WO2021083793A1 - Dispositif médical implantable comprenant des éléments d'ancrage - Google Patents

Dispositif médical implantable comprenant des éléments d'ancrage Download PDF

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Publication number
WO2021083793A1
WO2021083793A1 PCT/EP2020/079846 EP2020079846W WO2021083793A1 WO 2021083793 A1 WO2021083793 A1 WO 2021083793A1 EP 2020079846 W EP2020079846 W EP 2020079846W WO 2021083793 A1 WO2021083793 A1 WO 2021083793A1
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WO
WIPO (PCT)
Prior art keywords
implantable medical
medical device
anchoring element
electrode
tissue
Prior art date
Application number
PCT/EP2020/079846
Other languages
English (en)
Inventor
Thomas Dörr
Gernot Kolberg
Original Assignee
Biotronik Se & Co. Kg
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Biotronik Se & Co. Kg filed Critical Biotronik Se & Co. Kg
Publication of WO2021083793A1 publication Critical patent/WO2021083793A1/fr

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Classifications

    • 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
    • A61N1/0573—Anchoring means; Means for fixing the head inside the heart chacterised by means penetrating the heart tissue, e.g. helix needle or hook
    • 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
    • A61N1/37518—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
    • A61N1/372—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
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium
    • A61N1/059—Anchoring means

