Tissue-stimulating electrode having sealed, low-friction extendable/retractable active fixation means

• US 4,649,938 A
• Filed: 04/29/1985
• Issued: 03/17/1987
• Est. Priority Date: 04/29/1985
• Status: Expired due to Term

• Current Assignee: Pacesetter AB
• Original Assignee: Siemens-Elema AB (Siemens AG)
• Inventors: McArthur, William A.
• Primary Examiner(s): Coven, Edward M.
• Assistant Examiner(s): Hindenburg, Max F.
• Application Number:
  US06/728,985
• Time in Patent Office: 687 Days
• Field of Search: 128/303.13, 128/303.15, 128/419 P, 128/785, 128/790, 128/303.1, 128/786, 128/784, 128/642
• US Class Current: 607/127
• 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 electrode tip (14) of a tissue-stimulating lead provides active fixation of the tip of body tissue. Tissue attachment means (34), within the electrode tip, are selectively extended so as to protrude from the tip upon application of an external force. Otherwise, biasing means (40), also within the electrode tip, urge the tissue attachment means to a retracted position within the tip. Extension and retraction of the tissue attachment means are realized through the use of a carrier bobbin (44), to one end of which the tissue attachment means are affixed. The carrier bobbin is movably inserted into a barrel (30) of the tip. An O-ring (38) placed around the circumference of the carrier bobbin, sized so as to make sealable contact with the inside barrel wall, seals the back end of the barrel and prevents fluids from flowing therein. This O-ring also rolls along the surface of the carrier bobbin and barrel wall as the bobbin moves within the barrel, thereby reducing friction associated with the movement of the bobbin. The carrier bobbin moves to its extended position upon application of an axial force. This axial force is selectively supplied by a stylet (20) that passes through a lume (56) of the lead.

Claims

1. An electrode tip for use with a tissue-stimulating lead comprising:

an electrode connected to a distal end of said lead;

carrier means axially inserted into a barrel of said electrode;

tissue attachment means affixed to a distal end of said carrier means for securely holding the distal end of said carrier means to desired tissue, said tissue attachment means protruding from said barrel when said carrier means assumes an extended position, and said tissue attachment means remaining inside of said barrel when said carrier means assumes a retracted position;

movement means for selectively moving the carrier means between its retracted position and its extended position; and

sealing/friction-reducing means fitted around the circumference of said carrier means for preventing fluid flow around said carrier means into a proximal end of said barrel, and for reducing friction between said carrier means and said barrel as said carrier moves between its retracted and extended positions, said sealing/friction-reducing means being axially movable with respect to both the barrel of said electrode and said carrier means.

2. The electrode tip of claim 1 wherein said sealing/friction-reducing means rolls along the surface of said carrier means and an inner wall of said barrel as said carrier means moves between its retracted and extended positions.

3. The electrode tip of claim 2 wherein said sealing means comprises an O-ring placed around the outer circumference of said carrier means, said O-ring being sized so as to make sealable contact with said carrier means and an inside circumferential wall of said barrel.

4. The electrode tip of claim 2 further including biasing means housed therewithin for resiliently maintaining the carrier means in its retracted position, which biasing means further helps hold the ring electrode against the desired tissue once the tissue attachment means has been secured thereto.

5. The electrode tip of claim 4 wherein said biasing means exerts a force urging said carrier means to its retracted position with a maximum force that is less than a force that would pull body tissue into the barrel of the electrode.

6. The electrode tip of claim 4 wherein said movement means comprises means for selectively applying an axial force to said carrier means opposing said biasing means.

7. The elctrode tip of claim 6 wherein said lead includes a helically-wound conductor having a lumen through the length thereof and wherein said means for selectively applying an axial force to said carrier means comprises:

means for inserting a stylet through said lumen until a distal tip of said stylet engages a proximal end of said carrier means; and

means for applying an axial force to said stylet the continued application of said axial force, if of a magnitude greater than the opposing force asserted by said biasing means, causes the carrier means to slide to its extended position.

