METHOD AND SYSTEM FOR PLACEMENT OF ELECTRICAL LEAD INSIDE HEART

• US 20100042110A1
• Filed: 09/30/2009
• Published: 02/18/2010
• Est. Priority Date: 06/18/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Kelley, James F., Yang, Zhongping C., Stewart, Mark T.
• Granted Patent: US 8,409,219 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/12018 Elastic band ligators
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61N 1/059 Anchoring means

Abstract

A method of placing an electrical lead of an implantable cardiac device inside a heart of a patient. The method includes securing a tool to an atrial appendage of the heart to hold onto the atrial appendage, piercing the atrial appendage, and creating an aperture in the atrial appendage while holding the atrial appendage with the tool. The method also includes moving a distal end of the electrical lead into the heart through the aperture in the atrial appendage and into a ventricle of the heart. Furthermore, the method includes coupling the distal end of the electrical lead to cardiac tissue in the ventricle and delivering an electrical signal to the cardiac tissue in the ventricle of the heart to maintain a predetermined heartbeat of the heart.

Claims

1. A method of placing an electrical lead of an implantable cardiac device inside a heart of a patient comprising:

securing a tool to an atrial appendage of the heart to hold onto the atrial appendage;

piercing the atrial appendage and creating an aperture in the atrial appendage while holding the atrial appendage with the tool;

moving a distal end of the electrical lead into the heart through the aperture in the atrial appendage and into a ventricle of the heart;

coupling the distal end of the electrical lead to cardiac tissue in the ventricle; and

delivering an electrical signal to the cardiac tissue in the ventricle of the heart to maintain a predetermined heartbeat of the heart.

2. The method of claim 1, wherein securing the tool to the atrial appendage includes hooking the tool onto the atrial appendage.

3. The method of claim 1, wherein securing the tool to the atrial appendage includes pinching an outer surface of the atrial appendage with the tool.

4. The method of claim 1, wherein securing the tool to the atrial appendage includes adhering the tool to the atrial appendage.

5. The method of claim 1, wherein securing the tool to the atrial appendage includes holding the atrial appendage by suction.

6. The method of claim 1, further comprising introducing a distal end of a positioning tool into the patient, and moving the lead through a lumen in the positioning tool away from a proximal end of the positioning tool and toward the distal end of the positioning tool until the lead at least partially extends out of the positioning tool.

7. The method of claim 6, wherein piercing the atrial appendage includes piercing the atrial appendage with a piercing member, the piercing member operably coupled adjacent the distal end of the positioning tool.

8. The method of claim 1, wherein piercing the atrial appendage comprises piercing the left atrial appendage of the heart.

9. The method of claim 1, wherein coupling the distal end of the electrical lead includes coupling the distal end of the electrical lead to cardiac tissue in the left ventricle of the heart.

10. The method of claim 1, further comprising implanting an abutment member in the heart, the abutment member positioned between cardiac tissue and the electrical lead, the abutment member inhibiting direct contact between the cardiac tissue and the electrical lead.

11. The method of claim 10, wherein the abutment member is a sleeve having a lumen, the lumen receiving the electrical lead therethrough.

12. The method of claim 10, further comprising compressing the abutment member.

13. The method of claim 12, wherein compressing the abutment member includes holding the electrical lead against the abutment member.

14. The method of claim 1, further comprising occluding the atrial appendage.

15. The method of claim 14, further comprising:

resiliently stretching a resilient ring to be wide enough to fit over an outer surface of the atrial appendage;

reducing the stretching of the resilient ring to be more narrow; and

occluding the atrial appendage with the resilient ring.

16. The method of claim 1, further comprising:

inserting a catheter into the aperture;

steering the catheter to the ventricle;

guiding the electrical lead through the catheter to the ventricle; and

withdrawing the catheter from the heart while leaving the electrical lead connected to the cardiac tissue.

17. A system for delivering an electrical lead to a ventricle of a heart of a patient, the system comprising:

a securing member for securing and holding onto an atrial appendage of the heart;

a piercing member for piercing and forming an aperture in the atrial appendage while the securing member holds onto the atrial appendage;

an electrical lead having a distal end, the distal end insertable through the aperture in the atrial appendage and into the left ventricle of the heart, the electrical lead connectable to an implantable cardiac device, the electrical lead delivering an electrical signal to the cardiac tissue to maintain a predetermined heartbeat; and

an abutment member that is implantable in the heart, the abutment member surrounding the electrical lead and positionable between the heart and the electrical lead to inhibit direct contact between the heart and the electrical lead.

18. The system of claim 17, wherein the securing member includes a hook.

19. The system of claim 17, wherein the securing member includes a barb.

20. The system of claim 17, wherein the securing member includes a grasping member.

21. The system of claim 17, wherein the securing member includes an adhesive.

22. The system of claim 17, wherein the securing member includes a suction device.

23. The system of claim 17, wherein the securing member includes a passage for passing the distal end of the electrical lead through the securing member.

24. The system of claim 17, wherein the securing member includes a passage for passage of the piercing member through the securing member.

25. The system of claim 17, further comprising a resilient ring able to occlude the atrial appendage.

26. The system of claim 25, further comprising a ring spreader assembly releaseably attached to the resilient ring, the ring spreader assembly including a control for expanding and releasing the resilient ring.

27. The system of claim 17, wherein the abutment member is a sleeve having a lumen that receives the electrical lead.

28. The system of claim 27, further comprising a compression member that compresses the abutment member against the electrical lead to hold the electrical lead in place relative to the abutment member.

29. The system of claim 27, wherein the abutment member includes a base, a neck, and a lip, the base insertable into the atrial appendage to be held against the atrial appendage, the lip extendable out of the atrial appendage, and further comprising a compression member that compresses the neck of the abutment member, the lip retaining the compression member on the neck.

30. A method of placing a distal end of an electrical lead inside a heart of a patient comprising:

securing a tool to a left atrial appendage of the heart to hold onto the left atrial appendage;

piercing the atrial appendage with a piercing tool that is operably coupled to the tool to create an aperture in the left atrial appendage while holding onto the left atrial appendage;

moving the distal end of the electrical lead through a passage in the tool, through the aperture in the left atrial appendage, and into the left ventricle of the heart, while holding onto the left atrial appendage;

implanting a sleeve in the heart, the sleeve receiving the electrical lead and preventing direct contact between the heart and the electrical lead;

compressing the sleeve to hold the electrical lead in place relative to the sleeve;

connecting the distal end of the electrical lead to cardiac tissue inside the left ventricle of the heart;

connecting the electrical lead to an implantable cardiac device;

delivering an electrical signal to the cardiac tissue via the electrical lead to maintain a predetermined heartbeat of the heart;

manipulating the tool to resiliently stretch a resilient ring over an outer surface of the left atrial appendage; and

manipulating the tool to release the resilient ring to resiliently recover and occlude the left atrial appendage.