Systems and methods for cardiac pacing are provided, where a pacing lead is placed at or near the bundle of His. A method for pacing a heart of a patient comprises: introducing a sheath to vasculature of the patient; steering the sheath within a coronary sinus in the heart to lodge a distal end of the sheath to a target location proximal to the bundle of His above a septum separating a left ventricle and a right ventricle of the heart; advancing a pacing lead through a lumen of the sheath to the target location; coupling the pacing lead to cardiac tissue at the target location; removing the sheath; and electrically pacing the bundle of His using the pacing lead.

The ventricle of a heart can be reshaped by passing a plurality of catheters from inside the ventricle to outside the ventricle through holes in the ventricle wall. Fluid-tight bags are then delivered through the catheters and expanded outside the ventricle to a diameter that is larger than the holes. A fluid substance is introduced into the bags, and the fluid substance is configured to solidify into solid pads that are also larger than the holes. The solid pads are then pulled towards each other and locked in position in order to reshape the ventricle.

An electrode fixing sleeve for fixing an electrode lead to biological tissue, the electrode fixing sleeve including a distal sleeve section and a proximal sleeve section, at least one distal electrode guiding region on the distal sleeve section and at least one proximal electrode guiding region on the proximal sleeve section, the distal electrode guiding region and proximal electrode guiding region having a common longitudinal axis. The distal and proximal sleeve sections are adjustable relative to one another along the common longitudinal axis. The electrode fixing sleeve additionally includes at least one electrode fixing element at least parts of which have elastic properties, the electrode fixing element being mounted on both the distal and proximal sleeve sections, and being designed so that at least parts of it move along the common longitudinal axis if a tensile force acts on the electrode fixing element along the common longitudinal axis.

Systems and methods for separating an object such as a pacing lead from a patient tissue involve a flexible and torqueable shaft having an internal lumen sized to receive the object, and a hard separating mechanism for separating the object from the tissue. Typically the shaft and separating mechanism are advanced along or toward the object, and the separating mechanism is contacted with the tissue. The shaft is rotated to effect separation between the object and the tissue. The systems and methods are well suited for use in cardiac pacing or defibrillator lead explant procedures.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve includes an energy source, a balloon, an energy guide, and an electrical analyzer assembly. The energy source generates energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide is configured to receive energy from the energy source and guide the energy into the balloon interior. The electrical analyzer assembly is configured to monitor a balloon condition during use of the catheter system. The electrical analyzer assembly can include a first electrode, a second electrode, and an impedance detector that is electrically coupled to the first electrode and the second electrode. The impedance detector is configured to detect impedance between the first electrode and the second electrode.

Disclosed are various configurations of electrodes with accompanying extensions and wires configured to be attached at or near the left atrium of a heart to allow the device to be held snug against the endocardium and out of the blood flow for low energy defibrillation of the atria in response to atrial fibrillation or other atrial arrhythmias. The portion of the lead internal to the atrium (e.g., the left atrium) is restrained against the endocardium of the left atrium by way of a restraint mechanism. In one example, the electrode is configured to attach to the atrial septum, with wires containing memory-shaped metal to keep the wires against the heart wall. In yet another example, the electrode is configured to be part of a mitral valve device.

Devices and methods can be used for artificial cardiac pacing and/or resynchronization. For example, this document provides improved electrodes for stimulating and sensing electrical activity of the heart, and provides pacing and resynchronization systems incorporating such electrodes. While the devices and methods provided herein are described primarily in the context of pacing, it should be understood that resynchronization can additionally or alternatively be performed in an analogous manner, and that the scope of this disclosure includes such subject matter.

A biostimulator delivery system having a tether cable, is described. A connector can be mounted on the tether cable to connect to a biostimulator. The connector can be a protuberance that lodges within the biostimulator, or a threaded connector that screws into the biostimulator. The tether cable has a stranded cable configuration, including several strands extending about a core strand in a helical direction. The stranded cable structure resists breaking under bending stresses typically seen during a tether mode used during delivery of the biostimulator. The tether cable reliably secures the biostimulator to the delivery system in the tether mode. Other embodiments are also described and claimed.

A medical lead system including an elongated lead body configured to extend through vasculature of a patient. The lead body mechanically supports a fixation member extending distal to a distal end of the lead body. A balloon is affixed to a distal portion of the lead body. The balloon is configured to inflate to extend distal to the distal end of the lead body. The fixation member is configured to extend within a distal cavity defined by the inflated balloon. The medical lead system is configured such that an electrode mechanically supported by the fixation member may electrically communicate with tissue of the patient when the balloon is in the inflated configuration.

A wireless power transfer system that employs a form of conductively coupled power transfer to transfer energy to deeply implanted devices.