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 torque coupler. The snare is configured to engage a medical device. The torque coupler is configured to receive the medical device within the coupler volume. The snare and / or the torque coupler are configured to apply a force on the medical device such that the torque coupler applies a torque to a retrieval structure of the medical device, thereby rotating 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 a torque coupler, a snare, and / or a medical device.

Description

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 366,368, filed on June 14, 2022, the entire contents of which are incorporated herein by reference. Technical Field

[0002] The present disclosure relates to systems for delivering and / or retrieving implantable medical devices. Background Art

[0003] 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.

[0004] 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

[0005] 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's body. The medical system includes a snare configured to engage an implantable medical device and a torque coupler configured to receive at least some portion of the implantable medical device. The snare is configured to apply a proximal force on the IMD. The torque coupler is configured to apply a distal force on the retrieval structure of the IMD when the torque coupler receives the IMD. The snare and the torque coupler are configured so that the proximal force and / or the distal force generate a contact force from the torque coupler to the IMD retrieval structure. The medical system is configured to transfer torque from the torque coupler to the IMD when the contact force provides an engagement force. In an example, the medical system includes a delivery catheter configured to deliver and / or retrieve a torque coupler, an intermediate member and / or an implantable medical device through the patient's vascular system.

[0006] In an example, a medical system includes: a driver including a driver body and a torque coupler configured to receive torque from the driver body, wherein the driver body defines a lumen opening into a coupler volume defined by the torque coupler, wherein the torque coupler defines a coupler axis extending through the coupler volume and a plurality of protrusions extending toward the coupler axis, wherein the coupler volume is configured to receive a retrieval structure of an implantable medical device when the coupler axis defines an oblique angle with an IMD axis of the implantable medical device, and wherein the torque coupler is configured to apply a distally directed force on the retrieval structure when the coupler volume receives the retrieval structure; and a snare, the snare The invention relates to an implantable medical device comprising: a snare configured to translate within a lumen, wherein the snare is configured to exert a proximally directed force on the implantable medical device when the snare translates within the lumen, wherein the snare and the torque coupler are configured to generate an engagement force from the torque coupler to a retrieval structure when at least one of the snare exerts a proximally directed force or the torque coupler exerts a distally directed force, and wherein the plurality of protrusions are configured to transmit torque from the torque coupler to the retrieval structure when the coupler volume receives the retrieval structure, when the coupler axis defines an oblique angle with the IMD axis, when the snare and the torque coupler generate the engagement force, and when at least a first protrusion of the plurality of protrusions contacts the retrieval structure.

[0007] In an example, a technique includes: applying torque on a torque coupler of a driver through a driver body of the driver, wherein the driver body defines a tubular opening to a coupler volume defined by the torque coupler, wherein the torque coupler defines a coupler axis extending through the coupler volume and a plurality of protrusions extending toward the coupler axis, and wherein the coupler volume is configured to receive a retrieval structure of an implantable medical device when the coupler axis defines an oblique angle with an IMD axis of the implantable medical device; applying at least one of a distally directed force applied by the torque coupler on the retrieval structure or a proximally directed force applied by a snare on the IMD to the retrieval structure to generate an engagement force from the torque coupler to the retrieval structure, wherein the snare is configured to translate within the tubular cavity; and when the coupler volume receives the retrieval structure, transmitting torque from the torque coupler to the retrieval structure using a plurality of protrusions, the coupler axis defining an oblique angle with the IMD axis, and at least a first of the plurality of protrusions contacting the retrieval structure.

[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 exemplary medical system and delivery catheter within the heart.

[0010] Figure 2 is a schematic diagram illustrating an exemplary medical system including a snare, a torque coupler, and a delivery catheter.

[0011] Figure 3 yes Figure 2 Cross-sectional view of an exemplary medical system.

[0012] Figure 4 is a schematic diagram of an exemplary medical system in which a snare is distal to a torque coupler.

[0013] Figure 5 is a schematic diagram of an exemplary medical system in which a snare engages an implantable medical device.

[0014] Figure 6 is a schematic diagram of an exemplary medical system in which a snare sheath is distal to a torque coupler.

[0015] Figure 7 is a schematic diagram of an exemplary medical system in which a torque coupler engages an implantable medical device at a first tilt angle.

[0016] Figure 8 is a schematic diagram of an exemplary medical system in which a torque coupler engages an implantable medical device at a second tilt angle.

[0017] Fig. 9 is a schematic diagram of an exemplary medical system within a delivery container of a delivery catheter.

[0018] Fig.10 is a perspective view of an exemplary torque coupler and implantable medical device.

[0019] Fig.11A is a top plan view of an exemplary torque coupling.

[0020] Fig. 11B yes Fig. 11B Cross-sectional view of an exemplary torque coupling.

[0021] Fig.12 is a perspective view of an exemplary torque coupler with a snare engaging an implantable medical device.

[0022] Fig.13 is a schematic diagram of an exemplary torque coupler defining a non-planar coupler perimeter.

[0023] Fig.14 is a perspective view of an exemplary torque coupler and snare engaging an implantable medical device.

[0024] Fig.15 is a cross-sectional view of an exemplary torque coupler and snare engaging an implantable medical device.

[0025] Fig.16 Example techniques for transmitting torque to an implantable medical device are illustrated. DETAILED DESCRIPTION

[0026] 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. 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 an IMD 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 a target site, and / or otherwise cause reposition and / or reorientation of the medical device within the patient.

[0027] The medical system includes a driver (e.g., an elongated body) configured to receive torque (e.g., from a clinician) and transmit the torque to a torque coupler at the distal end of the driver. In an example, the torque coupler is a socket or cup, such as a torque cup or a torque socket. The torque coupler defines a coupler volume configured to receive at least a portion of an implantable medical device. In an example, the driver is configured to be at least partially located in the patient's vascular system when the torque coupler is positioned in the anatomical volume. In some examples, the driver includes a proximal portion configured outside the patient's body and a distal portion configured in the patient's body. The distal portion can support the torque coupler. The medical system can be configured so that (e.g., by a clinician) the torque applied to the proximal portion causes the distal portion to apply the torque to the torque coupler. The medical system is configured to transfer the torque from the torque coupler 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 member) configured to engage or disengage tissue based on the rotation of the IMD. The medical system can transmit torque from the torque coupler to the IMD to cause the IMD to rotate such that the attachment member engages or disengages from tissue.

[0028] The torque coupler includes a surface defining a coupler volume ("coupler surface") and an opening ("coupler opening") opening to the coupler volume at a distal end of the torque coupler ("coupler distal end"). In an example, the torque coupler defines an axis ("coupler axis") extending through the coupler volume and the coupler opening. The coupler opening is configured to allow at least a portion of an IMD retrieval structure ("IMD retrieval structure") of the IMD to pass therethrough when the coupler volume receives an implantable medical device. The torque coupler (e.g., the coupler surface) defines a plurality of protrusions extending toward the coupler axis. The plurality of protrusions are configured to engage the IMD retrieval structure to transfer torque to the IMD when the coupler volume receives the IMD retrieval structure and torque is applied to the driver (e.g., by a clinician).

[0029] As used herein, when a torque coupler (e.g., a coupler volume) receives an IMD retrieval structure, it means that the torque coupler receives at least a portion of the IMD retrieval structure. For example, the torque coupler can receive a distal portion of the IMD retrieval structure, some other portion of the IMD retrieval structure, or substantially the entire IMD retrieval structure. The IMD retrieval structure can be any structure and / or feature of the IMD that is configured to receive torque from the torque coupler when the torque coupler (e.g., a coupler volume) receives the IMD.

[0030] The torque coupler is configured to receive an IMD retrieval structure within a relative orientation range between a coupler axis and an IMD axis, the axis being defined by the IMD and extending through the IMD retrieval structure. The torque coupler can be configured to receive the IMD retrieval structure when the coupler axis and the IMD axis are offset so that the coupler axis and the IMD axis define an oblique angle (e.g., an oblique angle of approximately 30 degrees). The protrusion can be configured to engage the IMD retrieval structure when the torque coupler receives the IMD retrieval structure (e.g., at an oblique angle), and the torque coupler rotates relative to the IMD retrieval structure. In an example, the IMD retrieval structure defines a plurality of petals extending in a direction substantially radial to the IMD axis, and the protrusion is configured to engage one or more petals when the torque coupler rotates relative to the IMD retrieval structure (e.g., at an oblique angle).

[0031] The use of a torque coupler configured to receive an IMD at a basic tilt angle relative to the IMD can reduce mechanical coupling requirements that may otherwise occur when using a cup to capture and / or twist the IMD. For example, in some systems, the cup or container may be configured as a socket that is intended to mechanically cooperate with the proximal end of the IMD to transfer torque. The cup may 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 transmission of torque from the cup to the IMD may require a relatively precise alignment (e.g., a substantially parallel and / or coincident alignment) between the axis of the cup and the axis of the IMD to achieve the necessary mechanical fit. When the cup and the device are positioned in a restricted anatomical space of the patient (e.g., a chamber of the heart), it may be difficult to achieve such a relatively precise alignment. In contrast, the use of a torque coupler configured to receive and / or engage the IMD at a basic tilt angle relative to the IMD can alleviate this alignment burden.

[0032] The medical system includes a snare defining a body ("snare body") and a loop ("snare loop") at a distal end of the snare body. The snare (e.g., snare loop) is configured to engage an IMD (e.g., an IMD retrieval structure). The snare can be configured to engage the IMD to, for example, guide a torque coupler toward an IMD retrieval structure and / or cause the torque coupler to receive the IMD retrieval structure. In an example, a body of the driver ("driver body") defines a lumen ("driver lumen") and a lumen opening to a coupler volume ("driver lumen opening"). The snare can be configured to translate in a sliding manner within the driver lumen such that a clinician can translate the snare proximally and / or distally within the driver lumen, and / or translate the driver and torque coupler relative to the snare. For example, the snare can be configured to extend through the driver lumen and away from the torque coupler so that when the IMD is away from the torque coupler, the snare loop can engage the IMD (e.g., an IMD retrieval structure). When the snare loop is engaged with the IMD, the clinician can translate the driver and torque coupler distally over the snare so that the snare substantially guides the torque coupler toward the IMD retrieval structure.

[0033] The snare is configured to apply a proximally directed force on the IMD (e.g., a force acting on the IMD in a direction toward the torque coupler) when the snare engages the IMD. When the torque coupler receives the IMD retrieval structure, the torque coupler is configured to apply a distally directed force to the IMD retrieval structure (e.g., a force acting on the IMD in a direction toward the IMD). For example, a clinician can push the torque coupler (using the driver body) against the IMD retrieval structure so that the torque coupler applies a distally directed force on the IMD retrieval structure. The clinician can pull the IMD (using the snare) toward the torque coupler so that the snare applies a proximally directed force on the IMD. The medical system is configured such that when the torque coupler contacts the IMD retrieval structure (e.g., when the torque coupler receives the IMD retrieval structure), the proximally directed force and / or the distally directed force produces a contact force applied from the torque coupler to the IMD retrieval structure.

[0034] As used herein, the contact force applied from the torque coupler to the IMD retrieval structure may include one or more action forces and / or one or more reaction forces. For example, the contact force may include an action force applied by the torque coupler to the IMD retrieval structure when the torque coupler applies a distally directed force. The contact force may include a reaction force generated by the torque coupler in response to the snare applying a proximally directed force to the IMD and the IMD transmitting the proximally directed force to the torque coupler. Thus, the medical system is configured so that a clinician can use the driver and snare in combination or separately to control the contact force applied from the torque coupler to the IMD retrieval structure.

[0035] When contact is established between the torque coupler and the IMD retrieval structure, the clinician can control the contact force to improve and / or control torque transmission. For example, the torque coupler can approach the IMD along a path that is substantially deviated from (e.g., tilted to) the IMD axis of the IMD, so that when the torque coupler receives the IMD retrieval structure, the coupler axis and the IMD axis define an angle of inclination. The clinician can rotate the torque coupler around the coupler axis relative to the IMD retrieval structure (e.g., when the coupler axis and the IMD axis define an angle of inclination). The contact force applied to the IMD retrieval structure from the torque coupler can be increased (e.g., by a clinician) so that one or more of the protrusions fully engage the IMD retrieval structure to transfer torque. Therefore, the torque coupler can be configured to engage the IMD and / or transfer torque to the IMD when the torque coupler approaches the IMD along a path that is substantially deviated from (e.g., tilted to) the IMD axis of the IMD, thereby alleviating any alignment requirements between the torque coupler and the IMD, which otherwise may bring difficulties in the patient's limited anatomical space (e.g., a chamber of the heart).

