WO2003073942A2 - Improved system and method of positioning implantable medical devices - Google Patents
Improved system and method of positioning implantable medical devices Download PDFInfo
- Publication number
- WO2003073942A2 WO2003073942A2 PCT/US2002/036331 US0236331W WO03073942A2 WO 2003073942 A2 WO2003073942 A2 WO 2003073942A2 US 0236331 W US0236331 W US 0236331W WO 03073942 A2 WO03073942 A2 WO 03073942A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- lead
- infrared light
- catheter
- elongated shaft
- light
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/3137—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for examination of the interior of blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
-
- 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
-
- 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
- A61N2001/0585—Coronary sinus electrodes
Definitions
- This invention relates to implantable medical device systems, and in particular to a device and method for the placement and control of an implantable medical device into specific cardiovasculature locations such as the distal vasculature system of the coronary sinus.
- Implantable medical electrical stimulation and/or sensing leads is well known in the fields of cardiac stimulation and monitoring.
- Endocardial leads are placed through a transvenous route to place one or more sensing and/or stimulation electrodes in a desired location within a heart chamber or interconnecting vasculature.
- a delivery system may include a guide catheter, stylet, guidewire, steerable sheath, and/or an equivalent delivery mechanism.
- leads and/or other implantable medical devices may be positioned within the right atrium and/or ventricle to provide therapies for cardiac ailments.
- IMD implantable medical devices
- certain cardiac disfunctions such as heart failure may be effectively treated by positioning leads, catheters, and/or IMDs adjacent to, or within, the left side of the heart.
- cardiac resynchronization therapy may be accomplished by pacing both the left and right ventricles.
- Left ventricular pacing pulses may be delivered via a lead positioned within the coronary sinus or a branch cardiac vein in proximity to the left ventricle.
- a distal end of the device is advanced through the superior vena cava, into the right atrium, through the valve of the coronary sinus, and into the coronary sinus.
- the device may be further advanced into a coronary vein communicating 02 36331
- the coronary sinus such as the cardiac great vein, the middle cardiac vein, the posterial lateral cardiac vein, or the anterial lateral cardiac vein as examples.
- pacing leads or other types of leads, at other locations within the heart for various reasons. For example, it may be desirable to locate such leads in the right ventricular outflow tract (RVOT), the Bundle of His, or the triangle of Koch, as such alternates may enhance the effectiveness of the heart therapy delivered to such sites.
- RVT right ventricular outflow tract
- Bundle of His the Bundle of His
- the triangle of Koch may enhance the effectiveness of the heart therapy delivered to such sites.
- a guide catheter is navigated into the desired location in the vasculature.
- a lead is then fed through the inner lumen of the catheter such that the lead electrode(s) are positioned at predetermined locations.
- the guide catheter may then be withdrawn. This type of approach is described in commonly assigned U.S. Patent Numbers 6,006,137, 5,246,014, and 5,851 ,226 incorporated herein by reference in their entireties.
- the disclosed system includes a pusher mechanism that is adapted to slidably engage a guidewire that has previously been placed at a desired implant site.
- the pusher mechanism couples to a lead body to allow the pusher to guide the lead over the guidewire to the desired implant site.
- a significant challenge involves the location and navigation of a guide device, such as a catheter or guide wire, into the coronary sinus. Anomalies in the vascular anatomy, their small size, and the number of branch veins associated with the anatomy make locating the desired path challenging.
- Radiopaque dye This dye may be injected into the venous anatomy so that the chambers of the heart and the related vasculature system are visible using a fluoroscopic device. This procedure, sometimes referred to as a "venogram", allows the surgeon to locate the coronary sinus, its distal vasculature, or other anatomical structure when performing an implant procedure.
- fluoro visible media it may be undesirable to use fluoro visible media during an implant process for several reasons.
- the use of fluoroscopy exposes the patient, implant surgeon and assistants to radiation.
- the use of protective lead aprons prevents or limits exposure to the physician and his attending staff, but their heavy weight is problematic for long and/or several procedures daily.
- a fluoroscope of the type needed for obtaining the fluoro-visible image may not be available.
- obtaining the venogram adds additional steps to the implant procedure, lengthening the time required to complete the procedure, increases the cost of the procedure and increases the risk of infection and complications to the patient.
- That patent describes the use of an infrared imagining system that is capable of transmitting light into an environment containing opaque or semi-opaque fluids such as blood.
- a lead delivery method is not disclosed.
