US20070135883A1 - Cardiac Stimulation system - Google Patents
Cardiac Stimulation system Download PDFInfo
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- US20070135883A1 US20070135883A1 US11/549,352 US54935206A US2007135883A1 US 20070135883 A1 US20070135883 A1 US 20070135883A1 US 54935206 A US54935206 A US 54935206A US 2007135883 A1 US2007135883 A1 US 2007135883A1
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- electrode assembly
- tines
- heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6848—Needles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/29—Invasive for permanent or long-term implantation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6879—Means for maintaining contact with the body
- A61B5/6882—Anchoring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N1/0573—Anchoring means; Means for fixing the head inside the heart chacterised by means penetrating the heart tissue, e.g. helix needle or hook
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium
- A61N1/059—Anchoring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0031—Implanted circuitry
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
- A61N1/36843—Bi-ventricular stimulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37205—Microstimulators, e.g. implantable through a cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
Definitions
- This document relates to systems that electrically stimulate cardiac or other tissue.
- Pacing instruments can be used to treat patients suffering from a heart condition, such as a reduced ability to deliver sufficient amounts of blood from the heart. For example, some heart conditions may cause or be caused by conduction defects in the heart. These conduction defects may lead to irregular or ineffective heart contractions.
- Some pacing instruments e.g., a pacemaker
- pacemakers include a pulse generator that is implanted, typically in a patient's pectoral region just under the skin.
- One or more wired leads extend from the pulse generator so as to contact various portions of the heart.
- An electrode at a distal end of a lead may provide the electrical contact to the heart tissue for delivery of the electrical pulses generated by the pulse generator and delivered to the electrode through the lead.
- wired leads may limit the number of sites of heart tissue at which electrical energy may be delivered. For example, most commercially available pacing leads are not indicated for use in the left side of the heart. One reason is that the high pumping pressure on the left side of the heart may cause a thrombus or clot that forms on a bulky wired lead to eject into distal arteries, thereby causing stroke or other embolic injury. Thus, in order to pace the left side of the heart with a wired lead, most wired leads are directed through the cardiac venous system to a site (external to the left heart chambers) in a cardiac vein over the left side of the heart.
- Some pacing systems may use wireless electrodes that are attached to the epicardial surface of the heart (external to the heart chambers) to stimulate heart tissue.
- the wireless electrodes are screwed into the outside surface of the heart wall, which can reduce the effectiveness of the electrical stimulation in some circumstances.
- pacing systems employ wireless electrode assemblies to provide pacing therapy.
- the wireless electrode assemblies may receive energy via an inductive coupling so as to provide electrical stimulation to the surrounding heart tissue.
- a wireless electrode assembly may be directed through a guide catheter in a heart chamber to deliver at least a portion of the wireless electrode assembly through the endocardium.
- the electrode assembly may include first and second fixation devices to secure the electrode assembly to the heart chamber wall.
- the first fixation device may oppose rearward migration of the electrode assembly out of the heart chamber wall, and the second fixation device may oppose forward migration into the heart chamber wall. Accordingly, the wireless electrode assembly can be readily secured to the heart chamber wall and incorporated into the surrounding heart tissue over a period of time.
- a wireless electrode assembly may include a body portion that at least partially contains a circuit to electrically stimulate an electrode.
- the wireless electrode assembly may also include first and second biased tines to shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall.
- the first and second biased tines may be generally opposed to one another.
- Particular embodiments may include an electrode delivery system for delivering a wireless electrode assembly into a heart chamber.
- the system may include a wireless electrode assembly including a body portion and first and second biased tines to shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall.
- the first and second biased tines may oppose one another.
- the system may also include a delivery catheter to direct the wireless electrode assembly through a heart chamber and toward a heart chamber wall.
- the delivery catheter may include an opening in a distal end such that, when the wireless electrode assembly is separated from the opening in the distal end of the catheter, the first and second biased tines shift from the loaded condition to the outwardly extended condition.
- Some embodiments may include a method of inserting a wireless electrode assembly into a heart chamber wall.
- the method may include inserting a first biased tine of a wireless electrode assembly through a portion of endocardium and into a heart chamber wall.
- the first biased tine may shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall.
- the method may also include causing a second biased tine of the wireless electrode assembly to shift from the loaded condition to the outwardly extended condition to secure the body portion to a heart chamber wall.
- the first and second biased tines may be generally opposed to one another when in their respective outwardly extended conditions.
- the wireless electrode assemblies may eliminate or otherwise limit the need for wired pacing leads, thereby reducing the risk of stroke or other embolic injury from a thrombus or clot and reducing the risk of occluding cardiac veins (external to the heart chambers).
- the wireless electrode assemblies may be secured to the inner wall of one more heart chambers, which may provide more efficient transfer of electrical stimulation.
- the wireless electrode assemblies may be secured to a heart chamber wall in a manner that opposes both forward migration and rearward migration of the electrode assembly. In such circumstances, the secure attachment of the wireless electrode assembly with the heart wall may increase the likelihood of incorporating the electrode assembly into surrounding tissue, thereby further reducing the likelihood of forming a thrombus or clot in the heart chamber.
- FIG. 1 is a perspective view of a stimulation system and at least a portion of an electrode delivery system, in accordance with some embodiments of the invention.
- FIG. 2 is a diagram of at least a portion of a device of the stimulation system of FIG. 1 .
- FIG. 3 is a diagram of at least a portion of a wireless electrode assembly of the stimulation system of FIG. 1 .
- FIG. 4 is a section view of a heart and at least a portion of the electrode delivery system of FIG. 1 .
- FIG. 5 is a perspective view of a wireless electrode assembly, in accordance with some embodiments of the invention.
- FIG. 6 is a perspective view of a wireless electrode assembly, in accordance with some embodiments of the invention.
- FIGS. 7 A-D are partial cross-sectional views of the delivery of the wireless electrode assembly of FIG. 5 .
- FIG. 8 is a partial cross-sectional view of the delivery of the wireless electrode assembly of FIG. 6 .
- an electrical stimulation system 10 may include one or more wireless electrode assemblies 120 .
- the wireless electrode assemblies 120 are implanted within chambers of the heart 30 . In this example, there are two implanted in the left ventricle 34 and two implanted in the right ventricle 38 , but the wireless electrode assemblies may be implanted in the left atrium 32 , the right atrium 36 , or both. As described below in connection with FIGS. 4-8 , the wireless electrode assemblies 120 may be delivered to one or more chambers of the heart 30 using an electrode delivery system 100 .
- the electrode delivery system may include a guide catheter 110 that is directed through one or more veins or arteries to the targeted chamber of the heart 30 (e.g., the left ventricle 34 is the targeted chamber in the embodiment shown in FIG. 1 ).
- the wireless electrode assemblies 120 may be consecutively delivered through the guide catheter 110 using at least one delivery catheter 115 , which may include a steering mechanism (e.g., steering wires, a shape memory device, or the like) to delivery the wireless electrode assembly 120 to the targeted site on the heart chamber wall.
- a steering mechanism e.g., steering wires, a shape memory device, or the like
- each wireless electrode assembly 120 may include one or more fixation devices, such as tines As described in more detail below in connection with FIGS. 5 and 6 , the tines 132 and 134 can secure the wireless electrode assembly 120 to the heart chamber wall.
- each of the wireless electrode assemblies 120 may include a circuit comprising an internal coil and an electrical charge storage device (not shown in FIG. 1 ). As described in more detail below in connection with FIG. 3 , the internal coil can be inductively coupled with an external power source coil so as to charge the electrical charge storage device (e.g., a battery, capacitor, or the like) contained within the wireless electrode assembly 120 .
- the electrical charge storage device e.g., a battery, capacitor, or the like
- each of the wireless electrode assemblies 120 has a triggering mechanism in the circuit to deliver stored electrical charge to adjacent heart tissue (some examples are described in more detail below in connection with FIG. 3 ).
- one or more of the wireless electrode assemblies 120 may have no energy storage device.
- each wireless electrode assembly may be comprised, for example, of a ferrite core having caps at each end with ring electrodes encircling the caps. A number of turns of fine insulated wire may be wrapped around the central portion of the core so as to receive energy from a magnetic field produced by a shaped driving signal and designed to activate the electrodes.
- the system 10 may also include a pacing controller 40 and a transmitter 50 that drives an antenna 60 for communication with the wireless electrode assemblies 120 .
- the pacing controller 40 includes circuitry to sense and analyze the heart's electrical activity, and to determine if and when a pacing electrical pulse needs to be delivered and by which of the wireless electrode assemblies 120 .
- the sensing capability may be made possible by having sense electrodes included within the physical assembly of the pacing controller 40 .
- a conventional single or dual lead pacemaker may sense the local cardiac electrocardiogram (ECG) and transmit this information to antenna 60 for use by controller 40 in determination of the timing of wireless electrode assembly firing.
- ECG local cardiac electrocardiogram
- the wireless electrode assembly 120 need not be provided with sensing capability, and also the wireless electrode assemblies 120 need not be equipped with the capability of communicating to the pacing controller 40 (for example, to communicate information about sensed electrical events). In alternative embodiments, the wireless electrode assemblies may communicate sensed information to each other and/or to the controller 40 .
- the transmitter 50 which is in communication with, and is controlled by, the pacing controller 40 —may drive an RF signal onto the antenna 60 .
- the transmitter 50 provides both (1) a charging signal to charge the electrical charge storage devices contained within the wireless electrode assemblies 120 by inductive coupling, and (2) an information signal, such as a pacing trigger signal, that is communicated to a selected one or more of the wireless electrode assemblies 120 , commanding that wireless electrode assembly 120 deliver its stored charge to the adjacent heart tissue.
- each wireless electrode assembly 120 may require the maximum pacing threshold energy. This threshold energy is supplied to the wireless electrode assemblies between heartbeats by an external radio frequency generator (which may also be implanted), or other suitable energy source that may be implanted within the body. Parameter values for some embodiments may be:
- energy transmission through the body may be accomplished in some embodiments via a magnetic field at about 20-200 kHz (or by a magnetic field pulse that contains major frequency components in this range), and preferably by transmission of magnetic fields in the range of 100-200 kHz when transmission is through relatively conductive blood and heart muscle.
- the pacing controller 40 and the transmitter 50 may be housed in a single enclosure that is implantable within a patient.
- the single enclosure device may have a single energy source (battery) that may be either rechargeable or non-rechargeable.
- the pacing controller 40 and the transmitter 50 may be physically separate components.
- the pacing controller 50 may be implantable, for example in the conventional pacemaker configuration, whereas the transmitter 50 (along with the antenna 60 ) may be adapted to be worn externally, such as in a harness that is worn by the patient.
- the pacing controller 40 would have its own energy source (battery), and that energy would not be rechargeable given the relatively small energy requirements of the pacing controller 40 as compared to the energy requirements of the transmitter 50 to be able to electrically charge the wireless electrode assemblies 120 .
- the pacing controller 40 would sense the local cardiac ECG signal through a conventional pacing lead, and transmit the sensed information to the external controller. Again, transmission of information, as opposed to pacing energy, has a relatively low power requirement, so a conventional pacemaker enclosure and battery would suffice.
- the external programmer 70 is used to communicate with the pacing controller 40 , including after the pacing controller 40 has been implanted.
- the external programmer 70 may be used to program such parameters as the timing of stimulation pulses in relation to certain sensed electrical activity of the heart, the energy level of stimulation pulses, the duration of stimulation pulse (that is, pulse width), etc.
- the programmer 70 includes an antenna 75 to communicate with the pacing controller 40 , using, for example, RF signals.
- the implantable pacing controller 40 is accordingly equipped to communicate with the external programmer 70 , using, for example, RF signals.
- the antenna 60 may be used to provide such communications, or alternatively, the pacing controller 40 may have an additional antenna (not shown in FIG. 1 ) for external communications with the programmer 70 , and in an embodiment where the transmitter 50 and antenna 60 are housed separately from the controller 40 , for communications with the transmitter 50 .
- the controller 40 and transmitter 50 may be housed in a device that is shaped generally elongate and slightly curved so that it may be anchored between two ribs of the patient, or possibly around two or more ribs.
- the housing for the controller 40 and transmitter 50 is about 2 to 20 cm long and about 1 to 10 centimeters cm in diameter, may be about 5 to 10 cm long and about 3 to 6 cm in diameter.
- Such a shape of the housing for the controller 40 and transmitter 50 which allows the device to be anchored on the ribs, may provide an enclosure that is larger and heavier than conventional pacemakers, and may provide a larger battery having more stored energy.
- the controller 40 may comprise a defibrillator that discharges energy to the heart 30 through electrodes on the body of controller 40 when fibrillation is sensed.
- Other sizes and configurations may also be employed as is practical.
- the antenna 60 may be a loop antenna comprised of a long wire that is electrically connected across an electronic circuit contained within the controller/transmitter housing, which circuit delivers pulses of RF current to the antenna 60 , generating a magnetic field in the space around the antenna 60 to charge the wireless electrode assemblies 120 , as well as RF control magnetic field signals to command the wireless electrode assemblies 120 to discharge.
- the antenna 60 may comprise a flexible conductive material so that it may be manipulated by a physician during implantation into a configuration that achieves improved inductive coupling between the antenna 60 and the coils within the implanted wireless electrode assemblies 120 .
- the loop antenna 60 may be about 2 to 22 cm long, and about 1 to 11 cm wide, and may be about 5 to 11 cm long, and about 3 to 7 cm wide. Placement of the antenna 60 over the ribs may provide a relatively large antenna to be constructed that has improved efficiency in coupling RF energy to the pacing wireless electrode assemblies 120 .
- some embodiments of the system 10 may also include a pulse generator device 90 (or pacemaker device) and associated wired leads 95 which extend from the pulse generator device 90 and into one or more chambers of the heart 30 (e.g., into the right atrium 36 ).
- the system 10 may include wired leads 95 from the pulse generator device 90 that extend into the right atrium 36 and the right ventricle 38 while wireless electrode assemblies are disposed in the left atrium 32 and the left ventricle 34 .
- the pulse generator device 90 may be used to sense the internal ECG, and may also communicate with the controller 40 and/or transmitter 50 as previously described.
- each of the wireless electrode assemblies 120 includes a rechargeable battery or other charge storage device.
- This battery may provide power for delivering pacing energy to the tissue, and for operating communications, logic, and memory circuitry contained within the assembly.
- a transmitter and an antenna may be external to the patient (as opposed to the implantable transmitter 50 and antenna 60 depicted in FIG. 1 ), and may serve to recharge the batteries within the electrode assemblies.
- the recharge transmitter and antenna may be incorporated into furniture, incorporated into the patient's bed, or worn by the patient (e.g., in a vest-type garment). Daily recharging for predetermined to periods (e.g., about 30 minutes) may be required in some cases.
- the wireless electrode assemblies 120 may be autonomous pacemaker-like devices, which can sense the local electrogram and only pace when the local tissue is not refractory. Such electrodes may communicate with the programming unit 70 to receive pacing instructions and transmit data stored in local memory. In these embodiments, each wireless electrode assembly 120 may also communicate with other implanted wireless electrode assemblies 120 . For example, one electrode assembly 120 in the right atrium may be designated as the “master,” and all other implanted electrodes are “slaves,” that pace with pre-programmed delays relative to the “master.” As such, a master electrode in the right atrium may only sense the heart's sinus rhythm, and trigger pacing of the slaves with programmed delays.
- a device 80 including the controller 40 , transmitter 50 , associated antenna 60 is shown in block diagram form. Included within the device 80 is: a battery 82 , which may be recharged by receiving RF energy from a source outside the body via antenna 60 ; ECG sensing electrodes 84 and associated sensing circuitry 86 ; circuitry 87 for transmitting firing commands to the implanted wireless electrode assemblies, transmitting status information to the external programmer, receiving control instructions from the external programmer and receiving power to recharge the battery; and a controller or computer 88 that is programmed to control the overall functioning of the pacing control implant.
- antenna 60 may receive signals from the individual wireless electrode assemblies 120 containing information regarding the local ECG at the site of each wireless electrode assembly, and/or the antenna 60 may receive signals from a more conventional implanted pacemaker regarding the ECG signal at the sites of one or more conventional leads implanted on the right side of the heart.
- a wireless electrode assembly 120 may include a receiver coil 122 that is capable of being inductively coupled to a magnetic field source generating a time-varying magnetic field at the location of coil 122 , such as would be generated by the transmitter 50 and the antenna 60 depicted in FIG. 1 .
- the RF current in the external antenna may be a pulsed alternating current (AC) or a pulsed DC current, and thus the current induced through the receiver coil 122 would likewise be an AC or pulsed DC current.
- the current induced in coil 122 may be proportional to the time rate of change of the magnetic field generated at the site of coil 122 by the external RF current source.
- a four-diode bridge rectifier 123 may connected across the receiver coil 122 to rectify the AC or pulsed DC current that is induced in the receiver coil 122 .
- a three-position switch device 124 may be connected so that when the switch device 124 is in a first position, the rectifier 123 produces a rectified output that is imposed across a capacitor 125 . As such, when the switch device 124 is in the position 1 (as is the case in FIG. 4 ), the capacitor 125 stores the induced electrical energy.
- the switch device 124 in this example, is a voltage-controlled device and is connected to sense a voltage across the capacitor 125 to determine when the capacitor 125 has been sufficiently charged to a specified pacing threshold voltage level. When the capacitor 125 is sensed to have reached the specified pacing threshold level, the voltage-controlled switch device 124 moves to a position 2 , which disconnects the capacitor 125 from the coil 122 . With the switch device 124 in the position 2 , the capacitor 125 is electrically isolated and remains charged, and thus is ready to be discharged.
- the voltage controlled switch device 124 may comprise a solid state switch, such as a field effect transistor, with its gate connected to the output of a voltage comparator that compares the voltage on capacitor 125 to a reference voltage.
- the reference voltage may be set at the factory, or adjusted remotely (e.g., after being implanted) via signals sent from the physician programmer unit 70 ( FIG. 1 ), received by coil 122 and processed by circuitry not shown in FIG. 3 .
- Any electronic circuitry contained within the wireless electrode assembly 120 can be constructed with components that consume very little power, for example CMOS. Power for such circuitry is either taken from a micro-battery contained within the wireless electrode assembly, or supplied by draining a small amount of charge from capacitor 125 .
- a narrow band pass filter device 126 may also be connected across the receiver coil 122 , as well as being connected to the three-position switch device 124 .
- the band pass filter device 126 passes only a single frequency of communication signal that is induced in the coil 122 .
- the single frequency of the communication signal that is passed by the filter device 126 may be unique for the particular wireless electrode assembly 120 as compared to other implanted wireless electrode assemblies.
- the filter device 126 passes the voltage to the switch device 124 , which in turn moves to a position 3 .
- the capacitor 125 may be connected in series through two bipolar electrodes 121 and 129 , to the tissue to be stimulated. As such, at least some of the charge that is stored on the capacitor 125 is discharged through the tissue. When this happens, the tissue becomes electrically depolarized.
- the bipolar electrodes 121 and 129 across which stimulation pulses are provided are physically located at opposite ends (e.g., a proximal end and a distal end) of the wireless electrode assembly 120 . After a predetermined, or programmed, period of time, the switch returns to position 1 so the capacitor 125 may be charged back up to the selected threshold level.
- FIG. 3 shows only the electrical components for energy storage and switching for particular embodiments of the wireless electrode assembly 120 .
- electronics to condition the pacing pulse delivered to the tissues which circuitry should be understood from the description herein.
- Some aspects of the pulse may be remotely programmable via encoded signals received through the filter device 126 of the wireless electrode assembly 120 .
- filter 126 may be a simple band pass filter with a frequency unique to a particular wireless electrode assembly, and the incoming signal may be modulated with programming information.
- filter 126 may consist of any type of demodulator or decoder that receives analog or digital information induced by the external source in coil 122 .
- the received information may contain a code unique to each wireless electrode assembly to command discharge of capacitor 125 , along with more elaborate instructions controlling discharge parameters such as threshold voltage for firing, duration and shape of the discharge pulse, etc.
- all of the implanted wireless electrode assemblies 120 may be charged simultaneously by a single burst of an RF charging field from a transmitter antenna 60 . Because back reaction of the wireless electrode assemblies 120 on the antenna 60 may be small, transmitter 50 ( FIG. 1 ) losses may be primarily due to Ohmic heating of the transmit antenna 60 during the transmit burst, Ohmic heating of the receive coil 122 , and Ohmic heating of conductive body tissues by eddy currents induced in these tissues by the applied RF magnetic field.
- the transmitter 50 may be turned ON eight times as long, which may require almost eight times more transmit energy, the additional energy being primarily lost in heating of the transmit antenna 60 and conductive body tissues.
- the wireless electrode assembly 120 of FIG. 3 all implanted wireless electrode assemblies can be charged simultaneously with a burst of RF current in antenna 60 , and antenna and body tissue heating occurs only during the time required for this single short burst.
- Each wireless electrode assembly is addressed independently through its filter device 126 to trigger pacing.
- the transmitted trigger fields can be of much smaller amplitude, and therefore lose much less energy to Ohmic heating, than the transmitted charging pulse.
- an electrode delivery system 100 may include a guide catheter 110 and a delivery catheter 115 .
- the catheters 110 and 115 may comprise an elongate body that extends from a proximal end (outside the patient's body, not shown in FIG. 4 ) to a distal end (depicted in FIG. 4 as extending into the patient's heart 30 ).
- the delivery catheter 115 fits within a lumen of the guide catheter 110 , and can be advanced through the guide catheter 110 so that a distal end of the delivery catheter 115 extends out of a distal opening of the guide catheter 110 .
- the guide catheter 110 may be directed through one or more veins or arteries to the targeted chamber of the heart 30 (e.g., the left ventricle 34 is the targeted chamber in the embodiment shown in FIG. 4 ).
- the guide catheter 110 may comprise a steering mechanism (e.g., steering wires, shape memory device, or the like) to shift the distal end and may include at least one marker band 112 to permit viewability of the distal end of the guide catheter 110 using medical imaging techniques.
- a marker band 112 may aid a physician when steering the guide catheter 110 to the targeted heart chamber.
- the wireless electrode assemblies 120 may be advanced into the heart tissue through the guide catheter 110 using at least one delivery catheter 115 .
- the wireless electrode assemblies 120 may be consecutively delivered through the guide catheter 110 using at least one delivery catheter 115 .
- the delivery catheter 115 may include at least one marker band 116 to permit viewability of the distal end of the delivery catheter 115 using medical imaging techniques.
- the delivery catheter 115 may include a steering mechanism (e.g., steering wires, shape memory device, or the like) to shift the distal end.
- the delivery catheter 115 may comprise a shape memory device (e.g., one or more wires comprising Nitinol or another shape memory material) to provide a predetermined curvature near the distal end of the delivery catheter 115 .
- the shape memory device may be activated by a change in electrical charge or by a change in temperature.
- the delivery catheter 115 may include a shape memory device near the distal end that is capable of providing a 90-degree deflection curve near the distal end immediately before a longitudinally straight section at the distal end of the catheter 115 .
- the steering mechanism e.g., steering wires, shape memory device, or the like
- the delivery catheter 115 can be manipulated so that a deflected portion near the distal end of the delivery catheter abuts against the septum wall of the targeted heart chamber.
- the deflected portion of the delivery catheter may abut against the septum wall 39 between the left ventricle 34 and the right ventricle 38 while a longitudinally straight section of the catheter 115 extends the distal end against the targeted heart chamber wall to receive the wireless electrode assembly 120 (refer to the dotted-line example depicted in FIG. 4 ).
- the deflected portion of the delivery catheter 115 can abut against the septum wall to support the position of the distal end of the delivery catheter 115 during the deployment of the wireless electrode assembly 120 into the targeted heart tissue 35 (refer, for example, to FIGS. 7 A-D and 8 ).
- Such an approach may provide leverage and stability during the insertion process for the electrode assembly 120 .
- the delivery catheter 115 includes an opening at the distal end in which an associated wireless electrode assembly 120 is retained in a loaded position.
- the wireless electrode assembly 120 may include a body portion that has a length and a radius configured to be retained with the delivery catheter 115 . As described in more detail below, some embodiments of the body portion of the wireless electrode assembly 120 may have a radius, for example, of about 1.25 mm or less and may have a length, for example, of about 10 mm or less. Wireless electrode assemblies configured for insertion into an atrial wall may be smaller than those configured for insertion into the ventricle walls.
- the wireless electrode assemblies 120 comprise a pointed-tip cylindrical body having a forward portion embedded within the heart wall tissue and a rearward portion that is inside the heart chamber but not fully embedded in the heart wall tissue.
- the pointed distal tip 130 of the electrode assembly 120 facilitates penetration into the heart wall tissue, and the proximal end of the electrode assembly is configured to remain outside of the heart wall.
- both the distal tip 130 and the proximal end of the electrode assembly 120 can be embedded within the heart wall tissue 30 .
- the electrode assembly 120 may include two fixation devices 132 and 134 that generally oppose one another, such as a set of distal tines and a set of proximal tines.
- the distal tines can be coupled to and extend from a periphery of a forward portion of the body of the electrode assembly 120
- the proximal tines can be coupled to and extend from a periphery of a rearward portion of the body.
- the set of distal tines extend somewhat outwardly from the body of the electrode assembly 120 but also rearwardly so as to prevent the electrode from becoming dislodged from the heart wall once the electrode assembly 120 is implanted.
- the set of proximal tines extend somewhat outwardly from the body of the electrode assembly 120 but also forwardly so as to prevent the electrode assembly 120 from penetrating entirely through the heart wall.
- tines 132 and 134 located externally on the wireless electrode assembly 120 may adjust to a deployed position (e.g., an outwardly extended condition). Such an adjustment to the deployed position may be caused, for example, due to spring bias of the tines 132 and 134 (described in more detail below).
- the tines 132 and 134 are capable of securing the wireless electrode assembly 120 to the targeted tissue site (e.g., described in more detail below, for example, in connection with FIGS. 7-8 ).
- the opening at the distal end of the delivery catheter 115 may be part of conduit that extends through the elongated body of the catheter 115 .
- the opening at the distal end of the delivery catheter 115 may extend only a partial length into the delivery catheter 115 (e.g., with a narrower channel extending fully to the proximal end of the delivery catheter 115 to provide space for the plunger mechanism 140 ).
- the tines 132 and 134 of the wireless electrode assembly 120 may be configured in a number of orientations.
- the tines 132 and 134 can be arranged in a configuration (refer to FIG. 5 ) that permits the electrode assembly 120 to penetrate a substantial length into the heart wall tissue (described in more detail below in connection with FIGS. 7A-7D ).
- the tines 132 and 134 can be arranged in a configuration (refer to FIG. 6 ) that permits the electrode assembly 120 to penetrate a lesser amount into the heart wall tissue (described in more detail below in connection with FIG. 8 ).
