US3253595A - Cardiac pacer electrode system - Google Patents

Cardiac pacer electrode system Download PDF

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US3253595A
US3253595A US30054763A US3253595A US 3253595 A US3253595 A US 3253595A US 30054763 A US30054763 A US 30054763A US 3253595 A US3253595 A US 3253595A
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electrode
circuit
heart
stimulation
electrodes
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Jr William P Murphy
Jr John Walter Keller
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Cordis Corp
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Cordis Corp
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/375Constructional arrangements, e.g. casings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0587Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Description

May 31, 1966 w. P. MURPHY, JR, ETAL 3,253,595

CARDIAC PACER ELECTRODE SYSTEM Filed Aug. 7, 1963 United States Patent 3,253,595 CARDIAC PACER ELECTRODE SYSTEM. Viliiam P. Murphy, In, and John Walter Keller, Jr., lVIiami, Fla, assignors to Cordis Corporation, Miami,

Fla., a corporation of Florida Filed Aug. 7, 1963, Ser. No. 300,547 4 Claims. (Cl. 128-405) This invention relates to implantable cardiac pacers and more particularly to an electrode system for use with such pacers.

Heretofore it has been conventional practice in the use of implantable pacers to apply ventricular stimulation to a patients heart between two electrodes both of which are placed in spaced relation on the heart itself. Sensing of the P-wave at the heart for various electrocardiac functions has been accomplished in very similar manner.

According to the present invention it has been found that satisfactory and even superior stimulation of the ventricles can be achieved when one electrode is placed on the heart in conventional fashion and another electrode, of relatively large surface area, is placed in contact with tissue in a place remote from the heart, usually the abdomen. The ground electrode remote from the heart is large in area in order to reduce the current density and prevent local stimulation of muscle tissue. Conversely, the stimulating electrodes inserted in the heart muscle are small in area in order to increase their current density and cause stimulation at that point. The use of a remote ground is further useful in that it permits a simplification of leads or, if a plurality of stimulation electrodes are implanted as is current practi'ce, it permits a choice of stimulation contact points at a time after the original implantation without further surgery in the region of the heart itself.

v The remote electrode according to the present invention has particular utility in synchronous cardiac pacers such as that shown in copending application Serial No. 283,271, filed May 27, 1963 and entitled Cardiac Pacer. In that synchronous pacer, stimulation to the ventricles is applied after a suitable delay following the-contraction of the atrium as indicated by the presence of the so-called P-wave. The spread of'the P-wave signal over the surface of the atrium is in the form of a circumferential voltage gradient emanating from the sino-auricular node and passing over the atrium relatively uniformly. However, as the exact location of the sino-auricular node is not easily determined in practice, it is possible that if two sensing electrodes placed on the heart are used they will be equidistant from the node and will experience no or very little potential difference. The P-wave may, however, be advantageously detected between an electrode placed adjacent the atrium and the large remote electrode according to the present invention. The specific advantage of a remote ground is that it otters a relative level of potential unaffected by the point of origin of the P-wave and therefore provides extremely reliable sensing of the P-wave.

Preferably the large, common electrode is incorporated into the housing for the pacer circuitry and the entire pacer is located relatively remotely from the heart with appropriate leads extending to the electrodes placed at the heart. By incorporating the remote electrode into the pacer circuit housing the same conductive surface which serves as a large area' of contact with abdominal tissue can also be employed as an electric and magnetic shield for the pacer circuitry so that that circuitry will be so affected or triggered by extraneous fields.

In a preferred embodiment of the invention two stimulation electrodes and their associated leads are connected to the pacer circuitry through a reversibleplug 3,253,595 Patented May 31, 1966 and jack connection so that, merely by reversing the plug, a choice may be made as to which stimulation electrode is operative.

For the purpose of illustration a preferred embodiment of the invention is shown in the accompanying drawing in which FIG. 1 is a perspective view of a cardiac pacer and its cooperating lead assembly in disassembled relation;

FIG. 2 is a perspective view of the pacer and lead assembly of FIG. 1 in assembled relationship;

FIG. 3 is a section substantially on the line 3-3 of FIG. 1;

FIG. 4 is a side view of a stimulation electrode;

FIG. 5 is a top view of the stimulation electrode;

FIG. 6 is a side view of a sensing electrode.

