摘要:
A medical electrical lead and introducer system. The lead is a single pass, dual chamber lead, which features in one embodiment an atrial tine. The introducer system is particularly designed for introduction of single pass, dual chamber lead which has an atrial tine. The introducer system facilitates the introduction of a such lead into a patient's heart while safeguarding the tine from damage due to kinking during lead positioning. The lead is a single pass lead which features an atrial tine while the introducer system is particularly designed for introduction of a such lead into a patient's heart so as to safeguard the tine from damage due to kinking during lead positioning. The lead is designed so as to electrically couple both the atrium and the ventricular chambers of the heart. The lead generally features several lengths each having differing stiffness as well as a pre-formed bend. The lead also features a atrial tine having an electrode at the tip. Due to the relatively fragile as well as difficult to maneuver lead, an introducer system is also disclosed. The introducer system is particularly designed to introduce such a lead. In use a removable tubing split element surrounds the atrial tine area of the lead while it is disposed through the introducer sheath, the split element both blocks the tine from lateral movement and fills up the space between the lead body and the introducer, thereby preventing blood leakage through the introducer. The element also has a longitudinal split for receiving the atrial tine while holding it against transverse movement when the lead is being repositioned. After optimal positioning of the lead, the tubing split element is withdrawn, and then the introducer is withdrawn. The tubing split element is a generally cylindrical piece of TEFLON, here called a tube split element, or just a “tube split”, is positioned around the lead body in the atrial tine area. The tube split element has a thickness which substantially fills the radial gap between the smaller diameter lead body and the introducer inner cylindrical wall, and has a longitudinal separation, or split, which accommodates the atrial tine, thereby permitting the tine to extend longitudinally but not transversely. The tubing split element is preferably mounted on the lead at the time of lead assembly. It has a length sufficient to extend proximally out of the introducer so that it can be withdrawn, and has a longitudinal tear line whereby the element can be separated and removed from the lead after final positioning of the lead.
摘要:
The present invention is directed to a single pass medical electrical lead. In one embodiment, the lead features a pair of bipolar electrodes positioned along the lead body so that they are positioned in the ventricle and atrium respectively when the lead is implanted. The lead body features a 90 degree bent reinforced section. The bend has a radius of curvature approximately 13 mm and begins approximately 90 mm from the distal end. This curved section is approximately 40 mm in length when straightened. The ventricular electrodes are positioned approximately 28 mm apart. The bend has at least one tine extending therefrom, an electrode is mounted on the tine.
摘要:
The present invention is directed to a single pass medical electrical lead. In one embodiment, the lead features a pair of bipolar electrodes positioned along the lead body so that they are positioned in the ventricle and atrium respectively when the lead is implanted. The lead body features a 90 degree bent reinforced section. The bend has a radius of curvature approximately 13 mm and begins approximately 90 mm from the distal end. This curved section is approximately 40 mm in length when straightened. The ventricular electrodes are positioned approximately 28 mm apart. The ventricular cathode electrode is positioned at the distal end of the lead. The atrial electrodes are positioned approximately between 5-35 mm apart, with 28 mm preferred. The atrial anode is located at a position immediately adjacent and proximal the 90 degree bent reinforced section.
摘要:
A transvenous lead specifically designed for multi-chamber electrical stimulation or sensing. In a first embodiment the lead features one or more electrodes for communication with the right atrium as well as one or more electrodes for communication with either or both of the left chambers of the heart. The lead further features structures to simultaneously bring the first electrode into contact with a first chamber, such as the right atrial wall and the second electrode into contact with a particular portion of the coronary sinus wall, to electrically access the left atrium or ventricle. In the preferred embodiment the lead body has varying flex or stiffness characteristics along its length between each of the electrodes. The relation of the varying flex or stiffness characteristics along the lead body length as well as the various linear placements of the electrodes along the lead body length function to simultaneously bring the first electrode into contact with a first desired portion of the heart, such as the right atrial wall, and the second electrode into contact with a second desired portion of the heart, such as a portion of the coronary sinus wall.
摘要:
A transvenous lead specifically designed for coronary sinus implantation. In the preferred embodiment the lead features an electrode which is eccentricity placed along the lead body. Disposed on the opposite side of the lead body is a tine-like member to push or maintain the electrode into contact with the vessel wall. Because the electrode and tine-like member do not entirely block the cross sectional area of the vessel, blood flow through the vessel is not impeded. Through such a configuration electrical stimulation with the tissue comprising the left side of the heart may be accomplished. In alternative embodiments other mechanisms besides tine-like member are used to maintain the contact of the electrode with the vessel wall. In a still further alternative embodiment the eccentricity disposed electrode is positioned instead upon the tip of the tine.
摘要:
The present invention is directed to a single pass medical electrical lead. In one embodiment, the lead feature a pair of bipolar electrodes positioned along the lead body so that they are positioned in the ventricle and atrium respectively when the lead is implanted. The lead body features a 90 degree bent reinforced section. The bend has a radius of curvature approximately 13 mm and begins approximately 90 mm from the distal end. This curved section is approximately 40 mm in length when straightened. The ventricular electrodes are positioned approximately 28 mm apart. The ventricular cathode electrode is positioned at the distal end of the lead. The atrial electrodes are positioned approximately between 5-35 mm apart, with 28 mm preferred. The atrial anode is located at a position immediately adjacent and proximal the 90 degree bent reinforced section.
摘要:
Medical devices and methods for accessing an anatomical space of the body and particularly for penetrating the epicardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner employing suction are disclosed. The distal end of a tubular access sleeve having a sleeve wall surrounding a sleeve access lumen and extending between a sleeve proximal end and a sleeve distal end having a plurality of suction ports arrayed around the sleeve access lumen distal end opening is applied against an outer tissue layer. Suction is applied through the plurality of suction ports to a plurality of portions of the outer tissue layer. A perforation instrument is introduced through the sleeve access lumen to perforate the outer tissue layer to form an access perforation into the anatomic space while the applied suction stabilizes the outer tissue layer, whereby further treatment drugs and devices can be introduced into the anatomic space.
摘要:
A distal tip coupled to a body of an implantable medical device includes a canted passageway extending distally from a lumen of the body and an opening terminating the passageway and positioned in proximity to a distal end of the distal tip; a helical fixation element coupled to an elongated member extending within the lumen of the body is adapted to deflect along the canted passageway of the distal tip. The elongated member is adapted to move the helical member through the passageway of the distal tip and out from the opening and to rotate the helical element thereby affixing the helical element into an implant site.
摘要:
An improved medical lead assembly and method of use is provided. The lead assembly includes a lead body, and a spring member positioned adjacent to the lead body. The spring member may be deployed a selectable amount to maintain the lead body in a fixed location within a patient's body. The spring member may be an expandable coil, a mesh structure that is similar to a stent, or any other similar device that may be positioned in a low-profile state during a lead implant procedure. After the lead is positioned at a target destination, the spring member may be deployed an amount that is selected based on the characteristics of the surrounding tissue, including vessel size. According to one aspect of the invention, the lead assembly may provide means for facilitating chronic lead extraction.
摘要:
A sensor is provided on a lead and senses various physical parameters that are indicative of a desired anatomical target, such as the coronary sinus. The data from the sensor is used to navigate to the anatomical target and/or confirm that the anatomical target has been reached. In one embodiment, the sensor is a temperature sensor and increased temperature values in and around the coronary sinus are used for navigational purposes.