CN110198759B - 具有可拆卸固定件的无引线可植入装置 - Google Patents

具有可拆卸固定件的无引线可植入装置 Download PDF

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CN110198759B
CN110198759B CN201880007832.2A CN201880007832A CN110198759B CN 110198759 B CN110198759 B CN 110198759B CN 201880007832 A CN201880007832 A CN 201880007832A CN 110198759 B CN110198759 B CN 110198759B
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fixation
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依琳·克里斯汀·韦勃
布赖恩·J·斯沃克哈默尔
达娜·萨夏
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Cardiac Pacemakers Inc
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    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A61N1/37518—Anchoring of the implants, e.g. fixation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
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    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
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    • A61N1/057—Anchoring means; Means for fixing the head inside the heart
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    • A—HUMAN NECESSITIES
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    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37205—Microstimulators, e.g. implantable through a cannula

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Abstract

可植入医疗装置(IMD)可以包括固定模块和装置模块，所述装置模块被构造成可释放地连接至固定模块。装置模块可以具有近侧端部和远侧端部，并且可以包括电源和可操作地联接至电源的控制器。控制器可以构造成经由两个或更多个电极感测心电活动和/或经由两个或更多个电极输送起搏脉冲。装置模块可以包括可释放连接器的第一部分，而固定模块可以包括可释放连接器的第二部分，其中可释放连接器的第一部分和可释放连接器的第二部分配合以将装置模块与固定模块可释放地连接。

Description

具有可拆卸固定件的无引线可植入装置
相关申请的交叉引用
本申请要求2017年1月26日提交的美国临时专利申请序列号No.62/450,865的权益，其公开内容通过引用并入本文。
技术领域
本公开涉及可植入装置，比如无引线可植入装置，并且更具体地涉及具有可拆卸固定件的无引线可植入装置。
背景技术
目前，可植入医疗装置通常用于监测患者的生理参数或其它参数和/或向患者提供治疗。例如，为了帮助患有心脏相关病症的患者，可以将各种医疗装置(例如，起搏器、除颤器等)植入患者体内。这些装置可以监测并且在一些情况下向心脏提供电刺激(例如，起搏、除颤等)，以帮助心脏以更正常、有效和/或安全的方式操作。在另一示例中，可以使用神经刺激器来刺激患者的组织，以帮助减轻疼痛和/或其它病症。在又一示例中，可植入医疗装置可以简单地是可植入监测器，其监测患者的一个或更多个生理参数或其它参数，并将感测到的参数传送到另一装置，比如另一植入的医疗装置或外部装置。在一些情况下，可能需要移除或移植所植入的医疗装置并安装替换的植入医疗装置。
发明内容
本公开描述了可植入医疗装置(IMD)，比如但不限于无引线心脏起搏器(LCP)、神经刺激器(NS)和/或可植入监测器(IM)，其被构造为植入体内，有时植入心脏中或心脏附近。在一些情况下，可能需要移除或移植第一IMD并植入替换的第二IMD。这由于许多原因(比如第一IMD的电源已达到其寿命终结)可能是期望的。在一些情况下，第一IMD可以包括固定部分和装置部分。在一些情况下，装置部分可以构成第一IMD的主要部分，并且可以包括比如电池或类似物的电源。在植入后的一段时间之后，第一IMD的固定部分可能被显著的组织过度生长缠结或以其它方式捕获，这可能使得移除IMD的固定部分变得困难或不合需要。当发生这种情况时，第一IMD的装置部分可以与固定部分断开连接并从身体移除。固定部分可以留在原位。在一些情况下，可以在第一IMD的剩余固定部分附近的不同位置植入第二IMD。在其它情况下，第二IMD的装置部分可以联接至第一IMD的先前安装的固定部分。