- wireless electrode assembly 120 may include a proximal electrode 121 at or near a proximal end and a distal electrode 129 at or near a distal end.
- the proximal electrode 121 and distal electrode 129 may provide bipolar electrode capabilities for the wireless electrode assembly 120 , thereby permitting the assembly 120 to supply an electrical charge between the proximal and distal electrodes 121 and 129 (and across the nearby heart tissue).
- the fixation device 132 may include a set of biased tines arranged near the distal end of the wireless electrode assembly 120 so as to secure the wireless electrode assembly 120 to the heart chamber wall.
- the fixation device 134 may include a first set of biased tines arranged near the proximal end of the wireless electrode assembly 120 which can also serve to secure the assembly 120 to the heart chamber wall.
- the tines 134 arranged near the proximal end may have a different configuration and orientation from the opposing tines 132 arranged near the distal end.
- the distal tines 132 may generally oppose the proximal tines 134 .
- the tines 132 and 134 are biased to adjust from a loaded condition to a deployed condition.
- the tines 132 and 134 may be arranged generally along the body 128 of the wireless electrode assembly 120 so as to fit within the cavity at the distal end of the delivery catheter 115 (refer, for example, to FIG. 7 A).
- the tines 132 and 134 may be biased to adjust to the deployed condition while advancing from the delivery catheter 115 .
- the distal tines 132 When in the deployed condition, the distal tines 132 may be disposed in an outwardly extended orientation that opposes the outwardly extended orientation of the proximal tines 134 .
- the distal tip 130 may penetrate into the heart chamber wall when a force is applied to the wireless electrode assembly 120 (e.g., penetrate the endocardium and possibly into the myocardium).
- a force is applied to the wireless electrode assembly 120 (e.g., penetrate the endocardium and possibly into the myocardium).
- the tines 132 and 134 are biased to transition from the loaded condition (described in more detail below in connection with FIGS. 7 A-D) to the deployed condition as illustrated by tines 132 a and 134 a (in FIG. 5 ) and tines 132 b and 134 b (in FIG. 6 ).
- Such a configuration permits the wireless electrode assembly 120 to be readily secured to the heart chamber wall after advancing from the delivery catheter 115 .
- the wireless electrode assembly 120 may be arranged in the delivery catheter 115 ( FIG. 4 ) so that the tines 132 and 134 are in a loaded condition.
- the tines 132 and 134 may comprise biocompatible material that is capable of flexing from the loaded condition to the deployed condition.
- one ore more of the tines 132 and 134 may comprise a shape memory alloy (e.g., Nitinol or the like), stainless steel, titanium, metal alloys (e.g., nickel-cobalt base alloys such as MP35N), composite materials, or the like.
- the distal tines 132 a and proximal tines 134 a can be arranged so that a substantial length of the electrode assemble 120 penetrates into the heart wall tissue.
- the distal tines 132 a may penetrate in the heart wall tissue to hinder rearward migration of the electrode assembly 120 back into the hear chamber, and the proximal tines 134 a are configured to abut or partially penetrate into the wall surface to hinder forward migration of the assembly 120 toward the outside of the heart.
- the distal tines 132 a oppose migration of the wireless electrode assembly 120 in the generally proximal direction and the proximal tines 134 a oppose migration in the generally distal direction.
- the opposing orientation of the tines 132 a and 134 a secures the wireless electrode assembly 120 to the heart tissue in a manner so that a portion of the proximal end of the wireless electrode assembly 120 is not embedded in the heart tissue. Because tines 132 a and 134 a can retain the electrode assembly 120 in the heart tissue without substantial migration, the proximal end of the electrode assembly body 128 can be incorporated into the surrounding heart tissue over a period of days or weeks. In these embodiments, the wireless electrode assembly 120 may be immobilized by the surrounding tissue to prevent future dislodgement. In such circumstances, the patient may receive anti-coagulants, Aspirin, or other drugs (e.g., PLAVIX, CUMODIN, etc.) for several months after the operation or until incorporation of the wireless electrode assembly 120 into the surrounding tissue has occurred.
- anti-coagulants e.g., PLAVIX, CUMODIN, etc.
- the distal tines 132 a and the proximal tines 134 a are slightly curved and are oriented in an opposing manner when in the deployed condition.
- the curvature of the proximal tines 132 is such that the tines 134 a contact the surface of the heart tissue near the proximal tines' extremities.
- the proximal tines 134 a can be positioned along the body 128 and curved in a manner so that the free end 135 a of each proximal tine 134 a abuts or partially penetrates into the heart wall tissue after a portion of the electrode assembly 120 has penetrated therein.
- the wireless electrode assembly 120 can be advanced into the heart wall tissue 35 so that the proximal tines 134 a cause a slight spring-back action after abutting or partially penetrating into the heart wall tissue.
- the proximal tines 134 a may flex outwardly when forced into engagement with the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to the wireless electrode assembly 120 .
- the distal tines 132 a may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue between the distal tines 132 a and the proximal tines 134 a.
- the proximal tines 134 a can be positioned along the body 128 and curved in a manner so that the free end 135 a of each proximal tine 134 a abuts or partially penetrates into the heart wall tissue after a substantial portion of the electrode assembly 120 has penetrated therein.
- the proximal tines 134 a are configured such that the free end 135 a of each tine 134 a (when in the deployed condition) is disposed a longitudinal distance D 1 rearward of the distal tip 130 .
- the longitudinal distance D 1 is greater than half the overall length L of the electrode assembly 120 .
- a majority of the length of the electrode assembly 120 can penetrate into the heart wall tissue before the proximal tines 134 a engage the heart wall to oppose forward migration.
- This example of substantial penetration of the electrode assembly 120 into the heart wall tissue may be effective when advancing the electrode assembly 120 into portions of the heart having thicker myocardial walls (e.g., some heart walls around the left and right ventricles).
- the non-penetrating proximal portion of the electrode assembly 120 is reduced, thereby promoting efficient healing and incorporation into the surrounding heart tissue.
- the distal tines 132 b and proximal tines 134 b can be arranged so that a lesser length of the electrode assembly 120 penetrates into the heart wall tissue.
- the distal tines 132 b may be substantially different in length than the proximal tines 134 b .
- the proximal tines 134 b may have a greater curvature than the proximal tines 134 a previously described in connection with FIG. 5 so that the contact between the surface of the heart tissue and the proximal tines is near the apex of the curvature.
- the proximal tines 134 b can be positioned along the body 128 and curved in a manner so that the curvature apex 135 b of each proximal tine 134 b abuts the heart wall tissue after a partial length of the electrode assembly 120 has penetrated therein.
- the proximal tines 134 b are configured such that the apex 135 b (when in the deployed condition) is disposed at a longitudinal distance D 2 rearward of the distal tip 130 .
- the longitudinal distance D 2 is about half the overall length L of the electrode assembly 120 . Accordingly, about half of the electrode assembly 120 can penetrate into the tissue before the proximal tines 134 b oppose forward migration. Such penetration to a limited length of the electrode assembly 120 may be effective when advancing the electrode assembly 120 into portions of the heart wall having a reduced wall thickness (e.g., some heart walls around the right atrium).
- the tines 132 b and 134 b are oriented in an opposing fashion to secure the wireless electrode assembly 120 to the heart tissue in a manner that opposes reward migration and forward migration, thereby permitting incorporation into the surrounding tissue.
- the proximal tines 134 b may flex outwardly when forced against the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to the wireless electrode assembly 120 .
- the distal tines 132 b may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue between the distal tines 132 b and the proximal tines 134 b.
- the proximal tines 134 b of the electrode assembly may be nonaligned with the distal tines 132 b along the body of the electrode assembly 128 .
- the distal tines 132 b may be tangentially shifted about 45° along the body circumference as compared to the proximal tines 134 b so that the proximal tines 134 b and distal tines 132 b are nonaligned.
- such nonalignment between the proximal tines 134 b and the distal tines 132 b can permit one set of tines (e.g., the proximal tines 134 b ) to partially deploy before fully exiting the distal opening of the delivery catheter 115 .
- the partial deployment of the proximal tines 134 b before fully exiting the delivery catheter 115 can facilitate the abutting engagement between the proximal tines 134 b and the heart chamber wall.
- the distal tines 132 may also serve as at least a portion of the distal electrode 129 .
- proximal tines 134 may also serve as at least a portion of the proximal electrode 121 .
- the tines 132 and 134 may comprise an electrically conductive material (e.g., stainless steel or another metallic material) and may be electrically connected to the distal and proximal electrode circuitry (respectively).
- some embodiments of the wireless electrode assemblies 120 may be press fit into the conduit of the delivery catheter 115 so that a plunger mechanism 144 may be used to separate the wireless electrode assembly 120 from the delivery catheter 115 .
- the delivery catheter 115 may be steered and directed toward a targeted site at the surface of heart tissue 35 (e.g., a heart chamber wall).
- the delivery catheter 115 may contain at least a distal portion of a tube portion 142 that is coupled to an actuation rod 140 .
- the steering mechanism e.g., steering wires, shape memory device, or the like
- the steering mechanism can be manipulated so that a deflected portion near the distal end of the delivery catheter 115 abuts against the septum wall of the targeted heart chamber.
- the portion 117 ( FIG. 7A ) of the delivery catheter 115 may be deflected to abut against the septum wall while a longitudinally straight section of the catheter 115 extends toward the targeted heart tissue 35 .
- some portion e.g., portion 117
- the delivery catheter 115 can abut against the septum wall to support the position of the distal end of the delivery catheter 115 .
- the wireless electrode assembly 120 may be releasably engaged with the tube portion 142 .
- the wireless electrode assembly 120 may be press-fit into the tube portion 142 .
- the tube portion 142 may have a square cross-sectional shape, a hexagonal cross-sectional shape, a keyed cross-sectional shape, or other noncircular cross-sectional shape to engage the complementary shaped body of the wireless electrode assembly 120 .
- the tube portion 140 may be substantially rigid so as to retain the fixation devices 132 and 134 of the wireless electrode assembly 120 in a loaded condition (as shown, for example, in FIG. 7A ).
- one or both of the actuation rod 140 and the plunger mechanism 144 may extend to an actuation device (e.g., a hand-operated trigger mechanism) at the proximal end of the delivery catheter 115 outside the patient's body.
- the tube portion 142 and the actuation rod 140 may be fixedly arranged in the delivery catheter 115 so as to deliver one electrode assembly at a time.
- the tube portion 142 and the actuation rod 140 may be movable through lumen of the delivery catheter 115 so that a number of electrode assemblies can be consecutively passed through the delivery catheter 115 .
- the distal end of the delivery catheter 115 may abut the surface of the heart tissue 35 to prepare the wireless electrode assembly 120 for fixation to the tissue 35 .
- the distal end of the delivery catheter 115 includes a marker band 116 to facilitate the steering and guidance of the delivery catheter (e.g., a physician may employ medical imaging techniques to view the marker band 116 while the delivery catheter 115 is in the heart 30 ).
- the electrode assembly 120 can be advanced through the distal opening of the delivery catheter 115 (and the tube portion 142 ) and into the tissue 35 .
- This operation may be performed by advancing the plunger mechanism 144 against the proximal end of the wireless electrode assembly 120 to thereby force the distal tip 130 of the wireless electrode assembly 120 to penetrate through the endocardium and possibly into the myocardium.
- the force may be applied by manipulating the actuation device (e.g., the hand-operated trigger mechanism connected to the proximal end of the plunger mechanism 144 ) to force the plunger mechanism 144 in the distal direction relative to the actuation rod 140 (and the tube portion 142 ).
- the distal tip 130 of the electrode assembly 120 pierces the tissue surface and advances into the tissue 35 .
- the fixation devices 132 and 134 can transition from a loaded condition to a deployed condition.
- the fixation devices 132 and 134 comprise tines that are biased to the deployed condition (refer, for example, to FIGS. 5-6 ) after being released from the tube portion 142 of the delivery catheter 115 .
- the tines 132 and 134 can be configured so that a substantial portion of the electrode assembly 120 penetrates into the tissue 35 before the forward migration is hindered by the proximal tines 134 .
- the electrode assembly 120 can penetrate the longitudinal length D 1 into the heart tissue 35 so that a majority of the overall length of the electrode assembly 120 is advanced into the tissue 35 .
- the distal tines 132 a can transition to the deployed condition in which each tine 132 a is outwardly extended in a generally proximal direction when the distal tip 130 penetrates into the heart tissue 35 .
- the proximal tines 134 a can transition to the deployed condition in which each tine 134 a is extended outwardly in a generally distal direction when the delivery catheter 115 is separated from the proximal end of the wireless electrode assembly 120 .
- the proximal tines 134 a may flex outwardly when forced against the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to the wireless electrode assembly 120 .
- the distal tines 132 a may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue 35 between the distal tines 132 a and the proximal tines 134 a .
- Such an opposed orientation of the tines 132 a and 134 a hinders rearward migration and forward migration of the electrode assembly 120 .
- the tissue 35 may grow and eventually incorporate the wireless electrode assembly 120 therein, thereby preventing the wireless electrode assembly 120 from dislodgement from the tissue 35 .
- the proximal tines 134 a are illustrated as abutting against the heart tissue 35 . It should be understood that, in some embodiments, the proximal tines 134 a may at least partially penetrate into the heart tissue 35 when the electrode assembly 120 is advanced therein.
- the fixation devices 132 b and 134 b may include tines that are biased to transition into a deployed condition (after being released from the delivery catheter 115 ) as described in connection with FIG. 6 .
- the tines 132 b and 134 b may deploy to outwardly extended orientations that generally oppose one another.
- the tines 132 and 134 can be configured so that a limited length of the electrode assembly 120 penetrates the tissue 35 before the forward migration is opposed by the proximal tines 134 b (e.g., before the curvature apex 135 b abuts the tissue 35 ).
- the electrode assembly 120 can penetrate the longitudinal length D 2 into the heart tissue 35 so that about half of the overall length of the electrode assembly 120 is advanced into the tissue 35 .
- the proximal tines 134 b may flex outwardly when forced against the heart wall tissue 35 , and such an outward flexing action can cause a slight spring back motion to the wireless electrode assembly 120 .
- the distal tines 132 b may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue 35 between the distal tines 132 b and the proximal tines 134 b .
- the tissue 35 may grow and eventually incorporate the wireless electrode assembly 120 therein, thereby preventing the wireless electrode assembly 120 from dislodgement from the tissue 35 .
- the proximal tines 134 b may be configured to at least partially deploy before exiting the distal opening of the delivery catheter 115 . As such, the proximal tines 134 b may at least partially curve outwardly from the body 128 of the electrode assembly before contacting the heart wall tissue 35 . In these circumstances, the proximal tines 134 b may curve so as to abut against the heart wall tissue 134 b without the extremities of the proximal tines 134 b penetrating into the tissue 35 .
- the proximal tines 134 b can at least partially deploy before exiting the distal opening of the delivery catheter 115 , the proximal tines 134 b can achieve the greater curvature previously described in connection with FIG. 6 so that the contact between the heart tissue 35 and the proximal tines 134 b is near the curvature apex 135 b ( FIG. 6 ).
- electrode assembly 120 can be arranged in the tube portion 142 so that the proximal tines 134 b are aligned with deployment slots 146 ( FIG. 8 ) formed in the tube portion 142 . Accordingly, when the electrode assembly is advanced into the heart tissue 35 , the proximal tines 134 b at least partially extend outwardly into the deployment slots 146 , thereby permitting the proximal tines 134 b to partially deploy before exiting the distal opening of the delivery catheter 115 . As previously described in connection with FIG. 6 , the proximal tines 134 b may be nonaligned with the distal tines 132 b along the body of the electrode assembly 128 .
- Such nonalignment between the proximal tines 134 b and the distal tines 132 b can permit the proximal tines 134 b to partially deploy in the deployment slots 146 while the distal tines 132 b are retained against the electrode body 128 in the tube portion 142 .
- the distal tines 132 b can be generally aligned with the proximal tines 134 b so that both the distal tines 132 b and the proximal tines 134 b pass through the deployment slots 146 during advancement of the electrode assembly 120 from the delivery catheter 115 .
- the deployment slots 146 may extend through the distal circumferential end of the delivery catheter 115 so that the proximal tines 134 b can at least partially deploy through the distal circumferential end of the delivery catheter 115 before exiting the distal opening of the delivery catheter 115 .
- the delivery catheter 115 may be wholly separate from the actuation rod 140 so that the actuation rod 140 slides through a conduit passing through the delivery catheter 115 .
- the actuation rod 140 may be completely retracted from the delivery catheter so that a second wireless electrode assembly may be detachably coupled to the actuation rod 140 (or to an unused, different actuation rod 140 ) and then directed through the delivery catheter 115 already disposed in the patient's body.
- the delivery catheter 115 and the actuation rod 140 may be coupled to one another.
- the delivery catheter 115 and actuation rod 140 may be removed from the guide catheter 110 ( FIG. 4 ) so that a second wireless electrode assembly may be detachably coupled to the actuation rod 140 (or to a previously unused delivery catheter/actuation rod having a similar construction) and then directed through the guide catheter 110 already disposed in the patient's body.
- the delivery catheter 115 may include a tube portion that is configured to retain a plurality of wireless electrode assemblies 120 (e.g., similar to tube portion 142 but having a greater length to receive a multitude of assemblies 120 ).
- the delivery catheter may be configured to carry two, three, four, five, ten, twelve, or more electrode assemblies 120 in a serial (end to end) arrangement.
- the plunger mechanism 144 can be used to force each electrode assembly 120 into different tissue sites without retracting the delivery catheter out of the heart.
- the actuation mechanism may force the plunger 144 in a generally distal direction.
- the plunger 144 applies the force to the most rearward assembly 120 in the serial arrangement, which in turn applies a force from the distal tip 130 of the most rearward assembly 120 to the proximal end of the next assembly 120 in the serial arrangement.
- the application of force can propagate through the serial arrangement until the assembly 120 nearest the heart tissue 35 is delivered to the target site (as described previously, for example, in connection with FIG. 7D ).
- the serial arrangement may comprise electrode assemblies 120 as described in connection with FIG. 5 , as described in connection with FIG. 6 , or some combination thereof.
- Some of the embodiments described herein permit a plurality of pacing electrodes to be deployed at multiple pacing sites.
- the pacing sites may be located in the left atrium 32 , the left ventricle 34 , the right atrium 36 , the right ventricle, or a combination thereof.
- the pacing electrodes may comprise wired pacing leads 95 ( FIG. 1 ), wireless electrode assemblies, or a combination thereof.
- Providing electrical stimulation at multiple pacing sites and in multiple heart chambers may be used to treat a number of conditions.
- One such condition is congestive heart failure (CHF). It has been found that CHF patients have benefited from bi-ventricular pacing, that is, pacing of both the left ventricle 34 and the right ventricle 38 in a timed relationship.
- CHF congestive heart failure
- pacing at multiple sites may be beneficial where heart tissue through which electrical energy must propagate is scarred or dysfunctional, which condition halts or alters the propagation of an electrical signal through that heart tissue. In these cases multiple-site pacing may be useful to restart the propagation of the electrical signal immediately downstream of the dead or sick tissue area. Synchronized pacing at multiple sites on the heart may inhibit the onset of fibrillation resulting from slow or aberrant conduction, thus reducing the need for implanted or external cardiac defibrillators. Arrhythmias may result from slow conduction or enlargement of the heart chamber.
- a depolarization wave that has taken a long and/or slow path around a heart chamber may return to its starting point after that tissue has had time to re-polarize.
- a never ending “race-track” or “circus” wave may exist in one or more chambers that is not synchronized with normal sinus rhythm.
- Atrial fibrillation a common and life threatening condition, may often be associated with such conduction abnormalities.
- Pacing at a sufficient number of sites in one or more heart chambers, for example in the atria may force all tissue to depolarize in a synchronous manner to prevent the race-track and circus rhythms that lead to fibrillation.
Abstract
Some embodiments of pacing systems employ wireless electrode assemblies to provide pacing therapy. The wireless electrode assemblies may wirelessly receive energy via an inductive coupling so as to provide electrical stimulation to the surrounding heart tissue. In certain embodiments, the wireless electrode assembly may include one or more biased tines that shift from a first position to a second position to secure the wireless electrode assembly into the inner wall of the heart chamber.
Description
- This application claims priority to U.S. Provisional Application Ser. No. 60/748,964 filed on Dec. 9, 2005 and entitled “CARDIAC STIMULATION SYSTEM,” the contents of which are incorporated herein by reference.
- This document relates to systems that electrically stimulate cardiac or other tissue.
- Pacing instruments can be used to treat patients suffering from a heart condition, such as a reduced ability to deliver sufficient amounts of blood from the heart. For example, some heart conditions may cause or be caused by conduction defects in the heart. These conduction defects may lead to irregular or ineffective heart contractions. Some pacing instruments (e.g., a pacemaker) may be implanted in a patient's body so that pacing electrodes in contact with the heart tissue provide electrical stimulation to regulate electrical conduction in the heart tissue. Such regulated electrical stimulation may cause the heart to contract and hence pump blood.
- Conventionally, pacemakers include a pulse generator that is implanted, typically in a patient's pectoral region just under the skin. One or more wired leads extend from the pulse generator so as to contact various portions of the heart. An electrode at a distal end of a lead may provide the electrical contact to the heart tissue for delivery of the electrical pulses generated by the pulse generator and delivered to the electrode through the lead.
- The use of wired leads may limit the number of sites of heart tissue at which electrical energy may be delivered. For example, most commercially available pacing leads are not indicated for use in the left side of the heart. One reason is that the high pumping pressure on the left side of the heart may cause a thrombus or clot that forms on a bulky wired lead to eject into distal arteries, thereby causing stroke or other embolic injury. Thus, in order to pace the left side of the heart with a wired lead, most wired leads are directed through the cardiac venous system to a site (external to the left heart chambers) in a cardiac vein over the left side of the heart. While a single lead may occlude a cardiac vein over the left heart locally, this is overcome by the fact that other cardiac veins may compensate for the occlusion and deliver more blood to the heart. Nevertheless, multiple wired leads positioned in cardiac veins can cause significant occlusion, thereby limiting the number of heart tissue sites at which electrical energy may be delivered to the left side of the heart.
- Some pacing systems may use wireless electrodes that are attached to the epicardial surface of the heart (external to the heart chambers) to stimulate heart tissue. In these systems, the wireless electrodes are screwed into the outside surface of the heart wall, which can reduce the effectiveness of the electrical stimulation in some circumstances.
- Some embodiments of pacing systems employ wireless electrode assemblies to provide pacing therapy. The wireless electrode assemblies may receive energy via an inductive coupling so as to provide electrical stimulation to the surrounding heart tissue. In certain embodiments, a wireless electrode assembly may be directed through a guide catheter in a heart chamber to deliver at least a portion of the wireless electrode assembly through the endocardium. For example, the electrode assembly may include first and second fixation devices to secure the electrode assembly to the heart chamber wall. In such circumstances, the first fixation device may oppose rearward migration of the electrode assembly out of the heart chamber wall, and the second fixation device may oppose forward migration into the heart chamber wall. Accordingly, the wireless electrode assembly can be readily secured to the heart chamber wall and incorporated into the surrounding heart tissue over a period of time.
- In some embodiments, a wireless electrode assembly may include a body portion that at least partially contains a circuit to electrically stimulate an electrode. The wireless electrode assembly may also include first and second biased tines to shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall. The first and second biased tines may be generally opposed to one another.
- Particular embodiments may include an electrode delivery system for delivering a wireless electrode assembly into a heart chamber. The system may include a wireless electrode assembly including a body portion and first and second biased tines to shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall. The first and second biased tines may oppose one another. The system may also include a delivery catheter to direct the wireless electrode assembly through a heart chamber and toward a heart chamber wall. The delivery catheter may include an opening in a distal end such that, when the wireless electrode assembly is separated from the opening in the distal end of the catheter, the first and second biased tines shift from the loaded condition to the outwardly extended condition.
- Some embodiments may include a method of inserting a wireless electrode assembly into a heart chamber wall. The method may include inserting a first biased tine of a wireless electrode assembly through a portion of endocardium and into a heart chamber wall. The first biased tine may shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall. The method may also include causing a second biased tine of the wireless electrode assembly to shift from the loaded condition to the outwardly extended condition to secure the body portion to a heart chamber wall. The first and second biased tines may be generally opposed to one another when in their respective outwardly extended conditions.
- These and other embodiments described herein may provide one or more of the following advantages. First, the wireless electrode assemblies may eliminate or otherwise limit the need for wired pacing leads, thereby reducing the risk of stroke or other embolic injury from a thrombus or clot and reducing the risk of occluding cardiac veins (external to the heart chambers). Second, the wireless electrode assemblies may be secured to the inner wall of one more heart chambers, which may provide more efficient transfer of electrical stimulation. Third, the wireless electrode assemblies may be secured to a heart chamber wall in a manner that opposes both forward migration and rearward migration of the electrode assembly. In such circumstances, the secure attachment of the wireless electrode assembly with the heart wall may increase the likelihood of incorporating the electrode assembly into surrounding tissue, thereby further reducing the likelihood of forming a thrombus or clot in the heart chamber.
- The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the invention will be apparent from the description and drawings, and from the claims.
-
FIG. 1 is a perspective view of a stimulation system and at least a portion of an electrode delivery system, in accordance with some embodiments of the invention. -
FIG. 2 is a diagram of at least a portion of a device of the stimulation system ofFIG. 1 . -
FIG. 3 is a diagram of at least a portion of a wireless electrode assembly of the stimulation system ofFIG. 1 . -
FIG. 4 is a section view of a heart and at least a portion of the electrode delivery system ofFIG. 1 . -
FIG. 5 is a perspective view of a wireless electrode assembly, in accordance with some embodiments of the invention. -
FIG. 6 is a perspective view of a wireless electrode assembly, in accordance with some embodiments of the invention. - FIGS. 7A-D are partial cross-sectional views of the delivery of the wireless electrode assembly of
FIG. 5 . -
FIG. 8 is a partial cross-sectional view of the delivery of the wireless electrode assembly ofFIG. 6 . - Like reference symbols in the various drawings indicate like elements.