[0036] In an example, the contact force can be varied (e.g., by a clinician) such that the contact force is an engagement force or a sliding force. An engagement force is a contact force that, when at least one protrusion contacts the IMD retrieval structure, has a force magnitude sufficient to cause the protrusion to transfer torque from the torque coupler to the IMD retrieval structure. A sliding force is a contact force that, when at least one protrusion contacts the IMD retrieval structure, has a force magnitude insufficient to cause the protrusion to transfer torque from the torque coupler to the IMD retrieval structure. In an example, a plurality of protrusions are configured to translate in a sliding manner around the IMD retrieval structure (e.g., slide on it) when the torque coupler rotates relative to the IMD retrieval structure until the contact force increases from a sliding force (e.g., by a clinician) to an engagement force. A plurality of protrusions can be configured such that when the contact force increases to the engagement force, at least one protrusion transfers a torque to the IMD sufficient to cause the IMD to rotate about the IMD axis.

[0037] The force magnitude of the engagement force required to cause the first protrusion to transmit torque can depend on the orientation of the torque coupler relative to the IMD (e.g., depending on the tilt angle). For example, when the torque coupler and the IMD define a first tilt angle, the engagement force can have a first engagement force magnitude, and when the torque coupler and the IMD define a second tilt angle, the engagement force can have a second engagement force magnitude, wherein the first engagement force magnitude is different from (e.g., greater than or less than) the second engagement force magnitude. Similarly, the force magnitude of the sliding force can depend on the orientation of the torque coupler relative to the IMD. When the torque coupler and the IMD define a first tilt angle, the sliding force can have a first sliding force magnitude, and when the torque coupler and the IMD define a second tilt angle, the sliding force can have a second sliding force magnitude, wherein the first sliding force magnitude is different from the second sliding force magnitude.

[0038] Thus, the medical system is configured such that a proximally directed force applied by the snare on the IMD and a distally directed force applied by the torque coupler on the IMD retrieval structure generates a variable contact force from the torque coupler to the IMD retrieval structure. The contact force may be an engagement force sufficient to cause the torque coupler to transfer torque to the IMD. The contact force may be a sliding force insufficient to cause the torque coupler to transfer torque to the IMD. The proximally directed force and / or the distally directed force may be controlled by a clinician to provide an engagement force magnitude and / or sliding force magnitude appropriate for the orientation of the torque coupler relative to the IMD.

[0039] When the contact force is insufficient to cause the plurality of protrusions to transfer torque to the IMD retrieval structure (e.g., when the contact force provides a sliding force) and the torque coupler rotates relative to the IMD retrieval structure, the plurality of protrusions can be configured to translate substantially in a sliding manner around the IMD retrieval structure (e.g., slide on it). The plurality of protrusions can be configured to slide on the IMD retrieval structure until at least one protrusion is sufficiently engaged with the IMD retrieval structure to transfer torque (e.g., until the contact force provides an engagement force). In an example, the IMD retrieval structure defines a plurality of IMD petals extending substantially radially from an IMD axis defined by the IMD. The plurality of protrusions can be configured to translate substantially in a sliding manner around the plurality of IMD petals until one or more protrusions sufficiently engage the petals to cause the IMD to rotate about the IMD axis. In an example, the IMD retrieval structure defines at least a first IMD petal and a second IMD petal and a recess between the first IMD petal and the second IMD petal. The plurality of protrusions may be configured to translate in a sliding manner through the recess on the IMD retrieval structure until at least one protrusion is inserted into the recess and sufficiently engages the first petals and / or the second petals to cause the IMD to rotate about the IMD axis.

[0040] The plurality of protrusions may include at least a first protrusion and a second protrusion defined by a coupler surface of the torque coupler. The coupler surface further defines a base portion separating the first protrusion and the second protrusion. The first protrusion, the second protrusion, and / or the base portion may be configured to translate substantially in a sliding manner around the IMD retrieval structure when the contact force provides a sliding force. In an example, the first protrusion, the second protrusion, and / or the base portion define one or more fillets to help the first protrusion, the second protrusion, and / or the base portion translate in a sliding manner on the IMD retrieval structure. In an example, a plurality of IMD petals define one or more fillets. In some examples, at least one IMD petal includes a rounded convex corner that defines a curved profile, a curved profile, and / or a polygonal curved profile in a geometric plane substantially parallel to, perpendicular to, or including the IMD axis of the IMD.

[0041] At least one protrusion (e.g., a first protrusion) can be configured to transfer a force to an IMD retrieval structure to transfer torque from a torque coupler to an IMD. In an example, the first protrusion can be configured to distribute the force substantially over a protrusion support surface when multiple protrusions transfer torque to the IMD. In some examples, the protrusion support surface can be configured to transfer the force to an IMD support surface defined by an IMD petal. The IMD support surface can be configured to receive the force from the first protrusion as a distributed force over the IMD support surface. In an example, the IMD support surface extends substantially radially outward from the IMD axis of the IMD toward the distal end of the IMD petal. Thus, the IMD petal can be configured to receive the force from the first protrusion over an area extending radially outward toward the distal end of the petal, rather than, for example, having to receive the force as a substantially concentrated force in the distal end region of the IMD petal. This can facilitate the transfer of torque from the torque coupler to the IMD when the torque coupler receives the IMD at a substantially oblique angle.

[0042] In an example, the medical system is configured to cause the torque coupler to reduce (and in some cases, even substantially eliminate) the tilt angle defined between the coupler axis and the IMD axis. Reducing the tilt angle can improve the efficiency of torque transmission from the torque coupler to the IMD. For example, when the torque coupler contacts the IMD retrieval structure at an inclined angle, increasing the contact force can cause the torque coupler to pivot toward the IMD retrieval structure and / or translate in a sliding manner on the IMD retrieval structure to reduce the tilt angle. Reducing the tilt angle can improve the contact between the protrusion of the torque coupler and the IMD retrieval structure (e.g., one or more petals of the IMD retrieval structure), and / or cause an additional protrusion of the torque coupler to engage the IMD retrieval structure so that the torque coupler can more efficiently transmit torque to the IMD.

[0043] For example, the plurality of protrusions may be configured such that when the first protrusion is inserted into a first recess defined by a plurality of IMD petals, the second protrusion may be inserted into a second recess defined by a plurality of IMD petals. In an example, the medical system is configured such that when the first protrusion is inserted into the first recess, the tilt angle between the torque coupler and the IMD is reduced (e.g., by increasing the contact force) such that the torque coupler pivots toward the IMD retrieval structure, thereby inserting the second protrusion into the second recess. Reducing and / or substantially eliminating the tilt angle may improve contact between the protrusion of the torque coupler and the IMD retrieval structure (e.g., one or more petals of the IMD retrieval structure), and / or enable additional protrusions of the torque coupler to engage the IMD retrieval structure such that the torque coupler may more effectively transfer torque to the IMD.

[0044] In an example, a medical system is configured to control (e.g., increase and / or decrease) a contact force between a torque coupler and an IMD while limiting the total resultant force on the IMD. For example, the medical system may be configured such that a proximally directed force applied by a snare and a distally directed force applied by a torque coupler provide a reaction force on the IMD. The reaction force may increase and / or decrease the contact force while limiting the total resultant force on the IMD. For example, increasing the proximally directed force applied by the snare while increasing the distally directed force applied by the torque coupler may increase the contact force while limiting the resultant force (e.g., the difference between the proximally directed force and the distally directed force) acting on the IMD. Reducing the proximally directed force applied by the snare while reducing the distally directed force applied by the torque coupler may reduce the contact force while limiting the resultant force acting on the IMD. Limiting the resultant force acting on the IMD may improve the positional stability of the IMD in the patient when implanting, removing, repositioning, and / or reorienting the IMD.

[0045] The medical system may include a delivery catheter including a delivery container or container. The delivery container may define a delivery container volume, which is configured to receive at least a portion of a torque coupler, a snare, and an IMD. The delivery catheter may define a delivery catheter lumen and a delivery lumen opening that is open to the delivery container volume. A driver (e.g., a driver body) may be configured to translate in a sliding manner within the delivery catheter lumen and pass through the delivery lumen opening, so that the relative movement between the driver and the delivery catheter may position at least a portion of a torque coupler, a snare, and / or an IMD within the delivery container volume and / or leave the delivery container volume (via the delivery lumen opening). The delivery catheter may be configured to transfer through the patient's vascular system so that the torque coupler, a snare, and / or an IMD may be retrieved from the patient's anatomical volume (e.g., ventricle) and / or delivered to the patient's anatomical volume.

[0046] Thus, the medical system is configured to engage the IMD retrieval structure when the torque coupler of the medical system approaches the IMD along a path that is substantially deviated from (e.g., tilted to) the IMD axis of the IMD. The medical system is configured so that when the torque coupler rotates relative to the IMD, at least a first protrusion of the torque coupler can engage the IMD retrieval structure to transfer torque to the IMD. The medical system is configured so that a clinician can control the contact force (e.g., provide an engagement force) from the torque coupler to the IMD retrieval structure so that the first protrusion engages the IMD retrieval structure. In an example, the clinician can control (e.g., increase) the contact force to further engage the second protrusion with the IMD retrieval structure. Thus, the medical system is configured to significantly reduce the torque transmission from the torque cap to the IMD within a confined anatomical space of the patient (e.g., a chamber of the heart).

[0047] Figure 1 is a conceptual diagram of an exemplary medical system 100 illustrated within the right atrium ("RA") of a 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 being configured to be within a patient's body, and the proximal portion being external to the patient's body when driver body distal portion 105 is within the body. A torque coupler 106 is supported at a distal end 108 ("driver body distal end 108") of driver body 104. In some examples, torque coupler 106 and driver body 104 may be substantially separate components. In some examples, torque coupler 106 may be substantially adjacent to driver body 104 such that torque coupler 106 and driver body 104 define a unitary component.

[0048] The IMD 110 is positioned (eg, inserted) within a coupler volume 112 defined by the torque coupler 106. Figure 1 In the example of , a proximal portion 114 of an IMD 110 ("IMD proximal portion 114") including a retrieval structure 111 ("IMD retrieval structure 111") is positioned within the coupler volume 112. The IMD retrieval structure 111 can be configured to engage with the medical system 100 and / or another medical device to, for example, implant the IMD 110 within the anatomical volume, retrieve the IMD 110 from the anatomical volume, reposition the IMD 110 within the anatomical volume, and / or reorient the IMD 110 within the anatomical volume. Figure 11, the IMD proximal portion 114 (e.g., retrieval structure 111) is shown within the coupler volume 112 and is shown in phantom for clarity. The IMD 110 may include a distal portion 116 ("IMD distal portion 116") opposite the IMD proximal portion 114. In an example, the torque coupler 106 includes a coupler surface (e.g., coupler surface 147 ( Figure 2 , Figure 3 )).

[0049] 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 an IMD 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 IMD 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 IMD 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 IMD axis LD when the IMD 110 is rotated about the IMD axis LD. The medical system 100 may cause the IMD 110 to rotate about the IMD axis LD so that one or more of the 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.

[0050] The driver body 104 is configured to receive torque (eg, from a clinician) and transmit the torque to the torque coupler 106. The torque coupler 106 (eg, the coupler surface 147) defines one or more protrusions (eg, the protrusion 154, Figures 2 to 3), the one or more protrusions are configured to engage the IMD retrieval structure 111 to transfer the torque to the IMD 110 when the coupler volume 112 receives the IMD retrieval structure 111 and torque is applied (e.g., by a clinician) to the driver 102 (e.g., on the driver body proximal portion 107). Thus, the medical system 100 is configured to mechanically couple the torque coupler 106 and the IMD 110 using the one or more protrusions such that torque applied to the driver body 104 (e.g., by a clinician) can rotate the IMD 110 in the first rotational direction W1 and / or the second rotational direction W2 to, for example, implant the IMD 110 within an anatomical volume (such as a RA), retrieve the IMD 110, reposition the IMD 110, and / or reorient the IMD 110.

