Cardiac stimulating apparatus having a blood clot filter and atrial pacer

• US 6,941,169 B2
• Filed: 06/04/2002
• Issued: 09/06/2005
• Est. Priority Date: 06/04/2001
• Status: Active Grant

• Current Assignee: P3 Innovations LLC
• Original Assignee: Albert Einstein Healthcare Network (Main Line Health System)
• Inventors: Pappu, Ramesh
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US10/163,021
• Publication Number:
  US 20020183823A1
• Time in Patent Office: 1,190 Days
• Field of Search: 607/5, 607/9, 607/119, 607122-128, 606/200
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

An apparatus is provided for reducing the formation and migration of blood clots from an atrial appendage, such as the left atrial appendage, to the blood vessel system of a patient. The apparatus comprises an atrial pacer to treat non-rheumatic atrial fibrillation (NRAF) of an atrial appendage so that the formation blood clots within the atrial appendage is decreased or eliminated. In addition, the apparatus includes a blood clot filter supported by the atrial pacer proximate the atrial appendage and the atrium to reduce the migration of blood clots from the atrial appendage into the blood vessel system of a patient.

Claims

1. A cardiac stimulating apparatus, comprising:

a filter adapted to substantially prevent transport of emboli from an atrial

appendage to an atrium of the heart; and

an atrial pacer to support the filter between the atrial appendage and the atrium, the atrial pacer adapted to be in sensing contact with a wall of the atrial appendage to reduce atrial fibrillation in the atrial appendage.

2. The cardiac stimulating apparatus according to claim 1 wherein the filter comprises a plurality of spokes.

3. The cardiac stimulating apparatus according to claim 2 wherein the spokes include tines to attach the filter to the atrial appendage.

4. The cardiac stimulating apparatus according to claim 1 wherein the spokes extend generally radially outwardly from the atrial pacer.

5. The cardiac stimulating apparatus according to claim 1 wherein the filter comprises a mesh.

6. The cardiac stimulating apparatus according to claim 1 wherein the filter includes at least one of an expandable mesh and a plurality of expandable spokes.

7. The cardiac stimulating apparatus according to claim 6 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the atrial pacer for implantation into the atrial appendage through a catheter.

8. The cardiac stimulating apparatus according to claim 1 wherein atrial pacer includes a control unit adapted to be disposed external to the heart.

9. The cardiac stimulating apparatus according to claim 8 wherein, the control unit includes a sensor adapted to be in sensing contact with the wall of the atrial appendage.

10. The cardiac stimulating apparatus according to claim 9 wherein the control unit is adapted to be in wireless communication with the sensor.

11. The cardiac stimulating apparatus according to claim 8 wherein the control unit comprises circuitry for providing a control signal to control the atrial pacer.

12. The cardiac stimulating apparatus according to claim 8 wherein the atrial pacer includes a stimulator adapted to be disposed interior to the heart for applying a stimulating signal to the wall of the atrial appendage.

13. The cardiac stimulating apparatus according to claim 12 wherein the control unit is adapted to be in wireless communication with the stimulator.

14. The cardiac stimulating apparatus according to claim 12 wherein the control unit is adapted to be in wireless communication with the electrode.

15. The cardiac stimulating apparatus according to claim 1 wherein the atrial pacer includes at least one of a stimulator disposed therein for applying a stimulating signal to the wall of the atrial appendage and a sensor disposed therein to be in sensing contact with a wall of the atrial appendage.

16. The cardiac stimulating apparatus according to claim 1 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said atrial pacer.

17. The cardiac stimulating apparatus according to claim 16 wherein the charger and the energizer are in wireless communication.

18. The cardiac stimulating apparatus according to claim 16 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.

19. A cardiac stimulating apparatus, comprising:

a filter adapted to engage proximate an opening between an atrial appendage and an atrium of a heart; and

an atrial pacer to support the filter proximate the opening between the atrial appendage and the atrium, comprising

i) a sensor adapted to be in sensing contact with a wall of the atrial appendage for sensing fibrillation of the atrial appendage, and

ii) an electrode adapted to be in electrical contact with the wall of the atrial appendage for applying stimulating signals to the atrial appendage.

20. The cardiac stimulating apparatus according to claim 19 wherein the filter comprises a plurality of spokes.

21. The cardiac stimulating apparatus according to claim 20 wherein the spokes include tines to attach the filter to the atrial appendage.

22. The cardiac stimulating apparatus according to claim 19 wherein the spokes extend generally radially outwardly from the atrial pacer.

23. The cardiac stimulating apparatus according to claim 19 wherein the filter comprises a mesh.

24. The cardiac stimulating apparatus according to claim 19 wherein the filter includes at least one of an expandable mesh and a plurality of expandable spokes.

