Delivery and retrieval system for medical devices

Abstract

A medical system configured to apply a torque to a medical device within a patient. The medical system includes a driver including a driver body supporting a driver cup. The intermediate member is configured to be positioned within a cup recess of the driver cup and a device recess of the medical device when the medical device resides within a cup volume of the driver cup. The intermediate member is configured to transfer torque from the driver cup to the medical device to cause rotation of the medical device. In an example, the medical device includes an attachment member configured to engage or disengage tissue when the medical device is rotated. The medical system may include a delivery catheter configured to deliver and / or retrieve the driver cup, the intermediate member, and the medical device.

Description

Technical Field

[0001] The present disclosure relates to systems for delivering and / or retrieving implantable medical devices. Background Art

[0002] Various types of implantable medical devices have been implanted for treating or monitoring one or more conditions in a patient. Such implantable medical devices may be adapted to allow the medical device to monitor and / or treat conditions or functions associated with the heart, muscles, nerves, brain, stomach, endocrine organs, or other organs and their associated functions. Implantable medical devices may be implanted at target locations that are selected to detect a patient's physiological condition and / or deliver one or more treatments. For example, an implantable medical device may be delivered to a location within the atria or ventricles of the heart to sense intrinsic cardiac signals and deliver pacing or anti-tachyarrhythmic shock therapy.

[0003] Some implantable medical devices are sized to be fully implanted in a chamber of the heart and / or another anatomical volume of the patient to detect physiological conditions and / or deliver one or more treatments. Such implantable medical devices can utilize a delivery and / or retrieval system to allow a clinician to navigate the implantable medical device (e.g., through the patient's vascular system) to a target location, and / or retrieve the implantable medical device from the patient's body. In some examples, the implantable medical device may include one or more anchoring components that are intended to engage tissue at the target location (e.g., for implantation) and / or detach from tissue at the target location (e.g., for retrieval). Summary of the invention

[0004] The present disclosure describes a medical system configured to deliver, position, retrieve and / or otherwise reorient an implantable medical device within an anatomical volume (e.g., a chamber of the heart) within a patient. The medical system is configured to receive a torque (e.g., from a clinician) and apply the torque to a driver cup via a driver body. The driver cup defines a cup volume that is configured to receive at least some portion of the implantable medical device. The medical system includes an intermediate member that is configured to be positioned within a cup recess of the driver cup and a device recess of the implantable medical device to allow the driver cup to transfer torque from the driver cup to the implantable medical device via the intermediate member. In an example, the medical system includes a delivery catheter that is configured to deliver and / or retrieve the driver cup, the intermediate member and / or the implantable medical device through the patient's vascular system.

[0005] In one example, a medical system includes: a driver including a driver body configured to receive a torque, wherein the driver body defines a lumen and a lumen opening; a driver cup supported at a distal end of the driver body, wherein the driver body is configured to apply the torque on the driver cup, and wherein the driver cup includes a cup surface defining a cup volume, the cup volume configured to receive an implantable medical device, wherein the lumen opening opens into the cup volume; and an intermediate member including a member body and a transmission portion of the member body, wherein the member body The body is configured to slidably translate within the tubular cavity to position the transmission portion within the cup volume, wherein the transmission portion is configured to be positioned within a cup recess on the cup surface and a device recess of the implantable medical device when the cup volume receives the implantable medical device and the transmission portion is positioned within the cup volume, wherein the transmission portion is configured to transmit the torque from the driver cup to the implantable medical device when the transmission portion is positioned within the cup recess and the device recess, and wherein the driver body, the driver cup and the intermediate member are configured to be positioned within an anatomical volume defined by the patient's body.

[0006] In one example, a method includes: using a driver body of a driver to apply a torque on a driver cup supported at a distal end of the driver body, wherein the driver body defines a lumen and a lumen opening; and using a transfer portion of an intermediate member positioned within a cup recess and a device recess to transfer the torque from the driver cup defining a cup volume to an implantable medical device within the cup volume, wherein the lumen opening opens to the cup volume, wherein the cup recess is defined by the driver cup and the device recess is defined by the implantable medical device, wherein the intermediate member includes a member body, the member body including the transfer portion, wherein the member body is slidably translatable within the lumen, and wherein the driver body, the driver cup, and the intermediate member are positioned within an anatomical volume defined by the patient's body.

[0007] In an example, a medical system includes: a driver container capable of rotating relative to a longitudinal axis of the medical system, the driver container including a container surface defining a container volume, the container volume being configured to receive at least a proximal portion of an implantable medical device; and an intermediate member including a member body and a transfer portion of the member body, wherein the member body is configured to translate longitudinally relative to the container to position the transfer portion along the container volume, wherein the transfer portion is configured to be positioned within a container recess of the container surface when the container volume receives the implantable medical device and the transfer portion is positioned within the container volume, wherein the transfer portion is configured to transfer the torque from the driver container to the implantable medical device when the transfer portion is positioned within the container recess, and wherein the driver body, the driver container, and the intermediate member are configured to be positioned within an anatomical volume defined by a patient's body.

[0008] The details of one or more examples are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Figure 1 is a conceptual diagram illustrating an example medical system and delivery catheter within the heart.

[0010] Figure 2 is a perspective view of an example medical system including a driver, an intermediate member, and a delivery catheter.

[0011] Figure 3 is a cross-sectional diagram of an example medical system.

[0012] Figure 4 is a perspective view of an example medical system with an implantable medical device positioned within a driver cup.

[0013] Figure 5 is a cross-sectional view of an example medical system having an implantable medical device positioned within a driver cup.

[0014] Figure 6 is a cross-sectional view of a cup recess of a driver cup and a transmission portion within a device recess of an implantable medical device.

[0015] Figure 7 It is the device that transmits torque from the driver cup to the implanted medical device. Figure 6 Cross-sectional view of the transfer section.

[0016] Figure 8 is a perspective view of an example driver cup.

[0017] Fig. 9 is a cross-sectional view of an example driver cup and intermediate member.

[0018] Fig.10 is a schematic diagram of an intermediate member including a circular tether.

[0019] Fig.11 is a perspective view of an example loop tether engaging an implantable medical device.

[0020] Fig.12 is a cross-sectional view of a transmission portion defined by a cup recess of a driver cup and a loop tether within a device recess of an implantable medical device.

[0021] Fig.13 Is Fig.12 A cross-sectional view of a loop of a tether defining a transfer portion for transferring torque from a driver cup to an implantable medical device.

[0022] Fig.14 Example techniques for transmitting torque to an implantable medical device are illustrated. DETAILED DESCRIPTION

[0023] The present disclosure describes a medical system configured to deliver, position, and / or retrieve an implantable medical device ("IMD") within an anatomical volume (e.g., a chamber of the heart) within a patient's body. The medical system is configured to receive a torque (e.g., from a clinician) and apply the torque to the IMD to implant, retrieve, reposition, and / or reorient the IMD in the anatomical volume. In an example, the medical system is configured such that the IMD can rotate about a device axis when the medical system applies the torque. Rotation of the implantable medical device can cause an attachment member of the implantable medical device to engage tissue at a target site, disengage tissue at the target site, and / or otherwise reorient the medical device within the patient's body.

[0024] The medical system includes a driver (e.g., an elongated body) configured to receive torque (e.g., from a clinician) and apply the torque to a container or cup ("driver cup" or "driver container") at a distal end of the driver. The driver cup defines a cup volume that is configured to receive at least some portion of the implantable medical device. In an example, the driver is configured to be at least partially positioned within the vasculature of the patient when the driver cup is positioned within the anatomical volume. In some examples, the driver includes a proximal portion configured to be external to the patient and a distal portion configured to be within the patient. The distal portion may support the driver cup. The medical system may be configured such that torque applied to the proximal portion (e.g., by a clinician) causes the distal portion to apply torque to the driver cup. The medical system is configured to transfer torque from the driver cup to the IMD to implant, retrieve, reposition and / or reorient the IMD. In an example, the IMD includes an attachment member (e.g., a spiral) configured to engage or disengage tissue based on rotation of the IMD. The medical system can transmit torque from the driver cup to the IMD to cause the IMD to rotate such that the attachment member engages with or disengages from tissue.

[0025] The medical system includes an intermediate member configured to transfer torque from a driver cup to the IMD when the cup volume accommodates the IMD. The intermediate member is configured to be positioned substantially between the driver cup and the IMD when the cup volume accommodates the IMD, such that when the driver cup applies torque on the intermediate member, the intermediate member applies torque to the IMD. In an example, the intermediate member is configured to be positioned within a cup recess defined within the cup volume and a device recess defined by the IMD when the intermediate member is positioned between the driver cup and the IMD. The cup recess may be configured such that a portion of the intermediate member protrudes from the cup recess when the intermediate member is positioned in the cup recess. The protruding portion may reside within the device recess of the IMD such that the intermediate portion receives torque from the cup recess and transfers the torque to the device recess, thereby transferring the torque to the IMD. The device recess may be formed by, for example, a proximal portion of the IMD, a retrieval structure of the IMD, or some other portion of the IMD.

[0026] The driver (e.g., driver body) defines a lumen ("driver lumen") and a driver lumen opening that opens into a cup volume defined by the driver cup. The intermediate member is configured to slidably translate within the driver lumen such that a clinician can translate the intermediate member proximally and / or distally within the driver lumen and / or translate the driver and driver cup relative to the intermediate member. The relative translation can facilitate positioning the intermediate member within the cup recess and the device recess such that the intermediate member can transmit torque from the driver cup to the IMD. The intermediate member can include a proximal portion configured to be external to the patient's body and a distal portion configured to be internal to the patient's body (e.g., within the driver lumen).

[0027] For example, the intermediate member may be configured to extend through the cup volume and distally beyond the driver cup such that the intermediate member may be positioned within a device recess of an IMD (e.g., an implanted IMD) distal to the driver cup. The driver and driver cup may be advanced distally on the intermediate member such that the cup volume receives the IMD and the positioned intermediate member. The driver cup may be configured such that the intermediate member is positioned within the cup recess when the cup volume receives the IMD such that the intermediate member is positioned in both the device recess and the cup recess. In some examples, the intermediate member may extend into the cup volume, and the driver cup may be configured to receive the IMD with the intermediate member extending within the cup volume. The driver cup may be configured to rotate relative to the IMD such that the rotation causes the intermediate member to position the cup recess and / or the device recess (e.g., embed in the cup recess and / or the device recess) such that the intermediate member is positioned in both the device recess and the cup recess. With the intermediate member positioned in the cup recess and the device recess, the intermediate member may transmit torque applied to the driver cup (e.g., by the driver) to the IMD.