[0051] The medical system includes a snare 122 defining a body 124 ("snare body 124") and a ring 126 ("snare ring 126") at a distal end of the snare body 124. The snare ring 126 is configured to engage the IMD 110 (e.g., the IMD retrieval structure 111) to, for example, guide the torque coupler 106 toward the IMD retrieval structure 111 so that the torque coupler 106 receives the IMD retrieval structure 111 within the coupler volume 112, and / or control a contact force between the torque coupler 106 and the IMD 110 (e.g., the IMD retrieval structure 111). In an example, the driver body 104 defines a lumen 128 ("driver lumen 128") and a lumen opening (e.g., driver lumen opening 143, Figures 2 to 3 ). The snare 122 can be configured to translate in a sliding manner within the driver lumen 128 such that a clinician can translate the snare 122 proximally (e.g., in direction P) and / or distally (e.g., in direction D) within the driver lumen 128 and / or translate the driver 102 and the torque coupler 106 proximally and / or distally relative to the snare 122. For example, the snare 122 can be configured to extend through the driver lumen 128 and away from the torque coupler 106 to engage the IMD 110. When the snare loop 126 is engaged with the IMD 110, the clinician can translate the driver 102 and the torque coupler 106 distally on the snare 122 (e.g., on the snare body 124 and / or the snare loop 126) such that the snare 122 substantially guides the torque coupler 106 toward the IMD retrieval structure 111.

[0052] The torque coupler 106 is configured such that the coupler volume 112 can receive the IMD retrieval structure 111 when the torque coupler 106 (e.g., guided by the snare 122) approaches the IMD retrieval structure 111 along a path that is substantially offset (e.g., tilted) from the IMD axis LD of the IMD 110. Thus, the torque coupler 106 can approach the IMD retrieval structure 111 over a range of paths relative to the IMD retrieval structure 111. The range of available paths mitigates alignment difficulties that may occur within a confined anatomical space (e.g., RA) of a patient. For example, the torque coupler 106 can be configured to receive the IMD retrieval structure 111 when the torque coupler 106 approaches the IMD retrieval structure 111 along a path that is substantially offset from the IMD axis LD by about 30 degrees, about 20 degrees, or some other tilt angle. Further, the medical system 100 is configured such that a clinician can use the snare 122 and / or the driver body 104 to increase the contact force between the torque coupler 106 and the IMD 110. For example, when the snare loop 126 is engaged with the IMD retrieval structure 111, the clinician can cause the snare 122 to apply a proximally directed force to the IMD retrieval structure 111. When the torque coupler 106 receives the IMD retrieval structure 111, the clinician can cause the torque coupler 106 to apply a distally directed force to the IMD retrieval structure 111 (e.g., through the driver body 104). The increased contact force can cause one or more protrusions of the torque coupler 106 to fully engage the IMD retrieval structure 111 to transfer torque to the IMD retrieval structure 111. The increased contact force can cause the torque coupler 106 to substantially pivot toward or reorient relative to the IMD retrieval structure 111, reducing the tilt angle between the torque coupler 106 (e.g., the coupler axis LC) and the IMD axis LD to, for example, improve torque transfer from the torque coupler 106 to the IMD retrieval structure 111. Thus, medical system 100 may reduce the burden on clinicians when using medical system 100 to transmit torque to IMD 110 within a confined anatomical space (eg, an RA) of a patient.

[0053] In some examples, snare 122 includes a sheath 130 ("snare sheath 130") defining a lumen 132 ("sheath lumen 132"). Snare sheath 130 can be configured to translate in a sliding manner within driver lumen 128. Figure 1, for clarity, the snare sheath 130 is shown in phantom within the driver lumen 128. The snare body 124 and / or the snare ring 126 can be configured to translate in a sliding manner within the sheath lumen 132 so that the clinician can move the snare sheath 130 relative to the snare body 124 and / or the snare ring 126 (e.g., distally and / or proximally relative movement). For example, when the snare ring 126 is engaged with the IMD retrieval structure 111, the clinician can translate the snare sheath 130 distally relative to the snare body 124 and the snare ring 126 to retract the snare ring 126 around the IMD retrieval structure 111. The snare sheath 130 can be configured to substantially guide the torque coupler 106 toward the IMD retrieval structure 111 after retracting the snare ring 126 around the IMD retrieval structure 111. In an example, the snare body 124 includes: a distal portion 121 ("snare body distal portion 121"), which is configured to be inside the patient's body (e.g., via the snare lumen 132 and / or the driver lumen 128); and a proximal portion 123 ("snare body proximal portion 123"), which can be outside the patient's body when the snare body distal portion 121 is inside the body. The snare sheath 130 can include: a distal portion 131 ("snare sheath distal portion 131"), which is configured to be inside the patient's body (e.g., via the driver lumen 128); and a proximal portion 133 ("snare sheath proximal portion 133"), which can be outside the patient's body when the snare sheath distal portion 131 is inside the body. The medical system 100 may be configured such that a clinician may use the snare body proximal portion 123 and / or the snare sheath proximal portion 133 to cause relative movement between the snare sheath 130 and the snare body 124 and / or the snare loop 126 .

[0054] In some examples, medical system 100 includes a delivery catheter 134 configured to retrieve torque coupler 106, at least a portion of snare 122, and / or IMD 110 from an anatomical volume (e.g., RA) of a patient. In examples, delivery catheter 134 is configured to deliver torque coupler 106, at least a portion of snare 122, and / or IMD 110 to an anatomical volume of a patient. For clarity, in Figure 11 and 12. Delivery catheter 134 is illustrated as transparent in FIG. Delivery catheter 134 may include a distal portion 136 ("delivery catheter distal portion 136") configured to be within the patient's body and a proximal portion 138 ("delivery catheter proximal portion 129") that may be external to the patient's body when delivery catheter distal portion 136 is within the body. In examples, delivery catheter 134 is configured to deliver and / or retrieve torque coupler 106, at least a portion of snare 122, and / or IMD 110 using the patient's vasculature, such as the IVC or other vasculature leading to an anatomical volume.

[0055] In an example, the delivery conduit 134 includes a delivery container 140 or a container defining a delivery container volume (e.g., a delivery container volume 168 ( Figures 2 to 3 )), the delivery container volume is configured to receive the torque coupler 106, at least a portion of the snare 122, and at least a portion of the IMD 110. The delivery catheter 134 can define a lumen 142 ("delivery catheter lumen 142") leading to the delivery coupler volume 112. At least the driver body 104 can be configured to translate in a sliding manner within the delivery catheter lumen 142 and through the delivery lumen opening, such that relative movement between the driver body 104 and the delivery catheter 134 can cause relative movement between the torque coupler 106, at least a portion of the snare 122, and / or the IMD 110 and the delivery catheter 134. The delivery container 140 can be configured at a distal end of the delivery container 140 (e.g., the delivery container distal end 139 ( Figures 2 to 3 )) defines an opening (e.g., a delivery container opening 141 ( Figures 2 to 3 )). The delivery container opening can be configured such that the torque coupler 106, at least a portion of the snare 122, and at least a portion of the IMD 110 can pass therethrough.

[0056] The delivery catheter 134 can be configured to retrieve the IMD 110 when the IMD 110 is anchored to tissue within the target site 120 (e.g., anchored by the attachment member 118). For example, the delivery catheter 134 can be configured to be translated through the patient's vasculature to position the torque coupler 106 and the snare loop 126 proximate to the IMD 110 when the IMD 110 is anchored to tissue within the target site 120. The delivery catheter 134 can be configured such that a force in a distal direction D on the snare body 124 (e.g., applied by a clinician) causes the snare loop 126 to extend distally of the delivery container 140 and / or the torque coupler 106 (e.g., toward the IMD 110) to engage the IMD 110 (e.g., the IMD retrieval structure 111). The delivery catheter 134 can be configured such that a force on the driver body 104 in the distal direction D (e.g., applied by a clinician) causes the torque coupler 106 to extend distally to the delivery receptacle 140 (e.g., guided by the snare 122 engaged with the IMD 110), such that the torque coupler 106 engages the IMD 110 (e.g., the IMD retrieval structure 111). The delivery catheter 134 (e.g., the delivery receptacle 140) can be configured to receive the torque coupler 106, at least a portion of the snare 122, and some portion of the IMD 110 when the attachment member 118 is disengaged from the target site 120 (e.g., by torque transmitted from the torque coupler 106 to the IMD 110). For example, the delivery catheter 134 can be moved in the distal direction D relative to the snare 122, the torque coupler 106, and the IMD 110 to receive the snare 122, the torque coupler 106, and at least a portion of the IMD 110. The delivery catheter 134, torque coupler 106, snare 122, and IMD 110 may then be withdrawn from the patient (eg, via the patient's vasculature).

[0057] In an example, the delivery catheter 134 is configured to position the IMD 110 near the target site 120 so that the IMD 110 can be anchored to tissue within the target site 120 (e.g., anchored by the attachment member 118). For example, when the IMD 110 is positioned within the coupler volume 112 and the snare loop 126 is engaged with the IMD 110 (e.g., the IMD retrieval structure 111), the delivery catheter 134 can be configured to position the torque coupler 106 and at least the snare loop 126 within the delivery container volume. The delivery catheter 134 can be configured to traverse the vasculature of the patient 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 can apply 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 a force in the proximal direction P on the driver body 104 (e.g., proximal translation of the driver body 104) causes the torque coupler 106 to detach from the IMD 110 while the IMD 110 remains anchored to tissue via the attachment member 118. The medical system 100 can be configured such that the snare 122 and / or snare sheath 130 can be translated to detach the snare loop 126 from the IMD 110 while the IMD 110 remains anchored to tissue via the attachment member 118. The delivery catheter 134, the torque coupler 106, and the snare 122 can then be withdrawn from the patient (e.g., via the patient's vasculature).

[0058] 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.

[0059] Figure 2 A schematic diagram of a medical system 100 is illustrated that defines a longitudinal axis L and includes a snare 122 , a driver 102 , and a delivery catheter 134 . Figure 3The medical system 100 is illustrated in a cross-sectional view of the driver 102 and the delivery catheter 134, wherein the cross-sectional cutting plane is taken through the longitudinal axis L. The medical system 100 is positioned relative to the IMD 110 such that the coupler axis LC defined by the torque coupler 106 defines an inclination angle A1 with the device axis LD of the IMD 110. As will be discussed, the snare 122 can be configured to translate distally (e.g., in a distal direction D) and / or proximally (e.g., in a proximal direction P) within the driver lumen 128 relative to the driver 102 and the delivery catheter 134. The driver 102 can be configured to translate distally and / or proximally relative to both the snare 122 and the delivery catheter 134 within the delivery catheter lumen 142. The delivery catheter 134 can be configured to translate distally and / or proximally relative to the snare 122 and the driver 102. The driver body 104 defines a lumen opening 143 (“driver lumen opening 143 ”) that is configured to open into the driver lumen 128 . The snare 122 can extend through the driver lumen opening 143 to translate within the driver lumen 128 .

[0060] The snare 122 is configured to engage the IMD retrieval structure 111 when the snare loop 126 is positioned around or near the IMD retrieval structure 111. For example, the snare loop 126 can define an annular hole 146 that is configured to receive (e.g., substantially surround) at least some portion of the IMD retrieval structure 111 when the snare loop 126 is positioned around or near the IMD retrieval structure 111. The snare 122 can be configured to cause the snare loop 126 (e.g., the annular hole 146) to substantially contract around the IMD retrieval structure when the snare loop 126 is engaged with the IMD retrieval structure 111. For example, the snare 122 can be configured such that when the snare loop 126 engages the IMD retrieval structure 111, a proximal force (e.g., a force in the proximal direction P) applied to the snare body 124 causes the snare loop 126 (e.g., the annular hole 146) to contract around the IMD retrieval structure 111.

[0061] In some examples, when at least the snare body 124 is within the sheath lumen 132, the snare sheath 130 can be translated distally toward the snare loop 126 (e.g., by a clinician) to collapse the snare loop 126 (e.g., the loop hole 146) around the IMD retrieval structure 111. For example, translation of the snare sheath 130 toward the snare loop 126 can cause a portion of the snare loop 126 to enter the sheath lumen 132, at least partially collapse the loop hole 146, and collapse the snare loop 126 around the retrieval structure 111. In examples, the snare 122 is configured such that a force applied (e.g., by a clinician) to the proximal portion 123 ( Figure 1) and / or exerting a proximal force (e.g., by a clinician) on the snare sheath proximal portion 133 ( Figure 1 ) causes the snare ring 126 to contract around the retrieval structure 111.