在一个具体示例中，可植入医疗装置(IMD)可以包括固定模块和装置模块，所述装置模块被构造成可释放地连接至固定模块。装置模块可以具有近侧端部和远侧端部，并且可以包括电源和可操作地联接至电源的控制器。控制器可以构造成经由两个或更多个电极感测心电活动并经由两个或更多个电极输送起搏脉冲。装置模块可以包括可释放连接器的第一部分。固定模块可以包括：用于将固定模块锚定到患者的心脏的多个固定元件；以及可释放连接器的第二部分，其中可释放连接器的第一部分和可释放连接器的第二部分配合以将装置模块与固定模块可释放地连接。在一些情况下，装置模块可以具有一个或更多个第一荧光透视标记，并且固定模块具有一个或更多个第二荧光透视标记，其中所述一个或更多个第一荧光透视标记和所述一个或更多个第二荧光透视标记布置成使得第一荧光透视标记中的一个或更多个与第二荧光透视标记中的一个或更多个之间的预定对准确认可释放连接器处于完全连接状态。
替代地或另外地，装置模块可以进一步包括近侧电极和远侧电极，它们均操作性地联接至控制器，其中远侧电极设置在从可释放连接器的第一部分向远侧延伸的细长立柱上，并且其中固定模块限定孔口，当可释放连接器处于完全连接状态时，细长立柱延伸穿过所述孔口以将远侧电极支撑在固定模块的远侧上。
替代地或另外地，装置模块可以进一步包括近侧电极和远侧端子，它们均操作性地联接至控制器，并且其中固定模块包括在固定模块的远侧上的远侧电极，并且其中当可释放连接器处于完全连接状态时，装置模块的远侧端子操作性地联接至固定模块的远侧电极。
替代地或另外地，可释放连接器可以包括一个或更多个锁定凸片以及一个或更多个锁定狭槽。所述一个或更多个锁定凸片可以构造成抵靠偏置机构移动到所述一个或更多个锁定狭槽中，之后所述一个或更多个锁定凸片构造成相对于所述一个或更多个锁定狭槽旋转，直到锁定凸片中的一个或更多个被偏置机构推入到一个或更多个保持凹部中，此时可释放连接器处于完全连接状态。
替代地或另外地，锁定凸片中的至少一个和保持凹部中的至少一个的位置由相应的荧光透视标记来标记。
替代地或另外地，偏置机构可以包括位于装置模块与固定模块之间的硅树脂弹簧密封件。
替代地或另外地，可释放连接器可以包括一个或更多个接收件以及一个或更多个卡子，当可释放连接件处于完全连接状态时，所述卡子被偏置以延伸到接收件中的一个或更多个中并将其捕获，从而形成干涉连接。
替代地或另外地，可释放连接器的第一部分可以包括所述一个或更多个接收件，并且可释放连接器的第二部分可以包括所述一个或更多个卡子。
替代地或另外地，可释放连接器可以进一步包括密封件，用于在可释放连接器处于完全连接状态时将所述一个或更多个接收件和所述一个或更多个卡子与外部环境阻隔。
替代地或另外地，可释放连接器可以进一步包括一个或更多个电触头，用于在可释放连接器的第一部分与可释放连接器的第二部分之间形成电连接。
在另一示例中，被构造为从心脏腔室内的位置使患者的心脏起搏的可植入无引线心脏起搏器(LCP)可以包括：固定模块，其被构造成与心脏腔室接合；以及装置模块，其可释放地固定至固定模块，以便部署在心脏腔室内。固定模块可以包括固定模块壳体、多个锁定狭槽、一个或更多个保持凹部以及构造成容纳由装置模块承载的电极的孔口。装置模块可以包括：装置模块壳体；以及多个锁定凸片，其构造成与固定模块的锁定狭槽配合，从而通过将所述多个锁定凸片抵靠偏置机构插入锁定狭槽中，然后使装置模块相对于固定模块旋转，直到锁定凸片中的一个或更多个被偏置机构推入固定模块的保持凹部中的一个或更多个中，将装置模块可释放地固定至固定模块。电源设置在装置模块壳体内。第一电极可以设置在装置模块壳体上，并且第二电极可以设置在向多个锁定凸片的远侧延伸的细长立柱上，所述细长立柱构造成延伸穿过固定模块壳体中的孔口，从而当装置模块与固定模块接合并且所述LCP被植入时，将第二电极放置在第二电极能够接触心脏组织的位置。控制器可以设置在装置模块壳体内并且可以可操作地联接至电源，控制器构造成感测心电活动并经由第一电极和第二电极中的一个或更多个输送起搏脉冲。
替代地或另外地，固定模块可以进一步包括多个固定尖齿，所述固定尖齿构造成向远侧延伸到患者的心脏组织中，然后向近侧返回以钩住患者的心脏组织，从而将固定模块锚定到患者的心脏。
替代地或另外地，偏置机构可以是弹性密封件，其构造成接合固定模块壳体和装置模块壳体上的相应配合表面。
替代地或另外地，装置模块的锁定凸片中的一个或更多个可以包括荧光透视标记，并且固定模块可以包括相对于固定模块壳体固定的一个或更多个荧光透视标记，固定模块的一个或更多个荧光透视标记可以构造成在荧光透视下指示固定模块相对于装置模块的锁定凸片的定向。
在另一示例中，被构造为从心脏腔室内的位置使患者的心脏起搏的可植入无引线心脏起搏器(LCP)包括：固定模块，其被构造成与心脏腔室接合；以及装置模块，其可释放地固定至固定模块，以便部署在心脏腔室内。装置模块包括装置模块壳体和细长立柱，细长立柱从装置模块壳体向远侧延伸并且包括一个或更多个接收件以及一个或更多个电触头。固定模块包括固定模块壳体以及在固定模块壳体的远侧上的一个或更多个电极。固定模块包括：立柱接收孔口，其用于接收装置模块的细长立柱；以及一个或更多个卡子，当细长立柱被立柱接收孔口接收时，所述卡子被偏置以延伸到细长立柱的接收件中的一个或更多个中并将其捕获。固定模块包括：一个或更多个电触头，其在细长立柱被立柱接收孔口接收时与细长立柱的电触头中的一个或更多个形成电连接，其中固定模块的电触头中的一个或更多个操作性地联接至固定模块壳体的远侧上的电极中的一个或更多个。
替代地或另外地，LCP可以进一步包括密封件，其用于在装置模块的细长立柱与固定模块之间提供密封，用于在细长立柱被立柱接收孔口接收时将固定模块的一个或更多个电触头与外部环境阻隔。
替代地或另外地，所述一个或更多个接收件可以包括形成在细长立柱的外表面中的一个或更多个凹槽。
替代地或另外地，所述一个或更多个卡子可以包括螺旋弹簧，所述螺旋弹簧被偏置以延伸到细长立柱的凹槽中的一个或更多个中并将其捕获。
替代地或另外地，所述一个或更多个卡子可以包括板簧，所述板簧被偏置以延伸到细长立柱的凹槽中的一个或更多个中并将其捕获。
替代地或另外地，LCP可以进一步包括一个或更多个荧光透视标记，用于指示细长立柱是否被立柱接收孔口充分地接收从而处于完全连接状态。
一些实施例的以上概述并非旨在描述本公开的每个公开实施例或每个实施方式。以下的附图和详细描述更具体地示例说明这些实施例。
附图说明
考虑结合附图的以下描述，可以更全面地理解本公开，其中：
图1是根据本公开的例示性可植入医疗装置(IMD)的示意性框图；
