504results about "Transvascular endocardial electrodes" patented technology

The invention discloses a leadless pacemaker for pace-making in a left bundle branch area and a delivery sheathing canal thereof.The leadless pacemaker comprises a pacemaker body, the center of the pacemaker body is partially provided with a first internal thread section, and a pacemaker electrode is partially provided with a first external thread section; the first internal thread section and the first external thread section are matched and screwed, so that the pacemaker electrode can be controlled to extend or retract by rotating the pacemaker electrode; when the pacemaker is used, the front end of the pacemaker body is flush with the front end of the shell, and the front end of the pacemaker electrode and the electrode spiral structure of the pacemaker electrode extend out of the pacemaker body by the maximum distance of 10 mm. The device can be safely and effectively implanted into the left bundle branch area, is stable for a long time and cannot be fractured or dislocated, and pace-making of the left bundle branch area is achieved.

An electrode that includes an elongate lead body and a nerve cuff. The nerve cuff may include a biologically compatible, elastic, electrically insulative cuff body configured to be circumferentially disposed around a nerve, first and second relatively wide electrically conductive contacts carried by the cuff body that are spaced from one another in the length direction and that extend in the width direction to such an extent that they extend completely around the cuff body inner lumen when the cuff body is in the pre-set furled shape, and a plurality of relatively narrow electrically conductive contacts carried by the cuff body that are spaced from one another in the width direction and are located between the first and second relatively wide electrically conductive contacts.

A composite wire suitable for use as a pacing or biostimulation lead has improved durability when compared to currently available materials. Specifically, a lead includes a superelastic wire including, e.g., nitinol. The wire is coated with polyimide and subsequently wound into a strand, cable, coil, or helically stranded tube. This wound structure is thermomechanically treated to shape-set the wire construct and retain a desired wound and shaped configuration, without adversely affecting the integrity of the polyimide coating.

A delivery system and method are described that include a catheter and an active wire. The catheter has a catheter body that defines a primary lumen and a secondary lumen therethrough, which are spaced apart from each other. A distal end of the catheter body is configured to be located within a chamber of a heart proximate to myocardial tissue at a site of interest (SOI). The primary lumen has a greater cross-sectional size than the secondary lumen. The primary lumen is configured to receive at least a portion of an IMD therein and to permit the portion of the IMD to move relative to the catheter. The active wire is configured to extend through the secondary lumen so that a distal end of the active wire projects beyond the distal end of the catheter body to pierce the myocardial tissue at the SOI.

A delivery catheter for delivering a pacemaker lead into cardiac tissue. The catheter includes a distal end with a tip having an electrode configured for unipolar ablation of cardiac tissue that provides a breach of the endocardium while minimizing trauma to the patient.

Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods includes evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions.

Systems, devices, and methods for promoting a patient's volume return to the heart and cardiac pre-load by inducing constriction of at least a portion of the splanchnic bed of the patient are described herein. Constriction of at least a portion of the splanchnic bed is induced via electrical stimulation to splanchnic nerve fibers of one or more splanchnic nerves. Electrical stimulation to splanchnic nerve fibers is delivered using at least one intravenous electrode disposed within a vein of the patient proximate to the splanchnic nerve fibers.

A biostimulator and a biostimulator system for septal pacing, is described. The biostimulator includes an articulation to allow an electrode axis of a pacing electrode to be directed differently than a housing axis of a housing. The housing contains electrical circuitry that is electrically connected to the pacing electrode. The differently directed axes allow the pacing electrode to affix to target tissue of an interventricular septal wall of a heart when the housing of the biostimulator is located near an apex of the heart. The articulation can include a flexible portion of an extension, a hinge, or a tether. Other embodiments are also described and claimed.

A method and system is presented for an implantable wireless power receiver for use with a medical stimulation or monitoring device. The receiver receives transmitted energy through one or more non-inductive antenna(s), utilizes microelectronics to perform rectification of the received signal for generation of a DC power supply to power an implantable device, and may also utilize microelectronics to provide parameter settings to the device, or stimulating or other waveforms to a tissue.

