158 results about "Cardiac wall" patented technology

The invention is device and method for reducing regurgitation through a mitral valve. The device and method is directed to an anchor portion for engagement with the heart wall and an expandable valve portion configured for deployment between the mitral valve leaflets. The valve portion is expandable for preventing regurgitation through the mitral valve while allowing blood to circulate through the heart. The expandable valve portion may include apertures for reducing the stagnation of blood. In a preferred configuration, the device is configured to be delivered in two-stages wherein an anchor portion is first delivered and the valve structure is then coupled to the anchor portion. In yet another embodiment, the present invention provides a method of forming an anchor portion wherein a disposable jig is used to mold the anchor portion into a three-dimensional shape for conforming to a heart chamber.

The various aspects of the invention pertain to devices and related methods for treating heart conditions, including, for example, dilatation, valve incompetencies, including mitral valve leakage, and other similar heart failure conditions. The devices and related methods of the present invention operate to assist in the apposition of heart valve leaflets to improve valve function. According to one aspect of the invention, a method improves the function of a valve of a heart by placing an elongate member transverse a heart chamber so that each end of the elongate member extends through a wall of the heart, and placing first and second anchoring members external the chamber. The first and second anchoring members are attached to first and second ends of the elongate member to fix the elongate member in a position across the chamber so as to reposition papillary muscles within the chamber. Also described herein is a method for placing a splint assembly transverse a heart chamber by advancing an elongate member through vasculature structure and into the heart chamber.

A system for mapping electrical activity of a patient's heart includes a set of electrodes spaced from the heart wall and a set of electrodes in contact with the heart wall. Voltage measurements from the electrodes are used to generate three-dimensional and two-dimensional maps of the electrical activity of the heart.

A supportless atrioventricular valve intended for attaching to a circumferential valve ring and papillary muscles of a patient comprising a singular flexible membrane of tissue or synthetic biomaterial, wherein a minimally invasive delivery system is provided through a percutaneous intercostal penetration and a penetration at the cardiac wall into a left atrium of the heart.

Methods for evaluating motion of a tissue, such as of a cardiac location, e.g., heart wall, via electrical field tomography are provided. In the subject methods, an sensing element is stably associated with a tissue location of interest. Signals obtained from the sensing element are obtained to evaluate movement of the tissue location. Also provided are systems and devices for practicing the subject methods. In addition, innovative data displays and systems for producing the same are provided. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.

Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Steerable electrophysiology catheters for use in mapping and / or ablation of accessory pathways in myocardial tissue of the heart wall and methods of use thereof are disclosed. The catheter comprises a catheter body and handle, the catheter body having a proximal section and a distal section and manipulators that enable the deflection of a distal segment of the distal tip section with respect to the independently formed curvature of a proximal segment of the distal tip section through a bending or knuckle motion of an intermediate segment between the proximal and distal segments. A wide angular range of deflection within a very small curve or bend radius in the intermediate segment is obtained. At least one distal tip electrode is preferably confined to the distal segment which can have a straight axis extending distally from the intermediate segment. The curvature of the proximal segment and the bending angle of the intermediate segment are independently selectable. The axial alignment of the distal segment with respect to the nominal axis of the proximal shaft section of the catheter body can be varied between substantially axially aligned (0° curvature) in an abrupt knuckle bend through a range of about −90° to about +180° within a bending radius of between about 2.0 mm and 7.0 mm and preferably less than 5.0 mm. The proximal segment curve can be independently formed in a about +180° through about +270° with respect to the axis of the proximal shaft section to provide an optimum angular orientation of the distal electrode(s). The distal segment can comprise a highly flexible elongated distal segment body and electrode(s) that conform with the shape and curvature of the heart wall.

Devices and methods for improving the function of a valve (e.g., mitral valve) by positioning a spacing filling device outside and adjacent the heart wall such that the device applies an inward force against the heart wall acting on the valve. A substantially equal and opposite force may be provided by securing the device to the heart wall, and / or a substantially equal and opposite outward force may be applied against anatomical structure outside the heart wall. The inward force is sufficient to change the function of the valve, and may increase coaptation of the leaflets, for example. The space filling device may be implanted by a surgical approach, a transthoracic approach, or a transluminal approach, for example. The space filling portion may be delivered utilizing a delivery catheter navigated via the selected approach, and the space filling portion may be expandable between a smaller delivery configuration and a larger deployed configuration.