图2是作为图1的IMD的示例的可植入无引线心脏起搏器(LCP)的侧视图；
图3是形成图2的LCP的一部分的装置模块的侧视图；
图4是形成图2的LCP的一部分的固定模块的透视图；
图5是图3的装置模块的透视端视图；
图6是图4的固定模块的底部透视图；
图7是图2的LCP的端视图，其中各部分示出为透明的以显示内部细节；
图8是作为图1的IMD的另一示例的LCP的侧视图；
图9是形成图8的LCP的一部分的装置模块的侧视图；
图10是形成图8的LCP的一部分的固定模块的透视图；
图11是图10的固定模块的底部透视图；
图12是图9的装置模块的透视端视图；
图13是通过图8的LCP的远侧端部截取的示例示意性剖视图；
图14是通过图8的LCP的远侧端部截取的另一示例示意性剖视图；
图15是图8的LCP的端视图，其中各部分示出为透明的以显示内部细节；
以及
图16是根据本公开的示例的例示性LCP的示意性框图。
尽管本公开服从于各种变型和替代形式，但其具体内容在附图中已通过示例方式示出，并且将详细地描述。然而，应该理解的是，意图不是将本发明限制于所描述的特定实施例。相反，意图是覆盖落入本公开的精神和范围内的所有变型、等同方案以及替代方案。
具体实施方式
对于以下定义的术语，除非在权利要求书或本说明书的其它地方给出了不同的定义，否则将适用这些定义。
所有的数值在本文都假定为由术语“约”修饰，无论是否明确指出。术语“约”通常表示本领域技术人员认为等同于列举值(即，具有相同的功能或结果)的数字范围。在许多情况下，术语“约”可以表示包括四舍五入到最接近的有效数字的数。
通过端点列举的数值范围包括在该范围内的所有数字(例如，1至5包括1、1.5、2、2.75、3、3.80、4和5)。
尽管公开了与各种部件、特征和/或规格有关的一些合适的尺寸、范围和/或值，但是通过本公开的启发，本领域技术人员将理解期望的尺寸、范围和/或值可能偏离明确公开的那些尺寸、范围和/或值。
如在本说明书和所附权利要求书中使用的，单数形式“一”、“一个”和“该”包括或以其它方式指代单数以及复数对象，除非内容明确地另有指出。如在本说明书和所附权利要求书中所使用的，术语“或”通常以包括“和/或”的意义使用，除非内容明确地另有指出。
应当参照附图来阅读以下详细描述，其中不同附图中的类似元件的编号相同。详细描述以及不一定按比例绘制的附图示出了例示性实施例，并且不旨在限制本公开的范围。所描述的例示性实施例仅旨在作为示例。除非明确地相反陈述，否则任何例示性实施例的所选特征可以结合到另外的实施例中。
本公开涉及可植入医疗装置(IMD)，其可以包括装置模块和固定模块。在一些情况下，IMD可以在装置模块固定于固定模块的情况下植入，并因此可以作为单个结构提供，并且可以利用任何期望的植入技术和/或递送装置植入。在一些情况下，在植入IMD之后，可能希望移除IMD和/或替换IMD。例如，当所植入的IMD中的电源(例如，电池)达到其预期寿命的终结时，可以移除并替换IMD。在一些情况下，IMD的固定部分可以位于用于起搏和/或感测的良好部位，并且可能感兴趣的是能够将替换的IMD放置在相同位置。在一些情况下，由于组织向内生长等原因，IMD的固定部分可能难以移除。因此，在一些情况下，可以将装置模块从固定模块移除并从患者移除。在一些情况下，可以将新的装置模块递送并固定至先前植入的固定模块。在一些情况下，可以简单地将先前植入的固定模块留在原位，并且可以将具有新的装置模块和新的固定模块的新的IMD递送并植入于新的植入部位处。这些只是示例。
转到图1，示出了可植入医疗装置(IMD)10。例示性IMD 10包括装置模块12和固定模块14。应理解的是，图1是高度示意性的。装置模块12具有装置壳体16，该装置壳体从近侧端部18延伸到远侧端部20。例示性装置模块12包括电源22和可操作地联接至电源22的控制器24。在一些情况下，控制器24可以构造成经由两个或更多个电极感测心电活动，并且经由可以与用于感测心电活动的电极相同或者可以与感测心电活动的电极不同的两个或更多个电极输送起搏脉冲。装置模块12被示出为具有第一电极26和第二电极28。应理解的是，第一电极26和第二电极28可以相对于装置壳体16设置在任何期望的部位或位置，并且在一些情况下，可以位于近侧端部18和/或远侧端部20上。在一些情况下，也可能存在另外的电极。
在一些情况下，如将关于随后的附图所讨论的，第一电极26和第二电极28中的至少一个可以设置在装置壳体16的远侧端部20处或者甚至向远侧延伸超出装置壳体16的远侧端部20。在一些情况下，第一电极26和第二电极28中的至少一个可以从装置模块12向远侧延伸足够的距离以允许该电极延伸穿过固定模块14并接触组织。在一些情况下，第一电极26和第二电极28中的至少一个实际上可以固定至固定模块14。图2至图7提供了IMD的示例，其中电极从装置模块12向远侧延伸并穿过固定模块14以接触组织。图8至图15提供了IMD的示例，其中电极固定至固定模块14，并且固定模块14操作性地将装置模块的远侧电极连接至固定模块14的电极。
在图1中，装置模块12还包括第一连接器部分30，并且固定模块14包括第二连接器部分32。在一些情况下，第一连接器部分30和第二连接器部分32可以以组合方式被认为形成可释放连接器34。在一些情况下，第一连接器部分30和第二连接器部分32配合以将装置模块12与固定模块14可释放地连接。固定模块14可以被视为具有从近侧端部38延伸到远侧端部40的固定壳体36。第二连接器部分32可以固定至固定壳体36的近侧端部38。固定结构42可以固定至固定壳体36的远侧端部40。在一些情况下，固定结构42可以示意性地表示主动固定结构，例如固定螺旋。在一些情况下，固定结构42可以示意性地表示被动固定结构，比如固定尖齿。随后的附图将提供固定尖齿的示例。
在一些情况下，如随后的附图中所示，装置模块12可以包括一个或更多个第一荧光透视标记，并且固定模块14可以包括一个或更多个第二荧光透视标记。该一个或更多个第一荧光透视标记以及该一个或更多个第二荧光透视标记可以布置成使得第一荧光透视标记中的一个或更多个与第二荧光透视标记中的一个或更多个之间的预定对准确认可释放连接器34处于完全连接状态和/或完全断开状态。
