JP6182675B2 - リードレス心臓ペースメーカおよび回収デバイス - Google Patents
リードレス心臓ペースメーカおよび回収デバイス Download PDFInfo
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- JP6182675B2 JP6182675B2 JP2016534605A JP2016534605A JP6182675B2 JP 6182675 B2 JP6182675 B2 JP 6182675B2 JP 2016534605 A JP2016534605 A JP 2016534605A JP 2016534605 A JP2016534605 A JP 2016534605A JP 6182675 B2 JP6182675 B2 JP 6182675B2
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- 230000000747 cardiac effect Effects 0.000 title claims description 40
- 238000003032 molecular docking Methods 0.000 claims description 92
- 230000014759 maintenance of location Effects 0.000 claims description 90
- 238000011084 recovery Methods 0.000 claims description 14
- 230000000712 assembly Effects 0.000 claims description 3
- 238000000429 assembly Methods 0.000 claims description 3
- 238000000034 method Methods 0.000 description 30
- 210000005003 heart tissue Anatomy 0.000 description 8
- 230000008569 process Effects 0.000 description 7
- 230000000717 retained effect Effects 0.000 description 7
- 230000007246 mechanism Effects 0.000 description 5
- 230000000638 stimulation Effects 0.000 description 5
- 210000001519 tissue Anatomy 0.000 description 5
- 230000004962 physiological condition Effects 0.000 description 4
- 239000000463 material Substances 0.000 description 3
- 210000005241 right ventricle Anatomy 0.000 description 3
- 230000003068 static effect Effects 0.000 description 3
- 239000002775 capsule Substances 0.000 description 2
- 238000001827 electrotherapy Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 210000003484 anatomy Anatomy 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000005242 cardiac chamber Anatomy 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000005245 right atrium Anatomy 0.000 description 1
- 210000000591 tricuspid valve Anatomy 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
- 210000001631 vena cava inferior Anatomy 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
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- 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
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N2001/0578—Anchoring means; Means for fixing the head inside the heart having means for removal or extraction
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- Animal Behavior & Ethology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
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- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Electrotherapy Devices (AREA)
- Prostheses (AREA)
Description
本開示は、医療デバイスの構造およびアセンブリを製造するいくつかの代替的な設計、材料および方法、ならびに、その使用に関する。
本開示の態様は、添付の図面と関連して種々の実施形態の以下の詳細な説明を検討すればより完全に理解することができる。
本明細書において、全ての数値は、明示的に示されているか否かにかかわらず、「約」という用語によって修飾されるとみなされる。「約」という用語は、概して、記載されている値と同等である(すなわち、同じ機能または結果を有する)と当業者が考える、ある範囲の数字を指す。多くの場合、「約」という用語は、最も近い有効数字に四捨五入される数字を含むものとして示されることができる。
種々の構成要素、特徴および仕様、あるいは種々の構成要素、特徴または仕様に関するいくつかの好適な寸法、範囲および値、あるいは寸法、範囲または値が開示されるが、本開示によって動機付けされる当業者は、所望の寸法、範囲および値、あるいは所望の寸法、範囲または値が明示的に開示されるものから逸脱し得ることを理解するであろう。
Claims (12)
- 埋め込み可能な心臓ペーシングデバイスを回収するアセンブリであって、
ハウジング、前記ハウジングの遠位端に近接して位置決めされる電極、および、前記遠位端とは反対側の前記ハウジングの近位端から延びるドッキング部材を有する、埋め込み可能な心臓ペーシングデバイスであって、前記ドッキング部材は、ヘッド部分、および、前記ハウジングと前記ヘッド部分との間に延びるネック部分を含む、埋め込み可能な心臓ペーシングデバイスと、
回収デバイスとを備え、前記回収デバイスは、
回収カテーテルであって、近位端、遠位端、および、前記遠位端から前記回収カテーテル内に延びるルーメンを有する回収カテーテルと、