[0062] The snare body 124 and / or the snare ring 126 can translate in a distal direction D and / or a proximal direction P (e.g., within the driver lumen 128 and / or the sheath lumen 132) relative to the driver 102, the delivery catheter 134, and / or the IMD 110. The snare body 124 can be configured such that a force applied to the snare body 124 (e.g., a force applied by a clinician on the snare body proximal portion 123) causes the snare body 124 to translate within the driver lumen 128 and / or the sheath lumen 132, and the translation of the snare body 124 causes the translation of the snare ring 126. The snare body 124 can be configured to change the position of the snare 122 relative to the driver 102, the delivery catheter 134, and / or the IMD 110. For example, the snare 122 can be translated substantially toward the IMD 110 in a distal direction D (e.g., by a clinician applying a force to the snare body 124) to place the snare loop 126 near the IMD retrieval structure 111. Portions of the snare 122 (e.g., the snare body 124) can be translated substantially away from the IMD 110 in a proximal direction P (e.g., by a clinician applying a force on the snare body 124) to retract the snare loop 126 around the IMD retrieval structure 111. The snare 122 can be configured to translate within the driver lumen 128 and / or the sheath lumen 132 such that the snare loop 126 is positioned distally or proximally of an opening 141 defined by the delivery container 140 ("delivery container opening 141"). For example, the snare loop 126 can be positioned distally of the delivery container opening 141 (e.g., Figure 2 , Figure 3 ) and / or may be positioned proximal to the delivery container opening 141 (as shown in FIG. 11 ).

[0063] The torque coupler 106 includes a coupler surface 147 that at least partially defines the coupler volume 112. The coupler surface 147 is configured such that the torque coupler 106 can receive at least some portion of the IMD retrieval structure 111 within the coupler volume 112. In an example, the torque coupler 106 defines an opening 148 ("coupler opening 148") that opens to the coupler volume 112. The coupler opening 148 is sized such that at least a portion of the IMD retrieval structure 111 can pass through the coupler opening 148 when the coupler volume 112 receives the IMD retrieval structure 111. In an example, a distal end 150 ("coupler distal end 150") of the torque coupler 106 defines the coupler opening 148. The torque coupler 106 (e.g., the coupler surface 147) is configured such that when the torque coupler 106 approaches the IMD retrieval structure 111 along a path that is substantially offset from (e.g., inclined to) the IMD axis LD (e.g., along a path such that the coupler axis LC and the IMD axis LD define an inclined angle such as angle A1), the coupler volume 112 can receive at least a portion of the IMD retrieval structure 111. As will be discussed, the driver 102 can be configured such that when the snare 122 engages the IMD retrieval structure 111 and the driver 102 translates over the snare 122 (e.g., when the snare 122 extends within the driver lumen 128), the snare 122 substantially guides the driver 102 (e.g., the torque coupler 106) toward the IMD retrieval structure.

[0064] Coupler surface 147 defines a plurality of protrusions 154 ("protrusions 154"), including protrusion 156 and / or protrusion 158. Protrusions 156, 158 may extend within coupler volume 112 in a direction substantially toward coupler axis LC. Protrusions 156, 158 are configured to extend within coupler volume 112 in a direction substantially toward coupler axis LC when coupler volume 112 receives IMD retrieval structure 111 and torque is applied (e.g., by a clinician) to driver 102 (e.g., at driver body proximal portion 107 ( Figure 1)), engages the IMD retrieval structure 111 to transfer torque to the IMD 110. In an example, the IMD retrieval structure 111 defines a plurality of petals 160, including IMD petals 162 and / or IMD petals 164. The protrusions 156, 158 can be configured to engage the IMD petals 162, 164 to enable the torque coupler 106 to transfer torque to the IMD retrieval structure 111. In an example, the protrusions 156, 158 can be configured to substantially slide over the IMD petals 162, 164 as the torque coupler 106 rotates relative to the IMD retrieval structure 111 until at least one of the protrusions 156 or the protrusions 158 is sufficiently engaged with at least one of the IMD petals 162 or the IMD petals 164 to transfer torque to the IMD retrieval structure 111. In an example, medical system 100 is configured to increase the contact force between coupler surface 147 and IMD retrieval structure 111 so that protrusions 156, 158 fully engage IMD petals 162, 164 to transmit torque. For example, a clinician may increase the contact force between coupler surface 147 and IMD retrieval structure 111 to enable protrusions 156, 158 to fully engage IMD petals 162, 164 to transmit torque. Figure 1 )) applies a distal force on the snare 122 (e.g., the snare body proximal portion 123) to increase the contact force. The clinician can adjust the distal force and / or the proximal force to adjust the contact force.

[0065] The driver body 104 can translate in a distal direction D and / or a proximal direction P relative to the snare 122, the delivery catheter 134, and / or the IMD 110 (e.g., within the delivery catheter lumen 142). The driver body 104 can be configured such that a force applied to the driver body 104 (e.g., a force applied by a clinician on the driver body proximal portion 107) causes the driver body 104 to translate within the delivery catheter lumen 142, and the translation of the driver body 104 causes the translation of the torque coupler 106. The driver body 104 can be configured to change the position of the torque coupler 106 relative to the snare 122, the delivery catheter 134, and / or the IMD 110. For example, the torque coupler 106 can be moved substantially toward the IMD 110 in the distal direction D (e.g., by a clinician applying a force on the driver body 104) to cause the coupler volume 112 to receive the IMD proximal portion 114 (and / or the snare 122). The torque coupler 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 move the IMD 110 (and / or the snare 122) out of the coupler volume 112. The driver body 104 can be configured to translate within the delivery catheter lumen 142 such that the torque coupler 106 and / or other portions of the driver body 104 are positioned distally and / or proximally of either or both of the opening 141 defined by the delivery container 140 ("delivery container opening 141") and / or the snare 122. For example, the torque coupler 106 can be positioned distally of the delivery container opening 141 (e.g., Figure 2 , Figure 3 ) and / or may be positioned proximal to the delivery container opening 141 (eg Fig.10 shown).

[0066] The delivery container 140 can define a delivery container opening 141 into the delivery container volume 168 at a distal end 139 ("delivery container distal end 139") of the delivery container 140. The delivery container opening 141 is sized such that at least some portion of the snare 122, the torque coupler 106, at least some portion of the driver body distal portion 105, and / or at least some portion of the IMD 110 (e.g., the IMD retrieval structure 111) can pass through the delivery container opening 141 in a proximal direction P and / or in a distal direction D. The delivery catheter lumen 142 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 142.

[0067] The delivery container 140 defines a delivery container volume 168 that is configured to receive the torque coupler 106, at least a portion of the snare 122, and at least a portion of the IMD 110. The delivery container opening 141 and the delivery catheter lumen 142 open into the delivery container volume 168. The delivery container 140 is configured such that when the snare 122 and / or the torque coupler 106 are engaged with the IMD 110, at least the torque coupler 106, at least a portion of the snare 122, and at least a portion of the IMD 110 can be positioned within the delivery container volume 168. In an example, the delivery container 140 can be configured such that when the snare 122 and / or the torque coupler 106 are engaged with the IMD 110, substantially the entire IMD 110 can be positioned within the delivery container volume 168. For example, the delivery catheter 134 can be moved in a distal direction D relative to the snare 122, the torque coupler 106, and / or the IMD 110 to receive the snare 122, the torque coupler 106, and / or the IMD 110. The delivery catheter 134 can be moved in a proximal direction P relative to the snare 122, the torque coupler 106, and / or the IMD 110 to position the snare 122, the torque coupler 106, and / or the IMD 110 distally of the delivery receptacle opening 141.

[0068] Figures 4 to 9 Medical system 100 is illustrated retrieving IMD 110 secured to tissue wall 166 via attachment member 118. Figures 4 to 9 In the example of the embodiment of the present invention, the attachment member 118 defines a spiral. In other examples, the attachment member 118 can define other structures, such as one or more elongated prongs. The tissue wall 166 can be within the target site 120 ( Figure 1 ). Further, in Figures 4 to 8 In the example of FIG. 1 , the torque coupler 106 is oriented relative to the IMD 110 such that the coupler axis LC and the IMD axis LD define an angle of inclination (eg, angle A1 ( Figure 2 , Figure 3 )), but this is not necessary. Figures 4 to 8 In the example of FIG. 1 , the torque coupler 106 is oriented relative to the IMD 110 such that the coupler axis LC and the IMD axis LD define an inclination angle A4 ( Figure 4 )、Tilt Angle A5( Figure 5 )、Tilt Angle A6( Figure 6 )、Tilt Angle A7( Figure 7 ) and tilt angle A8( Figure 8). In examples, tilt angles A4, A5, A6, A7, A8 define an angular displacement between the coupler axis LC and the IMD axis LD. In some examples, tilt angles A4, A5, A6, A7, A8 define an angular displacement between the coupler axis LC and the projection of the IMD axis LD on a geometric plane that includes the coupler axis LC. Any of the tilt angles A4, A5, A6, A7, A8 may describe substantially the same angular displacement or a different angular displacement than any other of the tilt angles A4, A5, A6, A7, A8. Additionally, although not shown, the coupler axis LC and the IMD axis LD may be disposed at Fig. 9 The tilt angle is limited in the middle.

[0069] Figure 4 The snare 122 is illustrated, extending distally of the torque coupler 106 to engage the retrieval structure 111 of the IMD 110. The snare 122 (e.g., the snare loop 126 and / or the snare body 124) can be configured to engage the IMD retrieval structure 111 when the coupler axis LC and the IMD axis LD define an inclination angle A4. The snare 122 can be configured such that a force (distal force) applied to the snare body 124 (e.g., applied by a clinician on the snare body proximal portion 123) translates the snare loop 126 toward the IMD retrieval structure 111. The snare body 124 can have sufficient rigidity to extend the snare loop 126 distally beyond the coupler opening 148 so that the snare loop 126 is positioned proximate to the IMD retrieval structure 111. In examples, the snare loop 126 and / or the snare body 124 may be resiliently biased such that when the snare loop 126 is positioned distal to the torque coupler 106 and / or the driver lumen 128 (e.g., when the snare loop is substantially unconstrained by the torque coupler 106 and / or the driver lumen 128), the snare loop 126 substantially establishes a particular orientation relative to the snare body 124. For example, the snare loop 126 and / or the snare body 124 may be resiliently biased such that when the snare loop 126 is unconstrained by the torque coupler 106 and / or the driver lumen 128, the snare loop 126 and the snare body 124 define an angle (e.g., an angle of approximately 90 degrees, an angle of approximately 45 degrees, or some other angle). The snare body 124 can be translated (eg, by a clinician) through the driver lumen 128 such that the annulus 146 of the snare ring 126 receives (eg, substantially surrounds) at least some portion of the IMD 110 , such as the IMD retrieval structure 111 .

[0070] Figure 5The snare loop 126 is illustrated as engaging the retrieval structure 111 such that the loop aperture 146 substantially surrounds the IMD retrieval structure 111. In the example, the snare 122 is configured such that when the snare loop 126 engages the retrieval structure 111, the snare body 124 is translated proximally through the driver lumen 128 to cause the aperture 146 to contract around the retrieval structure 111. Figure 5 In the embodiment of the present invention, with the snare loop 126 engaged with the retrieval structure 111, the coupler axis LC and the IMD axis LD define an inclination angle A5, which can describe an angular displacement that is substantially similar or different from the inclination angle A4. Figure 6 As shown, the medical system 100 includes a snare sheath 130. The snare sheath 130 can translate relative to the snare loop 126 to shrink the snare loop 126 around the retrieval structure 111. Figure 6 , the coupler axis LC and the IMD axis LD define an inclination angle A6, which can describe an angular displacement that is substantially similar to or different from the inclination angles A4, A5, when the snare sheath translates relative to the snare ring 126. In examples, the snare 122 and / or the snare sheath 130 are configured such that when the snare 122 is engaged with the IMD retrieval structure 111, the snare 122 and / or the snare sheath 130 can substantially guide the torque coupler 106 toward the IMD retrieval structure to enable contact between the torque coupler 106 and the IMD retrieval structure (e.g., when the driver 102 is translated proximally as the snare 122 and / or the snare sheath 130 extends through the driver lumen 128).

[0071] Figure 7 The driver 102 is illustrated translating over the snare ring 126 and / or snare sheath 130 to cause contact between the torque coupler 106 and the IMD retrieval structure 111. With the torque coupler 106 contacting the IMD retrieval structure 111, the coupler axis LC and the IMD axis LD define a tilt angle A7, which can describe an angular displacement that is substantially similar or different than the tilt angles A4, A5, A6.