Devices and methods for improving the function of a valve (e.g., mitral valve) by positioning an implantable device outside and adjacent the heart wall such that the device alters the shape of the heart wall acting on the valve. The implantable device may alter the shape of the heart wall acting on the valve by applying an inward force and / or by circumferential shortening (cinching). The shape change of the heart wall acting on the valve is sufficient to change the function of the valve, and may increase coaptation of the leaflets, for example, to reduce regurgitation.

A cardiac ablation device treats atrial fibrillation by directing and focusing ultrasonic waves into a ring-like ablation region (A). The device desirably is steerable and can be moved between a normal disposition, in which the ablation region lies parallel to the wall of the heart for ablating a loop-like lesion, and a canted disposition, in which the ring-like focal region is tilted relative to the wall of the heart, to ablate only a short, substantially linear lesion. The ablation device desirably includes a balloon reflector structure (18, 1310) and an ultrasonic emitter assembly (23, 1326), and can be steered and positioned without reference to engagement between the device and the pulmonary vein or ostium. A contrast medium (C) can be injected through the ablation device to facilitate imaging, so that the device can be positioned based on observation of the images.

An apparatus for repairing a cardiac valve includes an annuloplasty ring having an expandable support member with oppositely disposed proximal and distal end portions and a main body portion between the end portions. The proximal end portion includes a plurality of wing members extending from the main body portion. Each of the wing members includes at least one hook member for embedding into a cardiac wall and a valve annulus to secure the annuloplasty ring therein. The apparatus also includes an energy delivery mechanism for selectively contracting the annuloplasty ring to restrict the valve annulus and correct valvular insufficiency. The energy delivery mechanism includes a detachable electrical lead having distal and proximal end portions. The distal end portion has a securing member for operably attaching the distal end portion to a portion of the expandable support member. The proximal end portion is operably connected to an energy delivery source.

A system for identifying locations for pacing the heart, the system comprising a pacing electrode, a remote navigation system for positioning the pacing electrode at each of a plurality of locations; a system for determining Pressure-Volume loop data resulting from pacing at each location; an ECG system, a phrenic nerve stimulation detection system, and a means of identifying at least one preferred location based upon at least the Pressure-Volume loop, ECG, and phrenic nerve stimulation data at each location. A method of identifying locations for pacing the heart, the method comprising: navigating a pacing electrode to each of a plurality of locations in the heart; pacing the heart at each of the plurality of locations; and assessing the effectiveness of the pacing at each location by measuring cardiac blood flow and cardiac wall strain.

A medical device and method are described for performing Trans Myocardial Revascularization (TMR) in a human heart. The device consists of a myocardial implant and a directable intracardiac catherter that are suited for delivery into a heart wall of the implant. The catheter utilizes a percutaneous, minimally-invasive access to reach the inner surface of the heart chambers. The catheter provides a conduit for advancing multiple myocardial implants to the heart wall. The implant may include anchoring elements or a retainer for holding the implant body into the heart wall. The implant may include a tapered leading end, and can be advanced into the heart wall using a rotational or a pushing technique until the implant is fully deployed. The implant is then released from the catheter, and another implant inserted into the catheter, or the catheter withdrawn from the human body. The myocardial implant is used to stimulate the formation of new blood vessels (angiogenesis) in the treated heart wall, and to result in Trans Myocardial Revascularization of this heart wall.

An implantable devices for the effective elimination of an arrhythmogenic site from the myocardium is presented. By inserting small biocompatible conductors and / or insulators into the heart tissue at the arrhythmogenic site, it is possible to effectively eliminate a portion of the tissue from the electric field and current paths within the heart. The device would act as an alternative to the standard techniques for the removal of tissue from the effective contribution to the hearts electrical action which require the destruction of tissue via energy transfer (RF, microwave, cryogenic, etc.). This device is a significant improvement in the state of the art in that it does not require tissue necrosis.In one preferred embodiment the device is a non conductive helix that is permanently implanted into the heart wall around the arrhythmogenic site. In variations on the embodiment, the structure is wholly or partially conductive, the structure is used as an implantable substrate for anti arrhythmic, inflammatory, or angiogenic pharmacological agents, and the structure is deliverable by a catheter with a disengaging stylet. In other preferred embodiments that may incorporate the same variations, the device is a straight or curved stake, or a group of such stakes that are inserted simultaneously.

