476results about "Epicardial electrodes" patented technology

Minimally invasive introducers and methods that can be used for rotationally securing devices within the human body. Introducers can include a distal element for releasably engaging a lead head controllable from a proximal control located outside of the body. An inner stem can extend between a proximal portion and a distal portion, and be pivotally and rotatably coupled to the distal lead engagement mechanism. An outer tube can be rotatably disposed over the inner stem and be flexibly coupled over the pivot to rotationally drive the distal element. A helical epicardial-myocardial lead electrode can be secured and oriented straight ahead and introduced through a port or small incision with the introducer in a straight configuration. The introducer can then be bent and rotated to screw the helical electrode into the heart.

Methods and devices for implanting pacing electrodes or other apparatus, or for delivering substances, to the heart of other tissues within the body. A guided tissue penetrating catheter is inserted into a body lumen (e.g., blood vessel) or into a body cavity or space (e.g., the pericardial space) and a penetrator is advanced from the catheter to a target location. In some embodiments, a substance or an apparatus (such as an electrode) may be delivered through a lumen in the penetrator. In other embodiments, a guidewire may be advanced through the penetrator, the penetrating catheter may then be removed and an apparatus (e.g., electrode) may then be advanced over that guidewire. Also disclosed are various implantable electrodes and electrode anchoring apparatus.

A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Apparatus and method for the treatment of congestive heart failure are disclosed that utilize a cuff that surrounds the heart and constrains cardiac dilation, while electrodes embedded in the cuff stimulate the myocardium to contractile function. An EKG signal can be processed to create an optimal pattern of selective stimulation of different areas of the heart at different times. An implantable circuit contains a power source and stimulation circuits. In some embodiments, a telemetry unit and an EKG collection circuit are also included. In accordance with the present disclosure, cuff limits the dilation of the heart and the stimulation electrodes enhance ventricular function by optimizing ventricular contractility.

Provided herein are biomedical devices and methods of making and using biomedical devices for sensing and actuation applications. For example, flexible and / or stretchable biomedical devices are provided including electronic devices useful for establishing in situ conformal contact with a tissue in a biological environment. The invention includes implantable electronic devices and devices administered to the surfaces(s) of a target tissue, for example, for obtaining electrophysiology data from a tissue such as cardiac, brain tissue or skin.

The invention relates to heart treatment devices and methods for performing diagnostic or therapeutic procedures in the region between a bodily organ and a covering of the bodily organ. The invention can be used for example to perform a diagnostic or therapeutic procedure in the pericardial space.

A catheter system for retrieving a leadless cardiac pacemaker from a patient is provided. The cardiac pacemaker can include a docking or retrieval feature configured to be grasped by the catheter system. In some embodiments, the retrieval catheter can include a snare configured to engage the retrieval feature of the pacemaker. The retrieval catheter can include a torque shaft selectively connectable to a docking cap and be configured to apply rotational torque to a pacemaker to be retrieved. Methods of delivering the leadless cardiac pacemaker with the delivery system are also provided.

An epicardial lead installation tool having an elongated tool body extending between a tool body proximal and distal ends and encloses a tool body lumen. At least one suction pad supported by a suction pad strut extends distally to a distal end surface of the tool body distal end. A lead implantation tool extending between implantation tool proximal and distal ends is inserted through the tool body lumen to dispose the implantation tool distal end proximate to the tool body distal end. The lead implantation tool distal end is adapted to engage the distal electrode head of an epicardial lead to enable the extension of the assembly of the of the lead installation tool, the lead implantation tool and the epicardial lead through a skin incision and to apply the suction pad against the epicardium. Suction is applied through the suction pad to affix it to the epicardium while the implantation tool proximal end is manipulated to affix the distal fixation mechanism to the myocardium at the implantation site.

An implantable battery powered leadless pacemaker or biostimulator is provided that may include any of a number of features. One feature of the biostimulator is that it safely operates under a wide range of MRI conditions. One feature of the biostimulator is that it has a total volume small enough to avoid excessive image artifacts during a MRI procedure. Another feature of the biostimulator is that it has reduced path lengths between electrodes to minimize tissue heating at the site of the biostimulator. Yet another feature of the biostimulator is that a current loop area within the biostimulator is small enough to reduce an induced current and voltage in the biostimulator during MRI procedures. Methods associated with use of the biostimulator are also covered.

An implantable lead system includes an elongated device slideably engaged within a lumen of a lead body. A distal portion of the elongated device is slidable through a helix tip coupled to a distal end of the lead body by passing through a pierceable fluid-tight seal disposed in proximity to the distal end of the lead body; the seal prevents ingress of bodily fluid into the lumen of the lead body.

Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient's heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace / sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace / sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Ultrasonic dissection instruments and methods provide for fluid delivery during subcutaneous dissection. An ultrasonic dissection tool includes a handle, a transducer and a dissecting member. The dissecting member extends from the distal end of the transducer, and a fluid channel system extends from at least the proximal end to the distal end of the dissecting member. The fluid channel system terminates in a port system. The port system may include one or more apertures, one or more channels, and be adapted to transport fluids such as, for example, irrigation fluids, fluids having analgesics, antibiotics, and combinations of fluids and agents.

The methods and apparatus for lead placement on a surface of the heart are employed using an elongated body having proximal and distal end portions. The body defines a lead receiving passageway extending between a proximal inlet and a distal outlet for receiving a lead therethrough for contact with the heart surface. The elongated body is adapted for insertion between a pericardium and an epicardial surface. At least a portion of the body may have a non-circular cross-sectional shape adapted to retain the body orientation between the pericardium and the epicardial surface.

An implantable lead having an elongated lead body that includes an electrical conductor extending between a distal end of the lead body and a proximal end of the lead body is disclosed. The lead further includes an electrode formed at the distal end of the lead body, the electrode being coupled to the electrical conductor and one or more passive fixation mesh sections coupled to the distal end of the lead body that promotes tissue over growth.

An implantable myocardial stimulation lead comprises a lead body having a distal end and a proximal end, and an electrical connector carried by the proximal end of the lead body. An electrode header carried by the distal end of the lead body has an axis and includes a helical fixation element extending along the axis, the electrode header having a surface configured to receive a driver for rotating the electrode header to screw the helical fixation element into the tissue of the heart. The lead body carries along its length a strain relief member resisting excessive bending of the lead body.

Minimally invasive introducers and methods that can be used for rotationally securing devices within the human body. Introducers can include a distal element for releasably engaging a lead head controllable from a proximal control located outside of the body. An inner stem can extend between a proximal portion and a distal portion, and be pivotally and rotatably coupled to the distal lead engagement mechanism. An outer tube can be rotatably disposed over the inner stem and be flexibly coupled over the pivot to rotationally drive the distal element. A helical epicardial-myocardial lead electrode can be secured and oriented straight ahead and introduced through a port or small incision with the introducer in a straight configuration. The introducer can then be bent and rotated to screw the helical electrode into the heart.

The present invention provides a method and apparatus for assessing ventricular function on a chronic basis using a plurality of electrodes disposed on or about a left ventricle and / or a right ventricle—and optionally, at least one mechanical or metabolic sensor—all operatively electrically coupled to an implantable medical device. The plurality of electrodes are preferably spaced-apart so that at least one electrode is disposed electrical communication with a discrete volume of ventricular tissue. In one embodiment, the discrete volume of tissue is defined by multiple longitudinal and axial planes as known and used in the medical arts. Thus, according to the present invention, at least one electrode couples to appropriate sensing circuitry and essentially provides a localized electrogram (EGM) that, when compared to other EGMs, provides for configurable, localized delivery of therapeutic pacing stimulus, diverse impedance-sensing vectors, various diagnostic information regarding myocardial function and / or anti-tachycardia pacing.

The epicardial pacing system and related method includes an epicardial catheter configured to be disposed in the middle mediastinum of the thorax of a subject for use in electrical pacing of the heart at one or more locations on the epicardial surface. The epicardial pacing catheter may include at least one electrode whereby the electrode is insulated on at least one side to allow pacing of the heart without damage to adjacent anatomical structures.

A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and / or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Lead placement apparatus to transmit electrical signals to stimulate selected body tissue includes an introducer handle supporting a tubular outer sheath of flexible resilient material including a rigid section and a deflectable section adjacent the distal end, enabling the deflectable section to deflect among a plurality of positions in orientations transverse of a longitudinal axis. An operative member on the introducer handle connected to the distal end of the outer sheath serves to move that distal end. An inner tubular sheath of flexible resilient material slidably received within the outer sheath includes a driving socket fixed to its distal end whereby, with a lead slidably received within the inner tubular sheath and including a driven socket fixed to its distal end for releasable mating engagement by the driving socket, an electrode at the distal tip of the lead can be advanced and directed to the selected body tissue for stimulation.