Methods, apparatuses, and systems for performing a valve replacement or repair. Apparatuses may include systems and may include an outer catheter, one or more interchangeable inner catheters, a guidewire and an expandable chordae tendinae deflector. Also described herein are rapid pacing sheaths that may be used with any of these apparatuses and methods.

Transvascular diaphragm pacing systems (TDPS) and methods are disclosed for providing respiratory therapy to a patient. The TDPS can provide rapid insertion and deployment of endovascular pacing electrodes in critically ill patients who require intubation and invasive PPMV in order to support the physiological requirements of the human ventilatory system. The systems and methods make best use of the contractile properties of the diaphragm muscle and prevent muscle disuse and muscle atrophy. This can be carried out by engaging the phrenic nerves using patterned functional electrical stimulation applied to endovascular electrodes that are temporarily and reversibly inserted in central veins of the patient, such as the left subclavian vein and the superior vena cava. The TDPS can be designed to seamlessly interface with any commercially available positive-pressure ventilatory assistance / support equipment such as is commonly in use in hospital intensive care units (ICU) for treating critically ill patients with breathing insufficiencies, pain, trauma, sepsis or neurological diseases or deficits.

Various systems and methods are provided for cardiac resynchronization therapy. In one example, apparatus for a multi-electrode pacemaker lead, comprises a plurality of ring electrodes distributed along a length of the multi-electrode pacemaker lead, the multi-electrode pacemaker lead configured to be implanted within myocardium of a wall of a ventricle of a heart such that an outer surface defining a circumference of at least one of the plurality of ring electrodes is in direct contact with the myocardium.

A biostimulator and a biostimulator system for septal pacing, is described. The biostimulator includes an articulation to allow an electrode axis of a pacing electrode to be directed differently than a housing axis of a housing. The housing contains electrical circuitry that is electrically connected to the pacing electrode. The differently directed axes allow the pacing electrode to affix to target tissue of an interventricular septal wall of a heart when the housing of the biostimulator is located near an apex of the heart. The articulation can include a flexible portion of an extension, a hinge, or a tether. Other embodiments are also described and claimed.

A method for manufacturing an implantable lead including an elongated lead body with a plurality of wires and an electrically isolating outer layer, wherein the method comprises:Providing a sleeve having a sealed end and an open cavity opposite the sealed end and including electrically conducting material;Pulling at least one wire out of the lead body;Positioning the pulled end of the at least one wire within the cavity of the sleeve;Forming the sleeve using a pressing tool such that the volume of the cavity is reduced, that the wire is fixed within the sleeve and that an electrical connection of the at least one wire and the formed sleeve is established;Attaching a contact element to the lead body such that the contact element fixes the formed sleeve at the lead body and establishes an electrical connection to the sleeve.

A delivery device (40) includes a first handle portion and a second handle portion. The first handle portion includes an inner shaft deflection mechanism (44). An inner shaft (46) is coupled to the first handle portion. The inner shaft is configured to deflect in a first deflection plane in response to actuation of the inner shaft deflection mechanism. The second handle portion includes an outer shaft deflection mechanism. The second handle portion is configured to rotate relative to the first handle portion. An outer shaft is coupled to the second handle portion. The outer shaft surrounds at least a portion of the inner shaft. The outer shaft is configured to deflect in a second deflection plane in response to actuation of the outer shaft deflection mechanism. Rotation of the second handle portion relative to the first handle portion causes the second deflection plane to rotate relative to the first deflection plane.

A biostimulator (100) includes a housing (302) having a longitudinal axis (304) and containing an electronics compartment (306). A pacing element (108) is coupled to the housing (302). The pacing element (108) includes a flexible conductor (410) extending along the longitudinal axis (304). A fixation element mount (311) is mounted on the housing (302). The fixation element mount (311) includes a distal mount end (430). A fixation element (106) is mounted on the fixation element mount (311). The fixation element (106) extends about the longitudinal axis (304). A radiopaque marker (502) has a distal marker end (504) longitudinally aligned with the distal mount end (430) of the fixation element mount (311). Other embodiments are also described and claimed.