- Referring to
FIG. 1 , anelectrical stimulation system 10 may include one or morewireless electrode assemblies 120. Thewireless electrode assemblies 120 are implanted within chambers of theheart 30. In this example, there are two implanted in theleft ventricle 34 and two implanted in theright ventricle 38, but the wireless electrode assemblies may be implanted in theleft atrium 32, theright atrium 36, or both. As described below in connection withFIGS. 4-8 , thewireless electrode assemblies 120 may be delivered to one or more chambers of theheart 30 using anelectrode delivery system 100. The electrode delivery system may include aguide catheter 110 that is directed through one or more veins or arteries to the targeted chamber of the heart 30 (e.g., theleft ventricle 34 is the targeted chamber in the embodiment shown inFIG. 1 ). After theguide catheter 110 is deployed into the targeted heart chamber thewireless electrode assemblies 120 may be consecutively delivered through theguide catheter 110 using at least onedelivery catheter 115, which may include a steering mechanism (e.g., steering wires, a shape memory device, or the like) to delivery thewireless electrode assembly 120 to the targeted site on the heart chamber wall. - The distal end of each
wireless electrode assembly 120 may include one or more fixation devices, such as tines As described in more detail below in connection withFIGS. 5 and 6 , thetines wireless electrode assembly 120 to the heart chamber wall. In some embodiments, each of thewireless electrode assemblies 120 may include a circuit comprising an internal coil and an electrical charge storage device (not shown inFIG. 1 ). As described in more detail below in connection withFIG. 3 , the internal coil can be inductively coupled with an external power source coil so as to charge the electrical charge storage device (e.g., a battery, capacitor, or the like) contained within thewireless electrode assembly 120. Also in some embodiments, each of thewireless electrode assemblies 120 has a triggering mechanism in the circuit to deliver stored electrical charge to adjacent heart tissue (some examples are described in more detail below in connection withFIG. 3 ). In alternative embodiments, one or more of thewireless electrode assemblies 120 may have no energy storage device. In such circumstances, each wireless electrode assembly may be comprised, for example, of a ferrite core having caps at each end with ring electrodes encircling the caps. A number of turns of fine insulated wire may be wrapped around the central portion of the core so as to receive energy from a magnetic field produced by a shaped driving signal and designed to activate the electrodes. - Referring still to
FIG. 1 , thesystem 10 may also include a pacingcontroller 40 and atransmitter 50 that drives anantenna 60 for communication with thewireless electrode assemblies 120. The pacingcontroller 40 includes circuitry to sense and analyze the heart's electrical activity, and to determine if and when a pacing electrical pulse needs to be delivered and by which of thewireless electrode assemblies 120. The sensing capability may be made possible by having sense electrodes included within the physical assembly of the pacingcontroller 40. Alternatively, a conventional single or dual lead pacemaker may sense the local cardiac electrocardiogram (ECG) and transmit this information toantenna 60 for use bycontroller 40 in determination of the timing of wireless electrode assembly firing. In either case, thewireless electrode assembly 120 need not be provided with sensing capability, and also thewireless electrode assemblies 120 need not be equipped with the capability of communicating to the pacing controller 40 (for example, to communicate information about sensed electrical events). In alternative embodiments, the wireless electrode assemblies may communicate sensed information to each other and/or to thecontroller 40. - The
transmitter 50—which is in communication with, and is controlled by, the pacingcontroller 40—may drive an RF signal onto theantenna 60. In one embodiment, thetransmitter 50 provides both (1) a charging signal to charge the electrical charge storage devices contained within thewireless electrode assemblies 120 by inductive coupling, and (2) an information signal, such as a pacing trigger signal, that is communicated to a selected one or more of thewireless electrode assemblies 120, commanding thatwireless electrode assembly 120 deliver its stored charge to the adjacent heart tissue. - One parameter of the
wireless electrode assembly 120 that may affect the system design is the maximum energy required to pace theventricle heart 30. This energy requirement can include a typical value needed to pace ventricular myocardium, but also can include a margin to account for degradation of contact between the electrodes and tissue over time. In certain embodiments, eachwireless electrode assembly 120 may require the maximum pacing threshold energy. This threshold energy is supplied to the wireless electrode assemblies between heartbeats by an external radio frequency generator (which may also be implanted), or other suitable energy source that may be implanted within the body. Parameter values for some embodiments may be: -
- Threshold pacing voltage=2.5 Volts
- Typical lead impedance=600 Ohms
- Typical pulse duration=0.4 mSec
- Derived threshold energy=4 micro-Joules
- Because RF fields at frequencies higher than about 200 kHz may be attenuated by the body's electrical conductivity, and because electric fields of any frequency may be attenuated within the body, energy transmission through the body may be accomplished in some embodiments via a magnetic field at about 20-200 kHz (or by a magnetic field pulse that contains major frequency components in this range), and preferably by transmission of magnetic fields in the range of 100-200 kHz when transmission is through relatively conductive blood and heart muscle.
- Still referring to
FIG. 1 , the pacingcontroller 40 and thetransmitter 50 may be housed in a single enclosure that is implantable within a patient. In such a configuration, the single enclosure device may have a single energy source (battery) that may be either rechargeable or non-rechargeable. In another configuration, the pacingcontroller 40 and thetransmitter 50 may be physically separate components. As an example of such a configuration, the pacingcontroller 50 may be implantable, for example in the conventional pacemaker configuration, whereas the transmitter 50 (along with the antenna 60) may be adapted to be worn externally, such as in a harness that is worn by the patient. In the latter example, the pacingcontroller 40 would have its own energy source (battery), and that energy would not be rechargeable given the relatively small energy requirements of the pacingcontroller 40 as compared to the energy requirements of thetransmitter 50 to be able to electrically charge thewireless electrode assemblies 120. In this case, the pacingcontroller 40 would sense the local cardiac ECG signal through a conventional pacing lead, and transmit the sensed information to the external controller. Again, transmission of information, as opposed to pacing energy, has a relatively low power requirement, so a conventional pacemaker enclosure and battery would suffice. - The external programmer 70 is used to communicate with the pacing
controller 40, including after the pacingcontroller 40 has been implanted. The external programmer 70 may be used to program such parameters as the timing of stimulation pulses in relation to certain sensed electrical activity of the heart, the energy level of stimulation pulses, the duration of stimulation pulse (that is, pulse width), etc. The programmer 70 includes anantenna 75 to communicate with the pacingcontroller 40, using, for example, RF signals. Theimplantable pacing controller 40 is accordingly equipped to communicate with the external programmer 70, using, for example, RF signals. Theantenna 60 may be used to provide such communications, or alternatively, the pacingcontroller 40 may have an additional antenna (not shown inFIG. 1 ) for external communications with the programmer 70, and in an embodiment where thetransmitter 50 andantenna 60 are housed separately from thecontroller 40, for communications with thetransmitter 50. - Still referring to
FIG. 1 , at least a portion of thesystem 10 is shown as having been implanted in a patient, and in addition, the programmer 70 is also shown that is external to the patient. Thecontroller 40 andtransmitter 50 may be housed in a device that is shaped generally elongate and slightly curved so that it may be anchored between two ribs of the patient, or possibly around two or more ribs. In one example, the housing for thecontroller 40 andtransmitter 50 is about 2 to 20 cm long and about 1 to 10 centimeters cm in diameter, may be about 5 to 10 cm long and about 3 to 6 cm in diameter. Such a shape of the housing for thecontroller 40 andtransmitter 50, which allows the device to be anchored on the ribs, may provide an enclosure that is larger and heavier than conventional pacemakers, and may provide a larger battery having more stored energy. In addition, thecontroller 40 may comprise a defibrillator that discharges energy to theheart 30 through electrodes on the body ofcontroller 40 when fibrillation is sensed. Other sizes and configurations may also be employed as is practical. - In some embodiments, the
antenna 60 may be a loop antenna comprised of a long wire that is electrically connected across an electronic circuit contained within the controller/transmitter housing, which circuit delivers pulses of RF current to theantenna 60, generating a magnetic field in the space around theantenna 60 to charge thewireless electrode assemblies 120, as well as RF control magnetic field signals to command thewireless electrode assemblies 120 to discharge. In such embodiments, theantenna 60 may comprise a flexible conductive material so that it may be manipulated by a physician during implantation into a configuration that achieves improved inductive coupling between theantenna 60 and the coils within the implantedwireless electrode assemblies 120. In one example, theloop antenna 60 may be about 2 to 22 cm long, and about 1 to 11 cm wide, and may be about 5 to 11 cm long, and about 3 to 7 cm wide. Placement of theantenna 60 over the ribs may provide a relatively large antenna to be constructed that has improved efficiency in coupling RF energy to the pacingwireless electrode assemblies 120. - As shown in
FIG. 1 , some embodiments of thesystem 10 may also include a pulse generator device 90 (or pacemaker device) and associated wired leads 95 which extend from the pulse generator device 90 and into one or more chambers of the heart 30 (e.g., into the right atrium 36). For example, thesystem 10 may include wired leads 95 from the pulse generator device 90 that extend into theright atrium 36 and theright ventricle 38 while wireless electrode assemblies are disposed in theleft atrium 32 and theleft ventricle 34. The pulse generator device 90 may be used to sense the internal ECG, and may also communicate with thecontroller 40 and/ortransmitter 50 as previously described. - As previously described, in some embodiments, each of the
wireless electrode assemblies 120 includes a rechargeable battery or other charge storage device. This battery may provide power for delivering pacing energy to the tissue, and for operating communications, logic, and memory circuitry contained within the assembly. In some alternative embodiments, a transmitter and an antenna may be external to the patient (as opposed to theimplantable transmitter 50 andantenna 60 depicted inFIG. 1 ), and may serve to recharge the batteries within the electrode assemblies. The recharge transmitter and antenna may be incorporated into furniture, incorporated into the patient's bed, or worn by the patient (e.g., in a vest-type garment). Daily recharging for predetermined to periods (e.g., about 30 minutes) may be required in some cases. In these circumstances, thewireless electrode assemblies 120 may be autonomous pacemaker-like devices, which can sense the local electrogram and only pace when the local tissue is not refractory. Such electrodes may communicate with the programming unit 70 to receive pacing instructions and transmit data stored in local memory. In these embodiments, eachwireless electrode assembly 120 may also communicate with other implantedwireless electrode assemblies 120. For example, oneelectrode assembly 120 in the right atrium may be designated as the “master,” and all other implanted electrodes are “slaves,” that pace with pre-programmed delays relative to the “master.” As such, a master electrode in the right atrium may only sense the heart's sinus rhythm, and trigger pacing of the slaves with programmed delays. - Referring to
FIG. 2 , an embodiment of adevice 80 including thecontroller 40,transmitter 50, associatedantenna 60 is shown in block diagram form. Included within thedevice 80 is: abattery 82, which may be recharged by receiving RF energy from a source outside the body viaantenna 60;ECG sensing electrodes 84 and associatedsensing circuitry 86;circuitry 87 for transmitting firing commands to the implanted wireless electrode assemblies, transmitting status information to the external programmer, receiving control instructions from the external programmer and receiving power to recharge the battery; and a controller orcomputer 88 that is programmed to control the overall functioning of the pacing control implant. In alternative embodiments,antenna 60 may receive signals from the individualwireless electrode assemblies 120 containing information regarding the local ECG at the site of each wireless electrode assembly, and/or theantenna 60 may receive signals from a more conventional implanted pacemaker regarding the ECG signal at the sites of one or more conventional leads implanted on the right side of the heart. - Referring to
FIG. 3 , some embodiments of awireless electrode assembly 120 may include areceiver coil 122 that is capable of being inductively coupled to a magnetic field source generating a time-varying magnetic field at the location ofcoil 122, such as would be generated by thetransmitter 50 and theantenna 60 depicted inFIG. 1 . The RF current in the external antenna may be a pulsed alternating current (AC) or a pulsed DC current, and thus the current induced through thereceiver coil 122 would likewise be an AC or pulsed DC current. The current induced incoil 122 may be proportional to the time rate of change of the magnetic field generated at the site ofcoil 122 by the external RF current source. In some embodiments, a four-diode bridge rectifier 123 may connected across thereceiver coil 122 to rectify the AC or pulsed DC current that is induced in thereceiver coil 122. A three-position switch device 124 may be connected so that when theswitch device 124 is in a first position, therectifier 123 produces a rectified output that is imposed across acapacitor 125. As such, when theswitch device 124 is in the position 1 (as is the case inFIG. 4 ), thecapacitor 125 stores the induced electrical energy. - The
switch device 124, in this example, is a voltage-controlled device and is connected to sense a voltage across thecapacitor 125 to determine when thecapacitor 125 has been sufficiently charged to a specified pacing threshold voltage level. When thecapacitor 125 is sensed to have reached the specified pacing threshold level, the voltage-controlledswitch device 124 moves to aposition 2, which disconnects thecapacitor 125 from thecoil 122. With theswitch device 124 in theposition 2, thecapacitor 125 is electrically isolated and remains charged, and thus is ready to be discharged. The voltage controlledswitch device 124 may comprise a solid state switch, such as a field effect transistor, with its gate connected to the output of a voltage comparator that compares the voltage oncapacitor 125 to a reference voltage. The reference voltage may be set at the factory, or adjusted remotely (e.g., after being implanted) via signals sent from the physician programmer unit 70 (FIG. 1 ), received bycoil 122 and processed by circuitry not shown inFIG. 3 . Any electronic circuitry contained within thewireless electrode assembly 120, including the voltage controlled switch, can be constructed with components that consume very little power, for example CMOS. Power for such circuitry is either taken from a micro-battery contained within the wireless electrode assembly, or supplied by draining a small amount of charge fromcapacitor 125. - Still referring to
FIG. 3 , a narrow bandpass filter device 126 may also be connected across thereceiver coil 122, as well as being connected to the three-position switch device 124. The bandpass filter device 126 passes only a single frequency of communication signal that is induced in thecoil 122. The single frequency of the communication signal that is passed by thefilter device 126 may be unique for the particularwireless electrode assembly 120 as compared to other implanted wireless electrode assemblies. When thereceiver coil 122 receives a short magnetic field burst at this particular frequency, thefilter device 126 passes the voltage to theswitch device 124, which in turn moves to aposition 3. - With the
switch device 124 in theposition 3, thecapacitor 125 may be connected in series through twobipolar electrodes capacitor 125 is discharged through the tissue. When this happens, the tissue becomes electrically depolarized. In one example embodiment described in more detail below, thebipolar electrodes wireless electrode assembly 120. After a predetermined, or programmed, period of time, the switch returns to position 1 so thecapacitor 125 may be charged back up to the selected threshold level. - It should be noted that, for sake of clarity, the schematic diagram of
FIG. 3 shows only the electrical components for energy storage and switching for particular embodiments of thewireless electrode assembly 120. Not necessarily shown are electronics to condition the pacing pulse delivered to the tissues, which circuitry should be understood from the description herein. Some aspects of the pulse, for example pulse width and amplitude, may be remotely programmable via encoded signals received through thefilter device 126 of thewireless electrode assembly 120. In this regard,filter 126 may be a simple band pass filter with a frequency unique to a particular wireless electrode assembly, and the incoming signal may be modulated with programming information. Alternatively, filter 126 may consist of any type of demodulator or decoder that receives analog or digital information induced by the external source incoil 122. The received information may contain a code unique to each wireless electrode assembly to command discharge ofcapacitor 125, along with more elaborate instructions controlling discharge parameters such as threshold voltage for firing, duration and shape of the discharge pulse, etc. - Using wireless electrode assemblies of the type shown in
FIG. 3 , all of the implantedwireless electrode assemblies 120 may be charged simultaneously by a single burst of an RF charging field from atransmitter antenna 60. Because back reaction of thewireless electrode assemblies 120 on theantenna 60 may be small, transmitter 50 (FIG. 1 ) losses may be primarily due to Ohmic heating of the transmitantenna 60 during the transmit burst, Ohmic heating of the receivecoil 122, and Ohmic heating of conductive body tissues by eddy currents induced in these tissues by the applied RF magnetic field. By way of comparison, if eightwireless electrode assemblies 120 are implanted and each is addressed independently for charging, thetransmitter 50 may be turned ON eight times as long, which may require almost eight times more transmit energy, the additional energy being primarily lost in heating of the transmitantenna 60 and conductive body tissues. With thewireless electrode assembly 120 ofFIG. 3 , however, all implanted wireless electrode assemblies can be charged simultaneously with a burst of RF current inantenna 60, and antenna and body tissue heating occurs only during the time required for this single short burst. Each wireless electrode assembly is addressed independently through itsfilter device 126 to trigger pacing. The transmitted trigger fields can be of much smaller amplitude, and therefore lose much less energy to Ohmic heating, than the transmitted charging pulse. - Pending U.S. patent application Ser. No. 10/971,550 (filed on Oct. 20, 2004), Ser. No. 11/075,375 (filed on Mar. 7, 2005), and Ser. No. 11/075,376 (filed on Mar. 7, 2005), all owned by the assignee of this application, describe various features of wireless electrode assemblies, systems to deliver the wireless electrode assemblies to the heart, and electronic components to activate the wireless electrode assemblies to deliver electrical stimulation. It should be understood from the description herein that some of the features described in these three patent applications (Ser. Nos. 10/971,550, 11/075,375, and 11/075,376) may be applicable to particular embodiments described herein.
- Referring now to
FIG. 4 , some embodiments of anelectrode delivery system 100 may include aguide catheter 110 and adelivery catheter 115. Thecatheters FIG. 4 ) to a distal end (depicted inFIG. 4 as extending into the patient's heart 30). Thedelivery catheter 115 fits within a lumen of theguide catheter 110, and can be advanced through theguide catheter 110 so that a distal end of thedelivery catheter 115 extends out of a distal opening of theguide catheter 110. Theguide catheter 110 may be directed through one or more veins or arteries to the targeted chamber of the heart 30 (e.g., theleft ventricle 34 is the targeted chamber in the embodiment shown inFIG. 4 ). Theguide catheter 110 may comprise a steering mechanism (e.g., steering wires, shape memory device, or the like) to shift the distal end and may include at least onemarker band 112 to permit viewability of the distal end of theguide catheter 110 using medical imaging techniques. Such amarker band 112 may aid a physician when steering theguide catheter 110 to the targeted heart chamber. - After the
guide catheter 110 is deployed into the targeted heart chamber, thewireless electrode assemblies 120 may be advanced into the heart tissue through theguide catheter 110 using at least onedelivery catheter 115. Thewireless electrode assemblies 120 may be consecutively delivered through theguide catheter 110 using at least onedelivery catheter 115. In some embodiments, thedelivery catheter 115 may include at least onemarker band 116 to permit viewability of the distal end of thedelivery catheter 115 using medical imaging techniques. Thedelivery catheter 115 may include a steering mechanism (e.g., steering wires, shape memory device, or the like) to shift the distal end. For example, thedelivery catheter 115 may comprise a shape memory device (e.g., one or more wires comprising Nitinol or another shape memory material) to provide a predetermined curvature near the distal end of thedelivery catheter 115. The shape memory device may be activated by a change in electrical charge or by a change in temperature. In one example, thedelivery catheter 115 may include a shape memory device near the distal end that is capable of providing a 90-degree deflection curve near the distal end immediately before a longitudinally straight section at the distal end of thecatheter 115. - In some approaches to the targeted tissue, the steering mechanism (e.g., steering wires, shape memory device, or the like) of the
delivery catheter 115 can be manipulated so that a deflected portion near the distal end of the delivery catheter abuts against the septum wall of the targeted heart chamber. For example, the deflected portion of the delivery catheter may abut against theseptum wall 39 between theleft ventricle 34 and theright ventricle 38 while a longitudinally straight section of thecatheter 115 extends the distal end against the targeted heart chamber wall to receive the wireless electrode assembly 120 (refer to the dotted-line example depicted inFIG. 4 ). Accordingly, the deflected portion of thedelivery catheter 115 can abut against the septum wall to support the position of the distal end of thedelivery catheter 115 during the deployment of thewireless electrode assembly 120 into the targeted heart tissue 35 (refer, for example, to FIGS. 7A-D and 8). Such an approach may provide leverage and stability during the insertion process for theelectrode assembly 120. - The
delivery catheter 115 includes an opening at the distal end in which an associatedwireless electrode assembly 120 is retained in a loaded position. Thewireless electrode assembly 120 may include a body portion that has a length and a radius configured to be retained with thedelivery catheter 115. As described in more detail below, some embodiments of the body portion of thewireless electrode assembly 120 may have a radius, for example, of about 1.25 mm or less and may have a length, for example, of about 10 mm or less. Wireless electrode assemblies configured for insertion into an atrial wall may be smaller than those configured for insertion into the ventricle walls. - In the exemplary embodiment shown in
FIG. 4 , thewireless electrode assemblies 120 comprise a pointed-tip cylindrical body having a forward portion embedded within the heart wall tissue and a rearward portion that is inside the heart chamber but not fully embedded in the heart wall tissue. The pointeddistal tip 130 of theelectrode assembly 120 facilitates penetration into the heart wall tissue, and the proximal end of the electrode assembly is configured to remain outside of the heart wall. However, in some embodiments, both thedistal tip 130 and the proximal end of theelectrode assembly 120 can be embedded within theheart wall tissue 30. As described in more detail below, theelectrode assembly 120 may include twofixation devices electrode assembly 120, and the proximal tines can be coupled to and extend from a periphery of a rearward portion of the body. As described in more detail below, the set of distal tines extend somewhat outwardly from the body of theelectrode assembly 120 but also rearwardly so as to prevent the electrode from becoming dislodged from the heart wall once theelectrode assembly 120 is implanted. Also as described in more detail below, the set of proximal tines extend somewhat outwardly from the body of theelectrode assembly 120 but also forwardly so as to prevent theelectrode assembly 120 from penetrating entirely through the heart wall. - As the
wireless electrode assembly 120 is deployed fromdelivery catheter 115,tines wireless electrode assembly 120 may adjust to a deployed position (e.g., an outwardly extended condition). Such an adjustment to the deployed position may be caused, for example, due to spring bias of thetines 132 and 134 (described in more detail below). When thetines tines wireless electrode assembly 120 to the targeted tissue site (e.g., described in more detail below, for example, in connection withFIGS. 7-8 ). In some embodiments, the opening at the distal end of thedelivery catheter 115 may be part of conduit that extends through the elongated body of thecatheter 115. In other embodiments, the opening at the distal end of thedelivery catheter 115 may extend only a partial length into the delivery catheter 115 (e.g., with a narrower channel extending fully to the proximal end of thedelivery catheter 115 to provide space for the plunger mechanism 140). - Referring to
FIGS. 5 and 6 , thetines wireless electrode assembly 120 may be configured in a number of orientations. For example, thetines FIG. 5 ) that permits theelectrode assembly 120 to penetrate a substantial length into the heart wall tissue (described in more detail below in connection withFIGS. 7A-7D ). In another example, thetines FIG. 6 ) that permits theelectrode assembly 120 to penetrate a lesser amount into the heart wall tissue (described in more detail below in connection withFIG. 8 ). In some embodiments,wireless electrode assembly 120 may include aproximal electrode 121 at or near a proximal end and adistal electrode 129 at or near a distal end. Theproximal electrode 121 anddistal electrode 129 may provide bipolar electrode capabilities for thewireless electrode assembly 120, thereby permitting theassembly 120 to supply an electrical charge between the proximal anddistal electrodes 121 and 129 (and across the nearby heart tissue). - As previously described, the