- the present invention provides a visual catheter guide system to navigate and position a medical device within the coronary sinus and branch veins, such as the cardiac great vein, the middle cardiac vein, the posterial lateral cardiac vein, the anterial lateral cardiac vein and similar other cardiac vasculature.
- the system enables continuous visual imaging of the deployment, location and vascular environment of the catheter inside the cardiac network of vasculatory system.
- a shaft adapted to be positioned within the cardiac vein or coronary artery incorporates a fiber optic cable suitable for transmitting light.
- an infrared light source transfers infrared light down the cable.
- An optical head assembly coupled to the cable is implemented as a transceiver for the infrared light.
- sensing systems receive the infrared light from the body using optical assemblies.
- An image is generated indicating the position of the distal portion of the elongated shaft, in addition to monitoring navigation on a real-time visual basis.
- the vision system may incorporate an ablation system for navigation and placement of an ablation electrode in a human heart.
- Another embodiment includes an implementation of a laser lead extraction system to view and remove a cardiac lead from the heart. Further, proper positioning of an ablation catheter prior to the application of ablation energy is enabled using the scheme and structure of the present invention.
- FIG. 1 depicts an infrared endoscope system connected to a catheter delivery system having a distal end positioned in a coronary vein;
- FIG. 2 depicts a catheter delivery system of the present invention;
- FIG. 3 A is a cross section of the catheter delivery system of FIG. 1;
- FIG. 3B is a cross section of a first alternative embodiment of the catheter delivery system of FIG. 1;
- FIG. 3C is a cross section of a second alternative embodiment of the catheter delivery system of FIG. 1;
- FIG. 4 is a cross section of an alternative implementation of the catheter delivery system of FIG. 1;
- FIG. 5 is an alternative delivery system for use with the vision system of FIG. 1; and FIG. 6 depicts an additional alternative embodiment of the present invention.
- the delivery and positioning of this left ventricular lead in the coronary sinus vasculature system is problematic.
- the claimed invention allows the rapid, accurate and easy deployment and positioning of a lead in the coronary sinus, distal coronary sinus, great cardiac vein, the middle cardiac vein, the posterial lateral cardiac vein, the anterial lateral cardiac vein or other distal vasculature.
- FIG. 1 illustrates a human heart 10 in cross section with the right atrium 12, right ventricle 14, left atrium 16, left ventricle 18, coronary sinus ostium 22 and superior vena cava 24 shown.
- FIG. 1 further illustrates the catheter guide system 20 shown in FIG. 2 disposed within the patient's vascular system with the distal section (not shown) of the catheter seated within the patient's coronary sinus ostium 22.
- the catheter guide system 20 has been introduced from the cephalic vein (not shown) and advanced through the superior vena cava 24 and into the right atrium 12.
- catheter guide system 20 coupled to a system 100 for transferring infrared light to the distal end of the catheter, capturing the reflected light, and displaying an image for use by an implanting physician.
- This catheter uses technology disclosed in U.S. Patent No. 6,178,346, incorporated herein by reference, to transmit light through opaic fluids such as blood.
- System 100 includes a laser diode 106 and infrared camera 112. Light reflected from within the coronary sinus is received by an optical head
- the image processing unit 120 uses known image processing techniques to enhance the image created by the reflected and scattering light to provide a view of the cardiac vasculature.
- the image processing unit 120 is connected with electrical cable 122 to the central processing unit or CPU 130, which reconfigures the signals and transmits these signals through an electrical cable 122 to a video processor 126 which processes the signals for video imaging.
- video recorder 128 may also be coupled to the video processor 126. 02 36331
- the system of FIG. 1 may be used to position catheter guide system 20 within the coronary sinus and branch veins such as the cardiac great vein, the middle cardiac vein, the posterial lateral cardiac vein, or the anterial lateral cardiac vein.
- structures may be visualized at a distance of 4-5 millimeters through blood. Wavelengths of approximately 2.1 microns would also be suitable for this embodiment. This region permits viewing arterial structures about 10 millimeters through blood. Higher wavelength regions (e.g., 3.8-4.4, 4.7-5.3, and 7-10) would generate more accurate images but also result in more rigid catheter designs because of the larger-sized optical fibers required in this embodiment.
- FIG. 1 may be used to position catheter guide system 20 within the coronary sinus and branch veins such as the cardiac great vein, the middle cardiac vein, the posterial lateral cardiac vein, or the anterial lateral cardiac vein.
- the invention includes a guide catheter system 20 such as disclosed in U.S. Patent No. 6,021,340, incorporated herein by reference in its entirety.