An attachment device for coupling a biostimulator to a delivery system includes a case, a tether dock, and a filament. The case has a wall, a first end, and a second end opposite the first end. The wall defines a passage and a slot. The passage extends between the first end and the second end. The slot extends through the wall such that the passage is accessible through the slot. The tether dock extends from second end of the case. The tether dock defines a groove extending therethrough. The filament has a fixed end and free end. The fixed end is attached to the first end of the case. The free end includes a bulb that is selectively receivable in the passage of the case through the slot.

An implantable lead for use with an implantable medical device (IMD) includes a tubular lead body having a proximal portion including a proximal end, a distal portion including a distal end opposite the proximal end, and an intermediate portion between the proximal portion and the distal portion. A helical electrode extends distally from the distal end of the tubular lead body. At least one atrial electrode is disposed in the intermediate portion of the tubular lead body. At least one electrical conductor extends through the tubular lead body and is mechanically and electrically coupled to the helical electrode and the at least one atrial electrode. The intermediate portion may have a pre-formed bend configured to urge the at least one atrial electrode against a surface of the right atrium when the lead is implanted. A distal pre-formed bend located in the distal portion of the tubular lead body may be configured to bias a plurality of pacing / sensing electrodes towards a surface of a right ventricle. A distal pre-formed bend located in the distal portion of the tubular lead body may be configured to bias the helical electrode and at least one pacing / sensing against a surface of a right ventricle.

In some examples, controlling delivery of CRT includes controlling an implantable medical device to deliver ventricular pacing according to a sequence of different values of a CRT parameter and acquire first and second electrograms from respective first and second electrode vectors. For each value of the CRT parameter, a value of a comparison metric of a first activation interval between a first fiducial point of a cardiac cycle detected in the first electrogram and an occurrence of a second fiducial point of the cardiac cycle and a second activation interval between the first fiducial point and the occurrence of the second fiducial point detected in the second electrogram can be determined. A target value of the comparison metric can be identified and an updated value of the CRT parameter determined based on the target value. The system can then control the IMD to deliver ventricular pacing at the updated value of the CRT parameter.

Systems and method for ambulatory cardiac pacing are provided. A method may include providing an implantable medical device and a medical lead and inserting the medical lead into a vein of a patient and securing the holder adjacent to an insertion site of the medical lead. The method may include selecting a pacing algorithm from among a first pacing algorithm configured to provide intermittent pacing support and a second pacing algorithm configured to provide continuous pacing support, for execution by the implantable medical device.

An introductory lead system can include a first implantable lead having a first electrode and a second implantable lead having a second electrode guided to an implant site by the first implantable lead. The second electrode can be implanted in a patient's heart at the same implant site as the first electrode or at a second implant site. The introductory lead system can be delivered to one or more implant sites using various methods, including at the Koch triangle for ventricular free wall to atrium (VfA) therapy, at the right ventricular septal wall for dual bundle branch pacing, or in the coronary vasculature for left-sided sensing and pacing.

A stabilizer sleeve is disclosed for use with cardiac implantable electronic device leads. The sleeve comprises a tubular body sized to receive the lead and shaped to bias the lead toward a desired anatomical location, thereby reducing migration, dislodgement, and interference with cardiac structures. The sleeve may be introduced with the lead as a unitary assembly or added after lead placement. Various embodiments include a slitted body for expansion, radiopaque markers for visualization, detachable nose-cone tips for guidewire tracking, and antimicrobial coatings. The sleeve may be formed of polymers, alloys, or composite materials, and may include features such as texturing or anchoring projections for tissue engagement. Applications include positioning within a tricuspid valve commissure to minimize regurgitation and stabilizing left ventricular leads within branches of the coronary sinus. The device and methods described provide improved long-term stability and performance of implanted cardiac leads.

A medical system configured to impart a torque to a medical device within a patient. The medical system includes a driver including a driver body supporting a torque coupler. A snare is configured to engage the medical device. The torque coupler is configured to receive the medical device within a coupler volume. The snare and / or the torque coupler are configured to exert forces on the medical device such that the torque coupler imparts a torque to a retrieval structure of the medical device, causing rotation of the medical device. In examples, the medical device includes an attachment member configured to engage or disengage tissue when the medical device rotates. The medical system may include a delivery catheter configured to deliver and / or retrieve the torque coupler, snare, and / or the medical device.

