LEAD ASSEMBLY AND METHODS INCLUDING A PUSH TUBE

• US 20100228263A1
• Filed: 05/24/2010
• Published: 09/09/2010
• Est. Priority Date: 08/16/2004
• Status: Active Grant

• Current Assignee: John S. Greenland, Paul E. Zarembo
• Original Assignee: John S. Greenland, Paul E. Zarembo
• Inventors: Zarembo, Paul E., Greenland, John S.
• Granted Patent: US 8,396,569 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 2001/0578 having means for removal or extraction

Abstract

A lead assembly includes an elongate body having a conductor electrically coupled with an electrode coupled to the elongate body. The lead assembly includes a push tube extending along at least a portion of the elongate body. A distal tip is coupled to the elongate body substantially adjacent to the distal end of the elongate body. The distal tip is sized and shaped to couple with a push tube distal end. In one option, the distal tip includes a seat to receive the push tube distal end. In another option, the seat is a side rail seat and a guide wire extends along the elongate body and is slidably coupled with the side rail seat. The lead assembly includes, optionally, an active fixation device slidably coupled with a portion of the elongate body, and the active fixation device is sized and shaped to couple with the push tube.

Claims

1. An apparatus comprising:

an elongate body extending from a proximal end to a distal end;

a conductor disposed within the elongate body;

an electrode coupled to the elongate body, wherein the electrode is in electrical communication with the conductor;

a push tube extending along at least a portion of the elongate body; and

a distal tip coupled to the elongate body substantially adjacent to the distal end, wherein the distal tip is sized and shaped to couple with a push tube distal end.

2. The apparatus of claim 1, wherein at least a portion of an outer perimeter of the distal tip includes a seat sized and shaped to receive a push tube distal end.

3. The apparatus of claim 2, wherein at least one of the push tube distal end and the seat has a noncircular outer perimeter and the other of the push tube distal end and the seat has a corresponding inner perimeter.

4. The apparatus of claim 2, wherein the elongate body is substantially adjacent to the push tube and the seat.

5. The apparatus of claim 2, wherein the seat includes a socket sized and shaped to grasp and immobilize the push tube distal end.

6. The apparatus of claim 5, wherein the seat includes a deformable coil disposed within the socket, and the deformable coil has an inner perimeter smaller than the outer perimeter of the push tube.

7. The apparatus of claim 1, wherein the outer perimeter of the distal tip tapers from a proximal portion of the distal tip toward a distal portion of the distal tip.

8. The apparatus of claim 1, wherein the distal tip includes an active fixation device.

9. The apparatus of claim 8, wherein the active fixation device includes at least one slot extending substantially along the active fixation device.

10. The apparatus of claim 1, wherein the distal tip includes an exit groove sized and shaped to immobilize at least a portion of the elongate body.

11. The apparatus of claim 1, wherein at least a first portion of the push tube is more flexible than a second portion of the push tube.

12. The apparatus of claim 11, wherein the push tube distal end is more flexible than the second portion of the push tube.

13. The apparatus of claim 11, wherein at least the portion of the push tube includes a groove extending at least part way between an outer perimeter of the push tube and an inner perimeter of the push tube.

14. An apparatus comprising:

an elongate body extending from a proximal end to a distal end;

a conductor disposed within the elongate body;

an electrode coupled to the elongate body, wherein the electrode is in electrical communication with the conductor;

a push tube extending along at least a portion of the elongate body; and

a side rail seat coupled along the elongate body substantially adjacent to the distal end, wherein the side rail seat includes;

a socket disposed along the elongate body, and the socket is sized and shaped to receive a push tube distal end, and

a guide wire lumen defined by an inner surface of the side rail seat, wherein the guide wire lumen is substantially concentric with the socket.

15. The apparatus of claim 14, further comprising:

a guide wire extending along at least the portion of the elongate body and disposed within the guide wire lumen, wherein the guide wire is slidably coupled to the side rail seat.

16. The apparatus of claim 15, wherein the push tube is slidably coupled around the guide wire.

17. The apparatus of claim 14, wherein at least a portion of the guide wire lumen is oblique with respect to the distal end of the elongate body.

18. The apparatus of claim 14, further comprising a distal tip coupled to the elongate body substantially adjacent to the distal end, wherein the distal tip includes the side rail seat.

19. The apparatus of claim 18, wherein a first outer perimeter of a proximal portion of the distal tip is larger than a second outer perimeter of a distal portion of the distal tip.

20. The apparatus of claim 14, wherein the socket has a noncircular inner perimeter and the push tube has a corresponding outer perimeter to the socket.

21. The apparatus of claim 14, wherein at least one of the push tube and the side rail seat includes a key substantially adjacent to the push tube distal end, and the other of the side rail seat and the push tube includes a corresponding recess to receive the key.

22. The apparatus of claim 14, further comprising an active fixation device slidably coupled with the elongate body, wherein the active fixation device is sized and shaped to engage with the push tube.

23. A method comprising:

guiding a lead assembly over a guide wire, wherein the guide wire is slidably coupled to a side rail seat substantially adjacent to a distal end of the lead assembly, and the side rail seat is disposed along the lead assembly; and

moving a push tube over the guide wire, wherein the push tube is coupled to the side rail seat, and the side rail seat and lead assembly move with the push tube.

24. The method of claim 23, further comprising coupling the push tube with the side rail seat.

25. The method of claim 24, wherein coupling the push tube with the side rail seat includes seating at least a push tube distal end within a socket in the side rail seat, wherein a surface defining the socket is sized and shaped to immobilize at least the push tube distal end.

26. The method of claim 24, wherein coupling the push tube with the side rail seat includes coupling a push tube distal end having a key with the side rail seat having a corresponding recess.

27. The method of claim 23, further comprising rotating the side rail seat and lead assembly with the push tube.

28. The method of claim 23, further comprising deflecting at least a push tube distal end, wherein the push tube distal end is more flexible than another portion of the push tube.

29. The method of claim 23, further comprising moving an active fixation device over the guide wire toward the lead assembly distal end with the push tube, wherein the push tube is coupled to the active fixation device.

30. The method of claim 29, further comprising uncoupling the push tube from the side rail seat.

31. The method of claim 29, further comprising coupling the active fixation device with a distal tip and the distal tip is coupled to the elongate body substantially adjacent to the distal end, wherein a combined outer perimeter of the active fixation device and the distal tip is greater than an outer perimeter of the distal tip.

32. The method of claim 31, wherein coupling the active fixation device with the distal tip includes engaging a pawl with a rack and inhibiting movement of the active fixation device away from the distal tip.

33. The method of claim 31, further comprising immobilizing the active fixation device in surrounding tissue including wedging the active fixation device and the distal tip within a vein or artery.

34. The method of claim 29, further comprising immobilizing the active fixation device in surrounding tissue.

35. The method of claim 34, wherein immobilizing the active fixation device in surrounding tissue includes expanding the active fixation device.

36. The method of claim 34, wherein immobilizing the active fixation device in surrounding tissue includes engaging a textured surface against surrounding tissue.

37. The method of claim 23, further comprising exchanging the guide wire for a second guide wire.