Single pass lead system

• US 20030163184A1
• Filed: 01/06/2003
• Published: 08/28/2003
• Est. Priority Date: 07/22/1998
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Heil,, Ronald W. Jr., Booker,, Robert S. III, Lin, Yayun, Carlson, Gerrard M., Scheiner, Avram, Zhu, Qingsheng, Warren, Jay A., Kelley, Peter T., Cole, Mary Lee, Hsu, William, Flynn, David M., Bartig, Jeffrey T., Janke, Aaron W., Heil, John E., Werlein, Carol, Lindstrom, Curtis C., Peterfeso, Randall M., Heitkamp, Douglas A., Goebel, Gary W.
• Application Number:
  US10/337,208
• Publication Number:
  US 20030163184A1
• Time in Patent Office: Days
• US Class Current: 607/122
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook

Abstract

A single-pass endocardial lead electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity includes a lead body which is adapted for implantation within a single chamber of the heart, or multiple chambers of the heart. The lead includes a first distal end electrode which has a first electrical conducting surface. The lead body also has a second electrode which has a second electrical conducting surface. The first and second electrodes are either passively or actively attached to the wall of the heart. The lead body also includes a curved portion which facilitates the positioning of the second electrode. The main lead body alternatively includes a recess into which an atrial lead body and an active fixation element attached to one end can travel from a recessed position to a position for fixation to the wall of the heart. The lead is attached to a pulse generator for producing pulses to the multiple sites within the heart.

Claims

1. An endocardial heart lead system, comprising:

an elongated generally flexible tubular housing having a proximal end for connection to a device and distal end for placement, in a use position, through the right atrium to the right ventricle of a heart;

a pair of ventricular electrodes respectively at and adjacent the distal end of the lead for contact in the ventricle and receiving ventricular signals of the heart;

an SVC electrode positioned on the tubular housing at a position spaced from the distal end for placement in the superior vena cava when the lead system is in the heart;

an atrial electrode positioned on the tubular housing at a position spaced from the distal end and from the SVC electrode for placement in the atrium when the lead system is in the heart;

the tubular housing including conductors therein connected to the electrodes and for connection to a device at the proximal end; and

said tubular housing having a curved portion, taking the form of a lateral protrusion along said tubular housing, in region of the atrial electrode to mechanically bias the atrial electrode into contact with the wall of the atrium of the heart when the lead system is in the use position.

2. A lead adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said lead comprising:

a lead body having a curved portion at a selected distance from the distal end of the lead body;

a first electrode attached to the lead body at the distal end of the lead body for contact with a first chamber of the heart; and

a second electrode attached to the lead body, the second electrode positioned a distance from the first electrode on the curved portion of the lead body to facilitate attachment of the second electrode to a second chamber of the heart.

3. A single pass dual chamber lead adapted for endocardial implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said system comprising:

a signal generator for producing pulses to apply to the heart;

a main lead body adapted to carry signals to and from the heart;

a first electrode having an active fixation portion, said main lead body having a first recess therein housing the first electrode, the first electrode capable of moving between a first recessed position within said first recess and a second extended position outside the first recess so that the active fixation portion of the distal electrode can attach to the wall of the heart; and

a second electrode associated with the main lead body, the first electrode housed within a first chamber of the heart and the second electrode housed within a second chamber in the heart, the second electrode having an active fixation portion, said main lead body having a second recess therein housing the second electrode, the second electrode capable of moving between a first recessed position within said second recess and a second extended position outside the second recess so that the active fixation portion of the proximal electrode can attach to the wall of the heart.

4. A single pass dual chamber lead adapted for endocardial implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said system comprising:

a signal generator for producing pulses to apply to the heart;

a main lead body adapted to carry signals to and from the heart;

a second lead body attached to the main lead body, the second lead body having an active fixation portion for attachment to the wall of the heart; and

a first electrode attached to the main lead body; and

a second electrode attached to the second lead body near the active fixation portion.

5. A lead adapted for endocardial implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said system comprising:

a lead body;

a first electrode attached to the distal end of the lead body; and

a second electrode attached to the lead body a selected distance away from the first electrode, the portion of said lead body between the first electrode and second electrode having a curve therein to facilitate positioning of the first electrode and the second electrode within the heart.

6. A system for detecting arrhythmias of the heart and for delivering signals to the heart, said system comprising:

an electronics system further comprising,

a cardiac activity sensor; and

a signal generator which produces signals to stimulate the heart; and

a lead adapted for endocardial implantation in, on or about the heart and for connection to the electronic system, said lead further comprising;

a main lead body having a first recess therein;

a supplemental lead body carrying a first electrode, said supplemental lead body capable of being moved between a first position substantially within the first recess, and a second position substantially outside the first recess; and

a second electrode attached to the lead body.