Referring now to the drawing, the pacer circuitry 40 with its powering batteries is contained within a discshaped plastic case 10 having an inserted metal cover 12. The cover may he ribbed as at 11 to provide stiffness. At one side of the case 10 there is provided a four terminal jack 14 by means of which a lead assembly 16 may be connected to the pacer circuitry. In the embodiment shown the jack 14 has an annular recess 18 and the lead assembly plug 17 includes a corresponding mating boot or lip 19 constructed of a resilient material such as silicone rubber so that the connections may be sealed and protected from the entrance of corrosive body fluids. In FIG. 1 this lip is shown rolled back so as to facilitate the insertion of the plug 17 into the jack 14.

To further provide a locking engagement between the plug 17 and the jack 14 the plug includes an apertured tab 20 fitting within a corresponding opening 21 in the jack 14. A transverse bore 23 allows a pin 25 to be inserted through the jack 14 and the apertured tab 20 thereby locking the plug and jack together. To facilitate this pinning the lip 19 may be rolled back on the plug 17 as shown in FIG. 1.

In the preferred embodiment shown the plug pins 22 and the corresponding receptacles 29 in the jack 14 are arranged in a symmetrical pattern so that the plug 17 may be inserted in either of two positions which are obtained by rotating the plug through Three leads 30, 31 and 32 emanate from the plug 17. Two of these leads 30 and 31 terminate in pronged stimulation electrodes 35 and 36 suitable for implantation on the ventrical portion of a heart. The stimulation electrodes (FIGS. 4 and 5) include flat tabs 50 of silicone rubber having apertures 51 by means of which the electrode can be sutured to the heart. A rib 52 on the back of the tab 50 facilitates its manipulation during surgery. The actual contact surface is in the form of a projecting coil 53 of platinum wire which can be inserted into a puncture wound made in a patients heart. The spacing between adjacent turns of the coil is approximately .010 to .025 inch so that the heart tissue can grow back between the turns without the formation of such scar tissue as would increase the contact resistance. The contact surface is, however, kept localized so that the stimulation pulse current density is high enough to produce satisfactory cardiac stimulation.

The third lead 32 from the plug terminates in a sensing electrode 37 appropriate for sensing the P-waves adjacent the atrial portion of the heart. The sensing electrode (FIG. 6) also employs a fiat apertured tab 60 but, since contact resistance is not of as great significance in this application, the contact surface is in the form of shallow loops 61 of platinum wire which project from the bottom of the tab. In the preferred embodiment of the invention the electrodes are connected to the jack 17 so that one of the stimulating electrodes 35 and 36 is connected to each of the outer ones of the plug pins 22 and the 3 sensing electrode 37 is connected to both of the inner pins. The length of the leads 30, 31 and 32 is such that, with the electrodes 35, 36 and 37 placed on a patients heart, the pacing circuitry case may be placed in the patients abdomen.

The pacer circuitry, indicated generally as 40 in FIG. 3, is connected, as at 41, so as to employ the metal cover 12 as a common electrode for establishing a reference potential. The P-wave is then reliably sensed between the electrode 37 and the plate 12 while stimulation pulses are applied to the heart between one of the electrodes 35 and 36 and the metal cover 12. In the embodiment shown the metal cover 12 provides a contact surface with the adjacent tissue of approximately 3.1 sq. in., an area sufficiently large to prevent local muscle stimulation during the application of the stimulating pulse. The metal cover 12 also, because of its substantial extent and adjacent relation to the pacer circuitry 40, provides effective shielding of the circuit against the effect of external fields. If desired, more complete shielding may of course be obtained by constructing the entire housing of metal so that the circuit is completely enclosed by a conductive surface.