Devices and methods for improving the function of a valve (e.g., mitral valve) by positioning a spacing filling device outside and adjacent the heart wall such that the device applies an inward force against the heart wall acting on the valve. A substantially equal and opposite force may be provided by securing the device to the heart wall, and / or a substantially equal and opposite outward force may be applied against anatomical structure outside the heart wall. The inward force is sufficient to change the function of the valve, and may increase coaptation of the leaflets, for example. The space filling device may be implanted by a surgical approach, a transthoracic approach, or a transluminal approach, for example. The space filling portion may be delivered utilizing a delivery catheter navigated via the selected approach, and the space filling portion may be expandable between a smaller delivery configuration and a larger deployed configuration.

Devices and methods for improving the function of a valve (e.g., mitral valve) by positioning an implantable device outside and adjacent the heart wall such that the device alters the shape of the heart wall acting on the valve. The implantable device may alter the shape of the heart wall acting on the valve by applying an inward force and / or by circumferential shortening (cinching). The shape change of the heart wall acting on the valve is sufficient to change the function of the valve, and may increase coaptation of the leaflets, for example, to reduce regurgitation.

A robotic catheter control system includes a proximity sensing function configured to generate a proximity signal that is indicative of the proximity of the medical device such as an electrode catheter to a nearest anatomic structure such as a cardiac wall. The control system includes logic that monitors the proximity signal during guided movement of the catheter to ensure that unintended contact with body tissue is detected and avoided. The logic includes a means for defining a plurality of proximity zones, such as a GREEN, YELLOW and RED designated zones, each having associated therewith a respective proximity (distance) criterion, with the RED zone being the nearest to the body tissue and the YELLOW zone being the next nearest to the body tissue. When the logic detects entry of the catheter into the RED zone, the logic terminates the operating power to the actuation units of the control system, to thereby stop movement of the catheter entirely. When the logic detects entry of the catheter into the YELLOW zone, the logic automatically reduces a pre-planned navigation speed of the catheter.

Methods for evaluating motion of a tissue, such as of a cardiac location, e.g., heart wall, via continuous field tomography are provided. In the subject methods, a continuous field (e.g., an electrical, mechanical, electro-mechanical, or other field) sensing element is stably associated with the tissue location. A property of the applied continuous field is detected with the sensing element to evaluate movement of the tissue location. Also provided are systems, devices and related compositions for practicing the subject methods. The subject methods and devices find use in a variety of different applications, including cardiac resynchronization therapy.

The present disclosure is directed to a cardiac reinforcement device (CRD) and method for the treatment of cardiomyopathy. The CRD provides for reinforcement of the walls of the heart by constraining cardiac expansion, beyond a predetermined limit, during diastolic expansion of the heart. A CRD of the invention can be applied to the epicardium of the heart to locally constrain expansion of the cardiac wall or to circumferentially constrain the cardiac wall during cardiac expansion.

Devices, systems, and methods for treating a heart of a patient may make use of structures which limit a size of a chamber of the heart, such as by deploying one or more tensile member to bring a wall of the heart and a septum of the heart into contact. A plurality of tension members may help exclude scar tissue and provide a more effective remaining ventricle chamber. The implant may be deployed during beating of the heart, often in a minimally invasive or less-invasive manner. Trauma to the tissues of the heart may be inhibited by selectively approximating tissues while a pressure within the heart is temporarily reduced. Three-dimensional implant locating devices and systems facilitate beneficial heart chamber volumetric shape remodeling.