[0072] exist Figure 7 In the embodiment, the snare 122 exerts a proximally directed force FP on the retrieval structure 111 (eg, by a clinician applying a force FP to the snare body proximal portion 123 ( Figure 1 ) is applied in a proximal direction on the driver body proximal portion 107). The torque coupler 106 applies a distally directed force FD on the retrieval structure 111 (eg, caused by a clinician applying a force FD to the driver body proximal portion 107 ( Figure 1) is caused by applying a distally directed force FD on the torque coupler 106). When the torque coupler 106 contacts the IMD retrieval structure 111, the proximally directed force FP and / or the distally directed force FD generate a contact force between the torque coupler 106 (e.g., the coupler surface 147) and the IMD retrieval structure 111 (e.g., one or more of the multiple petals 160). The medical system 100 is configured such that increasing or decreasing the proximally directed force FP (e.g., by a clinician) can increase or decrease the contact force between the torque coupler 106 and the IMD retrieval structure 111, respectively. The medical system 100 is configured such that increasing or decreasing the distally directed force FD (e.g., by a clinician) can increase or decrease the contact force, i.e., the contact force between the torque coupler 106 and the IMD retrieval structure 111, respectively. Thus, medical system 100 is configured such that a clinician can vary and / or change the contact force between torque coupler 106 and IMD retrieval structure 111 by varying and / or changing the proximally directed force FP and / or the distally directed force FD.

[0073] The torque coupler 106 may be rotated (eg, by a clinician) relative to the IMD retrieval structure 111 (eg, when the coupler axis LC and the IMD axis LD define an inclination angle A7). Figure 7 The driver 102 is illustrated as being subjected to torque (eg, by a clinician via the driver body proximal portion 107 ( Figure 1 ) is applied), causing the driver body 104 and the torque coupler 106 to rotate in a rotational direction W. The rotational direction W may be, for example, a first rotational direction W1 or a second rotational direction W2 ( Figure 1 ). The protrusions 154 (e.g., protrusions 156, 158) of the coupler surface 147 can be configured to translate in a sliding manner on (e.g., slide on) the IMD retrieval structure 111 (e.g., IMD petals 162, 164) when the torque coupler 106 contacts the IMD retrieval structure 111, the torque coupler 106 rotates in the rotational direction W, and the contact force (caused by the proximally directed force FP and / or the distally directed force FD) provides the sliding force. In an example, the protrusion 152 is configured to rotate about the coupler axis LC to translate in a sliding manner on the IMD retrieval structure 111. Protrusions 154 may slide over IMD retrieval structure 111 until a contact force provides an engagement force that causes at least one of protrusions 154 (e.g., at least one of protrusions 156 or protrusions 158) to transmit a torque that rotates IMD 110 (e.g., IMD 110 rotates about IMD axis LD).

[0074] The contact force can be increased from the sliding force (e.g., by a clinician) so that at least one of the protrusions 156 or 158 sufficiently engages the IMD retrieval structure 111 for transmitting a torque sufficient to cause the IMD 110 to rotate. For example, as the torque coupler 106 contacts the IMD retrieval structure 111 and rotates relative thereto, the clinician can increase the proximally directed force FP and / or increase the distally directed force FD to increase the contact force. The clinician can continue to controllably increase the contact force until the contact force provides an engagement force such that at least one of the protrusions 156 or 158 transmits a torque sufficient to rotate the IMD 110. As the protrusions 156, 158 transmit torque to the IMD retrieval structure 111, the clinician can substantially maintain and / or adjust the contact force such that the medical system 100 can transmit torque when the coupler axis LC of the torque coupler 106 and the IMD axis of the IMD define an inclination angle A7. Thus, when the torque coupler 106 approaches the IMD along a path that is substantially offset from (eg, tilted toward) an IMD axis of the IMD, the torque coupler 106 can be configured to engage the IMD and / or transfer torque to the IMD.

[0075] The medical system 100 can be configured to control (eg, increase, decrease, and / or substantially maintain) the contact force to improve and / or control the torque transfer from the torque coupler 106 to the IMD retrieval structure 111. For example, Figure 8 As shown, medical system 100 can be configured such that adjustment of distally directed force FD and / or proximally directed force FP and / or continued rotation of torque coupler 106 relative to IMD retrieval structure 111 causes torque coupler 106 and / or IMD 110 to reduce the tilt angle defined between coupler axis LC and IMD axis LD (e.g., from tilt angle A7 to A7). Figure 7 ) is reduced to an inclination angle A8).

[0076] In an example, the torque coupler 106 is configured to reduce the tilt angle when the distally directed force FD and the proximally directed force FP act on the IMD retrieval structure 111. For example, when the torque coupler 106 contacts the IMD retrieval structure 111, the contact can establish a pivot point PT ( Figure 7 , Figure 8), the torque coupler 106 can pivot and / or rock relative to the IMD retrieval structure 111 about the pivot point PT. The torque coupler 106 can be configured such that a contact force between the torque coupler 106 and the IMD retrieval structure 111 (e.g., controlled by a clinician) causes the torque coupler 106 to pivot substantially about the pivot point PT in a direction toward the IMD retrieval structure 111, thereby reducing the tilt angle between the coupler axis LC and the IMD axis LD. In some examples, in addition to pivoting about the pivot point PT, the torque coupler 106 can be configured such that the contact force causes the coupler surface 147 to translate in a sliding manner on the IMD retrieval structure 111 in a direction that reduces the tilt angle. For example, at least a portion of the coupler surface 147 can be configured to conform to a surface defined by the IMD petals 162, 164. The torque coupler 106 can be configured such that the contact force causes a portion of the coupler surface 147 to translate in a sliding manner on the surface defined by the IMD petals 162, 164 to reduce the tilt angle. In the example, Figure 8 As shown, when the torque coupler 106 pivots and / or translates in a sliding manner to reduce the tilt angle between the coupler axis LC and the IMD axis LD, the driver body 104 can be configured to flex and / or bend (e.g., define a bent shape or a curved shape). The driver body 104 and the torque coupler 106 can be configured to rotate along the rotational direction W when the driver body 104 flexes and / or bends.

[0077] Fig. 91 is a schematic diagram of the snare 122, the torque coupler 106, and the IMD 110 positioned within a delivery container volume 168 defined by the delivery container 140. The delivery catheter 134 can be moved in a distal direction D relative to the snare 122, the torque coupler 106, and / or the IMD 110 to position the snare 122, the torque coupler 106, and / or the IMD 110 within the delivery container volume 168. For example, after the attachment member 118 is detached from the tissue wall 166, the delivery container volume 168 can receive the snare 122, the torque coupler 106, and / or the IMD 110 so that the delivery catheter 134 can withdraw the snare 122, the torque coupler 106, and / or the IMD 110 from the patient's body (e.g., via the patient's vasculature). Likewise, the delivery catheter 134 can be moved in a proximal direction P relative to the snare 122, the torque coupler 106, and / or the IMD 110 to move the snare 122, the torque coupler 106, and / or the IMD 110 out of the delivery container volume 168 and / or to be positioned distally of the delivery container volume. For example, after delivering the snare 122, the torque coupler 106, and / or the IMD 110 to the patient's anatomical volume (e.g., via the patient's vasculature), the delivery catheter 134 can move the snare 122, the torque coupler 106, and / or the IMD 110 out of the delivery container volume 168 and / or to be positioned distally of the delivery container volume.

[0078] 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 170 supported by attachment member 118, electrode 172 supported by housing 174 of IMD 110 ("IMD housing 174"), and / or electrode 176 (e.g., a return electrode) supported by IMD housing 174. One or more of electrodes 170, 172, 176 may be electrically connected to operating circuitry 178. Operating circuitry 178 may be configured to deliver therapy to a patient and / or sense physiological signals of the patient using electrodes 170, 172, 176. In an example, at least a portion of operating circuitry 178 is supported by IMD housing 174. In some examples, at least a portion of operating circuitry 178 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).

[0079] Fig.10 is a perspective view illustrating a portion of torque coupler 106 and IMD 110 including retrieval structure 111 . Fig.11A is a schematic top view of the torque coupler 106, with the coupler axis LC and the y-axis of the xyz axis shown extending out of the page. Fig. 11Bis a schematic cross-sectional view of the torque coupler 106, wherein the cutting plane is taken through the coupler axis LC, and the z-axis of the xyz axes is shown extending outward from the page. Fig.12 is a perspective view illustrating an exemplary torque coupler 106 and IMD 110 with snare 122 engaging retrieval structure 111 . Fig.13 is a schematic plan view of an exemplary torque coupler 106. The y-axis is parallel to Fig.11A , Fig. 11B and Fig.13 The coupler axis LC in the Fig.12 The coupler axis LC and the device axis LD in the y-axis. Fig.11A The z-axis extends from Fig. 11B The page extends out and the z axis enters Fig.12 and Fig.13 The torque coupler 106 includes a coupler surface 147 defining protrusions 154, which include protrusions 156 (e.g., a first protrusion), protrusions 158 (e.g., a second protrusion), and a base portion 180 separating protrusions 156 and protrusions 158. Protrusions 154 may include one or more additional protrusions, such as protrusion 182.

[0080] Coupler surface 147 can define coupler volume 112. In an example, coupler surface 147 defines a boundary of coupler volume 112 that extends substantially from driver lumen opening 143 to coupler opening 148. Coupler surface 147 can be configured (e.g., shaped relative to coupler axis LC) to allow and / or facilitate contact between coupler surface 147 and IMD retrieval structure 111 when coupler axis LC and IMD axis LD define an oblique angle (e.g., oblique angles A1, A4, A5, A6, A7, A8). Coupler surface 147 can be configured such that contact forces (e.g., caused by proximally directed force FP and / or distally directed force FD) are contacted with each other. Figure 7 , Figure 8 ) causes the torque coupler 106 to pivot and / or translate in a sliding manner relative to the IMD retrieval structure 111 to reduce the tilt angle. In an example, at least a portion of the coupler surface 147 (e.g., the base portion 180) defines a concave surface that curves inwardly toward the coupler axis LC (e.g., in the xy plane, the xz plane, or the yz plane). In an example, as a portion of the coupler surface 147 extends in a direction from the driver lumen opening 143 toward the coupler opening 148, at least a portion of the coupler surface 147 (e.g., the base portion 180) gradually expands radially outward from the coupler axis LC.

[0081] The protrusions 156, 158, 182 can be configured to slide on the IMD retrieval structure 111 until at least one of the protrusions 156, 158, 182 engages the IMD retrieval structure 111 sufficient to transfer a torque to rotate the IMD 110 (e.g., until a contact force from the torque coupler 106 to the IMD retrieval structure 111 provides an engagement force). In some examples, the protrusions 156, 158, 182 define one or more fillets to assist in translating the protrusions 156, 158, 182 in a sliding manner on the IMD retrieval structure 111. The fillets can define a curved profile, a curved profile, and / or a polygonal curved profile in a geometric plane that is substantially parallel to, perpendicular to, or includes the coupler axis LC. For example, the protrusion 156 includes a fillet 184. The fillet 184 defines a curved profile, a curved profile, and / or a polygonal curved profile P1 ( Fig. 11B The fillet 184 defines a curved, curved, and / or polygonal curved profile P2 in a geometric plane defined by the x-axis and the z-axis and perpendicular to the coupler axis LC ( Fig.11A At least one protrusion (eg, protrusion 156) may define a convex surface (eg, a curved profile, a curved profile, and / or a polygonal curved profile P1, P2) that curves outwardly away from the coupler axis LC.

[0082] In examples, the protrusions 156, 158, 182 can be configured (e.g., shaped relative to the coupler axis LC) to allow and / or facilitate engagement with the IMD retrieval structure 111 when the coupler axis LC and the IMD axis LD define an angle of inclination A1, A4, A5, A6, A7, A8, and / or another angle of inclination. For example, the protrusions 156, 158, 182 can be configured to allow and / or facilitate insertion of the protrusions 156, 158, 182 into a recess defined by the IMD retrieval structure 111 between two or more IMD petals, such as the IMD recess 186 defined between the IMD petals 162 and the IMD petals 164. In examples, at least a portion of protrusions 156 , 158 , 182 (eg, portion 188 of protrusion 156 ) tapers radially inward from coupler axis LC as a portion of protrusions 156 , 158 , 182 extends in a direction from coupler opening 148 to driver lumen opening 143 .