[0028] The use of an intermediate member can alleviate any mechanical coupling requirements that may exist between the driver cup and the IMD in order to use the cup to apply torque to the IMD. For example, in some systems, the cup can be configured as a socket that is intended to mechanically mate with the proximal end of the IMD to transfer torque. The cup can define a recess configured to receive a protrusion defined by the IMD, and / or define a protrusion configured to be inserted into a recess defined by the IMD. Therefore, the transfer of torque from the cup to the IMD may require relatively precise alignment between the cup and the IMD to achieve the necessary mechanical fit. There may be difficulties in achieving such relatively precise alignment when the cup and the device are positioned within a confined anatomical space of a patient (e.g., a chamber of the heart).

[0029] In contrast, the use of an intermediate member to transfer torque received from the cup recess to the device recess can alleviate this alignment burden. For example, the cup recess and / or the device recess can be relatively larger than the intermediate member, thereby alleviating the difficulty of positioning the intermediate member in the cup recess and / or the device recess. The larger cup recess can be configured so that when the driver cup rotates relative to the IMD, the cup recess support surface substantially drives the intermediate member into the device recess support surface, so that despite the larger size of the cup recess and / or the device recess relative to the intermediate member, the intermediate member still transfers torque from the driver cup to the IMD. The relatively large size of the cup recess and / or the device recess relative to the intermediate member can alleviate any alignment requirements that may exist between the driver cup and the IMD for torque transfer.

[0030] The medical system may be configured such that the intermediate member substantially causes alignment between the cup recess and the device recess. In an example, a cup surface defining a cup volume may be configured such that rotation of the cup surface around a portion (e.g., a proximal portion) of the IMD (e.g., by rotating the driver cup) causes the intermediate member to slide between the cup surface and the IMD until the intermediate member is inserted (e.g., embedded) in the cup recess and the device recess. For example, rotation of the driver cup relative to the IMD may cause the intermediate member to slide between the cup surface and the IMD until the intermediate member is embedded in the cup recess, wherein subsequent rotation of the driver cup and the slotted intermediate member causes a protruding portion of the intermediate member to embed in the device recess, such that the intermediate member can transfer torque from the driver cup to the IMD. Alternatively, rotation of the driver cup relative to the IMD may cause the intermediate member to slide between the cup surface and the IMD until the intermediate member is embedded in the device recess, wherein subsequent rotation of the driver cup and the device slotted intermediate member causes a portion of the intermediate member to embed in the cup recess, such that the intermediate member can transfer torque from the driver cup to the IMD. Thus, using an intermediate member to transfer torque from the driver cup to the IMD may ease the alignment burden on a clinician who desires to transfer torque from the driver cup to the IMD.

[0031] The medical system may include a delivery catheter including a delivery cup or container. The delivery cup may define a delivery cup volume that is configured to receive at least a portion of the driver cup, the intermediate member, and the IMD. The delivery catheter may define a delivery catheter lumen and a delivery lumen opening that opens to the delivery cup volume. The driver may be configured to translate slidably within the delivery catheter lumen and through the delivery lumen opening, so that the relative movement between the driver and the delivery catheter may position at least a portion of the driver cup, the intermediate member, and / or the IMD within the delivery cup volume and / or away from the delivery cup volume (via the delivery lumen opening). The delivery catheter may be configured to transfer through the patient's vascular system so that the driver cup, the intermediate member, and / or the IMD may be retrieved from the patient's anatomical volume (e.g., a heart chamber) and / or delivered to the patient's anatomical volume.

[0032] Figure 11 is a conceptual diagram of an example medical system 100 within the right atrium (“RA”) of an example heart 101. Medical system 100 includes a driver 102, which includes a driver body 104. Driver body 104 may include a distal portion 105 (“driver body distal portion 105”) and a proximal portion 107 (“driver body proximal portion 107”), the distal portion configured to be within a patient's body, and the proximal portion may be outside the patient's body when driver body distal portion 105 is within the body. Driver cup 106 is supported at a distal end 108 (“driver body distal end 108”) of driver body 104. In some examples, driver cup 106 and driver body 104 may be substantially separate components. In some examples, driver cup 106 may be substantially adjacent to driver body 104, such that driver cup 106 and driver body 104 define a unitary component. IMD 110 is positioned (e.g., inserted) within a cup volume 112 defined by driver cup 106. exist Figure 1 In an example, a proximal portion 114 of the IMD 110 ("IMD proximal portion 114") is positioned within the cup volume 112. The IMD 110 may include a distal portion 116 ("IMD distal portion 116") opposite the IMD proximal portion 114. In an example, the driver cup 106 includes a cup surface (e.g., cup surface 113 ( Figure 2 , Figure 3 , Figures 6 to 9 )).

[0033] In examples, the IMD 110 (e.g., the IMD distal portion 116) supports an attachment member 118 that is configured to engage tissue within a target site 120 of an anatomical volume. The attachment member 118 may be supported in the IMD distal portion 116. In some examples, the attachment member 118 is configured (e.g., as a helix) such that rotation of the IMD 110 about a device axis LD defined by the IMD 110 causes the attachment member to engage and / or disengage tissue from the target site 120. For example, the attachment member 118 may be configured such that rotation of the IMD 110 about the device axis LD in a first rotational direction W1 causes the attachment member 118 to engage tissue within the target site 120 (or, alternatively, disengage from these combinations). The attachment member 118 may be configured such that rotation of the IMD 110 about the device axis LD in a second rotational direction W2 substantially opposite to the first rotational direction W1 causes the attachment member 118 to disengage from (or alternatively, engage a combination of) tissue within the target site 120. In an example, the IMD 110 includes one or more components (e.g., a communication antenna, a sensor, or another component) that are configured to rotate and / or turn about the device axis LD when the IMD 110 is rotated about the device axis LD. The medical system 100 may cause the IMD 110 to rotate about the device axis LD so that one or more of these components substantially establish a specific orientation relative to the patient's anatomy, another device implanted in or worn by the patient, another device external to the patient, and / or other devices.

[0034] The driver body 104 is configured to receive torque (e.g., from a clinician) and transmit the torque to the driver cup 106. The medical system 100 includes an intermediate member 122 that is configured to be positioned within the cup volume 112 between the driver cup 106 and the IMD proximal portion 114 to transmit torque from the driver cup 106 to the IMD proximal portion 114. The intermediate member 122 includes a body 119 ("member body 119"). The member body 119 can be a substantially elongated body. In an example, the intermediate member 122 (e.g., member body 119) includes a transmission portion 125 (e.g., a distal end portion of the member body 119) that is configured to be positioned within the cup volume 112 between the driver cup 106 and the IMD proximal portion 114 to transmit torque. The intermediate member 122 can be positioned within a cup recess (e.g., cup recess 156 ( Figures 2 to 9 , Fig.12 , Fig.13 )) and a device recess (e.g., device recess 154 ( Figures 2 to 7 , Fig.12 , Fig.13)). Intermediate member 122 is configured such that when intermediate member 122 receives torque from driver cup 106 (e.g., from a surface defining a cup recess) and intermediate member 122 is positioned in the device recess, intermediate member 22 applies torque to the IMD (e.g., a surface defining a device recess). Thus, medical system 100 is configured to mechanically couple driver cup 102 and IMD 110 using at least intermediate member 22 such that torque applied to driver body 104 may cause rotation of IMD 110 in first rotational direction W1 and / or second rotational direction W2.

[0035] The driver 102 (e.g., the driver body 104) defines a lumen 124 ("driver lumen 124") and a lumen opening 126 ("driver lumen opening 126") located at the driver body distal end 108. The driver lumen opening 126 opens to the cup volume 112. The intermediate member 122 (e.g., the member body 119) is configured to be slidably translated within the driver lumen 124 such that the intermediate member 122 can translate relative to the driver body 104 and the driver cup 106 in the distal direction D and / or the proximal direction P (and vice versa). The relative translation between the intermediate member 122 and the driver body 104 and / or the driver cup 106 can help position the intermediate member 122 within the cup recess and / or the device recess. In an example, the medical system 100 is configured such that when the intermediate member 122 is located between the driver cup 106 and the IMD 110 (e.g., the IMD proximal portion 114), rotation of the driver cup 106 relative to the IMD 110 (e.g., by applying torque to the driver body 104) can cause the intermediate member 122 to be inserted into at least one or both of the cup recess and the device recess, such that the intermediate member 122 can transfer torque from the driver cup 106 to the IMD 110.

[0036] The intermediate member 122 may include a distal portion 121 ("intermediate member distal portion 121") and a proximal portion 123 ("intermediate member proximal portion 123"), the distal portion being configured to be within the patient's body (e.g., within the driver lumen 124), and the proximal portion being external to the patient's body when the intermediate member distal portion 121 is within the body. The intermediate member distal portion 121 may include a transmission portion 125. In an example, the member body 119 defines the intermediate member distal portion 121 and the intermediate member proximal portion 123.

[0037] The medical system 100 may include a delivery catheter 128 configured to retrieve the driver cup 106, the intermediate member 122, and / or the IMD 110 from an anatomical volume (e.g., RA) of a patient. In an example, the delivery catheter 128 is configured to deliver the driver cup 106, the intermediate member 122, and / or the IMD 110 to the anatomical volume of the patient. For clarity, in Figure 1 1 and 2. Delivery catheter 128 is illustrated as transparent. Delivery catheter 128 may include a distal portion 127 ("delivery catheter distal portion 127") configured to be within the patient's body, and a proximal portion 129 ("delivery catheter proximal portion 129") that may be outside the patient's body when delivery catheter distal portion 127 is within the body. In examples, delivery catheter 128 is configured to deliver and / or retrieve driver cup 106, intermediate member 122, and / or IMD 110 using the patient's vasculature (such as an IVC or other vasculature leading to an anatomical volume).

[0038] In an example, the delivery conduit 128 includes a delivery cup 130 or defines a delivery cup volume (eg, a delivery cup volume 132 ( Figures 2 to 5 , Fig.11 )) of a container configured to receive driver cup 106, intermediate member 122, and at least a portion of IMD 110. Delivery catheter 128 can define a lumen 141 ("delivery catheter lumen 141") and a delivery lumen opening (e.g., delivery lumen opening 137) that opens to delivery cup volume 132. Figure 3 to Figure 4 )). At least the driver body 104 can be configured to slidably translate within the delivery catheter lumen 141 and through the delivery lumen opening, such that relative movement between the driver body 104 and the delivery catheter 128 can cause relative movement between the driver cup 106, the intermediate member 122, and / or the IMD 110 and the delivery catheter 128. The delivery cup 130 can be configured to slide at a distal end of the delivery cup 130 (e.g., the delivery cup distal end 136, Figures 2 to 5 ) defines an opening (eg, a delivery cup opening 134 ( Figure 3 , Figure 4 )). The delivery cup opening can be configured such that driver cup 106, intermediate member 122, and at least a portion of IMD 110 can pass therethrough.