25. The cardiac stimulating apparatus according to claim 24 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the atrial pacer for implantation into the atrial appendage through a catheter.

26. The cardiac stimulating apparatus according to claim 19 wherein atrial pacer includes a control unit adapted to be disposed external to the heart.

27. The cardiac stimulating apparatus according to claim 26 wherein the control unit is adapted to be in wireless communication with the sensor.

28. The cardiac stimulating apparatus according to claim 26 wherein the control unit comprises circuitry for providing a control signal to control the atrial pacer.

29. The cardiac stimulating apparatus according to claim 19 wherein the atrial pacer includes a stimulator for providing a stimulation control signal to the electrode.

30. The cardiac stimulating apparatus according to claim 19 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said atrial pacer.

31. The cardiac stimulating apparatus according to claim 30 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.

32. A cardiac stimulating apparatus, comprising:

a filtration device for reducing the transport of emboli from an atrial appendage to an atrium of the heart; and

an atrial pacer to support the filtration device between the atrial appendage and the atrium, the atrial pacer adapted to contact a wall of the atrial appendage for reducing atrial fibrillation in the atrial appendage.

33. The cardiac stimulating apparatus according to claim 32 wherein the filtration device comprises a plurality of spokes.

34. The cardiac stimulating apparatus according to claim 33 wherein the spokes include tines to attach the filtration device to the atrial appendage.

35. The cardiac stimulating apparatus according to claim 32 wherein the spokes extend generally radially outwardly from the atrial pacer.

36. The cardiac stimulating apparatus according to claim 32 wherein the filtration device comprises a mesh.

37. The cardiac stimulating apparatus according to claim 32 wherein the filtration device includes at least one of an expandable mesh and a plurality of expandable spokes.

38. The cardiac stimulating apparatus according to claim 37 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the atrial pacer for implantation into the atrial appendage through a catheter.

39. The cardiac stimulating apparatus according to claim 32 wherein atrial pacer includes a control unit adapted to be disposed external to the heart.

40. The cardiac stimulating apparatus according to claim 39 wherein, the control unit includes a sensor adapted to be in sensing contact with the wall of the atrial appendage.

41. The cardiac stimulating apparatus according to claim 40 wherein the control unit is adapted to be in wireless communication with the sensor.

42. The cardiac stimulating apparatus according to claim 39 wherein the control unit comprises circuitry for providing a control signal to control the atrial pacer.

43. The cardiac stimulating apparatus according to claim 39 wherein the atrial pacer includes a stimulator adapted to be disposed interior to the heart for applying a stimulating signal to the wall of the atrial appendage.

44. The cardiac stimulating apparatus according to claim 43 wherein the control unit is adapted to be in wireless communication with the stimulator.

45. The cardiac stimulating apparatus according to claim 32 wherein the atrial pacer includes at least one of a stimulator disposed therein for applying a stimulating signal to the wall of the atrial appendage and a sensor disposed therein to be in sensing contact with a wall of the atrial appendage.

46. The cardiac stimulating apparatus according to claim 32 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said atrial pacer.

47. The cardiac stimulating apparatus according to claim 46 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.

48. A cardiac stimulating apparatus comprising:

an atrial pacer comprising an elongated body adapted at one end thereof for making at least one of sensing and stimulating contact with a wall of an atrial appendage of a heart, said atrial pacer including at least one of an atrial sensor and an atrial stimulator; and

an filtration device mounted to said elongated body distal the one end thereof and adapted for intercepting emboli moving between the atrial appendage and an atrium of the heart.

49. The cardiac stimulating apparatus according to claim 48 wherein the filtration device comprises a plurality of spokes.

50. The cardiac stimulating apparatus according to claim 49 wherein the spokes include tines to attach the filtration device to the atrial appendage.

51. The cardiac stimulating apparatus according to claim 48 wherein the spokes extend generally radially outwardly from the atrial pacer.

52. The cardiac stimulating apparatus according to claim 48 wherein the filtration device comprises a mesh.

53. The cardiac stimulating apparatus according to claim 48 wherein the filtration device includes at least one of an expandable mesh and a plurality of expandable spokes.

54. The cardiac stimulating apparatus according to claim 53 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the atrial pacer for implantation into the atrial appendage through a catheter.

55. The cardiac stimulating apparatus according to claim 48 wherein atrial pacer includes a control unit adapted to be disposed external to the heart.

56. The cardiac stimulating apparatus according to claim 55 wherein the control unit is adapted to be in wireless communication with the atrial sensor.

57. The cardiac stimulating apparatus according to claim 55 wherein the control unit is adapted to be in wireless communication with the stimulator.