图2至图7示出了可以被视为无引线心脏起搏器(LCP)的IMD 50。例示性IMD 50包括在图3中单独示出的装置模块52以及在图4中单独示出的固定模块54。装置模块52包括从近侧端部58延伸到远侧端部60的装置壳体56。例示性装置模块52包括相对于近侧端部58固定的取回特征62。在远侧端部60处，装置模块52联接至固定模块54。在一些情况下，如图3中最佳所示，装置模块52可以包括在远侧立柱66上向远侧延伸的远侧电极64。远侧电极64可以可操作地联接至控制器24(图1)。装置模块52还可以包括可操作地联接至控制器24(图1)的近侧电极65。如图所示，近侧电极65可以是环形电极，但并非在所有情况下都需要如此。远侧立柱66在远侧电极64与控制器24之间提供机械和电连接，并且远侧立柱66的尺寸设定为当固定模块可释放地连接至装置模块52时允许远侧电极64从固定模块54向远侧延伸。
如图所示，固定模块54包括固定壳体68和固定尖齿组件70。在一些情况下，固定尖齿组件70可以包括一个或更多个被动固定尖齿72(示出了四个)，所述被动固定尖齿延伸穿过形成在固定壳体68内的相应孔口74。在一些情况下，被动固定尖齿72联接至环73(图6)或与环73一体形成，该环在固定壳体68下面将被动固定尖齿72连结在一起，并帮助将被动固定尖齿72彼此固定并相对于固定壳体68固定就位。如例如在图4中所见，固定壳体68可以包括中心孔口76，该中心孔口的尺寸设定为容纳远侧电极64，并且在一些情况下可以包括凹入部分78，该凹入部分的尺寸可以设定为容纳药物套环80(示出在图2中)。
图5至图7提供了关于装置模块52如何可以可释放地联接至固定模块54的另外细节。在一些情况下，装置模块52包括一个或更多个锁定凸片82。虽然示出了一对锁定凸片82，但是在一些情况下可以存在三个或更多个锁定凸片82。在一些情况下，该一个或更多个锁定凸片82中的每一个可以包括荧光透视标记84。如图6中可见，固定模块54可以包括一个或更多个相应的锁定狭槽86。虽然示出了一对锁定狭槽86，但是在一些情况下可以存在三个或更多个锁定狭槽86，以便无论装置模块52上存在多少锁定凸片82都能够容纳。在一些情况下，可以从该一个或更多个锁定狭槽86中的每一个径向向外设置荧光透视标记88，以帮助在荧光透视下可视化该一个或更多个锁定狭槽86的位置。
在所示示例中，该一个或更多个锁定狭槽86由保持结构90分开。在一些情况下，通过将一个或更多个锁定凸片82与相应的一个或更多个锁定狭槽86对准，可以将装置模块52固定至固定模块54。如将理解的，这可以通过将(在一个或更多个锁定凸片82上的)荧光透视标记84与(邻近一个或更多个锁定狭槽86的)荧光透视标记88在视觉上对准(在荧光透视下)来完成。一旦一个或更多个锁定凸片82与相应的一个或更多个锁定狭槽86对准，就可以通过将装置模块52相对于固定模块54向远侧移动而将装置模块52固定就位，使得一个或更多个锁定凸片82穿入到一个或更多个锁定狭槽86中。然后，装置模块52可以相对于固定模块54旋转，以将一个或更多个锁定凸片82在保持结构90下方移动到位。在一些情况下，装置模块52可以旋转90度。在一些情况下，一个或更多个锁定凸片82在一个或更多个相应的保持凹部87处保持就位。
在一些情况下，相对于固定模块54向远侧推动装置模块52涉及推动抵靠偏置机构，如可以理解的，所述偏置机构将有助于将一个或更多个锁定凸片82抵靠保持结构90保持就位，并且因此有助于防止装置模块52与固定模块54的意外分离，尤其是在植入之后。在一些情况下，偏置机构可以是固定至装置模块52的硅树脂弹簧密封件92。在一些情况下，保持结构90自身可以包括保持凹部，一个或更多个锁定凸片82可以装配到保持凹部中并通过偏置机构保持就位。
在一些情况下，该一个或更多个锁定凸片82中的每一个可以被视为是卡子，并且保持结构90的背侧可以包括一个或更多个接收件，其中每个卡子被偏置以延伸到接收件中，从而当装置模块52完全连接至固定模块54时形成干涉连接。图7示出了完成后的组件，其中固定壳体68被示出为透明的，从而可以看到一个或更多个锁定凸片82和相应的一个或更多个锁定狭槽86的相对布置。
图8至图15示出了可以被视为无引线心脏起搏器(LCP)的IMD 100。例示性IMD 100包括在图9中单独示出的装置模块102以及在图10中单独示出的固定模块104。装置模块102包括从近侧端部108延伸到远侧端部110的装置壳体106。例示性装置模块102包括相对于近侧端部108固定的取回特征112。在远侧端部110处，装置模块102联接至固定模块104。在一些情况下，如图所示，装置模块102包括可操作地联接至控制器24(图1)的近侧电极115。如图所示，近侧电极115是环形电极，但并非在所有情况下都需要如此。在一些情况下，固定模块104包括可操作地联接至控制器24的远侧电极114。
如图所示，固定模块104包括固定壳体118和固定尖齿组件70。在一些情况下，固定尖齿组件70可以包括一个或更多个被动固定尖齿72(示出了四个)，所述被动固定尖齿延伸穿过形成在固定壳体118内的相应孔口74。在一些情况下，虽然本文没有明确地示出，但被动固定尖齿72联接至环或与环一体形成，该环在固定壳体118下面将被动固定尖齿72连结在一起，并且有助于将被动固定尖齿72彼此固定并相对于固定壳体118固定就位。例如，参见前面相对于图6提到的环73。在一些情况下，药物套环130(参见图8)可以相对于固定壳体118设置。
因为远侧电极114相对于固定模块104固定，而不是直接固定至装置模块102，所以需要在在装置模块102中的控制器24(图1)与远侧电极114之间提供电连接。例如在图9和图12中可以看到的，例示性装置模块102包括远侧端子140，该远侧端子可操作地联接至控制器24并且从装置壳体106的远侧端部110向远侧延伸。在一些情况下，如图所示，远侧端子140可以具有锥形远侧端部142，以便于插入固定模块104中。如将讨论的，可以使用止挡件144以在装置模块102与固定模块104之间还提供可释放的机械连接。在一些情况下，远侧端子140可以包括一个或更多个密封件146，以便帮助防止流体桥接导体和/或引起体液(例如，血液)短路。至少远侧端部142可以被视为是电活性的。在一些情况下，如果需要，可以在远侧端部110处或附近设置辅助密封件148。