[0039] Delivery catheter 128 can be configured to retrieve IMD 110 when IMD 110 is anchored to tissue within target site 120 (e.g., anchored by attachment member 118). For example, delivery catheter 128 can be configured to be translated through the patient's vasculature to position driver cup 106 and intermediate member 122 proximate to IMD 110 when IMD 110 is anchored to tissue within target site 120. Delivery catheter 128 can be configured such that a force on intermediate member 122 in distal direction D (e.g., applied by a clinician) causes intermediate member 122 to extend distally of a delivery cup opening of delivery cup 130 (e.g., toward IMD 110). Delivery catheter 128 can be configured such that a force on driver body 104 in distal direction D (e.g., applied by a clinician) causes driver cup 106 to extend distally of a delivery cup opening of delivery cup 130 (e.g., toward IMD 110). The delivery catheter 128 (e.g., the driver cup 130) can be configured to receive the driver cup 106, the intermediate member 122, and a portion of the IMD 110 when the intermediate member 122 is positioned between the driver cup 106 and the IMD 110. For example, the delivery catheter 128 can be moved in a distal direction D relative to the driver cup 106, the intermediate member 122, and the IMD 110 to receive at least a portion of the driver cup 106, the intermediate member 122, and the IMD 110. The delivery catheter 128 can be configured to remove the driver cup 106, the intermediate member 122, and the IMD 110 from the patient's anatomical volume (e.g., RA) once, for example, the driver cup 106 and the intermediate member 122 have applied torque to the IMD 110 to disengage the attachment member 118 from tissue within the target site 120. Subsequently, the delivery catheter 128, the driver cup 106, the intermediate member 122, and the IMD 110 can be retracted from the patient (e.g., via the patient's vasculature).

[0040] In an example, delivery catheter 128 is configured to position IMD 110 proximate target site 120 such that IMD 110 can be anchored to tissue within target site 120 (e.g., anchored by attachment member 118). For example, delivery catheter 128 can be configured to position IMD 110 proximate target site 120 when IMD 110 is positioned within cup volume 112 and intermediate member 122 is positioned between driver cup 106 and IMD 110 (e.g., when intermediate member 122 is positioned within cup recess 156 and device recess 154). Figures 5 to 7 , Fig.1213), positioning the driver cup 106 and the intermediate member 122 within the delivery cup volume. The delivery catheter 128 can be configured to traverse the patient's vasculature to position the IMD 110 (e.g., the attachment member 118) within or near the target site 120. When the attachment member 118 is within or near the target site 120, the medical system 100 (e.g., the driver body 104, the driver cup 106, and the intermediate member 122) can apply a torque to the IMD 110 to cause the attachment member 118 to engage tissue (e.g., tissue within the target site 120). The medical system 100 can be configured such that when the IMD 110 remains anchored to tissue within or near the target site 120, a force on the driver body 104 in the proximal direction P causes the driver cup 106 and / or the intermediate member 122 to detach from the IMD 110. Subsequently, the delivery catheter 128 , driver cup 106 , and intermediate member 122 may be withdrawn from the patient (eg, via the patient's vasculature).

[0041] Although the examples herein discuss delivery, retrieval, and / or positioning of IMD 110 within the RA of heart 101, medical system 100 may be configured to position IMD 110 in any other chamber of heart 101 and / or other anatomical volumes of a patient in a manner similar to that described for the RA of heart 101. In addition, although the examples herein discuss attachment member 118 defining a helix, attachment member 118 may also define other structures, such as one or more elongated tines extending from, for example, IMD distal portion 116. Target site 120 may include an appendage of the RA, or a triangle of Koch's zone of the RA, or some other portion of heart 101, or some other location within the patient's body.

[0042] Figure 2 A perspective view of the medical system 100 is illustrated, wherein the intermediate member 122 extends distally of the driver cup 106 and the delivery cup 130 of the delivery catheter 128. The driver cup 106 defines an opening 131 ("driver cup opening 131") that opens to the cup volume 112. In the example, a distal end 133 of the driver cup 106 ("driver cup distal end 133") defines the driver cup opening 131. Figure 2 , the driver cup 106 is positioned within a cup volume 132 ("delivery cup volume 132") defined by the delivery cup 130. For clarity, in Figure 2 The delivery catheter 128 and the driver body 104 are presented as transparent. Figure 3 A cross-sectional view of the medical system 100 taken along a cutting plane parallel to the longitudinal axis L defined by the driver body 104 is illustrated, wherein the intermediate member 122 extends distally of the driver cup 106 and the driver cup 106 extends distally of the delivery cup 130 (via the driver body 104 ).

[0043] The driver cup opening 131 is configured (e.g., sized) such that the cup volume 112 can receive the IMD 110 via the driver cup opening 131. For example, the driver cup opening 131 can be sized such that when the cup volume 112 receives the IMD 110 (e.g., the IMD proximal portion 114), at least a portion of the IMD 110 (e.g., the IMD proximal portion 114) can pass through the driver cup opening 131 in the proximal direction P. In an example, the driver cup opening 131 is configured (e.g., sized) such that the IMD 110 can exit the cup volume 112 via the driver cup opening 131. For example, driver cup opening 131 may be sized such that IMD 110 (eg, IMD proximal portion 114 ) may pass through driver cup opening 131 in distal direction D when IMD 110 exits cup volume 112 (eg, when driver cup 106 is proximally retracted from IMD 110 by driver body 104 ).

[0044] The delivery cup 130 defines an opening 134 ("delivery cup opening 134") at a distal end 136 of the delivery cup 130 ("delivery cup distal end 136") that opens to the delivery cup volume 132. The delivery cup opening 134 is sized such that the intermediate member 122, the driver cup 106, at least some portion of the driver body distal portion 105, and / or at least the IMD proximal portion 114 can pass through the delivery cup opening 134 in a proximal direction P and / or in a distal direction D. In an example, the delivery catheter 128 defines a lumen 141 ("delivery catheter lumen 141") that opens to the delivery cup volume 132. The delivery catheter lumen 141 is configured such that at least the driver body 104 can translate in the distal direction D and / or in the proximal direction P within the delivery catheter lumen 141.

[0045] The driver body 104 can translate in a distal direction D and / or a proximal direction P relative to the intermediate member 122, the delivery catheter 128, and / or the IMD 110 (e.g., within the delivery catheter lumen 141). The driver body 104 can be configured such that a force applied to the driver body 104 (e.g., by a clinician) causes the driver body 104 to translate within the delivery catheter lumen 141, and the translation of the driver body 104 causes the driver cup 106 to translate. The driver body 104 can be configured to change the position of the driver cup 106 relative to the intermediate member 122, the delivery catheter 128, and / or the IMD 110. For example, the driver cup 106 can move in a distal direction D substantially toward the IMD 110 (e.g., by a clinician applying a force on the driver body 104) to cause the cup volume 112 to receive the IMD proximal portion 114 (and / or the intermediate member 122). The driver cup 106 can be moved substantially away from the IMD 110 in a proximal direction P (e.g., by a clinician applying a force on the driver body 104) to cause the IMD 110 (and / or the intermediate member 122) to exit the cup volume 112. The driver body 104 can be configured to translate within the delivery catheter lumen 141 such that the driver cup 106 and / or other portions of the driver body 104 are positioned distally and / or proximally of either or both of the delivery cup opening 134 and / or the distal end 157 of the intermediate member 122 ("intermediate member distal end 157"). For example, the driver cup 106 can be positioned distally of the delivery cup opening 134 (e.g., Figure 3 ) and / or may be positioned proximal to the delivery cup opening 134 (e.g. Figure 2 , Figure 4 , Figure 5 ).

[0046] IMD 110 (which, in some examples, may include a pacemaker such as a leadless pacemaker and / or a fully intracardiac pacemaker) may include one or more electrodes, such as electrode 142 supported by attachment member 118, electrode 144 supported by housing 146 of IMD 146 ("IMD housing 146"), and / or electrode 148 (e.g., a return electrode) supported by IMD housing 110. One or more of electrodes 142, 144, 148 may be electrically connected to operational circuitry 150. Operational circuitry 150 may be configured to deliver therapy to a patient and / or sense physiological signals of the patient using electrodes 142, 144, 148. In an example, at least a portion of operational circuitry 150 is supported by IMD housing 146. In some examples, at least a portion of operational circuitry 150 is supported by another device displaced from IMD 110 (such as another device within the patient's body and / or another device outside the patient's body). In an example, the IMD 110 (e.g., the IMD proximal portion 114) includes a retrieval structure 140 that is configured to engage with the medical system 100 and / or another medical device to, for example, implant the IMD 110 within an anatomical volume, retrieve the IMD 110 from the anatomical volume, and / or otherwise reorient the IMD 110 when the IMD 110 is positioned within the anatomical volume.

[0047] As discussed, intermediate member 122 is configured to translate in a distal direction D and / or a proximal direction P relative to driver body 104, driver cup 106, delivery catheter 128, and / or IMD 110 (e.g., within driver lumen 124). Relative translation of intermediate member 122 allows the position of transmission portion 125 relative to driver cup 106 and / or IMD 110 to change such that transmission portion 125 may be positioned within device recess 154 defined by IMD 106 (e.g., IMD proximal portion 114 and / or retrieval structure 140) and / or cup recess 156 defined by driver cup 110 (e.g., defined by cup surface 113). For example, intermediate member 122 may be configured such that (e.g., by a clinician) application of force to intermediate member proximal portion 123 ( Figure 1 ) causes a change in the position of the transmission portion 125 relative to the driver cup 106 and / or the IMD 110. The intermediate member 122 can be configured to translate within the driver lumen 124 such that the transmission portion 125 and / or other portions of the intermediate member distal portion 121 can be positioned distally and / or proximally of either or both of the driver cup opening 131 and / or the delivery cup opening 134.

[0048] In an example, the member body 119 defines a lumen 159 ("member lumen 159"). The member lumen 159 can extend at least partially through the intermediate member distal portion 121 and / or the intermediate member proximal portion 123. In an example, the member body 119 defines an opening 161 ("member lumen opening 161") at the intermediate member distal end 157 that opens to the member lumen 159. The intermediate member 122 can be configured to translate within the driver lumen 124 such that the member lumen opening 161 can be positioned distally and / or proximally of either or both of the driver cup opening 131 and / or the delivery cup opening 134.

[0049] Figure 4 A perspective view of medical system 100 is illustrated with intermediate member 122 and IMD 110 positioned within cup volume 112 ( Figure 2 , Figure 3 , Figure 5 ), and the driver cup 106, the intermediate member 122, and the IMD 110 are positioned within the delivery cup volume 132. For clarity, Figure 4 The delivery catheter 128 and the driver body 104 are presented as transparent. Figure 5 Illustrated along the Figure 3 1 , wherein intermediate member 122 and IMD 110 are positioned within cup volume 112 , and driver cup 106 , intermediate member 122 , and IMD 110 are positioned within delivery cup volume 132 .