Definitions

  • the present invention relates to an implantable medical device for implantation into a patient according to the preamble of claim 1.
  • An implantable medical device of this kind comprises a body, a first anchoring element arranged on the body and having a first electrode for at least one of emitting an electrical stimulation signal and sensing an electrical sense signal, and a second anchoring element arranged on the body having a second electrode for at least one of emitting an electrical stimulation signal and sensing an electrical sense signal.
  • the implantable medical device may for example have the shape of a leadless stimulation device, such as a leadless pacemaker device.
  • the body is formed by the housing of the leadless pacemaker device, which encapsulates components of the leadless pacemaker device such as a processor, a data memory, a battery and other processing equipment to allow for operation of the leadless pacemaker device in an autarkic manner.
  • the leadless pacemaker device may be implanted directly into the heart and may operate within the heart, for example within the right ventricle of the heart, without requiring any leads for placing an electrode at a location of interest within the heart.
  • the implantable medical device may be a stimulation device which comprises a generator to be implanted for example subcutaneously at a location remote from the heart.
  • the body is formed for example by a lead extending from the generator into the heart to allow for a stimulation or a sensing of signals at a location of interest within the heart, for example within the right ventricle.
  • an injection of stimulation signals generally is possible at the surface of intra-cardiac tissue, an electrode being in contact with intra-cardiac tissue in order to allow a injection of stimulation energy into the tissue.
  • the electrode when introducing an electrode for example arranged on a lead from the right ventricle into the septum in order to reach towards the left bundle branch, the electrode must be inserted into the tissue to reach a substantial depth in order to come to lie in the vicinity of the left bundle branch. This comes with the inherent risk that a piercing structure on which the electrode is arranged may pierce through the septum and may reach into the left ventricle. In addition, the piercing itself possibly may have a significant impact on tissue and may even destroy tissue.
  • WO 2008/058265 A2 discloses a cardiac stimulation system and method which allow to deliver a left ventricle stimulator from a right ventricle lead system in the right ventricle chamber, into a right side of the septum at a first location, and transmuscularly from the first location to a second location along the left side of the septum.
  • the left ventricle stimulator is fixed at the second location for transmuscular stimulation of the left ventricular conduction system.
  • a biventricular simulation system further includes a right ventricle stimulator also delivered by the right ventricle lead system to the first location along the right side of the septum for right ventricular stimulation.
  • US 2009/0276000 A1 discloses a method for delivering physiological pacing by selecting an electrode implant site for sensing cardiac signals, which is in proximity to the hearts intrinsic conduction system.
  • An arrangement of multiple electrodes herein is arranged on a tip of a lead.
  • US 10,406,370 discloses a device for providing cardiac pacing by multiple electrodes inserted using a single conduit. Acceptable electrodes herein are selected as active based on a predetermined criteria, and cardiac stimulation is provided for multiple chambers of the heart from a single location.
  • the first electrode is arranged at a first height with respect to the body, and the second electrode is arranged at a second height with respect to the body, wherein the first height is different than the second height.
  • the body may extend longitudinally along a longitudinal axis.
  • the body herein may for example form a distal end to be placed on tissue upon implantation of the implantable medical device, the first anchoring element and the second anchoring element being arranged on and extending from the distal end.
  • the first anchoring element and the second anchoring element may extend from the body generally along the longitudinal axis, the first anchoring element and the second anchoring element protruding from the body in order to allow a piercing of tissue by means of the first anchoring element and the second anchoring element in order to provide for an anchoring of the implantable medical device on tissue.
  • the body may be formed by a lead which is connectable to a generator of the implantable medical device.
  • the generator may be implanted into a patient for example subcutaneously remote from the heart, the lead forming the body extending from the generator into the heart such that the body with the electrodes arranged thereon are placed in the heart, for example within the right ventricle in order to engage with tissue at the right ventricle.
  • the first anchoring element and the second anchoring element are placed at the distal end of the body, the distal end is to be implanted into the heart to engage with intra-cardiac tissue for anchoring the body with its distal end on tissue within the heart.
  • the first electrode arranged on the first anchoring element and the second electrode arranged on the second anchoring element comes to engage with tissue and hence may be used to at least one of emitting an electrical stimulation signal and sensing an electrical sense signal.
  • the body may be formed by a housing of a leadless pacemaker device.
  • the implantable medical device is formed as a leadless device, which does not comprise leads extending from a location outside of the heart into the heart for providing for a stimulation and/or sensing within the heart.