- the catheter includes an elongated shaft 31, a distal shaft section 36, a proximal shaft section 34, an inner lumen 32 and a control handle 30 on the proximal end of the shaft 31.
- a port 38 is provided in the distal end of the catheter shaft 36 that is in fluid communication with the inner lumen 32.
- the distal shaft section 36 is controllable in a 3D manner via the proximal handle 30 as described in the '340 patent.
- the catheter shaft 31 contains optical fibers to transmit infrared light from the vision system 100 to a lens 40 and transmits reflected light back to the vision system 100 for processing and displaying vasculature structures.
- Catheter 20 may optionally contain distally located sense/pace electrodes for the verification and confirmation of proper location.
- FIG. 3A shows a cross sectional view of the guide catheter system 20 of FIGS. 1 and 2.
- the catheter body 52 contains several lumens 50 containing optical fibers for the transmission of infrared light from a proximal source 106 to a lens 40 on the distal end of the catheter and for the reflected light to be returned to the infrared camera 112.
- a pacing or defibrillation lead 62 is shown in a central lumen 56.
- the catheter guide system 20 is used to deliver the distal end of the catheter to a desired location and then a lead is threaded through lumen 56 to deliver the lead to the proper location. This method allows the use of very small diameter lead systems because a stylet lumen is not required in the lead body construction.
- FIG. 1 shows a cross sectional view of the guide catheter system 20 of FIGS. 1 and 2.
- the catheter body 52 contains several lumens 50 containing optical fibers for the transmission of infrared light from a proximal source 106 to a lens
- 3B shows an alternative cross sectional view of the guide catheter system 20 of FIGS. 1 and 2.
- the catheter body 52 contains several lumens 50 containing optical fibers for the transmission of infrared light from a proximal source 106 to the distal end of the catheter and for the reflected light to be returned to the infrared camera 112.
- a guide wire 54 is shown in a central lumen 56. This method allows the distal end of a guide wire to be positioned in the correct location, a lead body is tracked over the wire and the wire is then withdrawn.
- FIG.3C shows a cross sectional view of the guide catheter system 20 of FIGS.1 and 2 containing an alternative embodiment of catheter body construction.
- the catheter body 52 contains a single lumen 50 containing optical fibers for the transmission of infrared light from a proximal source 106 to the distal end of the catheter.
- an active pixel sensor is positioned to receive light reflected from the coronary sinus vasculature system.
- the active pixel sensor is as substantially described in U.S. Patent Nos. 6,204,524, 6,243,131, and published application No. 2001/0055832.
- the '524 and '131 patents and '832 application are incorporated herein by reference in their entireties.
- Lumen 58 contains several insulated electrical wires 60 for providing power to the sensor and return signals depicting the field of view of the active pixel sensor.
- a guide wire 54 is shown in a central lumen 56. The operation of delivering a lead via a properly positioned guide wire is as described above.
- This catheter design allows for a smaller, more flexible catheter design allowing it to reach smaller and more distal vasculature. Additionally, larger optical fibers may be used to allow a larger wavelength infrared light source (i.e., 3.8 4.4, 4.7-5.3, and 7-10 microns) to be used providing for images with improved clarity and increased accuracy.
- FIG. 4 depicts an alternative method of lead placement in the coronary sinus (see FIGS. 1, 2, 3B and 3C).
- a guide wire is advanced into the coronary sinus ostium and advanced through the vasculature system to the proper location for pacing and defibrillation lead placement as is well known in the art.
- the guide wire 314 is advanced under visual control by the system shown in FIG. 2 and herein described above.
- an over the wire pacing or defibrillation lead 306 can be inserted and then the lead passed over the guide wire 314 through lumen 322 until it is properly positioned.
- FIG. 5 depicts another embodiment, whereby the vision system described above is incorporated into an ablation system as described in U.S. Patent No. 6,325,797 for accurate location of the ablation electrode in a human heart 10.
- the '797 patent describes a catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein 204, from a chamber, such as the left atrium 16.
- the catheter assembly includes a catheter body 202 and at least one electrode 208.
- the distal portion of the catheter 202 extends from an intermediate portion (inserted from the inferior vena cava 200) and forms a substantially closed loop transverse to the longitudinal axis with the at least one electrode 208 disposed along the loop.
- the loop is axially directed into contact with the chamber wall about the pulmonary vessel ostium 204.
- the electrode ablates a continuous lesion pattern about the vessel ostium 204, thereby electrically isolating the vessel from the chamber.