The use of a remote ground facilitates such a sensitive detection of the P-wave that it is possible to sense this wave by means of an electrode which is in fact placed on the ventrical portion of the heart. Accordingly, since the stimulation function follows in time the sensing of the P-wave, it is possible according to the invention to provide synchronous cardiac pacing using but one electrode placed on the heart if suitable precautions are taken to prevent interaction between the input and output circuits which then share both the electrode at the heart and the remote ground.

In the preferred embodiment shown the pacer circuitry within the case 10 is connected to the jack 14 so that the input circuit is connected to the two inner jack receptacles 29 while the stimulation pulse output circuit is connected to only one of the outer of the receptacles 29. In this way a choice may be made as to which of the stimulation electrodes 35 and 36 will be employed for stimulation merely by appropriately positioning the plug 17. The other of the stimulation electrodes may be held as a spare and, if necessary, may be placed into operation merely by reversing the plug 17 in the jack 14, this connection being relatively easily accessible at the abdomen as opposed to the difi'iculties encountered in re-implanting stimulation electrodes on the heart. Having such a spare is highly desirable in case one of the electrodes develops too high a threshold for effective stimulation.

While a particular embodiment has been disclosed by Way of illustration, it should be understood that the present invention includes all modifications and equivalents falling within the scope of the appended claims.

We claim:

1. An electrical cardiac pacer for implantation entirely within a body, comprising a housing enclosing a circuit for producing cardiac stimulation signals, a first electrode for application to a location on the heart within said body, a second electrode providing a return path from said body to said circuit, and connect-ions between said electrodes and said circuit, characterized in that said second electrode is of substantially larger surface area than said first electrode, in that the connection between said circuit and said first electrode is longer than the connection between the circuit and said second electrode and extends in a different direction whereby the second electrode may be located outside the region of the heart, and in that said housing includes a conductive wall member comprising said second electrode.

2. A cardiac pacer according to claim 1 further characterized in that said wall member is disposed closely adjacent 'said circuit to shield said circuit from electro: magnetic fields.

3. A cardiac pacer according to claim 1 further characterized by a third electrode attached to a location on the heart different from the aforesaid location for sensing a cardiac signal apppearing between said third and second electrodes, and a connection between said third electrode and circuit for controlling the production of heart stimulation signals by said circuit, said circuit having means responsive to the signal sensed by the third electrode for controlling signal production by the circuit.

4. A cardiac pacer according to claim 2 further characterized by a third electrode attached to a location on the heart different from the aforesaid location for sensing a cardiac signal appearing between said third and second electrodes, and a connection between said third electrode and circuit for controlling the production of heart stimulation signals by said circuit, said circuit having means responsive to the signal sensed by the third electrode for controlling signal production by the circuit.

References Cited by the Examiner UNITED STATES PATENTS 3,057,356 10/1962 Greatbach 128-422 3,107,672 10/1963 Hofmann 128-405 OTHER REFERENCES RICHARD A. GAUDET, Primary Examiner.

W. E. KAMM, Assistant Examiner.

Claims (1)