8. The electrode tip of claim 7 wherein said tissue attachment means comprises a screw-in fixation helix, which fixation helix is affixed to the desired tissue by rotating the lead at the same time that the axial force is applied to said stylet.

9. A tissue-stimulating lead comprising:

a flexible conductor having a proximal end adapted for connection to a tissue-stimulating device and a distal end adapted for contact with desired tissue;

a stimulating tip connected to the distal end of the conductor, said stimulating tip having a barrel therein;

a movable carrier bobbin inserted into said barrel;

tissue attachment means affixed to one end of said carrier bobbin, said tissue attachment means protruding from said barrel whenever said carrier bobbin assumes an extended position, and said tissue attachment means remaining inside of said barrel whenever said carrier bobbin assumes a retracted position;

extension means for selectively applying forces to the carrier bobbin that position said carrier bobbin in its extended position, thereby facilitating the attachment of said tissue attachment means to the desired tissue; and

retraction means within said stimulating tip for continuously urging the carrier bobbin back towards its retracted position;

said retraction means helping to maintain contact between said tip electrode and the desired tissue once the desired tissue has been attached to the tissue attachment means.

10. The tissue-stimulating lead of claim 9 further including friction reducing means for reducing the friction between said carrier bobbin and the barrel, thereby facilitating the movement of the carrier bobbin as it moves between its extended and retracted positions within said barrel.

11. The tissue-stimulating lead of claim 10 wherein said friction reducing means are further for preventing fluid flow around said carrier bobbin into a back portion of said barrel.

12. The tissue-stimulating lead of claim 11 wherein said friction reducing means comprises an O-ring that is placed around the periphery of said carrier bobbin.

13. The tissue-stimulating lead of claim 12 wherein said O-ring rolls between the surfaces of said carrier bobbin and said barrel as said carrier bobbin moves in and out of said barrel.

14. The tissue-stimulating lead of claim 9 wherein said extension means comprises means for applying a force that urges said carrier bobbin into its extended position.

15. The tissue-stimulating lead of claim 14 wherein the flexible conductor of said lead has a lumen therein;

and wherein said means for applying a force comprises means for removably inserting a stylet into the lumen of said conductor until a distal end of said stylet engages said carrier bobbin, and means for applying an axial force to a proximal end of said stylet.

16. The tissue-stimulating lead of claim 15 wherein said retraction means comprises a spring engaged with said carrier bobbin and barrel, said spring being biased so as to urge the carrier bobbin to its retracted position with a force that does not exceed a prescribed value, said prescribed value being less than a force that would cause body tissue to be pulled inside of said barrel by said retraction means.

17. A method for attaching a tissue-stimulating lead to body tissue, said tissue-stimulating lead comprising a flexible conductor having a lumen therein, and having a tip electrode attached to a distal end thereof, and further having tissue attachment means connected to said tip, internal biasing means housed within the distal end of said lead for maintaining the tissue attachment means in a non-protruding recessed position within said tip, and means for extending said tissue attachment means to a protruding position from said tip upon application of an external force, said method comprising the steps of:

(a) positioning the tip electrode of said lead adjacent the tissue to which it is to be attached;

(b) applying an external force to the means for extending the tissue attachment means to cause said tissue attachment means to protrude from said tip;

(c) affixing said protruding tissue attachment means to the body tissue; and

(d) removing the external force applied in step (b), whereupon said internal biasing means helps maintain the tip electrode in contact with the attached body tissue.

18. The method of claim 17 wherein step (b) of applying an external force to the means for extending the tissue attachment means includes removably inserting a stylet into the lumen of said lead, and applying an axial force to a proximal end of said stylet, said axial force being transferred through said stylet to a distal end thereof, whereat said force is used to effectuate the protrusion of said tissue attachment means.