Patent Application
20150328468
The present invention refers to a sterilizable container, or containment, for an implantable medical device. The present invention further refers to a sterilizable container, or containment, containing an implantable medical device. In particular, the present invention refers to a sterilizable container, or containment, for an implantable programmable heart stimulator, such as an implantable pacemaker or an implantable cardioverter/defibrillator. The present invention further refers to a method of programming and/or testing an implantable medical device.
Implantable medical devices must be sterilized prior to use. Therefore, a container, or containment, is needed, wherein the implantable medical device can be maintained sterile. To ensure that the implantable medical device is maintained in a sterile condition, the implantable medical device is sterilized together with a container enclosing the device.
In some examples, implantable medical devices are implantable leadless pacemakers (“iLP”) that are small enough to be placed within a ventricle of a human heart. In some examples, implantable leadless pacemakers feature two electrode poles that are arranged on the pacemaker's casing and that are configured to deliver stimulation pulses to a conductive medium or tissue surrounding the implantable leadless pacemaker when in use. In contrast to iLP's, traditional implantable pacemakers utilize electrode leads which contain electrodes at or near their distal end. These electrode leads are connected to the implantable pacemaker and can be implanted and explanted separately from the pacemaker. Implantable leadless pacemakers, in contrast, utilize no electrode leads and therefore only one component needs to be implanted and is required to be kept sterile prior to implantation.
The present invention is directed toward overcoming one or more of the above-mentioned problems.
It is an object of the present invention to provide a suitable container for an implantable medical device and, in particular, for a programmable implantable leadless pacemaker.
According to the present invention, at least this object is achieved by means of an inner packaging for a sterilizable container for an implantable medical device. The inner packaging comprises an enclosure and at least two electric contacts that are arranged inside the enclosure and that are placed so as to contact an implantable medical device electrode when such implantable medical device is placed in said inner packaging. Each electric contact of said inner packaging is electrically connected to a respective planar electrode arranged at, or close to, an outer surface of said inner packaging so as to provide a capacitive communication interface. The inner packaging further comprises fixture means that are configured to securely hold an implantable medical device in place to ensure electric contact between the at least two electric contacts and a respective implantable medical device electrode when such implantable medical device is placed in the inner packaging.
At least the object is further achieved by sterilizable container for an implantable medical device. The container comprises an inner packaging as disclosed above and an outer packaging that encloses said inner packaging.
At least the object of the present invention is still further achieved by a method that comprises the steps of:
The present invention meets the desire to communicate with an implantable medical device before implant while it is still in the sterile packaging in order to perform pre-implant tests and programming. Methods of communication applied in the art of implantable pacemaker devices utilize RF or magnetic communication, both of which readily penetrate sterile packaging layers to perform this pre-implant communication function. Recent device miniaturization advances and applications have required reductions in communications power and increases in device communication depth within the body. These changes have required the development of novel forms of communication via electrical fields which do not readily penetrate sterile packaging.
The present invention provides a communication system and method which facilitates the transmission of electric field based methods of communication from the electrodes on a device across sterile packaging, and potentially multiple layers of standard, unmodified sterile packaging, to a communications unit outside of the sterile packaging.
Known solutions for device-communication include capacitive coupling across a sterile barrier and electrical contact through a sterile barrier as taught in U.S. Pat. No. 8,219,200; conductive liquid coupling (glycerol) as taught in U.S. Pat. No. 6,116,413; inductive coupling as taught in U.S. Publication No. 2012/0112690; wires which penetrate the sterile packaging and provide electrical connection to the implantable device as taught in U.S. Pat. No. 8,224,447; and wireless antenna coupling across sterile packaging as taught in U.S. Pat. No. 7,289,855. The inventors have recognized that the solutions known so far typically require a modification of standard sterile containers.
The present invention provides, in particular, a packaging and a container that allow communication with implantable medical devices that provide for an electric field based data communication, in particular, those micro-sized implantable medical devices that rely on electrical field based communication which does not easily penetrate sterile packaging. Testing of and communicating with an implantable medical device while it is still in a sterile package, without significant modifications to the sterile package or multiple payers of the sterile package, is achieved by means of the inventive inner packaging and the container comprising such inner packaging which maintains sterility and allows communication to the device as required.