1. AN ELECTRICAL CARDIAC PACER FOR IMPLANTATION ENTIRELY WITHIN A BODY, COMPRISING A HOUSING ENCLOSING A CIRCUIT FOR PRODUCING CARDIAC STIMULATION SIGNALS, A FIRST ELECTRODE FOR APPLICATION TO A LOCATION ON THE HEART WITHIN SAID BODY, A SECOND ELECTRODE PROVIDING A RETURN PATH FROM SAID BODY TO SAID CIRCUIT, AND CONNECTIONS BETWEEN SAID ELECTRODES AND SAID CIRCUIT, CHARACTERIZED IN THAT SAID SECOND ELECTRODE IS OF SUBSTANTIALLY LARGER SURFACE AREA THAN SAID FIRST ELECTRODE, IN THAT THE CONNECTION BETWEEN SAID CIRCUIT AND SAID FIRST ELECTRODE IS LONGER THAN THE CONNECTION BETWEEN THE CIRCUIT AND SAID SECOND ELECTRODE AND EXTENDS IN A DIFFERENT DIRECTION WHEREBY THE SECOND ELECTRODE MAY BE LOCATED OUTSIDE THE REGION OF THE HEART, AND IN THAT SAID HOUSING INCLUDES A CONDUCTIVE WALL MEMBER COMPRISING SAID SECOND ELECTRODE.
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Cited By (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3367339A (en) * 1964-10-09 1968-02-06 Robert W. Sessions Implantable nerve stimulating electrode and lead
US3472234A (en) * 1967-08-15 1969-10-14 Gen Electric Body organ electrode
US3476116A (en) * 1967-11-09 1969-11-04 Victor Parsonnet Nonpolarizing electrode for physiological stimulation
US3478746A (en) * 1965-05-12 1969-11-18 Medtronic Inc Cardiac implantable demand pacemaker
US3500823A (en) * 1967-11-20 1970-03-17 Us Air Force Electrocardiographic and bioelectric capacitive electrode
US3590810A (en) * 1968-05-27 1971-07-06 Honeywell Inc Biomedical body electrode
US3598128A (en) * 1968-10-28 1971-08-10 Medtronic Inc Lead-storing pacer
US3665916A (en) * 1968-09-30 1972-05-30 Tokyo Shibaura Electric Co Catheter type semiconductor radiation detector
US3683933A (en) * 1970-06-22 1972-08-15 Peter B Mansfield Implantable tissue stimulator with a porous anchoring enclosure
US3683932A (en) * 1970-06-01 1972-08-15 Adcole Corp Implantable tissue stimulator
FR2133843A1 (en) * 1971-04-19 1972-12-01 Medtronic Inc
US3707974A (en) * 1970-12-11 1973-01-02 W Raddi Body organ stimulator with voltage converter
US3718142A (en) * 1971-04-23 1973-02-27 Medtronic Inc Electrically shielded, gas-permeable implantable electro-medical apparatus
US3735766A (en) * 1971-04-19 1973-05-29 Gen Electric Optional unipolar-bipolar body organ stimulator
US3757789A (en) * 1971-10-26 1973-09-11 I Shanker Electromedical stimulator lead connector
US3788329A (en) * 1972-04-17 1974-01-29 Medtronic Inc Body implantable lead
DE2334049A1 (en) * 1973-07-04 1975-01-16 Hans Dr Med Lagergren Endocardelektrode
US3866616A (en) * 1973-07-12 1975-02-18 Coratomic Heart pacer
US3978865A (en) * 1974-01-25 1976-09-07 Hector Osvaldo Trabucco Implantable pacemaker and electrode member therefor
USRE28990E (en) * 1972-12-04 1976-10-05 Corometrics Medical Systems, Inc. Bipolar electrode structure for monitoring fetal heartbeat and the like
US4000745A (en) * 1968-08-05 1977-01-04 Goldberg Edward M Electrical leads for cardiac stimulators and related methods and means
US4058128A (en) * 1976-08-26 1977-11-15 Frank Howard A Electrode
US4066085A (en) * 1975-01-14 1978-01-03 Cordis Corporation Contact device for muscle stimulation