[0083] The coupler surface 147 can include a plurality of protrusion surfaces that define the protrusion 154, such as a protrusion surface 187 of the protrusion 156. In an example, the protrusion surface 187 and the base portion 180 form a contiguous portion of the coupler surface 147. For example, the protrusion surface 187 and the base portion 180 can be combined to define a curved portion of the coupler surface 147, a corner portion of the coupler surface 147, a substantially flat portion of the coupler surface 147, or a portion of the coupler surface 147 that presents another surface profile. In an example, at least a portion of the protrusion surface 187 and / or at least a portion of the base portion 180 defines a curved profile, a curvilinear profile, and / or a polygonal curved profile in a geometric plane that is substantially parallel to, perpendicular to, or includes the coupler axis LC.

[0084] When the protrusions 156, 158, 182 are translated in a sliding manner about the IMD retrieval structure 111 (e.g., when the torque coupler 106 contacts the IMD retrieval structure 111 and rotates relative thereto), the coupler distal end 150 can be configured to assist and / or facilitate insertion of the protrusions 156, 158, 182 into the IMD recess 186. In an example, the torque coupler 106 defines the coupler distal end 150 such that the end coupler perimeter PR ( Fig.11A , Fig.12 , Fig.13 ) is substantially non-planar. The non-planar coupler opening 148 can allow the protrusions 156, 158, 182 to be more easily inserted into the IMD recess 186 during rotation of the torque coupler 106 when, for example, the coupler axis LC and the IMD axis LD define an angle of inclination A1, A4, A5, A6, A7, A8, and / or another angle of inclination.

[0085] The end coupler periphery PR may include one or more curved segments, curved segments, polygonal curved segments, and / or other segments. In an example, the end coupler periphery PR is non-planar. For example, the end coupler periphery PR may include multiple non-coplanar points, such as PA, PB, PC, and PD. In some examples, the torque distal end 150 defines the end coupler periphery PR so that at least a portion 194 ("peripheral portion 194") of the end coupler periphery PR defines an acute angle AC relative to the coupler axis LC. For example, the peripheral portion 194 may define a plane PL1 that is angularly displaced from the coupler axis LC by an acute angle AC. The acute angle AC may define any acute angle displacement from the coupler axis LC. In an example, the acute angle AC defines an angular displacement of less than about 80 degrees, less than about 70 degrees, less than about 60 degrees, or less than about 45 degrees. In some examples, the end coupler periphery PR includes a second portion 196 ("second peripheral portion 196") that defines a plane PL2. The torque coupler 106 can define a perimeter PR such that the plane PL1 and the plane PL2 are angularly displaced by an angle AG such that the perimeter portion 194 and the second perimeter portion 196 are substantially non-coplanar and / or non-parallel. The angle AG can define any angular displacement between the perimeter portion 194 and the second perimeter portion 196. In examples, the angle AG defines an angular displacement greater than about 10 degrees, greater than about 20 degrees, greater than about 30 degrees, or greater than about 45 degrees. In some examples, the torque coupler 106 defines the coupler distal end 150 such that substantially the entire end coupler perimeter PR defines the plane PL1.

[0086] In an example, the IMD petals 162, 164 extend in a direction substantially radial to the IMD axis LD. The IMD petals 162, 164 can be configured to allow and / or facilitate slidable translation of the protrusions 156, 158, 182 on the IMD retrieval structure 111 until at least one of the protrusions 156, 158, 162 engages the IMD retrieval structure 111 to transmit torque that rotates the IMD 110 (e.g., until contact forces from the torque coupler 106 to the IMD retrieval structure 111 provide an engagement force). In an example, the IMD petals 162, 164 define one or more lobes (such as lobes 190 ( Fig.12)), the one or more lobes are configured to allow and / or assist in the slidable translation of the protrusions 156, 158, 182 on the IMD retrieval structure 111. The lobes 190 may include one or more fillets that define a curved profile, a curved profile, and / or a polygonal curved profile in a geometric plane that is substantially parallel to, perpendicular to, or includes the device axis LD. For example, the lobes 190 may include fillets 192. The fillets 192 define a curved profile, a curved profile, and / or a polygonal curved profile P3 in a geometric plane defined by the x-axis and the y-axis and substantially parallel to or including the device axis LD. The fillets 192 define a curved profile, a curved profile, and / or a polygonal curved profile P4 in a geometric plane defined by the x-axis and the z-axis and perpendicular to the coupler axis LC. In an example, at least one IMD petal (e.g., the IMD petal 164) may define a concave surface that curves inwardly toward the device axis LD (e.g., in the xy plane, the xz plane, or the yz plane).

[0087] As discussed, the projection 154 is configured such that when the proximal force FP ( Figure 7 , Figure 8 ) and the distally directed force FD ( Figure 7 , Figure 8 ) As the protrusions 156, 158, 182 contact the IMD retrieval structure 111 to generate an engagement force, at least one of the protrusions 156, 158, 182 transfers torque from the torque coupler 106 to the IMD retrieval structure. The engagement force is a contact force that is of sufficient magnitude to cause the protrusions 156, 158, 182 to transfer torque to the IMD retrieval structure 111, which is sufficient, for example, to rotate the IMD 110 about the IMD axis LD. In an example, when the torque coupler 106 is rotated relative to the IMD retrieval structure 111 and the protrusions 156, 158, 182 are inserted into the IMD recess 186, the engagement force causes the protrusions 156, 158, 182 to transfer torque to the IMD retrieval structure 111.

[0088] For example, Fig.14 1 is a perspective view of an exemplary torque coupler 106 with the protrusion 156 inserted into the IMD recess 186 of the IMD retrieval structure 111. The coupler axis LC and the IMD axis LD define an inclination angle A14, which can be any of the inclination angles A1, A4, A5, A6, A7, and / or another inclination angle. For clarity, the torque coupler 106 is shown in FIG. Fig.14 is illustrated as transparent. Fig.15 is a schematic cross-sectional view of the torque coupler 106 and the IMD retrieval structure 111 , wherein the cutting plane is taken perpendicular to the coupler axis LC. Fig.14 , Fig.15 It can be expressed that when the coupler axis LC and the IMD axis LD define a tilt angle (such as tilt angle A8) ( Figure 7 ) when the torque coupler 106 and the IMD retrieval structure are oriented accordingly.

[0089] The snare 122 (e.g., snare loop 126) is engaged with the IMD retrieval structure 111 such that the snare 122 can apply a proximally directed force FP on the IMD 110 (e.g., the IMD retrieval structure 111). In an example, the snare sheath 130 contracts the snare loop 126 around the IMD retrieval structure 111. The torque coupler 106 (e.g., coupler surface 147) contacts the IMD retrieval structure 111 such that the torque coupler 106 can apply a distally directed force FP on the IMD retrieval structure 111. The snare 122 and the torque coupler 106 are oriented relative to the IMD 110 such that the proximally directed force FP and / or the distally directed force FD generate a contact force applied from the torque coupler 106 to the IMD retrieval structure 111.

[0090] As discussed, when the torque coupler 106 contacts the IMD retrieval structure 111, the protrusion 156 is configured to translate (e.g., slide over) in a sliding manner on the IMD retrieval structure 111, the torque coupler 106 rotates in the rotational direction W, and the contact force provides a sliding force. The protrusion 156 can slide on the IMD retrieval structure 111 until the contact force provides an engagement force that is sufficient to cause the protrusion 156 to transfer torque to rotate the IMD 110. The proximal force FP and / or the distal force FD can be changed (e.g., increased) to substantially stop the sliding of the protrusion 156 on the IMD retrieval structure 111 (e.g., on the IMD petals 162, 164) and cause the protrusion 156 to transfer torque to the IMD retrieval structure 111. For example, the clinician can change the snare body proximal portion 123 ( Figure 1 ) to change the proximal force FP. The clinician can change the proximal portion 107 ( Figure 1 ) in a distal direction to change the proximal force FP. The clinician can change the proximal force FP and / or the distal force FD such that the contact force provides an engagement force and such that the protrusion 156 transmits a torque that rotates the IMD 110. For example, the protrusion 156 can be configured to transmit the force F to the IMD retrieval structure 111 (e.g., the IMD petals 162) when the torque coupler 106 is subjected to a torque in the rotational direction W and the proximal force FP and / or the distal force FD cause the contact force to provide an engagement force.

[0091] In an example, protrusion 156 includes a bearing surface 198 ("protrusion bearing surface 198") that is configured to contact IMD petals 162 when protrusion 156 is inserted into IMD recess 186. Protrusion 156 can be configured such that protrusion bearing surface 198 extends substantially radially inward toward coupler axis LC. Protrusion 156 can be configured to substantially distribute force F across protrusion bearing surface 198 when protrusion 156 transmits force F to IMD retrieval structure 111 (e.g., IMD petals 162). In some examples, protrusion bearing surface 198 is configured to contact bearing surfaces 202 ("IMD bearing surface 202") of IMD petals 162 when protrusion 156 is inserted into IMD recess 186.

[0092] The IMD bearing surface 202 can be configured to receive the force F from the protrusion 156 as a distributed force on the IMD bearing surface 202. The IMD petals 162 can be configured so that the IMD bearing surface 202 extends substantially radially outward from the device axis LD. In an example, the IMD includes a petal root 204 and a petal distal end 206 extending substantially radially outward along the device axis LD. The IMD petals 162 can be configured so that the IMD bearing surface 202 extends between the petal root 204 and the petal distal end 206 and / or substantially separates the petal root and the petal distal end. Therefore, the IMD petals 162 can be configured to receive the force F from the protrusion 156 over an area extending radially outward toward the petal distal end 206, rather than, for example, receiving the force F as a substantially concentrated force generally in the area of ​​the petal distal end 206.

[0093] In an example, when the protrusion 156 is inserted into the IMD recess 186, at least some portion of the protrusion support surface 198 is configured to be substantially parallel to and / or conform to at least some portion of the IMD support surface 198. The protrusion support surface 198 can be configured to contact the IMD support surface 198 when the coupler axis LC and the device axis LD define an angle of inclination (such as one or more of the angles of inclination A1, A4, A5, A6, A7, A14), so that when the torque coupler 106 is axially offset (e.g., inclined to) the IMD 110, the torque coupler 106 can transfer torque to the IMD 110. In an example, when the protrusion 156 is inserted into the IMD recess 186, the protrusion support surface 198 translates in a sliding manner on the IMD support surface 198, so that the protrusion support surface 198 can transfer the force F to the IMD support surface 202 within the angular displacement range defined by the angle of inclination A14.

[0094] As discussed, the driver body 104 is configured to transmit torque (e.g., torque about the coupler axis LC) to the torque coupler 106 to rotate the torque coupler 106 (e.g., about the coupler axis LC). The driver body 104 can be mechanically connected to the torque coupler 106 in any manner that establishes a rotational coupling between the driver body 104 and the torque coupler 106 (e.g., by welding, brazing, adhesive, pins, or some other suitable fastening method). In some examples, the driver body 104 includes a torque coil. The torque coil can have a spiral form that substantially surrounds the spiral interior. The medical system 100 can be configured so that the coupler axis LC passes through at least some portion of the spiral interior. In some examples, the spiral interior defines at least a portion of the driver lumen 128. In an example, the driver body 104 and / or the snare sheath 130 can include a polymer material, such as a medical grade polymer.

[0095] The operating circuit system 178 may include fixed-function circuit systems and / or programmable operating circuit systems. In an example, the operating circuit system 178 may include circuit systems configured to perform one or more functions of the operating circuit system 178, such as treatment delivery circuit systems, sensing circuit systems, processing circuit systems, switching circuit systems, communication circuit systems, and / or other circuit systems. The operating circuit system 178 and other processors, processing circuit systems, controllers, control circuit systems, etc. described herein may include any combination of the following: integrated circuit systems, discrete logic circuit systems, analog circuit systems, 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 system 178 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 circuit systems and / or analog circuit systems.

[0096] The functions attributed to the operating circuit system 178 may be embodied as software, firmware, hardware, or any combination thereof. The operating circuit system 178 may include, for example, various capacitors, transformers, switches, etc. configured to perform the functions of the operating circuit system 178. In an example, the operating circuit system 178 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 system 178 may include any suitable hardware, firmware, software, or any combination thereof for communicating with another device. In addition, the operating circuit system 178 may communicate with a networked computing device and / or a computer network. In an example, the operating circuit system 178 and / or other circuit systems of the medical system 100 are configured to deliver stimulation signals to the electrodes 170, 172, 176 and / or other electrodes and / or sensors within or outside the medical system 100 and / or receive sensing signals from them. The operating circuit system 178 may be configured to provide electrical signals to the electrodes 170, 172, 176, such as pacing therapy. The operating circuitry 178 may be configured to receive electrical signals, such as sensed cardiac electrical signals, from the electrodes 170 , 172 , 176 .

