the housing and rotatable relative to the housing to transition the attachment mechanism between the released and engaged states. The torque portion includes a shaft. The rotation limiter is in sliding engagement with the shaft between a first stop and a second stop. The rotation limiter includes a first helical thread. The leadless pacemaker delivery system also includes a second helical thread in threaded engagement with the first helical thread and operably coupled to the housing. Rotation of the torque portion rotates the rotation limiter such that the first helical thread is rotated against the second helical thread, thereby driving the rotation limiter along the shaft between the first stop and the second stop.