An intracardiac defibrillation catheter system includes a defibrillation catheter, a power supply device, and an electrocardiograph, in which an arithmetic processing unit of the power supply device sequentially senses an event estimated to be an R wave from an electrocardiogram input from the electrocardiograph, calculates a heart rate each time sensing is performed, and, when, after an event (V.sub.n) is sensed and after an application execution switch is input, an event (V.sub.n+m) is sensed, performs arithmetic processing so that a DC voltage is applied in synchronization with the event (V.sub.n+m) only in a case where the event (V.sub.n+m) is sensed after a lapse of a refractory period whose length corresponds to 50% of a reciprocal of a heart rate (A.sub.n) at a sensing time point of the event (V.sub.n), to control a DC power supply unit. The defibrillation catheter system can reliably avoid performing defibrillation in synchronization with a T wave without being affected by the level of the heart rate of a patient.

An example method includes establishing a communications link between an electrophysiology (EP) monitoring system and an implantable medical device (IMD). IMD electrical data is received at the monitoring system via the communications link. The IMD electrical data may be synchronized with EP measurement data to provide synchronized electrical data based on timing of a synchronization signal sensed by an IMD electrode and/or EP electrodes. The method also includes computing reconstructed electrical signals for locations on a surface of interest within the patient's body based on the synchronized electrical data and geometry data. The geometry data represents locations of the EP electrodes, a location of the IMD electrode within the patient's body and the surface of interest.

An implantable system includes an implantable medical device (IMD) and a non-transvenous lead that is configured to be implanted outside of a heart. The IMD includes an output configured to be connected at least to the lead, a current generator (CG) circuit configured to generate pacing pulses, a switching circuit coupled between the CG circuit and the output, one or more capacitors coupled in parallel with the CG circuit and the switching circuit, and a control circuit coupled to the CG circuit. The control circuit is configured to manage the CG circuit to generate the pacing pulses with a constant current at the output.

Implantable devices and systems include one or more leads adapted to be emplaced in the internal thoracic vein (ITV) of a patient. The lead may include features to adapt the lead for such placement. An associated device for use with the lead may include operational circuitry adapted for use with a lead having an electrode for sensing and/or therapy purposes coupled thereto. Methods for implantation and use of such devices and systems are disclosed as well.

Disclosed herein is an implantable electronic device for use with an implantable medical lead. The implantable electronic device includes a housing and a header connector assembly coupled to the housing and adapted to receive the proximal lead end of the implantable medical lead. The header connector assembly includes a connector assembly including a connector, a feedthrough extending through the housing, and a conductor coupling the feedthrough to the connector. The conductor includes a first conductor segment and a second conductor segment offset from the first conductor segment and each of the first conductor segment and the second conductor segment are resistance welded to the connector.

Systems and methods are provided for implanting a medical device. An implantable lead comprises a lead body, with electrodes positioned at the distal end and a lead connector positioned at the proximal end. The lead body has a body outer envelope configured to fit within a lumen of an introducer sheath and the lead connector has a connector outer envelope configured to fit within the lumen of the introducer sheath. A lead adaptor is configured to interconnect the implantable lead and the pulse generator. The lead adaptor has an insertable connector that includes mating contacts and an adaptor cavity that includes cavity contacts. The cavity contacts are positioned to engage the lead contacts of the lead connector when the lead connector is inserted into the adaptor cavity. The insertable connector is configured to be inserted into the connector cavity of the pulse generator.

A lead for an implantable stimulation device for cardiac stimulation of a patient generally extends along a longitudinal axis. The lead comprises a body section, a distal lead section extending from the body section along the longitudinal axis and forming a distal end, a first electrode device arranged on the distal lead section for at least one of transmitting an electrical pacing signal and sensing an electrical sense signal, the first electrode device being configured for placement in or on intra-cardiac tissue, and a second electrode device arranged on the body section for emitting an electrical defibrillation signal. The distal lead section in at least one portion comprises a reduced bending stiffness with respect to at least a portion of said body section.

A method includes, based on respective signals acquired by a plurality of electrodes on an anatomical surface of a heart, computing respective local activation times (LATs) at respective locations of the electrodes. The method further includes, based on the LATs, computing respective directions of electrical propagation at the locations. The method further includes selecting pairs of adjacent ones of the electrodes such that, for each of the pairs, a vector joining the pair is aligned, to within a predefined threshold degree of alignment, with the direction of electrical propagation at the location of one of the electrodes belonging to the pair. The method further includes associating respective bipolar voltages measured by the pairs of electrodes with a digital model of the anatomical surface. Other examples are also described.

A subcutaneously implantable device includes a housing, a clip attached to a top side of the housing, a first prong with a proximal end attached to the housing and a distal end extending away from the housing, and a first electrode on the first prong. The clip is configured to anchor the device to a muscle, a bone, and/or a tissue. The first prong is configured to contact a heart. The first electrode is configured to contact the heart. Sensing circuitry in the housing that is configured to sense an electrical signal from the heart, and therapeutic circuitry in the housing is in electrical communication with the first electrode and is configured to deliver electrical stimulation to the heart through the first electrode.

In an embodiment herein, an aortopulmonary stimulation method is provided including positioning at least one aortic electrode in or near the aorta, and using the at least one aortic electrode, to deliver stimulation to the aorta to decrease aortic after load.