Method and apparatus for sensing and avoiding cardiac conduction system during valve deployment

• US 8,888,709 B2
• Filed: 09/11/2013
• Issued: 11/18/2014
• Est. Priority Date: 09/12/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Shuros, Allan C., Grover, Joel P., Guler, Ismail, Grovender, Adam, Gunderson, Richard Charles
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/024,294
• Publication Number:
  US 20140073978A1
• Time in Patent Office: 433 Days
• Field of Search: 600508-509
• US Class Current: 600/508
• CPC Class Codes: A61B 2562/046 in a matrix array
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/6851 Guide wires
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation

Abstract

Various techniques are described for replacement heart valve implantation. In one example, a system includes a specialized conduction system tissue activation potential sensing device, configured for delivery to an intracardiac region, a specialized conduction system tissue activation detector circuit, configured to detect, using the sensing device, a specialized conduction system tissue activation potential, and a processor circuit, configured to use information about the detected specialized conduction system tissue activation potential to generate a heart valve placement indication.

Claims

1. A system comprising:

a specialized conduction system tissue activation potential sensing device, configured for delivery to an intracardiac region;

a specialized conduction system tissue activation detector circuit, configured to detect, using the sensing device, a specialized conduction system tissue activation potential; and

a processor circuit that generates a replacement heart valve placement indication using information about the detected specialized conduction system tissue activation potential.

2. The system of claim 1, wherein the specialized conduction system tissue potential sensing device is one of a balloon, a delivery wire, and a replacement heart valve.

3. The system of claim 1, wherein the replacement heart valve comprises a plurality of electrically conductive struts, wherein a portion of a first one of the plurality of struts defines a first one of the pair of electrodes, and wherein a portion of a second one of the plurality of struts defines a second one of the pair of electrodes.

4. The system of claim 3, wherein the replacement heart valve defines a longitudinal axis, and wherein the first one of the pair of electrodes and the second one of the pair of electrodes are spaced apart from one another along the longitudinal axis.

5. The system of claim 3, wherein the replacement heart valve has a circumference, and wherein the first one of the pair of electrodes and the second one of the pair of electrodes are spaced apart from one another along the circumference.

6. The system of claim 1, further comprising:

a user interface configured to display an image representative of a detected specialized conduction system tissue potential.

7. The system of claim 1, wherein the user interface is further configured to alert a user of a detected specialized conduction system tissue potential.

8. The system of claim 1, further comprising:

a pair of electrodes in communication with the specialized conduction system tissue activation potential sensing device;

a pair of conductors in communication with the pair of electrodes and the specialized conduction system tissue activation detector circuit,

wherein the pair of conductors is configured to be detached from the pair of electrodes.

9. The system of claim 8, wherein the pair of conductors are configured to be detached from the electrodes via one of mechanical detachment, electrolytic detachment, and thermal detachment.

10. The system of claim 2, wherein the replacement heart valve further comprises:

a pair of pacing electrodes configured to pace a heart of the patient.

11. A method comprising:

delivering a specialized conduction system tissue activation potential sensing device to an intracardiac region;

detecting, using the specialized conduction system tissue activation potential sensing device, a specialized conduction system tissue activation potential; and

generating a replacement heart valve placement indication using information about the detected specialized conduction system tissue activation potential.

12. The method of claim 11, wherein the specialized conduction system tissue potential sensing device is one of a balloon, a delivery wire, and a replacement heart valve.

13. The method of claim 12, wherein the replacement heart valve comprises a plurality of electrically conductive struts, wherein a portion of a first one of the plurality of struts defines a first one of the pair of electrodes, and wherein a portion of a second one of the plurality of struts defines a second one of the pair of electrodes.

14. The method of claim 13, wherein the replacement heart valve defines a longitudinal axis, and wherein the first one of the pair of electrodes and the second one of the pair of electrodes are spaced apart from one another along the longitudinal axis.

15. The method of claim 13, wherein the replacement heart valve has a circumference, and wherein the first one of the pair of electrodes and the second one of the pair of electrodes are spaced apart from one another along the circumference.

16. The method of claim 11, further comprising:

displaying an image representative of a detected specialized conduction system tissue potential.

17. The method of claim 11, further comprising:

alerting a user in response to sensing a specialized conduction system tissue potential.

18. The method of claim 11, further comprising:

detaching a pair of conductors from a pair of electrodes associated with the specialized conduction system tissue potential sensing device.

19. The method of claim 18, wherein detaching a pair of conductors from a pair of electrodes associated with the specialized conduction system tissue potential detection device comprises one of mechanical detachment, electrolytic detachment, and thermal detachment.

20. The method of claim 11, further comprising:

delivering pacing pulses to a heart of the patient.