48 results about "Bundle of His" patented technology

A method for delivering physiological pacing includes selecting an electrode implant site within an interventricular septal zone, which is in proximity to the bundle of His where pacing stimulation results in a rhythm breaking out at an intrinsic location, and wherein a ratio of sensed P-wave amplitude to sensed R-wave amplitude is less than approximately 0.5 and a pacing threshold is less than or equal to approximately 1.5 volts.

A catheter for mapping and / or ablating a region of the heart, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible preshaped section. The highly flexible section presets the tip assembly at an off-axis and / or off-plane angles from the intermediate section, to provide the following: a) The intermediate section when deflected approximates the generally convex region of the cavo-tricuspid isthmus and the preset angle of the flexible section is off axis in the same plane and same direction as deflection of the intermediate section to enable the tip assembly to contact the cavo-tricuspid isthmus for ablation and / or mapping. b) The intermediate section when deflected approximates the generally concave region of the VA / RV / LA / LV and the preset angle in the same plane and opposite direction of deflection enables the tip assembly to contact the walls of the cavity for ablation and / or mapping. c) The intermediate section when deflected approximates the generally convex region of the His area and the preset off plane angle of the flexible section enable the tip assembly to contact the Bundle of His region. A high bending modulus of the flexible section enables the flexible section to absorb displacement force applied to the tip assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the intermediate section. The flexible section prevents excessive force from being applied to the tip assembly, reducing the risk of any of the following: a) mechanical perforation, b) steam pop, c) burying the tip assembly in the myocardium resulting in high temperatures, low energy delivery, thrombus formation and char formation.

The present invention discloses a catheter for mapping and / or ablating a region of the heart, comprises a catheter body with an intermediate section that is connected to a tip assembly by a highly flexible preshaped section. The highly flexible section presets the tip assembly at an off axis and / or off plane angles from the intermediate section, to provide the following: a) The intermediate section when deflected approximates the generally convex region of the cavo tricuspid isthmus and the preset angle of the flexible section is off axis in the same plane and same direction as deflection of the intermediate section to enable the tip assembly to contact the cavo tricuspid isthmus for ablation and / or mapping. b) The intermediate section when deflected approximates the generally concave region of the VA / RV / LA / LV and the preset angle in the same plane and opposite direction of deflection enables the tip assembly to contact the walls of the cavity for ablation and / or mapping. c) The intermediate section when deflected approximates the generally convex region of the His area and the preset off plane angle of the flexible section enable the tip assembly to contact the Bundle of His region. A high bending modulus of the flexible section enables the flexible section to absorb displacement force applied to the tip assembly, such as when the tip assembly encounters uneven tissue surface, without displacing the intermediate section. The flexible section prevents excessive force from being applied to the tip assembly, reducing the risk of any of the following: a) mechanical perforation, b) steam pop, c) burying the tip assembly in the myocardium resulting in high temperatures, low energy delivery, thrombus formation and char formation.

The present disclosure relates generally to pacing of cardiac tissue, and more particularly to adjusting delivery of His bundle or bundle branch pacing in a cardiac pacing system to achieve synchronized ventricular activation. A left bundle branch (LBB) cathode electrode may be implanted a left side of the septum of the patient's heart proximate to the LBB, and a right bundle branch (RBB) cathode electrode may be implanted on a right side of the septum of the patient's heart proximate to the RBB. One or both cathode electrodes may be used to deliver synchronized left and right bundle-branch pacing based on one or both of an atrial event and a ventricular event. A device for bundle branch pacing may be implanted based on determining whether an LBB block pattern or an RBB block pattern is present in monitored electrical activity.

A device and method for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit are provided. The method includes providing a single conduit with multiple electrodes, positioning electrodes in the target zone of a heart, selecting acceptable electrodes as active based on a predetermined criteria and providing cardiac stimulation for multiple chambers of the heart from a single location.

A method for delivering physiological pacing includes selecting an electrode implant site within an interventricular septal zone, which is in proximity to the bundle of His where pacing stimulation results in a rhythm breaking out at an intrinsic location, and wherein a ratio of sensed P-wave amplitude to sensed R-wave amplitude is less than approximately 0.5 and a pacing threshold is less than or equal to approximately 1.5 volts.

