Multi-electrode epicardial pacing

Patent metadata

Field	Value
Publication number	US-11020589-B2
Application number	US-201916366754-A
Country	US
Kind code	B2
Filing date	Mar 27, 2019
Priority date	Mar 21, 2014
Publication date	Jun 1, 2021
Grant date	Jun 1, 2021

Abstract

Systems and methods for epicardial pacing are provided. For example, this document provides epicardial pacing using a percutaneously delivered bifurcated pacing lead that has multiple electrodes that are directionally insulated to prevent extracardiac stimulation, including prevention of phrenic stimulation. In addition, the devices, systems, and methods provided can be used for ablation, defibrillation, and/or defibrillation in combination with pacing.

First claim

What is claimed is:

1. An epicardial pacing lead device comprising:
a first shaft having one or more electrodes and insulation disposed thereon;
a second shaft having one or more electrodes and insulation disposed thereon; and
an elongate flexible spacing member that is slidably disposed in a lumen of either one of the first shaft or the second shaft but not in lumens of both the first and second shafts, and
wherein at least some of the electrodes are insulated by the insulation so as to inhibit emanation of electrical fields therefrom in a particular direction corresponding to locations of the insulation.

2. The epicardial pacing lead device of claim 1 , wherein the first shaft and the second shaft have the same number of electrodes.

3. The epicardial pacing lead device of claim 2 , wherein the epicardial pacing lead device is a bipolar epicardial pacing device.

4. The epicardial pacing lead device of claim 1 , further comprising a delivery sheath and wherein the first shaft and the second shaft are configured for deployment from one or more lumens defined by the delivery sheath.

5. The epicardial pacing lead device of claim 1 , wherein one or more of the electrodes that are insulated by the insulation are each insulated by the insulation so as to inhibit emanation of electrical fields therefrom in a same direction.

6. The epicardial pacing lead device of claim 1 , wherein the first shaft and the second shaft are distinctly separate distal end portions extending from a common shaft such that the separate distal end portions and the common shaft comprise a Y-shape.

7. The epicardial pacing lead device of claim 1 , wherein distal end portions of the first shaft and the second shaft are interconnected by the elongate flexible spacing member.

8. The epicardial pacing lead device of claim 7 , wherein the elongate flexible spacing member is movable by a clinician operator relative to only one of the first shaft and the second shaft to: (i) draw the distal end portions of the first shaft and the second shaft towards each other and (ii) separate the distal end portions of the first shaft and the second shaft away from each other.

9. The epicardial pacing lead device of claim 7 , wherein the elongate flexible spacing member is a first elongate flexible spacing member, and further comprising a second elongate flexible spacing member interconnecting the first shaft and the second shaft, and wherein the second elongate flexible spacing member is located proximally of the first elongate flexible spacing member.

10. The epicardial pacing lead device of claim 1 , further comprising a stabilization member interconnecting the first shaft and the second shaft, and wherein the stabilizing member projects away from a plane defined by the first shaft in combination with the second shaft.

11. The epicardial pacing lead device of claim 1 , further comprising an ancillary device that is slidably deliverable through the delivery sheath, and wherein the ancillary device includes an anchoring member.

12. An epicardial pacing device system comprising:
an epicardial pacing lead device comprising a shaft defining a lumen and having one or more electrodes and insulation disposed thereon, wherein at least some of the electrodes are insulated by the insulation so as to inhibit emanation of electrical fields therefrom in a particular direction corresponding to locations of the insulation, wherein the epicardial pacing lead device defines at least one aperture spaced between two adjacent electrodes of the one or more electrodes;
an imaging catheter that is slidably disposable within the lumen of the shaft, the imaging catheter including an imaging sensor sized for performing imaging through the at least one aperture; and
a delivery sheath, wherein a first lumen of the delivery sheath is configured to slidably receive the epicardial pacing lead device.

13. The epicardial pacing device system of claim 12 , wherein at least a distal end portion of the delivery sheath is steerable.

14. The epicardial pacing device system of claim 12 , wherein at least a distal end of the shaft is steerable.

Assignees

• Mayo Found Medical Education & Res
• St Annes Univ Hospital Brno

Inventors

• Syed Faisal F
• Bruce Charles J
• Desimone Christopher V
• Friedman Paul A
• Asirvatham Samuel J
• Kara Tomas
• Leinveber Pavel
• Novak Miroslav
• Starek Zdenek
• Wolf Jiri

Classifications

• A61B2018/00363

  Epicardium · CPC title

• A61B2018/00279

  deployable · CPC title

• A61N1/3627

  for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy · CPC title

• A61N1/0587 Primary

  Epicardial electrode systems; Endocardial electrodes piercing the pericardium · CPC title

• A61N1/39622

  Pacing therapy · CPC title