Electrode and method for endocardial atrial pacing

A bipolar pacing electrode for rapid insertion into the heart of a patient and for interconnection with an external pacemaker comprising:

• (a) a pair of electrically insulated flexible conductors;
• (b) an outer, electrically non-conductive flexible sheath around said conductors, said sheath formed of a material having an elastic memory;
• (c) said conductors and sheath forming a flexible curve at one end thereof with said conductors connected with exposed terminals at spaced intervals along the surface of said sheath at said end;
• and
• (d) means along said sheath and including a wing extending laterally from said sheath for indicating the orientation of said curve after said electrode has been inserted into the heart.

A temporary pacing electrode for rapid insertion into the heart for pacing the atrium from an external pacemaker, comprising:

• (a) a flexible conductor having an outer, insulative sheath and a curve at the distal extremity, said curve having an elastic memory;
• (b) a conductive terminal at said distal extremity;
• (c) an external terminal at the proximal extremity of said flexible conductor, said external terminal, said flexible conductor and said distal conductive terminal being electrically coupled so as to permit electronic stimuli to be emitted by said conductive terminal when said external terminal is connected to an external pacemaker;
• (d) orientation means coupled to said insulative sheath and including a wing extending laterally from said sheath for providing indicia outside a patient's body of the orientation of said curve when said curve is positioned in the right atrium;
• and wherein
• (e) appropriate electrical contact between said conductive terminal on the distal end of said conductor and the inner wall of the right atrium is consistently obtained by insertion of said electrode with reference to said orientation means.

A method for rapidly inserting a temporary pacing electrode into the heart of a patient and for orienting the electrode for temporary pacing of the right atrium without fluoroscopy, comprising the steps of:

• (a) providing an electrode having a curve at the distal end with an elastic memory and means including a lateral wing along said electrode for indicating the orientation of said curve;
• (b) straightening the curve;
• (c) introducing said straightened distal end of said electrode through the right subclavian vein, through the superior vena cava and into the cavity of the right atrium of the patient;
• (d) permitting said curve to reform within the right atrium of the patient;
• (e) positioning said orientation means with reference to the lateral direction of said wing during said electrode introduction to orient the extremity of said curved end toward the appendage of the right atrium;
• and thereafter
• (f) partially withdrawing said electrode a short distance to move the extremity of said curved distal end of said electrode into engagement within the pocket of the right atrial appendage.

A method for rapidly inserting a pacing electrode into a patient's body and for orienting an extremity of said pacing electrode with respect to a desired position in the patient's body, said method comprising the steps of:

• (a) providing a pair of lateral wings along said pacing electrode, the lateral direction of said wings indicating the orientation of said extremity;
• (b) introducing said pacing electrode into the patient's body;
• and
• (c) positioning said wings to orient said extremity in the desired manner.

A method for rapidly inserting a pacing electrode into the right atrium of a patient, said method comprising the steps of:

• (a) providing a flexible electrode with an elastic memory and having a curve near the distal end so that said electrode assumes a generally "J" configuration and with a terminal at said distal end, said electrode further including a laterally-extending wing, the lateral direction of which indicates the orientation of said curve;
• (b) straightening said curve and thereafter introducing said electrode into and through the right subclavian vein, the superior vena cava and right atrium with continuous reference to said wing and with the wing parallel to the skin of the patient;
• (c) permitting said curve to reform within the right atrium of the patient;
• and
• (d) partially withdrawing said electrode to move said terminal into engagement with the right atrium.