A device and method for cardiac pacing is disclosed in which anodal pacing of the left ventricle is provided. Anodal pacing occurs when an anodal surface area is sufficiently small to create an area of hyper-polarization of the myocardial cell membrane. This creates a virtual cathode at a location remote from the anode. The virtual cathode results in depolarization of the heart in a manner similar to the virtual cathode at the true fixed cathode. In addition a device and method for summation anodal pacing is provided in which one anode is common between two or more cathodes. This results in hyperpolarization of a larger segment of the myocardium as compared to non-summation anodal pacing and thereby forms a larger virtual electrode to enable capture of localized, discrete cardiac structures such as the bundle of His or the very proximal portions of the right and left bundles.

The present disclosure relates to devices and methods for cardiac pacing therapy. Disclosed herein are methods for His bundle cardiac pacing; cardiac leads and leadless cardiac pacemakers that enables pacing and sensing of the His bundle as well as the right atrium and right ventricle; and delivery sheaths for placing the cardiac lead or leadless cardiac pacemaker in the heart. The devices and methods disclosed increase the success at which His bundle pacing can be implemented.

A device and method for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit are provided. The method includes providing a single conduit with multiple electrodes, positioning electrodes in the target zone of a heart, selecting acceptable electrodes as active based on a predetermined criteria and providing cardiac stimulation for multiple chambers of the heart from a single location.

A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal tip, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position spaced from the distal tip of the sheath. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a straight configuration to a dual hinged curved configuration that positions the electrodes in the vicinity of the bundle of His.

A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal end face, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position exposed on or spaced from the distal end face. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a substantially straight configuration to a dual hinged curved configuration that maneuvers and positions the electrodes in the vicinity of the bundle of His. The sheath may include a PTFE liner having axially oriented, platelet-like fibril features that enable the sheath to be split along its length from a proximal end to the distal end.

Systems and methods for His bundle pacing and classifying response to pacing impulses include applying, using a pulse generator, an impulse through a stimulating electrode to induce a response from a patient heart. A response to the impulse is measured using at least one sensing electrode and time-domain based characteristics of the response are analyzed to determine whether His bundle capture has occurred and, if so, what type of capture has occurred.

A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal tip, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position spaced from the distal tip of the sheath. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a straight configuration to a dual hinged curved configuration that positions the electrodes in the vicinity of the bundle of His.

A leadless cardiac pacemaker is adapted for implantation into triangle of Koch or His bundle with a plurality of individual electrodes spread in the vicinity of implantation site. Individual electrodes are first evaluated for their suitability for sensing and pacing of atrial and ventricular chambers of the heart. Individual electrodes are then selected for delivery of cardiac pacing to multiple heart chambers from a single intra-cardiac location. Remaining non-selected individual electrodes may be abandoned. Also described is an adapter with multiple electrodes configured to dock with a conventional leadless or standard pacemaker to operate in the same way.

Systems for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit that may generate His- bundle pacing (HBP) pulses for delivery at or near the His bundle. In response to the delivery of the HBP pulse, the system senses a near-field cardiac activity representative of excitation of a para-Hisian myocardial tissue, and a far-field cardiac activity representative of excitation of the His bundle and a ventricle. The system classifies a tissue response to HBP into one of a plurality of capture types based on the sensed near-field and far-field cardiac activities. The system includes a control circuit to adjust one or more stimulation parameters based on the classified capture type. The electrostimulation circuit generates and delivers the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

Systems and methods for pacing cardiac conductive tissue are described. A medical system includes electrostimulation circuit that may generate His-bundle pacing (HBP) pulses for delivery at or near the His bundle. A capture verification circuit may detect, from a far-field signal representing ventricular response to the HBP pulses, a His-bundle response representative of excitation of the His bundle directly resulting from the HBP pulses, and a myocardial response representative of excitation of the myocardium directly resulting from the HBP pulses. A control circuit may adjust one or more stimulation parameters based on the His-bundle response and myocardial response. The electrostimulation circuit may generate and deliver the HBP pulses according to the adjusted stimulation parameters toexcite the His bundle.

An electro-anatomical model of the mammalian His / Purkinje system includes a shell simulating the anatomy of at least a portion of a mammalian heart. The shell has a hollow interior and a first port providing an aperture to the interior of the shell. A plug is inserted in the first port so that a surface of the plug is exposed to the interior of the shell. An electrical circuit provides signals to electrodes in the plug which simulate the electrical signals generated by the bundle of His / Purkinje system in vivo. A second port provides access to the interior of the shell for an introducer catheter to locate the simulated bundle of His and to insert a pacing lead therein. The model is useful for developing tools for His pacing and for training users in techniques for implanting His pacing leads.

