IMD devices and implantation methods are discussed and disclosed. Electrode structures may be employed to allow electrical stimulation to heart tissue and/or sense a physiological condition. Devices may be used for the placement of the electrode structures in a patient and facilitate the degree of contact between the electrode structures and the tissue of the patient.

The disclosure describes techniques and systems for delivering an implantable medical device. In one example, an implantable medical device (IMD) delivery system may include an elongated member comprising a first distal end configured to mate with the IMD, a resilient member disposed along at least a portion of the elongated member, a housing configured to accept a first proximal end of the elongated member and a second proximal end of the resilient member, a rotation control mechanism wherein user movement of the rotation control mechanism causes rotation of the elongated member with respect to the housing and a fixation element of the IMD into tissue, and a deflection control mechanism wherein user movement of the deflection control mechanism causes longitudinal displacement of the resilient member along a longitudinal axis of the elongated member and the housing resulting in angular deflection of the first distal end of the elongated member.

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.

Systems, apparatus, and methods for treating medication refractory epilepsy are disclosed. In one embodiment, a method of treating epilepsy is disclosed comprising detecting, using a first electrode array coupled to a first endovascular carrier, an electrophysiological signal of a subject. The method further comprises analyzing the electrophysiological signal using a neuromodulation unit electrically coupled to the first electrode array and stimulating an intracorporeal target of the subject using a second electrode array coupled to a second endovascular carrier implanted within a part of a bodily vessel superior to a base of the skull of the subject.

An example system includes processing circuitry; and an endovascular device includes an expandable substrate configured to be delivered endovascularly to a trial therapy delivery location in a patient; one or more first electrodes positioned on the expandable substrate, wherein the one or more first electrodes are configured to deliver nerve tissue stimulation trial therapy to a target nerve tissue of the patient; and one or more second electrodes positioned on the expandable substrate, wherein the one or more second electrodes are configured to sense one or more activation signals of the target nerve tissue, wherein the processing circuitry is configured to determine whether activation of the target nerve tissue at the trial therapy delivery location satisfies a target nerve tissue activation threshold based on the one or more sensed activation signals.

Systems, apparatus, and methods for treating medication refractory epilepsy are disclosed. In one embodiment, a method of treating epilepsy is disclosed comprising detecting, using a first electrode array coupled to a first endovascular carrier, an electrophysiological signal of a subject. The method further comprises analyzing the electrophysiological signal using a neuromodulation unit electrically coupled to the first electrode array and stimulating an intracorporeal target of the subject using a second electrode array coupled to a second endovascular carrier implanted within a part of a bodily vessel superior to a base of the skull of the subject.

The present disclosure relates to an array of electrodes and integrated electronics on a flexible scaffolding, with the ability to collapse into an axial configuration suitable for deploying through a narrow cylindrical channel. The electrode arrays can be placed into the ventricular system of the brain, blood vessels of the brain, and/or into other body cavities, constituting a minimally invasive platform for precise spatial and temporal localization of electrical activity within the brain and/or body, and precise electrical stimulation of tissue, to diagnose and restore function in conditions caused by abnormal electrical activity in the brain, nervous system, and/or elsewhere in the body.

Tumor treating fields (TTFields) may be applied to a person's body using six different types of electrodes. More specifically, the electrodes may be shaped and dimensioned (a) for insertion into blood vessels so that they make contact with the person's blood; (b) for insertion into a central canal of a spinal cord, so that they make contact with the CSF; (c) for insertion into a body orifice at a position that contacts an interior surface of the person's body; (d) for affixation to skin of the person's body (e.g., on the person's head, torso, back, abdomen, etc.); (e) for insertion into a brain ventricle so that they make contact with the person's CSF; or (f) for insertion into lymph vessels so that they make contact with the person's lymph. Applying an AC voltage between any two of these electrodes will create TTFields in respective parts of the person's body.