Introducer for a minimally invasive physiologic parameter recorder

• US 9,198,591 B2
• Filed: 09/13/2012
• Issued: 12/01/2015
• Est. Priority Date: 01/30/2008
• Status: Expired due to Fees

• Current Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Original Assignee: Greatbatch Limited (Greatbatch Incorporated)
• Inventors: Brockway, Brian P., Mills, Perry A.
• Primary Examiner(s): Manahan, Todd
• Assistant Examiner(s): Lewis, Casey B
• Application Number:
  US13/613,419
• Publication Number:
  US 20130012800A1
• Time in Patent Office: 1,174 Days
• Field of Search: 606/108, 606/129, 606/190, 128/899, 607/37
• US Class Current: 1/1
• CPC Class Codes: A61B 2560/0219 of externally powered implanted units
• CPC Class Codes: A61B 2560/063 Devices specially adapted for delivering implantable medical measuring apparatus
• CPC Class Codes: A61B 2560/066 catheters therefor
• CPC Class Codes: A61B 2562/164 the sensor is mounted in or on a conformable substrate or carrier
• CPC Class Codes: A61B 2562/18 Shielding or protection of sensors from environmental influences, e.g. protection from mechanical damage
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• 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

An implantable monitoring device includes a flexible lead body that includes at least one sensing element. The device also includes a rigid main body connected to the flexible lead body at an attachment point. The rigid main body is generally centered about a longitudinal axis defined by the flexible lead body when the lead body is unflexed. The device further includes a measurement circuit, which is housed within the rigid main body and electrically coupled to the at least one sensing element of the flexible lead body and at least another sensing element on an outside surface of the rigid main body. The measurement circuit is configured to measure a potential difference between the at least one sensing element of the flexible lead body and the at least another sensing element of the main body.

Claims

1. An introducer system for implanting an implantable medical device at a subcutaneous location within a body of a patient, the introducer system comprising:

a) an insert extending from a distal insert portion having a closed distal insert end to a proximal insert end, wherein at least a portion of the insert is sized and shaped to match at least a portion of the implantable medical device; and

b) a sheath, comprising;

i) a first leg extending from a distal first leg end to a proximal first finger grip;

ii) a second leg extending from a distal second leg end to a proximal second finger grip;

iii) an intermediate tapered portion extending distally and inwardly toward a longitudinal axis for at least a portion of its length from an open proximal tapered portion end to an open distal tapered portion end, wherein the distal first and second leg ends, opposite the respective finger grips, are connected at spaced apart locations to the open proximal tapered portion end; and

iv) a distal sheath portion defining a sheath lumen extending along the longitudinal axis from the open distal tapered portion end to an open distal sheath portion end thereof,

v) wherein the intermediate and distal sheath portions define an opening sized to separately house the insert and at least a portion of the implantable medical device,

c) wherein with the insert received in the sheath, the closed distal insert end extends distally out past the open distal sheath end with the proximal insert end being proximal the open proximal tapered portion end so that the proximal insert end is manipulatable in a distal direction to move the insert and the sheath distally through the body to a desired implant location, and wherein the open proximal sheath end permits removal of the insert from the sheath to thereby provide for moving the implantable medical device through the open proximal sheath end and into the tapered intermediate portion and the distal sheath portion, and

d) wherein the first and second finger grips are manipulatable to move their respective first and second legs from a first position relatively closely spaced to each other to a second position of a greater distance from each other than the first position to thereby separate the intermediate tapered and distal portions of the sheath into a first split portion connected to the first leg and its finger grip and a second split portion connected to the second leg and its finger grip to thereby facilitate removal of the sheath from the subcutaneous implant location while leaving the medical device implanted in the body.

2. The introducer system of claim 1 wherein the distal sheath portion is sized and shaped in proportion to receive the corresponding distal insert portion therein.

3. The introducer system of claim 1 wherein the distal sheath portion is more flexible than the distal insert portion.

4. The introducer system of claim 3 wherein the distal insert portion has sufficient rigidity to avoid substantial deflection when directed through a fatty tissue layer of the patient, but sufficient flexibility to, upon contacting a surface of a muscle layer of the patient, deflect and slide across the surface of the muscle layer without penetrating the muscle layer.

5. The introducer system of claim 1 wherein an external surface of the intermediate tapered and distal sheath portions includes diametrically opposed surface modifications extending from the open proximal tapered portion to the open distal sheath portion end, the surface modifications reducing a tensile strength of the sheath to facilitate manipulation of the sheath into the first and second split portions.

6. The introducer system of claim 1 wherein the semi-flexible insert defines a cavity sized and shaped to receive a rod member preformed to define an arc angle, and wherein the rod member is more rigid than the insert.

7. The introducer system of claim 1 wherein the proximal insert end is closed.

8. The introducer system of claim 1 wherein with the insert received in the sheath, the proximal insert end is proximal the open proximal tapered portion end, but distal the first and second finger grips.

9. The introducer system of claim 1 wherein the first and second legs of the sheath extend proximally along the longitudinal axis away from the intermediate tapered portion.

10. The introducer system of claim 1 wherein the intermediate tapered portion of the sheath comprises a first tapered sheath section widening linearly and proximally along the longitudinal axis from a first width at the open distal tapered portion end to a second, wider width meeting a constant width section of the intermediate portion and then to a second tapered sheath section extending proximally along the longitudinal axis from a third width to a fourth, wider width at the open proximal tapered portion end of the sheath.