58. The cardiac stimulating apparatus according to claim 48 wherein the stimulator is adapted to apply a stimulating signal to the wall of the atrial appendage and the sensor is adapted to be in sensing contact with a wall of the atrial appendage.

59. The cardiac stimulating apparatus according to claim 48 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said atrial pacer.

60. The cardiac stimulating apparatus according to claim 59 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.

61. A cardiac stimulating apparatus comprising:

an atrial pacer comprising an elongated body adapted at one end thereof for making at least one of sensing and stimulating contact with a wall of an atrial appendage of a heart, said atrial pacer including an atrial sensor and an atrial stimulator disposed in said elongated body; and

an filtration device mounted to said elongated body distal the one end thereof and adapted for intercepting emboli moving between the atrial appendage and an atrium of the heart.

62. The cardiac stimulating apparatus according to claim 61 wherein the filtration device comprises a plurality of spokes.

63. The cardiac stimulating apparatus according to claim 62 wherein the spokes include tines to attach the filtration device to the atrial appendage.

64. The cardiac stimulating apparatus according to claim 61 wherein the spokes extend generally radially outwardly from the atrial pacer.

65. The cardiac stimulating apparatus according to claim 61 wherein the filtration device comprises a mesh.

66. The cardiac stimulating apparatus according to claim 61 wherein the filtration device includes at least one of an expandable mesh and a plurality of expandable spokes.

67. The cardiac stimulating apparatus according to claim 66 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the atrial pacer for implantation into the atrial appendage through a catheter.

68. The cardiac stimulating apparatus according to claim 61 wherein the atrial pacer includes a control unit adapted to be disposed external to the heart.

69. The cardiac stimulating apparatus according to claim 68 wherein the control unit is adapted to be in wireless communication with the sensor.

70. The cardiac stimulating apparatus according to claim 68 wherein the control unit is adapted to be in wireless communication with the stimulator.

71. The cardiac stimulating apparatus according to claim 61 wherein the stimulator is adapted to apply a stimulating signal to the wall of the atrial appendage and the sensor is adapted to be in sensing contact with a wall of the atrial appendage.

72. The cardiac stimulating apparatus according to claim 61 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said atrial pacer.

73. The cardiac stimulating apparatus according to claim 72 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.

74. A cardiac stimulating apparatus, comprising:

a filtration means for reducing the transport of emboli from an atrial appendage to an atrium of the heart; and

a pacing means for supporting the filtration device between the atrial appendage and the atrium and for reducing atrial fibrillation in the atrial appendage.

75. The cardiac stimulating apparatus according to claim 74 wherein the filtration means comprises a plurality of spokes.

76. The cardiac stimulating apparatus according to claim 74 wherein the spokes extend generally radially outwardly from the pacing means.

77. The cardiac stimulating apparatus according to claim 74 wherein the filtration means comprises a mesh.

78. The cardiac stimulating apparatus according to claim 74 wherein the filtration means includes at least one of an expandable mesh and a plurality of expandable spokes.

79. The cardiac stimulating apparatus according to claim 78 wherein said one of said expendable mesh and said plurality of expendable spokes are collapsible to be disposed near the pacing means for implantation into the atrial appendage through a catheter.

80. The cardiac stimulating apparatus according to claim 74 wherein pacing means includes a control unit adapted to be disposed external to the heart.

81. The cardiac stimulating apparatus according to claim 80 wherein, the control unit includes a sensor adapted to be in sensing contact with the wall of the atrial appendage.

82. The cardiac stimulating apparatus according to claim 81 wherein the control unit is adapted to be in wireless communication with the sensor.

83. The cardiac stimulating apparatus according to claim 80 wherein the pacing means includes a stimulator adapted to be disposed interior to the heart for applying a stimulating signal to the wall of the atrial appendage.

84. The cardiac stimulating apparatus according to claim 83 wherein the control unit is adapted to be in wireless communication with the stimulator.

85. The cardiac stimulating apparatus according to claim 74 wherein the pacing means includes at least one of a stimulator disposed therein for applying a stimulating signal to the wall of the atrial appendage and a sensor disposed therein to be in sensing contact with a wall of the atrial appendage.

86. The cardiac stimulating apparatus according to claim 74 comprising:

i) a charger adapted to be disposed external to a patient'"'"'s body for providing a power signal in the form of electromagnetic energy; and

ii) an energizer adapted to be disposed internal to a patient'"'"'s body for receiving the power signal provided by the generator unit to energize said pacing means.

87. The cardiac stimulating apparatus according to claim 86 wherein the generator unit comprises a first coil for transmitting the power signal and the energizing unit comprises a second coil for receiving the power signal.