  • the housing of the leadless pacemaker device may be placed on tissue with a distal end formed by the housing, the first anchoring element with the first electrode arranged thereon and the second anchoring element with the second electrode arranged thereon beneficially being placed on the distal end and engaging with tissue when placing the leadless pacemaker device on tissue with its distal end.
  • At least one of the first anchoring element and the second anchoring element is formed by a flexibly bendable tine.
  • a tine of this kind may in particular be arranged on the body with a first end and may extend from the body in a distal direction to form an apex and to bend backwards generally opposite to the distal direction to form a hook.
  • the tine When being placed on tissue, the tine may engage with tissue such that the apex is placed within tissue, a second, far end of the tine for example being placed outside of the tissue such that the tine forms a hook to anchor the implantable medical device to tissue at a location of interest.
  • each anchoring element may be brought into engagement with tissue, wherein upon deployment each tine flexibly deforms and resets towards its original, unbent shape in order to form a hook for anchoring the implantable medical device to the tissue.
  • both anchoring elements are formed by a tine.
  • Each anchoring element herein carries an electrode, which in an implanted state comes to rest within tissue to electrically contact with tissue.
  • the first anchoring element comprises a first apex and the second anchoring element comprises a second apex.
  • the apex denotes that portion of the anchoring element which is farthest removed from the body (along a direction of extension along which the anchoring element extends from the body and which may generally point along the longitudinal axis along which the body extends).
  • the first electrode of the first anchoring element herein may be placed at the first apex
  • the second electrode of the second anchoring element may be placed at the second apex.
  • the first apex and the second apex herein may be placed at different heights with respect to the body, such that the anchoring elements extend, when being placed within tissue, into different depths and hence may engage with different tissue cells at different depths for example within the septum of the heart.
  • the implantable medical device herein may comprise two or more anchoring elements, each carrying one or multiple electrodes. By selecting one or multiple of the electrodes for at least one of emitting an electrical stimulation signal and sensing an electrical sense signal, an excitation or sensing for example at the left bundle branch in a spatially differentiated manner may be achieved, in that one or multiple electrodes may be selected which are closest and best coupled to the left bundle branch.
  • the implantable medical device may be implanted into the patient's heart such that at least one of the first anchoring element with the first electrode arranged thereon and the second anchoring element with the second electrode arranged thereon comes to rest in the region of the left bundle branch and may electrically contact the left bundle branch, a pacing at the left bundle branch may be provided, allowing for a physiological stimulation by achieving a propagation of stimulation signals along the bundle branches of the ventricles at low stimulation thresholds.
  • a left bundle branch stimulation may allow for an easy and reliable implantation and easy stimulation algorithms, in particular not requiring a particular adjustment of AV delays as necessary for example for an HIS bundle pacing.
  • Implantation of the implantable medical device in particular becomes easy because for the implantation it is not required to place each and every anchoring element in the immediate vicinity of the left bundle branch. It may be sufficient to generally implant the implantable medical device such that the body of the lead or the leadless pacemaker device is placed on the septum in the general region of the left bundle branch, wherein after implantation and during operation one or multiple electrodes of the anchoring elements may be selected in order to establish a spatially differentiated, effective coupling to the left bundle branch. Hence, implantation may be easy, and operation may be reliable.
  • At least one of the first anchoring element and the second anchoring element comprises an electrically conductive core.
  • the core may be made from a nickel titanium alloy material (such as nitinol), wherein an electrically insulating coating may be placed on the outside of the core to electrically insulate the core towards the outside.
  • the coating may be interrupted at one or multiple locations in order to expose the core towards the outside, such that the core at one or multiple locations may come into electrical contact with surrounding tissue, hence forming one or multiple electrodes on the respective anchoring elements.
  • the respective anchoring element may comprise multiple layers, wherein electrically conductive layers and electrically insulating layers may alternate. Different electrodes may be formed in this way on an anchoring element at different locations, wherein each electrode is associated with a particular layer of the anchoring element.
  • at least one of the first anchoring element and the second anchoring element may have a body formed from a (electrically non-conductive) plastics material, wherein one or multiple electrodes may be placed on an outer surface of the body. Conductors herein may be embedded in the inner body to electrically contact the electrodes on the outside of the body.