- additional lumens filled with optical fibers may be employed as described above to allow the visualization of the location of the catheter 202 via a lens 206 located at the distal end of catheter 202.
- the visualization will allow the proper positioning of the ablation electrode(s) in a fixed and proper location (for example, the pulmonary vein ostium 204).
- FIG. 6 depicts yet another embodiment incorporating the vision system as described above into a lead extraction device as substantially described in U.S. Patent Nos. 5,423,806 and 5,674,217, both to Wahlstrom, et al. which utilizes laser light to separate an implanted object, such as a pacemaker lead, from fibrous scar tissue and thereby permit the implanted object to be extracted from a body.
- the extraction device features a catheter 406 having a central lumen 414 dimensioned so a pacemaker lead will fit within. The catheter 406 is thereby guided by the lead.
- the catheter 406 has at least one optical fiber 412 to emit laser light 402 from the distal end 408 and thereby separate the lead from fibrous scar tissue.
- the lead may be separated along its length, as well as separated at its distal end from fibrous scar tissue, thereby permitting the lead to be readily extracted from the body.
- additional fibers 412 may be employed as described above to allow the visualization of the location and the rapid positioning of the catheter in relation to the fibrous scar tissue or bone that may be holding the lead body in a fixed location.
- the present invention provides a system and method for utilizing an infrared imaging system for placing leads or any other device within the coronary sinus, branch cardiac veins and/or specific locations in the heart.
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Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002467385A CA2467385A1 (en) | 2002-02-28 | 2002-11-13 | Improved system and method of positioning implantable medical devices |
JP2003572467A JP2005518861A (en) | 2002-02-28 | 2002-11-13 | Improved system and method for deploying an implantable medical device |
EP02786708A EP1511426A2 (en) | 2002-02-28 | 2002-11-13 | Improved system and method of positioning implantable medical devices |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/087,949 US20030092995A1 (en) | 2001-11-13 | 2002-02-28 | System and method of positioning implantable medical devices |
US10/087,949 | 2002-02-28 |
Publications (2)
Publication Number | Publication Date |
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WO2003073942A2 true WO2003073942A2 (en) | 2003-09-12 |
WO2003073942A3 WO2003073942A3 (en) | 2005-01-13 |
Family
ID=27787582
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2002/036331 WO2003073942A2 (en) | 2002-02-28 | 2002-11-13 | Improved system and method of positioning implantable medical devices |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP1511426A2 (en) |
JP (1) | JP2005518861A (en) |
CA (1) | CA2467385A1 (en) |
WO (1) | WO2003073942A2 (en) |
Cited By (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6979290B2 (en) | 2002-05-30 | 2005-12-27 | The Board Of Trustees Of The Leland Stanford Junior University | Apparatus and methods for coronary sinus access |
JP2008520363A (en) * | 2004-11-17 | 2008-06-19 | バイオセンス・ウェブスター・インコーポレイテッド | Real-time evaluation system for tissue ablation |
US8357145B2 (en) | 2007-11-12 | 2013-01-22 | Boston Scientific Neuromodulation Corporation | Implanting medical devices |
US8956280B2 (en) | 2002-05-30 | 2015-02-17 | Intuitive Surgical Operations, Inc. | Apparatus and methods for placing leads using direct visualization |
US9192287B2 (en) | 2005-10-25 | 2015-11-24 | Intuitive Surgical Operations, Inc. | Tissue visualization device and method variations |
US9226648B2 (en) | 2006-12-21 | 2016-01-05 | Intuitive Surgical Operations, Inc. | Off-axis visualization systems |
US9332893B2 (en) | 2005-02-02 | 2016-05-10 | Intuitive Surgical Operations, Inc. | Delivery of biological compounds to ischemic and/or infarcted tissue |
US9468364B2 (en) | 2008-11-14 | 2016-10-18 | Intuitive Surgical Operations, Inc. | Intravascular catheter with hood and image processing systems |