Systems and methods for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses for delivery at or near a Hisbundle of the heart. A control circuit may time the delivery of the HBP pulses within a tissue refractory period subsequent to an intrinsic His-bundle activation of a first His-bundle portion. Basedon an evoked His-bundle activation of a second His-bundle portion, the system may determine whether correction of intra-Hisian block has occurred. The system additionally includes a threshold test circuit to determine an individualized pacing threshold representing minimal energy to excite the His bundle and to correct the cardiac conduction abnormality.

Systems and methods for His bundle pacing using a stimulation device include applying an impulse to a His bundle of a patient heart using the stimulation device. The stimulation device then measures a response of the patient heart to application of the impulse that includes a response of a ventricle of the patient heart. The stimulation device calculates a ventricular delay as a time from application of the impulse to onset of the response of the ventricle and delivers, using a lead of the stimulation device, a backup impulse to the ventricle when at least the ventricular delay exceeds a delay value stored in a memory of the stimulation device. The stored delay may, for example, correspond to a previously determined value indicative of selective or other His bundle capture.

Systems and methods for pacing cardiac conductive tissue are described. An embodiment of a medical system includes an electrostimulation circuit to generate His-bundle pacing (HBP) pulses to stimulatea His bundle, and a cardiac event detector to detect a His-bundle activity within a time window following an atrial activity. The cardiac event detector may use a cross-chamber blanking, or an adjustable His-bundle sensing threshold, to avoid or reduce over-sensing of far-field atrial activity and inappropriate inhibition of HBP therapy. The electrostimulation circuit may deliver HBP in the presence of the His-bundle activity. The system may further recognize the detected His-bundle activity as either a FFPW or a valid inhibitory event, and deliver or withhold HBP therapy based on the recognition of the His-bundle activity.

The present disclosure relates to a device for valve regurgitation surgery and pacemaker lead fixation, and more particularly, to a device for valve regurgitation surgery and pacemaker lead fixation that allows mitral regurgitation surgery, tricuspid regurgitation surgery, and fixation of a pacemaker lead to an interventricular septum to be performed using a single device. The device for valve regurgitation surgery and pacemaker lead fixation according to the present disclosure includes a cerclage wire, a coronary sinus tube which has a lumen formed to insert the cerclage wire thereinto and which is inserted into a coronary sinus, a tricuspid valve tube which has a lumen formed to insert the cerclage wire thereinto and which crosses a tricuspid valve and protects tissues of the tricuspid valve and the interventricular septum, a lead insertion tube which is coupled to the tricuspid valve tube and has an end facing the interventricular septum, and a pacemaker lead which is inserted into the lead insertion tube and has an end inserted into the bundle of His.

The present invention relates to a device for placing, in the His bundle, a pacemaker lead tip having passed through the coronary sinus and, more particularly, to a device for placing, in the His bundle, a pacemaker lead tip having passed through the coronary sinus, as one way to more effectively deliver electrical stimulation in treating patients with cardiac arrhythmia by using a pacemaker. Thedevice for placing, in the His bundle, a pacemaker lead tip having passed through the coronary sinus comprises: a surgical wire; a capture catheter in which an electrocardiogram sensor is provided todetermine the location of the His bundle in the interventricular septum, and which captures the surgical wire located in the right ventricle; and a pacemaker lead which has a through hole for passingthe surgical wire therethrough such that the tip of the pacemaker lead is inserted into the His bundle along the surgical wire.

A delivery device for delivering a pacing lead to the His bundle of a patient's heart includes an elongated sheath having a distal end, and a plurality of mapping electrodes positioned at the distal end. The distal end of the sheath may have a distal end face, and the mapping electrodes may include two electrodes that diametrically oppose one another at a position exposed on or spaced from the distal end face. The sheath includes a plurality of flexible sections spaced apart from one another, and a pull wire that causes the sheath to deflect from a substantially straight configuration to a dual hinged curved configuration that maneuvers and positions the electrodes in the vicinity of the bundle of His. The sheath may include a PTFE liner having axially oriented, platelet-like fibril features that enable the sheath to be split along its length from a proximal end to the distal end.

