摘要:
Certain aspects of the disclosure pertain to methods and apparatus for providing positive fixation of medical components to a portion of incised pericardial tissue. Accordingly, a resilient member protrudes through an incision in the pericardium and produces a positive biasing force to adjacent pericardial tissue against a side surface of an attached body structure. The resilient member can optionally be compressed during implantation and then relaxed to thereafter provide the positive biasing force. Diverse medical components can thus be safely and reliably chronically deployed into the pericardial space, including without limitation, cardiac sensing/pacing, defibrillation and/or cardioversion electrodes, mechanical and/or metabolic sensors and the like. More than one body structure can be linked to a single medical electrical lead and the medical components can couple within and/or upon a portion of the body structure, the resilient member, and the lead in myriad configurations.
摘要:
The present disclosure pertains to methods and apparatus for providing positive fixation of medical components to a portion of pericardial tissue via both vacuum- and/or mechanically-assisted means. According to the invention, a source of vacuum couples via a lumen to a recessed portion of a body structure deployed into the pericardial space. The recessed portion is adapted to form a seal around its periphery with adjacent pericardial tissue so that when the recessed portion is evacuated, the tissue is drawn into the recessed portion. Then, a sharpened instrument, such as a stylet, is deployed through the lumen and pierces the tissue, thus anchoring the body structure. Other embodiment involve coupling a source fluid for delivery to the pericardial space (e.g., contrast media; saline solution; biological, genetic and pharmaceutical substances and the like).
摘要:
Displacement or migration of a left ventricular lead located within the coronary sinus or coronary veins of the heart is detected by comparing an electrogram (EGM) waveform pattern from the lead with a stored baseline EGM waveform pattern. Based upon the extent of lead migration, if any, a lead displacement may produce an annunciating response. The patient may be alerted, an electrical stimulus applied through the lead may be adjusted to compensate for lead migration, or an alternative electrode on the lead may be used for EGM sensing and pacing.
摘要:
An implantable passive fixation lead is disclosed. The passive fixation lead comprises an elongate lead body having at least one elongate conductive element. The lead body includes a proximal end and a distal end. A support member has a first surface and a second surface. The second surface is coupled to the distal end of the lead body. A linking material is coupled to the first surface of the support member. A bioadhesive material is coupled to the linking material. A removable cover is placed over the bioadhesive material.
摘要:
Medical devices and methods for accessing an anatomical space of the body and particularly for penetrating the epicardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner employing suction are disclosed. The distal end of a tubular access sleeve having a sleeve wall surrounding a sleeve access lumen and extending between a sleeve proximal end and a sleeve distal end having a plurality of suction ports arrayed around the sleeve access lumen distal end opening is applied against an outer tissue layer. Suction is applied through the plurality of suction ports to a plurality of portions of the outer tissue layer. A perforation instrument is introduced through the sleeve access lumen to perforate the outer tissue layer to form an access perforation into the anatomic space while the applied suction stabilizes the outer tissue layer, whereby further treatment drugs and devices can be introduced into the anatomic space.