如例如在图11、图13和图14中可看到的，固定模块104可以包括连接组件150。在一些情况下，例如，远侧端子140(装置模块102的一部分)可以被视为第一连接器部分，并且连接组件150(固定模块104的一部分)可以被视为第二连接器部分。第一连接器部分和第二连接器部分可以例如被视为形成可释放连接器，该可释放连接器在控制器24(图1)与远侧电极114之间提供电连接以及在装置模块102与固定模块104之间提供机械连接。
例示性连接组件150包括孔口152(在图11中最佳示出)，该孔口构造成容纳远侧端子140。如图13中所示，在一些情况下，连接组件150包括板簧触头154，其有助于在远侧端子140与远侧电极114之间提供电连接。板簧触头154可以定位成使得它们延伸到止挡件144中。板簧触头154可以构造成在远侧端子140插入穿过孔口152并进入连接组件150中时挠曲，然后可以卡合到止挡件144中。一旦卡合到止挡件144中，板簧触头154就可以被视为装置模块102与固定模块104之间的合适的可释放机械连接，该可释放机械连接将装置模块102固定至固定模块104以防止意外分离但允许在需要时分离。
图14示出了其中连接组件150包括环形螺旋弹簧触头164的示例。螺旋弹簧触头164可以构造成在远侧端子140插入穿过孔口152并进入连接组件150中时挠曲，并且可以卡合到止挡件144中。应当理解的是，这可以在装置模块102与固定模块104之间提供机械连接。一旦卡合到止挡件144中，螺旋弹簧触头164就可以被视为装置模块102与固定模块104之间的合适的可释放机械连接，该可释放机械连接将装置模块102固定至固定模块104以防止意外分离但允许在需要时分离。在一些情况下，螺旋弹簧触头164可以构造成具有相对较低的插入力和相对较高的拔出力，以便有助于组装但是阻止意外拆除。这可以通过具有由卷绕丝形成的环形螺旋弹簧来实现，其中卷绕丝弯曲成沿着环状螺旋弹簧的顶部具有比沿着环状螺旋弹簧的底部的半径R2更小的半径R1。这只是一个示例。
图15是IMD 100的一部分的透视图，其中固定壳体118被示出为透明的，以便看到内部细节。具体而言，可以存在固定至远侧端子140的第一荧光透视环170以及固定至固定壳体118的第二荧光透视环172。当装置模块102插入固定模块104中时，第一荧光透视环170将与第二荧光透视环172未对准，但随着装置模块102朝向完全连接状态插入(例如，板簧触头154卡合到止挡件144中或螺旋弹簧触头164卡合到止挡件144中)，第一荧光透视环170将更靠近第二荧光透视环172。当第一荧光透视环170与第二荧光透视环172轴向对准时，这表明装置模块102完全插入固定模块104中。在一些情况下，取决于观察的相对角度，第一荧光透视环170和第二荧光透视环172可以显得更亮或更暗，这取决于荧光透视显示的是正图像还是负图像。
图16是根据本公开的示例的例示性LCP的示意性框图。例示性LCP可以植入患者体内并且可以操作以向心脏递送适当的治疗，比如递送抗心动过速起搏(ATP)治疗、心脏再同步治疗(CRT)、心动过缓治疗和/或类似治疗。如在图16中可以看到的，例示性LCP 200可以是紧凑型装置，其中所有部件容纳在壳体220内或直接位于壳体220上。在一些情况下，LCP200可以被视为IMD 10(图1)、IMD 50(图2)或IMD 100(图8)的示例。在一些情况下，LCP 200可以包括通信模块202、脉冲发生器模块204、电感测模块206、机械感测模块208、处理模块210、能量存储模块212(例如，电池)和电极214中的一个或更多个。
如图16中所示，LCP 200可以包括电极214，所述电极可以相对于壳体220固定并且电暴露于围绕LCP 200的组织和/或血液。电极214通常可以从和向LCP 200以及周围的组织和/或血液传导电信号。这些电信号可以包括通信信号、电刺激脉冲和固有心电信号，仅举几例。固有心电信号可以包括由心脏产生的电信号，并且可以由心电图(ECG)表示。
电极214可以包括一种或更多种生物相容的导电材料，比如已知可安全植入人体内的各种金属或合金。在一些情况下，电极214通常可以设置在LCP 200的任一端上，并且可以与模块202、204、206、208和210中的一个或更多个电连通。在电极214直接固定至壳体220的实施例中，绝缘材料可以将电极214与相邻电极、壳体220和/或LCP 200的其它部分电隔离。在一些情况下，一部分或全部电极214可以与壳体220间隔开，并且可以通过连接线连接至壳体220和/或LCP 200的其它部件。在这些情况下，电极214可以设置在远离壳体220延伸出的尾部(未示出)上。如图16中所示，在一些实施例中，LCP 200可以包括电极214'。电极214'可以是除电极214之外的电极，或者可以替换电极214中的一个或更多个。除了电极214'设置在LCP 200的侧部之外，电极214'可以类似于电极214。在一些情况下，电极214'可以增加LCP 200可以通过其输送通信信号和/或电刺激脉冲和/或可以感测固有心电信号、通信信号和/或电刺激脉冲的电极的数量。
电极214和/或214'可以呈现各种尺寸和/或形状中的任何一种，并且可以以各种间距中的任何一种间隔开。例如，电极214可以具有二至二十毫米(mm)的外径。在其它实施例中，电极214和/或214'可以具有二、三、五、七毫米(mm)的直径，或者任何其它合适的直径、尺寸和/或形状。电极214和/或214'的示例长度可以包括例如一、三、五、十毫米(mm)或者任何其它合适的长度。如本文所使用的，长度是电极214和/或214'的远离壳体220的外表面延伸的尺寸。在一些情况下，电极214和/或214'中的至少一些可以彼此间隔开二十、三十、四十、五十毫米(mm)的距离或者任何其它合适的间距。单个装置的电极214和/或214'可以相对于彼此具有不同的尺寸，并且装置上的电极的间距和/或长度可以是或可以不是统一的。