US9510732B2 (en) | 2005-10-25 | 2016-12-06 | Intuitive Surgical Operations, Inc. | Methods and apparatus for efficient purging |
US9526401B2 (en) | 2005-02-02 | 2016-12-27 | Intuitive Surgical Operations, Inc. | Flow reduction hood systems |
US10004388B2 (en) | 2006-09-01 | 2018-06-26 | Intuitive Surgical Operations, Inc. | Coronary sinus cannulation |
US10064540B2 (en) | 2005-02-02 | 2018-09-04 | Intuitive Surgical Operations, Inc. | Visualization apparatus for transseptal access |
US10070772B2 (en) | 2006-09-01 | 2018-09-11 | Intuitive Surgical Operations, Inc. | Precision control systems for tissue visualization and manipulation assemblies |
US10092172B2 (en) | 2007-05-08 | 2018-10-09 | Intuitive Surgical Operations, Inc. | Complex shape steerable tissue visualization and manipulation catheter |
US10278588B2 (en) | 2005-02-02 | 2019-05-07 | Intuitive Surgical Operations, Inc. | Electrophysiology mapping and visualization system |
US10470643B2 (en) | 2006-06-14 | 2019-11-12 | Intuitive Surgical Operations, Inc. | In-vivo visualization systems |
US11406250B2 (en) | 2005-02-02 | 2022-08-09 | Intuitive Surgical Operations, Inc. | Methods and apparatus for treatment of atrial fibrillation |
US11478152B2 (en) | 2005-02-02 | 2022-10-25 | Intuitive Surgical Operations, Inc. | Electrophysiology mapping and visualization system |
Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5246014A (en) | 1991-11-08 | 1993-09-21 | Medtronic, Inc. | Implantable lead system |
US5851226A (en) | 1996-10-22 | 1998-12-22 | Medtronic, Inc. | Temporary transvenous endocardial lead |
US5902331A (en) | 1998-03-10 | 1999-05-11 | Medtronic, Inc. | Arrangement for implanting an endocardial cardiac lead |
US6006137A (en) | 1998-03-06 | 1999-12-21 | Medtronic, Inc. | Method for single elecrode bi-atrial pacing |
US6021340A (en) | 1995-06-07 | 2000-02-01 | Cardima, Inc. | Guiding catheter for the coronary sinus |
US6178346B1 (en) | 1998-10-23 | 2001-01-23 | David C. Amundson | Infrared endoscopic imaging in a liquid with suspended particles: method and apparatus |
US6204524B1 (en) | 1999-07-14 | 2001-03-20 | Micron Technology, Inc. | CMOS imager with storage capacitor |
US6243131B1 (en) | 1991-05-13 | 2001-06-05 | Interactive Pictures Corporation | Method for directly scanning a rectilinear imaging element using a non-linear scan |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE69633411T2 (en) * | 1995-10-13 | 2005-10-20 | Transvascular, Inc., Menlo Park | METHOD AND DEVICE FOR PREVENTING ARTERIAL ATTRACTIONS AND / OR FOR CARRYING OUT OTHER TRANSVASCULAR INTERVENTIONS |
GB9707414D0 (en) * | 1997-04-11 | 1997-05-28 | Imperial College | Anatomical probe |
-
2002
- 2002-11-13 CA CA002467385A patent/CA2467385A1/en not_active Abandoned
- 2002-11-13 WO PCT/US2002/036331 patent/WO2003073942A2/en not_active Application Discontinuation
- 2002-11-13 JP JP2003572467A patent/JP2005518861A/en active Pending
- 2002-11-13 EP EP02786708A patent/EP1511426A2/en not_active Withdrawn
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6243131B1 (en) | 1991-05-13 | 2001-06-05 | Interactive Pictures Corporation | Method for directly scanning a rectilinear imaging element using a non-linear scan |
US5246014A (en) | 1991-11-08 | 1993-09-21 | Medtronic, Inc. | Implantable lead system |
US6021340A (en) | 1995-06-07 | 2000-02-01 | Cardima, Inc. | Guiding catheter for the coronary sinus |
US5851226A (en) | 1996-10-22 | 1998-12-22 | Medtronic, Inc. | Temporary transvenous endocardial lead |
US6006137A (en) | 1998-03-06 | 1999-12-21 | Medtronic, Inc. | Method for single elecrode bi-atrial pacing |
US5902331A (en) | 1998-03-10 | 1999-05-11 | Medtronic, Inc. | Arrangement for implanting an endocardial cardiac lead |
US6178346B1 (en) | 1998-10-23 | 2001-01-23 | David C. Amundson | Infrared endoscopic imaging in a liquid with suspended particles: method and apparatus |
US6204524B1 (en) | 1999-07-14 | 2001-03-20 | Micron Technology, Inc. | CMOS imager with storage capacitor |
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EP1511426A2 (en) | 2005-03-09 |
CA2467385A1 (en) | 2003-09-12 |
WO2003073942A3 (en) | 2005-01-13 |
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