Telescoping, dual-site pacing lead

• US 20060064150A1
• Filed: 06/03/2005
• Published: 03/23/2006
• Est. Priority Date: 08/13/2004
• Status: Active Grant

• Current Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Original Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Inventors: Heist, E. Kevin, Singh, Jagmeet P.
• Granted Patent: US 7,395,120 B2
• Time in Patent Office: Days
• US Class Current: 607/122
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A lead with a proximal electrode and a telescoping distal electrode enables dual-site electrical pacing or stimulation of a heart or another organ. The lead includes an outer tube with a proximal electrode and an inner tube connected to a distal electrode. The inner tube is concentric and slides inside the outer tube. This design enables the proximal electrode to be placed at a desired location by threading the lead along a guide wire, and then extending the distal electrode a variable distance beyond the proximal electrode.

Claims

1. An apparatus comprising:

a first tube;

a first lead conductor having a portion extending through the first tube;

a proximal electrode disposed at a distal end of the first tube, the proximal electrode being in electrical communication with the first lead conductor;

a second tube arranged slideably within the first tube, the second tube forming a central lumen sized to accommodate a guide wire;

a second lead conductor extending through the second tube;

a distal electrode disposed at a distal end of the second tube, the distal electrode being in electrical communication with the second lead conductor; and

a bipolar connector attached to the first and second lead conductors and configured to be removably attached to a pacing control system.

2. The apparatus of claim 1, wherein the connector is further configured to transmit first and second signals from the pacing control system to the first and second lead conductors, respectively.

3. The apparatus of claim 2, wherein the connector comprises:

first and second connecting conductors attached to the first and second lead conductors and configured to be received by a port in the pacing control system; and

a housing at least partially enclosing the first and second connecting conductors.

4. The apparatus of claim 3, wherein the first and second connecting conductors are arranged coaxially.

5. The apparatus of claim 3, wherein the first and second connecting conductors are arranged twinaxially.

6. The apparatus of claim 2, wherein the connector complies with at least one of:

an IS-1 international pace maker standard, a VS-1 standard, a VS-1A standard, and a VS-1B standard.

7. The apparatus of claim 1, wherein the second tube is longer than the first tube.

8. The apparatus of claim 1, wherein the distal end of the first tube comprises a first appendage, and wherein the proximal electrode is attached to an outer surface of the first appendage.

9. The apparatus of claim 8, wherein the distal end of the second tube comprises a second appendage, and wherein the distal electrode is attached to an outer surface of the second appendage.

10. The apparatus of claim 9, wherein the first and second appendages each comprises a radio-opaque marker.

11. The apparatus of claim 9, wherein at least one of the first and second appendages comprises a number of times, the number being selected from a group consisting of one, and more than one.

12. The apparatus of claim 1, wherein the first lead conductor comprises a coil.

13. The apparatus of claim 1, wherein the second lead conductor comprises a coil.

14. The apparatus of claim 1, further comprising a fixation device to prevent motion of the second tube relative to the first tube.

15. The apparatus of claim 1, wherein the first and second lead conductors are bipolar.

16. The apparatus of claim 1, wherein the distal electrode can be extended approximately at least five centimeters beyond the proximal electrode.

17. The apparatus of claim 1, wherein the first and second tubes are electrically insulating.

18. The apparatus of claim 1, further comprising a third tube having proximal and distal ends wherein:

the distal end of the third tube is attached to a portion of the first tube, the portion defining an opening in the first tube;

the proximal end of the third tube is attached to a portion of the second tube, the portion defining an opening in the second tube; and

the first lead conductor extends through portions of the first, second, and third tubes, and passes through the openings in the first and second tubes.

19. An implantable biventricular pacemaker comprising the apparatus of claim 1.

20. A method for positioning the apparatus of claim 1 in the heart, the method comprising:

moving a guide wire through a blood vessel against normal flow of blood to a desired section of the blood vessel;

threading the apparatus onto the guide wire through the blood vessel to the desired section of the blood vessel;

sliding the second lead conductor in a distal direction such that the distal electrode moves distally away from the proximal electrode;

moving the distal electrode to a tributary branch of the blood vessel;

securing the inner tube against the outer tube; and

removing the guide wire.

21. The method of claim 20, wherein sliding the second lead conductor in a distal direction comprises sliding the distal electrode up to approximately five centimeters away from the proximal electrode.

22. The method of claim 20, further comprising monitoring the position of radio-opaque markers on the guide wire and proximal and distal electrodes of the lead.

23. The method of claim 22, wherein monitoring comprises illuminating the markers with x-rays.

24. The method of claim 20, wherein moving the guide wire comprises selecting the blood vessel from a group consisting of an arterial tree branch and a venous tree branch.

25. The method of claim 20, further comprising pacing the heart by applying an electric charge to the first and second lead conductors.