Implant tools for extravascular implantation of medical leads

A method of creating a pathway for an implantable defibrillation lead within a patient, the patient having a torso, the torso having a center, a left side, a right side, and a high sternal area, the method comprising:

• creating an incision at a first location on at least one from the group consisting of the left side and the right side of the torso of the patient;
• positioning a sheath over a first medical device;
• advancing the first medical device and a second medical device through the incision and through subcutaneous tissue toward a second location proximate the center of the torso;
• deflecting a distal end of the first medical device at the second location toward a third location proximate the high sternal area;
• advancing, from the second location, a distal portion of the second medical device out through the distal end of the first medical device toward the third location, the second medical device defining a substantially rigid column when advanced out through the distal end of the first medical device;
• and
• positioning the sheath within the torso, the sheath spanning a distance between the first location and the second location and a distance between the second location and the third location.

A method of creating a pathway for an implantable defibrillation electrical lead within a patient, the patient having a torso, the torso having a center, a left side, and a high sternal area, the method comprising:

• creating an incision at a first location on the left side of the torso of the patient;
• advancing a first medical device and a second medical device through the incision and through subcutaneous tissue toward a second location proximate the center of the torso;
• deflecting a distal end of the first medical device at the second location toward a third location proximate the high sternal area;
• advancing a distal portion of the second medical device out through the distal end of the first medical device toward the third location, the distal portion of the second medical device having a plurality of electrodes, when the distal end of the first medical device is deflected the distal portion of the of the second medical device bends to an angle of approximately 90 degrees with respect to a proximal portion of the second medical device;
• the first medical device defines a first length and the second medical device defines a second length, and wherein the second length is longer than the first length;
• positioning a sheath within the torso, the sheath spanning a distance between the first location and the second location and a distance between the second location and the third location;
• removing the first medical device and the second medical device while leaving the sheath spanning the distance between the first location and the second location and the distance between the second location and the third location;
• advancing the defibrillation lead through the sheath and positioning the distal portion of the defibrillation lead between the second location and the third location;
• creating a subcutaneous pocket proximate the incision, the subcutaneous pocket sized to retain an implantable cardioverter-defibrillator having a can electrode;
• and
• electrically connecting the proximal end of the defibrillation lead to the can electrode.