A capture catheter for sensing myocardial electrical signals is proposed, the capture catheter sensing the His bundle by sensing myocardial electrical signals and capturing a rope having passed through the His bundle. The capture catheter includes: a sheath catheter having a through hole formed therein; a myocardial sensing catheter inserted into the through hole of the sheath catheter to sense the His bundle; and at least one capturing device of which both ends are coupled to an outer circumferential surface of the myocardial sensing catheter to form an annular shape.

The present disclosure relates generally to pacing of cardiac tissue, and more particularly to adjusting delivery of His bundle or bundle branch pacing in a cardiac pacing system to achieve synchronized ventricular activation. Bundle pacing may be delivered in response to determining whether the QRS parameter or activation interval is greater than a threshold. A set of AV delays may be generated, and an optimal AV delay may be selected from the stored set of AV delays. His-bundle or bundle-branch pacing may be selectively delivered based on RV or LV activation time. Pacing may also be adjusted based on dyssynchrony detected or the type of bundle branch block pattern detected.

A method of pacing a His bundle of a patient heart using a stimulation system including a memory, a pulse generator, a stimulating electrode and at least one sensing electrode includes applying a plurality of impulses through the stimulating electrode to induce a plurality of responses from the patient heart. Each impulse of the plurality of impulses is delivered at a different impulse energy corresponding to a respective output setting of the stimulation system. The response characteristics for each of the plurality of responses are measured and each impulse is assigned a classification based on whether the respective response characteristics indicate capture of one or both of the His bundle and a ventricle of the patient heart. The output setting and classification for each impulse is then stored in the memory.

The invention relates to the technical field of cardiac pacing, in particular to a pacemaker and an implantation method thereof. The pacemaker comprises a hollow pacing shell, a battery used for providing electric energy is installed at the position, close to the middle, in the pacing shell, and a sensing electrode and a pacing electrode are arranged on the two sides of the battery respectively. The pacemaker is installed in the ventricular septum, can replace a His bundle to play a role, is special in position, can well sense the electrical activity of the atrium and the ventricle, obtains more comprehensive data, is beneficial to guiding the work of a pacemaker, adopts a lead-free pacemaker, avoids the possibility of subsequent complications such as lead breakage, and improves the use safety of the device, meanwhile, the ventricular septum is close to the body surface, the trouble of follow-up replacement of the pacing shell is reduced, operation is conducted through ultrasonic guidance, harm caused by long-time contact of an operator and a patient with rays is avoided, meanwhile, by the adoption of the implantation method, trauma is small, and normal activity can be recovered after implantation.

A His bundle-detecting snare catheter according to the present invention detects a myocardial electrical signal and locates the position of a His bundle through the insertion of a snare and an EP catheter into a dual lumen catheter having two lumens, and captures a cerclage wire, which has passed through the His bundle, and safely guides same into a body. The His bundle-detecting snare catheter according to the present invention comprises: a dual lumen catheter having formed therein a first lumen and a second lumen; an electrical signal detection catheter which is inserted into the first lumen or the second lumen and detects a myocardial electrical signal; and a snare which is inserted into the first lumen or the second lumen and has one or more annular wires at a distal portion thereof, wherein the electrical signal detection catheter and the snare are inserted into different lumens.

The invention relates to an implantable system for stimulating a human or animal heart, comprising a processor, a storage unit, a stimulation unit for stimulating a His beam or another heart region of a human or animal heart, a sensing unit for sensing an electrical signal of the heart, and a diagnostic unit for checking functional parameters of the implantable system. During operation, the system performs the following procedures: a) detecting, by the diagnostic unit, whether there is at least one fault state of the implantable system; b) checking (220) whether an electrode provided to stimulate a His beam of the human or animal heart is connected to the stimulation unit; c) switching the operational state of the implantable system to a safety mode, selected at least from a first safety mode (230) and a second safety mode (240), when a failure state is detected, in which i) the implantable system is switched to a safety mode when the examination (220) performed in step b) has shown that no electrode of a His beam provided to stimulate the human or animal heart is connected to the stimulation unit, the first safety mode (230) is selected, and ii) the second safety mode (240) is selected when the examination (220) performed in step b) has shown that the electrode of the His beam provided to stimulate the human or animal heart is connected to the stimulation unit.