US4140131A (en) * 1976-11-03 1979-02-20 Medtronic, Inc. Body tissue stimulation apparatus with warning device
US4144890A (en) * 1975-01-14 1979-03-20 Cordis Corporation Contact device for muscle stimulation
US4144891A (en) * 1977-04-20 1979-03-20 Medtronic, Inc. Heart stimulator lead set
US4157720A (en) * 1977-09-16 1979-06-12 Greatbatch W Cardiac pacemaker
FR2421626A1 (en) * 1978-02-01 1979-11-02 Anvar Multiple contact heart stimulating electrode - has coiled wire inside sleeve interrupted for intermediate contacts, terminating in spherical final contact
USRE30366E (en) * 1970-09-21 1980-08-12 Rasor Associates, Inc. Organ stimulator
US4248238A (en) * 1979-03-26 1981-02-03 Joseph Simon P Heart stimulating apparatus
US4261372A (en) * 1977-11-22 1981-04-14 Hansen Carl C Electrode for implantation into cochlea
US4282886A (en) * 1979-11-13 1981-08-11 Medtronic, Inc. Adhesive bonded positive fixation epicardial lead
US4301805A (en) * 1980-07-30 1981-11-24 Cordis Corporation Cardiac pacer connector system
US4353372A (en) * 1980-02-11 1982-10-12 Bunker Ramo Corporation Medical cable set and electrode therefor
US4355642A (en) * 1980-11-14 1982-10-26 Physio-Control Corporation Multipolar electrode for body tissue
EP0033242B1 (en) * 1980-01-23 1983-09-21 Medtronic, Inc. Implantable pulse generator with passive sensing reference electrode
US4411277A (en) * 1981-04-28 1983-10-25 Medtronic, Inc. Implantable connector
US4411276A (en) * 1981-04-28 1983-10-25 Medtronic, Inc. Implantable multiple connector
US4817634A (en) * 1987-06-18 1989-04-04 Medtronic, Inc. Epicardial patch electrode
US4971070A (en) * 1987-06-18 1990-11-20 Medtronic, Inc. Epicardial patch electrode
US5085218A (en) * 1990-08-31 1992-02-04 Cardiac Pacemakers, Inc. Bipolar myocardial positive fixation lead with improved sensing capability
US5388578A (en) * 1992-01-14 1995-02-14 Incontrol, Inc. Electrode system for use with an implantable cardiac patient monitor
US20060148062A1 (en) * 2004-10-07 2006-07-06 Transmedics, Inc. Systems and methods for ex-vivo organ care
US20060154357A1 (en) * 2004-10-07 2006-07-13 Transmedics, Inc. Systems and methods for ex-vivo organ care
US20070173905A1 (en) * 2001-02-13 2007-07-26 Greenberg Robert J Implantable retinal electrode array configuration for minimal retinal damage and method of reducing retinal stress
US20080234768A1 (en) * 2007-03-20 2008-09-25 Transmedics, Inc Systems for monitoring and applying electrical currents in an organ perfusion system
US20090197240A1 (en) * 2008-01-31 2009-08-06 Transmedics, Inc Systems and methods for ex vivo lung care
US20100204548A1 (en) * 2007-06-05 2010-08-12 Frank Bonadio Instrument Access Device
US20110136096A1 (en) * 2006-04-19 2011-06-09 Transmedics, Inc. Systems and Methods for Ex Vivo Organ Care
US9078428B2 (en) 2005-06-28 2015-07-14 Transmedics, Inc. Systems, methods, compositions and solutions for perfusing an organ
US9756851B2 (en) 1997-09-23 2017-09-12 The Department Of Veteran Affairs Compositions, methods and devices for maintaining an organ
US9894894B2 (en) 2004-10-07 2018-02-20 Transmedics, Inc. Systems and methods for ex-vivo organ care and for using lactate as an indication of donor organ status