fixation device 132 may include a set of biased tines arranged near the distal end of thewireless electrode assembly 120 so as to secure thewireless electrode assembly 120 to the heart chamber wall. Thefixation device 134 may include a first set of biased tines arranged near the proximal end of thewireless electrode assembly 120 which can also serve to secure theassembly 120 to the heart chamber wall. In some embodiments, thetines 134 arranged near the proximal end may have a different configuration and orientation from the opposingtines 132 arranged near the distal end. For example, as shown in the embodiments depicted inFIGS. 5-6 , thedistal tines 132 may generally oppose theproximal tines 134. In these circumstances, at least some of thetines tines body 128 of thewireless electrode assembly 120 so as to fit within the cavity at the distal end of the delivery catheter 115 (refer, for example, to FIG. 7A). Thetines delivery catheter 115. When in the deployed condition, thedistal tines 132 may be disposed in an outwardly extended orientation that opposes the outwardly extended orientation of theproximal tines 134. In one example, thedistal tip 130 may penetrate into the heart chamber wall when a force is applied to the wireless electrode assembly 120 (e.g., penetrate the endocardium and possibly into the myocardium). During penetration, thetines tines FIG. 5 ) andtines FIG. 6 ). Such a configuration permits thewireless electrode assembly 120 to be readily secured to the heart chamber wall after advancing from thedelivery catheter 115. - As previously described, the
wireless electrode assembly 120 may be arranged in the delivery catheter 115 (FIG. 4 ) so that thetines electrode assembly 120 is advanced out of the distal end of thedelivery catheter 115, thetines tines tines - In the embodiment depicted in
FIG. 5 , thedistal tines 132 a andproximal tines 134 a can be arranged so that a substantial length of the electrode assemble 120 penetrates into the heart wall tissue. In these circumstances, thedistal tines 132 a may penetrate in the heart wall tissue to hinder rearward migration of theelectrode assembly 120 back into the hear chamber, and theproximal tines 134 a are configured to abut or partially penetrate into the wall surface to hinder forward migration of theassembly 120 toward the outside of the heart. Thus, when in the deployed condition, thedistal tines 132 a oppose migration of thewireless electrode assembly 120 in the generally proximal direction and theproximal tines 134 a oppose migration in the generally distal direction. Accordingly, the opposing orientation of thetines wireless electrode assembly 120 to the heart tissue in a manner so that a portion of the proximal end of thewireless electrode assembly 120 is not embedded in the heart tissue. Becausetines electrode assembly 120 in the heart tissue without substantial migration, the proximal end of theelectrode assembly body 128 can be incorporated into the surrounding heart tissue over a period of days or weeks. In these embodiments, thewireless electrode assembly 120 may be immobilized by the surrounding tissue to prevent future dislodgement. In such circumstances, the patient may receive anti-coagulants, Aspirin, or other drugs (e.g., PLAVIX, CUMODIN, etc.) for several months after the operation or until incorporation of thewireless electrode assembly 120 into the surrounding tissue has occurred. - In this embodiment depicted in
FIG. 5 , thedistal tines 132 a and theproximal tines 134 a are slightly curved and are oriented in an opposing manner when in the deployed condition. The curvature of theproximal tines 132 is such that thetines 134 a contact the surface of the heart tissue near the proximal tines' extremities. In addition, theproximal tines 134 a can be positioned along thebody 128 and curved in a manner so that thefree end 135 a of eachproximal tine 134 a abuts or partially penetrates into the heart wall tissue after a portion of theelectrode assembly 120 has penetrated therein. Thewireless electrode assembly 120 can be advanced into theheart wall tissue 35 so that theproximal tines 134 a cause a slight spring-back action after abutting or partially penetrating into the heart wall tissue. For example, theproximal tines 134 a may flex outwardly when forced into engagement with the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to thewireless electrode assembly 120. Thedistal tines 132 a may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue between thedistal tines 132 a and theproximal tines 134 a. - Still referring to
FIG. 5 , theproximal tines 134 a can be positioned along thebody 128 and curved in a manner so that thefree end 135 a of eachproximal tine 134 a abuts or partially penetrates into the heart wall tissue after a substantial portion of theelectrode assembly 120 has penetrated therein. For example, in this embodiment, theproximal tines 134 a are configured such that thefree end 135 a of eachtine 134 a (when in the deployed condition) is disposed a longitudinal distance D1 rearward of thedistal tip 130. In this embodiment, the longitudinal distance D1 is greater than half the overall length L of theelectrode assembly 120. In such circumstances, a majority of the length of theelectrode assembly 120 can penetrate into the heart wall tissue before theproximal tines 134 a engage the heart wall to oppose forward migration. This example of substantial penetration of theelectrode assembly 120 into the heart wall tissue may be effective when advancing theelectrode assembly 120 into portions of the heart having thicker myocardial walls (e.g., some heart walls around the left and right ventricles). In addition, when a substantial portion of theelectrode assembly 120 penetrates into the heart tissue, the non-penetrating proximal portion of theelectrode assembly 120 is reduced, thereby promoting efficient healing and incorporation into the surrounding heart tissue. - In the embodiment depicted in
FIG. 6 , thedistal tines 132 b andproximal tines 134 b can be arranged so that a lesser length of theelectrode assembly 120 penetrates into the heart wall tissue. For example, thedistal tines 132 b may be substantially different in length than theproximal tines 134 b. Also, theproximal tines 134 b may have a greater curvature than theproximal tines 134 a previously described in connection withFIG. 5 so that the contact between the surface of the heart tissue and the proximal tines is near the apex of the curvature. In these embodiments, theproximal tines 134 b can be positioned along thebody 128 and curved in a manner so that thecurvature apex 135 b of eachproximal tine 134 b abuts the heart wall tissue after a partial length of theelectrode assembly 120 has penetrated therein. For example, theproximal tines 134 b are configured such that the apex 135 b (when in the deployed condition) is disposed at a longitudinal distance D2 rearward of thedistal tip 130. In this embodiment, the longitudinal distance D2 is about half the overall length L of theelectrode assembly 120. Accordingly, about half of theelectrode assembly 120 can penetrate into the tissue before theproximal tines 134 b oppose forward migration. Such penetration to a limited length of theelectrode assembly 120 may be effective when advancing theelectrode assembly 120 into portions of the heart wall having a reduced wall thickness (e.g., some heart walls around the right atrium). - As previously described, the
tines wireless electrode assembly 120 to the heart tissue in a manner that opposes reward migration and forward migration, thereby permitting incorporation into the surrounding tissue. For example, theproximal tines 134 b may flex outwardly when forced against the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to thewireless electrode assembly 120. Thedistal tines 132 b may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of the heart tissue between thedistal tines 132 b and theproximal tines 134 b. - In some embodiments, the
proximal tines 134 b of the electrode assembly may be nonaligned with thedistal tines 132 b along the body of theelectrode assembly 128. For example, as shown inFIG. 6 , thedistal tines 132 b may be tangentially shifted about 45° along the body circumference as compared to theproximal tines 134 b so that theproximal tines 134 b anddistal tines 132 b are nonaligned. As described in more detail below in connection withFIG. 8 , such nonalignment between theproximal tines 134 b and thedistal tines 132 b can permit one set of tines (e.g., theproximal tines 134 b) to partially deploy before fully exiting the distal opening of thedelivery catheter 115. In these circumstances, the partial deployment of theproximal tines 134 b before fully exiting thedelivery catheter 115 can facilitate the abutting engagement between theproximal tines 134 b and the heart chamber wall. - It should be understood that in some embodiments of the
wireless electrode assembly 120, thedistal tines 132 may also serve as at least a portion of thedistal electrode 129. Also, in some embodiments,proximal tines 134 may also serve as at least a portion of theproximal electrode 121. For example, thetines - Referring now to FIGS. 7A-D, some embodiments of the
wireless electrode assemblies 120 may be press fit into the conduit of thedelivery catheter 115 so that aplunger mechanism 144 may be used to separate thewireless electrode assembly 120 from thedelivery catheter 115. As shown inFIG. 7A , thedelivery catheter 115 may be steered and directed toward a targeted site at the surface of heart tissue 35 (e.g., a heart chamber wall). Thedelivery catheter 115 may contain at least a distal portion of atube portion 142 that is coupled to anactuation rod 140. As previously described, in some approaches to the targeted tissue, the steering mechanism (e.g., steering wires, shape memory device, or the like) of thedelivery catheter 115 can be manipulated so that a deflected portion near the distal end of thedelivery catheter 115 abuts against the septum wall of the targeted heart chamber. For example, the portion 117 (FIG. 7A ) of thedelivery catheter 115 may be deflected to abut against the septum wall while a longitudinally straight section of thecatheter 115 extends toward the targetedheart tissue 35. As such, some portion (e.g., portion 117) thedelivery catheter 115 can abut against the septum wall to support the position of the distal end of thedelivery catheter 115. - The
wireless electrode assembly 120 may be releasably engaged with thetube portion 142. For example, thewireless electrode assembly 120 may be press-fit into thetube portion 142. In another example, thetube portion 142 may have a square cross-sectional shape, a hexagonal cross-sectional shape, a keyed cross-sectional shape, or other noncircular cross-sectional shape to engage the complementary shaped body of thewireless electrode assembly 120. Thetube portion 140 may be substantially rigid so as to retain thefixation devices wireless electrode assembly 120 in a loaded condition (as shown, for example, inFIG. 7A ). In some embodiments, one or both of theactuation rod 140 and theplunger mechanism 144 may extend to an actuation device (e.g., a hand-operated trigger mechanism) at the proximal end of thedelivery catheter 115 outside the patient's body. In some embodiments, thetube portion 142 and theactuation rod 140 may be fixedly arranged in thedelivery catheter 115 so as to deliver one electrode assembly at a time. Alternatively, thetube portion 142 and theactuation rod 140 may be movable through lumen of thedelivery catheter 115 so that a number of electrode assemblies can be consecutively passed through thedelivery catheter 115. - As shown in
FIG. 7B , the distal end of thedelivery catheter 115 may abut the surface of theheart tissue 35 to prepare thewireless electrode assembly 120 for fixation to thetissue 35. In this embodiment, the distal end of thedelivery catheter 115 includes amarker band 116 to facilitate the steering and guidance of the delivery catheter (e.g., a physician may employ medical imaging techniques to view themarker band 116 while thedelivery catheter 115 is in the heart 30). - Referring to
FIG. 7C , theelectrode assembly 120 can be advanced through the distal opening of the delivery catheter 115 (and the tube portion 142) and into thetissue 35. This operation may be performed by advancing theplunger mechanism 144 against the proximal end of thewireless electrode assembly 120 to thereby force thedistal tip 130 of thewireless electrode assembly 120 to penetrate through the endocardium and possibly into the myocardium. For example, the force may be applied by manipulating the actuation device (e.g., the hand-operated trigger mechanism connected to the proximal end of the plunger mechanism 144) to force theplunger mechanism 144 in the distal direction relative to the actuation rod 140 (and the tube portion 142). As such, thedistal tip 130 of theelectrode assembly 120 pierces the tissue surface and advances into thetissue 35. - Referring to
FIG. 7D , when thedelivery catheter 115 is fully separated from thewireless electrode assembly 120, thefixation devices fixation devices FIGS. 5-6 ) after being released from thetube portion 142 of thedelivery catheter 115. As previously described in connection withFIG. 5 , thetines electrode assembly 120 penetrates into thetissue 35 before the forward migration is hindered by theproximal tines 134. For example, theelectrode assembly 120 can penetrate the longitudinal length D1 into theheart tissue 35 so that a majority of the overall length of theelectrode assembly 120 is advanced into thetissue 35. In these embodiments, thedistal tines 132 a can transition to the deployed condition in which eachtine 132 a is outwardly extended in a generally proximal direction when thedistal tip 130 penetrates into theheart tissue 35. Also in these embodiments, theproximal tines 134 a can transition to the deployed condition in which eachtine 134 a is extended outwardly in a generally distal direction when thedelivery catheter 115 is separated from the proximal end of thewireless electrode assembly 120. - As previously described, in some circumstances, the
proximal tines 134 a may flex outwardly when forced against the heart wall tissue, and such an outward flexing action can cause a slight spring back motion to thewireless electrode assembly 120. Thedistal tines 132 a may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of theheart tissue 35 between thedistal tines 132 a and theproximal tines 134 a. Such an opposed orientation of thetines electrode assembly 120. As previously described, thetissue 35 may grow and eventually incorporate thewireless electrode assembly 120 therein, thereby preventing thewireless electrode assembly 120 from dislodgement from thetissue 35. In the example depicted inFIG. 7D , theproximal tines 134 a are illustrated as abutting against theheart tissue 35. It should be understood that, in some embodiments, theproximal tines 134 a may at least partially penetrate into theheart tissue 35 when theelectrode assembly 120 is advanced therein. - Referring to
FIG. 8 , other embodiments of thewireless electrode assembly 120 includefixation devices fixation devices FIG. 6 . In such embodiments thetines tines electrode assembly 120 penetrates thetissue 35 before the forward migration is opposed by theproximal tines 134 b (e.g., before thecurvature apex 135 b abuts the tissue 35). For example, theelectrode assembly 120 can penetrate the longitudinal length D2 into theheart tissue 35 so that about half of the overall length of theelectrode assembly 120 is advanced into thetissue 35. As previously described, in some circumstances, theproximal tines 134 b may flex outwardly when forced against theheart wall tissue 35, and such an outward flexing action can cause a slight spring back motion to thewireless electrode assembly 120. Thedistal tines 132 b may flex outwardly in response to this slight spring-back motion in the proximal direction, thereby enhancing the engagement of theheart tissue 35 between thedistal tines 132 b and theproximal tines 134 b. Such opposed orientations of thetines electrode assembly 120. Also, as previously described, thetissue 35 may grow and eventually incorporate thewireless electrode assembly 120 therein, thereby preventing thewireless electrode assembly 120 from dislodgement from thetissue 35. - Still referring to
FIG. 8 , theproximal tines 134 b may be configured to at least partially deploy before exiting the distal opening of thedelivery catheter 115. As such, theproximal tines 134 b may at least partially curve outwardly from thebody 128 of the electrode assembly before contacting theheart wall tissue 35. In these circumstances, theproximal tines 134 b may curve so as to abut against theheart wall tissue 134 b without the extremities of theproximal tines 134 b penetrating into thetissue 35. Because theproximal tines 134 b can at least partially deploy before exiting the distal opening of thedelivery catheter 115, theproximal tines 134 b can achieve the greater curvature previously described in connection withFIG. 6 so that the contact between theheart tissue 35 and theproximal tines 134 b is near thecurvature apex 135 b (FIG. 6 ). - For example, in some embodiments,
electrode assembly 120 can be arranged in thetube portion 142 so that theproximal tines 134 b are aligned with deployment slots 146 (FIG. 8 ) formed in thetube portion 142. Accordingly, when the electrode assembly is advanced into theheart tissue 35, theproximal tines 134 b at least partially extend outwardly into thedeployment slots 146, thereby permitting theproximal tines 134 b to partially deploy before exiting the distal opening of thedelivery catheter 115. As previously described in connection withFIG. 6 , theproximal tines 134 b may be nonaligned with thedistal tines 132 b along the body of theelectrode assembly 128. Such nonalignment between theproximal tines 134 b and thedistal tines 132 b can permit theproximal tines 134 b to partially deploy in thedeployment slots 146 while thedistal tines 132 b are retained against theelectrode body 128 in thetube portion 142. Alternatively, thedistal tines 132 b can be generally aligned with theproximal tines 134 b so that both thedistal tines 132 b and theproximal tines 134 b pass through thedeployment slots 146 during advancement of theelectrode assembly 120 from thedelivery catheter 115. It should be understood that, in some embodiments, thedeployment slots 146 may extend through the distal circumferential end of thedelivery catheter 115 so that theproximal tines 134 b can at least partially deploy through the distal circumferential end of thedelivery catheter 115 before exiting the distal opening of thedelivery catheter 115. - In some embodiments of the
delivery catheter 115 described herein, thedelivery catheter 115 may be wholly separate from theactuation rod 140 so that theactuation rod 140 slides through a conduit passing through thedelivery catheter 115. In such circumstances, theactuation rod 140 may be completely retracted from the delivery catheter so that a second wireless electrode assembly may be detachably coupled to the actuation rod 140 (or to an unused, different actuation rod 140) and then directed through thedelivery catheter 115 already disposed in the patient's body. In other embodiments, thedelivery catheter 115 and theactuation rod 140 may be coupled to one another. In such circumstances, thedelivery catheter 115 andactuation rod 140 may be removed from the guide catheter 110 (FIG. 4 ) so that a second wireless electrode assembly may be detachably coupled to the actuation rod 140 (or to a previously unused delivery catheter/actuation rod having a similar construction) and then directed through theguide catheter 110 already disposed in the patient's body. - In some embodiments, the
delivery catheter 115 may include a tube portion that is configured to retain a plurality of wireless electrode assemblies 120 (e.g., similar totube portion 142 but having a greater length to receive a multitude of assemblies 120). For example, the delivery catheter may be configured to carry two, three, four, five, ten, twelve, ormore electrode assemblies 120 in a serial (end to end) arrangement. As such, theplunger mechanism 144 can be used to force eachelectrode assembly 120 into different tissue sites without retracting the delivery catheter out of the heart. As described previously, the actuation mechanism may force theplunger 144 in a generally distal direction. In the serially arranged embodiment, theplunger 144 applies the force to the mostrearward assembly 120 in the serial arrangement, which in turn applies a force from thedistal tip 130 of the mostrearward assembly 120 to the proximal end of thenext assembly 120 in the serial arrangement. In this fashion, the application of force can propagate through the serial arrangement until theassembly 120 nearest theheart tissue 35 is delivered to the target site (as described previously, for example, in connection withFIG. 7D ). It should be understood that the serial arrangement may compriseelectrode assemblies 120 as described in connection withFIG. 5 , as described in connection withFIG. 6 , or some combination thereof. - Some of the embodiments described herein permit a plurality of pacing electrodes to be deployed at multiple pacing sites. The pacing sites may be located in the
left atrium 32, theleft ventricle 34, theright atrium 36, the right ventricle, or a combination thereof. Furthermore, the pacing electrodes may comprise wired pacing leads 95 (FIG. 1 ), wireless electrode assemblies, or a combination thereof. Providing electrical stimulation at multiple pacing sites and in multiple heart chambers may be used to treat a number of conditions. One such condition is congestive heart failure (CHF). It has been found that CHF patients have benefited from bi-ventricular pacing, that is, pacing of both theleft ventricle 34 and theright ventricle 38 in a timed relationship. It is believed that many more patients could benefit if multiple sites in the left andright ventricles - A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, other embodiments are within the scope of the following claims.
Claims (22)
1. A wireless electrode assembly for electrical stimulation of heart tissue, comprising:
a body portion at least partially containing a circuit to deliver electrical energy to an electrode to electrically stimulate heart wall tissue;
a first fixation structure extending from the body portion in a generally forward orientation and being biased to shift from a retained condition to an outwardly extended condition to engage heart wall tissue; and
a second fixation structure extending from the body portion in a generally rearward orientation and being to shift from a retained condition to an outwardly extended condition to engage heart wall tissue.
2. The wireless electrode assembly of claim 1 , wherein the first fixation structure comprises at least one tine that opposes forward migration of the body portion through the heart wall tissue when in the outwardly extended condition.
3. The wireless electrode assembly of claim 2 , wherein the second fixation structure comprises at least one tine that opposes rearward migration of the body portion through the heart wall tissue when in the outwardly extended condition.
4. The wireless electrode assembly of claim 1 , wherein at least the electrode of the body portion is insertable through endocardium and into myocardium of the heart wall tissue.
5. The wireless electrode assembly of claim 4 , wherein the body portion has a radius of about 1.25 mm or less, and wherein the body portion has a length of about 10 mm or less.
6. The wireless electrode assembly of claim 1 , wherein the first and second fixation structures comprise a material selected from the group consisting of Nitinol, stainless steel, and a nickel-cobalt alloy.
7. The wireless electrode assembly of claim 1 , wherein the circuit comprises an internal coil to inductively couple with an external power source coil and comprises an electrical charge storage device that is recharged from current inductively generated by the internal coil.
8. A wireless electrode assembly at least partially implantable through an interior surface of a heart chamber wall, the electrode assembly comprising:
a body portion having an electrode for electrically stimulating cardiac tissue;
a first set of tines biased outwardly and extending forwardly from a rearward radial periphery of the body portion, the first set of tines opposing a rearward portion, but not a forward portion, of the body portion from being advanced into the heart chamber wall when the electrode assembly is longitudinally advanced in a forward direction toward the interior surface of the heart chamber wall; and
a second set of tines extending rearwardly and biased outwardly from a forward radial periphery of the body portion, the second set of tines opposing the forward portion of the body portion from becoming dislodged from heart wall tissue after the longitudinal advancement of the forward body portion into the heart chamber wall.
9. The wireless electrode assembly of claim 8 , wherein at least the forward portion of the body portion is insertable through endocardium and into myocardium of the heart wall tissue.
10. The wireless electrode assembly of claim 9 , wherein the body portion has a radius of about 1.25 mm or less, and wherein the body portion has a length of about 10 mm or less.
11. The wireless electrode assembly of claim 8 , wherein the first set of tines and the second set of tines comprise a material selected from the group consisting of Nitinol, stainless steel, and a nickel-cobalt alloy.
12. The wireless electrode assembly of claim 8 , wherein the body portion comprises a circuit that includes an internal coil to inductively couple with an external power source coil and an electrical charge storage device that is recharged from current inductively generated by the internal coil.
13. An electrode delivery system, the system comprising:
a wireless electrode assembly including a body portion and first and second tines that are biased to shift from a loaded condition to an outwardly extended condition to secure the body portion to a heart chamber wall, the first and second biased tines generally opposing one another; and
a delivery catheter to direct the wireless electrode assembly through a heart chamber and toward an interior surface of a heart chamber wall, the delivery catheter including an opening in a distal end such that, when the wireless electrode assembly is separated from the opening in the distal end of the catheter, the first and second tines shift from the loaded condition to the outwardly extended condition.
14. The electrode delivery system of claim 13 , wherein when the first and second tines shift to the outwardly extended condition, the first tines are outwardly extended in a generally distal orientation and the second biased tines are outwardly extended in a generally proximal orientation.
15. The electrode delivery system of claim 13 , further comprising a guide catheter to direct the distal end of the delivery catheter into the heart chamber.
16. The electrode delivery system of claim 15 , further comprising an actuation member that includes a push rod device to separate the wireless electrode assembly from the opening in the distal end of the delivery catheter.
17. The electrode delivery system of claim 13 , wherein the wireless electrode assembly is releasably retained in the delivery catheter by a tubular wall, the tubular wall comprising one or more deployment slots generally aligned with at least one of the first and second tines.
18. A method of inserting a wireless electrode assembly into a heart chamber wall, comprising:
inserting a set of distal tines of a wireless electrode assembly through a portion of endocardium and into a heart chamber wall, the set of distal tines being biased to shift from a retained condition to an outwardly extended condition to secure the wireless electrode assembly to a heart chamber wall; and
causing a set of proximal tines of the wireless electrode assembly to shift from a retained condition to an outwardly extended condition to secure the wireless electrode assembly to the heart chamber wall,
the set of distal tines extending in a generally rearward orientation when in the outwardly extended condition and the set of proximal tines extending in a generally forward orientation when in the outwardly extended condition.
19. The method of claim 18 , wherein a portion of the wireless electrode assembly is secured to the heart chamber so as to be at least partially incorporated into the endocardium of the heart chamber wall over a period of time.
20. The method of claim 18 , further comprising delivering the wireless electrode assembly in a delivery catheter to a targeted heart chamber.
21. The method of claim 20 , when the set of distal tines and the set of proximal tines are shifted to their respective outwardly extended conditions when the wireless electrode assembly is separated from a distal opening of the delivery catheter.
22. The method of claim 18 , further comprising implanting a wireless power source coil proximal to the heart so that the wireless power source coil is arrange for inductive coupling with an internal coil of the wireless electrode assembly.
