Intravenous channel cardiac electrode and lead assembly and method

• US 4,458,677 A
• Filed: 11/19/1981
• Issued: 07/10/1984
• Est. Priority Date: 09/19/1979
• Status: Expired due to Fees

• Current Assignee: Charles E. Mccorkle Jr
• Original Assignee: Charles E. Mccorkle Jr
• Inventors: McCorkle, Charles E. Jr.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US06/322,878
• Time in Patent Office: 964 Days
• Field of Search: 128/419 P, 128/784, 128/785, 128/786
• US Class Current: 607/123
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

An intravenous lead assembly for atrial ventricular (AV) sequential pacing includes a channel and a separable core lead. The channel lead and the core lead respectively include first and second helical coil conductors through which first and second wire stylets can be inserted. The first and second helical coil conductors are embedded in first and second elongated silicone rubber sleeves, respectively. The silicone rubber sleeve of the channel lead includes an elongated channel. In use, the core lead is passed through the channel of the channel lead either before or after the channel lead is passed through selected veins into a patient'"'"'s heart. Handles are provided on the proximal ends of the stylets to enable a physician to manipulate the distal ends of the channel lead and core lead. In one embodiment of the invention, the channel terminates in a side port of the channel lead, enabling the physician to guide the tip of the core lead out of the side port and into the right ventricle after the distal end of the channel lead has been positioned in the coronary sinus or the right atrial appendage.

Claims

1. A method for intravenously introducing first and second leads into a patient'"'"'s heart, said method comprising the steps of:

(a) making only one incision in only one vein in a venous path leading to the patient'"'"'s heart;

(b) inserting a first end of a channel lead into the vein through the incision, the channel lead having a first end and a second end, the channel lead having an elongated channel terminating in a side port opening located a predetermined distance from the second end of the channel lead, the channel being capable of accommodating passing of a core lead through the channel, the core lead having a first end and a second end;

(c) guiding the first end of the channel lead through a venous path to the entrance of a first predetermined cavity of the patient'"'"'s heart;

(d) withdrawing first and second stylets from the channel lead, the channel lead being preformed to assume a bent configuration with a bend located approximately at the location of said side port opening when the first and second stylets are withdrawn in order to direct the first end of the core lead into said predetermined cavity in the patient'"'"'s heart adjacent to said venous path, said chanel lead being preformed to tend to assume said bent configuration to cause the second end of said channel lead to move into said predetermined cavity of the patient'"'"'s heart when the stylet is removed, said side port opening being located near the lowest portion of said bend when the second end of said channel lead is in the deepest portion of said predetermined cavity;

(e) guiding the first end of said channel lead deep into said predetermined cavity; and

(f) guiding the first end of said core lead through the channel, out of said side port opening, into the right ventricle of the patient'"'"'s heart.

2. A lead assembly for intravenously conducting electrical signals through a venous path to or from a patient'"'"'s heart, the lead assembly comprising in combination:

(a) a core lead having first and second ends, said core lead including

(i) first flexible sleeve means;

(ii) a first conductor surrounded by material of said first flexible sleeve means, said first conductor extending approximately between the first and second ends of said core lead;

(iii) first electrode means attached to said first flexible sleeve means approximately at the first end of said core lead, said first electrode means being electrically connected to said first conductor;

(iv) a second conductor surrounded by material of said first flexible sleeve means, said second conductor being spaced from and electrically insulated from said first conductor, said second conductor extending approximately between the first and second ends of said core lead;

(v) second electrode means attached to said first flexible sleeve means a first predetermined distance from said first electrode means, said second electrode means being electrically connected to said second conductor;

(b) a first removable stylet extending through said first flexible sleeve means to facilitate control of said core lead, said core lead being preformed to tend to assume a straight configuration when said first stylet is removed from said core lead;

(c) a channel lead having first and second ends, said channel lead including

(i) second flexible sleeve means, said second flexible sleeve means having an elongated channel for receiving said core lead, said channel extending through a major portion of the length of said channel lead, said channel extending from a first opening in said channel lead to a second opening in said channel lead, said first opening being located at said first end of said channel lead, said second opening being a side port opening located a first predetermined distance from said second end of said channel lead;

(ii) a third conductor surrounded by material of said second flexible sleeve means, said third conductor being disposed outside of said channel and extending approximately between the first and second ends of said second flexible sleeve means;

(iii) third electrode means attached to said second flexible sleeve means approximately at the first end of said channel lead, said third electrode means being electrically connected to said second conductor;

(iv) a fourth conductor surrounded by material of said second flexible sleeve means, said fourth conductor being disposed outside of said channel and extending approximately between the first and second ends of said second flexible sleeve means;

(v) fourth electrode means attached to said second flexible sleeve means a second predetermined distance from said third electrode means; and

(d) a second removable stylet extending through said second flexible sleeve means to facilitate control of said channel lead, said core lead being disposed in said channel lead, the first end of said core lead extending from said first opening and the second end of said core lead extending from said second opening, said first opening being located within the patient'"'"'s heart when said channel lead is positioned to conduct the electrical signals to a predetermined portion of the patient'"'"'s heart, said channel lead being preformed to tend to assume a bent configuration with a sufficient amount of bending located approximately at the location of said side port opening to cause said second end of said channel lead to move into a predetermined cavity in the patient'"'"'s heart adjacent to said venous path when said second stylet is removed, said side port opening being located near the entrance to said predetermined cavity when the second end of said channel lead is in the deepest portion of said predetermined cavity, said core lead extending slidably through said side port opening deep into the right ventricle of the patient'"'"'s heart.

3. The lead assembly of claim 2 including a third removable stylet extending through said first flexible sleeve means to facilitate control of said core lead.

4. The lead assembly of claim 2 including a third removable stylet extending through said second flexible sleeve means to facilitate control of said channel lead.