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US3057356A (en) * 1960-07-22 1962-10-09 Wilson Greatbatch Inc Medical cardiac pacemaker
US3107672A (en) * 1958-05-27 1963-10-22 Ewald Rose Electrical apparatus for cosmetic treatment of the skin

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3107672A (en) * 1958-05-27 1963-10-22 Ewald Rose Electrical apparatus for cosmetic treatment of the skin
US3057356A (en) * 1960-07-22 1962-10-09 Wilson Greatbatch Inc Medical cardiac pacemaker

Cited By (67)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3367339A (en) * 1964-10-09 1968-02-06 Robert W. Sessions Implantable nerve stimulating electrode and lead
US3478746A (en) * 1965-05-12 1969-11-18 Medtronic Inc Cardiac implantable demand pacemaker
US3472234A (en) * 1967-08-15 1969-10-14 Gen Electric Body organ electrode
US3476116A (en) * 1967-11-09 1969-11-04 Victor Parsonnet Nonpolarizing electrode for physiological stimulation
US3500823A (en) * 1967-11-20 1970-03-17 Us Air Force Electrocardiographic and bioelectric capacitive electrode
US3590810A (en) * 1968-05-27 1971-07-06 Honeywell Inc Biomedical body electrode
US4000745A (en) * 1968-08-05 1977-01-04 Goldberg Edward M Electrical leads for cardiac stimulators and related methods and means
US3665916A (en) * 1968-09-30 1972-05-30 Tokyo Shibaura Electric Co Catheter type semiconductor radiation detector
US3598128A (en) * 1968-10-28 1971-08-10 Medtronic Inc Lead-storing pacer
US3683932A (en) * 1970-06-01 1972-08-15 Adcole Corp Implantable tissue stimulator
US3683933A (en) * 1970-06-22 1972-08-15 Peter B Mansfield Implantable tissue stimulator with a porous anchoring enclosure
USRE30366E (en) * 1970-09-21 1980-08-12 Rasor Associates, Inc. Organ stimulator
US3707974A (en) * 1970-12-11 1973-01-02 W Raddi Body organ stimulator with voltage converter
US3735766A (en) * 1971-04-19 1973-05-29 Gen Electric Optional unipolar-bipolar body organ stimulator
FR2133843A1 (en) * 1971-04-19 1972-12-01 Medtronic Inc
US3718142A (en) * 1971-04-23 1973-02-27 Medtronic Inc Electrically shielded, gas-permeable implantable electro-medical apparatus
US3757789A (en) * 1971-10-26 1973-09-11 I Shanker Electromedical stimulator lead connector
US3788329A (en) * 1972-04-17 1974-01-29 Medtronic Inc Body implantable lead
USRE28990E (en) * 1972-12-04 1976-10-05 Corometrics Medical Systems, Inc. Bipolar electrode structure for monitoring fetal heartbeat and the like
DE2334049A1 (en) * 1973-07-04 1975-01-16 Hans Dr Med Lagergren Endocardelektrode
DE2334049C3 (en) * 1973-07-04 1988-12-22 Hans Dr Med Lagergren Endocardium-electrode assembly
US3866616A (en) * 1973-07-12 1975-02-18 Coratomic Heart pacer
US3978865A (en) * 1974-01-25 1976-09-07 Hector Osvaldo Trabucco Implantable pacemaker and electrode member therefor
US4066085A (en) * 1975-01-14 1978-01-03 Cordis Corporation Contact device for muscle stimulation
US4144890A (en) * 1975-01-14 1979-03-20 Cordis Corporation Contact device for muscle stimulation
US4058128A (en) * 1976-08-26 1977-11-15 Frank Howard A Electrode
US4140131A (en) * 1976-11-03 1979-02-20 Medtronic, Inc. Body tissue stimulation apparatus with warning device
US4144891A (en) * 1977-04-20 1979-03-20 Medtronic, Inc. Heart stimulator lead set
US4157720A (en) * 1977-09-16 1979-06-12 Greatbatch W Cardiac pacemaker
US4261372A (en) * 1977-11-22 1981-04-14 Hansen Carl C Electrode for implantation into cochlea
FR2421626A1 (en) * 1978-02-01 1979-11-02 Anvar Multiple contact heart stimulating electrode - has coiled wire inside sleeve interrupted for intermediate contacts, terminating in spherical final contact
US4248238A (en) * 1979-03-26 1981-02-03 Joseph Simon P Heart stimulating apparatus
US4282886A (en) * 1979-11-13 1981-08-11 Medtronic, Inc. Adhesive bonded positive fixation epicardial lead