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Cited By (123)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060085039A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20070135882A1 (en) * | 2005-12-09 | 2007-06-14 | Drasler William J | Cardiac stimulation system |
US20080021505A1 (en) * | 2006-07-21 | 2008-01-24 | Roger Hastings | Electrical stimulation of body tissue using interconnected electrode assemblies |
US20080109054A1 (en) * | 2004-10-20 | 2008-05-08 | Scimed Life Systems, Inc. | Leadless Cardiac Stimulation Systems |
US20080263524A1 (en) * | 2005-09-09 | 2008-10-23 | International Business Machines Corporation | Method and System for State Machine Translation |
US7647109B2 (en) | 2004-10-20 | 2010-01-12 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US7840281B2 (en) | 2006-07-21 | 2010-11-23 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US7917226B2 (en) | 2008-04-23 | 2011-03-29 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US8050774B2 (en) | 2005-12-22 | 2011-11-01 | Boston Scientific Scimed, Inc. | Electrode apparatus, systems and methods |
US8204605B2 (en) | 2008-02-07 | 2012-06-19 | Cardiac Pacemakers, Inc. | Multi-site atrial electrostimulation |
US8301248B1 (en) | 2002-03-06 | 2012-10-30 | Boston Scientific Neuromodulation Corporation | Sequenced and simultaneous stimulation for treating congestive heart failure |
US8644934B2 (en) | 2006-09-13 | 2014-02-04 | Boston Scientific Scimed Inc. | Cardiac stimulation using leadless electrode assemblies |
US20140039570A1 (en) * | 2012-08-01 | 2014-02-06 | Nanostim, Inc. | Biostimulator circuit with flying cell |
EP2818202A1 (en) * | 2013-06-24 | 2014-12-31 | Sorin CRM SAS | Coupling system between a medical device and an accessory for in situ implantation thereof |
EP2818201A1 (en) * | 2013-06-24 | 2014-12-31 | Sorin CRM SAS | Intracardiac capsule and accessory for in situ implantation by the femoral route |
US20150025612A1 (en) * | 2013-07-22 | 2015-01-22 | Cardiac Pacemakers, Inc. | System and methods for chronic fixation of medical devices |
US9289612B1 (en) | 2014-12-11 | 2016-03-22 | Medtronic Inc. | Coordination of ventricular pacing in a leadless pacing system |
US9393427B2 (en) | 2013-08-16 | 2016-07-19 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US9399140B2 (en) | 2014-07-25 | 2016-07-26 | Medtronic, Inc. | Atrial contraction detection by a ventricular leadless pacing device for atrio-synchronous ventricular pacing |
US9480850B2 (en) | 2013-08-16 | 2016-11-01 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker and retrieval device |
US9492668B2 (en) | 2014-11-11 | 2016-11-15 | Medtronic, Inc. | Mode switching by a ventricular leadless pacing device |
US9492669B2 (en) | 2014-11-11 | 2016-11-15 | Medtronic, Inc. | Mode switching by a ventricular leadless pacing device |
US9492674B2 (en) | 2013-08-16 | 2016-11-15 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US9526909B2 (en) | 2014-08-28 | 2016-12-27 | Cardiac Pacemakers, Inc. | Medical device with triggered blanking period |
US9592391B2 (en) | 2014-01-10 | 2017-03-14 | Cardiac Pacemakers, Inc. | Systems and methods for detecting cardiac arrhythmias |
US9623234B2 (en) | 2014-11-11 | 2017-04-18 | Medtronic, Inc. | Leadless pacing device implantation |
US20170119999A1 (en) * | 2015-10-29 | 2017-05-04 | Medtronic, Inc. | Interventional medical systems, associated assemblies and methods |
US9669230B2 (en) | 2015-02-06 | 2017-06-06 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US9700732B2 (en) | 2013-08-16 | 2017-07-11 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker and retrieval device |
US9724519B2 (en) | 2014-11-11 | 2017-08-08 | Medtronic, Inc. | Ventricular leadless pacing device mode switching |
US9795781B2 (en) | 2014-04-29 | 2017-10-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with retrieval features |
US9853743B2 (en) | 2015-08-20 | 2017-12-26 | Cardiac Pacemakers, Inc. | Systems and methods for communication between medical devices |
CN107592821A (en) * | 2015-05-13 | 2018-01-16 | 美敦力公司 | Implanted medical apparatus is secured in place to reduce perforation simultaneously |
US9956414B2 (en) | 2015-08-27 | 2018-05-01 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US9968787B2 (en) | 2015-08-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Spatial configuration of a motion sensor in an implantable medical device |
US10029107B1 (en) | 2017-01-26 | 2018-07-24 | Cardiac Pacemakers, Inc. | Leadless device with overmolded components |
US10046167B2 (en) | 2015-02-09 | 2018-08-14 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US10050700B2 (en) | 2015-03-18 | 2018-08-14 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
CN108434600A (en) * | 2018-02-26 | 2018-08-24 | 郭成军 | Chambers of the heart implant, pacemaker, implanted device and method for implantation |
US10065041B2 (en) | 2015-10-08 | 2018-09-04 | Cardiac Pacemakers, Inc. | Devices and methods for adjusting pacing rates in an implantable medical device |
US10080887B2 (en) | 2014-04-29 | 2018-09-25 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices including tissue engagement verification |
US10092760B2 (en) | 2015-09-11 | 2018-10-09 | Cardiac Pacemakers, Inc. | Arrhythmia detection and confirmation |
US10137305B2 (en) | 2015-08-28 | 2018-11-27 | Cardiac Pacemakers, Inc. | Systems and methods for behaviorally responsive signal detection and therapy delivery |
US10159842B2 (en) | 2015-08-28 | 2018-12-25 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10179236B2 (en) | 2013-08-16 | 2019-01-15 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US10183170B2 (en) | 2015-12-17 | 2019-01-22 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10213610B2 (en) | 2015-03-18 | 2019-02-26 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
US10220213B2 (en) | 2015-02-06 | 2019-03-05 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US10226631B2 (en) | 2015-08-28 | 2019-03-12 | Cardiac Pacemakers, Inc. | Systems and methods for infarct detection |
US10265503B2 (en) | 2013-08-16 | 2019-04-23 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US10328272B2 (en) | 2016-05-10 | 2019-06-25 | Cardiac Pacemakers, Inc. | Retrievability for implantable medical devices |
US10350423B2 (en) | 2016-02-04 | 2019-07-16 | Cardiac Pacemakers, Inc. | Delivery system with force sensor for leadless cardiac device |
US10357159B2 (en) | 2015-08-20 | 2019-07-23 | Cardiac Pacemakers, Inc | Systems and methods for communication between medical devices |
US10391319B2 (en) | 2016-08-19 | 2019-08-27 | Cardiac Pacemakers, Inc. | Trans septal implantable medical device |
US10390720B2 (en) | 2014-07-17 | 2019-08-27 | Medtronic, Inc. | Leadless pacing system including sensing extension |
US10413733B2 (en) | 2016-10-27 | 2019-09-17 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10426962B2 (en) | 2016-07-07 | 2019-10-01 | Cardiac Pacemakers, Inc. | Leadless pacemaker using pressure measurements for pacing capture verification |
US10434314B2 (en) | 2016-10-27 | 2019-10-08 | Cardiac Pacemakers, Inc. | Use of a separate device in managing the pace pulse energy of a cardiac pacemaker |
US10434317B2 (en) | 2016-10-31 | 2019-10-08 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10463305B2 (en) | 2016-10-27 | 2019-11-05 | Cardiac Pacemakers, Inc. | Multi-device cardiac resynchronization therapy with timing enhancements |
US10463853B2 (en) | 2016-01-21 | 2019-11-05 | Medtronic, Inc. | Interventional medical systems |
WO2019212733A1 (en) * | 2018-04-30 | 2019-11-07 | Khairkhahan Sebastian | Pericardial space access device and method |
US10512784B2 (en) | 2016-06-27 | 2019-12-24 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed P-waves for resynchronization pacing management |
US10518084B2 (en) | 2013-07-31 | 2019-12-31 | Medtronic, Inc. | Fixation for implantable medical devices |
US10561330B2 (en) | 2016-10-27 | 2020-02-18 | Cardiac Pacemakers, Inc. | Implantable medical device having a sense channel with performance adjustment |
US10583303B2 (en) | 2016-01-19 | 2020-03-10 | Cardiac Pacemakers, Inc. | Devices and methods for wirelessly recharging a rechargeable battery of an implantable medical device |
US10583301B2 (en) | 2016-11-08 | 2020-03-10 | Cardiac Pacemakers, Inc. | Implantable medical device for atrial deployment |
US10617874B2 (en) | 2016-10-31 | 2020-04-14 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10632313B2 (en) | 2016-11-09 | 2020-04-28 | Cardiac Pacemakers, Inc. | Systems, devices, and methods for setting cardiac pacing pulse parameters for a cardiac pacing device |
US10639486B2 (en) | 2016-11-21 | 2020-05-05 | Cardiac Pacemakers, Inc. | Implantable medical device with recharge coil |
US10668294B2 (en) | 2016-05-10 | 2020-06-02 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker configured for over the wire delivery |
US10688304B2 (en) | 2016-07-20 | 2020-06-23 | Cardiac Pacemakers, Inc. | Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10722723B2 (en) | 2013-08-16 | 2020-07-28 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US10722720B2 (en) | 2014-01-10 | 2020-07-28 | Cardiac Pacemakers, Inc. | Methods and systems for improved communication between medical devices |
US10737102B2 (en) | 2017-01-26 | 2020-08-11 | Cardiac Pacemakers, Inc. | Leadless implantable device with detachable fixation |
US10758737B2 (en) | 2016-09-21 | 2020-09-01 | Cardiac Pacemakers, Inc. | Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter |
US10758724B2 (en) | 2016-10-27 | 2020-09-01 | Cardiac Pacemakers, Inc. | Implantable medical device delivery system with integrated sensor |
US10765871B2 (en) | 2016-10-27 | 2020-09-08 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10780278B2 (en) | 2016-08-24 | 2020-09-22 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing |
US10821288B2 (en) | 2017-04-03 | 2020-11-03 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate |
US10835753B2 (en) | 2017-01-26 | 2020-11-17 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10842993B2 (en) | 2013-08-16 | 2020-11-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US10870008B2 (en) | 2016-08-24 | 2020-12-22 | Cardiac Pacemakers, Inc. | Cardiac resynchronization using fusion promotion for timing management |
US10874861B2 (en) | 2018-01-04 | 2020-12-29 | Cardiac Pacemakers, Inc. | Dual chamber pacing without beat-to-beat communication |
US10881869B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Wireless re-charge of an implantable medical device |
US10881868B2 (en) | 2016-05-24 | 2021-01-05 | Sorin Crm Sas | Torque limiting mechanism between a medical device and its implantation accessory |
US10881863B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with multimode communication |
US10894163B2 (en) | 2016-11-21 | 2021-01-19 | Cardiac Pacemakers, Inc. | LCP based predictive timing for cardiac resynchronization |
US10905889B2 (en) | 2016-09-21 | 2021-02-02 | Cardiac Pacemakers, Inc. | Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery |
US10905872B2 (en) | 2017-04-03 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device with a movable electrode biased toward an extended position |
US10905886B2 (en) | 2015-12-28 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device for deployment across the atrioventricular septum |
US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
US20210046306A1 (en) * | 2019-08-13 | 2021-02-18 | Medtronic, Inc. | Fixation component for multi-electrode implantable medical device |
US10994145B2 (en) | 2016-09-21 | 2021-05-04 | Cardiac Pacemakers, Inc. | Implantable cardiac monitor |
US11027125B2 (en) | 2016-01-21 | 2021-06-08 | Medtronic, Inc. | Interventional medical devices, device systems, and fixation components thereof |
US11052258B2 (en) | 2017-12-01 | 2021-07-06 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials within a search window from a ventricularly implanted leadless cardiac pacemaker |
US11058880B2 (en) | 2018-03-23 | 2021-07-13 | Medtronic, Inc. | VFA cardiac therapy for tachycardia |
US11065459B2 (en) | 2017-08-18 | 2021-07-20 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US11071870B2 (en) | 2017-12-01 | 2021-07-27 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker |
US11116988B2 (en) | 2016-03-31 | 2021-09-14 | Cardiac Pacemakers, Inc. | Implantable medical device with rechargeable battery |
US11147979B2 (en) | 2016-11-21 | 2021-10-19 | Cardiac Pacemakers, Inc. | Implantable medical device with a magnetically permeable housing and an inductive coil disposed about the housing |
US11185703B2 (en) | 2017-11-07 | 2021-11-30 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker for bundle of his pacing |
US11207527B2 (en) | 2016-07-06 | 2021-12-28 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US11207532B2 (en) | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
US11213676B2 (en) | 2019-04-01 | 2022-01-04 | Medtronic, Inc. | Delivery systems for VfA cardiac therapy |
US11229799B2 (en) | 2018-10-17 | 2022-01-25 | Cairdac | System for coupling a cardiac autonomous capsule to a tool for implanting the same |
US11235163B2 (en) | 2017-09-20 | 2022-02-01 | Cardiac Pacemakers, Inc. | Implantable medical device with multiple modes of operation |
US11235159B2 (en) | 2018-03-23 | 2022-02-01 | Medtronic, Inc. | VFA cardiac resynchronization therapy |
US11235161B2 (en) | 2018-09-26 | 2022-02-01 | Medtronic, Inc. | Capture in ventricle-from-atrium cardiac therapy |
US11260216B2 (en) | 2017-12-01 | 2022-03-01 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials during ventricular filling from a ventricularly implanted leadless cardiac pacemaker |
US11285326B2 (en) | 2015-03-04 | 2022-03-29 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11305127B2 (en) | 2019-08-26 | 2022-04-19 | Medtronic Inc. | VfA delivery and implant region detection |
US11400296B2 (en) | 2018-03-23 | 2022-08-02 | Medtronic, Inc. | AV synchronous VfA cardiac therapy |
US11529523B2 (en) | 2018-01-04 | 2022-12-20 | Cardiac Pacemakers, Inc. | Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone |
US11679265B2 (en) | 2019-02-14 | 2023-06-20 | Medtronic, Inc. | Lead-in-lead systems and methods for cardiac therapy |
US11697025B2 (en) | 2019-03-29 | 2023-07-11 | Medtronic, Inc. | Cardiac conduction system capture |
US11712188B2 (en) | 2019-05-07 | 2023-08-01 | Medtronic, Inc. | Posterior left bundle branch engagement |
US11759632B2 (en) | 2019-03-28 | 2023-09-19 | Medtronic, Inc. | Fixation components for implantable medical devices |
US11813463B2 (en) | 2017-12-01 | 2023-11-14 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with reversionary behavior |
US11813464B2 (en) | 2020-07-31 | 2023-11-14 | Medtronic, Inc. | Cardiac conduction system evaluation |
US11813466B2 (en) | 2020-01-27 | 2023-11-14 | Medtronic, Inc. | Atrioventricular nodal stimulation |
US11911168B2 (en) | 2020-04-03 | 2024-02-27 | Medtronic, Inc. | Cardiac conduction system therapy benefit determination |
US11951313B2 (en) | 2018-11-17 | 2024-04-09 | Medtronic, Inc. | VFA delivery systems and methods |
Families Citing this family (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8175702B2 (en) | 2004-11-04 | 2012-05-08 | The Washington University | Method for low-voltage termination of cardiac arrhythmias by effectively unpinning anatomical reentries |
US8457742B2 (en) | 2005-10-14 | 2013-06-04 | Nanostim, Inc. | Leadless cardiac pacemaker system for usage in combination with an implantable cardioverter-defibrillator |
US9168383B2 (en) | 2005-10-14 | 2015-10-27 | Pacesetter, Inc. | Leadless cardiac pacemaker with conducted communication |
WO2009070743A1 (en) * | 2007-11-26 | 2009-06-04 | Eastern Virginia Medical School | Magnaretractor system and method |
AU2015202987B2 (en) * | 2007-11-26 | 2017-08-03 | Attractive Surgical, Llc | Magnaretractor system and method |
US8874208B2 (en) | 2007-12-11 | 2014-10-28 | The Washington University | Methods and devices for three-stage ventricular therapy |
EP2231263B1 (en) | 2007-12-11 | 2016-03-16 | Washington University in St. Louis | Device for low-energy termination of atrial tachyarrhythmias |
US8560066B2 (en) | 2007-12-11 | 2013-10-15 | Washington University | Method and device for three-stage atrial cardioversion therapy |
US10695126B2 (en) | 2008-10-06 | 2020-06-30 | Santa Anna Tech Llc | Catheter with a double balloon structure to generate and apply a heated ablative zone to tissue |
US20100114283A1 (en) * | 2008-10-31 | 2010-05-06 | Medtronic, Inc. | Implantable medical lead |
US8527068B2 (en) | 2009-02-02 | 2013-09-03 | Nanostim, Inc. | Leadless cardiac pacemaker with secondary fixation capability |
EP2394695B1 (en) * | 2010-06-14 | 2012-09-26 | Sorin CRM SAS | Standalone intracardiac capsule and implantation accessory |
US9060692B2 (en) | 2010-10-12 | 2015-06-23 | Pacesetter, Inc. | Temperature sensor for a leadless cardiac pacemaker |
CN103249452A (en) | 2010-10-12 | 2013-08-14 | 内诺斯蒂姆股份有限公司 | Temperature sensor for a leadless cardiac pacemaker |
US9020611B2 (en) | 2010-10-13 | 2015-04-28 | Pacesetter, Inc. | Leadless cardiac pacemaker with anti-unscrewing feature |
US20120130460A1 (en) * | 2010-11-22 | 2012-05-24 | Pacesetter, Inc. | Hybrid implantable lead assembly |
US8615310B2 (en) | 2010-12-13 | 2013-12-24 | Pacesetter, Inc. | Delivery catheter systems and methods |
US9126032B2 (en) | 2010-12-13 | 2015-09-08 | Pacesetter, Inc. | Pacemaker retrieval systems and methods |
EP2654889B1 (en) | 2010-12-20 | 2017-03-01 | Pacesetter, Inc. | Leadless pacemaker with radial fixation mechanism |
US20120253437A1 (en) * | 2011-03-31 | 2012-10-04 | Seifert Kevin R | Coupling mechanisms for use with a medical electrical lead |
US9101281B2 (en) * | 2011-09-27 | 2015-08-11 | Medtronic, Inc. | IMD stability monitor |
US9511236B2 (en) | 2011-11-04 | 2016-12-06 | Pacesetter, Inc. | Leadless cardiac pacemaker with integral battery and redundant welds |
CA2869743C (en) | 2012-04-05 | 2022-07-26 | University Of Southern California | Minimally invasive epicardial pacemaker |
US8755909B2 (en) | 2012-06-01 | 2014-06-17 | Medtronic, Inc. | Active fixation medical electrical lead |
US8923963B2 (en) | 2012-10-31 | 2014-12-30 | Medtronic, Inc. | Leadless pacemaker system |
US9808633B2 (en) * | 2012-10-31 | 2017-11-07 | Medtronic, Inc. | Leadless pacemaker system |
US8868178B2 (en) | 2012-12-11 | 2014-10-21 | Galvani, Ltd. | Arrhythmia electrotherapy device and method with provisions for mitigating patient discomfort |
US8764769B1 (en) | 2013-03-12 | 2014-07-01 | Levita Magnetics International Corp. | Grasper with magnetically-controlled positioning |
US11020588B2 (en) * | 2013-05-08 | 2021-06-01 | Children's Hospital Los Angeles | Epicardial lead design |
US10449361B2 (en) | 2014-01-10 | 2019-10-22 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
WO2015112645A1 (en) | 2014-01-21 | 2015-07-30 | Levita Magnetics International Corp. | Laparoscopic graspers and systems therefor |
CN106573149A (en) * | 2014-06-25 | 2017-04-19 | 心脏起搏器股份公司 | Systems and methods for treating cardiac arrhythmias |
US10478620B2 (en) | 2014-08-26 | 2019-11-19 | Medtronic, Inc. | Interventional medical systems, devices, and methods of use |
EP3967244A1 (en) | 2015-04-13 | 2022-03-16 | Levita Magnetics International Corp. | Retractor devices |
ES2895900T3 (en) | 2015-04-13 | 2022-02-23 | Levita Magnetics Int Corp | Magnetically controlled location handle |
US11331140B2 (en) | 2016-05-19 | 2022-05-17 | Aqua Heart, Inc. | Heated vapor ablation systems and methods for treating cardiac conditions |
CN106362288B (en) * | 2016-09-14 | 2019-06-11 | 郭成军 | Cardiac implant and its fixing means |
EP4295897A3 (en) * | 2017-02-02 | 2024-03-20 | Flow Neuroscience AB | Headset for transcranial direct-current stimulation, tdcs, and a system comprising the headset |
CN110418661B (en) * | 2017-03-10 | 2024-01-02 | 心脏起搏器股份公司 | Fixing piece for leadless cardiac device |
US11376039B2 (en) | 2017-03-30 | 2022-07-05 | Medtronic, Inc. | Interventional medical systems and associated assemblies |
US11426578B2 (en) | 2017-09-15 | 2022-08-30 | Medtronic, Inc. | Electrodes for intra-cardiac pacemaker |
EP3758791B1 (en) | 2018-03-02 | 2024-04-24 | Medtronic, Inc. | Implantable medical electrode assemblies and devices |
WO2020104846A1 (en) * | 2018-11-19 | 2020-05-28 | Microtech Medical Technologies Ltd. | System and method for deployment of an implantable device having an attachment element and methods of monitoring physiological data using multiple sensor devices |
US11413453B2 (en) | 2019-02-18 | 2022-08-16 | Pacesetter, Inc. | Biostimulator having resilient scaffold |
US11331475B2 (en) | 2019-05-07 | 2022-05-17 | Medtronic, Inc. | Tether assemblies for medical device delivery systems |
US11541232B2 (en) | 2019-06-18 | 2023-01-03 | Medtronic, Inc. | Electrode configuration for a medical device |
US11524139B2 (en) | 2019-07-15 | 2022-12-13 | Medtronic, Inc. | Catheter with active return curve |
US11524143B2 (en) | 2019-07-15 | 2022-12-13 | Medtronic, Inc. | Catheter with distal and proximal fixation members |
WO2023191058A1 (en) * | 2022-03-31 | 2023-10-05 | 日本ゼオン株式会社 | Medical marker |
US20240075282A1 (en) * | 2022-09-07 | 2024-03-07 | Pacesetter, Inc. | Biostimulator having pivotable electrode |
Citations (83)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3667477A (en) * | 1966-11-25 | 1972-06-06 | Canadian Patents Dev | Implantable vesical stimulator |
US3713449A (en) * | 1970-08-31 | 1973-01-30 | P Mulier | Cardiac pacer with externally controllable variable width output pulse |
US3727616A (en) * | 1971-06-15 | 1973-04-17 | Gen Dynamics Corp | Electronic system for the stimulation of biological systems |
US3943936A (en) * | 1970-09-21 | 1976-03-16 | Rasor Associates, Inc. | Self powered pacers and stimulators |
US4157720A (en) * | 1977-09-16 | 1979-06-12 | Greatbatch W | Cardiac pacemaker |
US4162679A (en) * | 1976-09-28 | 1979-07-31 | Reenstierna Erik G B | Method and device for the implantation of one or more pacemaker electrodes in a heart |
US4198991A (en) * | 1978-05-17 | 1980-04-22 | Cordis Corporation | Cardiac pacer lead |
US4256115A (en) * | 1976-12-20 | 1981-03-17 | American Technology, Inc. | Leadless cardiac pacer |
US4441210A (en) * | 1981-09-18 | 1984-04-03 | Hochmair Erwin S | Transcutaneous signal transmission system and methods |
US4525774A (en) * | 1981-11-24 | 1985-06-25 | Hitachi, Ltd. | Regulated AC-DC converter having saturation inductance in resonant circuit |
US4641664A (en) * | 1984-04-13 | 1987-02-10 | Siemens Aktiengesellschaft | Endocardial electrode arrangement |
US4721118A (en) * | 1981-04-20 | 1988-01-26 | Cordis Leads, Inc. | Pervenous electrical pacing lead with foldable fins |
US4830006A (en) * | 1986-06-17 | 1989-05-16 | Intermedics, Inc. | Implantable cardiac stimulator for detection and treatment of ventricular arrhythmias |
US4987897A (en) * | 1989-09-18 | 1991-01-29 | Medtronic, Inc. | Body bus medical device communication system |
US5178149A (en) * | 1989-11-06 | 1993-01-12 | Michael Imburgia | Transesophageal probe having simultaneous pacing and echocardiographic capability, and method of diagnosing heart disease using same |
US5193540A (en) * | 1991-12-18 | 1993-03-16 | Alfred E. Mann Foundation For Scientific Research | Structure and method of manufacture of an implantable microstimulator |
US5193539A (en) * | 1991-12-18 | 1993-03-16 | Alfred E. Mann Foundation For Scientific Research | Implantable microstimulator |
US5300107A (en) * | 1992-10-22 | 1994-04-05 | Medtronic, Inc. | Universal tined myocardial pacing lead |
US5312439A (en) * | 1991-12-12 | 1994-05-17 | Loeb Gerald E | Implantable device having an electrolytic storage electrode |
US5314458A (en) * | 1990-06-01 | 1994-05-24 | University Of Michigan | Single channel microstimulator |
US5324325A (en) * | 1991-06-27 | 1994-06-28 | Siemens Pacesetter, Inc. | Myocardial steroid releasing lead |
US5383924A (en) * | 1992-06-03 | 1995-01-24 | Ela Medical | Extractable cardiac probe and its application procedure |
US5411535A (en) * | 1992-03-03 | 1995-05-02 | Terumo Kabushiki Kaisha | Cardiac pacemaker using wireless transmission |
US5411537A (en) * | 1993-10-29 | 1995-05-02 | Intermedics, Inc. | Rechargeable biomedical battery powered devices with recharging and control system therefor |
US5531780A (en) * | 1992-09-03 | 1996-07-02 | Pacesetter, Inc. | Implantable stimulation lead having an advanceable therapeutic drug delivery system |
US5591217A (en) * | 1995-01-04 | 1997-01-07 | Plexus, Inc. | Implantable stimulator with replenishable, high value capacitive power source and method therefor |
US5622168A (en) * | 1992-11-18 | 1997-04-22 | John L. Essmyer | Conductive hydrogels and physiological electrodes and electrode assemblies therefrom |
US5624316A (en) * | 1994-06-06 | 1997-04-29 | Catapult Entertainment Inc. | Video game enhancer with intergral modem and smart card interface |
US5628778A (en) * | 1994-11-21 | 1997-05-13 | Medtronic Inc. | Single pass medical electrical lead |
US5755764A (en) * | 1996-09-10 | 1998-05-26 | Sulzer Intermedics Inc. | Implantable cardiac stimulation catheter |
US5779715A (en) * | 1997-07-28 | 1998-07-14 | Irvine Biomedical, Inc. | Lead extraction system and methods thereof |
US5871532A (en) * | 1997-05-22 | 1999-02-16 | Sulzer Intermedics Inc. | Epicardial lead for minimally invasive implantation |
US6041258A (en) * | 1997-05-28 | 2000-03-21 | Transneuronix, Inc. | Medical stimulation |