[0097] The medical system 100 (e.g., the operating circuit system 178) 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 system 178. 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 random access memory (RAM), read-only memory (ROM), non-volatile RAM (NVRAM), electrically erasable programmable ROM (EEPROM), ferroelectric RAM (FRAM), flash memory, or any other digital medium. In some examples, the memory includes computer-readable instructions that, when executed by the processing circuit system 178, cause the operating circuit system 178 to perform the various functions described herein and / or other functions of the operating circuit system 178.

[0098] The IMD housing 174 can encapsulate the operating circuit system 178 and / or other circuits within the medical system 10. The IMD housing 174 can be configured to isolate the operating circuit system 178 and / or other circuit systems from the environmental fluid that contacts the outer surface of the IMD housing 174. In an example, the IMD housing 174 is configured to hermetically seal the enclosure defined by the IMD 110 and retain the operating circuit system 178 and / or other circuit systems. The IMD housing 174 can be configured to define a shape that is easily accepted by the patient's body while minimizing patient discomfort. For example, the IMD housing 174 can define a substantially cylindrical shape with a cylindrical sidewall. In other examples, the IMD housing 174 can define a substantially rectangular or other non-cylindrical shape. The IMD housing 174 can define a shape in which the corners and edges are designed to have a relatively large radius so as to present a housing with an outer surface with a smooth contour. In an example, the attachment member 118 is coupled to the IMD housing 174.

[0099] 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.

[0100] Fig.14 The technique of applying torque using the medical system 100 is exemplified in Figures 1 to 15 The technology is described with reference to medical system 100 , but in other examples, the technology may be applied to other medical systems.

[0101] The technique includes transmitting torque (1602) on a torque coupler 106 supported at a distal end 108 of the driver body using a driver body 104 of a driver 102. The driver body 104 can apply torque on the torque coupler 106 to rotate the torque coupler 106 within an anatomical volume defined by a patient (e.g., a chamber of a heart). The torque coupler 106 can receive an IMD retrieval structure 111 within a coupler volume 112 defined by a coupler surface 147 of the torque coupler 106. The torque can rotate a plurality of protrusions 154 defined by the coupler surface 147 and extend toward a coupler axis LC extending through the coupler volume 112. In an example, the coupler volume 112 receives the retrieval structure 111 when the coupler axis LC defines an oblique angle with the IMD axis LD of the IMD 110.

[0102] The technique may include applying at least one of a proximally directed force FP on the IMD or a distally directed force FD on the IMD retrieval structure to generate an engagement force from the torque coupler 106 to the IMD retrieval structure 111 (1604). The snare 122 may engage the IMD 110 to apply the proximally directed force FP. In an example, a snare ring 126 supported by a snare body 124 engages the IMD 110 (e.g., the IMD retrieval structure) to apply the proximally directed force FP. The snare ring 126 may contract around the IMD 110 to engage the IMD 110. In an example, the snare sheath 130 translates (e.g., translates distally) relative to the snare body 124 to contract the snare ring 126 around the IMD 110. When a proximal force is applied on the snare body proximal portion 123 (e.g., applied by a clinician), the snare ring 126 can apply a proximally directed force FP on the IMD 110. In an example, when the snare 122 engages the IMD 110, the snare body 124 extends through the driver lumen 128 and the driver lumen opening 143. When the proximally directed force FP is applied, the snare 122 can cause the coupler volume 112 to receive the IMD 110 (e.g., the IMD retrieval structure 111). In an example, the IMD 110 moves proximally (e.g., in a proximal direction P) relative to the torque coupler 106 to cause the coupler volume 112 to receive the IMD 110. In an example, the torque coupler 106 moves distally (e.g., in a distal direction D) relative to the IMD 110 to cause the coupler volume 112 to receive the IMD 110.

[0103] The torque coupler 106 can engage (e.g., contact) the IMD retrieval structure 111 to apply a distally directed force FD. When the coupler volume 112 receives the IMD retrieval structure, the torque coupler 106 can engage the IMD retrieval structure 111. When a distal force (e.g., by a clinician) is applied to the driver body proximal portion 107, the torque coupler 106 can apply a distally directed force FD on the IMD 110. In an example, the driver body 104 extends through the delivery catheter lumen 142 of the delivery catheter 134.

[0104] The technique includes using a plurality of protrusions 154 to transfer torque from a torque coupler 106 to an IMD 110 (1606). The torque coupler 106 can transfer torque when the coupler volume 112 receives the retrieval structure 111 and the coupler axis LC defines an oblique angle with the IMD axis LD. The torque coupler 106 can transfer torque when at least a first protrusion 156 of the plurality of protrusions 154 contacts the retrieval structure 111 and a proximally directed force FP and / or a distally directed force FD generate a contact force that provides an engagement force. When the torque coupler 106 transfers torque from the torque coupler 106 to the IMD 110, the torque coupler 106 can rotate the IMD 110 about the IMD axis LD. In an example, when the torque coupler 106 rotates the IMD 110, the torque coupler 106 disengages the attachment member 118 of the IMD 110 from tissue within or near a target site 120 in a patient's body. In an example, when the torque coupler 106 rotates the IMD 110 , the torque coupler 106 causes the attachment member 118 of the IMD 110 to engage tissue within or near the target site 120 .

[0105] The technique may include translating the first protrusion 156 in a sliding manner on the IMD retrieval structure 111 when the proximally directed force FP and / or the distally directed force FD generate a contact force that provides a sliding force. The torque coupler 106 may be rotated relative to the IMD retrieval structure 111 about the coupler axis LC to translate the first protrusion 156 in a sliding manner on the IMD retrieval structure 111. In an example, the proximally directed force FP and / or the distally directed force FD may be varied (e.g., by a clinician applying force to the snare body proximal portion 123 and / or the driver body proximal portion 107) to vary the contact force such that the contact force provides an engagement force and causes the first protrusion 156 to transmit torque to the IMD retrieval structure 111. In an example, the first protrusion 156 applies a force F on the IMD petals 162, 164 of the IMD retrieval structure 111 to transmit torque. The IMD petals 162, 164 may extend in a direction radially outward from the IMD axis LD.

[0106] In an example, slidingly translating the first protrusion 156 on the IMD retrieval structure 111 includes slidingly translating a rounded corner of the first protrusion on the IMD retrieval structure 111. In an example, slidingly translating the first protrusion 156 on the IMD retrieval structure 111 includes slidingly translating the first protrusion 156 on the rounded corners of the IMD petals 162, 164. When the first protrusion 156 contacts the IMD retrieval structure 111, the first protrusion 156 can distribute the force F on the protrusion support surface 198, which extends radially in a direction toward the coupler axis LC. The IMD petals 162, 164 can distribute the force F applied to the IMD support surface 202 defined by at least one of the IMD petals 162 or the IMD petals 164. In some examples, protrusion 156 transfers force F from protrusion support surface 198 to IMD support surface 202 .

[0107] The technique may include positioning at least a portion of the driver body 104, the torque coupler 106, the snare 122, and / or the IMD 110 within a delivery receptacle 140 of the delivery catheter 134 using a delivery catheter 134. The delivery catheter 134 may transport at least a portion of the driver body 104, the torque coupler 106, the snare 122, and / or the IMD 110 through the vasculature of the patient to at least one of: remove the IMD 110 from the patient's anatomical volume and / or implant the IMD 110 into the patient's anatomical volume. In an example, the driver body 104 and / or the snare body 124 may be positioned within the delivery receptacle volume 168 by translating in a sliding manner through a delivery catheter lumen 142 defined by the delivery catheter 134.

[0108] The present disclosure includes the following embodiments.

[0109] Embodiment 1: A medical system, comprising: a driver, the driver comprising a driver body and a torque coupler, the torque coupler being configured to receive torque from the driver body, wherein the driver body defines a lumen opening into a coupler volume defined by the torque coupler, wherein the torque coupler defines a coupler axis extending through the coupler volume and a plurality of protrusions extending toward the coupler axis, wherein the coupler volume is configured to receive a retrieval structure of an implantable medical device when the coupler axis defines an oblique angle with an IMD axis of the implantable medical device, and wherein the torque coupler is configured to apply a distally directed force on the retrieval structure when the coupler volume receives the retrieval structure; and a snare, the snare being configured to be snare within the lumen. wherein the snare is configured to apply a proximally directed force on the implantable medical device when the snare translates within the lumen, wherein the snare and the torque coupler are configured to generate an engagement force from the torque coupler to the retrieval structure when at least one of the snare applies the proximally directed force or the torque coupler applies the distally directed force, wherein the plurality of protrusions are configured to transmit the torque from the torque coupler to the retrieval structure when the coupler volume receives the retrieval structure, when the coupler axis defines the oblique angle with the IMD axis, when the snare and the torque coupler generate the engagement force, and when at least a first protrusion of the plurality of protrusions contacts the retrieval structure.

[0110] Embodiment 2: The medical system of Embodiment 1, wherein the snare and the torque coupler are configured to generate the engagement force when the snare applies the proximally directed force and the torque coupler applies the distally directed force.

[0111] Embodiment 3: The medical system of Embodiment 1 or Embodiment 2, wherein the first protrusion is configured to slidingly engage the retrieval structure when the coupler volume receives the retrieval structure, when the torque coupler is rotated relative to the retrieval structure, and when the snare and the torque coupler generate a sliding force from the torque coupler to the retrieval structure when at least one of the snare applies the proximally directed force or the torque coupler applies the distally directed force, wherein the sliding force is insufficient to cause the plurality of protrusions to transfer the torque from the torque coupler to the retrieval structure.

[0112] Embodiment 4: The medical system of Embodiment 3, wherein the snare and the torque coupler are configured to generate the engagement force at a first force magnitude and generate the sliding force at a second force magnitude, wherein the first force magnitude is greater than the second force magnitude.

[0113] Example 5: The medical system of Example 3 or Example 4, wherein the snare and the torque coupler are configured to generate the sliding force when the snare applies the proximally directed force and the torque coupler applies the distally directed force.

[0114] Embodiment 6: The medical system of any one of Embodiments 1 to 5, wherein the torque coupler defines at least three protrusions.

[0115] Embodiment 7: The medical system of Embodiment 6, wherein the tilt angle is greater than at least one of about 10 degrees, about 20 degrees, or about 30 degrees.

[0116] Embodiment 8: The medical system of any one of Embodiments 1 to 7, wherein the torque coupler is configured to apply the distally directed force in a direction substantially opposite to the proximally directed force applied by the snare.

[0117] Embodiment 9: The medical system of any one of Embodiments 1 to 8, wherein the torque coupler is configured to reduce an angular displacement of the tilt angle when the snare and the torque coupler generate an engagement force.

[0118] Embodiment 10: A medical system according to any one of embodiments 1 to 9, wherein the torque coupler includes a coupler surface, the coupler surface defines the coupler volume and defines the plurality of protrusions, wherein the plurality of protrusions include the first protrusion and the second protrusion, and wherein the coupler surface defines a base portion separating the first protrusion and the second protrusion.

[0119] Embodiment 11: The medical system of Embodiment 10, wherein the first protrusion defines a convex surface relative to the coupler axis.

[0120] Embodiment 12: The medical system of Embodiment 10 or Embodiment 11, wherein the base portion defines a concave surface relative to the coupler axis.

[0121] Embodiment 13: A medical system according to any one of embodiments 1 to 12, wherein at least the first protrusion defines one or more rounded corners, and the one or more rounded corners are configured to engage the retrieval structure in a sliding manner when the coupler volume receives the retrieval structure and the torque coupler rotates relative to the retrieval structure substantially around the coupler axis.

[0122] Embodiment 14: The medical system of Embodiment 13, wherein at least one of the fillets defines at least one of a curved profile or a curvilinear profile in a plane substantially parallel to the coupler axis.

[0123] Embodiment 15: The medical system of Embodiment 13 or Embodiment 14, wherein at least one of the fillets defines at least one of a curved profile or a curvilinear profile in a plane substantially containing the coupler axis.

[0124] Embodiment 16: The medical system of any one of Embodiments 13 to 15, wherein at least one of the fillets defines at least one of a curved profile or a curvilinear profile in a plane substantially perpendicular to the coupler axis.