  • the implantable medical device comprises a processing device configured to control operation of the first electrode and the second electrode for at least one of emitting an electrical stimulation signal and sensing an electrical sense signal using at least one of said first electrode and said second electrode.
  • the processing device may be part of a generator, in case the body is formed by a lead extending from the generator. Alternatively, the processing device may be part of a leadless pacemaker device forming the implantable medical device.
  • the processing device may control operation of the implantable medical device, in that for example one or multiple electrodes are selected in order to capture the left bundle branch and to provide for a stimulation or sensing at the left bundle branch using one or multiple electrodes of one or multiple anchoring elements.
  • Fig. 1 shows a schematic view of the human heart, including the Sinotrial node, the Atrioventricular node, the HIS bundle and the left bundle branch and right bundle branch extending from the HIS bundle;
  • Fig. 2 shows a schematic drawing of the heart with a lead implanted therein;
  • Fig. 3 shows a view of another embodiment with an implantable medical device in the shape of a leadless pacemaker device implanted in the right ventricle of the heart;
  • Fig. 4 shows a view of yet another embodiment of an implantable medical device in the shape of a leadless pacemaker device
  • Fig. 5 shows a view of an anchoring element in the shape of a tine having an electrically conductive core covered by a coating and exposed, at an apex, to the outside to form an electrode on the anchoring element.
  • Fig. 1 shows, in a schematic drawing, the human heart comprising the right atrium RA, the right ventricle RV, the left atrium LA and the left ventricle LV, the so-called sinoatrial node SAN being located in the wall of the right atrium RA, the sinoatrial node SAN being formed by a group of cells having the ability to spontaneously produce an electrical impulse that travels through the heart’s electrical conduction system, thus causing the heart to contract in order to pump blood through the heart.
  • the atrioventricular node AVN serves to coordinate electrical conduction in between the atria and the ventricles and is located at the lower back section of the intra-atrial septum near the opening of the coronary sinus.
  • the HIS bundle H is extending, the HIS bundle H being comprised of heart muscle cells specialized for electrical conduction and forming part of the electrical conduction system for transmitting electrical impulses from the atrioventricular node AVN via the so-called right bundle branch RBB around the right ventricle RV and via the left bundle branch LBB around the left ventricle LV.
  • an implantable medical device 1 in the shape of a stimulation device such as a CRT device, is implanted in a patient, the implantable medical device 1 comprising a generator 12 connected to leads 10, 11 extending from the generator 12 through the superior vena V into the patient's heart.
  • the leads 10, 11 electrical signals for providing a pacing action in the heart shall be injected into intra-cardiac tissue potentially at different locations within the heart, and sense signals may be received.
  • a defibrillation therapy may be performed by an electrode arrangement arranged on one or both of the leads 10, 11.
  • a lead 10 is implanted into the heart such that it extends into the right ventricle RV of the heart and, at a distal end 101 of a lead body 100, is arranged on intra-cardiac tissue at the septum M in between the right ventricle RV and the left ventricle LV of the heart.
  • anchoring elements 13, 14 in the shape of tines are arranged, the anchoring elements 13, 14 serving to anchor the lead 10 with its body 100 to tissue in particular in the region of the septum M within the heart.
  • electrodes are placed on the anchoring elements 13, 14, as shall be described in further detail according to the embodiments of Figs. 3 to 5 below.
  • An implantable medical device 1 as concerned herein may generally be a cardiac stimulation device such as a cardiac pacemaker device.
  • a stimulation device of this kind may comprise a generator 12, as shown in Fig. 1, which may be subcutaneously implanted into a patient at a location remote from the heart, one or multiple leads 10, 11 extending from the generator 12 into the heart for emitting stimulation signals in the heart or for obtaining sense signals at one or multiple locations from the heart.
  • a lead 10 forms a generally longitudinal, tubular body 100 extending along a longitudinal axis L, as shown in Fig. 2, which reaches into the heart and is anchored at a location of interest for example on the septum M of the heart in the region of the right ventricle RV.
  • the implantable medical device 1 may be a leadless pacemaker device, which does not comprise leads, but has the shape of a capsule and may be directly implanted into the heart, for example into the right ventricle RV of the heart.
  • an implantable medical device 1 in the shape of a leadless pacemaker device 15 comprises a body 150 in the shape of a housing which extends longitudinally along a longitudinal axis L and encapsulates components of the leadless pacemaker device 15, such as a processing device 16, a data memory, a battery, pulse generation circuitry and the like to allow for a stimulation operation immediately within the heart.
  • the body 150 in the shape of the housing of the leadless pacemaker device 15 forms a distal end 151 which is placed on intra-cardiac tissue in the range of the septum M of the heart, anchoring elements 13, 14 being arranged on the body 150 in the region of the distal end 151 and extending from the distal end 151 generally along the longitudinal axis L.