A splint assembly for placement transverse a heart chamber to reduce the heart chamber radius and improve cardiac function has a tension member formed of a braided cable with a covering. A fixed anchor assembly is attached to one end of the tension member and a leader for penetrating a heart wall and guiding the tension member through the heart is attached to the other end. An adjustable anchor assembly can be secured onto the tension member opposite to the side on which the fixed pad assembly is attached. The adjustable anchor assembly can be positioned along the tension member so as to adjust the length of the tension member extending between the fixed and adjustable anchor assemblies. The pad assemblies engage with the outside of the heart wall to hold the tension member in place transverse the heart chamber. A probe and marker delivery device is used to identify locations on the heart wall to place the splint assembly such that it will not interfere with internal heart structures. The device delivers a marker to these locations on the heart wall for both visual and tactile identification during implantation of the splint assembly in the heart.

A blood flow path is formed from a heart chamber to a coronary vessel on an exterior surface of a heart wall. A hollow conduit has a vessel portion and a myocardial portion. The vessel portion has an open leading end sized to be inserted into the coronary vessel. The myocardial portion has an open leading end and the myocardium portion is sized to extend through a thickness of the heart wall. The myocardial portion is placed in the heart wall with the open leading end of the myocardial portion protruding into the heart chamber. Blood flow through the conduit from the heart chamber is at least partially blocked. The leading end of the vessel portion is placed in the coronary vessel. Blood flow through the conduit from the heart chamber and into the vessel is then opened.

An apparatus for mapping and / or ablating tissue includes a braided conductive member that may be inverted to provide a ring-shaped surface. When a distal tip of the braided conductive member is retracted within the braided conductive member, the lack of protrusion allows the ring-shaped surface to contact a tissue wall such as a cardiac wall. In an undeployed configuration, the braided conductive member is longitudinally extended, and in a deployed configuration, the distal end of the braided conductive member is retracted to invert the braided conductive member.

This invention is directed to a device and method of using the device for partitioning a patient's heart chamber into a productive portion and a non-productive portion. The device is particularly suitable for treating patients with congestive heart failure. The device has an inflatable partitioning element which separates the productive and non-productive portions of the heart chamber and in some embodiments also has a supporting element, which may also be inflatable, extending between the inflatable partitioning element and the wall of the non-productive portion of the patient's heart chamber. The supporting element may have a non-traumatic distal end to engage the ventricular wall or a tissue penetrating anchoring element to secure the device to the patient's heart wall.

A method and system for estimating the volume of blood ejected from a cardiac ventricle or atrium uses ultrasound to track speckle patterns in the heart. The process utilizes the M-mode to estimate volume differences in a view of the ventricle or atrium over time using speckle pattern motion to estimate volume differences between systole and diastole. Alternatively, the ultrasound speckle tracking method may be used in combination with Doppler processing techniques or to obtain temporal flow profiles across flow cross-sectional areas, from which the flow volume is computed. The method can also measure the phase delay of motion of sites on the cardiac wall relative to each other or relative to an ECG signal.

Disclosed are devices, a systems, and methods for determining the dipole densities on heart walls. In particular, a triangularization of the heart wall is performed in which the dipole density of each of multiple regions correlate to the potential measured at various locations within the associated chamber of the heart. To create a database of dipole densities, mapping information recorded by multiple electrodes located on one or more catheters and anatomical information is used. In addition skin electrodes may be implemented.

A system and method for real-time quantitative analysis of heart wall motion is provided. A Doppler imaging system is used to monitor the movement of a heart, or other organ. A B-mode reference image of the target organ is made and then a region-of-interest is defined through the use of a gate. Then pulsed wave spectral tissue Doppler data of the region-of-interest is formed and used to determine the velocity of a region of the target organ. The system may be used for determining appropriate biventricular pacemaker settings for patients suffering from heart disease.

Methods and systems are disclosed for treating injury to cardiac tissue by delivering a composition which provides structural support to the cardiac tissue. The composition helps to prevent chamber remodeling by providing structural reinforcement of the tissue or structural reinforcement of the tissue combined with biological therapy. The structurally reinforcing composition can thicken the wall of a heart, or act to prevent further thinning and thereby provide resistance against further remodeling. A number of compositions are disclosed, including multi-component substances such as autologous platelet gel, and other substances. The compositions disclosed can contain additives to augment / enhance the desired effects of the injection.