Coronary sinus-anchored sheath for delivery of his bundle pacing lead

A lead delivery system, comprising:

• a lead delivery catheter including
• a tubular body extending along a longitudinal axis from a proximal end to a distal tip, wherein the distal tip includes an anchor needle configured to actively pivotally anchor in tissue near an implantation site,
• an extension that projects outward from an exterior surface of the tubular body to an exit port, wherein the extension has a cylindrical wall over an extension length, and
• a lead lumen extending through the tubular body along the longitudinal axis and through the extension to the exit port;
• and
• a pacing lead configured to advance through the lead lumen and to project laterally through the exit port.

A method, comprising:

• anchoring a distal tip of a lead delivery catheter near an implantation site, wherein the lead delivery catheter includes a tubular body extending along a longitudinal axis from a proximal end to the distal tip, an extension that projects outward from an exterior surface of the tubular body, wherein the extension has a cylindrical wall over an extension length, and a lead lumen extending through the tubular body along the longitudinal axis and through the extension to the exit port of the extension;
• and
• pivoting the lead delivery catheter to cause the extension to sweep through an arc of rotation about the longitudinal axis such that the exit port is directed to the implantation site;
• and
• advancing a pacing lead through the lead lumen and the exit port to the implantation site.