Other

St Jude Medical, Atrial Fibrillation Division, Inc

Henry Ford Health System

American Express Bank Ltd.

Krishnan, Subramaniam, Chitoor

Subramaniam Chitoor Krishnan

Kalyanam Shivkumar

Nitin Patil

Nageswararao Dasari

Steven Aponte

Joseph Fernandez

Colleen Wolfe

Eddy Almonte

Nina Eckstein

Gennaro Bruni

Bill Gilbert

Gordon Joost

Arthur McGrath

Gabriela Crespo

George Kreiner

Suresh Rathnam

Luiz C Couto

Ramaswamy Madhavan

The disclosure presents methods and systems for applying a suction force to a surface of a left atrial appendage (LAA) with a tube attached to an exterior surface of an inflatable balloon. The disclosure also presents methods and systems for inflating a first inflatable balloon within a cavity of a left atrial appendage (LAA). A method may include applying a suction force with at least one tube coupled to the first inflatable balloon to attract the first inflatable balloon to an interior surface of the LAA or to a second inflatable balloon. A method may include puncturing, using a tissue-penetrating tip, a target surface of the LAA.

Methods and systems for preventing bleeding from the left atrial appendage

The disclosure presents methods and systems for applying a suction force to a surface of a left atrial appendage (LAA) with a plurality of tubes. A method may include puncturing the surface of the LAA using a tissue-penetrating tip while the suction force is applied to the surface. The disclosure also presents methods and systems for inflating a first inflatable balloon within a cavity of a left atrial appendage (LAA). A method may include applying a suction force with at least one tube coupled to the first inflatable balloon to attract the first inflatable balloon to an interior surface of the LAA or to a second inflatable balloon.

A lead for in vivo procedures for stimulation of a tissue is provided that has stimulating electrodes and a fixation mechanism disposed at a distal end of the lead. The fixation mechanism includes a fixation component disposed on an opposite side with respect to an active surface of the stimulation electrodes. The lead fixation mechanism when deployed disposes the active surface of stimulation electrodes onto a tissue region opposite to the fixation component. A system and a method for optimally positioning the lead for stimulation of the tissue are also provided.

Mechanism, system, method for in vivo lead fixation

The invention presents methods and systems for accessing a pericardial space and preventing strokes arising from a left atrial appendage ('LAA') by achieving a complete occlusion of the LAA using an epicardial approach without creating a puckering of the LAA ostium. A complete occlusion of the LAA is desired because blood clots arising from the LAA often leads to embolic strokes. Due to the peculiar anatomy of the LAA ostium, traditional LAA ligation techniques using sutures can lead to puckering, thus compromising the occlusion of the LAA. The invention achieves a complete occlusion and a more effective hemostatic seal with the use of inflatable balloons having electromagnetic coils internally, as well as hydrogels, sponges, and caliber tubes attached to the respective balloon's exterior, anchoring balloons, a closure device having a suture looped through two semi-rigid hollow tube that can be coated with hydrogel or silicone, and locking mechanisms.

Methods and systems for accessing a pericardial space and preventing strokes arising from the left atrial appendage

The instant disclosure relates to a family of devices and methods for both measuring electrophysiological signals and delivering elongate medical devices. In an embodiment, a kit is described that includes a hollow catheter adapted to navigate a patient's vasculature having a hollow lumen terminating at a distal end, structure configured for sensing cardiac electrical activity adjacent the distal end of the hollow catheter and for acquiring electrograms. The fossa ovalis of a subject can be located therefrom and a second medical device can be advanced into and through the hollow lumen to such an extent that a distal tip of the second medical device protrudes beyond a proximal end and the distal end of the hollow catheter at the same time.

Methods and apparatus for locating the fossa ovalis and performing transseptal puncture

Bleeding arising from the left atrial appendage (LAA) can have fatal consequences because it can result in cardiac tamponade. The present invention provides apparatuses and methods for treating and preventing bleeding arising from the LAA, at the pre-hemorrhage and post-hemorrhage stages. In particular, catheters having inflatable catheter balloons are advanced into the LAA and the inflatable catheter balloons are inflated in and around the LAA in a manner that occludes the LAA ostium and the LAA cavity. Additionally, electromagnetic coils are present within the inflatable catheter balloons to create electromagnetic forces that help to further occlude the LAA ostium firmly. When the catheter balloons are inflated, these electromagnetic coils also expand. Alternatively, the LAA ostium can be occluded using electromagnetic coils present in an inflated endocardial catheter balloon and electromagnetic coils present in an inflated epicardial catheter balloon deployed around the circumference of the LAA ostium epicardially.