Systems and methods which provide a bulkhead anchor configuration in which an anchor body includes flexure finger members and a radial bulkhead operable in cooperation to impart a radial compressive force to a corresponding lead body are described. A first portion of a bulkhead anchor body may comprise a plurality of flexure finger members disposed in a corolla configuration forming an anchor lumen through which a lead body may be inserted. A second portion of the bulkhead anchor body may comprise a radial bulkhead having a flexure profile configured to operatively engage the flexure finger members. A locking mechanism may be used to retain the first and second portions of the bulkhead anchor in their relative positions such that the radial compressive force is maintained upon the lead body indefinitely.

Apparatus, systems, and methods are provided for placing pacing leads or other devices within a patient's heart. In an exemplary embodiment, the apparatus includes a tubular member comprising a flexible distal portion defining a curvilinear shape in a relaxed state including a curved first region defining a first radius lying within a first plane, a substantially straight second region extending from the first curved region defining a first length, and a curved third region extending from the second region defining a second radius smaller than the first radius.

A tether handle assembly comprising: a first element coupled to a proximal end of a pull shaft and comprising: an elongate body; one or more first features; and a second element configured to hold the elongate body, the second element comprising: a housing defining a recess; and one or more second features disposed within the recess, wherein the first element is configured to rotate to transition between a locked orientation and an unlocked orientation, wherein when in the locked orientation, the one or more first features are configured to interface with the one or more second features to inhibit movement of the first element relative to the second element, wherein when in the unlocked orientation, the first element is configured to move relative to the second element along the longitudinal axis and apply a force along the pull shaft.

An apparatus for artificial stimulation of the heart of a subject, comprising an elongated body stent-like structure configured to be located in the coronary sinus of the subject, a first electrode assembly mechanically coupled to the body and oriented for electrifying the left atrium of the subject when the body is located in the coronary sinus, a second electrode assembly mechanically coupled to the body sufficiently distant from the first electrode assembly and oriented for electrifying the left ventricle of the subject when the body is located in the coronary sinus and the first electrode assembly is oriented for electrifying the left atrium, and a controller assembly electrically coupled to the first electrode assembly and to the second electrode assembly, the controller assembly is configured to drive a pacing electrical signal to the first electrode assembly and / or to the second electrode assembly.

The present invention is entitled "Grading of Pacing-Induced Electrical Activation." In one embodiment, a medical procedure system includes: a probe for insertion into a cardiac chamber of a living subject and including a first electrode for applying a pacing pulse sequence at a location in the chamber; a second electrode for sensing an electrical activation signal in response to capturing electrical activation induced by the pacing pulse in myocardium of the chamber; a display; and processing circuitry for assessing successful acquisition of the induced electrical activation by the second electrode in response to the electrical activation signal, the successful acquisition indicating successful capture of the pacing pulse by the myocardium, calculating a capture grade in response to the assessment of successful acquisition of the induced electrical activation, the capture grade indicating a count of the induced electrical activations assessed as successfully acquired, and presenting the capture grade to the display.

To provide a system for ablating tissue through irreversible electroporation.SOLUTION: A system comprises: a signal generator configured for generating a pulse waveform: and an ablation device coupled to the signal generator and configured to receive the pulse waveform. The ablation device includes a set of leads, each lead of the set of leads having insulation associated therewith, each lead of the set of leads configured to form a loop at a distal portion such that the ablation device including a set of loops, each loop of the set of loops including an uninsulated portion as an electrode such that the ablation device includes a set of electrodes at the distal portion, the ablation device configured to deliver the pulse waveform to tissue during use via the set of electrodes.SELECTED DRAWING: Figure 5

In some instances, a tethered head assembly of a delivery system includes an inner retainer and an outer retainer defining an orifice comprising a container configured to receive an attachment member of a medical device, a passage, and a recess. The inner retainer is movable within the recess between a second position and a first position, in which the passage is sized to receive the attachment member, and in the first position, the passage is sized to prevent the attachment member from passing through. A tethered handle assembly defines a channel, a force transmitter within the channel, a slidable member partially received at a first end of the channel, and a button partially received at a second end of the channel. A distally directed force applied to the button causes the force transmitter to apply a proximally directed force to the slidable member, thereby moving the slidable member and the attached tether proximally.