在所示实施例中，通信模块202可以电联接至电极214、214'中的两个或更多个，并且可以构造成向患者的组织输送通信脉冲，用于与其它装置(比如传感器、程控器、其它医疗装置和/或类似装置)通信。如本文所使用的，通信信号可以是通过自身或者与一个或更多个其它调制信号结合将信息传送到另一装置的任何调制信号。在一些实施例中，通信信号可以限于亚阈值信号，其不会导致心脏的捕获但仍传送信息。通信信号可以被输送到位于患者身体外部或内部的另一装置。在一些情况下，通信可以采取由不同时间量分开的独特通信脉冲的形式。在一些这样的情况中，连续脉冲之间的定时(timing)可以传送信息。通信模块202可以另外被构造成感测由可以位于患者身体的外部或内部的其它装置输送的通信信号。
通信模块202可以通信以帮助实现一种或更多种期望的功能。一些示例功能包括输送感测数据、使用通信数据来确定比如心律失常之类的事件的发生、协调电刺激治疗的递送和/或其它功能。在一些情况下，LCP 200可以使用通信信号来传达原始信息、处理后的信息、消息和/或命令、和/或其它数据。原始信息可以包括比如感测的电信号(例如，感测的ECG)、从联接传感器收集的信号等信息。在一些实施例中，处理后的信息可以包括利用一种或更多种信号处理技术滤波的信号。处理后的信息还可以包括由LCP 200和/或另一装置确定的参数和/或事件，比如确定的心率、确定的心跳的定时、其它确定的事件的定时、阈值交叉的确定、监测时间段的到期、加速计信号、活动水平参数、血氧参数、血压参数、心音参数等。在一些情况下，处理后的信息可以例如由化学传感器或光学接口传感器提供。消息和/或命令可以包括引导另一装置采取动作的指令或类似物、发送装置的即将发生动作的通知、从接收装置读取的请求、向接收装置写入数据的请求、信息消息和/或其它消息命令。
在至少一些实施例中，通信模块202(或LCP 200)可以进一步包括切换电路，以选择性地将电极214、214'和/或214”中的一个或更多个连接至通信模块202，以便选择通信模块202与电极214、214'和/或214”中的哪个输送通信脉冲。可设想，通信模块202可以经由传导信号、射频(RF)信号、光学信号、声学信号、电感耦合和/或任何其它合适的通信方法与其它装置通信。在通信模块202产生电通信信号的情况下，通信模块202可以包括一个或更多个电容器元件和/或其它电荷存储装置，以协助产生和输送通信信号。在所示实施例中，通信模块202可以利用存储在能量存储模块212中的能量来产生通信信号。在至少一些示例中，通信模块202可以包括连接至能量存储模块212的切换电路，并且利用该切换电路，通信模块可以将能量存储模块212连接至电极214/214'/214”中的一个或更多个以产生通信信号。
如图16中所示，脉冲发生器模块204可以电连接至电极214、214'和/或214”中的一个或更多个。脉冲发生器模块204可以构造成产生电刺激脉冲并经由电极214、214'和/或214”中的一个或更多个将电刺激脉冲输送到患者的组织，以便实现一种或更多种电刺激治疗。如本文所使用的，电刺激脉冲意在包括可以输送到患者的组织以便治疗任何类型的疾病或异常的任何电信号。例如，当用于治疗心脏疾病时，脉冲发生器模块204可以产生电刺激起搏脉冲，用于捕获患者的心脏，即，使心脏响应于所输送的电刺激脉冲而收缩。在一些这样的情况中，LCP 200可以例如以频率适应性起搏改变脉冲发生器模块204产生电刺激脉冲的频率。在其它实施例中，电刺激脉冲可以包括除颤/心脏复律脉冲，用于电击心脏脱离纤维性颤动或者进入正常心律。在再一些实施例中，电刺激脉冲可以包括抗心动过速起搏(ATP)脉冲。应该明白的是，这些只是一些示例。脉冲发生器模块204可以包括一个或更多个电容器元件和/或其它电荷存储装置，以帮助产生并输送适当的电刺激脉冲。在至少一些实施例中，脉冲发生器模块204可以利用存储在能量存储模块212中的能量来产生电刺激脉冲。在一些特定实施例中，脉冲发生器模块204可以包括切换电路，所述切换电路连接至能量存储模块212，并且可以将能量存储模块212连接至电极214/214'/214”中的一个或更多个以产生电刺激脉冲。在一些情况下，脉冲发生器模块204可以利用电极214提供起搏脉冲以使心脏H的RV(右心室)起搏，并且可以利用电极214”向心脏H的LV(左心室)提供起搏脉冲。在一些情况下，如果需要，由脉冲发生器模块204产生的用于起搏心脏H的RV的起搏脉冲与由脉冲发生器模块204产生的用于起搏心脏H的LV的起搏脉冲可以在时间上偏移，具有不同的持续时间，具有不同的幅度和/或具有不同的形状。
LCP 200可以进一步包括电感测模块206和机械感测模块208。电感测模块206可以构造成感测从电极214、214'和/或214”传导至电感测模块206的固有心电信号。例如，电感测模块206可以电连接至电极214、214'和/或214”中的一个或更多个，并且电感测模块206可以构造成经由传感器放大器或类似物接收通过电极214、214'和/或214”传导的心电信号。在一些实施例中，来自电极214和/或214'的心电信号可以表示来自RV的本地信息，而来自LV电极214”的心电信号可以表示来自心脏H的LV的本地信息。
机械感测模块208可以包括或电连接至各种传感器，比如加速度计(包括多轴加速度计，比如两轴或三轴加速度计)、陀螺仪(包括多轴陀螺仪，比如两轴或三轴陀螺仪)、血压传感器、心音传感器、压电传感器、血氧传感器和/或测量心脏和/或患者的一个或更多个生理参数的其它传感器。当存在时，机械感测模块208可以从传感器收集指示各种生理参数的信号。电感测模块206和机械感测模块208可以都连接至处理模块210，并且可以将表示感测到的心电信号和/或生理信号的信号提供给处理模块210。虽然关于图16描述为单独的感测模块，但是在一些实施例中，电感测模块206和机械感测模块208可以组合成单个模块。在至少一些示例中，LCP 200可以仅包括电感测模块206和机械感测模块208中的一个。在一些情况下，处理模块210、电感测模块206、机械感测模块208、通信模块202、脉冲发生器模块204和/或能量存储模块的任何组合可以被视为LCP 200的控制器。
