Transcoronary sinus pacing system, LV summit pacing, early mitral closure pacing, and methods therefor

• US 10,369,356 B2
• Filed: 01/15/2016
• Issued: 08/06/2019
• Est. Priority Date: 10/03/2006
• Status: Active Grant

• Current Assignee: Vincent Gaudiani
• Original Assignee: Case Western Reserve University
• Inventors: Gauduani, Vincent A.
• Primary Examiner(s): Hulbert, Amanda K
• Assistant Examiner(s): Patel, Natasha
• Application Number:
  US14/996,631
• Publication Number:
  US 20160193459A1
• Time in Patent Office: 1,299 Days
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/485 involving fluorescence X-ray imaging
• CPC Class Codes: A61B 8/5292 using additional data, e.g. patient information, image labeling, acquisition parameters
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A transcoronary sinus pacing system comprising a sheath having a lumen, a pacing catheter having a pacing needle, wherein the catheter can be advanced within the lumen and placed in the LV summit, and a right ventricular pacing device. A LV summit pacing device. An early mitral valve closure pacing device configured to operate with a right ventricular apex pacing device. A method for implanting a pacing device at a target coronary sinus tissue location, wherein the target can be the posterior LV summit. A method for achieving early closure of a mitral valve. A method for using visualization devices such as fluoroscopy or ultrasound and/or catheter features such as a radiopaque marker to locate a target location for LV pacing and to avoid piercing an artery or the pericardium when anchoring the LV pacing electrode.

Claims

1. A pacing system, comprising:

a. a guiding catheter comprising a first guidewire lumen and a second pacing catheter lumen separate from and parallel to the first guidewire lumen, wherein the first guidewire lumen is longer than the second pacing catheter lumen and configured to allow a guidewire to pass therethrough, wherein a distal end of the first guidewire lumen has a first guidewire lumen exit port that is configured to lodge within a coronary sinus of a heart distal to cardiac tissue;

b. a pacing catheter configured to pass through the second pacing catheter lumen, and having a pacing electrode wire, a pacing needle at a distal end of the pacing electrode wire with a tip capable of piercing the coronary sinus and a pacing needle anchor proximal to the pacing needle electrode configured to lodge in the cardiac tissue without breaching the cardiac tissue and shaped as a pigtail knot formed of the pacing electrode wire to anchor the pacing needle electrode in the coronary sinus, wherein the pacing needle extends at least 1 cm beyond the pacing needle anchor; and

c. a pacing device, wherein the pacing device engages the pacing electrode wire.

2. The system of claim 1, wherein the guiding catheter is steerable by the guidewire.

3. The system of claim 1, wherein the guiding catheter further provides a radiopaque marker.

4. The system of claim 1, wherein the guiding catheter has a teardrop cross-section.

5. The system of claim 1, wherein the pacing catheter optimizes early closure of the mitral valve when anatomically positioned within a heart.

6. The system of claim 1, wherein the pacing catheter reduces a time required to activate the left ventricle when anatomically positioned within a heart.

7. The system of claim 1, wherein placement of the pacing catheter is irrespective or an anatomical position of the veins of a coronary sinus.

8. The system of claim 1, wherein the guiding catheter is removable.

9. The system of claim 1, wherein the first guidewire lumen exit port is distal to a second lumen exit port.

10. The system of claim 1, wherein the anchor of the top of the pacing catheter comprises one or more of a pigtail or an enlarged end.

11. An early mitral valve closure pacing system, comprising:

a. a guiding catheter comprising a first guidewire lumen and a second pacing catheter lumen separate from and parallel to the first guidewire lumen, wherein the first guidewire lumen is longer than the second pacing catheter lumen and configured to allow a guidewire to pass therethrough, wherein a distal end of the first guidewire lumen has a first guidewire lumen exit port that is configured to lodge within a coronary sinus of a heart distal to cardiac tissue;

b. a pacing catheter configured to pass through the second pacing catheter lumen, and having a pacing electrode wire, a pacing needle at a distal end of the pacing electrode wire with a tip capable of piercing the coronary sinus and a pacing needle anchor proximal to the pacing needle electrode and shaped as a pigtail knot formed of the pacing electrode wire configured to lodge in the cardiac tissue without breaching the cardiac tissue to anchor the pacing needle electrode in the coronary sinus, wherein the pacing needle electrode extends at least 1 cm beyond the pacing needle anchor, the pacing catheter being configured to activate early mitral valve closure; and

c. a pacing device configured to engage the pacing electrode wire, wherein the pacing device operates in conjunction with a right ventricular apex pacing device.

12. The system of claim 11, wherein the guiding catheter is steerable by a guidewire.

13. The system of claim 11, wherein the guiding catheter further provides a radiopaque marker.

14. The system of claim 11, wherein the guiding catheter has a teardrop cross-section.

15. The system of claim 11, wherein the pacing catheter optimizes early closure of the mitral valve when anatomically positioned within a heart.

16. The system of claim 11, wherein the pacing catheter reduces the time required to activate the left ventricle when anatomically positioned within a heart.

17. The system of claim 11, wherein placement of the pacing catheter is irrespective or an anatomical position of the veins of a coronary sinus.

18. The system of claim 11, wherein the guiding catheter is removable.

19. The system of claim 11, wherein the first guidewire lumen exit port is distal to a second lumen exit port.

20. The system of claim 11, wherein the anchor of the top of the pacing catheter comprises one or more of a pigtail or an enlarged end.