Cardiac access methods and apparatus

• US 7,881,810 B1
• Filed: 05/24/2007
• Issued: 02/01/2011
• Est. Priority Date: 05/24/2007
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Falkenberg, Eric, Williams, Sheldon, Helland, John R., McGarvey, Andrew W., Chitre, Yougandh, Morgan, Kevin L., Yang, Michael, Bornzin, Gene A.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Kimball; Jeremiah T
• Application Number:
  US11/753,484
• Time in Patent Office: 1,349 Days
• Field of Search: 607/119
• US Class Current: 607/129
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61F 2/2478 Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Abstract

A chamber or vasculature of a heart may be accessed via the pericardial space of the heart. Initially, the pericardial space may be accessed via a transmyocardial approach or a subxiphoid approach. A lead or other implantable apparatus may thus be routed into the pericardial space, through myocardial tissue and into the chamber or vasculature. The lead or other apparatus may be used to sense activity in or provide therapy to the heart.

Claims

1. A transmyocardial delivery apparatus, comprising:

an elongated body defining a lumen and adapted for transvenous delivery to a heart of a patient;

a piercing member adapted to extend from a distal portion of the elongated body and adapted to pierce myocardial tissue of the heart;

an electrode at a distal end of the piercing member, adapted to sense cardiac activity to provide a signal indicative of the distal end of the piercing member passing through the myocardial tissue and into a pericardial space of the heart; and

a spring adapted to expand from a distal end of the piercing member as the distal end of the piercing member passes through the myocardial tissue and into the pericardial space.

2. The apparatus of claim 1, further comprising an active fixation member on a distal portion of the elongated body.

3. The apparatus of claim 1, further comprising an electrode on the distal portion of the elongated body, and adapted to sense cardiac electrical activity in the myocardial tissue.

4. The apparatus of claim 1, further comprising an electrode on the spring adapted to sense signals indicative of a distal end of the spring passing through the myocardial tissue and into the pericardial space.

5. The apparatus of claim 1, wherein the piercing member is adapted to be inserted into the pericardial space and is adapted to curve from the pericardial space back toward the myocardial tissue.

6. The apparatus of claim 1, wherein the piercing member is adapted to slide within the lumen.

7. The apparatus of claim 1, further comprising a delivery instrument adapted to extend from a distal portion of the elongated body and adapted to carry the piercing member.

8. The apparatus of claim 7, wherein the delivery instrument is adapted to slide within the lumen.

9. The apparatus of claim 7, wherein the delivery instrument comprises a lumen and the piercing member is adapted to slide within the delivery instrument lumen.

10. The apparatus of claim 7, wherein the delivery instrument comprises a lumen and a side port adapted to direct the piercing member inserted therein, toward the myocardial tissue.

11. The apparatus of claim 1, wherein the piercing member comprises a lumen.

12. The apparatus of claim 11, further comprising a guidewire, wherein the guidewire is adapted to slide within the piercing member lumen.