处理模块210可以构造成引导LCP 200的操作，并且在一些实施例中，可以称为控制器。例如，处理模块210可以构造成从电感测模块206接收心电信号和/或从机械感测模块208接收生理信号。基于接收到的信号，处理模块210可以确定例如心律失常的发生和类型以及其它确定，比如LCP 200是否已经脱落。处理模块210可以进一步从通信模块202接收信息。在一些实施例中，处理模块210可以另外利用这种接收到的信息来确定心律失常的发生和类型和/或其它确定，比如LCP 200是否已经脱落。在又一些另外的实施例中，例如，如果接收到的信息被认为比从电感测模块206和/或机械感测模块208接收的信号更准确，或者如果电感测模块206和/或机械感测模块208被禁用或从LCP 200中省去，则LCP 200可以利用接收到的信息，而不是从电感测模块206和/或机械感测模块208接收的信号。
在确定心律失常的发生之后，根据一种或更多种电刺激治疗，处理模块210可以控制脉冲发生器模块204产生电刺激脉冲，从而治疗所确定的心律失常。例如，处理模块210可以控制脉冲发生器模块204产生具有变化参数和不同序列的起搏脉冲，以实现一种或更多种电刺激治疗。作为一个示例，在控制脉冲发生器模块204输送心动过缓起搏治疗时，处理模块210可以控制脉冲发生器模块204输送设计成以规则间隔捕获患者的心脏的起搏脉冲，以帮助防止患者的心脏跌到预定阈值以下。在一些情况下，起搏频率可以随着患者的活动水平的增加而增加(例如，频率适应性起搏)。例如，处理模块210可以监测患者的可以指示需要增加心率(例如，由于增加的代谢需求)的一个或更多个生理参数。然后，处理模块210可以增加脉冲发生器模块204产生电刺激脉冲的频率。基于一个或更多个生理参数调整电刺激脉冲的输送频率可以通过仅在生理参数指示需要增加心脏输出时需要更高的电刺激脉冲输送频率来延长LCP 200的电池寿命。此外，调整电刺激脉冲的输送频率可以通过更紧密地匹配电刺激脉冲的输送频率与患者的心脏输出需求来提高患者的舒适水平。
对于ATP治疗，处理模块210可以控制脉冲发生器模块204以比患者的固有心率更快的频率输送起搏脉冲，以试图迫使心脏响应于所输送的起搏脉冲而不是固有心电信号来跳动。一旦心脏跟随起搏脉冲，处理模块210可以控制脉冲发生器模块204将输送的起搏脉冲的频率降低到更安全的水平。在CRT中，处理模块210可以控制脉冲发生器模块204与另一装置协调地输送起搏脉冲，以使心脏更有效地收缩。在脉冲发生器模块204能够产生用于除颤/心脏复律治疗的除颤和/或心脏复律脉冲的情况下，处理模块210可以控制脉冲发生器模块204产生这种除颤和/或心脏复律脉冲。在一些情况下，处理模块210可以控制脉冲发生器模块204产生电刺激脉冲，以提供与上述那些示例不同的电刺激治疗。
除了控制脉冲发生器模块204产生不同类型和不同序列的电刺激脉冲外，在一些实施例中，处理模块210还可以控制脉冲发生器模块204产生具有变化的脉冲参数的各种电刺激脉冲。例如，每个电刺激脉冲可以具有脉冲宽度和脉冲幅度。处理模块210可以控制脉冲发生器模块204产生具有特定脉冲宽度和脉冲幅度的各种电刺激脉冲。例如，如果电刺激脉冲没有有效地捕获心脏(例如，RV或LV捕获)，则处理模块210可以使脉冲发生器模块204调整电刺激脉冲的脉冲宽度和/或脉冲幅度。对各种电刺激脉冲的特定参数的这种控制可以帮助LCP 200提供电刺激治疗的更有效输送。
在一些实施例中，处理模块210可以进一步控制通信模块202向其它装置发送信息。例如，处理模块210可以控制通信模块202产生一个或更多个通信信号，用于与装置系统的其它装置通信。例如，处理模块210可以控制通信模块202产生特定脉冲序列的通信信号，其中特定序列传送不同的信息。通信模块202还可以接收处理模块210用于潜在动作的通信信号。
在进一步的实施例中，处理模块210可以控制切换电路，通过该切换电路，通信模块202和脉冲发生器模块204将通信信号和/或电刺激脉冲输送给患者的组织。如上所述，通信模块202和脉冲发生器模块204都可以包括用于将电极214、214'和/或214”中的一个或更多个连接至通信模块202和/或脉冲发生器模块204的电路，因此这些模块可以将通信信号和电刺激脉冲输送给患者的组织。一个或更多个电极(通信模块202和/或脉冲发生器模块204通过所述电极输送通信信号和电刺激脉冲)的特定组合可以影响通信信号的接收和/或电刺激脉冲的有效性。尽管描述了通信模块202和脉冲发生器模块204中的每个可以包括切换电路，但是在一些实施例中，LCP 200可以具有连接至通信模块202、脉冲发生器模块204以及电极214、214'和/或214”的单个切换模块。在这样的实施例中，处理模块210可以控制切换模块根据情况连接模块202/204和电极214/214'/214”。在一些情况下，LV电极214”也可以联接至切换模块并且可以用于通信。
在一些实施例中，处理模块210可以包括预编程芯片，比如超大规模集成(VLSI)芯片或专用集成电路(ASIC)。在这样的实施例中，芯片可以用控制逻辑预编程，以便控制LCP200的操作。通过使用预编程芯片，处理模块210可以使用比其它可编程电路更少的功率，同时能够维持基本功能，从而潜在地增加LCP 200的电池寿命。在其它情况下，处理模块210可以包括可编程微处理器或类似物。这种可编程微处理器可以允许用户在制造之后调整LCP200的控制逻辑，从而允许LCP 200比使用预编程芯片时具有更大的灵活性。在再一些实施例中，处理模块210可以不是单个部件。例如，处理模块210可以包括定位在LCP 200内的不同位置的多个部件，以便执行各种所描述的功能。例如，某些功能可以在处理模块210的一个部件中执行，而其它功能在处理模块210的不同部件中执行。
在另外的实施例中，处理模块210可以包括存储器电路，并且处理模块210可以在存储器电路上存储信息和从存储器电路读取信息。在其它实施例中，LCP200可以包括与处理模块210通信的单独的存储器电路(未示出)，使得处理模块210可以从该单独的存储器电路读取信息并向该单独的存储器电路写入信息。该存储器电路，无论是处理模块210的一部分还是与处理模块210分开，可以是易失性存储器、非易失性存储器、或易失性存储器和非易失性存储器的组合。
