US 6,185,464 B2 · Arrangement for planting an endocardial cardiac lead

Abstract

An arrangement for introducing and implanting the electrode(s) of an endocardial implantable cardiac lead at a cardiac implantation site within a heart chamber or vessel. An elongated guide body formed of flexible material and extending between a guide body proximal end and a guide body distal end is advanced transvenously to position the guide body distal end in relation to the cardiac implantation site. A guide body tracking mechanism is coupled with the lead distal end for receiving and slidingly engaging the guide body to allow the cardiac lead to be advanced along the guide body until the electrode is positioned at the cardiac implantation site. A pusher mechanism formed of an elongated pusher body of flexible material extends between a pusher body proximal end and a pusher body distal end and has a cardiac lead engaging mechanism for engaging the cardiac lead at or adjacent the distal lead end. The pusher body has sufficient column strength to be advanced alongside the guide body and lead body with the cardiac lead engaging mechanism engaging and slidingly advancing the guide body tracking mechanism and the cardiac lead distally along the guide body to thereby allow the cardiac lead to be advanced along the guide body until the electrode is positioned at the cardiac implantation site. The lead body is released from the lead engaging mechanism and fixed, if the lead includes a fixation mechanism. The pusher mechanism is retracted by retraction of the pusher body.

Claims12

Dependent claims

An arrangement to facilitate the introduction and advancement of an endocardial cardiac lead transvenously within a patient's body to position an electrode of said cardiac lead at a cardiac implantation site, said lead including a lead body extending between a lead proximal end and a distal lead end, a lead conductor extending within said lead body between said proximal and distal lead ends, and the electrode at or adjacent said lead distal end electrically connected to said lead conductor, said arrangement comprising:

elongated guiding means for guiding the transvenous introduction and advancement of said endocardial lead to position said electrode at said cardiac implantation site and comprising an elongated flexible guide body extending between a guide body proximal end and a guide body distal end and capable of being advanced transvenously to position said guide body distal end in relation to a cardiac implantation site;
and
pusher means formed of an elongated pusher body of flexible material and extending between a pusher body proximal end and a pusher body distal end for advancing said cardiac lead transvenously alongside said guide body, said pusher means further comprising:
guide body tracking means coupled with said pusher body distal end for receiving and slidingly engaging said guide body as said pusher body proximal end is advanced;
cardiac lead engaging means for engaging a feature of said cardiac lead at or adjacent said lead distal end and coupled with said guide body tracking means to allow said cardiac lead to be advanced with advancement of said guide body tracking means along said guide body as said pusher body proximal end is advanced until said electrode is positioned at said cardiac implantation site;
and
wherein said guide body tracking means and said cardiac lead engaging means are both fixedly attached to said distal pusher body end and wherein said cardiac lead engaging means further comprises lead breach means normally having a narrow breach width to prevent said lead body from passing therethrough and capable of being widened to a wide breach width to allow said lead body to pass therethrough.

4 more elements

A method of introducing and advancing an endocardial cardiac lead through an incision in a patient's skin and a vein and transvenously within the patient's vasculature to position an electrode of said cardiac lead at a cardiac implantation site employing an arrangement adapted to facilitate the introduction and advancement of an endocardial cardiac lead transvenously within a patient's body to position an electrode of said cardiac lead at a cardiac implantation site, said lead including a lead body extending between a lead proximal end and a distal lead end, a lead conductor extending within said lead body between said proximal and distal lead ends, and the electrode at or adjacent said lead distal end electrically connected to said lead conductor, said arrangement comprising:

elongated guiding means for guiding the transvenous introduction and advancement of said endocardial lead to position said electrode at said cardiac implantation site and comprising an elongated flexible guide body extending between a guide body proximal end and a guide body distal end and capable of being advanced transvenously to position said guide body distal end in relation to a cardiac implantation site,
pusher means formed of an elongated pusher body of flexible material and extending between a pusher body proximal end and a pusher body distal end for advancing said cardiac lead transvenously alongside said guide body, said pusher means further comprising guide body tracking means coupled with said pusher body distal end having a guide body tracking lumen for receiving and slidingly engaging said guide body as said pusher body proximal end is advanced;
and
cardiac lead engaging means for clamping said cardiac lead body and coupled with said guide body tracking means to allow said cardiac lead to be advanced with advancement of said guide body tracking means along said guide body as said pusher body proximal end is advanced until said electrode is positioned at said cardiac implantation site;
and
means for releasing said cardiac lead from said engaging means to enable transvenous retraction of said pusher means after said cardiac lead is advanced to position said electrode at said cardiac implantation site;
comprising the steps of:
(a) prior to or following steps (b), (c) and (d), introducing said elongated flexible guide body through said incisions and advancing said guide body through the patient's vasculature until said guide body distal end is positioned in relation to a cardiac implantation site and said guide body proximal end extends proximally from said incisions;
(b) fitting said cardiac lead body within said cardiac lead engaging means;
(c) operating said cardiac lead engaging means in said clamped state;
(d) fitting said guide body within said guide body tracking lumen;
(e) applying advancement force to said pusher body to distally advance said guide body tracking means over said guide body and said cardiac lead engaging means and said cardiac lead through said incisions and distally through the patient's vasculature until said cardiac electrode is located at said cardiac implantation site;
(f) operating said cardiac lead engaging means in saiD released state;
and
(g) retracting said guide body and said pusher body including said guide body tracking means and said cardiac lead engaging means proximally through the patient's vasculature and incisions.

12 more elements

Dependencies are inferred from the claim text.

Arrangement for planting an endocardial cardiac lead

Life of this patent

Arrangement for planting an endocardial cardiac lead

Life of this patent

Abstract

Claims12