US6200303B1 (en) * | 1997-04-30 | 2001-03-13 | Beth Israel Deaconess Medical Center, Inc. | Method and kit for transvenously accessing the pericardial space via the right atrium |
US6208894B1 (en) * | 1997-02-26 | 2001-03-27 | Alfred E. Mann Foundation For Scientific Research And Advanced Bionics | System of implantable devices for monitoring and/or affecting body parameters |
US6223079B1 (en) * | 1997-12-15 | 2001-04-24 | Medtronic, Inc | Bi-ventricular pacing method |
US6240316B1 (en) * | 1998-08-14 | 2001-05-29 | Advanced Bionics Corporation | Implantable microstimulation system for treatment of sleep apnea |
US6266567B1 (en) * | 1999-06-01 | 2001-07-24 | Ball Semiconductor, Inc. | Implantable epicardial electrode |
US20020018379A1 (en) * | 2000-07-07 | 2002-02-14 | Tatsushi Hakuchoh | Method for controlling starting operation of unit and executing self-checking test |
US6351673B1 (en) * | 1998-05-08 | 2002-02-26 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6363279B1 (en) * | 1996-01-08 | 2002-03-26 | Impulse Dynamics N.V. | Electrical muscle controller |
US6363938B2 (en) * | 1998-12-22 | 2002-04-02 | Angiotrax, Inc. | Methods and apparatus for perfusing tissue and/or stimulating revascularization and tissue growth |
US6370434B1 (en) * | 2000-02-28 | 2002-04-09 | Cardiac Pacemakers, Inc. | Cardiac lead and method for lead implantation |
US6381495B1 (en) * | 1997-05-28 | 2002-04-30 | Transneuronix, Inc. | Medical device for use in laparoscopic surgery |
US20020052632A1 (en) * | 1996-01-08 | 2002-05-02 | Shlomo Ben-Haim | Electrical muscle controller |
US6385472B1 (en) * | 1999-09-10 | 2002-05-07 | Stereotaxis, Inc. | Magnetically navigable telescoping catheter and method of navigating telescoping catheter |
US20020065543A1 (en) * | 2000-11-29 | 2002-05-30 | Pacesetter, Inc. | Double threaded stylet for extraction of leads with a threaded electrode |
US20020077685A1 (en) * | 2000-12-20 | 2002-06-20 | Medtronic, Inc. | Medical electrical lead and method of use |
US20020077556A1 (en) * | 2000-12-18 | 2002-06-20 | Yitzhack Schwartz | Anchoring mechanism for implantable telemetric medical sensor |
US6409674B1 (en) * | 1998-09-24 | 2002-06-25 | Data Sciences International, Inc. | Implantable sensor with wireless communication |
US20030036773A1 (en) * | 2001-08-03 | 2003-02-20 | Whitehurst Todd K. | Systems and methods for treatment of coronary artery disease |
US20030050681A1 (en) * | 1998-11-20 | 2003-03-13 | Pianca Anne M. | Self-anchoring coronary sinus lead |
US6556874B2 (en) * | 2000-03-02 | 2003-04-29 | Biotronik Mess -Und Therapiegeraete Gmbh & Co. Ingenieurbuero Berlin | Electrode arrangement |
US20030088278A1 (en) * | 2000-09-18 | 2003-05-08 | Cameron Health, Inc. | Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator |
US6564807B1 (en) * | 1997-02-26 | 2003-05-20 | Alfred E. Mann Foundation For Scientific Research | System of implantable devices for monitoring and/or affecting body parameters |
US20030109914A1 (en) * | 2000-08-30 | 2003-06-12 | Randy Westlund | Coronary vein leads having an atraumatic TIP and method therefor |
US6582441B1 (en) * | 2000-02-24 | 2003-06-24 | Advanced Bionics Corporation | Surgical insertion tool |
US20040059392A1 (en) * | 2002-06-28 | 2004-03-25 | Jordi Parramon | Microstimulator having self-contained power source |
US20040102830A1 (en) * | 2002-11-22 | 2004-05-27 | Williams Terrell M. | System for coupling an implanatable medical device to an epicardial site |
US20040106954A1 (en) * | 2002-11-15 | 2004-06-03 | Whitehurst Todd K. | Treatment of congestive heart failure |
US20040103906A1 (en) * | 1997-02-26 | 2004-06-03 | Schulman Joseph H. | Battery-powered patient implantable device |
US20040147973A1 (en) * | 2002-06-27 | 2004-07-29 | Hauser Robert G. | Intra cardiac pacer and method |
US20050043765A1 (en) * | 2003-06-04 | 2005-02-24 | Williams Michael S. | Intravascular electrophysiological system and methods |
US20050060011A1 (en) * | 2003-09-16 | 2005-03-17 | Stephen Denker | Omnidirectional antenna for wireless communication with implanted medical devices |
US6895280B2 (en) * | 1999-07-27 | 2005-05-17 | Advanced Bionics Corporation | Rechargeable spinal cord stimulator system |
US6907285B2 (en) * | 2001-01-16 | 2005-06-14 | Kenergy, Inc. | Implantable defibrillartor with wireless vascular stent electrodes |
US20050131511A1 (en) * | 2003-12-11 | 2005-06-16 | Randy Westlund | Cardiac lead having coated fixation arrangement |
US20060015097A1 (en) * | 1998-07-07 | 2006-01-19 | Medtronic, Inc | Helical needle apparatus for creating a virtual electrode used for the ablation of tissue |
US7003350B2 (en) * | 2003-11-03 | 2006-02-21 | Kenergy, Inc. | Intravenous cardiac pacing system with wireless power supply |
US20060085039A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20060085042A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20060095089A1 (en) * | 1997-11-07 | 2006-05-04 | Medtronic, Inc. | Method and system for myocardial infarction repair |
US20060136001A1 (en) * | 2004-12-20 | 2006-06-22 | Action Medical, Inc. | Ventricular pacing |
US20060136004A1 (en) * | 2004-12-21 | 2006-06-22 | Ebr Systems, Inc. | Leadless tissue stimulation systems and methods |
US7076305B2 (en) * | 2001-05-01 | 2006-07-11 | Intrapace, Inc. | Gastric device and instrument system and method |
US20070075905A1 (en) * | 2005-10-05 | 2007-04-05 | Kenergy, Inc. | Radio frequency antenna for a wireless intravascular medical device |
US20070135882A1 (en) * | 2005-12-09 | 2007-06-14 | Drasler William J | Cardiac stimulation system |
US20080021532A1 (en) * | 2006-07-21 | 2008-01-24 | Kveen Graig L | Delivery of cardiac stimulation devices |
US20080021505A1 (en) * | 2006-07-21 | 2008-01-24 | Roger Hastings | Electrical stimulation of body tissue using interconnected electrode assemblies |
US20080039904A1 (en) * | 2006-08-08 | 2008-02-14 | Cherik Bulkes | Intravascular implant system |
US20080077188A1 (en) * | 2006-09-27 | 2008-03-27 | Stephen Denker | Intravascular stimulation system with wireless power supply |
US20080109054A1 (en) * | 2004-10-20 | 2008-05-08 | Scimed Life Systems, Inc. | Leadless Cardiac Stimulation Systems |
US20080140142A1 (en) * | 1996-01-08 | 2008-06-12 | Nissim Darvish | Electrical muscle controller and pacing with hemodynamic enhancement |
Family Cites Families (248)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3057356A (en) | 1960-07-22 | 1962-10-09 | Wilson Greatbatch Inc | Medical cardiac pacemaker |
US3357434A (en) | 1964-04-06 | 1967-12-12 | Avco Corp | Inductively linked receiver |
US3596662A (en) | 1968-09-04 | 1971-08-03 | Medtronic Inc | Electrode for cardiac stimulator |
US3835864A (en) | 1970-09-21 | 1974-09-17 | Rasor Ass Inc | Intra-cardiac stimulator |
US3902501A (en) | 1973-06-21 | 1975-09-02 | Medtronic Inc | Endocardial electrode |
US3942535A (en) | 1973-09-27 | 1976-03-09 | G. D. Searle & Co. | Rechargeable tissue stimulating system |
JPS5076501A (en) | 1973-11-12 | 1975-06-23 | ||
FR2300580A1 (en) | 1975-02-14 | 1976-09-10 | Ethicon Inc | NEEDLE SURGICAL ELECTRODES IMPROVEMENT |
JPH0210459Y2 (en) | 1979-05-22 | 1990-03-15 | ||
DE3130104A1 (en) | 1981-07-30 | 1983-02-17 | Messerschmitt-Bölkow-Blohm GmbH, 8000 München | ARRANGEMENT FOR STIMULATING A HUMAN MUSCLE |
US4543955A (en) | 1983-08-01 | 1985-10-01 | Cordis Corporation | System for controlling body implantable action device |
FR2559391B3 (en) | 1984-02-09 | 1986-12-19 | Martin Jacques | IMPLANTABLE HEART STIMULATOR |
JPS61203730A (en) | 1985-03-07 | 1986-09-09 | Yanase & Assoc:Kk | Radio receiver |
US4681111A (en) | 1985-04-05 | 1987-07-21 | Siemens-Pacesetter, Inc. | Analog and digital telemetry system for an implantable device |
US4644957A (en) | 1985-04-08 | 1987-02-24 | Ricciardelli Robert H | Applicator structure for biological needle probes employing spiral-shaped retaining coils |
US4860750A (en) | 1986-04-17 | 1989-08-29 | Intermedics Inc. | Sidelock pacer lead connector |
IT1214738B (en) | 1986-11-11 | 1990-01-18 | Sbm Soc Brevetti Medicina | IMPROVEMENT IN CARDIAC STIMULATION SYSTEMS VIA PACEMAKER |
US4858623A (en) | 1987-07-13 | 1989-08-22 | Intermedics, Inc. | Active fixation mechanism for lead assembly of an implantable cardiac stimulator |
US4913164A (en) * | 1988-09-27 | 1990-04-03 | Intermedics, Inc. | Extensible passive fixation mechanism for lead assembly of an implantable cardiac stimulator |
US5749914A (en) | 1989-01-06 | 1998-05-12 | Advanced Coronary Intervention | Catheter for obstructed stent |
JPH02307481A (en) * | 1989-05-08 | 1990-12-20 | Intermedics Inc | Positive fixing mechanism for lead assembly of buried cardiotonic device |
US4953564A (en) | 1989-08-23 | 1990-09-04 | Medtronic, Inc. | Screw-in drug eluting lead |
US5143090A (en) | 1989-11-02 | 1992-09-01 | Possis Medical, Inc. | Cardiac lead |
US5255693A (en) | 1989-11-02 | 1993-10-26 | Possis Medical, Inc. | Cardiac lead |
JPH03234059A (en) * | 1990-02-09 | 1991-10-18 | Sony Corp | Semiconductor memory |
US5078736A (en) | 1990-05-04 | 1992-01-07 | Interventional Thermodynamics, Inc. | Method and apparatus for maintaining patency in the body passages |
JPH0495090A (en) | 1990-08-08 | 1992-03-27 | Mitsubishi Gas Chem Co Inc | Purification of trioxane |
US5113869A (en) | 1990-08-21 | 1992-05-19 | Telectronics Pacing Systems, Inc. | Implantable ambulatory electrocardiogram monitor |
US5170802A (en) | 1991-01-07 | 1992-12-15 | Medtronic, Inc. | Implantable electrode for location within a blood vessel |
US5139033A (en) | 1991-03-04 | 1992-08-18 | Cardiac Pacemakers, Inc. | Sutureless myocardial lead implantation device |
US5383915A (en) | 1991-04-10 | 1995-01-24 | Angeion Corporation | Wireless programmer/repeater system for an implanted medical device |
US6144879A (en) | 1991-05-17 | 2000-11-07 | Gray; Noel Desmond | Heart pacemaker |
US5954757A (en) | 1991-05-17 | 1999-09-21 | Gray; Noel Desmond | Heart pacemaker |
US6044300A (en) | 1991-05-17 | 2000-03-28 | Gray; Noel Desmond | Heart pacemaker |
US5243977A (en) | 1991-06-26 | 1993-09-14 | Trabucco Hector O | Pacemaker |
US5335664A (en) | 1991-09-17 | 1994-08-09 | Casio Computer Co., Ltd. | Monitor system and biological signal transmitter therefor |
JPH0576501A (en) * | 1991-09-17 | 1993-03-30 | Casio Comput Co Ltd | Monitoring system and portable electronic equipment used for monitoring system |
GB9122937D0 (en) | 1991-10-30 | 1991-12-18 | Depuy Int Ltd | A femoral prosthesis |
US5246014A (en) | 1991-11-08 | 1993-09-21 | Medtronic, Inc. | Implantable lead system |
JP2602625B2 (en) | 1991-12-12 | 1997-04-23 | ターゲット セラピューティクス,インコーポレイテッド | Removable pusher with occlusal connection-vaso-occlusive coil assembly |
US5234437A (en) | 1991-12-12 | 1993-08-10 | Target Therapeutics, Inc. | Detachable pusher-vasoocclusion coil assembly with threaded coupling |
US5261916A (en) | 1991-12-12 | 1993-11-16 | Target Therapeutics | Detachable pusher-vasoocclusive coil assembly with interlocking ball and keyway coupling |
US5336252A (en) | 1992-06-22 | 1994-08-09 | Cohen Donald M | System and method for implanting cardiac electrical leads |
US5350397A (en) | 1992-11-13 | 1994-09-27 | Target Therapeutics, Inc. | Axially detachable embolic coil assembly |
US5250071A (en) | 1992-09-22 | 1993-10-05 | Target Therapeutics, Inc. | Detachable embolic coil assembly using interlocking clasps and method of use |
US5312415A (en) | 1992-09-22 | 1994-05-17 | Target Therapeutics, Inc. | Assembly for placement of embolic coils using frictional placement |
AU5331094A (en) | 1992-10-20 | 1994-05-09 | Noel Desmond Gray | A heart pacemaker |
US5342408A (en) | 1993-01-07 | 1994-08-30 | Incontrol, Inc. | Telemetry system for an implantable cardiac device |
WO1995010226A1 (en) | 1993-10-14 | 1995-04-20 | Ep Technologies, Inc. | Locating and ablating pathways in the heart |
US5800535A (en) | 1994-02-09 | 1998-09-01 | The University Of Iowa Research Foundation | Wireless prosthetic electrode for the brain |
US5487760A (en) | 1994-03-08 | 1996-01-30 | Ats Medical, Inc. | Heart valve prosthesis incorporating electronic sensing, monitoring and/or pacing circuitry |
US5571148A (en) | 1994-08-10 | 1996-11-05 | Loeb; Gerald E. | Implantable multichannel stimulator |
IL116561A0 (en) | 1994-12-30 | 1996-03-31 | Target Therapeutics Inc | Severable joint for detachable devices placed within the body |
US5876429A (en) | 1995-06-07 | 1999-03-02 | Intermedics, Inc. | Methods and devices for in vivo repair of cardiac stimulator leads |
US5775331A (en) | 1995-06-07 | 1998-07-07 | Uromed Corporation | Apparatus and method for locating a nerve |
EP0758542B1 (en) | 1995-08-16 | 2003-03-12 | Manuel A. Villafana | Heart valve prosthesis incorporating electronic monitoring and/or pacing circuitry |
IL124038A (en) | 1995-10-13 | 2004-02-19 | Transvascular Inc | Apparatus for bypassing arterial obstructions and/or performing other transvascular procedures |
US7167748B2 (en) | 1996-01-08 | 2007-01-23 | Impulse Dynamics Nv | Electrical muscle controller |
JP4175662B2 (en) | 1996-01-08 | 2008-11-05 | インパルス ダイナミクス エヌ.ヴイ. | Electric muscle control device |
US9713723B2 (en) | 1996-01-11 | 2017-07-25 | Impulse Dynamics Nv | Signal delivery through the right ventricular septum |
US5772693A (en) | 1996-02-09 | 1998-06-30 | Cardiac Control Systems, Inc. | Single preformed catheter configuration for a dual-chamber pacemaker system |
US6141591A (en) | 1996-03-06 | 2000-10-31 | Advanced Bionics Corporation | Magnetless implantable stimulator and external transmitter and implant tools for aligning same |
US5735887A (en) | 1996-12-10 | 1998-04-07 | Exonix Corporation | Closed-loop, RF-coupled implanted medical device |
US5814089A (en) | 1996-12-18 | 1998-09-29 | Medtronic, Inc. | Leadless multisite implantable stimulus and diagnostic system |
ES2208963T3 (en) | 1997-01-03 | 2004-06-16 | Biosense, Inc. | PRESSURE SENSITIVE VASCULAR ENDOPROTESIS. |
US6695885B2 (en) | 1997-02-26 | 2004-02-24 | Alfred E. Mann Foundation For Scientific Research | Method and apparatus for coupling an implantable stimulator/sensor to a prosthetic device |
US6443158B1 (en) | 1997-06-19 | 2002-09-03 | Scimed Life Systems, Inc. | Percutaneous coronary artery bypass through a venous vessel |
ES2283020T3 (en) | 1997-07-16 | 2007-10-16 | Metacure Nv | SMOOTH MUSCLE CONTROLLER. |
US5861019A (en) | 1997-07-25 | 1999-01-19 | Medtronic Inc. | Implantable medical device microstrip telemetry antenna |
US5851227A (en) | 1997-07-30 | 1998-12-22 | Sulzer Intermedics Inc. | Cardiac pacemaker cable lead |
US5876431A (en) * | 1997-07-30 | 1999-03-02 | Sulzer Intermedics Inc. | Small cable endocardial lead with exposed guide tube |
US20060064135A1 (en) | 1997-10-14 | 2006-03-23 | Transoma Medical, Inc. | Implantable pressure sensor with pacing capability |
WO1999020339A1 (en) | 1997-10-17 | 1999-04-29 | Respironics, Inc. | Muscle stimulating device and method for diagnosing and treating a breathing disorder |
US5848299A (en) | 1997-12-05 | 1998-12-08 | Shepper; John | Integumentary enclosure for video equipment |
US6132456A (en) | 1998-03-10 | 2000-10-17 | Medtronic, Inc. | Arrangement for implanting an endocardial cardiac lead |
DE69926502T2 (en) | 1998-05-08 | 2006-06-01 | Cardiac Pacemakers, Inc., St. Paul | HEART RINSING USING ADJUSTABLE ATRIO-VENTRICULAR DELAY INTERVALS |
SE9802104D0 (en) | 1998-06-12 | 1998-06-12 | Pacesetter Ab | Medical electrode device |
US6322559B1 (en) | 1998-07-06 | 2001-11-27 | Vnus Medical Technologies, Inc. | Electrode catheter having coil structure |
US6141588A (en) | 1998-07-24 | 2000-10-31 | Intermedics Inc. | Cardiac simulation system having multiple stimulators for anti-arrhythmia therapy |
JP2002522103A (en) | 1998-08-07 | 2002-07-23 | インフィニット バイオメディカル テクノロジーズ インコーポレイテッド | Method for detecting, indicating and operating implantable myocardial ischemia |
US6035239A (en) | 1998-11-10 | 2000-03-07 | Intermedics Inc. | Cardiac lead with reduced inner crimp sleeve |
WO2000030534A1 (en) | 1998-11-25 | 2000-06-02 | Ball Semiconductor, Inc. | Spherically-shaped biomedical ic |
US6336937B1 (en) | 1998-12-09 | 2002-01-08 | Gore Enterprise Holdings, Inc. | Multi-stage expandable stent-graft |
US6115636A (en) | 1998-12-22 | 2000-09-05 | Medtronic, Inc. | Telemetry for implantable devices using the body as an antenna |
US6161029A (en) | 1999-03-08 | 2000-12-12 | Medtronic, Inc. | Apparatus and method for fixing electrodes in a blood vessel |
US7020530B1 (en) | 1999-03-30 | 2006-03-28 | The Uab Research Foundation | Method and apparatus for passive cardiac stimulation |
US6647291B1 (en) | 1999-04-05 | 2003-11-11 | Medtronic, Inc. | Method and apparatus for cardiac defibrillation |
US6123724A (en) | 1999-04-14 | 2000-09-26 | Denker; Stephen | Heart assist method and apparatus employing magnetic repulsion force |
US6317615B1 (en) | 1999-04-19 | 2001-11-13 | Cardiac Pacemakers, Inc. | Method and system for reducing arterial restenosis in the presence of an intravascular stent |
WO2001000114A1 (en) | 1999-06-25 | 2001-01-04 | Vahid Saadat | Apparatus and methods for treating tissue |
US7303526B2 (en) * | 1999-08-09 | 2007-12-04 | Cardiokinetix, Inc. | Device for improving cardiac function |
EP1106202A3 (en) | 1999-11-30 | 2004-03-31 | BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin | Electrode for intravascular stimulation, cardioversion and /or defibrillation |
US6970742B2 (en) | 2000-01-11 | 2005-11-29 | Savacor, Inc. | Method for detecting, diagnosing, and treating cardiovascular disease |
US6441747B1 (en) | 2000-04-18 | 2002-08-27 | Motorola, Inc. | Wireless system protocol for telemetry monitoring |
US6510345B1 (en) | 2000-04-24 | 2003-01-21 | Medtronic, Inc. | System and method of bridging a transreceiver coil of an implantable medical device during non-communication periods |
US7006858B2 (en) | 2000-05-15 | 2006-02-28 | Silver James H | Implantable, retrievable sensors and immunosensors |
US7181261B2 (en) | 2000-05-15 | 2007-02-20 | Silver James H | Implantable, retrievable, thrombus minimizing sensors |
US6442413B1 (en) | 2000-05-15 | 2002-08-27 | James H. Silver | Implantable sensor |
EP1166820B1 (en) * | 2000-06-19 | 2009-09-30 | Medtronic, Inc. | Implantable medical device with external recharging coil |
FR2810250B1 (en) | 2000-06-20 | 2002-08-02 | Rossignol Sa | SNOW SNOWBOARD WITH UPPER REINFORCEMENT |
US6684109B1 (en) * | 2000-09-13 | 2004-01-27 | Oscor Inc. | Endocardial lead |
WO2002032499A1 (en) | 2000-09-14 | 2002-04-25 | Alfred E. Mann Institute For Biomedical Engineering At The University Of Southern California | Method and apparatus to treat disorders of gastrointestinal peristalsis |
US6647292B1 (en) | 2000-09-18 | 2003-11-11 | Cameron Health | Unitary subcutaneous only implantable cardioverter-defibrillator and optional pacer |
US7616997B2 (en) | 2000-09-27 | 2009-11-10 | Kieval Robert S | Devices and methods for cardiovascular reflex control via coupled electrodes |
US6522926B1 (en) | 2000-09-27 | 2003-02-18 | Cvrx, Inc. | Devices and methods for cardiovascular reflex control |
US7283874B2 (en) | 2000-10-16 | 2007-10-16 | Remon Medical Technologies Ltd. | Acoustically powered implantable stimulating device |
DE10055686A1 (en) | 2000-11-03 | 2002-05-08 | Biotronik Mess & Therapieg | Device for influencing cell proliferation mechanisms in vessels of the human or animal body |
US6574510B2 (en) | 2000-11-30 | 2003-06-03 | Cardiac Pacemakers, Inc. | Telemetry apparatus and method for an implantable medical device |
WO2002049714A2 (en) | 2000-12-21 | 2002-06-27 | Medtronic, Inc. | Electrically responsive promoter system |
US6890295B2 (en) | 2002-10-31 | 2005-05-10 | Medtronic, Inc. | Anatomical space access tools and methods |
US20020123785A1 (en) | 2001-03-02 | 2002-09-05 | Cardiac Pacemakers, Inc. | Cardiac lead permitting easy extraction |
US20020188323A1 (en) | 2001-03-19 | 2002-12-12 | Remon Medical Technologies Ltd. | Methods, systems and devices for in vivo electrochemical production of therapeutic agents |
US6901294B1 (en) | 2001-05-25 | 2005-05-31 | Advanced Bionics Corporation | Methods and systems for direct electrical current stimulation as a therapy for prostatic hypertrophy |
JP2005508208A (en) * | 2001-06-04 | 2005-03-31 | アルバート・アインシュタイン・ヘルスケア・ネットワーク | Cardiac stimulator with thrombus filter and atrial pacemaker |
US7209783B2 (en) | 2001-06-15 | 2007-04-24 | Cardiac Pacemakers, Inc. | Ablation stent for treating atrial fibrillation |
EP1408688B1 (en) | 2001-07-13 | 2012-01-25 | Sony Corporation | Video information recording apparatus and reproducing apparatus |
US6675049B2 (en) | 2001-07-17 | 2004-01-06 | Medtronic, Inc. | Method and apparatus for automatic implantable medical lead recognition and configuration |
US6456256B1 (en) | 2001-08-03 | 2002-09-24 | Cardiac Pacemakers, Inc. | Circumferential antenna for an implantable medical device |
EP1432345B1 (en) | 2001-09-24 | 2011-11-09 | Given Imaging Ltd. | System for controlling a device in vivo |
US6718212B2 (en) * | 2001-10-12 | 2004-04-06 | Medtronic, Inc. | Implantable medical electrical lead with light-activated adhesive fixation |
AU2002343692A1 (en) * | 2001-11-09 | 2003-05-19 | Cardio-Optics, Inc. | Direct, real-time imaging guidance of cardiac catheterization |
US7187980B2 (en) | 2001-11-09 | 2007-03-06 | Oscor Inc. | Cardiac lead with steroid eluting ring |
US6978176B2 (en) * | 2001-12-08 | 2005-12-20 | Lattouf Omar M | Treatment for patient with congestive heart failure |
US6736771B2 (en) | 2002-01-02 | 2004-05-18 | Advanced Bionics Corporation | Wideband low-noise implantable microphone assembly |
US8364278B2 (en) | 2002-01-29 | 2013-01-29 | Boston Scientific Neuromodulation Corporation | Lead assembly for implantable microstimulator |
US8321036B2 (en) | 2002-02-15 | 2012-11-27 | Data Sciences International, Inc. | Cardiac rhythm management device |
US20090088813A1 (en) | 2004-03-12 | 2009-04-02 | Brockway Brian P | Cardiac Rhythm Management Device |
US7236821B2 (en) | 2002-02-19 | 2007-06-26 | Cardiac Pacemakers, Inc. | Chronically-implanted device for sensing and therapy |
AUPS101502A0 (en) | 2002-03-11 | 2002-04-11 | Neopraxis Pty Ltd | Wireless fes system |
US7551964B2 (en) | 2002-03-22 | 2009-06-23 | Leptos Biomedical, Inc. | Splanchnic nerve stimulation for treatment of obesity |
US7239912B2 (en) | 2002-03-22 | 2007-07-03 | Leptos Biomedical, Inc. | Electric modulation of sympathetic nervous system |
US7236822B2 (en) | 2002-03-22 | 2007-06-26 | Leptos Biomedical, Inc. | Wireless electric modulation of sympathetic nervous system |
US7689276B2 (en) | 2002-09-13 | 2010-03-30 | Leptos Biomedical, Inc. | Dynamic nerve stimulation for treatment of disorders |
JP4295627B2 (en) | 2002-03-27 | 2009-07-15 | シーブイアールエックス, インコーポレイテッド | Electrode structure and its use in controlling circulatory system reflection |
US7588565B2 (en) | 2002-05-15 | 2009-09-15 | Rocky Mountain Biosystems, Inc. | Method and device for anastomoses |
US20040193229A1 (en) | 2002-05-17 | 2004-09-30 | Medtronic, Inc. | Gastric electrical stimulation for treatment of gastro-esophageal reflux disease |
US20030216729A1 (en) | 2002-05-20 | 2003-11-20 | Marchitto Kevin S. | Device and method for wound healing and uses therefor |
US7967839B2 (en) | 2002-05-20 | 2011-06-28 | Rocky Mountain Biosystems, Inc. | Electromagnetic treatment of tissues and cells |
US20040127895A1 (en) | 2002-05-20 | 2004-07-01 | Flock Stephen T. | Electromagnetic treatment of tissues and cells |
AU2002323811A1 (en) | 2002-08-05 | 2004-02-23 | Japan As Represented By President Of National Cardiovascular Center | Subminiature integrated heart pace maker and dispersed heart pacing system |
US7558623B2 (en) | 2002-09-20 | 2009-07-07 | Angel Medical Systems, Inc. | Means and method for the detection of cardiac events |
WO2004028348A2 (en) * | 2002-09-26 | 2004-04-08 | Savacor, Inc. | Cardiovascular anchoring device and method of deploying same |
US8303511B2 (en) | 2002-09-26 | 2012-11-06 | Pacesetter, Inc. | Implantable pressure transducer system optimized for reduced thrombosis effect |
US7615010B1 (en) | 2002-10-03 | 2009-11-10 | Integrated Sensing Systems, Inc. | System for monitoring the physiologic parameters of patients with congestive heart failure |
US20040230090A1 (en) | 2002-10-07 | 2004-11-18 | Hegde Anant V. | Vascular assist device and methods |
US20050256549A1 (en) | 2002-10-09 | 2005-11-17 | Sirius Implantable Systems Ltd. | Micro-generator implant |
US20040073267A1 (en) | 2002-10-09 | 2004-04-15 | Asher Holzer | Micro-generator implant |
US7697972B2 (en) | 2002-11-19 | 2010-04-13 | Medtronic Navigation, Inc. | Navigation system for cardiac therapies |
JP2004173790A (en) | 2002-11-25 | 2004-06-24 | Terumo Corp | Heart treatment equipment |
US7452334B2 (en) | 2002-12-16 | 2008-11-18 | The Regents Of The University Of Michigan | Antenna stent device for wireless, intraluminal monitoring |
TWI235523B (en) | 2002-12-31 | 2005-07-01 | Ind Tech Res Inst | A radio transmitter and receiver of an implantable medical device |
US7357818B2 (en) | 2003-03-26 | 2008-04-15 | Boston Scientific Scimed, Inc. | Self-retaining stent |
US20050025797A1 (en) | 2003-04-08 | 2005-02-03 | Xingwu Wang | Medical device with low magnetic susceptibility |
US7016733B2 (en) | 2003-04-23 | 2006-03-21 | Medtronic, Inc. | Telemetry antenna for an implantable medical device |
