Catheter-based system for delivery and retrieval of a leadless pacemaker

Patent metadata

Field	Value
Publication number	US-10758271-B2
Application number	US-201715783475-A
Country	US
Kind code	B2
Filing date	Oct 13, 2017
Priority date	Oct 14, 2016
Publication date	Sep 1, 2020
Grant date	Sep 1, 2020

Abstract

Catheter-based delivery systems for delivery and retrieval of a leadless pacemaker include features to facilitate improved manipulation of the catheter and improved capture and docking functionality of leadless pacemakers. Such functionality includes mechanisms directed to deflecting and locking a deflectable catheter, maintaining tension on a retrieval feature, protection from anti-rotation, and improved docking cap and drive gear assemblies.

First claim

What is claimed is:

1. A system for retrieving an implantable medical device from within a patient, the system comprising:
a torque shaft;
a retrieval feature extending through the torque shaft; and
a handle coupled to the torque shaft such that rotation of the handle rotates the torque shaft, the handle comprising:
a torsion release assembly coupled to the retrieval feature and comprising a first gear, the torsion release assembly rotationally supported within the handle; and
a shuttle coupled to the handle and comprising a second gear,
wherein the shuttle is translatable between a first shuttle position in which the first gear is engaged with the second gear such that rotation of the handle rotates the torsion release assembly, and a second shuttle position in which the first gear is disengaged from the second gear such that rotation of the handle does not rotate the torsion release assembly.

2. The system of claim 1 , wherein the first shuttle position corresponds to a proximal shuttle position and the second shuttle position is a distal shuttle position.

3. The system of claim 1 , wherein, when in the second shuttle position, the first gear is disposed within the second gear.

4. The system of claim 1 , further comprising a bearing disposed within the housing, the torsion release assembly rotationally supported within the handle by the bearing.

5. The system of claim 4 , wherein the bearing includes a ball bearing comprising at least one of metal or plastic balls.

6. The system of claim 1 , wherein the shuttle is rotationally fixed relative to the handle.

7. The system of claim 1 , wherein the first gear has a substantially square cross-section and the second gear defines a substantially square cavity into which the first gear is inserted when the shuttle is in the first shuttle position.

8. The system of claim 7 , wherein
the second gear extends along a longitudinal axis, the longitudinal axis being normal to a cross-sectional plane of the second gear, and
the second gear comprises a proximal gear end, the proximal gear end comprising:
a first half having a first face defining a first plane oriented at a first angle relative to the cross-sectional plane; and
a second half having a second face defining a second plane oriented at a second angle relative to the cross-sectional plane such that the first angle and the second angle are supplementary and the first plane and the second plane intersect along a line perpendicular to the longitudinal axis.

9. The system of claim 8 , wherein the first angle is from and including 35 degrees to and including 55 degrees.

10. The system of claim 1 , wherein the first gear comprises a shaft and a plurality of first splines extending along the shaft, the second gear comprises at least one second spline extending parallel to each of the plurality of first splines, and, when in the second position, the at least one second spline is disposed between adjacent splines of the plurality of first splines.

11. The system of claim 1 , wherein the retrieval feature is configured to couple to an implantable medical device and to apply tension and tighten coupling between the torque shaft and the implantable medical device.

12. The system of claim 11 , wherein the retrieval feature is configured to couple to a corresponding retrieval feature of the implantable medical device.

13. The system of claim 11 , wherein the retrieval feature includes at least one of a snare, a tether, or a lasso.

14. A torsion release system for an elongated body of a medical device having a rotatable handle, the torsion release system comprising:
a first gear coupled to the elongated body and rotationally supported within the rotatable handle; and
a second gear rotationally fixed to the rotatable handle,
wherein the first gear and the second gear transition between a first configuration in which the first gear is engaged with the second gear such that rotation of the rotatable handle rotates the first gear and transmits torque to the elongated body, and a second configuration in which the first gear is disengaged from the second gear such that rotation of the handle does not rotate the first gear.

15. The torsion release system of claim 14 , wherein transition between the first configuration and the second configuration includes translating the second gear between a first position corresponding to the first configuration and a second position corresponding to the second configuration.

16. The torsion release system of claim 14 , wherein, when in the second configuration, the first gear is freely rotatable within the housing.

17. The torsion release system of claim 14 , wherein the first gear is rotationally supported within the rotatable handle by a ball bearing.

18. The torsion release system of claim 14 , wherein in the second configuration the first gear is at least partially disposed within the second gear.

19. The torsion release system of claim 18 , wherein the first gear has a substantially square cross-section and the second gear defines a substantially square cavity into which the first gear is inserted in the second configuration.

20. A system for retrieving an implantable medical device from within a patient, the system comprising:
a torque shaft;
a retrieval feature extending through the torque shaft;
a handle coupled to the torque shaft such that rotation of the handle rotates the torque shaft;
a selectively rotatable body coupled to the retrieval feature; and
a shuttle rotationally fixed relative to the handle,
wherein the shuttle and selectively rotatable body transition between a first configuration in which the shuttle is engaged with the selectively rotatable body, thereby preventing rotation of the selectively rotatable body relative to the handle, and a second configuration in which the shuttle is disengaged from the selectively rotatable body and the selectively rotatable body is permitted to rotate relative to the handle.

21. The system of claim 20 , wherein the selectively rotatable body comprises a first gear and the shuttle comprises a second gear, the first gear engaging the second gear when in the first configuration.

22. The system of claim 20 , wherein, when the retrieval feature is under torsion in a first rotational direction and the system is in the first configuration, transition into the second configuration releases the torsion and causes rotation of the retrieval feature and the selectively rotatable body in a second rotational direction opposite the first direction.

23. The system of claim 20 , the system further comprising a rotatable mount disposed within the handle, wherein the selectively rotatable body is supported by the rotatable mount within the handle.

24. The system of claim 20 , wherein the retrieval feature is configured to couple to an implantable medical device and to apply tension and tighten coupling between the torque shaft and the implantable medical device.

25. The system of claim 24 , wherein the retrieval feature is configured to couple to a corresponding retrieval feature of the implantable medical device.

26. The system of claim 24 , wherein the retrieval feature includes at least one of a snare, a tether, or a lasso.

Assignees

• Pacesetter Inc

Inventors

• Goodman Daniel
• Coyle Daniel
• Rickheim David

Classifications

• A61N1/3756 Primary

  Casings with electrodes thereon, e.g. leadless stimulators · CPC title

• A61N1/37512

  Pacemakers · CPC title

• A61M25/0082

  Catheter tip comprising a tool · CPC title

• A61M25/0662

  Guide tubes · CPC title

• A61B17/32053

  Punch like cutting instruments, e.g. using a cylindrical or oval knife (A61B17/326 takes precedence; trepans A61B17/1695) · CPC title