A transcoronary sinus pacing system comprising a sheath having a lumen, a pacing catheter having a pacing needle, wherein the catheter can be advanced within the lumen and placed in the LV summit, and a right ventricular pacing device. A LV summit pacing device. An early mitral valve closure pacing device configured to operate with a right ventricular apex pacing device. A method for implanting a pacing device at a target coronary sinus tissue location, wherein the target can be the posterior LV summit. A method for achieving early closure of a mitral valve. A method for using visualization devices such as fluoroscopy or ultrasound and / or catheter features such as a radiopaque marker to locate a target location for LV pacing and to avoid piercing an artery or the pericardium when anchoring the LV pacing electrode.

The lead body of a medical lead comprises a distal end portion carrying at least one electrode for placement in the pericardial sac of a human heart. The distal end portion of the lead body includes a multi-turn section having opposed ends, opposing forces applied to the ends tending to flatten the multi-turn section, the multi-turn section being thereby adapted to be retained within the pericardial sac. The turns of the multi-turn section may become progressively smaller from one end of the section to the other end of the section. The multi-turn section may have, in a relaxed state thereof, a generally conical, helical configuration. The at least one electrode may be carried adjacent to the end of the multi-turn section having the larger turns. Alternatively, the at least one electrode may be carried adjacent to the end of the multi-turn section having the smaller turns.

An epicardial electrode which is suitable, in particular, for use with a cardiac stimulation device, comprises an electrode body which has a stimulation surface adapted to bear against the cardiac tissue and to stimulate a part of the heart, that is to say a partial region of the heart, and at least one fixing element for fixing the stimulation surface to the cardiac tissue. The at least one fixing element is adapted for engagement into the cardiac tissue. The epicardial electrode can be secured to the outside and in particular to the outer skin of the cardiac muscle (epicardium) without being sewn to the cardiac muscle like a patch electrode. Only the fixing element has to be brought into engagement with the cardiac tissue.

Devices and methods provide for ablation of cardiac tissue for treating cardiac arrhythmias such as atrial fibrillation. Although the devices and methods are often be used to ablate epicardial tissue in the vicinity of at least one pulmonary vein, various embodiments may be used to ablate other cardiac tissues in other locations on a heart. Devices generally include at least one tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue, and at least one ablation member for ablating the tissue. Various embodiments include features, such as suction apertures, which enable the device to attach to the epicardial surface with sufficient strength to allow the tissue to be stabilized via the device. For example, some embodiments may be used to stabilize a beating heart to enable a beating heart ablation procedure. Many of the devices may be introduced into a patient via minimally invasive introducer devices and the like. Although devices and methods of the invention may be used to ablate epicardial tissue to treat atrial fibrillation, they may also be used in veterinary or research contexts, to treat various heart conditions other than atrial fibrillation and / or to ablate cardiac tissue other than the epicardium.

The present invention provides for transesophageal implantation of cardiac electrodes (102) and (104) for pacing and / or defibrillation The electronic module (110) could be implanted in the abdomen or thorax using a transesophageal, transgastric, thoracoscopic or open surgical approach In another aspect, the invention provides for transesophageal delivery of other cardiac therapies including ablation, phototherapy, radiation therapy and implantation or injection of therapeutic substances into the heart The transesophageal approach takes advantage of the proximity between the esophagus and the chambers of the heart, allowing surgical access to the heart with very low morbidity and risk of complications.

An assembly for introducing a leadless intra-cardiac medical device includes a sheath having an internal passage, wherein the sheath is configured to be maneuvered into the heart of the patient. A housing may be retained within the internal passage, wherein the housing is configured to be pushed out of the sheath, the housing having a first anchoring member configured to anchor the housing to a first implant location within the heart. The assembly may also include an electrode trailing the housing within the internal passage, wherein the electrode is also configured to be pushed out of the sheath. The electrode has a second anchoring member configured to anchor the electrode to a second implant location within the heart. A conductive wire connects the housing to the electrode, wherein movement of the housing out of the sheath causes the electrode to follow the movement to a distal end of the sheath.

A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and / or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Endoscopic subxiphoid surgical procedures and instruments facilitate translumination of tissue through the pericardium, and promote encircling an intrapericardial region with one or more tissue-ablating probes for ablating cardiac tissue substantially encircling the left and right pulmonary veins as a treatment for chronic atrial fibrillation. Such endoscopic subxiphoid surgical procedures and instruments also facilitate placement of epicardial tacks about the annulus of the mitral valve for supporting a tensioned suture or band that decreases the size of the mitral annulus to repair a regurgitant valve. Suction-oriented instruments facilitate temporary attachment to an organ to establish precise positioning on the organ during a surgical procedure.