Pacemaker retrieval systems and methods
A catheter system for retrieving a leadless cardiac pacemaker from a patient is provided. The cardiac pacemaker can include a docking or retrieval feature configured to be grasped by the catheter system. In some embodiments, the retrieval catheter can include a snare configured to engage the retrieval feature of the pacemaker. The retrieval catheter can include a torque shaft selectively connectable to a docking cap and be configured to apply rotational torque to a pacemaker to be retrieved. Methods of delivering the leadless cardiac pacemaker with the delivery system are also provided.
1. A delivery system for delivering a leadless pacemaker, comprising:
a first shaft extending along a longitudinal axis to a distal portion, wherein the first shaft has an outer shaft dimension,
a docking cap disposed on the distal portion of the first shaft, wherein the docking cap has an outer cap dimension and an interior configured to receive the leadless pacemaker, wherein the outer cap dimension is greater than the outer shaft dimension, and wherein the interior includes a proximal surface,
a snare locking sleeve disposed within the first shaft, wherein the snare locking sleeve is movable along the longitudinal axis relative to the first shaft, and wherein the snare locking sleeve includes a distal feature having a proximal contour sized and shaped to mate with the proximal surface of the interior of the docking cap,
a snare configured to grasp a retrieval feature of the leadless pacemaker, wherein the snare extends longitudinally through the snare locking sleeve, and
a handle coupled to the first shaft, the snare locking sleeve, and the snare, wherein the handle includes a control knob longitudinally slidable along the handle to move the snare locking sleeve and the snare relative to the first shaft.
2. The delivery system of claim 1 , wherein the snare includes a snare loop to grasp the retrieval feature.
3. The delivery system of claim 1 , wherein the delivery system includes a deflection knob configured to steer the first shaft.
4. The delivery system of claim 3 , wherein the deflection knob slides to deflect the distal portion of the first shaft.
5. The delivery system of claim 1 , wherein the distal portion of the first shaft is pre-curved.
6. The delivery system of claim 1 , wherein the first shaft includes segments having different stiffnesses.
7. The delivery system of claim 1 further comprising a flush port extending outward from the handle distal to the control knob.
8. A leadless pacemaker system, comprising:
a leadless pacemaker having a retrieval feature; and
a delivery system including
a first shaft extending along a longitudinal axis to a distal portion, wherein the first shaft has an outer shaft dimension,
a docking cap disposed on the distal portion of the first shaft, wherein the docking cap has an outer cap dimension and an interior configured to receive the leadless pacemaker, wherein the outer cap dimension is greater than the outer shaft dimension, and wherein the interior includes a proximal surface,
a snare locking sleeve disposed within the first shaft, wherein the snare locking sleeve is movable along the longitudinal axis relative to the first shaft, and wherein the snare locking sleeve includes a distal feature having a proximal contour sized and shaped to mate with the proximal surface of the interior of the docking cap,
a snare configured to grasp a retrieval feature of the leadless pacemaker, wherein the snare extends longitudinally through the snare locking sleeve, and
a handle coupled to the first shaft, the snare locking sleeve, and the snare, wherein the handle includes a control knob longitudinally slidable along the handle to move the snare locking sleeve and the snare relative to the first shaft.
9. The leadless pacemaker system of claim 8 , wherein the snare includes a snare loop to grasp the retrieval feature.
10. The leadless pacemaker system of claim 8 , wherein the delivery system includes a deflection knob configured to steer the first shaft.
11. The leadless pacemaker system of claim 10 , wherein the deflection knob slides to deflect the distal portion of the first shaft.
12. The leadless pacemaker system of claim 8 , wherein the distal portion of the first shaft is pre-curved.
13. The leadless pacemaker system of claim 8 , wherein the first shaft includes segments having different stiffnesses.
14. The leadless pacemaker system of claim 8 further comprising a flush port extending outward from the handle distal to the control knob.
15. The leadless pacemaker system of claim 8 , wherein the leadless pacemaker includes one or more tines to affix the leadless pacemaker to tissue.
16. A method, comprising:
grasping, by a snare of a delivery system, a retrieval feature of a leadless pacemaker, wherein the snare extends through a snare locking sleeve of the delivery system, wherein the snare locking sleeve is disposed within a first shaft of the delivery system and is movable along a longitudinal axis relative to the first shaft, wherein the first shaft has an outer shaft dimension, wherein the delivery system includes a docking cap disposed on a distal portion of the first shaft, wherein the docking cap has an outer cap dimension and an interior configured to receive the leadless pacemaker, wherein the outer cap dimension is greater than the outer shaft dimension, wherein the interior includes a proximal surface, and wherein the snare locking sleeve includes a distal feature having a proximal contour sized and shaped to mate with the proximal surface of the interior of the docking cap; and
sliding a control knob of a handle longitudinally along the handle, wherein the handle is coupled to the first shaft, the snare locking sleeve, and the snare, and wherein sliding the control knob moves the snare locking sleeve and the snare relative to the first shaft.
17. The method of claim 16 , wherein moving the snare locking sleeve and the snare relative to the first shaft causes the docking cap to move toward the retrieval feature of the leadless pacemaker such that the proximal contour of the distal feature of the snare locking sleeve mates with the proximal surface of the interior of the docking cap.
18. The method of claim 16 , wherein the snare includes a snare loop to grasp the retrieval feature.
19. The method of claim 18 further comprising moving the snare locking sleeve longitudinally over the snare to cause the snare loop to close onto the retrieval feature.
20. The method of claim 16 further comprising sliding a deflection knob of the handle to steer the first shaft.