[0050] like Figure 4 , Figure 5, the driver body 104 and the driver cup 106 can be advanced distally (e.g., in the distal direction D) toward the IMD 110 so that the cup volume 112 receives the IMD 110 (e.g., the IMD proximal portion 114) and / or the transmission portion 125. In an example, the cup volume 112 can receive the IMD 110 and the transmission portion 125 when the transmission portion 125 is positioned within the device recess 154. The driver cup 106 can be configured such that the intermediate member 122 is positioned within the cup recess 156 when the cup volume 112 receives the IMD 110, such that the intermediate member 122 (e.g., the transmission portion 125) is positioned in both the device recess 154 and the cup recess 156. For example, the driver cup 106 can be configured to rotate relative to the IMD 110. Rotation of the driver cup 106 relative to the IMD 110 (e.g., when the intermediate member is positioned between the driver cup 106 and the IMD 110) can cause the intermediate member 122 to be positioned (e.g., embedded) in the cup recess 156 and / or the device recess 154, such that the intermediate member 122 (e.g., the transfer portion 125) is positioned in both the cup recess 156 and the device recess 154. With the intermediate member 122 positioned in the cup recess 156 and the device recess 154, the intermediate member 122 can transfer a torque applied to the driver cup 106 (e.g., by the driver body 104) to the IMD 110, for example, to engage the attachment member 118 with tissue, disengage the attachment member from tissue, and / or otherwise reorient the IMD 110.

[0051] Figure 6 Illustrated along the Figure 5 The cross-sectional view of the medical system 100 is taken at a cutting plane A. The cutting plane A is substantially perpendicular to the longitudinal axis L. Figure 6 The intermediate member 122 (e.g., the transmission portion 125 and / or the member body 119) is illustrated as being positioned within a cup recess 156 of the driver cup 106 and positioned within a device recess 154 of the IMD 110. In an example, the device recess 154 is defined by the IMD proximal portion 114 and / or the retrieval structure 140. The IMD 110 (e.g., the IMD proximal portion 114 and / or the retrieval structure 140) is positioned within the cup volume 112 of the driver cup 106. In an example, the driver cup 106 defines additional cup recesses (such as the cup recess 160), which can be configured similarly to the cup recess 156. The IMD 110 can define additional device recesses (such as the device recess 162), which can be configured similarly to the device recess 154.

[0052] The intermediate member 122 (e.g., the transfer portion 125) is positioned within the cup recess 156 and the device recess 154 such that when the driver cup 106 applies a torque on the intermediate member 122, the intermediate member 122 applies the torque to the IMD 110. In an example, the driver cup 106 defines a cup recess surface 164 that is configured to apply a force on the intermediate member 122 to apply a torque on the intermediate member 122 when the driver cup 106 rotates about the longitudinal axis L. The intermediate member 122 can be configured to apply a force on the device recess surface 166 of the IMD 110 to transfer the torque from the driver cup 106 to the IMD 110. The cup recess surface 164 can be a portion of the cup surface 113. In an example, the cup recess surface 164 at least partially defines the cup recess 156. The device recess surface 166 can at least partially define the device recess 154. In an example, when driver cup 106 applies torque on intermediate member 122 , transfer portion 125 applies the torque to IMD 110 .

[0053] For example, Figure 7 The driver cup 106 is illustrated as being subjected to torque (eg, from the driver body 104 ( Figure 5 ) is applied), so that the driver cup 106 rotates along the rotation direction W. The rotation direction W can be, for example, a first rotation direction W1 or a second rotation direction W2 ( Figure 1 ). Rotation of the driver cup 106 causes the cup recess surface 164 to contact the intermediate member 122 (e.g., the member body 119) and exert a force on the intermediate member. In examples, the force applied from the cup recess surface 164 to the intermediate member 122 includes at least a force component that is substantially perpendicular to the longitudinal axis L. In response, the intermediate member 122 contacts and transmits at least some portion of the force (e.g., a torsional force) to the device recess surface 166 of the IMD 110. The portion of the force transmitted to the device recess surface 166 causes a resultant torque to be generated on the IMD 110 about the longitudinal axis L. Therefore, the action of the intermediate member 122 (e.g., the transfer portion 125) to transmit the force from the cup recess surface 164 to the device recess surface 166 serves to transmit the torque from the driver cup 106 to the IMD 110.

[0054] In an example, the cup recess 156 (e.g., the cup recess surface 164 defining the cup recess 156) is configured such that the transfer portion 125 rotates about (e.g., orbits around) the longitudinal axis L when the transfer portion 125 transfers torque from the driver cup 106 to the IMD 110. The transfer portion 125 can cause the device recess 154 (e.g., the device recess surface 166 defining the device recess 154) to rotate about the longitudinal axis L when the transfer portion 125 rotates about the longitudinal axis L. In an example, the IMD 110 is configured to rotate about the longitudinal axis L when the transfer portion 125 and / or the device recess 154 rotate about the longitudinal axis L. In an example, the transfer portion 125 exerts a force on the device recess surface 166 that includes at least a force component that is substantially parallel to the force exerted on the transfer portion 125 by the cup recess surface 164.

[0055] The intermediate member 122, the cup recess 156, and / or the device recess 154 can be configured to ease any alignment between the driver cup 106 and the IMD 110 that may be required prior to torque transfer. In an example, the intermediate member 122 is sized such that the cross-sectional dimension defined by the cup recess 156 and / or the device recess 154 is larger than the cross-sectional dimension defined by the intermediate member 122, such that the intermediate member 122 can be more easily positioned within the cup recess 156 and the device recess 154 simultaneously. For example, the intermediate member 122 (e.g., the transfer portion 125) can define a cross-sectional dimension D1. The cup recess surface 164 can define the cup recess 156 such that the cup recess 156 extends over a cross-sectional dimension D2, wherein the cross-sectional dimension D2 is larger than the cross-sectional dimension D1. In an example, the cross-sectional dimension D2 is at least 10%, at least 20%, at least 50%, at least 100%, or at least another percentage greater than the cross-sectional dimension D1.

[0056] Similarly, the device recess surface 166 can define the device recess 154 such that the device recess 154 extends substantially over the cross-sectional dimension D2. In examples, when the intermediate member 122 is simultaneously positioned in the cup recess 156 and the device recess 154, the cross-sectional dimension D1 is substantially parallel to the cross-sectional dimension D2. In some examples, when the intermediate member 122 is simultaneously positioned in the cup recess 156 and the device recess 154, the cross-sectional dimension D1 and the cross-sectional dimension D2 are substantially perpendicular to the longitudinal axis LM passing through the member body 119 (e.g., through the member lumen 159). The relatively large size of the cup recess 156 and / or the device recess 154 relative to the intermediate member 122 can alleviate any alignment requirements that may exist between the driver cup 106 and the IMD 110 so that the intermediate member 122 transmits torque from the driver cup 106 to the IMD 110. In other examples, at least some portions of the cup recess surface 164 and / or the device recess surface 166 are configured to substantially conform to at least some portions of a surface defined by the intermediate member 122 (eg, the transfer portion 145 ).

[0057] The member body 119 can be configured to bend and / or define a curvature (e.g., within the vasculature of a patient) and to transmit torque from the driver cup 106 to the IMD 110. In an example, the member body 119 defines a flexible portion that supports the transmission portion 125 and / or is adjacent to the transmission portion. The flexible portion can be, for example, a portion of the member body 119 that is proximal to the transmission portion 125 (e.g., one or more portions of the intermediate member distal portion 121 and / or the intermediate member proximal portion 123). In an example, the transmission portion defines a first stiffness and the flexible portion defines a second stiffness, wherein the first stiffness is greater than the second stiffness. The first stiffness can indicate the degree to which the transmission portion 125 resists deformation in response to a force on the transmission portion 125 (e.g., a force applied by the cup recess surface 164). The second stiffness can indicate the degree to which the flexible portion resists deformation in response to the force. Thus, the flexible portion (having a lower stiffness) may be configured to bend and / or define a curvature while the transfer portion 125 (having a higher stiffness) transfers torque from the driver cup 106 to the IMD 110 .

[0058] Figure 8 A perspective view of an example driver cup 106 of the medical system 100 is illustrated. Fig. 9 Example along Figure 8 The cutting plane B intercepts Figure 8 Cross-sectional view of the driver cup. Fig. 9 Illustrated are the intermediate member 122 within the driver lumen 124 and the transfer portion 125 positioned within the cup recess 156 and contacting the cup recess surface 164 .

[0059] The intermediate member 122 (e.g., the transfer portion 125) and / or the cup recess 156 can be configured such that when the intermediate member 122 is positioned in the cup recess 156 (e.g., when the intermediate member 122 contacts at least some portion of the cup recess surface 164), a portion 168 of the intermediate member 122 ("protruding portion 168") protrudes from the cup recess 156. The intermediate member 122 and / or the device recess 154 can be configured such that the protruding portion 168 can reside within the device recess 154 so that when the cup recess surface 164 transfers torque to the intermediate member 122, the protruding portion 168 can transfer torque to the device recess surface 166 (e.g., as Figure 7 depicted).

[0060] For example, the cup surface 113 (e.g., the cup recess surface 164) may define the cup recess 156 so that the cup recess 156 extends over a recess depth RD. The recess depth RD may be substantially perpendicular to the longitudinal axis L extending through the cup volume 112. The intermediate member 122 may be configured to define a displacement D3 greater than the recess depth RD. When the intermediate member 122 contacts the cup surface 113 (e.g., the cup recess surface 164), the displacement D3 may be substantially perpendicular to the longitudinal axis L. In an example (e.g., when the transfer portion 125 is substantially circular), the displacement D3 may be substantially the same as the displacement D1. The intermediate member 122 may be configured so that when the intermediate member 122 is positioned within the cup recess 156 (e.g., when the intermediate member 122 contacts the cup surface 113), the protrusion 158 defines a protrusion displacement PD that protrudes from the cup recess 156.

[0061] In some examples, the cup surface 113 includes a main cup surface 170 in addition to the cup recess surface 164. In examples, the main cup surface 170 and the cup recess surface 164 form contiguous portions of the cup surface 113. For example, the main cup surface 170 and the cup recess surface 164 may combine to define a corner portion of the cup surface 113, a curved portion of the cup surface 113, a substantially planar portion of the cup surface 113, or a portion of the cup surface 113 that exhibits another surface contour. Figure 8 and Fig. 9 The main cup surface 170 and the cup recess surface are depicted in FIG. Fig. 9 , a portion of the main cup surface 170 is depicted as a hidden line (eg, hidden by the intermediate member 122 positioned within the cup recess 156).

