Current steering to achieve spatial selectivity for his bundle pacing

Patent metadata

Field	Value
Publication number	US-11338145-B2
Application number	US-201916250715-A
Country	US
Kind code	B2
Filing date	Jan 17, 2019
Priority date	Jan 17, 2018
Publication date	May 24, 2022
Grant date	May 24, 2022

Abstract

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for pacing a HIS bundle of a patient. The apparatuses, systems, and methods may include applying stimulation energy through one or more of a plurality of electrodes to direct a stimulation locus and pace a HIS bundle of a patient.

First claim

We claim:

1. An apparatus comprising:
a lead body;
a plurality of electrodes arranged with the lead body configured with a distal portion of the lead body having a bias configured to force the distal portion of the lead body against a tissue wall circumferentially about an area corresponding to a HIS bundle of a patient; and
an implantable medical device coupled to the plurality of electrodes and configured to:
convey electrical energy to one or more of the plurality of electrodes to stimulate a portion of the HIS bundle of the patient at a stimulation locus;
analyze electrical signals via one or more of the plurality of electrodes in response to the conveyed electrical energy; and
displace the stimulation locus based on the analyzed signals to pace the HIS bundle of the patient;

wherein the distal portion of the lead body forms a spiral with the plurality of electrodes arranged with the spiral and the plurality of electrodes are directed toward a tissue wall about the HIS bundle; and
wherein the lead body includes a bias portion configured to stabilize the plurality of electrodes of the spiral against the tissue wall of the HIS bundle.

2. The apparatus of claim 1 , wherein the implantable medical device is configured to activate two or more of the electrodes to displace the stimulation locus between the plurality of electrodes.

3. The apparatus of claim 1 , wherein the distal portion of the lead body includes one or more expandable tines, and the plurality of electrodes are arranged on the one or more expandable tines.

4. The apparatus of claim 1 , wherein the distal portion of the lead body includes one or more wings extending outwardly from the distal portion relative to an end portion of the lead body, and the plurality of electrodes are arranged on at least one of the one or more wings and the end portion of the lead body.

5. The apparatus of claim 1 , wherein the distal portion of the lead body includes one or more expandable balloon portions, and the plurality of electrodes are arranged with the one or more expandable balloon portions.

6. The apparatus of claim 1 , wherein an end portion of the lead body includes the plurality of electrodes, and the plurality of electrodes are segmented by an insulative material.

7. The apparatus of claim 1 , further comprising a fixation helix arranged at a distal end of the lead body, the fixation helix configured to anchor the lead body to the tissue wall about the HIS bundle.

8. The apparatus of claim 7 , wherein the fixation helix is one of the plurality of electrodes.

9. The apparatus of claim 1 , wherein the implantable medical device is configured to pace the HIS bundle of the patient based on a comparison of an electrical delay of an atrial-His bundle (AH) delay and a mechanical response of a portion of a heart of the patient.

10. The apparatus of claim 9 , further comprising a lead body coupled to the implantable medical device and a sensor arranged with the lead body, and the sensor is configured to determine the mechanical response.

11. A system comprising:
a plurality of electrodes arranged with a lead body configured with a distal portion of the lead body having a bias configured to force the distal portion of the lead body against a tissue wall circumferentially about an area corresponding to a HIS bundle of a patient;
an implantable medical device coupled to the plurality of electrodes and configured to convey electrical energy to one or more of the plurality of electrodes to stimulate a portion of the HIS bundle of the patient at a stimulation locus and displace the stimulation locus to pace a HIS bundle of a patient; and
an external programmer configured to receive the signals from the implantable medical device, analyze electrical signals via one or more of the plurality of electrodes in response to the conveyed electrical energy and transmit stimulation parameters to the implantable medical device to define the displacement of the stimulation locus;
wherein the distal portion of the lead body forms a spiral with the plurality of electrodes arranged with the spiral and the plurality of electrodes are directed toward a tissue wall about the HIS bundle; and
wherein the lead body includes a bias portion configured to stabilize the plurality of electrodes of the spiral against the tissue wall of the HIS bundle.

12. The system of claim 11 , wherein the plurality of electrodes are separated by an insulative material to direct the electrical energy toward the HIS bundle of the patient.

13. The system of claim 11 , wherein the distal portion of the lead body forms a curvature, and the distal portion includes a bias configured to stabilize the plurality of electrodes against a tissue wall of the HIS bundle.

14. The system of claim 11 , wherein the distal portion of the lead body includes one or more expandable portions, and the plurality of electrodes are arranged on the one or more expandable portions.

15. The system of claim 11 , wherein the expandable portions include at least one of expandable tines, expandable wings, and an expandable balloon.

16. A method of pacing a HIS bundle of a patient, the method comprising:
arranging a plurality of electrodes at a HIS bundle of a patient, the plurality of electrodes being arranged with a lead body configured with a distal portion of the lead body having a bias configured to force the distal portion of the lead body against a tissue wall circumferentially about an area corresponding to a HIS bundle of a patient;
conveying electrical energy to one or more of the plurality of electrodes to stimulate a portion of the HIS bundle of the patient at a stimulation locus;
analyzing electrical signals via one or more of the plurality of electrodes in response to the conveyed electrical energy; and
displacing the stimulation locus based on the analyzed signals to pace the HIS bundle of the patient;
wherein the distal portion of the lead body forms a spiral with the plurality of electrodes arranged with the spiral and the plurality of electrodes are directed toward a tissue wall about the HIS bundle; and
wherein the lead body includes a bias portion configured to stabilize the plurality of electrodes of the spiral against the tissue wall of the HIS bundle.

17. The method of claim 16 , further comprising a implantable medical device and the plurality of electrodes are arranged with the lead body and further comprising directing the plurality of electrodes to apply the stimulation energy toward the HIS bundle using at least one of insulative material on the lead body and expandable portions arranged at the distal portion of the lead body.

18. The method of claim 17 , wherein the expandable portions include at least one of expandable tines, expandable wings, and an expandable balloon, and wherein the plurality of electrodes are arranged with the expandable portions.

Assignees

• Cardiac Pacemakers Inc

Inventors

• Thakur Pramodsingh H
• Shuros Allan C
• Soltis Brian
• Hincapie Juan G
• An Qi
• Yu Yinghong
• Maile Keith R

Classifications

• A61N1/37512

  Pacemakers · CPC title

• A61N1/0573 Primary

  chacterised by means penetrating the heart tissue, e.g. helix needle or hook · CPC title

• A61N1/056 Primary

  Transvascular endocardial electrode systems · CPC title

• A61N1/37518

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

• A61N1/3627

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