NZ526115A (en) | 2003-05-23 | 2006-10-27 | Auckland Uniservices Ltd | Methods and apparatus for detuning a pick-up of a contactless power supply |
US7006864B2 (en) | 2003-06-17 | 2006-02-28 | Ebr Systems, Inc. | Methods and systems for vibrational treatment of cardiac arrhythmias |
US7317951B2 (en) * | 2003-07-25 | 2008-01-08 | Integrated Sensing Systems, Inc. | Anchor for medical implant placement and method of manufacture |
US7184830B2 (en) | 2003-08-18 | 2007-02-27 | Ebr Systems, Inc. | Methods and systems for treating arrhythmias using a combination of vibrational and electrical energy |
US7289853B1 (en) | 2003-08-28 | 2007-10-30 | David Campbell | High frequency wireless pacemaker |
US8048369B2 (en) | 2003-09-05 | 2011-11-01 | Ati Properties, Inc. | Cobalt-nickel-chromium-molybdenum alloys with reduced level of titanium nitride inclusions |
US7186209B2 (en) | 2003-10-09 | 2007-03-06 | Jacobson Jerry I | Cardioelectromagnetic treatment |
US20050095197A1 (en) | 2003-10-31 | 2005-05-05 | Tuszynski Jack A. | Anti-mitotic compound |
US7050849B2 (en) | 2003-11-06 | 2006-05-23 | Ebr Systems, Inc. | Vibrational therapy device used for resynchronization pacing in a treatment for heart failure |
WO2005062823A2 (en) | 2003-12-19 | 2005-07-14 | Savacor, Inc. | Digital electrode for cardiac rhythm management |
US20050149138A1 (en) | 2003-12-24 | 2005-07-07 | Xiaoyi Min | System and method for determining optimal pacing sites based on myocardial activation times |
US7186214B2 (en) | 2004-02-12 | 2007-03-06 | Medtronic, Inc. | Instruments and methods for accessing an anatomic space |
US20050182456A1 (en) | 2004-02-18 | 2005-08-18 | Ziobro John F. | Automated cortical mapping |
US7840263B2 (en) | 2004-02-27 | 2010-11-23 | Cardiac Pacemakers, Inc. | Method and apparatus for device controlled gene expression |
JP2005245215A (en) | 2004-03-01 | 2005-09-15 | Fu Sheng Industrial Co Ltd | Method for producing reel seat for fishing rod |
US20050215764A1 (en) | 2004-03-24 | 2005-09-29 | Tuszynski Jack A | Biological polymer with differently charged portions |
US20050245977A1 (en) | 2004-04-12 | 2005-11-03 | Advanced Neuromodulation Systems, Inc. | Voltage limited systems and methods |
US20050245846A1 (en) | 2004-05-03 | 2005-11-03 | Casey Don E | Vibrating, magnetically guidable catheter with magnetic powder commingled with resin, extruded as an integral part the catheter |
WO2005107863A2 (en) | 2004-05-04 | 2005-11-17 | University Of Rochester | Implantable bio-electro-physiologic interface matrix |
WO2005107852A1 (en) | 2004-05-04 | 2005-11-17 | University Of Rochester | Leadless implantable intravascular electrophysiologic device for neurologic/cardiovascular sensing and stimulation |
US8412348B2 (en) | 2004-05-06 | 2013-04-02 | Boston Scientific Neuromodulation Corporation | Intravascular self-anchoring integrated tubular electrode body |
US7162310B2 (en) | 2004-05-10 | 2007-01-09 | Pacesetter, Inc. | Flat wire helix electrode used in screw-in cardiac stimulation leads |
US7260431B2 (en) | 2004-05-20 | 2007-08-21 | Cardiac Pacemakers, Inc. | Combined remodeling control therapy and anti-remodeling therapy by implantable cardiac device |
EP1758642A2 (en) | 2004-06-01 | 2007-03-07 | Remon Medical Technologies Ltd. | System for evaluating heart performance |
US20060020316A1 (en) | 2004-06-03 | 2006-01-26 | Medtronic, Inc. | Implantable cardioversion and defibrillation system including intramural myocardial elecrtode |
WO2005117737A2 (en) | 2004-06-04 | 2005-12-15 | The Regents Of The University Of Michigan | Electromagnetic flow sensor device |
US20070106357A1 (en) | 2005-11-04 | 2007-05-10 | Stephen Denker | Intravascular Electronics Carrier Electrode for a Transvascular Tissue Stimulation System |
US7765001B2 (en) | 2005-08-31 | 2010-07-27 | Ebr Systems, Inc. | Methods and systems for heart failure prevention and treatments using ultrasound and leadless implantable devices |
US7747333B2 (en) | 2004-08-16 | 2010-06-29 | Cardiac Pacemakers, Inc. | Lead assembly and methods including a push tube |
US7200437B1 (en) | 2004-10-13 | 2007-04-03 | Pacesetter, Inc. | Tissue contact for satellite cardiac pacemaker |
US7522962B1 (en) | 2004-12-03 | 2009-04-21 | Remon Medical Technologies, Ltd | Implantable medical device with integrated acoustic transducer |
US7410497B2 (en) | 2004-12-14 | 2008-08-12 | Boston Scientific Scimed, Inc. | Stimulation of cell growth at implant surfaces |
WO2006069327A2 (en) | 2004-12-21 | 2006-06-29 | Ebr Systems, Inc. | Implantable transducer devices |
US7558631B2 (en) | 2004-12-21 | 2009-07-07 | Ebr Systems, Inc. | Leadless tissue stimulation systems and methods |
US20060173505A1 (en) | 2005-01-28 | 2006-08-03 | Salo Rodney W | Controlled delivery of electrical pacing therapy for treating mitral regurgitation |
US20060173504A1 (en) | 2005-01-28 | 2006-08-03 | Qingsheng Zhu | Electrical pacing therapy for treating mitral regurgitation |
US7532932B2 (en) | 2005-03-08 | 2009-05-12 | Kenergy, Inc. | Implantable medical apparatus having an omnidirectional antenna for receiving radio frequency signals |
US7634313B1 (en) | 2005-04-11 | 2009-12-15 | Pacesetter, Inc. | Failsafe satellite pacemaker system |
US7565195B1 (en) | 2005-04-11 | 2009-07-21 | Pacesetter, Inc. | Failsafe satellite pacemaker system |
DE102005020071A1 (en) | 2005-04-22 | 2006-10-26 | Biotronik Crm Patent Ag | Pacemaker |
NZ539771A (en) | 2005-04-29 | 2007-10-26 | Auckland Uniservices Ltd | Tuning methods and apparatus for inductively coupled power transfer (ICPT) systems |
US20060247753A1 (en) * | 2005-04-29 | 2006-11-02 | Wenger William K | Subcutaneous lead fixation mechanisms |
NZ539770A (en) | 2005-04-29 | 2007-10-26 | Auckland Uniservices Ltd | Inductively coupled power transfer system |
JP5245215B2 (en) | 2005-06-16 | 2013-07-24 | 株式会社竹屋 | Amusement center membership management system |
US8547248B2 (en) | 2005-09-01 | 2013-10-01 | Proteus Digital Health, Inc. | Implantable zero-wire communications system |
US7702392B2 (en) | 2005-09-12 | 2010-04-20 | Ebr Systems, Inc. | Methods and apparatus for determining cardiac stimulation sites using hemodynamic data |
US9168383B2 (en) | 2005-10-14 | 2015-10-27 | Pacesetter, Inc. | Leadless cardiac pacemaker with conducted communication |
US8457742B2 (en) | 2005-10-14 | 2013-06-04 | Nanostim, Inc. | Leadless cardiac pacemaker system for usage in combination with an implantable cardioverter-defibrillator |
US8050774B2 (en) | 2005-12-22 | 2011-11-01 | Boston Scientific Scimed, Inc. | Electrode apparatus, systems and methods |
US8160722B2 (en) | 2006-02-28 | 2012-04-17 | Medtronic, Inc. | Subcutaneous lead fixation mechanisms |
US7927737B2 (en) | 2006-03-24 | 2011-04-19 | Medtronic, Inc. | Implantable medical device and lithium battery |
US7937161B2 (en) | 2006-03-31 | 2011-05-03 | Boston Scientific Scimed, Inc. | Cardiac stimulation electrodes, delivery devices, and implantation configurations |
US20070276444A1 (en) | 2006-05-24 | 2007-11-29 | Daniel Gelbart | Self-powered leadless pacemaker |
US8116862B2 (en) | 2006-06-08 | 2012-02-14 | Greatbatch Ltd. | Tank filters placed in series with the lead wires or circuits of active medical devices to enhance MRI compatibility |
US7899542B2 (en) | 2006-06-20 | 2011-03-01 | Ebr Systems, Inc. | Systems and methods for implantable leadless spine stimulation |
US20070293904A1 (en) | 2006-06-20 | 2007-12-20 | Daniel Gelbart | Self-powered resonant leadless pacemaker |
US7894904B2 (en) | 2006-06-20 | 2011-02-22 | Ebr Systems, Inc. | Systems and methods for implantable leadless brain stimulation |
US7894910B2 (en) | 2006-06-20 | 2011-02-22 | Ebr Systems, Inc. | Systems and methods for implantable leadless cochlear stimulation |
US7894907B2 (en) | 2006-06-20 | 2011-02-22 | Ebr Systems, Inc. | Systems and methods for implantable leadless nerve stimulation |
US7899541B2 (en) | 2006-06-20 | 2011-03-01 | Ebr Systems, Inc. | Systems and methods for implantable leadless gastrointestinal tissue stimulation |
US7877142B2 (en) | 2006-07-05 | 2011-01-25 | Micardia Corporation | Methods and systems for cardiac remodeling via resynchronization |
US7643879B2 (en) | 2006-08-24 | 2010-01-05 | Cardiac Pacemakers, Inc. | Integrated cardiac rhythm management system with heart valve |
US8644934B2 (en) | 2006-09-13 | 2014-02-04 | Boston Scientific Scimed Inc. | Cardiac stimulation using leadless electrode assemblies |
US7899537B1 (en) | 2006-10-27 | 2011-03-01 | Pacesetter, Inc. | Pericardial cardioverter defibrillator |
DE102006055340A1 (en) | 2006-11-23 | 2008-05-29 | Siemens Ag | Explosion-proof module construction for power components, in particular power semiconductor components and its manufacture |
US7792588B2 (en) | 2007-01-26 | 2010-09-07 | Medtronic, Inc. | Radio frequency transponder based implantable medical system |
WO2008101409A1 (en) | 2007-02-16 | 2008-08-28 | Sun Medical-Scientific (Shanghai) Co., Ltd. | Non-electrode-lead ultra-thin micro multifunctional heart rate adjusting device |
US8103359B2 (en) | 2007-05-17 | 2012-01-24 | Cardiac Pacemakers, Inc. | Systems and methods for fixating transvenously implanted medical devices |
WO2009039400A1 (en) | 2007-09-20 | 2009-03-26 | Nanostim, Inc. | Leadless cardiac pacemaker with secondary fixation capability |
US8019419B1 (en) | 2007-09-25 | 2011-09-13 | Dorin Panescu | Methods and apparatus for leadless, battery-less, wireless stimulation of tissue |
US20090082827A1 (en) | 2007-09-26 | 2009-03-26 | Cardiac Pacemakers, Inc. | Hinged anchors for wireless pacing electrodes |
US7877136B1 (en) | 2007-09-28 | 2011-01-25 | Boston Scientific Neuromodulation Corporation | Enhancement of neural signal transmission through damaged neural tissue via hyperpolarizing electrical stimulation current |
US8165694B2 (en) | 2008-01-29 | 2012-04-24 | Boston Scientific Neuromodulation Corporation | Thermal management of implantable medical devices |
JP5153892B2 (en) | 2008-02-07 | 2013-02-27 | カーディアック ペースメイカーズ, インコーポレイテッド | Wireless tissue electrical stimulation |
WO2009120636A1 (en) | 2008-03-25 | 2009-10-01 | Ebr Systems, Inc. | Temporary electrode connection for wireless pacing systems |
US20090275998A1 (en) | 2008-04-30 | 2009-11-05 | Medtronic, Inc. | Extra-cardiac implantable device with fusion pacing capability |
US8527068B2 (en) | 2009-02-02 | 2013-09-03 | Nanostim, Inc. | Leadless cardiac pacemaker with secondary fixation capability |
US20110077708A1 (en) | 2009-09-28 | 2011-03-31 | Alan Ostroff | MRI Compatible Leadless Cardiac Pacemaker |
US8478431B2 (en) | 2010-04-13 | 2013-07-02 | Medtronic, Inc. | Slidable fixation device for securing a medical implant |
US8532790B2 (en) * | 2010-04-13 | 2013-09-10 | Medtronic, Inc. | Slidable fixation device for securing a medical implant |
US20110270340A1 (en) | 2010-04-30 | 2011-11-03 | Medtronic Vascular,Inc. | Two-Stage Delivery Systems and Methods for Fixing a Leadless Implant to Tissue |
US20110270339A1 (en) | 2010-04-30 | 2011-11-03 | Medtronic Vascular, Inc. | Two-Stage Delivery Systems and Methods for Fixing a Leadless Implant to Tissue |
EP2433675B1 (en) | 2010-09-24 | 2013-01-09 | Sorin CRM SAS | Active implantable medical device including a means for wireless communication via electric pulses conducted by the interstitial tissue of the body |
CN103249452A (en) | 2010-10-12 | 2013-08-14 | 内诺斯蒂姆股份有限公司 | Temperature sensor for a leadless cardiac pacemaker |
US20120095539A1 (en) | 2010-10-13 | 2012-04-19 | Alexander Khairkhahan | Delivery Catheter Systems and Methods |
US9020611B2 (en) | 2010-10-13 | 2015-04-28 | Pacesetter, Inc. | Leadless cardiac pacemaker with anti-unscrewing feature |
US20120095521A1 (en) | 2010-10-19 | 2012-04-19 | Medtronic, Inc. | Detection of heart rhythm using an accelerometer |
US8666505B2 (en) | 2010-10-26 | 2014-03-04 | Medtronic, Inc. | Wafer-scale package including power source |
US8825170B2 (en) | 2010-10-29 | 2014-09-02 | Medtronic, Inc. | Low-power system clock calibration based on a high-accuracy reference clock |
US9126032B2 (en) | 2010-12-13 | 2015-09-08 | Pacesetter, Inc. | Pacemaker retrieval systems and methods |
EP2654889B1 (en) | 2010-12-20 | 2017-03-01 | Pacesetter, Inc. | Leadless pacemaker with radial fixation mechanism |
US10112045B2 (en) | 2010-12-29 | 2018-10-30 | Medtronic, Inc. | Implantable medical device fixation |
JP6510459B2 (en) | 2016-04-28 | 2019-05-08 | 株式会社豊田自動織機 | DPF manual regeneration control device |
JP7016299B2 (en) | 2018-07-13 | 2022-02-04 | 株式会社トッパンTomoegawaオプティカルフィルム | Die head and coating equipment |
-
2006
- 2006-08-28 WO PCT/US2006/033414 patent/WO2007067231A1/en active Application Filing
- 2006-08-28 AT AT06790023T patent/ATE493167T1/en not_active IP Right Cessation
- 2006-08-28 US US11/511,152 patent/US7848823B2/en not_active Expired - Fee Related
- 2006-08-28 EP EP06790023A patent/EP1957147B1/en not_active Not-in-force
- 2006-08-28 DE DE602006019309T patent/DE602006019309D1/en active Active
- 2006-08-28 JP JP2008544324A patent/JP2009518115A/en active Pending
- 2006-10-13 EP EP06825988A patent/EP1957148B1/en not_active Not-in-force
- 2006-10-13 AT AT06825988T patent/ATE499142T1/en not_active IP Right Cessation
- 2006-10-13 JP JP2008544332A patent/JP5073672B2/en not_active Expired - Fee Related
- 2006-10-13 DE DE602006020328T patent/DE602006020328D1/en active Active
- 2006-10-13 WO PCT/US2006/040291 patent/WO2007067253A1/en active Application Filing
- 2006-10-13 US US11/549,352 patent/US20070135883A1/en not_active Abandoned
-
2013
- 2013-10-02 US US14/044,094 patent/US10022538B2/en active Active
-
2018
- 2018-06-14 US US16/008,562 patent/US11154247B2/en active Active
-
2021
- 2021-09-27 US US17/485,918 patent/US11766219B2/en active Active
-
2023
- 2023-08-16 US US18/234,631 patent/US20230389876A1/en active Pending
Patent Citations (99)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3667477A (en) * | 1966-11-25 | 1972-06-06 | Canadian Patents Dev | Implantable vesical stimulator |
US3713449A (en) * | 1970-08-31 | 1973-01-30 | P Mulier | Cardiac pacer with externally controllable variable width output pulse |
US3943936A (en) * | 1970-09-21 | 1976-03-16 | Rasor Associates, Inc. | Self powered pacers and stimulators |
US3727616A (en) * | 1971-06-15 | 1973-04-17 | Gen Dynamics Corp | Electronic system for the stimulation of biological systems |
US4162679A (en) * | 1976-09-28 | 1979-07-31 | Reenstierna Erik G B | Method and device for the implantation of one or more pacemaker electrodes in a heart |
US4256115A (en) * | 1976-12-20 | 1981-03-17 | American Technology, Inc. | Leadless cardiac pacer |
US4157720A (en) * | 1977-09-16 | 1979-06-12 | Greatbatch W | Cardiac pacemaker |
US4198991A (en) * | 1978-05-17 | 1980-04-22 | Cordis Corporation | Cardiac pacer lead |
US4721118A (en) * | 1981-04-20 | 1988-01-26 | Cordis Leads, Inc. | Pervenous electrical pacing lead with foldable fins |
US4441210A (en) * | 1981-09-18 | 1984-04-03 | Hochmair Erwin S | Transcutaneous signal transmission system and methods |
US4525774A (en) * | 1981-11-24 | 1985-06-25 | Hitachi, Ltd. | Regulated AC-DC converter having saturation inductance in resonant circuit |
US4641664A (en) * | 1984-04-13 | 1987-02-10 | Siemens Aktiengesellschaft | Endocardial electrode arrangement |
US4830006A (en) * | 1986-06-17 | 1989-05-16 | Intermedics, Inc. | Implantable cardiac stimulator for detection and treatment of ventricular arrhythmias |
US4830006B1 (en) * | 1986-06-17 | 1997-10-28 | Intermedics Inc | Implantable cardiac stimulator for detection and treatment of ventricular arrhythmias |
US4987897A (en) * | 1989-09-18 | 1991-01-29 | Medtronic, Inc. | Body bus medical device communication system |
US5178149A (en) * | 1989-11-06 | 1993-01-12 | Michael Imburgia | Transesophageal probe having simultaneous pacing and echocardiographic capability, and method of diagnosing heart disease using same |
US5314458A (en) * | 1990-06-01 | 1994-05-24 | University Of Michigan | Single channel microstimulator |
US5324325A (en) * | 1991-06-27 | 1994-06-28 | Siemens Pacesetter, Inc. | Myocardial steroid releasing lead |
US5312439A (en) * | 1991-12-12 | 1994-05-17 | Loeb Gerald E | Implantable device having an electrolytic storage electrode |
US5193540A (en) * | 1991-12-18 | 1993-03-16 | Alfred E. Mann Foundation For Scientific Research | Structure and method of manufacture of an implantable microstimulator |
US5324316A (en) * | 1991-12-18 | 1994-06-28 | Alfred E. Mann Foundation For Scientific Research | Implantable microstimulator |
US5193539A (en) * | 1991-12-18 | 1993-03-16 | Alfred E. Mann Foundation For Scientific Research | Implantable microstimulator |
US5405367A (en) * | 1991-12-18 | 1995-04-11 | Alfred E. Mann Foundation For Scientific Research | Structure and method of manufacture of an implantable microstimulator |
US5411535A (en) * | 1992-03-03 | 1995-05-02 | Terumo Kabushiki Kaisha | Cardiac pacemaker using wireless transmission |
US5383924A (en) * | 1992-06-03 | 1995-01-24 | Ela Medical | Extractable cardiac probe and its application procedure |
US5531780A (en) * | 1992-09-03 | 1996-07-02 | Pacesetter, Inc. | Implantable stimulation lead having an advanceable therapeutic drug delivery system |
US5300107A (en) * | 1992-10-22 | 1994-04-05 | Medtronic, Inc. | Universal tined myocardial pacing lead |
US5622168A (en) * | 1992-11-18 | 1997-04-22 | John L. Essmyer | Conductive hydrogels and physiological electrodes and electrode assemblies therefrom |
US5411537A (en) * | 1993-10-29 | 1995-05-02 | Intermedics, Inc. | Rechargeable biomedical battery powered devices with recharging and control system therefor |
US5624316A (en) * | 1994-06-06 | 1997-04-29 | Catapult Entertainment Inc. | Video game enhancer with intergral modem and smart card interface |
US5628778A (en) * | 1994-11-21 | 1997-05-13 | Medtronic Inc. | Single pass medical electrical lead |
US5769877A (en) * | 1995-01-04 | 1998-06-23 | Plexus, Inc. | High value capacitive, replenishable power source |
US5591217A (en) * | 1995-01-04 | 1997-01-07 | Plexus, Inc. | Implantable stimulator with replenishable, high value capacitive power source and method therefor |
US7062318B2 (en) * | 1996-01-08 | 2006-06-13 | Impulse Dynamics (Israel) Ltd | Electrical muscle controller |
US20020052632A1 (en) * | 1996-01-08 | 2002-05-02 | Shlomo Ben-Haim | Electrical muscle controller |
US20080140142A1 (en) * | 1996-01-08 | 2008-06-12 | Nissim Darvish | Electrical muscle controller and pacing with hemodynamic enhancement |
US6363279B1 (en) * | 1996-01-08 | 2002-03-26 | Impulse Dynamics N.V. | Electrical muscle controller |
US5755764A (en) * | 1996-09-10 | 1998-05-26 | Sulzer Intermedics Inc. | Implantable cardiac stimulation catheter |
US6564807B1 (en) * | 1997-02-26 | 2003-05-20 | Alfred E. Mann Foundation For Scientific Research | System of implantable devices for monitoring and/or affecting body parameters |
US6208894B1 (en) * | 1997-02-26 | 2001-03-27 | Alfred E. Mann Foundation For Scientific Research And Advanced Bionics | System of implantable devices for monitoring and/or affecting body parameters |
US20040103906A1 (en) * | 1997-02-26 | 2004-06-03 | Schulman Joseph H. | Battery-powered patient implantable device |
US6200303B1 (en) * | 1997-04-30 | 2001-03-13 | Beth Israel Deaconess Medical Center, Inc. | Method and kit for transvenously accessing the pericardial space via the right atrium |
US5871532A (en) * | 1997-05-22 | 1999-02-16 | Sulzer Intermedics Inc. | Epicardial lead for minimally invasive implantation |
US6381495B1 (en) * | 1997-05-28 | 2002-04-30 | Transneuronix, Inc. | Medical device for use in laparoscopic surgery |
US6041258A (en) * | 1997-05-28 | 2000-03-21 | Transneuronix, Inc. | Medical stimulation |
US5779715A (en) * | 1997-07-28 | 1998-07-14 | Irvine Biomedical, Inc. | Lead extraction system and methods thereof |
US20060095089A1 (en) * | 1997-11-07 | 2006-05-04 | Medtronic, Inc. | Method and system for myocardial infarction repair |
US6223079B1 (en) * | 1997-12-15 | 2001-04-24 | Medtronic, Inc | Bi-ventricular pacing method |
US6360127B1 (en) * | 1998-05-08 | 2002-03-19 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6351673B1 (en) * | 1998-05-08 | 2002-02-26 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6859665B2 (en) * | 1998-05-08 | 2005-02-22 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US6856836B2 (en) * | 1998-05-08 | 2005-02-15 | Cardiac Pacemakers, Inc. | Cardiac pacing using adjustable atrio-ventricular delays |
US20060015097A1 (en) * | 1998-07-07 | 2006-01-19 | Medtronic, Inc | Helical needle apparatus for creating a virtual electrode used for the ablation of tissue |
US6345202B2 (en) * | 1998-08-14 | 2002-02-05 | Advanced Bionics Corporation | Method of treating obstructive sleep apnea using implantable electrodes |
US6240316B1 (en) * | 1998-08-14 | 2001-05-29 | Advanced Bionics Corporation | Implantable microstimulation system for treatment of sleep apnea |
US6409674B1 (en) * | 1998-09-24 | 2002-06-25 | Data Sciences International, Inc. | Implantable sensor with wireless communication |
US20030050681A1 (en) * | 1998-11-20 | 2003-03-13 | Pianca Anne M. | Self-anchoring coronary sinus lead |
US6363938B2 (en) * | 1998-12-22 | 2002-04-02 | Angiotrax, Inc. | Methods and apparatus for perfusing tissue and/or stimulating revascularization and tissue growth |
US6266567B1 (en) * | 1999-06-01 | 2001-07-24 | Ball Semiconductor, Inc. | Implantable epicardial electrode |
US6895280B2 (en) * | 1999-07-27 | 2005-05-17 | Advanced Bionics Corporation | Rechargeable spinal cord stimulator system |
US6385472B1 (en) * | 1999-09-10 | 2002-05-07 | Stereotaxis, Inc. | Magnetically navigable telescoping catheter and method of navigating telescoping catheter |
US6582441B1 (en) * | 2000-02-24 | 2003-06-24 | Advanced Bionics Corporation | Surgical insertion tool |
US6370434B1 (en) * | 2000-02-28 | 2002-04-09 | Cardiac Pacemakers, Inc. | Cardiac lead and method for lead implantation |
US6556874B2 (en) * | 2000-03-02 | 2003-04-29 | Biotronik Mess -Und Therapiegeraete Gmbh & Co. Ingenieurbuero Berlin | Electrode arrangement |
US20020018379A1 (en) * | 2000-07-07 | 2002-02-14 | Tatsushi Hakuchoh | Method for controlling starting operation of unit and executing self-checking test |
US20030109914A1 (en) * | 2000-08-30 | 2003-06-12 | Randy Westlund | Coronary vein leads having an atraumatic TIP and method therefor |
US20030088278A1 (en) * | 2000-09-18 | 2003-05-08 | Cameron Health, Inc. | Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator |
US20020065543A1 (en) * | 2000-11-29 | 2002-05-30 | Pacesetter, Inc. | Double threaded stylet for extraction of leads with a threaded electrode |
US20020077556A1 (en) * | 2000-12-18 | 2002-06-20 | Yitzhack Schwartz | Anchoring mechanism for implantable telemetric medical sensor |
US20020077685A1 (en) * | 2000-12-20 | 2002-06-20 | Medtronic, Inc. | Medical electrical lead and method of use |
US6907285B2 (en) * | 2001-01-16 | 2005-06-14 | Kenergy, Inc. | Implantable defibrillartor with wireless vascular stent electrodes |
US7076305B2 (en) * | 2001-05-01 | 2006-07-11 | Intrapace, Inc. | Gastric device and instrument system and method |
US20030036773A1 (en) * | 2001-08-03 | 2003-02-20 | Whitehurst Todd K. | Systems and methods for treatment of coronary artery disease |
US20040147973A1 (en) * | 2002-06-27 | 2004-07-29 | Hauser Robert G. | Intra cardiac pacer and method |
US20050057905A1 (en) * | 2002-06-28 | 2005-03-17 | He Tom Xiaohai | Electronic module design to maximize the volume efficiency in a miniature medical device |
US20040059392A1 (en) * | 2002-06-28 | 2004-03-25 | Jordi Parramon | Microstimulator having self-contained power source |
US20040098068A1 (en) * | 2002-06-28 | 2004-05-20 | Rafael Carbunaru | Chair pad charging and communication system for a battery-powered microstimulator |
US20050021108A1 (en) * | 2002-06-28 | 2005-01-27 | Klosterman Daniel J. | Bi-directional telemetry system for use with microstimulator |
US20040106954A1 (en) * | 2002-11-15 | 2004-06-03 | Whitehurst Todd K. | Treatment of congestive heart failure |
US20040102830A1 (en) * | 2002-11-22 | 2004-05-27 | Williams Terrell M. | System for coupling an implanatable medical device to an epicardial site |
US20050043765A1 (en) * | 2003-06-04 | 2005-02-24 | Williams Michael S. | Intravascular electrophysiological system and methods |
US20050060011A1 (en) * | 2003-09-16 | 2005-03-17 | Stephen Denker | Omnidirectional antenna for wireless communication with implanted medical devices |
US7003350B2 (en) * | 2003-11-03 | 2006-02-21 | Kenergy, Inc. | Intravenous cardiac pacing system with wireless power supply |
US20050131511A1 (en) * | 2003-12-11 | 2005-06-16 | Randy Westlund | Cardiac lead having coated fixation arrangement |
US20060085041A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20070150037A1 (en) * | 2004-10-20 | 2007-06-28 | Hastings Roger N | Leadless Cardiac Stimulation Systems |
US20060085039A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20060085042A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US20080109054A1 (en) * | 2004-10-20 | 2008-05-08 | Scimed Life Systems, Inc. | Leadless Cardiac Stimulation Systems |
US20060136001A1 (en) * | 2004-12-20 | 2006-06-22 | Action Medical, Inc. | Ventricular pacing |
US20060136004A1 (en) * | 2004-12-21 | 2006-06-22 | Ebr Systems, Inc. | Leadless tissue stimulation systems and methods |
US20080046040A1 (en) * | 2005-10-05 | 2008-02-21 | Stephen Denker | Radio frequency antenna for a wireless intravascular medical device |