  • the anchoring elements 13, 14 are formed by flexibly bendable tines which at one end 133, 143 are connected to the body 150 of the leadless pacemaker device 15 to extend from the body 150 to form an apex 132, 142 and to then bend backwards to exit from tissue with far ends 130, 140.
  • the anchoring elements 13, 14 hence form hooks which provide for an anchoring of the implantable medical device 1 on tissue, in that the anchoring elements 13, 14 extend through the tissue and, by forming hooks, fix the implantable medical device 1 to the tissue.
  • each anchoring element 13, 14, in the embodiment of Fig. 3, comprises an electrode 131, 141 which is placed at the apex 132, 142 of the respective anchoring element 13, 14.
  • apices 132, 142 are arranged at different heights HI, H2 with respect to the body 150 and hence, in an implanted state of the implantable medical device 1, come to lie at different depths within tissue, by means of the different electrodes 132, 142 an excitation at different locations within the tissue may be provided, in particular within the septum M of the heart.
  • one of the electrodes 131, 141 may be located in the vicinity of the left bundle branch LBB, such that the respective electrode 131 of the anchoring element 13 may couple with the left bundle branch LBB and hence may capture the left bundle branch LBB to inject signals into the left bundle branch LBB and/or receive sense signals from the left bundle branch LBB.
  • the implantable medical device 1 may comprise more than two anchoring elements 13, 14, for example three, four, five, six or even more anchoring elements 13, 14, for example in the shape of tines.
  • Each anchoring element 13, 14 herein may comprise one or multiple electrodes 131, 141 being placed at different heights HI, H2 with respect to the body 150.
  • anchoring elements 13, 14 each comprise multiple electrodes 131A-131C, 141A-141C, the electrodes 131A-131C, 141A-141C being placed at different heights H1-H6 with respect to the body 150, as indicated in Fig. 4.
  • Electrodes 131, 131A-131C, 141, 141A-141C in the embodiments of Figs. 3 and 4, may be placed at different depths within tissue and hence may provide for an excitation and/or sensing at different depths within tissue, one or multiple electrodes 131, 131 A- 131 C, 141, 141A-141C may be selected during operation of the implantable medical device 1 in order to provide for a pacing and/or sensing action.
  • algorithms for operating the implantable medical device 1 may include a configuration algorithm by which one or multiple electrodes 131, 131 A- 131 C, 141, 141A-141C are selected which may provide for an optimum coupling to the left bundle branch LBB, such that an effective stimulation and/or sensing at the left bundle branch LBB may be achieved.
  • electrodes 131, 131 A- 131 C, 141, 141A-141C may be selected after implantation for achieving an effective operation of the implantable medical device 1, implantation may become easy. In particular, it is not required to place a particular electrode 131, 131A- 131C, 141, 141A-141C at a particular location and depth within the tissue in order to for example reach the left bundle branch LBB.
  • the implantable medical device 1 may generally be placed on the tissue in the vicinity of the left bundle branch LBB, wherein subsequently - after implantation - a subset of the electrodes 131, 131A-131C, 141, 141 A- 141C may be selected for emitting and/or sensing electrical signals.
  • each anchoring element 13, 14 may have the shape of a flexibly bendable tine, wherein the tine may for example comprise an electrically conductive core 134, 144 formed for example from a nickel titanium alloy material, such as nitinol.
  • the core 134, 144 herein may be covered, substantially along its entire length, by a coating
  • the coating 135, 145 which is electrically insulating.
  • the coating 135, 145 herein exposes the core 134, 144 for example at one location towards the outside to form an electrode 131, 141 for example in the region of the apex 132, 142 of the anchoring element 13, 14.
  • the electrode 131, 141 may come into electrical contact with surrounding tissue, such that a coupling to the tissue may be achieved.
  • multiple electrodes 131, 131 A- 131 C, 141, 141A-141C shall be formed on an anchoring element 13, 14, this may be achieved by exposing the core 134, 144 at multiple locations to the outside by removing the coating 135, 145.
  • each tine in order to provide electrodes 131, 131A-131C, 141, 141A-141C which are electrically independent of each other, each tine may have a multilayered configuration, wherein each electrode 131, 131A-131C, 141, 141A-141C is associated with a particular, electrically conductive layer, which is electrically separated from another electrically conductive layer by an intermediate, insulating layer.
  • an anchoring element 13, 14 may be formed as a tine from a plastics material, wherein one or multiple electrodes may be placed on the body of the tine and may be electrically coupled for example by means of electrical conductors being embedded in the plastics body.
  • the anchoring elements 13, 14 may for example be formed from flexible circuit boards, formed for example from a liquid crystal polymer material (LCP).
  • LCP liquid crystal polymer material
  • one or multiple metallic wires, such as nitinol wires, may be embedded in the circuit boards.
  • the implantable medical device may have the shape of a stimulation device comprising leads, or may have the shape of a leadless pacemaker device.
  • Anchoring elements may have the shape of tines, wherein at least two anchoring elements may be provided.
  • Each anchoring element herein may carry one or multiple electrodes, such that an electrical coupling to surrounding tissue may be established by a set of electrodes of one or multiple anchoring elements.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

