Transvenous mediastinum access for the placement of cardiac pacing and defibrillation electrodes
AssigneeCardiac Pacemakers, Inc.
InventorG. Shantanu Reddy
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Abstract
Implantation of a cardiac stimulus system into the mediastinum using the ITV. Superior, intercostal, and inferior access methods are discussed and disclosed. Superior access may be performed using the brachiocephalic vein to access the ITV, with access to the brachiocephalic vein achieved using subclavian vein, using standard visualization techniques. Inferior access may be accomplished inferior to the lower rib margin via the superior epigastric vein. Intercostal access may include creating an opening in an intercostal space between two ribs and advancing a needle using ultrasound guidance.
Claims20
A method of implanting a lead for use in a cardiac stimulus system in a patient, the lead having a proximal end, a distal end, and at least one electrode thereon;
- the method comprising:
- inserting the lead into the internal thoracic vein (ITV);
- and
- advancing the lead from the ITV into the mediastinum.
A method of treating a patient comprising delivering cardiac electrical therapy between:
- a first electrode disposed on a lead which is placed in a mediastinum of a patient through an internal thoracic vein (ITV) of the patient, and
- at least a second electrode disposed on an implantable pulse generator placed in a subcutaneous position.
A method of implanting a defibrillator system comprising an implantable pulse generator (IPG) and a lead having a proximal end for coupling to the IPG and a distal end with one or more electrodes thereon, the method comprising:
- making at least one incision on the chest of the patient;
- accessing a first vein via the at least one incision;
- accessing the internal thoracic vein (ITV) by advancing through the first vein;
- establishing a route from the ITV into the mediastinum;
- inserting the distal end of the lead into the accessed vein and advancing the distal end of the lead into the internal thoracic vein and thence into the mediastinum;
- coupling the proximal end of the lead to the IPG;
- and
- implanting the IPG.
Dependencies are inferred from the claim text.