[0062] In an example, the main cup surface 170 defines a fourth displacement D4 (e.g., a first radius) from the longitudinal axis L, and the cup recess surface 164 defines a fifth displacement D5 (e.g., a second radius) from the longitudinal axis L. The fourth displacement D4 may be less than the fifth displacement D5. In an example, the fifth displacement D5 and the fourth displacement D4 (e.g., the difference between the fifth displacement D5 and the fourth displacement D4) define a recess depth RD of the cup recess 156. The fifth displacement D5 may be substantially parallel to the fourth displacement D4. In some examples, the fifth displacement D5 and the fourth displacement D4 are substantially perpendicular to the longitudinal axis L. In some examples, the main cup surface 170 is some portion of a first surface of rotation defined around the longitudinal axis L.

[0063] In some examples, the driver cup 106 (e.g., the main cup surface 170 and / or the cup recess surface 164 of the driver cup 106) and / or the IMD 110 can be configured such that the intermediate member 122 (e.g., the transfer portion 125) substantially causes an alignment between the cup recess 156 and the device recess 154 that is sufficient to enable the intermediate member 122 to transfer torque. For example, the driver cup 106 can be configured such that rotation of the cup surface 113 about a portion of the IMD 110 (e.g., the IMD distal portion 116) (e.g., by rotating the driver cup 106) causes the intermediate member 122 to slide between the cup surface 113 and the IMD 110 until the intermediate member 122 is inserted (e.g., embedded) into the cup recess 156 and / or the device recess 154.

[0064] For example, rotation of the driver cup 106 relative to the IMD 110 can cause the intermediate member 122 to slide between the cup surface 113 and the IMD 110 until the intermediate member 122 is embedded in the cup recess 156. Subsequent rotation of the driver cup 106 and the slotted intermediate member 122 can cause the protrusion 158 to embed in the device recess 154, such that the protrusion 158 can transfer torque from the driver cup 106 to the IMD 110. Alternatively, rotation of the driver cup 106 relative to the IMD 110 can cause the intermediate member 122 to slide between the cup surface 113 and the IMD 110 until the intermediate member 122 is embedded in the device recess 154. Subsequent rotation of the driver cup 106 and the device slotted intermediate member 122 can cause a portion of the intermediate member 122 (e.g., a portion other than the protrusion 158) to embed in the cup recess 156, such that the protrusion 158 can transfer torque from the driver cup 106 to the IMD 110. Thus, using cup surface 113 , main cup surface 170 , cup recess surface 164 , intermediate member 122 , and / or device recess 154 to transfer torque from driver cup 106 to IMD 110 may ease the alignment burden for clinicians desiring to transfer torque from driver cup 106 to IMD 110 .

[0065] In an example, the driver cup 106 (e.g., the cup surface 113) defines a support structure 171 that is configured to guide the intermediate member 122 into the cup recess 156. The support structure 171 may include a support surface 173 that is configured to protrude from the cup surface 113 (e.g., the main cup surface 170) toward the longitudinal axis L. In an example, the support structure 171 is substantially adjacent to the cup recess 156. The support surface 173 may be configured to contact the intermediate member 122 to stop and / or substantially prevent relative rotation between the cup surface 113 and some portion of the intermediate member 122 (e.g., the transfer portion 125), so that the intermediate member 122 is positioned within the cup recess 156.

[0066] The medical system 100 may be configured to exert a proximal force (e.g., a proximal force exerted by a clinician) on the IMD 110. The medical system 100 may be configured to engage the IMD 110 (e.g., the retrieval structure 140) to exert a proximal force on the IMD 110. The medical system 100 may exert a proximal force on the IMD 110 to cause the cup volume 112 to receive the IMD 110 and / or for other reasons. For example, the medical system 100 may exert a proximal force on the IMD 110 to cause the IMD 110 to move proximally relative to the driver cup 106, thereby causing the cup volume 112 to receive the IMD 110. The medical system 100 may exert a proximal force on the IMD 110 to help cause the driver cup 106 to move distally relative to the IMD 110, thereby causing the cup volume 112 to receive the IMD 110. The medical system 100 can be configured to apply a proximal force on the IMD 112 when the IMD 110 is within the cup volume 132 (e.g., after the cup volume 112 has received the IMD 110), for example, to cause the delivery cup volume 110 of the delivery catheter 128 to receive the driver cup 106 and the IMD 110. In an example, the medical system 100 defines a loop (e.g., a snare loop 176 ( Figure 2 )、Tether ring 182( Figures 10 to 13 )), the ring is configured to engage IMD 110 (eg, retrieval structure 140) to enable application of a proximal force (eg, a proximal force applied by a clinician).

[0067] In some examples, the medical system 100 includes a snare 172 ( Figure 2), the snare includes a body 174 ("snare body 174") supporting a loop 176 ("snare loop 176"). The snare body 174 can be an elongated body defining a proximal portion 178 ("snare proximal portion 178") and a distal portion 180 ("snare distal portion 180"). The snare 172 can support the snare loop 176 with the snare distal portion 180. In examples, the snare proximal portion 178 is configured to be outside the patient's body when the snare distal portion 180 and / or at least some portion of the snare loop 176 are inside the patient's body.

[0068] The snare loop 176 is configured to engage the IMD 110 (e.g., the retrieval structure 140). The snare 172 is configured such that when the snare loop 176 is engaged with the IMD 110, a proximal force (e.g., in the proximal direction P) applied to the snare body 174 (e.g., by a clinician) causes the snare loop 176 to apply a proximal force on the IMD 110. In examples, at least the snare body 174 is configured to slidably translate within a lumen (e.g., the member lumen 159, the driver lumen 124, and / or the delivery catheter lumen 141) of the medical system 100 such that the snare loop 176 applies a proximal force on the IMD 110. Some portion or substantially all of the snare loop 176 may be configured to slidably translate within a lumen of the medical system 100 as the snare body 174 translates within the lumen. For example, the snare loop 176 is configured to at least partially collapse to slidably translate within a lumen of the medical system 100. In examples, the snare body 174 is sufficiently flexible to define a bend and / or curvilinear shape within a lumen of the medical system 100. In some examples, the snare body 174 can be sufficiently rigid to allow the snare loop 176 to extend distally beyond the driver cup opening 131 to engage with (e.g., capture) the IMD 110. The snare loop 176 and / or the snare body 174 can be resiliently biased such that the snare loop 176 substantially establishes a particular orientation relative to the snare body 174 when the snare loop 176 is not constrained by the lumen of the medical system. For example, the snare loop 176 and / or snare body 174 may be resiliently biased such that the snare loop 176 and snare body 174 define an angle (e.g., an angle of approximately 90 degrees, approximately 45 degrees, or some other angle) when the snare loop 176 is unconstrained by a lumen of a medical system.

[0069] In some examples, intermediate member 122 includes a ring configured to engage IMD 110. For example, Fig.10 An intermediate member 122 (eg, member body 119 ) supporting a tether loop 182 is illustrated. Fig.11Medical system 100 is illustrated with tether loop 182 engaging IMD 110 (eg, retrieval structure 140).

[0070] Intermediate member 122 can support tether loop 182 using intermediate member distal portion 121 and / or intermediate member distal end 157. Tether loop 182 is configured such that when tether loop 182 is engaged with IMD 110 (e.g., as Fig.11 174 ), a proximal force (e.g., in a proximal direction P) applied to the member body 119 (e.g., by a clinician) causes the tether loop 182 to apply a proximal force on the IMD 110. The tether loop 182 can be configured to engage the IMD 110 in the same or similar manner as described for the snare loop 176. The tether loop 182 can be configured relative to the member body 119 in the same or similar manner as the snare loop 176 is configured relative to the snare body 174. For example, the member body 119 can be configured such that the tether loop 182 applies a proximal force on the IMD 110 when the member body is slidably translated in the proximal direction P within the driver lumen 124. Some portion or substantially all of the tether loop 182 can be configured to slidably translate within the driver lumen 124 when the member body 119 is translated within the driver lumen 124. In some examples, member body 119 can be sufficiently rigid to allow tether loop 182 to extend distally beyond driver cup opening 131 to engage (e.g., capture) IMD 110. In examples, tether loop 182 and / or member body 119 can be resiliently biased such that tether loop 182 substantially establishes a particular orientation (e.g., an angle of approximately 90 degrees, approximately 45 degrees, or some other angle) relative to member body 119 when tether loop 182 is unconstrained by driver lumen 124.

[0071] As discussed, the driver body 104 is configured to transmit torque (e.g., torque about the longitudinal axis L) to the driver cup 106 to cause rotation of the driver cup 106 (e.g., about the longitudinal axis L). The driver body 104 can be mechanically connected to the driver cup 106 in any manner that establishes a rotational coupling between the driver body 104 and the driver cup 106 (such as by welding, brazing, adhesive, pins, or some other suitable fastening method). In some examples, the driver body 104 may include a torque coil 188. The torque coil 188 may have a helical form that substantially surrounds the helical interior. The torque coil 188 may be configured within the medical system 100 such that the longitudinal axis L passes through at least some portion of the helical interior. In some examples, the helical interior defines at least a portion of the driver lumen 124.

[0072] In the example, portions of the tether loop 182 define the transfer portion 125 of the intermediate member 122. For example, Fig.12Illustrated along with Figure 5 A cutting plane A is similar to a cutting plane that cuts a cross-sectional view of the medical system 100 . Fig.12 Tether loop 182 is illustrated as being engaged with IMD 110 (eg, retrieval structure 140). Fig.12 15 , tether loop 182 is illustrated in phantom as engaging IMD 110 for clarity. Tether loop 182 is configured such that when tether loop 182 engages IMD 110, first portion 184 of tether loop 182 (“first loop portion 184”) and / or second portion 186 of tether loop 182 (“second loop portion 186”) may be positioned within cup recess 156 and / or device recess 154. Tether loop 182 is configured such that when first loop portion 184 and / or second loop portion 186 are positioned within cup recess 156 and device recess 154 and driver cup 106 applies torque on first loop portion 184 and / or second loop portion 186, first loop portion 184 and / or second loop portion 186 apply the torque to IMD 110. The first ring portion 184 and / or the second ring portion 186 can be individually or collectively configured with respect to the driver cup 106 in the same or similar manner as the intermediate member 122 and / or the transfer portion 125 are configured with respect to the driver cup 106. For example, the cup recess surface 164 can be configured to exert a force on the first ring portion 184 and / or the second ring portion 186 when the driver cup 106 is rotated about the longitudinal axis L. The first ring portion 184 and / or the second ring portion 186 can be configured to exert a force on the device recess surface 166 to transfer torque from the driver cup 106 to the IMD 110. The first ring portion 184 and / or the second ring portion 186 can define the protrusion 158.

