US 7,270,669 B1Granted

Epicardial lead placement for bi-ventricular pacing using thoracoscopic approach

AssigneeMedtronic, Inc.

InventorJasbir S. Sra

Life of this patent

Estimating the term…

Loading patent…

Abstract

A method and apparatus for placing an epicardial lead over a desired, predetermined location on the left ventricle using a minimally invasive approach. A thoracoscope having a handle portion and a probe tube defining a central opening is placed through an incision in the patient generally aligned with the desired position for the pacing lead. An introducer and pacing lead are placed within the central opening of the thoracoscope and moved into contact with the pericardium at the desired lead location. An attachment member of the pacing lead attaches an electrode of the pacing lead to the pericardium. The pacing lead includes a mesh disk surrounding the electrode to aid in long term attachment of the electrode to the heart. Alternatively, the pericardium can be incised such that the lead is placed directly over the epicardial surface of the left ventricle.

Claims18

Dependent claims

A method of placing a pacing lead in contact with an epicardial surface of a left ventricle of a patient's heart for delivering an electric signal thereto, the method comprising the steps of:

identifying a desired placement position for the pacing lead on the epicardial surface of the patient's heart using an external imaging system;
creating an incision in the patient above the patient's left pleural cavity and generally aligned with the desired pacing lead placement position;
providing a thoracoscope having a handle portion and a rigid hollow probe tube adapted for viewing throughout a chest cavity of the patient extending from the handle, the thoracoscope having a central opening extending along a longitudinal axis through the handle portion and the probe tube;
inserting the probe tube through the incision;
inserting an introducer into the central opening of the thoracoscope, the introducer having a hollow body extending from a proximal end to a distal end;
inserting the pacing lead into the introducer, the pacing lead having an electrode for delivering the electric signal and a mesh disk surrounding the electrode, the pacing lead being inserted into the introducer such that the electrode and the mesh disk are received within the distal end of the introducer;
moving the introducer along the longitudinal axis of the thoracoscope until the distal end of the introducer contacts a surface of a pericardium of the heart at the desired lead placement position;
moving the pacing lead along the longitudinal axis until the electrode and the mesh disk extend from the distal end of the introducer and into contact with the pericardial surface of the heart, the mesh disk returning to a pre-formed orientation;
and
securing the electrode to the epicardial surface of the heart.

7 more elements

An apparatus for placing a lead in contact with an epicardium of a left ventricle of a patient, the apparatus comprising:

a thoracoscope including a handle portion and a hollow probe tube extending from the handle portion, the thoracoscope having a central opening extending along a longitudinal axis through the handle portion and the probe tube;
an introducer configured for receipt in the central opening, the introducer having a hollow body portion extending from a proximal end to a distal end, the distal end projecting from the probe tube when the introducer is received in the thoracoscope, wherein the introducer is movable along the longitudinal axis and rotatable about the longitudinal axis;
and
a pacing lead configured for receipt in the introducer, the pacing lead having an electrode coupled to a lead wire for delivering an electric signal to the epicardium, the pacing lead including a mesh disk surrounding the electrode and an attachment member for securing the electrode to the epicardium, wherein the pacing lead is movable along the longitudinal axis such that the electrode and the mesh disk are movable between a retracted position in which the electrode and mesh disk are contained within the distal end of the introducer and an extended position in which the electrode and mesh disk extend from the distal end of the introducer.

1 more element

Dependencies are inferred from the claim text.