Methods and apparatus for defibrillating a heart refractory to electrical stimuli
First Claim
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1. A method of defibrillating a heart in fibrillation comprising steps of:
- providing apparatus having a cutting head for boring a channel in a wall of the heart and means for aspirating tissue severed by the cutting head; and
repeating, until the heart ceases fibrillating, steps of;
positioning the cutting head against a wall of the heart;
actuating the cutting head to form a transmural channel in the wall of the heart; and
evacuating tissue cut by the cutting head.
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Abstract
Apparatus and methods for defibrillating a heart in fibrillation are provided using apparatus that forms a plurality of transmural channels in a wall of the heart. The apparatus includes a single-use handpiece having a mechanical cutting head and means for stabilizing the cutting head in contact with the tissue. The handpiece is coupled by a disposable cable to a controller that houses a vacuum pump and mechanisms for driving the cutting head. The cutting head is adapted to cooperate with the vacuum pump to evacuate tissue severed during the channel forming process.
1254 Citations
22 Claims
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1. A method of defibrillating a heart in fibrillation comprising steps of:
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providing apparatus having a cutting head for boring a channel in a wall of the heart and means for aspirating tissue severed by the cutting head; and
repeating, until the heart ceases fibrillating, steps of;
positioning the cutting head against a wall of the heart;
actuating the cutting head to form a transmural channel in the wall of the heart; and
evacuating tissue cut by the cutting head. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. Apparatus for defibrillating a heart in fibrillation, the apparatus comprising:
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a first vacuum source; and
a handpiece having;
a body, a shaft coupled to the body, the shaft including a lumen;
a cutting head having a bore coupled to the first vacuum source, a first position wherein the cutting head extends from within the lumen to form a channel in the tissue, tissue severed by the cutting head being aspirated through the bore by the first vacuum source, and a second position wherein the cutting head is retracted within the lumen; and
a stabilizer surface that contacts the heart and the cutting head in contact with the tissue. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
a controller housing a linear motor; and
a cable coupling the linear motor to the cutting head to move the cutting head between the first and second positions.
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12. The apparatus as defined in claim 11 wherein the first vacuum source is housed within the controller.
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13. The apparatus as defined in claim 11 further comprising a rotary motor disposed within the controller and coupled by the cable to the cutting head to rotate the cutting head.
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14. The apparatus as defined in claim 13 wherein the handpiece further comprises a control panel having buttons that cause activation of the linear and rotary motors.
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15. The apparatus as defined in claim 13 wherein the cable comprises a drive cable and the apparatus further comprises a coupling that transmits rotary motion and longitudinal motion from the rotary and linear motors, respectively, to the drive cable.
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16. The apparatus as defined in claim 15 wherein the handpiece further comprises a spool coupled between the drive cable and the cutting head, the spool including struts defining apertures that permit tissue aspirated through the bore of the cutting head to pass to a tissue filter.
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17. The apparatus as defined in claim 10 wherein the shaft comprises a portion capable of articulating the cutting head to a position forming an angle relative to a longitudinal axis of the shaft.
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18. The apparatus as defined in claim 10 wherein the cutting head, in the first position, also experiences motion selected from the group consisting of reciprocatory motion, angular motion, vibrational motion and high speed longitudinal motion.
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19. The apparatus as defined in claim 10 wherein the stabilizer surface comprises a suction opening disposed near the cutting head and means for inducing suction through the suction opening.
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20. The apparatus as defined in claim 19 wherein the first vacuum source provides a first level of suction to the cutting head and the means for inducing suction through the suction cup comprises a second vacuum source that provides a second level of suction, the second level of suction lower than the first level of suction.
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21. The apparatus as defined in claim 10 wherein the handpiece is discarded after a single use.
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22. The apparatus as defined in claim 10 wherein the handpiece further comprises a drive tube coupled between the drive cable and the cutting head, the drive tube comprising:
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a rigid proximal portion;
a rigid distal portion; and
a flexible drive coupling disposed between the rigid proximal portion and the rigid distal portion.
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Specification