EP0033242B1 (en) * 1980-01-23 1983-09-21 Medtronic, Inc. Implantable pulse generator with passive sensing reference electrode
US4353372A (en) * 1980-02-11 1982-10-12 Bunker Ramo Corporation Medical cable set and electrode therefor
US4301805A (en) * 1980-07-30 1981-11-24 Cordis Corporation Cardiac pacer connector system
US4355642A (en) * 1980-11-14 1982-10-26 Physio-Control Corporation Multipolar electrode for body tissue
US4411277A (en) * 1981-04-28 1983-10-25 Medtronic, Inc. Implantable connector
US4411276A (en) * 1981-04-28 1983-10-25 Medtronic, Inc. Implantable multiple connector
US4817634A (en) * 1987-06-18 1989-04-04 Medtronic, Inc. Epicardial patch electrode
US4971070A (en) * 1987-06-18 1990-11-20 Medtronic, Inc. Epicardial patch electrode
US5085218A (en) * 1990-08-31 1992-02-04 Cardiac Pacemakers, Inc. Bipolar myocardial positive fixation lead with improved sensing capability
US5388578A (en) * 1992-01-14 1995-02-14 Incontrol, Inc. Electrode system for use with an implantable cardiac patient monitor
US9756851B2 (en) 1997-09-23 2017-09-12 The Department Of Veteran Affairs Compositions, methods and devices for maintaining an organ
US9756849B2 (en) 1997-09-23 2017-09-12 The Department Of Veteran Affairs Compositions, methods and devices for maintaining an organ
US9756850B2 (en) 1997-09-23 2017-09-12 The Department Of Veteran Affairs Compositions, methods and devices for maintaining an organ
US20070173905A1 (en) * 2001-02-13 2007-07-26 Greenberg Robert J Implantable retinal electrode array configuration for minimal retinal damage and method of reducing retinal stress
US8060211B2 (en) * 2001-02-13 2011-11-15 Second Sight Medical Products, Inc. Method of reducing retinal stress caused by an implantable retinal electrode array
US20060154357A1 (en) * 2004-10-07 2006-07-13 Transmedics, Inc. Systems and methods for ex-vivo organ care
US9301519B2 (en) 2004-10-07 2016-04-05 Transmedics, Inc. Systems and methods for ex-vivo organ care
US9215867B2 (en) 2004-10-07 2015-12-22 Transmedics, Inc. Systems and methods for ex-vivo organ care
US20060148062A1 (en) * 2004-10-07 2006-07-06 Transmedics, Inc. Systems and methods for ex-vivo organ care
US9055740B2 (en) 2004-10-07 2015-06-16 Transmedics, Inc. Systems and methods for ex-vivo organ care
US9894894B2 (en) 2004-10-07 2018-02-20 Transmedics, Inc. Systems and methods for ex-vivo organ care and for using lactate as an indication of donor organ status
US9078428B2 (en) 2005-06-28 2015-07-14 Transmedics, Inc. Systems, methods, compositions and solutions for perfusing an organ
US8822203B2 (en) 2006-04-19 2014-09-02 Transmedics, Inc. Systems and methods for ex vivo organ care
US20110136096A1 (en) * 2006-04-19 2011-06-09 Transmedics, Inc. Systems and Methods for Ex Vivo Organ Care
US20080234768A1 (en) * 2007-03-20 2008-09-25 Transmedics, Inc Systems for monitoring and applying electrical currents in an organ perfusion system
US9457179B2 (en) * 2007-03-20 2016-10-04 Transmedics, Inc. Systems for monitoring and applying electrical currents in an organ perfusion system
US20100204548A1 (en) * 2007-06-05 2010-08-12 Frank Bonadio Instrument Access Device
US9247728B2 (en) 2008-01-31 2016-02-02 Transmedics, Inc. Systems and methods for ex vivo lung care
US9516875B2 (en) 2008-01-31 2016-12-13 Transmedics, Inc. Systems and methods for ex vivo lung care
US20090197325A1 (en) * 2008-01-31 2009-08-06 Transmedics, Inc SYSTEMS AND METHODS FOR Ex vivo LUNG CARE
US20090197240A1 (en) * 2008-01-31 2009-08-06 Transmedics, Inc Systems and methods for ex vivo lung care
US20090197292A1 (en) * 2008-01-31 2009-08-06 Transmedics, Inc Systems and methods for ex vivo lung care
US9814230B2 (en) 2008-01-31 2017-11-14 Transmedics, Inc. Systems and methods for ex vivo lung care
US9462802B2 (en) 2008-01-31 2016-10-11 Transmedics, Inc. Systems and methods for ex vivo lung care

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