The inventors have further recognized that wireless antenna coupling across a sterile packaging, as described in U.S. Pat. No. 7,289,855, is applicable when communicating at RF frequencies and with sufficient power; however, these frequencies are not optimal for intra-body propagation. Communications carrier frequencies which are optimal for intra-body propagation poorly couple electromagnetically between antennas in air. Therefore, communication across the sterile packaging would require increased power or greatly increased antenna size to facilitate electromagnetic coupling. The present invention provides a solution that allows data communication with carrier frequencies which are optimal for intra-body propagation without requiring increased power.
Preferred embodiments of the present invention include an inner packaging, wherein at least one of the electric contacts is a soft conductive interface plug that is configured to contact a first electrode of the implantable device to make electrical contact without damaging the first electrode of the implantable device or an electrode coating. Thus, it is achieved that the electrical contact to the implantable device electrode does not damage sensitive coatings or put significant pressure on sensitive flexible components such as, for example, screw electrodes. Common compression interfaces are not adequate to preserve the screw electrode.
Preferably, the soft conductive interface plug comprises rubber or a gel material, or both. The rubber is preferably silicone-based. The gel material preferably comprises glycerol. Other materials are contemplated.
According to further preferred embodiments of the inner packaging, the fixture means for securely holding an implantable medical device in place comprises a rigid frame arranged inside the inner packaging. At least one of the electric contacts is mounted in the rigid frame to ensure reliable electric contact between each respective electric contact and a respective implantable medical device electrode through sterilization and transportation.
Preferably, the rigid frame is made from plastic material.
According to further preferred embodiments of the inner packaging, each planar electrode has an electrode surface of more than 10 cm2 or more than 20 cm2 and less than 50 cm2. A preferred size of the planar electrodes is between 20 cm2 and 35 cm2.
Preferably, the inner packaging contains an implantable medical device. The implantable medical device is preferably configured for impedance-based data communication with an external device. In a further preferred embodiment, the implantable medical device is an implantable leadless pacemaker having at least one screw or spring electrode that contacts the soft conductive interface plug.
The present invention provides an interface across the sterile container comprising an inner packaging and an external communication wand which allows the medium frequency communications pulses to be capacitively coupled, allowing bidirectional communication across the sterile membrane without requiring modifications to the sterile container. The inner packaging contains at least two planar electrodes which serve to enlarge the electrical surface area available for coupling across the sterile container. In addition, a soft conductive interface plug is inserted in contact with a first electrode of the implantable device (screw of iLP) to make electrical contact without damaging the electrode or electrode coating. The plug may be composed of rubber (e.g., possibly silicone-based) or a gel (e.g., glycerol) material. A second contact is made with a second electrode of the device (e.g., possibly the fin of an iLP) and both contacts are mounted in a rigid frame of the inner packaging for reliable contact through sterilization and transportation.
Communication is facilitated between the inner packaging, inside the sterile container, and an external communications wand adapted to couple to the inner fixture across the sterilization package. The external wand comprises two communication electrodes that can couple capacitively to the planar electrodes of the inner packaging. The external wand is not a component of the container, but is applied across the walls of the container such that at least two communication electrodes are positioned in alignment with the at least two planar electrodes on the other side of the container wall. Coupling, potentially magnetic, between the inner packaging and the external wand facilitates this alignment and compresses the sterile container such that the reduced inter-electrode distance allows capacitive coupling between the wand communication electrodes and the planar electrodes of the inner packaging, facilitating communication.
Preferably, the spacing between the wand electrodes and the planar electrodes of the inner packaging is less than 5 mm, and preferably 1 mm to 5 mm, to facilitate capacitive coupling.
According to another embodiment of the present invention, coupling and alignment between the inner packaging and the wand is facilitated by 3-dimensional features patterned into the inner or outer packaging and wand such that the features nest together when proper alignment is achieved.
According to a preferred embodiment of the method, the method further comprises the steps of:
Thus, an implantable medical device within a sterilized container is provided that can be tested or programmed by means of the method steps mentioned supra.
Further features, aspects, objects, advantages, and possible applications of the present invention will become apparent from a study of the exemplary embodiments and examples described below, in combination with the Figures, and the appended claims.
The above and other aspects, features and advantages of the present invention will be more apparent from the following more particular description thereof, presented in conjunction with the following Figures.
In the drawings:
In the exemplary embodiment illustrated by
The implantable leadless pacemaker 16 is mounted in the inner packaging 12. The inner packaging 12 comprises fixture means that comprise a plastic frame 20. The plastic frame 20 can be integral part of enclosure 18 of the inner packaging 12.
