US 7,191,015 B2Granted

Devices and methods for transluminal or transthoracic interstitial electrode placement

AssigneeMedtronic Vascular, Inc.

InventorsTheodore C. Lamson, Joshua Makower, J. Christopher Flaherty

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Abstract

Methods and devices for implanting pacing electrodes or other apparatus, or for delivering substances, to the heart of other tissues within the body. A guided tissue penetrating catheter is inserted into a body lumen (e.g., blood vessel) or into a body cavity or space (e.g., the pericardial space) and a penetrator is advanced from the catheter to a target location. In some embodiments, a substance or an apparatus (such as an electrode) may be delivered through a lumen in the penetrator. In other embodiments, a guidewire may be advanced through the penetrator, the penetrating catheter may then be removed and an apparatus (e.g., electrode) may then be advanced over that guidewire. Also disclosed are various implantable electrodes and electrode anchoring apparatus.

Claims44

Dependent claims

A method for implantation of an electrode at an intended location outside of the lumen of a blood vessel or other anatomical conduit within the a human or veterinary patient, the method comprising the steps of:

a) providing a tissue penetrating catheter that comprises i) an elongate catheter body, ii) a hollow tissue penetrator that is moveable from a retracted position within the catheter body to an extended position wherein it extends laterally from the catheter body and iii) an orientation element useable while the penetrator is in its retracted position to determine the lateral direction in which the penetrator will subsequently advance from the catheter body as it is moved to its extended position;
b) positioning the catheter body in the blood vessel or other anatomical conduit;
c) using the orientation element while the penetrator is in its retracted position to adjust the rotational orientation of the catheter body as needed to substantially ensure that subsequent movement of the penetrator to its extended position will cause the penetrator to enter the intended location where the electrode is to be implanted;
d) advancing the penetrator into the intended location where the electrode is to be implanted and, thereafter,
e) implanting an electrode at the intended location by at least one of the following procedures:
i) advancing a pacing electrode trough the lumen of the penetrator and into the intended extravascular location;
or,
ii) advancing a guidewire through the penetrator and into the intended location and, thereafter, advancing the electrode over the guidewire and into the intended location;
or,
iii) advancing a guidewire through the penetrator and into the intended location, advancing a tract enlarging apparatus over the guidewire and using the tract enlarging apparatus to enlarge the tract created by the penetrator and/or the guidewire and, thereafter, advancing the electrode over the guidewire and through the enlarged penetration tract to the intended location.

7 more elements

A method for positioning an electrode in contact with the wall of a blood vessel or other anatomical conduit, the method comprising the steps of:

a) providing a tissue penetrating catheter that comprises i) an elongate catheter body, ii) a hollow tissue penetrator that is moveable from a retracted position within the catheter body to an extended position wherein it extends laterally from the catheter body and iii) an orientation element useable while the penetrator is in its retracted position to determine the lateral direction in which the penetrator ill subsequently advance from the catheter body as it is moved to its extended position;
b) positioning the catheter body in the blood vessel or other anatomical conduit;
c) using the orientation element while the penetrator is in its retracted position to adjust the rotational orientation of the catheter body as needed to substantially ensure that subsequent movement of the penetrator to its extended position will cause the penetrator to pass into or through the wall of the blood vessel or other anatomical conduit at a location adjacent to the location at which it is desired for the electrode to contact the wall of the vessel or anatomical conduit;
d) advancing the penetrator into or through the wall of the blood vessel or other anatomical conduit at a location adjacent to the location at which it is desired for the electrode to contact the wall of the vessel or anatomical conduit;
e) causing the penetrator to become substantially anchored in tissue so as to resist pull our of the penetrator:
and,
f) drawing the catheter body against the wall of the blood vessel or other anatomical conduit such that the electrode located on the outer surface of the catheter body is held in abutting contact with the wall of the blood vessel or anatomical conduit.

4 more elements

Dependencies are inferred from the claim text.

Facts

Application: 10/411,891Filed 11 Apr 2003 · us provisional application
Priority: 11 Apr 2002
Published: US 2004/0015193 A122 Jan 2004
Granted: 13 Mar 2007
Term ends: Not estimatedThe source records don’t support an estimate.

Classification8 codes

A61N 1/0573
Anchoring means; Means for fixing the head inside the heart: chacterised by means penetrating the heart tissue, e.g. helix needle or hook
A61N 1/056
For implantation or insertion into the body, e.g. heart electrode: transvascular endocardial electrode systems
A61B 2017/22095
For crossing total occlusions, i.e. piercing: accessing a blood vessel true lumen from the sub-intimal space
A61N 1/0587
For implantation or insertion into the body, e.g. heart electrode: epicardial electrode systems; Endocardial electrodes piercing the pericardium