11. The introducer system of claim 10 wherein at least a portion of the second tapered sheath section extends arcuately and proximally along the longitudinal axis from the third width to the fourth, wider width at the open proximal tapered portion end of the sheath.

12. The introducer system of claim 1 wherein the first finger grip is substantially aligned along a first imaginary plane and the second finger grip is substantially aligned along a second imaginary plane parallel to the first imaginary plane and wherein a third imaginary plane bisects the intermediate tapered portion and the distal portion of the sheath, the third imaginary plane being aligned substantially perpendicular to the first and second imaginary parallel planes.

13. A sheath, comprising:

a) a first leg extending from a distal first leg end to a proximal first finger grip;

b) a second leg extending from a distal second leg end to a proximal second finger grip;

c) an intermediate tapered portion extending distally and inwardly toward a longitudinal axis for at least a portion of its length from an open proximal tapered portion end to an open distal tapered portion end, wherein the distal first and second leg ends, opposite the respective finger grips, are connected at spaced apart locations to the open proximal tapered portion end,

d) wherein the first finger grip is substantially aligned along a first imaginary plane and the second finger grip is substantially aligned along a second imaginary plane parallel to the first imaginary plane and wherein a third imaginary plane bisects the intermediate tapered portion and the distal portion of the sheath, the third imaginary plane being aligned substantially perpendicular to the first and second imaginary parallel planes; and

e) a distal sheath portion defining a sheath lumen extending along the longitudinal axis from the open distal tapered portion end to an open distal sheath portion end thereof,

e) wherein the intermediate and distal sheath portions define an opening sized to separately house an insert and at least a portion of an implantable medical device, and

f) wherein the first and second finger grips are manipulatable laterally along the third imaginary plane to move their respective first and second legs from a first position relatively closely spaced to each other to a second position of a greater distance from each other than the first position to thereby separate the intermediate tapered and distal portions of the sheath into a first split portion connected to the first leg and its finger grip and a second split portion connected to the second leg and its finger grip.

14. The sheath of claim 13 wherein an external surface of the intermediate tapered and distal sheath portions includes diametrically opposed surface modifications extending from the open proximal tapered portion to the open distal sheath portion end, the surface modifications reducing a tensile strength of the sheath to facilitate manipulation of the sheath into the first and second split portions.

15. The sheath of claim 13 wherein the first and second legs extend proximally along the longitudinal axis away from the intermediate tapered portion.

16. The sheath of claim 13 wherein the intermediate tapered portion comprises a first tapered sheath section widening linearly and proximally along the longitudinal axis from a first width at the open distal tapered portion end to a second, wider width meeting a constant width section of the intermediate portion and then to a second tapered sheath section extending proximally along the longitudinal axis from a third width to a fourth, wider width at the open proximal tapered portion end of the sheath.

17. An introducer system for implanting an implantable medical device at a subcutaneous location within a body of a patient, the introducer system comprising:

a) an insert extending from a distal insert portion having a closed distal insert end to a closed proximal insert end, wherein at least a portion of the insert is sized and shaped to match at least a portion of the implantable medical device; and

b) a sheath, comprising;

i) a first leg extending from a distal first leg end to a proximal first finger grip;

ii) a second leg extending from a distal second leg end to a proximal second finger grip;

iii) an intermediate tapered portion comprising a first tapered sheath section widening linearly and proximally along a longitudinal axis from a first width at an open distal tapered portion end to a second, wider width meeting a constant width section of the intermediate portion and then to a second tapered sheath section extending proximally along the longitudinal axis from a third width to a fourth, wider width at an open proximal tapered portion end of the sheath,

iv) wherein the distal first and second leg ends, opposite the respective finger grips, are connected at spaced apart locations to the open proximal tapered portion end; and

v) a distal sheath portion defining a sheath lumen extending along the longitudinal axis from the open distal tapered portion end to an open distal sheath portion end thereof,

vi) wherein the intermediate and distal sheath portions define an opening sized to separately house the insert and at least a portion of the implantable medical device,

c) wherein with the insert received in the sheath, the closed distal insert end extends distally out past the open distal sheath end with the proximal insert end being proximal the open proximal tapered portion end so that the closed proximal insert end is manipulatable in a distal direction to move the insert and the sheath distally through the body to a desired implant location, and wherein the open proximal sheath end permits removal of the insert from the sheath to thereby provide for moving the implantable medical device through the open proximal sheath end and into the tapered intermediate portion and the distal sheath portion, and

d) wherein the first and second finger grips are manipulatable to move their respective first and second legs from a first position relatively closely spaced to each other to a second position of a greater distance from each other than the first position to thereby separate the intermediate tapered and distal portions of the sheath into a first split portion connected to the first leg and its finger grip and a second split portion connected to the second leg and its finger grip to thereby facilitate removal of the sheath from the subcutaneous implant location while leaving the medical device implanted in the body.

18. The introducer system of claim 17 wherein at least a portion of the second tapered sheath section extends arcuately and proximally along the longitudinal axis from the third width to the fourth width.

19. The introducer system of claim 17 wherein the first finger grip is substantially aligned along a first imaginary plane, the second finger grip is substantially aligned along a second imaginary plane parallel to the first imaginary plane, and a third imaginary plane bisects the intermediate tapered portion and the distal portion of the sheath, and wherein the third imaginary plane is aligned substantially perpendicular to the first and second imaginary parallel planes.

20. The introducer system of claim 17 wherein with the insert received in the sheath, the proximal insert end is proximal the open proximal tapered portion end, but distal the first and second finger grips.