The plastic frame 20 bears two electric contacts 22 and 24, one for each of the implantable medical device electrodes 16.1 and 16.2. The first electric contact 22 is placed in electrical communication with the implantable medical device's spring or screw electrode 16.1. This first electric contact 22 is composed of a soft material so as to not damage the spring coating or the electrode surface of the implantable medical device electrode 16.1. The first electric contact 22 thus is a soft conductive interface plug made from soft material, that is, for example, a biocompatible, stable, non-evaporative gel or a conductive, biocompatible silicon.
Plastic frame 20 further houses the second electric contact 24 in electrical communication with a fin electrode of the implantable leadless pacemaker 16, said fin electrode being the second implantable medical device electrode 16.2. The second electric contact 24 is configured to make electrical contact to the second implantable medical device electrode 16.2 via compression against the second medical implant electrode 16.2.
The two electric contacts 22 and 24 are arranged on the plastic frame 20 so as to provide positive electric contact to the implantable medical device electrodes 16.1 or 16.2, respectively, while the implantable medical device 16 is securely held by the plastic frame 20.
The two electric contacts 22 and 24 are electrically connected to two planar electrodes 26 and 28. The electric connection between each electric contact 22 or 24, respectively, to a respective planar electrode 26 or 28 can be provided by a wire or any other electrically conducting material.
The planar electrodes 26 and 28 are arranged inside the inner packaging 10 at, or close to, an enclosure wall of enclosure 18. Each planar electrode 26 or 28 has a surface of approximately 30 cm2. The spacing between the two planar electrodes is approximately 2 cm.
The planar electrodes 26 and 28 serve as trans-packaging communication electrodes.
Preferably, the inner packaging 12 further houses at least one ferromagnetic slug 30, which facilitates alignment of the inner packaging 12 and the planar electrodes 26 and 28 thereof, with an alignment magnet in an external wand.
The external wand (not shown) comprises two communication electrodes 32 and 34 (see
A trans-packaging communication system thus comprises a communications wand (not shown) with two communication electrodes 22 and 24 that are sized and spaced to align with the two planar electrodes 22 and 24 of the inner packaging.
Preferable, the wand (not shown) preferably further comprises a magnet (not shown), which facilitates alignment of the wand communication electrodes 32 and 34 with the planar electrodes 22 and 24 of the inner packaging by means of the ferromagnetic slug 30 of the inner packaging. Thus, reduced inter-electrode distance between the wand communication electrodes 32 and 34 and the planar electrodes 22 and 24 of the inner packaging 12 can be achieved by means of compressing the container 10.
In such arrangement, capacitance in the order of nF develops across the sterile container 10 between each communication electrode 32 or 34, respectively, and a respective planar electrode 22 or 24 of the inner packaging 12, facilitating electrical communication to and from the implantable medical device 16.
According to a preferred embodiment, electrical communication takes place at below 1 MHz, preferably between 216 kHz and 400 kHz, or at or about 400 kHz, which sufficiently crosses the capacitance of the container interface to allow data communication.
This method of trans-package communication is compatible with both impedance-based communication and continuous wave-based communication.
The container according to the present invention enables wireless electric data communication and implantable medical device programming while it is still in its sterile container. This technology allows miniature implantable devices to be brought to market, which use low-power wireless electric communication (both impedance type and continuous wave type). The container according to the present invention does not require modifications to the outer packaging to enable communication.
It will be apparent to those skilled in the art that numerous modifications and variations of the described examples and embodiments are possible in light of the above teachings of the disclosure. The disclosed examples and embodiments are presented for purposes of illustration only. Other alternate embodiments may include some or all of the features disclosed herein. Therefore, it is the intent to cover all such modifications and alternate embodiments as may come within the true scope of this invention, which is to be given the full breadth thereof. Additionally, the disclosure of a range of values is a disclosure of every numerical value within that range.
This patent application claims the benefit of co-pending U.S. Provisional Patent Application No. 61/992,930, filed on May 14, 2014, and U.S. Provisional Patent Application No. 62/101,378, filed on Jan. 9, 2015, both of which are hereby incorporated by reference in their entireties.
| Number | Date | Country | |
|---|---|---|---|
| 62101378 | Jan 2015 | US | |
| 61992930 | May 2014 | US |