[0073] For example, Fig.13 The driver cup 106 is illustrated as being subjected to torque (eg, from the driver body 104 ( Figure 5 ) is applied), thereby causing the driver cup 106 to rotate in the rotational direction W. The rotation of the driver cup 106 causes the cup recess surface 164 to contact the first ring portion 184 and / or the second ring portion 186 and exert a force on the first ring portion and / or the second ring portion. In an example, the force applied from the cup recess surface 164 to the first ring portion 184 and / or the second ring portion 186 includes at least a force component that is substantially perpendicular to the longitudinal axis L. In response, the first ring portion 184 and / or the second ring portion 186 contacts at least some portion of the force (e.g., a torsional force) and transmits it to the device recess surface 166. The portion of the force transmitted to the device recess surface 166 causes a resultant torque to be generated on the IMD 110 about the longitudinal axis L. Therefore, the action of the first ring portion 184 and / or the second ring portion 186 to transmit the force from the cup recess surface 164 to the device recess surface 166 serves to transfer the torque from the driver cup 106 to the IMD 110.

[0074] The operating circuit 150 may include fixed function circuits and / or programmable operating circuits. In an example, the operating circuit 150 may include circuits configured to perform one or more functions of the operating circuit 150, such as treatment delivery circuits, sensing circuits, processing circuits, switching circuits, communication circuits, and / or other circuits. The operating circuit 150 and other processors, processing circuits, controllers, control circuits, etc. described herein may include any combination of integrated circuits, discrete logic circuits, analog circuits, such as one or more microprocessors, digital signal processors (DSPs), application specific integrated circuits (ASICs), or field programmable gate arrays (FPGAs). In some examples, the operating circuit 150 includes multiple components, such as one or more microprocessors, one or more DSPs, one or more ASICs, or one or more FPGAs, as well as any combination of other discrete or integrated logic circuits and / or analog circuits.

[0075] Functions attributed to the operating circuit 150 may be embodied as software, firmware, hardware, or any combination thereof. The operating circuit 150 may include, for example, various capacitors, transformers, switches, etc. configured to perform the functions of the operating circuit 150. In an example, the operating circuit 150 may be configured to communicate with another device (such as a patient input / output device, a clinician input / output device, and / or other devices). The operating circuit 150 may include any suitable hardware, firmware, software, or any combination thereof for communicating with another device. In addition, the operating circuit 150 may communicate with a networked computing device and / or a computer network. In an example, the operating circuit 150 and / or other circuits of the medical system 100 are configured to deliver stimulation signals to the electrodes 142, 144, 148 and / or other electrodes and / or sensors within or outside the medical system 100 and / or receive sensing signals from them. The operating circuit 150 may be configured to provide electrical signals to the electrodes 142, 144, 148, such as pacing therapy. The operational circuit 150 may be configured to receive electrical signals, such as sensed cardiac electrical signals, from the electrodes 142 , 144 , 148 .

[0076] The medical system 100 (e.g., the operating circuit 150) may also include a memory configured to store program instructions (such as software), which may include one or more program modules that can be executed by the operating circuit 150. The program instructions may be embodied in software and / or firmware. The memory may include any volatile medium, non-volatile medium, magnetic medium, optical medium, or electrical medium, such as a random access memory (RAM), a read-only memory (ROM), a non-volatile RAM (NVRAM), an electrically erasable programmable ROM (EEPROM), a ferroelectric RAM (FRAM), a flash memory, or any other digital medium. In some examples, the memory includes computer-readable instructions that, when executed by the processing circuit 150, cause the operating circuit 150 to perform the various functions described herein and / or other functions of the operating circuit 150.

[0077] The IMD housing 146 may enclose the operating circuit 150 and / or other circuits within the medical system 10. The IMD housing 146 may be configured to isolate the operating circuit 150 and / or other circuits from the environmental fluid in contact with the outer surface of the IMD housing 146. In an example, the IMD housing 146 is configured to hermetically seal the enclosure defined by the IMD 110 and retaining the operating circuit 150 and / or other circuits. The IMD housing 146 may be configured to define a shape that is easily accepted by the patient's body while minimizing patient discomfort. For example, the IMD housing 146 may define a substantially cylindrical shape with a cylindrical sidewall. In other examples, the IMD housing 146 may define a substantially rectangular or other non-cylindrical shape. The IMD housing 146 may define a shape in which the corners and edges are designed to have a relatively large radius so as to present a housing having an outer surface with a smooth contour. In an example, the attachment member 118 is coupled to the IMD housing 146.

[0078] As used herein, when a first part of a system (e.g., medical system 100) supports a second part of the system, this means that when the second part causes a first force to be applied to the first part, the first part causes a second force to be applied to the second part in response to the first force. The first force and / or the second force can be a contact force and / or a remote force. For example, the first force and / or the second force can be a mechanical force, a magnetic force, a gravity force, or some other type of force. The first part of the system can be a part of the system or a part of a component of the system. The second part of the system can be another part of the system or another part of the same component or a different component. In some examples, when the first part of the system supports the second part of the system, this can mean that the second part is mechanically supported by the first part and / or mechanically connected to the first part.

[0079] Fig.14 The technique of applying torque using the medical system 100 is exemplified in Figures 1 to 13 The technology is described with reference to medical system 100 , but in other examples, the technology may be applied to other medical systems.

[0080] The technique includes applying a torque (1402) on a driver cup 106 supported at a distal end 108 of the driver body using a driver body 104 of a driver 102. The driver body 104 may apply a torque on the driver cup 106 to rotate the driver cup within an anatomical volume (e.g., a heart chamber) defined by a patient. In an example, the technique includes using the driver body 104 to position a transfer portion 125 of an intermediate member 122 that extends through a driver lumen 124 and a driver lumen opening 126 defined by the driver 102. The driver body 104 may position the transfer portion 125 within a cup recess 156 of the driver cup 106. The driver body 104 may position the transfer portion 125 within a device recess 154 of the IMD 110. The IMD 110 may define the device recess 154 together with the IMD proximal portion 114 and / or the retrieval structure 140.

[0081] The technique may include engaging the IMD 110 with a ring of the medical system 100 that is configured such that a proximal force is generated on the IMD 110. In some examples, a snare 172 including a snare loop 176 engages the IMD 110 using the snare loop 176. When a proximal force (e.g., by a clinician) is applied to a snare body 174 supporting the snare loop 176, the snare loop 176 may apply a proximal force on the IMD 110. In an example, the snare body 174 and / or the snare loop 176 extend through a member lumen 159 and a member lumen opening 161 defined by the intermediate member 122. When the snare body 174 is slidably translated within the member lumen 159, the snare loop 176 may at least partially collapse (e.g., around the IMD 110). In some examples, the intermediate member 122 engages the IMD 110 using a tether loop 182. When a proximal force (e.g., by a clinician) is applied to member body 119 supporting tether loop 182, tether loop 182 may apply a proximal force on IMD 110. As member body 119 slidably translates within driver lumen 124, tether loop 182 may at least partially collapse (e.g., around IMD 110).

[0082] When a proximal force is applied, the tether loop 182 or the snare loop 176 can cause the cup volume 112 defined by the driver cup 106 (e.g., defined by the cup surface 113) to receive the IMD 110 (e.g., the IMD proximal portion 114). In an example, the IMD 110 moves proximally (e.g., in a proximal direction P) relative to the driver cup 106 to cause the cup volume 112 to receive the IMD 110. In an example, the driver cup 106 moves distally (e.g., in a distal direction D) relative to the IMD 110 to cause the cup volume 112 to receive the IMD 110.

[0083] In an example, the driver cup 106 positions the transmission portion 125 within the cup recess 156 and / or the device recess 154. The driver cup 106 can be rotated relative to the IMD 110 to position the transmission portion 125 within the cup recess 156 and / or the device recess 154. In an example, the rotation of the driver cup 106 relative to the IMD 110 and / or other portions of the medical system 100 causes the intermediate member 122 to be inserted (e.g., embedded) into the cup recess 156. In an example, the rotation of the driver cup 106 relative to the IMD 110 and / or other portions of the medical system 100 causes the intermediate member 122 to be inserted (e.g., embedded) into the device recess 154. In some examples, the rotation of the driver cup 106 relative to the IMD 110 and / or other portions of the medical system 100 causes the intermediate member 122 to slide between the cup surface 113 and the IMD 110 until the intermediate member 122 is embedded in the cup recess 156 and / or the device recess 154. In some examples, tether loop 182 enables first loop portion 184 and / or second loop portion 186 to be inserted into device recess 154 when tether loop 182 engages IMD 110. First loop portion 184 and / or second loop portion 186 can define transmission portion 125.

[0084] The technique includes transferring torque from the driver cup 106 to the IMD 110 using a transfer portion 125 (1404). In an example, when the transfer portion is positioned in the cup recess 156, the transfer portion 125 defines a protrusion 168 that protrudes from the cup recess 156. In an example, the protrusion 168 is positioned in the device recess 154. The driver cup 106 can transfer torque to the IMD 110 using the protrusion 168. In an example, when the transfer portion 125 transfers torque to the IMD 110, the transfer portion 125 rotates about a longitudinal axis L defined by the driver body 104. In an example, when the driver body 104 applies torque on the driver cup 106, the cup recess surface 164 applies a force from the cup recess 156 to the transfer portion 125. The transfer portion 125 can transmit at least some portion of the force from the transfer portion 125 to the device recess surface 166 to transfer torque from the driver cup 106 to the IMD 110.

[0085] When the transfer portion 125 transfers torque from the driver cup 106 to the IMD 110, the driver cup 106 can rotate the IMD 110 about a device axis LD defined by the IMD 110. In an example, when the driver cup 106 rotates the IMD 110 about the device axis LD, the driver cup 106 disengages the attachment member 118 of the IMD 110 from tissue within or near a target site 120 in the patient. In an example, when the driver cup 106 rotates the IMD 110 about the device axis LD, the driver cup 106 engages the attachment member 118 of the IMD 110 with tissue within or near the target site 120. In an example, when the driver cup 106 rotates the IMD 110 about the device axis LD, the driver cup 106 rotates one or more device components of the IMD 110 about the device axis LD.

[0086] The technology may include positioning at least a portion of the driver body 104, the driver cup 106, and / or the intermediate member 122 within an anatomical volume of the patient using a delivery catheter 128. In an example, the delivery catheter 128 positions at least a portion of the driver body 104, the driver cup 106, and / or the intermediate member 122 within a chamber of the patient's heart. The delivery catheter 128 may transport at least a portion of the driver body 104, the driver cup 106, and / or the intermediate member 122 through the patient's vasculature. In an example, at least the driver cup 106 is positioned within a delivery cup volume 132 defined by the delivery catheter 128. The driver body 104 may be positioned within the delivery cup volume 132 by slidably translating through a delivery catheter lumen 141 defined by the delivery catheter 128.

[0087] The present disclosure includes (but is not limited to) the following embodiments.