7. A lead comprising:

a lead body;

a first leg having at least one pacing electrode; and

a second leg having at least one pacing electrode, said first and second leg for positioning within a chamber of the heart;

wherein the first leg is positioned at a first site within a single chamber of the heart and the second leg is positioned at a second site within the single chamber of the heart.

8. A lead comprising:

a lead body having a curved end portion;

a first leg having at least one pacing electrode; and

a second leg having at least one pacing electrode, said first and second leg for positioning within a chamber of the heart; and

the first pacing electrode and the second pacing electrode positioned at two positions on the curved end portion of the lead body, said curved end portion being positioned within a single chamber of the heart so that the first pacing electrode is located at a first position within the single chamber and the second pacing electrode is located at a second position with the single chamber of the heart.

9. A lead comprising:

a main lead body adapted to carry signals to and from a heart, the main lead body having a first recess therein;

a first leg associated with the main lead body, the first leg including a first electrode having an active fixation portion, the first electrode removably disposed within the first recess; and

a second leg associated with the main lead body, the second leg including a second electrode; and

where the first recess receives the first electrode therein.

10. An implantable electrode with a helical tip comprising:

an electrode having a distal end and a proximal end; and

a helix disposed on said electrode, which helix is aligned along a radial axis of the electrode at said distal end; and

said implantable electrode having at least one feature selected from the group consisting of;

a) said helix having a coating of an insulating material on 5-95% of its surface,

b) said helix having at least part of its surface beyond said distal end of said electrode and said distal end of said electrode having a porous conductive surface,

c) a conductive porous surface at said distal end of said electrode, and

d) a porous conductive surface at the distal end of the electrode having an insulating coating covering from 5-95% of the surface of said porous conductive surface.

11. A distal tip electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said electrode comprising:

an electrode tip;

a porous conductive element disposed at a distal end of the electrode tip;

a surface area at the distal end of the electrode tip;

a helix disposed within said electrode, said helix comprising a conductor disposed in helical shape, wherein said helix travels along a radial axis of the electrode through said surface area; and

a helix guiding mechanism for directing movement of the helix during travel.

12. An electrode adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said electrode comprising:

a lead body having a first end and a second end;

an electrode disposed proximate the first end of the lead body;

connector terminal disposed at said second end of the lead body, said connector terminal for connecting with a pulse generating unit;

an electrode tip disposed proximate one end of the electrode;

a surface at the distal end of the electrode tip, said surface further comprising an electrical conducting surface wherein said surface is comprised of a porous conductive element;

a helix disposed within said electrode, said helix comprising a conductor disposed in a helical shape, wherein said helix travels along a radial axis of the electrode through said surface thereby placing said helix in extension and retraction; and

a helix guiding groove for directing movement of the helix during extension and retraction of said helix.

13. A lead adapted for implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said lead comprising:

a lead body having a curved portion at a selected distance from the distal end of the lead body;

an first electrode attached to the lead body;

a second electrode attached to one side of the curved portion of the lead body;

said first electrode disposed at the distal end of the lead body for contact with a first chamber of the heart; and

said second electrode positioned a distance from the first electrode on the curved portion of the lead body to facilitate attachment of the second electrode to a second chamber of the heart, where the second electrode protrudes outwardly from the lead body.

14. An electrode adapted for endocardial implantation in, on or about the heart and for connection to a system for monitoring or stimulating cardiac activity, said electrode comprising:

an electrode end;

a first electrically conducting surface at the distal end of the electrode end; and

a lead body having a circumferential outer surface, said lead body attached to said electrode end, said lead body having second electrical conduction surface protruding from a portion of the circumference of said lead body.

15. A bifurcated lead adapted for implantation in, on or about a heart, the lead comprising:

a main lead adapted to carry signals to and from the heart, the main lead body extending from a proximal end to a distal end, the distal end of the main lead body having a first electrode leg and a second electrode leg;

the first electrode leg including a first electrode assembly comprising a bipolar electrode having a first electrode and a second electrode, the first electrode assembly being adapted to be disposed within a first chamber of the heart; and

the second electrode leg including a second electrode assembly, the second electrode assembly comprising a bipolar electrode having a third electrode and a fourth electrode, the second electrode assembly being adapted to be disposed within a second chamber of the heart.

16. A lead adapted for implantation in, on or about a heart, the lead comprising:

a main lead body adapted to carry signals to and from the heart, the main lead body extending from a proximal end to a distal end, the distal end of the main lead body having at least one leg;

the at least one leg having an active fixation portion; and

a movement assembly operatively coupled with the active fixation portion of the at least one leg, the movement assembly configured to extend and retract the active fixation portion, the movement assembly comprising;

a housing having an internally threaded portion; and

an externally threaded collar engaged with the internally threaded housing.