能量存储模块212可以向LCP 200提供电源以用于其操作。在一些实施例中，能量存储模块212可以是不可再充电的锂基电池。在其它实施例中，不可再充电电池可以由其它合适的材料制成。在一些实施例中，能量存储模块212可以被视为可再充电电源，比如但不限于可再充电电池。在再一些实施例中，能量存储模块212可以包括其它类型的能量存储装置，比如电容器或超级电容器。在一些情况下，如将讨论的，能量存储模块212可以包括可再充电的一次电池和不可再充电的二次电池。在一些情况下，一次电池和第二电池(如果存在)都可以是可再充电的。
为了将LCP 200植入患者体内，操作者(例如，医生、临床医师等)可以将LCP 200固定至患者心脏的心脏组织。为了便于固定，LCP 200可以包括一个或更多个锚定件216。该一个或更多个锚定件216可以包括任何数量的固定或锚定机构。例如，一个或更多个锚定件216可以包括一个或更多个销、钉、螺纹、螺钉、螺旋、尖齿和/或类似物。在一些实施例中，虽然未示出，但是一个或更多个锚定件216可以在其外表面上包括可以沿着锚定构件的至少部分长度延伸的螺纹。螺纹可以在心脏组织与锚定件之间提供摩擦，以帮助将锚定构件固定在心脏组织内。在一些情况下，一个或更多个锚定件216可以包括具有可拧入心脏组织中的瓶塞钻形状的锚定构件。在其它实施例中，锚定件216可以包括其它结构，比如倒钩、栓钉或类似物，以便于与周围心脏组织的接合。
应该理解，本公开在许多方面仅是例示性的。在不超出本公开范围的情况下，可以在细节上，特别是在形状、尺寸和步骤布置方面，进行改变。在适当的程度上，这可以包括使用一个示例实施例的在其它实施例中使用的任何特征。

Claims (8)

1.一种可植入医疗装置IMD，包括：
装置模块，其具有近侧端部和远侧端部，所述装置模块包括：
电源；
控制器，其可操作地联接至所述电源，所述控制器构造为经由两个或更多个电极感测心电活动并且经由两个或更多个电极输送起搏脉冲；
可释放连接器的第一部分；
固定模块，包括：
多个固定件，其用于将所述固定模块锚定到患者的心脏；
可释放连接器的第二部分，其中所述可释放连接器的第一部分和所述可释放连接器的第二部分配合以将所述装置模块与所述固定模块可释放地连接；
所述装置模块具有一个或更多个第一荧光透视标记，并且所述固定模块具有一个或更多个第二荧光透视标记，其中所述一个或更多个第一荧光透视标记和所述一个或更多个第二荧光透视标记布置成使得第一荧光透视标记中的一个或更多个与第二荧光透视标记中的一个或更多个之间的预定旋转对准确认所述可释放连接器处于完全连接状态，
其中，所述可释放连接器包括：
一个或更多个锁定凸片；
一个或更多个锁定狭槽；
其中，所述一个或更多个锁定凸片构造成抵靠偏置机构移动到所述一个或更多个锁定狭槽中，之后所述一个或更多个锁定凸片构造成相对于所述一个或更多个锁定狭槽旋转，直到锁定凸片中的一个或更多个被所述偏置机构推入到一个或更多个保持凹部中，此时所述可释放连接器处于完全连接状态，
其中，所述锁定凸片中的至少一个和所述保持凹部中的至少一个的位置由相应的荧光透视标记来标记。
2.根据权利要求1所述的IMD，其中，所述装置模块进一步包括均操作地联接至所述控制器的近侧电极和远侧电极，其中所述远侧电极设置在从所述可释放连接器的第一部分向远侧延伸的细长立柱上，并且其中所述固定模块限定孔口，当所述可释放连接器处于完全连接状态时，所述细长立柱延伸穿过所述孔口以将所述远侧电极支撑在所述固定模块的远侧上。
3.根据权利要求1所述的IMD，其中，所述装置模块进一步包括均操作地联接至所述控制器的近侧电极和远侧端子，并且其中所述固定模块包括在所述固定模块的远侧上的远侧电极，并且其中当所述可释放连接器处于完全连接状态时，所述装置模块的远侧端子操作性地联接至所述固定模块的远侧电极。
4.根据权利要求1至3中任一项所述的IMD，其中，所述可释放连接器包括：
一个或更多个接收件；
一个或更多个卡子，当所述可释放连接器处于完全连接状态时，所述卡子被偏置以延伸到所述接收件中的一个或更多个中并将其捕获，从而形成干涉连接。
5.根据权利要求4所述的IMD，其中，所述可释放连接器进一步包括密封件，用于在所述可释放连接器处于完全连接状态时将所述一个或更多个接收件和所述一个或更多个卡子与外部环境阻隔。
6.根据权利要求4所述的IMD，其中，所述可释放连接器进一步包括一个或更多个电触头，用于在所述可释放连接器的第一部分与所述可释放连接器的第二部分之间形成电连接。
7.根据权利要求1所述的IMD，其被构造为从心脏腔室内的位置使患者的心脏起搏的可植入无引线心脏起搏器LCP，其中，所述固定模块被构造成与所述心脏腔室接合，并且所述装置模块可释放地固定至所述固定模块，以便部署在所述心脏腔室内；
所述固定模块包括：
固定模块壳体；
多个锁定狭槽；
孔口，其被构造为容纳由所述装置模块承载的电极；
所述装置模块包括：
装置模块壳体；
多个锁定凸片，其构造成与所述固定模块的锁定狭槽配合，从而通过将所述多个锁定凸片抵靠所述偏置机构插入所述锁定狭槽中，然后使所述装置模块相对于所述固定模块旋转，直到锁定凸片中的一个或更多个被所述偏置机构推入所述固定模块的保持凹部中的一个或更多个中，将所述装置模块可释放地固定至所述固定模块；
所述电源，其设置在所述装置模块壳体内；
设置在所述装置模块壳体上的第一电极以及设置在向所述多个锁定凸片的远侧延伸的细长立柱上的第二电极，所述细长立柱构造成延伸穿过所述固定模块壳体中的孔口，从而当所述装置模块与所述固定模块接合并且所述LCP被植入时，将所述第二电极放置在所述第二电极能够接触心脏组织的位置；以及
所述控制器，其设置在所述装置模块壳体内，所述控制器构造成感测心电活动并经由所述第一电极和所述第二电极中的一个或更多个输送起搏脉冲。
8.根据权利要求7所述的IMD，其中，所述固定模块进一步包括多个固定尖齿，所述固定尖齿构造成向远侧延伸到患者的心脏组织中，然后向近侧返回以钩住患者的心脏组织，从而将所述固定模块锚定到患者的心脏。
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