Implantable medical device for vascular deployment

Patent metadata

Field	Value
Publication number	US-11123570-B2
Application number	US-201816225570-A
Country	US
Kind code	B2
Filing date	Dec 19, 2018
Priority date	Dec 22, 2017
Publication date	Sep 21, 2021
Grant date	Sep 21, 2021

Abstract

A leadless pacing device may include a housing having a proximal end and a distal end, and a set of one or more electrodes supported by the housing. The housing may include a first a distal extension extending distally from the distal end thereof. The distal extension may include a retractable and/or rotatable distal electrode. The distal electrode may be configured to be delivered to and pace at the Bundle of His. The leadless pacing device may be releasably coupled to an expandable anchor mechanism.

First claim

What is claimed is:

1. A cardiac device configured for deployment within a patient's vasculature at a location near the patient's heart, the cardiac device comprising:
an elongated housing configured to be positioned within the patient's vasculature proximate the patient's heart, the elongated housing having a proximal end and a distal end;
a power source disposed within the elongated housing;
circuitry disposed within the elongated housing and operatively coupled to the power source, the circuitry configured to pace the patient's heart and/or sense electrical activity of the patient's heart;
a first electrode fixed relative to the elongated housing and operatively coupled to the circuitry;
a second electrode fixed relative to the elongated housing and operatively coupled to the circuitry, the second electrode spaced from the first electrode and positioned along a side wall of the elongated housing;
a distal extension extending distally from the distal end of the elongated housing, the distal extension defining a lumen extending from a side port proximate a proximal end of the distal extension to a distal opening proximate a distal end of the distal extension and including a distal electrode positioned at distal end thereof and operatively coupled to the circuitry and configured to provide pacing pulses to the Bundle of His; and
an expandable tubular member releasably coupled to the elongated housing such that the elongated housing is disposed at least partially inside the tubular member, the expandable tubular member having a collapsed configuration for delivery and an expanded configuration that anchors the cardiac device within the patient's vasculature.

2. The cardiac device of claim 1 , wherein the distal electrode is slidably and rotatably disposed within the lumen of the distal extension.

3. The cardiac device of claim 1 , further comprising an actuator disposed within the lumen of the distal extension and coupled to the distal electrode.

4. The cardiac device of claim 3 , wherein the actuator is configured to direct the distal electrode toward a side wall of the patient's vasculature.

5. The cardiac device of claim 1 , wherein the distal electrode comprises a helical electrode.

6. The cardiac device of claim 5 , wherein the helical electrode is configured to be in contact with the Bundle of His.

7. The cardiac device of claim 1 , wherein the distal electrode comprises a curved tine electrode.

8. The cardiac device of claim 7 , wherein the curved tine electrode is configured to be in contact with the Bundle of His.

9. The cardiac device of claim 1 , wherein the distal extension increases in flexibility from the proximal end to the distal end.

10. The cardiac device of claim 1 , further comprising one or more intermediate electrodes positioned on the distal extension at a location proximal to the distal electrode.

11. The cardiac device of claim 1 , wherein the expandable tubular member is configured to bring at least one of the first or second electrodes of the housing in contact with a vessel wall.

12. The cardiac device of claim 1 , wherein the expandable tubular member is configured to anchor the cardiac device in the patient's superior vena cava proximate the patient's right atrium.

13. The cardiac device of claim 1 , wherein the expandable tubular member is configured to anchor the cardiac device in the patient's inferior vena cava proximate the patient's right atrium.

14. The cardiac device of claim 1 , wherein the distal extension is configured to extend into the right atrium.

15. The cardiac device of claim 10 , wherein the one or more intermediate electrodes are configured to sense atrial events.

16. A cardiac device configured for deployment within a patient's vasculature at a location near the patient's heart, the cardiac device comprising:
a housing configured to be positioned within the patient's vena cava proximate the patient's right atrium, the elongated housing having a proximal end and a distal end;
a power source disposed within the elongated housing;
circuitry disposed within the elongated housing and operatively coupled to the power source, the circuitry configured to pace the patient's heart and/or sense electrical activity of the patient's heart;
a first electrode fixed relative to the elongated housing and operatively coupled to the circuitry;
a second electrode fixed relative to the elongated housing and operatively coupled to the circuitry, the second electrode spaced from the first electrode and positioned along a side wall of the elongated housing;
an expandable tubular member releasably coupled to the elongated housing, the expandable tubular member having a collapsed configuration for delivery and an expanded configuration that locates the cardiac device within the patient's vasculature; and
a distal extension extending distally from the distal end of the elongated housing, the distal extension comprising:
a lumen extending from a side port proximate a proximal end of the distal extension to a distal opening proximate a distal end of the distal extension;
a distal electrode positioned at distal end thereof and operatively coupled to the circuitry and configured to provide pacing pulses to the Bundle of His; and
an actuator slidably and rotatably disposed within the lumen of the distal extension and mechanically coupled to the distal electrode, wherein the actuator has a curved end configured to direct the distal ends way from a longitudinal axis of the distal extension when the actuator is distally actuated.

17. The cardiac device of claim 16 , wherein the distal electrode comprises a helical electrode.

18. The cardiac device of claim 16 , wherein the distal electrode comprises a curved tine electrode.

19. The cardiac device of claim 16 , wherein the expandable anchoring device is configured to position a side wall of the elongated housing in contact with a vessel wall.

20. A cardiac device configured for deployment within a patient's vasculature at a location near the patient's heart, the cardiac device comprising:
a housing configured to be positioned within the patient's vena cava proximate the patient's right atrium, the elongated housing having a proximal end and a distal end;
a power source disposed within the elongated housing;
circuitry disposed within the elongated housing and operatively coupled to the power source, the circuitry configured to pace the patient's heart and/or sense electrical activity of the patient's heart;
a first electrode fixed relative to the elongated housing and operatively coupled to the circuitry;
a second electrode fixed relative to the elongated housing and operatively coupled to the circuitry, the second electrode spaced from the first electrode and positioned along a side wall of the elongated housing;
an expandable tubular member releasably coupled to the elongated housing, the expandable tubular member having a collapsed configuration for delivery and an expanded configuration that locates the cardiac device within the patient's vasculature; and
a distal extension extending distally from the distal end of the elongated housing and configured to be positioned in the right atrium, the distal extension comprising:
a lumen extending from a side port proximate a proximal end of the distal extension to a distal opening proximate a distal end of the distal extension;
a distal helical electrode positioned at distal end thereof and operatively coupled to the circuitry and configured to provide pacing pulses to the Bundle of H

Assignees

• Cardiac Pacemakers Inc

Inventors

• Koop Brendan Early
• Haasl Benjamin J
• Shuros Allan Charles
• Gilkerson James O
• Liu Lili
• Maile Keith R
• Soltis Brian
• Fellows Brandon Christopher

Classifications

• A61N1/37518

  Anchoring of the implants, e.g. fixation · CPC title

• A61N1/365

  controlled by a physiological parameter, e.g. heart potential {(evoked response A61N1/371)} · CPC title

• A61N1/056

  Transvascular endocardial electrode systems · CPC title

• A61N1/37288

  Communication to several implantable medical devices within one patient · CPC title

• A61N1/057

  Anchoring means; Means for fixing the head inside the heart · CPC title