[0125] Embodiment 17: A medical system according to any one of Embodiments 1 to 16, wherein the lumen defines a lumen opening to the coupler volume, and wherein the torque coupler defines a coupler opening to the coupler volume, and wherein as the coupler surface extends from the lumen opening to the coupler opening, at least a portion of the coupler surface extends radially outward from the coupler axis.

[0126] Embodiment 18: The medical system of Embodiment 17, wherein the base portion expands radially outward from the coupler axis as the base portion extends in a direction from the lumen opening to the coupler opening.

[0127] Embodiment 19: The medical system of Embodiment 17 or Embodiment 18, wherein the portion of the coupler surface defining the first protrusion gradually extends inwardly toward the coupler axis as the portion of the coupler surface extends in a direction from the lumen opening to the coupler opening.

[0128] Embodiment 20: A medical system according to any one of embodiments 1 to 19, wherein the first protrusion defines a protrusion support surface extending radially in a direction toward the coupler axis, wherein the first protrusion is configured to distribute force on the protrusion support surface when the first protrusion contacts the retrieval structure and the multiple protrusions transfer the torque to the retrieval structure.

[0129] Embodiment 21: A medical system according to any one of embodiments 1 to 20, wherein the distal end of the torque coupler defines an end coupler periphery surrounding the coupler opening according to embodiment 17, and wherein at least a portion of the end coupler periphery defines a plane, wherein the plane defines an angle between the plane and the coupler axis.

[0130] Embodiment 22: The medical system of Embodiment 21, wherein the plane defines an angle between the plane and the coupler axis that is less than 80 degrees.

[0131] Embodiment 23: The medical system of any one of Embodiments 1 to 22, wherein the snare is configured to exert the proximally directed force on the retrieval structure.

[0132] Embodiment 24: The medical system of any one of Embodiments 1 to 23, wherein the coupler surface at least partially surrounds the coupler axis.

[0133] Embodiment 25: The medical system of any one of Embodiments 1 to 24, wherein the torque coupler is configured to rotate substantially about the coupler axis relative to the snare when the snare engages the implantable medical device.

[0134] Embodiment 26: According to the medical system described in any one of Embodiments 1 to 25, the medical system also includes the implantable medical device.

[0135] Embodiment 27: The medical system of Embodiment 26, wherein the retrieval structure defines a plurality of petals extending radially outward from the IMD axis.

[0136] Embodiment 28: A medical system according to Embodiment 27, wherein the first protrusion is configured to be inserted into a recess defined by a first petal-shaped member of the plurality of petals and a second petal-shaped member of the plurality of petals when the coupler volume receives the implantable medical device.

[0137] Example 29: A medical system according to Example 27 or Example 28, wherein at least one petal defines a petal support surface extending radially from the IMD axis, wherein the at least one petal is configured to distribute the force applied from the first protrusion on the support surface when the first protrusion contacts the retrieval structure and the multiple protrusions transfer the torque from the torque coupler to the retrieval structure.

[0138] Embodiment 30: A medical system according to any one of Embodiments 27 to 29, wherein at least one petal defines one or more rounded corners, and the one or more rounded corners are configured to engage at least one of the first protrusion or the second protrusion in a sliding manner when the coupler volume receives the implantable medical device and the torque coupler is rotated substantially about the coupler axis relative to the retrieval structure.

[0139] Embodiment 31: The medical system of Embodiment 30, wherein at least one of the rounded corners defines at least one of a curved profile or a curvilinear profile in a plane substantially parallel to the IMD axis.

[0140] Embodiment 32: The medical system of Embodiment 30 or Embodiment 31, wherein at least one of the rounded corners defines at least one of a curved profile or a curvilinear profile in a plane substantially containing the IMD axis.

[0141] Embodiment 33: The medical system of any one of Embodiments 30 to 32, wherein at least one of the rounded corners defines at least one of a curved profile or a curvilinear profile in a plane substantially perpendicular to the IMD axis.

[0142] Embodiment 34: The medical system of any one of Embodiments 30 to 33, wherein the retrieval structure defines one or more surfaces configured to conform to the coupler surface of Embodiment 10 when the coupler volume receives the implantable medical device.

[0143] Embodiment 35: A method, the method comprising: applying a torque on a torque coupler of the driver via a driver body of the driver, wherein the driver body defines a lumen opening to a coupler volume defined by the torque coupler, wherein the torque coupler defines a coupler axis extending through the coupler volume and a plurality of protrusions extending toward the coupler axis, and wherein the coupler volume is configured to receive a retrieval structure of an implantable medical device when the coupler axis defines an oblique angle with an IMD axis of the implantable medical device; applying the torque applied by the torque coupler to a retrieval structure of the implantable medical device; at least one of a distally directed force applied to the retrieval structure or a proximally directed force applied by a snare to the IMD is applied to the retrieval structure to generate an engagement force from the torque coupler to the retrieval structure, wherein the snare is configured to translate within the lumen; and when the coupler volume receives the retrieval structure, the torque is transmitted from the torque coupler to the retrieval structure using the plurality of protrusions, the coupler axis defining the inclination angle with the IMD axis, and at least a first protrusion of the plurality of protrusions contacts the retrieval structure.

[0144] Example 36: According to the method of Example 35, the method also includes applying the proximally directed force and the distally directed force.

[0145] Example 37: According to the method of Example 35 or Example 36, the method also includes slidingly engaging the first protrusion and the retrieval structure in the following circumstances: when the coupler volume receives the retrieval structure, when the torque coupler is rotated relative to the retrieval structure, and when at least one of the snare applies the proximal force or the torque coupler applies the distal force, the snare and the torque coupler generate a sliding force from the torque coupler to the retrieval structure, wherein the sliding force is insufficient to cause the multiple protrusions to transfer the torque from the torque coupler to the retrieval structure.

[0146] Example 38: The method of any one of Examples 35 to 37, further comprising generating the sliding force when the snare applies the proximally directed force and the torque coupler applies the distally directed force.

[0147] Embodiment 39: The method of any one of Embodiments 35 to 38, the medical system of Embodiment 6, further comprising receiving the retrieval structure in the coupler volume when the tilt angle is greater than at least one of 10 degrees, about 20 degrees, or about 30 degrees.

[0148] Embodiment 40: According to any one of embodiments 35 to 39, the method also includes applying the distally directed force in a direction substantially opposite to the proximally directed force.

[0149] Embodiment 41: The method according to any one of embodiments 35 to 40 further comprises using at least one of the proximally directed force or the distally directed force to reduce the angular displacement of the tilt angle.

[0150] Embodiment 42: The method of any one of Embodiments 35 to 41, further comprising slidingly engaging the first protrusion and one or more fillets of the retrieval structure.

[0151] Embodiment 43: According to the method described in any one of Embodiments 35 to 42, the method further includes distributing force on a protrusion support surface extending radially in a direction toward the coupler axis through the first protrusion when the first protrusion contacts the retrieval structure and the multiple protrusions transmit the torque to the retrieval structure.

[0152] Embodiment 44: According to any one of embodiments 35 to 43, the method also includes applying the proximally directed force on the retrieval structure.

[0153] Embodiment 45: The method of any one of Embodiments 35 to 44, further comprising rotating the torque coupler relative to the snare about the coupler axis when the snare engages the implantable medical device.

[0154] Embodiment 46: The method of any one of Embodiments 35 to 45, further comprising rotating the torque coupler about the coupler axis relative to the retrieval structure while the torque coupler applies the distally directed force.

[0155] Embodiment 47: According to the method described in any one of Embodiments 35 to 46, the method further includes rotating the torque coupler relative to the retrieval structure around the coupler axis so that the first petal-shaped object is inserted between the first petal-shaped object defined by the retrieval structure and the second petal-shaped object defined by the retrieval structure.

[0156] Embodiment 48: A method according to any one of Embodiments 35 to 47, the method also includes distributing the force applied from the first petal-shaped member on an IMD support surface defined by at least one IMD petal-shaped member, wherein the petal-shaped member support surface extends in a radial direction away from the IMD axis.

[0157] Embodiment 49: The method of any one of Embodiments 35 to 48, further comprising slidingly engaging one or more rounded corners of at least one IMD petal with the first protrusion.

[0158] Various examples of the 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 comprising a driver body and a torque coupler, the torque coupler being configured to receive torque from the driver body, wherein the driver body defines a lumen opening into a coupler volume defined by the torque coupler, wherein the torque coupler defines a coupler axis extending through the coupler volume and a plurality of protrusions extending toward the coupler axis, wherein the coupler volume is configured to receive a retrieval structure of the implantable medical device when the coupler axis defines an oblique angle with an IMD axis of the implantable medical device, and wherein the torque coupler is configured to exert a distally directed force on the retrieval structure when the coupler volume receives the retrieval structure; and a snare configured to translate within the lumen, wherein the snare is configured to exert a proximally directed force on the implantable medical device as the snare translates within the lumen, wherein the snare and the torque coupler are configured to generate an engagement force from the torque coupler to the retrieval structure when at least one of the snare applies the proximally directed force or the torque coupler applies the distally directed force, wherein the plurality of protrusions are configured to transfer the torque from the torque coupler to the retrieval structure when: When the coupler volume receives the retrieval structure, When the coupler axis and the IMD axis define the tilt angle, When the snare and the torque coupler generate the engagement force, and When at least a first protrusion of the plurality of protrusions contacts the retrieval structure.

2. The medical system of claim 1 , wherein the first protrusion is configured to slidably engage the retrieval structure when: When the coupler volume receives the retrieval structure, When the torque coupler is rotated relative to the retrieval structure, and When at least one of the snare exerting the proximally directed force or the torque coupler exerting the distally directed force occurs, the snare and the torque coupler generate a sliding force from the torque coupler to the retrieval structure, Wherein the sliding force is insufficient to cause the plurality of protrusions to transfer the torque from the torque coupler to the retrieval structure.

3. The medical system of claim 1 or claim 2, wherein the angle of inclination is greater than at least one of about 10 degrees, about 20 degrees, or about 30 degrees.

4. The medical system of any one of claims 1 to 3, wherein the torque coupler is configured to reduce an angular displacement of the tilt angle when the snare and the torque coupler generate the engagement force.

5. A medical system according to any one of claims 1 to 4, wherein the torque coupler includes a coupler surface that defines the coupler volume and defines the plurality of protrusions, wherein the plurality of protrusions include the first protrusion and the second protrusion, and wherein the coupler surface defines a base portion that separates the first protrusion and the second protrusion. The medical system of claim 5 , wherein the first protrusion defines a convex surface relative to the coupler axis.

7. The medical system of claim 5 or 6, wherein the base portion defines a concave surface relative to the coupler axis.

8. A medical system according to any one of claims 1 to 7, wherein at least the first protrusion defines one or more rounded corners, and the one or more rounded corners are configured to engage the retrieval structure in a sliding manner when the coupler volume receives the retrieval structure and the torque coupler is rotated relative to the retrieval structure substantially around the coupler axis.

9. A medical system according to any one of claims 1 to 8, wherein the lumen defines a lumen opening to the coupler volume, and wherein the torque coupler defines a coupler opening to the coupler volume, and wherein as the coupler surface extends from the lumen opening to the coupler opening, at least a portion of the coupler surface extends radially outward from the coupler axis.

10. The medical system of claim 9, wherein the portion of the coupler surface defining the first protrusion gradually extends inwardly toward the coupler axis as the portion of the coupler surface extends in a direction from the lumen opening to the coupler opening.

11. A medical system according to any one of claims 1 to 10, wherein the first protrusion defines a protrusion support surface extending radially in a direction toward the coupler axis, wherein the first protrusion is configured to distribute force on the protrusion support surface when the first protrusion contacts the retrieval structure and the multiple protrusions transfer the torque to the retrieval structure.

12. A medical system according to any one of claims 1 to 11, wherein the distal end of the torque coupler defines an end coupler periphery, wherein at least a portion of the end coupler periphery defines a plane, wherein the plane defines an angle between the plane and the coupler axis, and wherein the plane defines an angle between the plane and the coupler axis that is less than 80 degrees.

13. A medical system according to any one of claims 1 to 12, wherein the medical system also includes the implantable medical device, wherein the retrieval structure defines a plurality of petals extending radially outward from the IMD axis, and the first protrusion is configured to be inserted into a recess defined by a first petal of the plurality of petals and a second petal of the plurality of petals when the coupler volume receives the implantable medical device.

14. The medical system of claim 13, wherein at least one petal defines one or more fillets configured to slidingly engage the first protrusion when the coupler volume receives the implantable medical device and the torque coupler is rotated substantially about the coupler axis relative to the retrieval structure.

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