US20070075905A1 (en) * | 2005-10-05 | 2007-04-05 | Kenergy, Inc. | Radio frequency antenna for a wireless intravascular medical device |
US20070135882A1 (en) * | 2005-12-09 | 2007-06-14 | Drasler William J | Cardiac stimulation system |
US20080021532A1 (en) * | 2006-07-21 | 2008-01-24 | Kveen Graig L | Delivery of cardiac stimulation devices |
US20080021505A1 (en) * | 2006-07-21 | 2008-01-24 | Roger Hastings | Electrical stimulation of body tissue using interconnected electrode assemblies |
US20080039904A1 (en) * | 2006-08-08 | 2008-02-14 | Cherik Bulkes | Intravascular implant system |
US20080077188A1 (en) * | 2006-09-27 | 2008-03-27 | Stephen Denker | Intravascular stimulation system with wireless power supply |
US20080077184A1 (en) * | 2006-09-27 | 2008-03-27 | Stephen Denker | Intravascular Stimulation System With Wireless Power Supply |
Cited By (195)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8301248B1 (en) | 2002-03-06 | 2012-10-30 | Boston Scientific Neuromodulation Corporation | Sequenced and simultaneous stimulation for treating congestive heart failure |
US10076658B2 (en) | 2004-10-20 | 2018-09-18 | Cardiac Pacemakers, Inc. | Leadless cardiac stimulation systems |
US20080109054A1 (en) * | 2004-10-20 | 2008-05-08 | Scimed Life Systems, Inc. | Leadless Cardiac Stimulation Systems |
US20060085039A1 (en) * | 2004-10-20 | 2006-04-20 | Hastings Roger N | Leadless cardiac stimulation systems |
US9925386B2 (en) | 2004-10-20 | 2018-03-27 | Cardiac Pacemakers, Inc. | Leadless cardiac stimulation systems |
US7532933B2 (en) | 2004-10-20 | 2009-05-12 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US7647109B2 (en) | 2004-10-20 | 2010-01-12 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US7650186B2 (en) | 2004-10-20 | 2010-01-19 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US10850092B2 (en) | 2004-10-20 | 2020-12-01 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US8478408B2 (en) | 2004-10-20 | 2013-07-02 | Boston Scientific Scimed Inc. | Leadless cardiac stimulation systems |
US9072911B2 (en) | 2004-10-20 | 2015-07-07 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US9545513B2 (en) | 2004-10-20 | 2017-01-17 | Cardiac Pacemakers, Inc. | Leadless cardiac stimulation systems |
US10493288B2 (en) | 2004-10-20 | 2019-12-03 | Boston Scientific Scimed Inc. | Leadless cardiac stimulation systems |
US8340780B2 (en) | 2004-10-20 | 2012-12-25 | Scimed Life Systems, Inc. | Leadless cardiac stimulation systems |
US10029092B2 (en) | 2004-10-20 | 2018-07-24 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US8332036B2 (en) | 2004-10-20 | 2012-12-11 | Boston Scientific Scimed, Inc. | Leadless cardiac stimulation systems |
US20080263524A1 (en) * | 2005-09-09 | 2008-10-23 | International Business Machines Corporation | Method and System for State Machine Translation |
US20070135882A1 (en) * | 2005-12-09 | 2007-06-14 | Drasler William J | Cardiac stimulation system |
US10022538B2 (en) | 2005-12-09 | 2018-07-17 | Boston Scientific Scimed, Inc. | Cardiac stimulation system |
US7848823B2 (en) | 2005-12-09 | 2010-12-07 | Boston Scientific Scimed, Inc. | Cardiac stimulation system |
US11154247B2 (en) | 2005-12-09 | 2021-10-26 | Boston Scientific Scimed, Inc. | Cardiac stimulation system |
US11766219B2 (en) | 2005-12-09 | 2023-09-26 | Boston Scientific Scimed, Inc. | Cardiac stimulation system |
US8050774B2 (en) | 2005-12-22 | 2011-11-01 | Boston Scientific Scimed, Inc. | Electrode apparatus, systems and methods |
US9662487B2 (en) | 2006-07-21 | 2017-05-30 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US7840281B2 (en) | 2006-07-21 | 2010-11-23 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US8290600B2 (en) | 2006-07-21 | 2012-10-16 | Boston Scientific Scimed, Inc. | Electrical stimulation of body tissue using interconnected electrode assemblies |
US11338130B2 (en) | 2006-07-21 | 2022-05-24 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US20080021505A1 (en) * | 2006-07-21 | 2008-01-24 | Roger Hastings | Electrical stimulation of body tissue using interconnected electrode assemblies |
US9308374B2 (en) | 2006-07-21 | 2016-04-12 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US8185213B2 (en) | 2006-07-21 | 2012-05-22 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US10426952B2 (en) | 2006-07-21 | 2019-10-01 | Boston Scientific Scimed, Inc. | Delivery of cardiac stimulation devices |
US9956401B2 (en) | 2006-09-13 | 2018-05-01 | Boston Scientific Scimed, Inc. | Cardiac stimulation using intravascularly-deliverable electrode assemblies |
US8644934B2 (en) | 2006-09-13 | 2014-02-04 | Boston Scientific Scimed Inc. | Cardiac stimulation using leadless electrode assemblies |
US9393405B2 (en) | 2008-02-07 | 2016-07-19 | Cardiac Pacemakers, Inc. | Wireless tissue electrostimulation |
US8204605B2 (en) | 2008-02-07 | 2012-06-19 | Cardiac Pacemakers, Inc. | Multi-site atrial electrostimulation |
US9795797B2 (en) | 2008-02-07 | 2017-10-24 | Cardiac Pacemakers, Inc. | Wireless tissue electrostimulation |
US10307604B2 (en) | 2008-02-07 | 2019-06-04 | Cardiac Pacemakers, Inc. | Wireless tissue electrostimulation |
US8738147B2 (en) | 2008-02-07 | 2014-05-27 | Cardiac Pacemakers, Inc. | Wireless tissue electrostimulation |
US8483838B2 (en) | 2008-04-23 | 2013-07-09 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US7917226B2 (en) | 2008-04-23 | 2011-03-29 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US20110152971A1 (en) * | 2008-04-23 | 2011-06-23 | Enteromedics Inc. | Antenna arrangements for implantable therapy device |
US20140039570A1 (en) * | 2012-08-01 | 2014-02-06 | Nanostim, Inc. | Biostimulator circuit with flying cell |
US20200324123A1 (en) * | 2012-08-01 | 2020-10-15 | Pacesetter, Inc. | Biostimulator circuit with flying cell |
US11938330B2 (en) | 2012-08-01 | 2024-03-26 | Pacesetter, Inc. | Implantable leadless pacemakers |
US20180008833A1 (en) * | 2012-08-01 | 2018-01-11 | Pacesetter, Inc. | Biostimulator Circuit with Flying Cell |
US11759646B2 (en) * | 2012-08-01 | 2023-09-19 | Pacesetter, Inc. | Biostimulator circuit with flying cell |
US9802054B2 (en) * | 2012-08-01 | 2017-10-31 | Pacesetter, Inc. | Biostimulator circuit with flying cell |
US10744332B2 (en) * | 2012-08-01 | 2020-08-18 | Pacesetter, Inc. | Biostimulator circuit with flying cell |
US10933235B2 (en) | 2013-06-24 | 2021-03-02 | Sorin Crm Sas | Coupling system between a medical device and implantation accessory |
US9974948B2 (en) | 2013-06-24 | 2018-05-22 | Sorin Crm Sas | Coupling system between a medical device and its implantation accessory |
EP2818202A1 (en) * | 2013-06-24 | 2014-12-31 | Sorin CRM SAS | Coupling system between a medical device and an accessory for in situ implantation thereof |
US9889295B2 (en) | 2013-06-24 | 2018-02-13 | Sorin Crm S.A.S. | Intracardiac capsule and an implantation accessory for use with the femoral artery |
US10695559B2 (en) | 2013-06-24 | 2020-06-30 | Sorin Crm Sas | Intracardiac capsule and an implantation accessory for use with the femoral artery |
EP2818201A1 (en) * | 2013-06-24 | 2014-12-31 | Sorin CRM SAS | Intracardiac capsule and accessory for in situ implantation by the femoral route |
US11478637B2 (en) | 2013-06-24 | 2022-10-25 | Sorin Crm Sas | Intracardiac capsule and an implantation accessory for use with the femoral artery |
US9333342B2 (en) * | 2013-07-22 | 2016-05-10 | Cardiac Pacemakers, Inc. | System and methods for chronic fixation of medical devices |
US20150025612A1 (en) * | 2013-07-22 | 2015-01-22 | Cardiac Pacemakers, Inc. | System and methods for chronic fixation of medical devices |
US11400281B2 (en) | 2013-07-31 | 2022-08-02 | Medtronic, Inc. | Fixation for implantable medical devices |
US10518084B2 (en) | 2013-07-31 | 2019-12-31 | Medtronic, Inc. | Fixation for implantable medical devices |
US10857353B2 (en) | 2013-08-16 | 2020-12-08 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US9480850B2 (en) | 2013-08-16 | 2016-11-01 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker and retrieval device |
US9393427B2 (en) | 2013-08-16 | 2016-07-19 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US11446511B2 (en) | 2013-08-16 | 2022-09-20 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US10625085B2 (en) | 2013-08-16 | 2020-04-21 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US10722723B2 (en) | 2013-08-16 | 2020-07-28 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US11666752B2 (en) | 2013-08-16 | 2023-06-06 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US9700732B2 (en) | 2013-08-16 | 2017-07-11 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker and retrieval device |
US10286220B2 (en) | 2013-08-16 | 2019-05-14 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US10265503B2 (en) | 2013-08-16 | 2019-04-23 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US10981008B2 (en) | 2013-08-16 | 2021-04-20 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US10842993B2 (en) | 2013-08-16 | 2020-11-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US9492674B2 (en) | 2013-08-16 | 2016-11-15 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
US10179236B2 (en) | 2013-08-16 | 2019-01-15 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US9592391B2 (en) | 2014-01-10 | 2017-03-14 | Cardiac Pacemakers, Inc. | Systems and methods for detecting cardiac arrhythmias |
US10722720B2 (en) | 2014-01-10 | 2020-07-28 | Cardiac Pacemakers, Inc. | Methods and systems for improved communication between medical devices |
US10420932B2 (en) | 2014-04-29 | 2019-09-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with retrieval features |
US10080887B2 (en) | 2014-04-29 | 2018-09-25 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices including tissue engagement verification |
US11717677B2 (en) | 2014-04-29 | 2023-08-08 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with retrieval features |
US9795781B2 (en) | 2014-04-29 | 2017-10-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with retrieval features |
US10390720B2 (en) | 2014-07-17 | 2019-08-27 | Medtronic, Inc. | Leadless pacing system including sensing extension |
US10674928B2 (en) | 2014-07-17 | 2020-06-09 | Medtronic, Inc. | Leadless pacing system including sensing extension |
US9399140B2 (en) | 2014-07-25 | 2016-07-26 | Medtronic, Inc. | Atrial contraction detection by a ventricular leadless pacing device for atrio-synchronous ventricular pacing |
USRE48197E1 (en) | 2014-07-25 | 2020-09-08 | Medtronic, Inc. | Atrial contraction detection by a ventricular leadless pacing device for atrio-synchronous ventricular pacing |
US9526909B2 (en) | 2014-08-28 | 2016-12-27 | Cardiac Pacemakers, Inc. | Medical device with triggered blanking period |
US9492668B2 (en) | 2014-11-11 | 2016-11-15 | Medtronic, Inc. | Mode switching by a ventricular leadless pacing device |
US9724519B2 (en) | 2014-11-11 | 2017-08-08 | Medtronic, Inc. | Ventricular leadless pacing device mode switching |
US9808628B2 (en) | 2014-11-11 | 2017-11-07 | Medtronic, Inc. | Mode switching by a ventricular leadless pacing device |
US9623234B2 (en) | 2014-11-11 | 2017-04-18 | Medtronic, Inc. | Leadless pacing device implantation |
US10279168B2 (en) | 2014-11-11 | 2019-05-07 | Medtronic, Inc. | Leadless pacing device implantation |
US9492669B2 (en) | 2014-11-11 | 2016-11-15 | Medtronic, Inc. | Mode switching by a ventricular leadless pacing device |
US9289612B1 (en) | 2014-12-11 | 2016-03-22 | Medtronic Inc. | Coordination of ventricular pacing in a leadless pacing system |
US11020595B2 (en) | 2015-02-06 | 2021-06-01 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US9669230B2 (en) | 2015-02-06 | 2017-06-06 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11224751B2 (en) | 2015-02-06 | 2022-01-18 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US10220213B2 (en) | 2015-02-06 | 2019-03-05 | Cardiac Pacemakers, Inc. | Systems and methods for safe delivery of electrical stimulation therapy |
US10238882B2 (en) | 2015-02-06 | 2019-03-26 | Cardiac Pacemakers | Systems and methods for treating cardiac arrhythmias |
US10046167B2 (en) | 2015-02-09 | 2018-08-14 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US11020600B2 (en) | 2015-02-09 | 2021-06-01 | Cardiac Pacemakers, Inc. | Implantable medical device with radiopaque ID tag |
US11285326B2 (en) | 2015-03-04 | 2022-03-29 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
US11476927B2 (en) | 2015-03-18 | 2022-10-18 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
US10213610B2 (en) | 2015-03-18 | 2019-02-26 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
US10050700B2 (en) | 2015-03-18 | 2018-08-14 | Cardiac Pacemakers, Inc. | Communications in a medical device system with temporal optimization |
US10946202B2 (en) | 2015-03-18 | 2021-03-16 | Cardiac Pacemakers, Inc. | Communications in a medical device system with link quality assessment |
CN107592821A (en) * | 2015-05-13 | 2018-01-16 | 美敦力公司 | Implanted medical apparatus is secured in place to reduce perforation simultaneously |
US9853743B2 (en) | 2015-08-20 | 2017-12-26 | Cardiac Pacemakers, Inc. | Systems and methods for communication between medical devices |
US10357159B2 (en) | 2015-08-20 | 2019-07-23 | Cardiac Pacemakers, Inc | Systems and methods for communication between medical devices |
US9968787B2 (en) | 2015-08-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Spatial configuration of a motion sensor in an implantable medical device |
US10709892B2 (en) | 2015-08-27 | 2020-07-14 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US9956414B2 (en) | 2015-08-27 | 2018-05-01 | Cardiac Pacemakers, Inc. | Temporal configuration of a motion sensor in an implantable medical device |
US10137305B2 (en) | 2015-08-28 | 2018-11-27 | Cardiac Pacemakers, Inc. | Systems and methods for behaviorally responsive signal detection and therapy delivery |
US10589101B2 (en) | 2015-08-28 | 2020-03-17 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10226631B2 (en) | 2015-08-28 | 2019-03-12 | Cardiac Pacemakers, Inc. | Systems and methods for infarct detection |
US10159842B2 (en) | 2015-08-28 | 2018-12-25 | Cardiac Pacemakers, Inc. | System and method for detecting tamponade |
US10092760B2 (en) | 2015-09-11 | 2018-10-09 | Cardiac Pacemakers, Inc. | Arrhythmia detection and confirmation |
US10065041B2 (en) | 2015-10-08 | 2018-09-04 | Cardiac Pacemakers, Inc. | Devices and methods for adjusting pacing rates in an implantable medical device |
US20170119999A1 (en) * | 2015-10-29 | 2017-05-04 | Medtronic, Inc. | Interventional medical systems, associated assemblies and methods |
US10434283B2 (en) * | 2015-10-29 | 2019-10-08 | Medtronic, Inc. | Interventional medical systems, associated assemblies and methods |
US10183170B2 (en) | 2015-12-17 | 2019-01-22 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10933245B2 (en) | 2015-12-17 | 2021-03-02 | Cardiac Pacemakers, Inc. | Conducted communication in a medical device system |
US10905886B2 (en) | 2015-12-28 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device for deployment across the atrioventricular septum |
US10583303B2 (en) | 2016-01-19 | 2020-03-10 | Cardiac Pacemakers, Inc. | Devices and methods for wirelessly recharging a rechargeable battery of an implantable medical device |
US10463853B2 (en) | 2016-01-21 | 2019-11-05 | Medtronic, Inc. | Interventional medical systems |
US11027125B2 (en) | 2016-01-21 | 2021-06-08 | Medtronic, Inc. | Interventional medical devices, device systems, and fixation components thereof |
US10350423B2 (en) | 2016-02-04 | 2019-07-16 | Cardiac Pacemakers, Inc. | Delivery system with force sensor for leadless cardiac device |
US11116988B2 (en) | 2016-03-31 | 2021-09-14 | Cardiac Pacemakers, Inc. | Implantable medical device with rechargeable battery |
US10668294B2 (en) | 2016-05-10 | 2020-06-02 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker configured for over the wire delivery |
US10328272B2 (en) | 2016-05-10 | 2019-06-25 | Cardiac Pacemakers, Inc. | Retrievability for implantable medical devices |
US10881868B2 (en) | 2016-05-24 | 2021-01-05 | Sorin Crm Sas | Torque limiting mechanism between a medical device and its implantation accessory |
US11497921B2 (en) | 2016-06-27 | 2022-11-15 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed p-waves for resynchronization pacing management |
US10512784B2 (en) | 2016-06-27 | 2019-12-24 | Cardiac Pacemakers, Inc. | Cardiac therapy system using subcutaneously sensed P-waves for resynchronization pacing management |
US11207527B2 (en) | 2016-07-06 | 2021-12-28 | Cardiac Pacemakers, Inc. | Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10426962B2 (en) | 2016-07-07 | 2019-10-01 | Cardiac Pacemakers, Inc. | Leadless pacemaker using pressure measurements for pacing capture verification |
US10688304B2 (en) | 2016-07-20 | 2020-06-23 | Cardiac Pacemakers, Inc. | Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system |
US10391319B2 (en) | 2016-08-19 | 2019-08-27 | Cardiac Pacemakers, Inc. | Trans septal implantable medical device |
US10870008B2 (en) | 2016-08-24 | 2020-12-22 | Cardiac Pacemakers, Inc. | Cardiac resynchronization using fusion promotion for timing management |
US10780278B2 (en) | 2016-08-24 | 2020-09-22 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing |
US11464982B2 (en) | 2016-08-24 | 2022-10-11 | Cardiac Pacemakers, Inc. | Integrated multi-device cardiac resynchronization therapy using p-wave to pace timing |
US10758737B2 (en) | 2016-09-21 | 2020-09-01 | Cardiac Pacemakers, Inc. | Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter |
US10905889B2 (en) | 2016-09-21 | 2021-02-02 | Cardiac Pacemakers, Inc. | Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery |
US10994145B2 (en) | 2016-09-21 | 2021-05-04 | Cardiac Pacemakers, Inc. | Implantable cardiac monitor |
US10434314B2 (en) | 2016-10-27 | 2019-10-08 | Cardiac Pacemakers, Inc. | Use of a separate device in managing the pace pulse energy of a cardiac pacemaker |
US10758724B2 (en) | 2016-10-27 | 2020-09-01 | Cardiac Pacemakers, Inc. | Implantable medical device delivery system with integrated sensor |
US11305125B2 (en) | 2016-10-27 | 2022-04-19 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10765871B2 (en) | 2016-10-27 | 2020-09-08 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10463305B2 (en) | 2016-10-27 | 2019-11-05 | Cardiac Pacemakers, Inc. | Multi-device cardiac resynchronization therapy with timing enhancements |
US10413733B2 (en) | 2016-10-27 | 2019-09-17 | Cardiac Pacemakers, Inc. | Implantable medical device with gyroscope |
US10561330B2 (en) | 2016-10-27 | 2020-02-18 | Cardiac Pacemakers, Inc. | Implantable medical device having a sense channel with performance adjustment |
US10434317B2 (en) | 2016-10-31 | 2019-10-08 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10617874B2 (en) | 2016-10-31 | 2020-04-14 | Cardiac Pacemakers, Inc. | Systems and methods for activity level pacing |
US10583301B2 (en) | 2016-11-08 | 2020-03-10 | Cardiac Pacemakers, Inc. | Implantable medical device for atrial deployment |
US10632313B2 (en) | 2016-11-09 | 2020-04-28 | Cardiac Pacemakers, Inc. | Systems, devices, and methods for setting cardiac pacing pulse parameters for a cardiac pacing device |
US10881869B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Wireless re-charge of an implantable medical device |
US10639486B2 (en) | 2016-11-21 | 2020-05-05 | Cardiac Pacemakers, Inc. | Implantable medical device with recharge coil |
US10894163B2 (en) | 2016-11-21 | 2021-01-19 | Cardiac Pacemakers, Inc. | LCP based predictive timing for cardiac resynchronization |
US11147979B2 (en) | 2016-11-21 | 2021-10-19 | Cardiac Pacemakers, Inc. | Implantable medical device with a magnetically permeable housing and an inductive coil disposed about the housing |
US10881863B2 (en) | 2016-11-21 | 2021-01-05 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with multimode communication |
US11207532B2 (en) | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
US10835753B2 (en) | 2017-01-26 | 2020-11-17 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US11590353B2 (en) | 2017-01-26 | 2023-02-28 | Cardiac Pacemakers, Inc. | Intra-body device communication with redundant message transmission |
US10029107B1 (en) | 2017-01-26 | 2018-07-24 | Cardiac Pacemakers, Inc. | Leadless device with overmolded components |
US10737102B2 (en) | 2017-01-26 | 2020-08-11 | Cardiac Pacemakers, Inc. | Leadless implantable device with detachable fixation |
US10821288B2 (en) | 2017-04-03 | 2020-11-03 | Cardiac Pacemakers, Inc. | Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate |
US10905872B2 (en) | 2017-04-03 | 2021-02-02 | Cardiac Pacemakers, Inc. | Implantable medical device with a movable electrode biased toward an extended position |
US11065459B2 (en) | 2017-08-18 | 2021-07-20 | Cardiac Pacemakers, Inc. | Implantable medical device with pressure sensor |
US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
US11235163B2 (en) | 2017-09-20 | 2022-02-01 | Cardiac Pacemakers, Inc. | Implantable medical device with multiple modes of operation |
US11185703B2 (en) | 2017-11-07 | 2021-11-30 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker for bundle of his pacing |
US11260216B2 (en) | 2017-12-01 | 2022-03-01 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials during ventricular filling from a ventricularly implanted leadless cardiac pacemaker |
US11071870B2 (en) | 2017-12-01 | 2021-07-27 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker |
US11052258B2 (en) | 2017-12-01 | 2021-07-06 | Cardiac Pacemakers, Inc. | Methods and systems for detecting atrial contraction timing fiducials within a search window from a ventricularly implanted leadless cardiac pacemaker |
US11813463B2 (en) | 2017-12-01 | 2023-11-14 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with reversionary behavior |
US10874861B2 (en) | 2018-01-04 | 2020-12-29 | Cardiac Pacemakers, Inc. | Dual chamber pacing without beat-to-beat communication |
US11529523B2 (en) | 2018-01-04 | 2022-12-20 | Cardiac Pacemakers, Inc. | Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone |
US20190255318A1 (en) * | 2018-02-16 | 2019-08-22 | Chengjun Guo | Intra-cardiac implant, cardiac pacemaker, implantation device and method for implanting intra-cardiac implant |
US11058873B2 (en) * | 2018-02-16 | 2021-07-13 | Chengjun Guo | Intra-cardiac implant, cardiac pacemaker, implantation device and method for implanting intra-cardiac implant |
CN108434600A (en) * | 2018-02-26 | 2018-08-24 | 郭成军 | Chambers of the heart implant, pacemaker, implanted device and method for implantation |
US11235159B2 (en) | 2018-03-23 | 2022-02-01 | Medtronic, Inc. | VFA cardiac resynchronization therapy |
US11058880B2 (en) | 2018-03-23 | 2021-07-13 | Medtronic, Inc. | VFA cardiac therapy for tachycardia |
US11819699B2 (en) | 2018-03-23 | 2023-11-21 | Medtronic, Inc. | VfA cardiac resynchronization therapy |
US11400296B2 (en) | 2018-03-23 | 2022-08-02 | Medtronic, Inc. | AV synchronous VfA cardiac therapy |
WO2019212733A1 (en) * | 2018-04-30 | 2019-11-07 | Khairkhahan Sebastian | Pericardial space access device and method |
US11235161B2 (en) | 2018-09-26 | 2022-02-01 | Medtronic, Inc. | Capture in ventricle-from-atrium cardiac therapy |
US11229799B2 (en) | 2018-10-17 | 2022-01-25 | Cairdac | System for coupling a cardiac autonomous capsule to a tool for implanting the same |
US11951313B2 (en) | 2018-11-17 | 2024-04-09 | Medtronic, Inc. | VFA delivery systems and methods |
US11679265B2 (en) | 2019-02-14 | 2023-06-20 | Medtronic, Inc. | Lead-in-lead systems and methods for cardiac therapy |
US11759632B2 (en) | 2019-03-28 | 2023-09-19 | Medtronic, Inc. | Fixation components for implantable medical devices |
US11697025B2 (en) | 2019-03-29 | 2023-07-11 | Medtronic, Inc. | Cardiac conduction system capture |
US11213676B2 (en) | 2019-04-01 | 2022-01-04 | Medtronic, Inc. | Delivery systems for VfA cardiac therapy |
US11712188B2 (en) | 2019-05-07 | 2023-08-01 | Medtronic, Inc. | Posterior left bundle branch engagement |
US11684776B2 (en) * | 2019-08-13 | 2023-06-27 | Medtronic, Inc. | Fixation component for multi-electrode implantable medical device |
US20210046306A1 (en) * | 2019-08-13 | 2021-02-18 | Medtronic, Inc. | Fixation component for multi-electrode implantable medical device |
US11305127B2 (en) | 2019-08-26 | 2022-04-19 | Medtronic Inc. | VfA delivery and implant region detection |
US11813466B2 (en) | 2020-01-27 | 2023-11-14 | Medtronic, Inc. | Atrioventricular nodal stimulation |
US11911168B2 (en) | 2020-04-03 | 2024-02-27 | Medtronic, Inc. | Cardiac conduction system therapy benefit determination |
US11813464B2 (en) | 2020-07-31 | 2023-11-14 | Medtronic, Inc. | Cardiac conduction system evaluation |
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JP2009518116A (en) | 2009-05-07 |
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EP1957148A1 (en) | 2008-08-20 |
US10022538B2 (en) | 2018-07-17 |
ATE493167T1 (en) | 2011-01-15 |
US20230389876A1 (en) | 2023-12-07 |
JP5073672B2 (en) | 2012-11-14 |
DE602006020328D1 (en) | 2011-04-07 |
EP1957147A1 (en) | 2008-08-20 |
US11154247B2 (en) | 2021-10-26 |
ATE499142T1 (en) | 2011-03-15 |
JP2009518115A (en) | 2009-05-07 |
US7848823B2 (en) | 2010-12-07 |
US20140039591A1 (en) | 2014-02-06 |
WO2007067231A1 (en) | 2007-06-14 |
DE602006019309D1 (en) | 2011-02-10 |
US20070135882A1 (en) | 2007-06-14 |
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