前記回収カテーテルの前記遠位端から前進可能なスネアであって、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に引き込むように前記ドッキング部材に連結されるよう構成されているループを有するスネアとを含み、
前記回収カテーテルは、前記回収カテーテルの内面から径方向内方に延びると共に前記ドッキング部材の前記ヘッド部分に係合するように構成されている前記ルーメン内の保持特徴部を含むことで、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に前記スネアによって引き込んだ後の前記ルーメン内での前記埋め込み可能な心臓ペーシングデバイスの保持を容易にし、前記保持特徴部は、前記ドッキング部材の前記ヘッド部分と締まり嵌めを形成するように構成されているテーパ状の内面を含み、前記テーパ状の内面は、前記ドッキング部材の前記ヘッド部分の外径よりも大きい第1の直径から、前記ドッキング部材の前記ヘッド部分の外径よりも小さい第2の直径まで近位にテーパ状になる、アセンブリ。 - 埋め込み可能な心臓ペーシングデバイスを回収するアセンブリであって、
ハウジング、前記ハウジングの遠位端に近接して位置決めされる電極、および、前記遠位端とは反対側の前記ハウジングの近位端から延びるドッキング部材を有する、埋め込み可能な心臓ペーシングデバイスであって、前記ドッキング部材は、ヘッド部分、および、前記ハウジングと前記ヘッド部分との間に延びるネック部分を含む、埋め込み可能な心臓ペーシングデバイスと、
回収デバイスとを備え、前記回収デバイスは、
回収カテーテルであって、近位端、遠位端、および、前記遠位端から前記回収カテーテル内に延びるルーメンを有する回収カテーテルと、
前記回収カテーテルの前記遠位端から前進可能なスネアであって、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に引き込むように前記ドッキング部材に連結されるよう構成されているループを有するスネアとを含み、
前記回収カテーテルは、前記回収カテーテルの内面から径方向内方に延びると共に前記ドッキング部材の前記ヘッド部分に係合するように構成されている前記ルーメン内の保持特徴部を含むことで、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に前記スネアによって引き込んだ後の前記ルーメン内での前記埋め込み可能な心臓ペーシングデバイスの保持を容易にし、前記保持特徴部は、前記回収カテーテルの内面から径方向内方に延びると共に前記ドッキング部材の前記ヘッド部分に螺合するように構成されている雌ねじを含む、アセンブリ。 - 前記ドッキング部材の前記ヘッド部分は、前記雌ねじの隣接する巻き線間に位置決め可能である、請求項2に記載のアセンブリ。
- 前記雌ねじの小径は、前記ドッキング部材の前記ヘッド部分の外径よりも小さく、前記雌ねじの大径は、前記ドッキング部材の前記ヘッド部分の前記外径よりも大きい、請求項2に記載のアセンブリ。
- 前記雌ねじは不連続的である、請求項2に記載のアセンブリ。
- 前記テーパ状の内面は、不連続的な円錐台の面である、請求項1に記載のアセンブリ。
- 埋め込み可能な心臓ペーシングデバイスを回収するアセンブリであって、
ハウジング、前記ハウジングの遠位端に近接して位置決めされる電極、および、前記遠位端とは反対側の前記ハウジングの近位端から延びるドッキング部材を有する、埋め込み可能な心臓ペーシングデバイスであって、前記ドッキング部材は、ヘッド部分、および、前記ハウジングと前記ヘッド部分との間に延びるネック部分を含む、埋め込み可能な心臓ペーシングデバイスと、
回収デバイスとを備え、前記回収デバイスは、
回収カテーテルであって、近位端、遠位端、および、前記遠位端から前記回収カテーテル内に延びるルーメンを有する回収カテーテルと、
前記回収カテーテルの前記遠位端から前進可能なスネアであって、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に引き込むように前記ドッキング部材に連結されるよう構成されているループを有するスネアとを含み、
前記回収カテーテルは、前記回収カテーテルの内面から径方向内方に延びると共に前記ドッキング部材の前記ヘッド部分に係合するように構成されている前記ルーメン内の保持特徴部を含むことで、前記埋め込み可能な心臓ペーシングデバイスを前記回収カテーテルの前記ルーメン内に前記スネアによって引き込んだ後の前記ルーメン内での前記埋め込み可能な心臓ペーシングデバイスの保持を容易にし、前記保持特徴部は、前記ルーメン内に延びる周方向リムと、前記周方向リムの周りに間隔を空けて配置された複数の凹部とを有し、前記複数の凹部は、前記埋め込み可能な心臓ペーシングデバイスの前記ハウジングの前記近位端から近位に延びると共に間隔を空けて配置された複数の突起を受け入れる、請求項1に記載のアセンブリ。 - 前記突起は、前記凹部内にプレス嵌めされる、請求項7に記載のアセンブリ。
- 前記保持特徴部は、複数の径方向に延びるリブを含み、前記複数の突起は、前記複数の径方向に延びるリブと噛み合うように構成されかつ前記ドッキング部材の前記ヘッド部分に設けられた複数の径方向に延びるスポークを含む、請求項7に記載のアセンブリ。
- 各リブは、前記ドッキング部材の前記ヘッド部分の隣接するスポーク間に押圧されるように構成されている、請求項9に記載のアセンブリ。
- 前記保持特徴部の遠位の前記ルーメンの遠位部分は、前記埋め込み可能な心臓ペーシングデバイスの前記ハウジングを内部に受け入れるようにサイズ決めされる、請求項1に記載のアセンブリ。
- 前記スネアは、前記保持特徴部を通る中央開口を通って延びる、請求項1に記載のアセンブリ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US201361866650P | 2013-08-16 | 2013-08-16 | |
US61/866,650 | 2013-08-16 | ||
PCT/US2014/049766 WO2015023474A1 (en) | 2013-08-16 | 2014-08-05 | Leadless cardiac pacemaker and retrieval device |
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JP2016527989A JP2016527989A (ja) | 2016-09-15 |
JP6182675B2 true JP6182675B2 (ja) | 2017-08-16 |
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JP2016534605A Expired - Fee Related JP6182675B2 (ja) | 2013-08-16 | 2014-08-05 | リードレス心臓ペースメーカおよび回収デバイス |
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US (1) | US9700732B2 (ja) |
EP (1) | EP3033145B1 (ja) |
JP (1) | JP6182675B2 (ja) |
CN (1) | CN105744987B (ja) |
WO (1) | WO2015023474A1 (ja) |
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JP2016527989A (ja) | 2016-09-15 |
US9700732B2 (en) | 2017-07-11 |
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