Method and system for implanting self-anchoring epicardial defibrillation electrodes
First Claim
1. A method of percutaneously implanting a defibrillation lead within the intrapericardial space of a patient'"'"'s heart, the defibrillation lead having a distal electrode, a body, and proximal connection means capable of making electrical contact to an implantable defibrillation device, the method comprising the steps of:
- distending the pericardium from the epicardium by injecting a small volume of fluid into the pericardium, so that pericardial effusion results;
percutaneously perforating the pericardium by advancing a perforation device having a lumen therethrough towards the distended pericardium until the fluid flows out of the lumen, thereby indicating that the pericardium wall has been perforated;
inserting a guide wire into the pericardium through the lumen of the perforation device until a distal end thereof is positioned within the pericardium;
enlarging the perforated opening in the pericardium by inserting an introducer over the guide wire and into the tissue; and
inserting the distal electrode of the defibrillation lead within the introducer until the distal electrode is likewise positioned within the pericardium.
5 Assignments
0 Petitions
Accused Products
Abstract
A method and system for positioning a defibrillation electrode within the pericardial space of a mammal is disclosed which includes means for distending the pericardium from the heart by injecting a small volume of fluid into the pericardium. A needle having a lumen therethrough is inserted from a sub-xiphoid or other percutaneous position into the body tissue until a tip thereof punctures the distended pericardium at a selected location. A guide wire is inserted into the pericardium through the lumen of the needle, and while the guide wire remains in the pericardial space, the needle is removed. A sheath is introduced over the guide wire, with the aid of a dilator, and inserted into the tissue until one end thereof is positioned within the pericardium. The defibrillation lead, with its electrode in a retracted position, is inserted through the sheath until the electrode is likewise positioned within the pericardium, whereupon the electrode is deployed in order to make contact with a large area of tissue within the pericardium. Additional leads and electrodes may be introduced and deployed in a like manner.
-
Citations
41 Claims
-
1. A method of percutaneously implanting a defibrillation lead within the intrapericardial space of a patient'"'"'s heart, the defibrillation lead having a distal electrode, a body, and proximal connection means capable of making electrical contact to an implantable defibrillation device, the method comprising the steps of:
-
distending the pericardium from the epicardium by injecting a small volume of fluid into the pericardium, so that pericardial effusion results; percutaneously perforating the pericardium by advancing a perforation device having a lumen therethrough towards the distended pericardium until the fluid flows out of the lumen, thereby indicating that the pericardium wall has been perforated; inserting a guide wire into the pericardium through the lumen of the perforation device until a distal end thereof is positioned within the pericardium; enlarging the perforated opening in the pericardium by inserting an introducer over the guide wire and into the tissue; and inserting the distal electrode of the defibrillation lead within the introducer until the distal electrode is likewise positioned within the pericardium. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
-
-
18. A method of positioning at least one defibrillation lead within the pericardium of a mammal, the defibrillation lead having deployable distal electrode means for selectively placing an electrode in contact with a desired tissue area when the electrode is deployed, and for selectively maintaining the electrode in a retracted position, thereby facilitating the movement and positioning of the electrode until the electrode is positioned at a desired tissue location, the method comprising the steps of:
-
(a) injecting a fluid between the heart and the pericardium, thereby extending the pericardium away from the heart; (b) percutaneously inserting a guide wire having a lumen therethrough into the extended pericardium at a desired tissue contact location until the fluid injected between the heart and the pericardium flows out of the lumen, thereby indicating that the pericardium wall has been perforated; (c) placing a sheath introducer into the pericardium over the guide wire; (d) inserting the electrode, in its retracted position, within the pericardium through the sheath introducer; and (e) deploying the electrode within the pericardium, whereby the electrode makes contact with a large tissue area at the desired tissue contact location within the pericardium. - View Dependent Claims (19, 20, 21)
-
-
22. A method for anchoring a distal electrode of a defibrillation lead within the pericardium comprising the steps of:
-
(a) capturing an autologous blood clot on the distal electrode; (b) inserting the distal electrode within the pericardium; and (c) coagulating the blood clot to tissue within the pericardium. - View Dependent Claims (23, 24, 25, 26, 27)
-
-
28. A system for implanting a defibrillation lead in a mammal, the mammal having a heart surrounded by a pericardium, the system comprising:
-
a defibrillation lead having a deployable distal electrode that selectively assumes a retracted position adapted to promote the positioning of the distal electrode without having the distal electrode becoming entangled with body tissue, and an extended position adapted to promote contact with body tissue over a large area, the defibrillation lead having deployment means for extending the distal electrode to its extended position; means for injecting a fluid between the heart and the pericardium, thereby extending the pericardium away from the heart; a perforation device having a lumen therethrough, the perforation device being sub-xiphoidally inserted toward the extended pericardium until the fluid flows out of the lumen, thereby indicating that the extended pericardium wall has been perforated; and insertion means for inserting the defibrillation lead, with its deployable distal electrode in its retracted position, into the pericardium until the distal electrode is positioned at a desired location within the pericardium. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35, 36)
-
-
37. A defibrillation lead system comprising:
-
a sheath; means for passing said sheath through a pericardium surrounding a heart from a percutaneous position; a defibrillation lead having a distal electrode, said defibrillation lead being of a size that allows it to be slidably inserted through said sheath until said distal electrode resides within the pericardium; and means for anchoring said distal electrode to a desired location within the pericardium, said anchoring means comprising means for stimulating a fibrosis attachment site. - View Dependent Claims (38, 39, 40, 41)
-
Specification