Cardiac electrode anchoring system

• US 20050033396A1
• Filed: 04/09/2004
• Published: 02/10/2005
• Est. Priority Date: 04/10/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ospyka, Peter
• Granted Patent: US 9,220,891 B2
• Time in Patent Office: Days
• US Class Current: 607/130
• CPC Class Codes: A61N 1/059 Anchoring means
• CPC Class Codes: A61N 2001/0578 having means for removal or extraction

Abstract

A cardiac electrode arrangement has one or several heart electrodes arranged on the exterior surface of a heart or attached to the heart from the outside and/or arranged with a pole in the cardiac tissue. The electrodes, which can be fixed in the operating position by an anchor, run to an implanted heart pacemaker. For positioning and affixing the anchor, a tool is used that is designed as a rod or stylet and acts on an attachment site of the anchor, whereby the anchor can be pushed into or through the myocardium. The anchor is, at the same time, attached to a tension element or thread, over which the electrode, which has an inner guide channel that accommodates the tension element or thread, can be moved in a fitted and controlled manner. In the operating position, the electrode can be connected to the tension element or thread located in the guide channel.

Claims

1. -17. (canceled).

18. An apparatus for inserting an electrode into a myocardium of the heart, the apparatus comprising:

an anchor for abutting ;

L surface of the heart, said anchor having an attachment area;

a tension element attached to the anchor; and

a tool detachably coupled to the attachment area for inserting the anchor through the myocardium to an operating position.

19. The apparatus of claim 18 further comprising a receiver tube for pre-forming a canal through the myocardium, the tulle defining a lumen adapted to hold the anchor and the tool during insertion into the heart.

20. The apparatus of claim 18 wherein the attachment area further includes a region having a reduced cross sectional area at a trailing end of the anchor for coupling to an attachable end of the tool.

21. The apparatus of claim 18 wherein the attachment area further includes a receiving aperture disposed at a trailing end of the anchor for fittingly receiving the tool.

22. The apparatus of claim 18 wherein the anchor further comprises at least one element having a position for deployment into the myocardium and an expanded position at the operating position.

23. The apparatus of claim 22 wherein a spring force biases the at least on element to the expanded operating position.

24. The apparatus of claim 18 wherein the anchor is rod-shaped having a first end and a second end and the attachment area is a longitudinal opening at the first end for receiving the tool and wherein the tension element is attached to the anchor between the first end and the second end.

25. The apparatus of claim 24 wherein the tether attached to the anchor at a location between the center of the anchor and a leading end.

26. The apparatus of claim 18 wherein the anchor is disk-shaped and the attachment area is a radially-oriented aperture in the anchor adapted for receiving the tool.

27. The apparatus of claim 18 wherein the anchor has a first angled leg and a second angled leg, the first leg having an aperture forming the attachment area for receiving the tool.

28. The apparatus of claim 18 wherein the anchor further comprises:

a central leg;

at least two outer legs; and

a membrane stretched between the central leg and the outer legs.

29. The apparatus of claim 18 wherein the anchor includes a plurality of legs defining a star-shape and the attachment area is an aperture in one of the legs adapted for receiving the tool.

30. The apparatus of claim 18 wherein the anchor has a plurality of leaves defining a cloverleaf-shape and the attachment area is an aperture adapted for receiving the tool and is disposed between two of the individual leaves.

31. The apparatus of claim 18 wherein the tool is a thin, flexible stylet.

32. The apparatus of claim 18 further comprising an electrode defining an inner guide channel to accommodate the tension element and having a pole at an end adapted for stimulating the myocardium.

33. The apparatus of claim 32 wherein the electrode defines at least one exit opening from the guide channel at a connection point near the exit opening such that the tension element is attachable to the electrode.

34. The apparatus of claim 33 wherein the exit opening for the tension element is closed by a medical adhesive.

35. The apparatus of claim 33 wherein the connection point includes a loop structure for attaching the tension clement to the electrode.

36. The apparatus of claim 33 wherein the tension element includes a stop located at a distance from the anchor for fixing the electrode to prevent movement in either of a forward or a rearward direction.

37. The apparatus of claim 35 wherein the stop comprises a thickening on the tension element having a diameter which exceeds an inner diameter of the guide channel.

