# US 11,077,297 B2 · Active medical device with attachment features > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,077,297 B2 - Document ID: US11077297B2 - Status: Granted - Kind: B2 - Application number: 15/955,331 - Filed: 2018-04-17 - Published: 2018-10-18 - Granted: 2021-08-03 - Earliest claimed: 2017-04-18 - Assignees: Cardiac Pacemakers, Inc. - Applicants: Cardiac Pacemakers, Inc. - Inventors: Andrew L. De Kock; G. Shantanu Reddy; Lili Liu; James K. Cawthra, Jr.; Christopher Alan Fuhs; Peter Hall; James O. Gilkerson; Benjamin Philip Gundale; Daniel J. Foster; Henry J. Pepin - Web page: https://patentgrep.com/patent/US11077297B2 ## CPC - A61N 1/05: for implantation or insertion into the body, e.g. heart electrode (A61N1/06 takes precedence) - A61B 6/12: Arrangements for detecting or locating foreign bodies - A61B 8/0841: {for locating instruments} - A61M 25/09: Guide wires - A61N 1/0563: {specially adapted for defibrillation or cardioversion} - A61N 1/059: {Anchoring means} - A61N 1/37518: {Anchoring of the implants, e.g. fixation} - A61N 1/39: Heart defibrillators - A61M 2025/09166: {having radio-opaque features} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract Implantable leads of a cardiac stimulus system are disclosed, as well as methods for implanting leads of a cardiac stimulus system. The lead may be comprised of a proximal portion having a coupler for coupling to an implantable pulse generator, an intermediate portion comprising a plurality of electrodes disposed thereon, and a distal portion. The intermediate portion may have a first diameter and the distal portion may have a second diameter. The distal portion may also have an attachment feature for attaching to a lead pulling tool for delivery to an ITV and an intercostal vein. Methods may include pulling a lead from a first position to a second position within the vasculature, exiting the vasculature at the second location, and attaching a portion of the lead that exits the vasculature to an electrode or implantable device for use with the lead. ## Claims ### Claim 1 A method of implanting a lead for use in a cardiac stimulus system in a patient, the lead having a proximal end and a distal end, the distal end comprising an attachment feature, the method using a lead pulling tool having a distal end adapted for advancement into the vasculature of the patient and a proximal end having a coupler for mechanical coupling to the attachment feature of the lead, the method comprising: establishing venous access into the patient; advancing the distal end of the lead pulling tool into a brachiocephalic vein; advancing the distal end of the lead pulling tool from the brachiocephalic vein into an internal thoracic vein (ITV); obtaining a location of the lead pulling tool in the venous vasculature; establishing an external access to the venous vasculature in order to access the distal end of the lead pulling tool; securing the lead attachment feature to the lead pulling tool coupler; and drawing the lead at least into the ITV by pulling the lead pulling tool out of the patient using the external access. ### Claim 2 (depends on 1) The method of claim 1, further comprising detaching the lead attachment feature from the lead pulling tool coupler, securing an electrode to the lead attachment feature, and implanting the electrode at a subcutaneous location. ### Claim 3 (depends on 1) The method of claim 1 further comprising advancing the lead pulling tool into an intercostal vein, wherein the external access is made by accessing the intercostal vein, such that the lead is implanted with a portion thereof extending within the intercostal vein. ### Claim 4 (depends on 1) The method of claim 1 further comprising advancing the lead subcutaneously from the location of the external access to a desired subcutaneous location, detaching the lead attachment feature from the lead pulling tool coupler, and attaching an electrode to the lead attachment feature. ### Claim 5 (depends on 4) The method of claim 4 wherein the electrode is a mesh patch electrode, and the method further comprises implanting the mesh patch electrode at the desired subcutaneous location. ### Claim 6 (depends on 4) The method of claim 4 wherein the electrode is a solid disk electrode, and the method further comprises implanting the solid disk electrode at the desired subcutaneous location. ### Claim 7 (depends on 4) The method of claim 4 wherein the electrode is a coil electrode, and the method further comprises implanting the coil electrode at the desired subcutaneous location. ### Claim 8 (depends on 4) The method of claim 4 wherein the electrode is a rod electrode, and the method further comprises implanting the rod electrode at the desired subcutaneous location. ### Claim 9 (depends on 4) The method of claim 4 wherein the electrode is a jointed disk array electrode, and the method further comprises implanting the jointed disk array electrode at the desired subcutaneous location. ### Claim 10 (depends on 1) The method of claim 1 wherein the attachment feature is a tether retention structure having a hole for receiving a tether, hook or fastener.