Trans-septal/trans-myocardial ventricular pacing lead

• US 20060224224A1
• Filed: 03/31/2005
• Published: 10/05/2006
• Est. Priority Date: 03/31/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Struble, Chester L., Muhlenberg, Lambert
• Granted Patent: US 7,321,798 B2
• Time in Patent Office: Days
• US Class Current: 607/122
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Abstract

An medical electrical lead in embodiments of the teachings may include one or more of the following features: (a) a lead body having a proximal end and a distal end, (b) a conductor traversing from the proximal end to the distal end, (c) an electrode disposed at the distal end of the lead body and electrically coupled to the conductor adapted to electrically stimulate a heart, (d) occlusion fabric disposed at the distal end of the lead body and supported by the electrode in a shape adapted to cover holes in the heart, and (f) a second electrode adapted to provide bipolar electrical stimulation of the heart.

Claims

1. A medical electrical lead, comprising:

a lead body having a proximal end and a distal end;

a conductor traversing from the proximal end to the distal end;

an electrode disposed at the distal end of the lead body and electrically coupled to the conductor adapted to electrically stimulate a heart; and

occlusion fabric disposed at the distal end of the lead body and supported by the electrode in a shape adapted to cover puncture in the heart.

2. The lead of claim 1, wherein the electrode provides a cambered fabric support structure for the occlusion fabric.

3. The lead of claim 2, wherein the electrode has a center portion with legs extending outward in a cambered fashion.

4. The lead of claim 3, further comprising a second electrode adapted to provide bipolar electrical stimulation of the heart.

5. The lead of claim 2, wherein the occlusion fabric is an electrically insulative material.

6. The lead of claim 2, wherein the occlusion fabric operably couples the cambered fabric support structure comprises a collapsible canopy.

7. The lead of claim 2, wherein the occlusion fabric is operably coupled to the cambered fabric support structure is in the shape of leaflets.

8. The lead of claim 1, wherein the puncture in the heart is in the transventricular septum or the myocardial wall.

9. The lead of claim 8, wherein the puncture in the heart is in the ventricular septum or the ventricular myocardial wall.

10. The lead of claim 8, wherein the electrode is adapted to be in electrical contact with the left ventricular side of the transventricular system.

11. A medical electrical lead, comprising:

a lead body having a proximal end and a distal end;

a conductor traversing from the proximal end to the distal end;

an electrode disposed at the distal end of the lead body and electrically coupled to the conductor adapted to electrically stimulate a heart, the electrode extending radially outward from the lead body and being flexible; and

occlusion fabric supported by the electrode, the occlusion fabric being flexible, the flexibility permitting the occlusion fabric and the electrode to conform to a surface of the heart to cap punctures in the heart.

12. The lead of claim 11, wherein the electrode provides a cambered fabric support structure for the occlusion fabric.

13. The lead of claim 12, wherein the occlusion fabric is operably coupled to the cambered fabric support structure comprises a collapsible canopy.

14. The lead of claim 12, wherein the occlusion fabric is operably coupled to the cambered fabric support structure is in the shape of leaflets.

15. The lead of claim 13, further comprising a tine that is covered by the cambered fabric support structure during implantation of the medical lead.

16. The lead of claim 15, wherein the tine is exposed after insertion of the distal end into the left ventricle, the tine oriented to allow withdrawal of the distal end from the left ventricle and prevent further movement of the distal end into the left ventricle.

17. The lead of claim 11, wherein the distal end can be inserted into the left ventricle with a catheter or a trans-septal bore needle.

18. The lead of claim 11, wherein the distal end has a saw-tooth shaped surface.

19. The lead of claim 18, further comprising a fixation ring that can be pushed over the saw tooth surface wherein the fixation ring cannot be retracted and the distal end of the lead cannot be pushed further into the left ventricle.

20. The lead of claim 19, wherein the fixation ring has a diameter larger than the diameter of the aperture in the heart.

21. A method of electrically stimulating the heart with an implantable lead, comprising:

entering a vein with a catheter;

translating the catheter through the vein to a right ventricle of the heart;

puncturing a septum wall between the right ventricle and a left ventricle to form a hole therein;

inserting the catheter into the left ventricle via the hole;

inserting a distal end of the lead into the left ventricle via the catheter and the hole, the distal end having an electrode structure supporting an occlusion fabric, the electrode structure and occlusion fabric being adapted to expand from a compressed configuration after insertion into the left ventricle; and

retracting the lead until the electrode structure and occlusion fabric contact the septal wall in the left ventricle and seal off the hole in the septal wall.

22. The method of claim 21, further comprising the step of securing the distal end of the lead in the septal wall with a tine oriented to allow withdrawal of the distal end from the left ventricle and prevent further movement of the distal end into the left ventricle.

23. The method of claim 21, further comprising the step of pushing a fixation ring down the lead over a saw-tooth surface at the distal end of the lead till the fixation ring abuts the septal wall to provide fixation of the distal end in the septal wall.

24. The method of claim 21, wherein the electrode includes a center portion with legs extending outward in a cambered fashion.

25. The method of claim 21, wherein the occlusion fabric includes an electrically insulative material.

26. A method of electrically stimulating the heart with an implantable lead, comprising:

puncturing a myocardial wall outside a left ventricle to form a hole therein with a puncturing means;

entering the left ventricle with the puncturing means;

inserting a distal end of the lead into the left ventricle through the puncturing means, the distal end having an electrode structure supporting an occlusion fabric, the electrode structure and occlusion fabric being adapted to expand from a compressed configuration after insertion into the left ventricle; and

retracting the lead until the electrode structure and occlusion fabric contact an inner wall of the left ventricle and seal off the hole; and

electrically stimulating the heart via the electrode structure upon the detection of a heart abnormality.

27. The method of claim 26, further comprising the step of suturing the fixation ring to the myocardial wall.