Leadless Cardiac Stimulation Systems

• US 20070150037A1
• Filed: 03/08/2007
• Published: 06/28/2007
• Est. Priority Date: 10/20/2004
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Smith, Scott, Hastings, Roger, Drasler, William, Sadasiva, Anupama, Lafontaine, Daniel
• Granted Patent: US 8,478,408 B2
• Time in Patent Office: Days
• US Class Current: 607/119
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/059 Anchoring means
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37223 Circuits for electromagnetic coupling
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna
• CPC Class Codes: A61N 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

Various configurations of systems that employ leadless electrodes to provide pacing therapy are provided. In one example, a system that provides multiple sites for pacing of myocardium of a heart includes wireless pacing electrodes that are implantable at sites proximate the myocardium using a percutaneous, transluminal, catheter delivery system. Each of the electrodes contains a source of electrical energy for pacing the myocardium and is adapted to receive electromagnetic energy from a source outside the myocardium. The system also includes a source adapted for placement outside the myocardium and that uses locally measured electrocardiograms to synchronize pacing of the heart by sending electromagnetic commands to the electrodes to pace the myocardium surrounding the electrodes. Also disclosed is various configurations of such systems, wireless electrode assemblies, and delivery catheters for delivering and implanting the electrode assemblies.

Claims

1. A catheter delivery system for implantation of wireless electrodes into the myocardium, comprising:

an elongate tube having a proximal end and a distal end and having a lumen passing therethrough;

an elongate rod having a proximal end and a distal end with a wireless electrode attached to its distal end, wherein the rod comprises a detachment mechanism to detach the wireless electrode from the rod following delivery of the wireless electrode to the myocardium, and wherein the rod with an attached wireless electrode is passable through the tube for delivery to the myocardium.

2. The catheter delivery system of claim 1 in which said elongate tube contains a steering mechanism to aid in placement of the distal end of the tube against a selected site on the wall of the heart.

3. The catheter delivery system of claim 1 in which the elongate tube contains an electrode at its distal end for sensing the local electrocardiogram at the selected site on the wall of the heart.

4. A method of delivering a wireless electrode to a location proximate the myocardium, the method comprising:

delivering an elongate member having a proximal end and a distal end and a lumen therethrough to a site proximate the myocardium;

delivering a wireless electrode attached to a rod through the lumen of the elongate member and into the myocardium proximate the distal end of the elongate member;

enabling a detachment mechanism to detach the rod from the wireless electrode; and

removing the rod and the catheter from the body of the patient.

5. The method of claim 4 in which a local electrocardiogram is measured at the distal end of the elongate member to determine the suitability of the site proximate the myocardium for pacing.

6. The method of claim 4 in which a tube is threaded over the rod but inside the lumen of the elongate member, and wherein the tube abuts the proximal end of the wireless electrode to push the electrode through the lumen.

7. The method of claim 4 in which a short burst of current is applied to the rod to heat and detach the rod at a spot on the rod having relatively high electrical resistance.