La présente invention concerne un dispositif médical implantable (1) destiné à être implanté dans un patient comprenant un corps (100, 150), un premier élément d'ancrage (13) disposé sur le corps (100, 150) et ayant une première électrode (131, 131A-131C) destinée à émettre un signal de stimulation électrique et/ou détecter un signal de détection électrique, et un second élément d'ancrage (14) disposé sur le corps (100, 150) et ayant une seconde électrode (141, 141A-141C) destinée à émettre un signal de stimulation électrique et/ou détecter un signal de détection électrique. La première électrode (131, 131A-131C) est disposée à une première hauteur (H1, H3, H5) par rapport au corps (100, 150), et la seconde électrode (141, 141A-141C) est disposée à une seconde hauteur (H2, H4, H6) par rapport au corps (100, 150), la première hauteur (H1, H3, H5) étant différente de la seconde hauteur (H2, H4, H6).
PCT/EP2020/079846 2019-11-01 2020-10-23 Dispositif médical implantable comprenant des éléments d'ancrage WO2021083793A1 (fr)

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EP19206699.1 2019-11-01
EP19206699 2019-11-01

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Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070049980A1 (en) * 2005-08-30 2007-03-01 Zielinski Todd M Trans-septal pressure sensor
WO2008058265A2 (fr) 2006-11-08 2008-05-15 Emerge Medsystems Llc Dérivations de stimulation cardiaque transmusculaire pour le ventricule gauche et systèmes et procédés apparentés
US20090163822A1 (en) * 2005-09-09 2009-06-25 Pacesetter, Inc. Method of measuring pressure with a septal lead
US20090276000A1 (en) 2002-09-30 2009-11-05 Medtronic, Inc. Pacing method
US20170326369A1 (en) * 2016-05-10 2017-11-16 Cardiac Pacemakers, Inc. Trans septal implantable medical device
US20190076664A1 (en) * 2017-09-14 2019-03-14 Sorin Crm Sas Attachment means for implantable cardiac device
US20190083779A1 (en) * 2017-09-15 2019-03-21 Medtronic, Inc. Electrodes for intra-cardiac pacemaker
US20190134413A1 (en) * 2017-11-06 2019-05-09 Pacesetter, Inc. Biostimulator Having Fixation Element
US10406370B1 (en) 2018-07-15 2019-09-10 Eagle Point Medical LLC Single conduit multi-electrode cardiac pacemaker and methods of using thereof
US20190290910A1 (en) * 2018-03-23 2019-09-26 Medtronic, Inc. Av synchronous vfa cardiac therapy
US20200069938A1 (en) * 2018-09-02 2020-03-05 EPQuant LLC Systems, devices, and methods for his bundle cardiac pacing

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090276000A1 (en) 2002-09-30 2009-11-05 Medtronic, Inc. Pacing method
US20070049980A1 (en) * 2005-08-30 2007-03-01 Zielinski Todd M Trans-septal pressure sensor
US20090163822A1 (en) * 2005-09-09 2009-06-25 Pacesetter, Inc. Method of measuring pressure with a septal lead
WO2008058265A2 (fr) 2006-11-08 2008-05-15 Emerge Medsystems Llc Dérivations de stimulation cardiaque transmusculaire pour le ventricule gauche et systèmes et procédés apparentés
US20170326369A1 (en) * 2016-05-10 2017-11-16 Cardiac Pacemakers, Inc. Trans septal implantable medical device
US20190076664A1 (en) * 2017-09-14 2019-03-14 Sorin Crm Sas Attachment means for implantable cardiac device
US20190083779A1 (en) * 2017-09-15 2019-03-21 Medtronic, Inc. Electrodes for intra-cardiac pacemaker
US20190134413A1 (en) * 2017-11-06 2019-05-09 Pacesetter, Inc. Biostimulator Having Fixation Element
US20190290910A1 (en) * 2018-03-23 2019-09-26 Medtronic, Inc. Av synchronous vfa cardiac therapy
US10406370B1 (en) 2018-07-15 2019-09-10 Eagle Point Medical LLC Single conduit multi-electrode cardiac pacemaker and methods of using thereof
US20200069938A1 (en) * 2018-09-02 2020-03-05 EPQuant LLC Systems, devices, and methods for his bundle cardiac pacing

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