Devices, systems, and methods for treating cardiac arrhythmias

Abstract

Medical devices are described for performing mapping, ablating, and/or pacing procedures on one or more layers of the cardiac wall via an epicardial approach in a minimally invasive (e.g., orthoscopic) surgical procedure. One of the medical devices described includes a main support member and one or more secondary support members extending outwardly from the main support member having electrodes configured to receive electrical impulses. The secondary support member may include a support pad configured to be removably attached to a corresponding area of the epicardium for holding the medical device in place during a procedure, such as through application of vacuum pressure via a containment dome provided on each secondary support member. Further, an ablating electrode may be slidably disposed along the main support member for transmitting energy to a target site proximate the electrode. Associated methods are also described.

1 - 20 . (canceled) 
     
     
         21 . A method for treating cardiac arrhythmias, the method comprising:
 inserting a medical device in a patient's body;   advancing the medical device towards a target area of the patient's heart from a location outside the heart; and   activating one or more pacing electrodes on the medical device to electrically stimulate tissue proximate the target area during a pacing procedure.   
     
     
         22 . The method of  claim 21 , wherein inserting the medical device comprises non-transvenously inserting the medical device in the patient's body. 
     
     
         23 . The method of  claim 21 , wherein advancing the medical device towards the target area comprises approaching the heart epicardially. 
     
     
         24 . The method of  claim 21 , wherein the target area is disposed over portions of a heart atrium and a heart ventricle. 
     
     
         25 . The method of  claim 21 , wherein the target area is disposed over portions of a left side and a right side of the heart. 
     
     
         26 . The method of  claim 25  further comprising pacing the left and right sides of the heart via the medical device. 
     
     
         27 . The method of  claim 21 , wherein inserting the medical device comprises collapsing the medical device and inserting the medical device through an incision in the patient's body in a collapsed position. 
     
     
         28 . The method of  claim 27 , wherein the medical device comprises:
 a central axis defined between a proximal end and a distal end opposite the proximal end;
 a plurality of support members disposed between the proximal and distal ends, each support member being movable relative to the central axis between the collapsed position and an expanded position; and 
 a plurality of pacing electrodes disposed over the plurality of support members, the pacing electrodes being configured to transmit an electrical impulse during the pacing procedure. 
   
     
     
         29 . The method of  claim 28 , wherein collapsing the medical device comprises positioning each support member substantially parallel to the central axis. 
     
     
         30 . The method of  claim 29 , further comprising expanding the medical device proximate the target area prior to activating one or more of the pacing electrodes. 
     
     
         31 . The method of  claim 30 , wherein expanding the medical device comprises moving each support member to a position that is non-parallel to the central axis. 
     
     
         32 . The method of  claim 21  further comprising disposing one or more attachment members on the medical device and securing the attachment members proximate the target area. 
     
     
         33 . The method of  claim 32 , wherein the one or more attachment members comprises a hook, a wire, a sheet, or other engaging point. 
     
     
         34 . The method of  claim 32  further comprising coating the one or more attachment members with a soluble coating prior to securing the attachment members proximate the target site. 
     
     
         35 . The method of  claim 21 , wherein activating one or more of the pacing electrodes comprises selectively activating less than all of the pacing electrodes during the pacing procedure. 
     
     
         36 . The method of  claim 21 , wherein activating the one or more pacing electrodes comprises wirelessly activating the pacing electrodes. 
     
     
         37 . The method of  claim 21 , wherein activating the one or more pacing electrodes comprises activating the electrodes via a pulse generator installed in the patient's body. 
     
     
         38 . A medical device liar treating cardiac arrhythmias, the device comprising:
 a central axis defined between a proximal end and a distal end opposite the proximal end;   a plurality of support members disposed between the proximal and distal ends, each support member being movable relative to the central axis between a collapsed position and an expanded position; and   a plurality of pacing electrodes disposed over the plurality of support members, the pacing electrodes being configured to transmit an electrical impulse to tissue during a pacing procedure;   wherein, in the collapsed position, each support member is substantially parallel to the central axis, and, in the expanded position, each support member is not parallel to the central axis.   
     
     
         39 . The device of  claim 38 , wherein, in the expanded position, adjacent support members are spaced apart from each other and the central axis. 
     
     
         40 . The device of  claim 38 , wherein, in the collapsed position, adjacent support members contact each other. 
     
     
         41 . The device of  claim 38 , wherein each pacing electrode is independently controllable so as to selectively transmit energy to a target area during the pacing procedure. 
     
     
         42 . The device of  claim 38  further comprising at least one attachment member configured to secure the device to tissue at a target area. 
     
     
         43 . The device of  claim 42 , wherein the at least one attachment member comprises a hook, a wire, a sheet, or other engaging point configured to secure the device to the tissue at the target area. 
     
     
         44 . The device of  claim 42 , wherein the tissue is on the outside of a heart.