[0088] Embodiment 1. A medical system, the medical system comprising: a driver, the driver comprising a driver body configured to receive a torque, wherein the driver body defines a lumen and a lumen opening; a driver cup, the driver cup supported at a distal end of the driver body, wherein the driver body is configured to apply the torque on the driver cup, and wherein the driver cup comprises a cup surface defining a cup volume, the cup volume being configured to receive an implantable medical device, wherein the lumen opening opens into the cup volume; and an intermediate member, the intermediate member comprising a member body and a transmission portion of the member body, wherein the member The member body is configured to slidably translate within the lumen to position the transmission portion within the cup volume, wherein the transmission portion is configured to be positioned within a cup recess on the cup surface and a device recess of the implantable medical device when the cup volume receives the implantable medical device and the transmission portion is positioned within the cup volume, wherein the transmission portion is configured to transmit the torque from the driver cup to the implantable medical device when the transmission portion is positioned within the cup recess and the device recess, and wherein the driver body, the driver cup and the intermediate member are configured to be positioned within an anatomical volume defined by the patient's body.

[0089] Embodiment 2. The medical system of embodiment 1, wherein the driver body, the driver cup, and the intermediate member are configured to be positioned within a chamber of the patient's heart. Embodiment 3. The medical system of embodiment 1 or embodiment 2, wherein the driver body, the driver cup, and the intermediate member are configured to travel through the patient's vasculature.

[0090] Embodiment 4. A medical system according to any one of embodiments 1 to 3, wherein the transfer portion defines a cross-sectional dimension, and wherein the cross-sectional dimension is such that when the transfer portion is positioned within the cup recess, a portion of the transfer portion protrudes from the cup recess.

[0091] Embodiment 5. The medical system of Embodiment 4, wherein the protruding portion of the transfer portion is configured to transfer the torque from the driver cup to the implantable medical device.

[0092] Embodiment 6. A medical system according to any one of embodiments 1 to 5, wherein the intermediate member defines a first cross-sectional dimension, and wherein the cup surface includes a cup recess surface defining a second cross-sectional dimension, wherein the second cross-sectional dimension is larger than the first cross-sectional dimension.

[0093] Embodiment 7. A medical system according to any one of embodiments 1 to 6, wherein the driver body defines a longitudinal axis extending through the cup volume, and wherein the cup recess is configured so that when the transmission portion transmits the torque, the transmission portion rotates about the longitudinal axis.

[0094] Embodiment 8. A medical system according to any one of embodiments 1 to 7, wherein the cup recess is configured to exert a force substantially perpendicular to the longitudinal axis on the transmission portion when the transmission portion transmits the torque.

[0095] Embodiment 9. A medical system according to Embodiment 8, wherein the protrusion according to Embodiment 5 is configured to exert a torsional force on the transfer portion when the cup recess exerts the force on the transfer portion and the transfer portion is positioned within the container recess and the device recess.

[0096] Embodiment 10. The medical system of Embodiment 9, wherein the torsional force defines a force component parallel to the force exerted by the cup recess on the transfer portion.

[0097] Embodiment 11. A medical system according to any one of embodiments 1 to 10, wherein the component body defines a flexible portion adjacent to and close to the transmission portion, wherein the transmission portion defines a first stiffness and the flexible portion defines a second stiffness, wherein the first stiffness is greater than the second stiffness.

[0098] Example 12. A medical system according to any one of Examples 1 to 11, the medical system also includes a snare defining a snare loop, the snare loop being configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, wherein the snare is configured to slidably translate within the lumen.

[0099] Example 13. A medical system according to any one of Examples 1 to 12, wherein the intermediate member defines a member lumen extending through the transfer portion and defines a member lumen opening in the transfer portion, wherein the member lumen opening is configured to open to the cup volume when the transfer portion is positioned within the cup recess.

[0100] Example 14. The medical system of Example 13, wherein the snare of Example 12 is configured to slidably translate within the lumen of the member.

[0101] Example 15. A medical system according to any one of Examples 1 to 14, wherein the component body defines a distal portion and a tether loop located at a distal end of the distal portion, wherein the tether loop is configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, and wherein at least one of the distal portion or the tether loop defines the transmission portion.

[0102] Example 16. The medical system of Example 15, wherein the distal portion is configured to apply the proximal force to the tether loop.

[0103] Embodiment 17. The medical system of any one of Embodiments 1 to 16, further comprising a delivery catheter having a delivery cup, wherein the delivery cup defines a delivery cup volume configured to receive at least a portion of the implantable medical device, wherein the delivery catheter defines a delivery lumen and a delivery lumen opening, wherein the delivery lumen opening opens to the delivery cup volume, and wherein the driver cup is configured to slidably translate within the delivery lumen and pass through the delivery lumen opening. Embodiment 18. The medical system of Embodiment 17, wherein the delivery cup volume is configured to receive the driver cup.

[0104] Embodiment 19. The medical system of Embodiment 17 or Embodiment 18, wherein the delivery cup volume is configured to receive the driver cup when the transfer portion is positioned within the cup recess.

[0105] Embodiment 20 The medical system of any one of Embodiments 17 to 19, wherein the driver cup is configured to rotate relative to the delivery cup when the delivery cup volume receives the driver cup.

[0106] Embodiment 21. The medical system of any one of Embodiments 17 to 20, wherein the driver body is configured to rotate relative to the delivery cup when the driver body is positioned within the delivery lumen.

[0107] Embodiment 22. According to any one of embodiments 1 to 21, the medical system also includes the implantable medical device.

[0108] Embodiment 23. The medical system of Embodiment 22, wherein the driver cup is configured to rotate relative to the implantable medical device such that the transfer portion is positioned within the device recess when the cup volume receives the implantable medical device.

[0109] Embodiment 24. The medical system of Embodiment 21 or Embodiment 22, wherein the implantable medical device includes a retrieval structure in a proximal portion of the implantable medical device, wherein the driver cup is configured to receive at least some portion of the retrieval structure.

[0110] Embodiment 25. The medical system of Embodiment 24, wherein the retrieval structure defines the device recess.

[0111] Embodiment 26. A medical system according to any one of Embodiments 21 to 25, wherein the implantable medical device is configured to rotate about a device axis defined by the implantable medical device when the transfer portion transfers the torque from the driver cup to the implantable medical device.

[0112] Embodiment 27. A medical system according to Embodiment 26, wherein the implantable medical device includes an attachment member configured to at least one of: engage with tissue or disengage from tissue when the implantable medical device is rotated about the device axis.

[0113] Example 28. A medical system according to Example 26 or Example 27, wherein the implantable medical device supports one or more device components, and the one or more device components are configured to rotate around the device axis when the implantable medical device rotates around the device axis.

[0114] Embodiment 29. A method, comprising: using a driver body of a driver to apply a torque on a driver cup supported at a distal end of the driver body, wherein the driver body defines a lumen and a lumen opening; and using a transfer portion of an intermediate member positioned within a cup recess and a device recess to transfer the torque from the driver cup defining a cup volume to an implantable medical device within the cup volume, wherein the lumen opening opens to the cup volume, wherein the cup recess is defined by the driver cup and the device recess is defined by the implantable medical device, wherein the intermediate member includes a member body, the member body including the transfer portion, wherein the member body is slidably translatable within the lumen, and wherein the driver body, the driver cup, and the intermediate member are positioned within an anatomical volume defined by the patient's body.

[0115] Embodiment 30. The method according to Embodiment 29, further comprising transmitting the torque to the implantable medical device using a portion of the transmission portion protruding from the cup recess when the transmission portion is positioned within the cup recess.

[0116] Embodiment 31. The method according to embodiment 29 or embodiment 30, the method also includes causing the transmission part to rotate around a longitudinal axis defined by the driver body when the transmission part transmits the torque.

[0117] Embodiment 32. The method according to any one of embodiments 29 to 31, further comprising:

[0118] When the driver body applies the torque on the driver cup, a force is applied from the cup recess to the transfer portion; and at least some portion of the force is transmitted from the transfer portion to the device recess to transfer the torque to the implantable medical device.

[0119] Example 33. A method according to any one of Examples 29 to 32, the method also includes engaging the implantable medical device using a snare loop defined by a snare to apply at least a proximal force on the implantable medical device, wherein the snare is configured to slidably translate within the lumen.

[0120] Example 34. The method of any one of Examples 29 to 33, further comprising slidably translating the snare of Example 33 through a member lumen defined by the intermediate member, wherein the member lumen extends through the transfer portion and opens into the cup volume.

[0121] Example 35. A medical system according to any one of Examples 29 to 34, wherein the component body defines a distal portion and a tether loop located at a distal end of the distal portion, and the method further includes positioning at least one of the distal portion or the tether loop within the cup recess and the device recess such that the at least one of the distal portion or the tether loop defines the transfer portion.

[0122] Example 36. The method of any one of Examples 29 to 35, further comprising engaging the implantable medical device using a tether loop according to Example 35 to exert at least a proximal force on the implantable medical device.

[0123] Example 37. The method of any one of Examples 29 to 36, further comprising positioning the driver cup within a delivery cup volume defined by a delivery cup of the delivery catheter by slidably translating the driver body through a delivery lumen defined by the delivery catheter.

[0124] Example 38. The method of any one of Examples 29 to 37, further comprising positioning the driver body, the driver cup, and the intermediate member within a chamber of the patient's heart using a delivery catheter according to Example 37.

[0125] Example 39. The method of any one of Examples 29 to 38, further comprising delivering the driver body, the driver cup, and the intermediate member through the patient's vasculature using a delivery catheter of Example 37.

[0126] Embodiment 40. The method of any one of embodiments 29 to 39, further comprising when the driver cup is positioned within the delivery cup volume of embodiment 37,

[0127] The driver cup is rotated relative to the delivery cup according to Example 37.

[0128] Embodiment 41. The method of any one of Embodiments 29 to 40, further comprising rotating the driver body relative to the delivery cup of Embodiment 37 to apply the torque on the driver cup.

[0129] Embodiment 42. The method of Embodiments 29 to 41, further comprising rotating the driver cup relative to the implantable medical device so that the transfer portion is positioned within the device recess.

[0130] Embodiment 43. The method of Embodiments 29 to 42, further comprising receiving a retrieval structure of the implantable medical device within the cup volume.

[0131] Embodiment 44. The method according to embodiments 29 to 43, further comprising using the torque applied by the driver body to rotate the implantable medical device around a device axis defined by the implantable medical device.

[0132] Embodiment 45. The method according to Embodiment 44 further comprises causing the attachment member of the implantable medical device to at least one of: engage with tissue or disengage from tissue when the implantable medical device is rotated about the device axis.

[0133] Example 46. The method according to Example 44 or Example 45, further comprising causing one or more device components to rotate about the device axis when the implantable medical device rotates about the device axis so that the one or more device components achieve a specific orientation relative to the body of the patient.

