US 11,986,254 B2
Fluoroless vascular sheath manipulation and electrogram monitoring
Jeffrey P. Moak, Bethesda, MD (US); and Henry Blicharz, Colombia, MD (US)
Assigned to Children's National Medical Center, Washington, DC (US)
Appl. No. 16/490,942
Filed by CHILDREN'S NATIONAL MEDICAL CENTER, Washington, DC (US)
PCT Filed Mar. 7, 2018, PCT No. PCT/US2018/021316
§ 371(c)(1), (2) Date Sep. 4, 2019,
PCT Pub. No. WO2018/165277, PCT Pub. Date Sep. 13, 2018.
Claims priority of provisional application 62/468,577, filed on Mar. 8, 2017.
Prior Publication US 2020/0008883 A1, Jan. 9, 2020
Int. Cl. A61B 34/20 (2016.01); A61B 5/287 (2021.01); A61B 17/34 (2006.01); A61B 18/14 (2006.01); A61M 25/00 (2006.01); A61M 29/00 (2006.01); A61B 18/00 (2006.01); A61M 25/01 (2006.01)
CPC A61B 34/20 (2016.02) [A61B 5/287 (2021.01); A61B 18/1492 (2013.01); A61M 29/00 (2013.01); A61B 17/3478 (2013.01); A61B 2018/00351 (2013.01); A61B 2018/00577 (2013.01); A61B 2018/00839 (2013.01); A61B 2018/1425 (2013.01); A61B 2018/1475 (2013.01); A61B 2034/2051 (2016.02); A61B 2562/0209 (2013.01); A61M 25/0082 (2013.01); A61M 2025/0166 (2013.01)] 18 Claims
OG exemplary drawing
 
1. An apparatus comprising:
a sheath comprising a proximal end, a distal end, an outer surface having a diameter sized for introduction into a blood vessel of a subject, and a lumen extending between the proximal and distal ends of the sheath;
a sheath electrode coupled to the sheath at or near the distal end of the sheath;
a tapered dilator positioned within the sheath lumen and extending distally past the distal end of the sheath, the dilator comprising a proximal end, a distal end, and a lumen extending between the proximal and distal ends of the dilator;
a dilator electrode coupled to the dilator at or near the distal end of the dilator;
a transseptal needle retractably positioned within the dilator lumen, the transseptal needle comprising a proximal end and a distal end, the distal end of the transseptal needle comprising a transseptal needle electrode and a magnetic field sensor configured to detect the strength of a magnetic field; and
a lead connected to the sheath electrode;
wherein the transseptal needle electrode, the dilator electrode, and the sheath electrode are telescopically movable with respect to each other;
wherein the magnetic field sensor is telescopically movable with respect to the dilator and the sheath; and
wherein the sheath electrode forms a bipolar electrode pair with the dilator electrode to record electrograms.