Apparatus and method for treating bleeding arising from left atrial appendage

The invention presents methods and systems for accessing a pericardial space and preventing strokes arising from a left atrial appendage ('LAA') by achieving a complete occlusion of the LAA using an epicardial approach without creating a puckering of the LAA ostium. A complete occlusion of the LAA is desired because bleeding arising from the LAA often leads to embolic strokes. Due to the peculiar anatomy of the LAA ostium, traditional LAA ligation techniques using sutures can lead to puckering, thus compromising the occlusion of the LAA. The invention achieves a complete occlusion and a more effective hemostatic seal with the use of inflatable balloons having electromagnetic coils internally, as well as hydrogels, sponges, and caliber tubes attached to the respective balloon's exterior, anchoring balloons, a closure device having a suture looped through two semi-rigid hollow tube that can be coated with hydrogel or silicone, and locking mechanisms.

Apparatus is provided of locating the fossa ovalis in a patient by locating at least one of the His bundle, the plane of the interatrial septum, and the coronary sinus ostium in a patient, and thereafter locating the fossa ovalis on the basis of one or more predetermined distances between these locations. Software is also provided that can determine and display the location of the fossa ovalis in a patient based on predetermined distances between the locations. Such software can for example be provided within an electroanatomical system. Methods of determining the location of the fossa ovalis, performed by either a clinician or a central processing unit-controlled surgical system, are also provided and determined using predetermined measurements from defined locations. An apparatus for locating the fossa ovalis and performing a transseptal puncture is also provided.

Method and apparatus for locating the fossa ovalis, creating a virtual fossa ovalis and performing transseptal puncture

A method of identifying the fossa ovalis in a patient by positioning one or more electrodes against the tissue of the interatrial septum of the patient and acquiring unipolar and/or bipolar electrograms of the tissue of the interatrial septum while moving the electrodes to a plurality of positions against the tissue of the interatrial septum. The fossa ovalis is identified on the basis of unipolar voltage reduction, signal fractionation, broadened signal, reduced signal slew rate, reduced local myocardial impedance, increased phase angle and/or increased pacing threshold. An apparatus for identifying the fossa ovalis is also provided.

The present invention comprises methods and systems for treating a cardiac arrhythmia in a mammal by administering gated or pulsed radiofrequency current or other ablative energy to the mammal during one or more time periods of increased coronary blood flow. Preferred embodiments of the invention comprise, without limitation, the gated or pulsed administration of radiofrequency current in association with the formation of the dicrotic notch in the arterial blood pressure curve of the mammal. In accordance with the invention, the thermal effects of ablative energy application on the coronary artery are avoided or mitigated due to rapid coronary blood flow resulting in heat loss and minimization of damage to blood vessels.

Methods and systems for gated or pulsed application of ablative energy in the treatment of cardiac disorders

A method of identifying the fossa ovalis in a patient by positioning one or more electrodes against the tissue of the interatrial septum of the patient and acquiring unipolar and/or bipolar electrograms of the tissue of the interatrial septum while moving the electrodes to a plurality of positions against the tissue of the interatrial septum. The fossa ovalis is identified on the basis of unipolar voltage reduction, signal fractionation, broadened signal, reduced signal slew rate, reduced local myocardial impedance, increased phase angle and/or increased pacing threshold. An apparatus for identify the fossa ovalis is also provided.

Method and apparatus for locating the fossa ovalis and performing transseptal puncture

A method of locating the fossa ovalis in a patient by locating the His bundle, plane of the interatrial septum, and coronary sinus ostium in a patient, and thereafter locating the fossa ovalis on the basis of one or more predetermined distances between the fossa ovalis and the His bundle and the coronary sinus ostium. An apparatus for locating the fossa ovalis and performing a transseptal puncture is also provided.

A system for facilitating electronic transfer of funds includes a transfer administrator in communication with a transferor institution, one or more intermediary institution, and a transferee institution, the transferor institution having an account at the one or more intermediary institution. The transfer administrator may be configured to receive an incoming payment request designating said transferor institution, a quantity of funds to be transferred, and the transferee institution. The transfer administrator generates and issues a translated payment order based at least in part on the incoming payment request and configured to accomplish a transfer among the transferor institution, the one or more intermediary institution, and the transferee institution. Finally, the transfer administrator may facilitate processing of a balancing payment among the transferor institution, the one or more intermediary institution, and the transferee institution.

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Sacramento, CA, United States of America

Subramaniam Chitoor Krishnan