[0134] Embodiment 47. A medical system, comprising: a drive container capable of rotating relative to a longitudinal axis of the medical system, the drive container comprising a container surface defining a container volume, the container volume being configured to receive at least a proximal portion of an implantable medical device; and an intermediate member comprising a member body and a transfer portion of the member body, wherein the member body is configured to translate longitudinally relative to the container to position the transfer portion along the container volume, wherein the transfer portion is configured to be positioned within a container recess of the container surface when the container volume receives the implantable medical device and the transfer portion is positioned within the container volume, wherein the transfer portion is configured to transfer the torque from the drive container to the implantable medical device when the transfer portion is positioned within the container recess, and wherein the drive body, the drive container, and the intermediate member are configured to be positioned within an anatomical volume defined by a patient's body.

[0135] Example 48. The medical system of Example 47, wherein the driver receptacle and the intermediate member are configured to be positioned within a chamber of the patient's heart.

[0136] Embodiment 49. The medical system of Embodiment 47 or Embodiment 48, wherein the driver receptacle and the intermediate member are configured to travel through the patient's vasculature. Embodiment 50. The medical system of any one of Embodiments 47 to 49, wherein the transmission portion defines a cross-sectional dimension, and wherein the cross-sectional dimension is such that a portion of the transmission portion protrudes from the receptacle recess when the transmission portion is positioned within the receptacle recess.

[0137] Embodiment 51. A medical system according to Embodiment 50, wherein the protruding portion of the transfer portion is configured to transfer the torque from the driver container to the implantable medical device.

[0138] Embodiment 52. A medical system according to any one of Embodiments 47 to 51, wherein the intermediate member defines a first cross-sectional dimension, and wherein the container surface includes a container recess surface defining a second cross-sectional dimension, wherein the second cross-sectional dimension is larger than the first cross-sectional dimension.

[0139] Embodiment 53. The medical system of any one of Embodiments 47 to 52, wherein the container recess is configured such that the transmission portion rotates about the longitudinal axis when the transmission portion transmits the torque.

[0140] Embodiment 54. A medical system according to any one of Embodiments 47 to 53, wherein the container recess is configured to exert a force on the transmission portion that is substantially perpendicular to the longitudinal axis when the transmission portion transmits the torque.

[0141] Example 55. A medical system according to Example 54, wherein: the implantable medical device also includes a device recess; the transfer portion is configured to be positioned within the container recess and the device recess when the container volume receives the implantable medical device and the transfer portion is positioned within the container volume; and the protrusion according to Example 5 is configured to exert a torsional force on the transfer portion when the container recess exerts the force on the transfer portion and the transfer portion is positioned within the container recess and the device recess.

[0142] Embodiment 56. A medical system according to Embodiment 55, wherein the torsional force defines a force component parallel to the force exerted by the container recess on the transfer portion.

[0143] Embodiment 57. A medical system according to any one of Embodiments 47 to 56, wherein the component body defines a flexible portion adjacent to and proximal to the transmission portion, wherein the transmission portion defines a first stiffness and the flexible portion defines a second stiffness, wherein the first stiffness is greater than the second stiffness.

[0144] Example 58. A medical system according to any one of Examples 47 to 57, the medical system also including a snare defining a snare loop, the snare loop being configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, wherein the snare is configured to slidably translate within the lumen.

[0145] Example 59. A medical system according to any one of Examples 47 to 58, wherein the intermediate member defines a member lumen extending through the transfer portion and defines a member lumen opening in the transfer portion, wherein the member lumen opening is configured to open to the container volume when the transfer portion is positioned within the container recess.

[0146] Example 60. The medical system of Example 59, wherein the snare of Example 12 is configured to slidably translate within the lumen of the member.

[0147] Example 61. A medical system according to any one of Examples 47 to 60, wherein the component body defines a distal portion and a tether loop located at a distal end of the distal portion, wherein the tether loop is configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, and wherein at least one of the distal portion or the tether loop defines the transmission portion.

[0148] Example 62. A medical system according to Example 61, wherein the distal portion is configured to apply the proximal force to the tether loop.

[0149] Example 63. A medical system according to any one of Examples 47 to 62, the medical system further comprising a delivery catheter having a delivery container, wherein the delivery container defines a delivery container volume configured to receive at least a portion of the implantable medical device, wherein the delivery catheter defines a delivery lumen and a delivery lumen opening, wherein the delivery lumen opening opens to the delivery container volume, and wherein the drive container is configured to slidably translate within the delivery lumen and pass through the delivery lumen opening.

[0150] Embodiment 64. The medical system of Embodiment 63, wherein the delivery container volume is configured to receive the driver container.

[0151] Embodiment 65. The medical system of Embodiment 63 or Embodiment 64, wherein the delivery container volume is configured to receive the driver container when the transfer portion is positioned within the container recess.

[0152] Embodiment 66. The medical system of any one of Embodiments 63 to 65, wherein the driver receptacle is configured to rotate relative to the delivery container when the delivery container volume receives the driver receptacle.

[0153] Embodiment 67. According to any one of Embodiments 63 to 66, the medical system also includes a driver body extending proximally from the driver container, and the driver body is configured to rotate relative to the delivery container when the driver body is positioned in the delivery tube cavity.

[0154] Embodiment 68. According to any one of Embodiments 47 to 67, the medical system also includes the implantable medical device.

[0155] Embodiment 69. The medical system of Embodiment 68, wherein the driver receptacle is configured to rotate relative to the implantable medical device such that the transfer portion is positioned within the device recess when the receptacle volume receives the implantable medical device.

[0156] Example 70. A medical system according to Example 67 or Example 68, wherein the implantable medical device includes a retrieval structure in a proximal portion of the implantable medical device, wherein the drive receptacle is configured to receive at least some portion of the retrieval structure.

[0157] Embodiment 71. The medical system of Embodiment 70, wherein the retrieval structure defines the device recess.

[0158] Example 72. A medical system according to any one of Examples 47 to 71, wherein the implantable medical device is configured to rotate about a device axis defined by the implantable medical device when the transmission portion transmits the torque from the driver container to the implantable medical device.

[0159] Example 73. A medical system according to Example 72, wherein the implantable medical device includes an attachment member configured to perform at least one of the following: engage with tissue or disengage from the tissue when the implantable medical device is rotated about the device axis.

[0160] Example 74. A medical system according to Example 72 or Example 73, wherein the implantable medical device supports one or more device components, and the one or more device components are configured to rotate around the device axis when the implantable medical device rotates around the device axis.

[0161] Embodiment 75 The medical system of Embodiment 47, further comprising a driver body configured to apply torque to the driver receptacle,

[0162] The driver body defines a lumen and a lumen opening to the container volume.

[0163] Embodiment 76. A method comprising applying torque to the implantable medical device using the medical system according to any one of Embodiments 47 to 75.

[0164] Example 77. The method of Example 76, wherein applying the torque comprises implanting the implantable medical device into cardiac tissue.

[0165] Example 78. A method according to Example 76, wherein applying torque includes removing the implantable medical device from cardiac tissue.

[0166] Various embodiments of the present disclosure have been described. Any combination of the described systems, operations, or functions is contemplated. These and other embodiments are within the scope of the following claims.

Claims

1. A medical system, comprising: a driver receptacle rotatable relative to a longitudinal axis of the medical system, the driver receptacle comprising a receptacle surface defining a receptacle volume configured to receive at least a proximal portion of an implantable medical device; and an intermediate member comprising a member body and a transfer portion of the member body, wherein the member body is configured to translate longitudinally relative to the container to position the transfer portion along the container volume, wherein the transmission portion is configured to be positioned within a container recess of the container surface when the container volume receives the implantable medical device and the transmission portion is positioned within the container volume, wherein the transfer portion is configured to transfer torque from the driver receptacle to the implantable medical device when the transfer portion is positioned within the receptacle recess, and wherein the driver body, the driver receptacle, and the intermediate member are configured to be positioned within an anatomical volume defined by a patient's body. 2 . The medical system of claim 1 , wherein the driver receptacle and the intermediate member are configured to be positioned within a chamber of the patient's heart. 3 . The medical system of claim 1 , wherein the driver receptacle and the intermediate member are configured to advance through the patient's vasculature.

4. The medical system of claim 1, wherein the transfer portion defines a cross-sectional dimension, and wherein the cross-sectional dimension is such that when the transfer portion is positioned within the container recess, a portion of the transfer portion protrudes from the container recess.

5. The medical system of claim 4, wherein the protruding portion of the transfer portion is configured to transfer the torque from the driver receptacle to the implantable medical device.

6. The medical system of any one of claims 1, 3 or 4, wherein the intermediate member defines a first cross-sectional dimension, and wherein the container surface includes a container recess surface defining a second cross-sectional dimension, wherein the second cross-sectional dimension is greater than the first cross-sectional dimension.

7. The medical system of any one of claims 1, 3 or 4, wherein the container recess is configured such that when the transmission portion transmits the torque, the transmission portion rotates about the longitudinal axis.

8. The medical system of any one of claims 1, 3 or 4, wherein the container recess is configured to exert a force substantially perpendicular to the longitudinal axis on the transmission portion when the transmission portion transmits the torque.

9. The medical system of claim 8, wherein: The implantable medical device also includes a device recess; the transfer portion being configured to be positioned within the container recess and the device recess when the container volume receives the implantable medical device and the transfer portion is positioned within the container volume; and The protruding portion according to claim 4 is configured to exert a torsional force on the transfer portion when the container recess exerts the force on the transfer portion and the transfer portion is positioned within the container recess and the device recess.

10. The medical system of claim 9, wherein the torsional force defines a force component that is parallel to the force exerted by the container recess on the transfer portion.

11. A medical system according to any one of claims 1, 3 or 4, wherein the component body defines a flexible portion adjacent to and proximal to the transmission portion, wherein the transmission portion defines a first stiffness and the flexible portion defines a second stiffness, wherein the first stiffness is greater than the second stiffness.

12. A medical system according to any one of claims 1, 3 or 4, further comprising a snare defining a snare loop, the snare loop being configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, wherein the snare is configured to slidably translate within the lumen.

13. A medical system according to any one of claims 1, 3 or 4, wherein the intermediate member defines a member lumen extending through the transfer portion and defines a member lumen opening in the transfer portion, wherein the member lumen opening is configured to open to the container volume when the transfer portion is positioned within the container recess.

14. The medical system of claim 13, wherein the snare of claim 12 is configured to slidably translate within the member lumen.

15. The medical system of any one of claims 1, 3 or 4, wherein the member body defines a distal portion and a tether loop at a distal end of the distal portion, wherein The tether loop is configured to engage the implantable medical device to exert at least a proximal force on the implantable medical device, and wherein at least one of the distal portion or the tether loop defines the transmission portion.

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