38. The apparatus of claim 32 wherein the pole includes an anode spaced apart from a cathode.

39. The apparatus of claim 18 further comprising a first and a second electrode branching from a common supply lead, each electrode defining an inner guide channel sized to accommodate a first and a second Tension element, respectively, and each electrode having a pole at an end adapted for stimulating the myocardium.

40. The apparatus of claim 39 further comprising an exit opening from the guide channel near the branch of the supply lead.

41. The apparatus of claim 40 wherein the tension elements extend through the guide channels and are knotted together outside the exit openings.

42. The apparatus of claim 39 further comprising an anode positioned on the common supply lead and a cathode positioned on each of the first and second electrodes.

43. An apparatus for inserting an electrode into a myocardium of the heart, the apparatus comprising:

an anchor adapted for abutting an exterior surface of the heart, said anchor having an attachment area;

a tension element attached to the anchor; and

a first heart pacemaker electrode defining an inner guide channel to accommodate the tension element and having a pole near a forward end adapted for stimulating the myocardium.

44. The apparatus of claim 43 further comprising a tool detachably coupled to the attachment area for inserting the anchor through the myocardium to an operating position.

45. The apparatus of claim 44 further comprising a receiver tube for creating a canal through the myocardium, the receiver tube defining a lumen sized for holding the anchor and the tool during insertion into the heart.

46. The apparatus of claim 43 wherein the first electrode has at least one exit opening from the guide channel for the tension element such that the tension element is attachable to the first electrode at a connection point at or outside the exit opening.

47. The apparatus of claim 46 further comprising a stop provided on the tension element at a distance from the anchor for fixing the first electrode to prevent movement in a forward direction.

48. The apparatus of claim 43 wherein the pole includes an anode spaced apart from a cathode.

49. The apparatus of claim 43 further comprising a second electrode defining an inner guide channel to accommodate the tension element and having a pole at an end for stimulating the myocardium, the second electrode branching from a common supply lead with the first electrode.

50. An apparatus for inserting an electrode into a myocardium of the heart, the apparatus comprising:

a tension element;

an electrode defining an inner guide channel to accommodate the tension element and having a pole at an end for stimulating the myocardium; and

means for anchoring an end of the tension element within the myocardium.

51. A method for inserting in electrode within a myocardium of a heart, the method comprising:

inserting an anchor coupled to a tension element through the myocardium to an operating position adjacent an exterior surface of the myocardium;

providing an electrode defining an inner guide channel for accommodating the tension element and having a pole at an end for stimulating the myocardium;

advancing the electrode into the myocardium over the tension element; and

affixing the tension element to the electrode at a connection point to prevent movement of the electrode in a direction away from the anchor.

52. The method of claim 51 comprising pre-forming a canal through the myocardium to the operating position adjacent an exterior surface of the myocardium.

53. The method of claim 51 wherein inserting the anchor through the myocardium further comprises detachably coupling a tool to a deformation on the anchor.

54. The method of claim 51 further comprising manipulating the anchor to an orientation generally parallel to the exterior surface in the operating position.

55. The method of claim 51 wherein affixing the tension element to the first electrode further comprises positioning a front end of the electrode against a stop on the tension element.

56. The method of claim 51 wherein affixing the tension element to the first electrode further includes knotting the tension element to a loop structure on the electrode.

57. The method of claim 51 wherein affixing the tension element to the electrode further comprises adhering the tension element to the electrode with a medical adhesive.

58. The method of claim 51 wherein affixing the tension element to the electrode further comprises tautly securing the tension element between the anchor and the connection point.

59. The method of claim 51 wherein affixing the tension element to the electrode further comprises stopping the electrode at a stop on the tension element, the stop located a distance from the anchor.

60. The method of claim 51 wherein affixing the tension element to the first electrode further comprises tautly securing the tension element between the stop and the connection point.

61. The method of claim 51 further comprising positioning a cathode of the electrode within the myocardium and an anode of the electrode at a distance from the cathode.

62. The method of claim 51 further comprising positioning the anode outside of the myocardium.

63. The method of claim 51 further comprising repeating the method to insert a second electrode within the myocardium, the second electrode branching out from a common supply lead.

64. The method of claim 63 further comprising fixing the tension elements extending through the first and second electrodes to each other.

65. The method of claim 51 wherein inserting the anchor to the operating position further comprises situating the anchor on an exterior surface of the myocardium.