Transvenously placed defibrillation leads via an inferior vena cava access site and method of use
First Claim
1. A method of transvenously implanting a defibrillation lead about a mammalian heart;
- said heart being located within a chest cavity, said heart having a major vein proximate thereto, said defibrillation lead having at least one distal electrode, a flexible body, and proximal connection means for making electrical contact with the distal electrode from a proximal end of the lead;
said method comprising the steps of;
(a) transvenously inserting guide means into the chest cavity from a position within said major vein;
(b) inserting the distal electrode of the defibrillation lead into the chest cavity following said guide means; and
(c) positioning said distal electrode within the chest cavity so as to be about said heart.
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Accused Products
Abstract
A method and system for positioning a defibrillation electrode about the heart includes means for placing the electrode in contact with epicardial or pericardial tissue from an inferior vena cava (IVC) access site. A small hole is made in the IVC at the selected access site. A defibrillation lead having the defibrillation electrode near its distal end is transvenously inserted through the IVC and out through the small hole into a chest cavity adjacent the heart. The electrode is then positioned so as to contact the desired cardiac tissue. If pericardial contact is to be made, the distal end of the lead, including the electrode, is looped around the pericardium. If epicardial contact is to be made, an additional small hole is made in the pericardium, and the distal end of the lead, including the electrode, is inserted through the additional hole into the pericardial space, and the electrode is positioned to contact the desired epicardial tissue.
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Citations
34 Claims
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1. A method of transvenously implanting a defibrillation lead about a mammalian heart;
- said heart being located within a chest cavity, said heart having a major vein proximate thereto, said defibrillation lead having at least one distal electrode, a flexible body, and proximal connection means for making electrical contact with the distal electrode from a proximal end of the lead;
said method comprising the steps of;(a) transvenously inserting guide means into the chest cavity from a position within said major vein; (b) inserting the distal electrode of the defibrillation lead into the chest cavity following said guide means; and (c) positioning said distal electrode within the chest cavity so as to be about said heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
- said heart being located within a chest cavity, said heart having a major vein proximate thereto, said defibrillation lead having at least one distal electrode, a flexible body, and proximal connection means for making electrical contact with the distal electrode from a proximal end of the lead;
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10. A method of implanting a defibrillation lead about the heart of a patient, said defibrillation lead having at least one exposed conductive surface near its distal end that serves as an electrode, said method comprising the steps of:
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(a) accessing the inferior vena cava (IVC) of the patient; (b) making a first small hole in said IVC at a location proximate the heart of the patient; (c) inserting the distal end of said defibrillation lead through said first small hole; and (d) positioning the electrode of said defibrillation lead about the heart of the patient. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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19. A method of positioning at least one defibrillation electrode about the heart of a mammal, said heart being contained within pericardial tissue, said pericardial tissue having an inner layer adjacent epicardial tissue of said heart, and an outer layer facing away from said heart, said method including:
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inserting said at least one electrode through a vein that passes proximate said heart; routing said at least one electrode through an access site in a wall of said vein to an adjacent chest cavity, said pericardial tissue being located within said chest cavity; and positioning said at least one electrode within said chest cavity so as to make contact with said pericardial tissue. - View Dependent Claims (20, 21, 22)
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23. A system for implanting a defibrillation lead in a mammal, said mammal having a heart surrounded by a pericardium, said defibrillation lead having at least one flexible elongate electrode near a distal end thereof, said system comprising:
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guide means for transvenously gaining direct access to a chest cavity of said mammal, said heart and pericardium being located within said chest cavity, said direct access passing directly from an access site in a wall of a vein proximate said chest cavity to the chest cavity without passing through said heart; means for inserting the distal end of said electrode, including said at least one electrode, into said chest cavity following said guide means; and means for positioning said at least one electrode within said chest cavity about said heart. - View Dependent Claims (24, 25, 26, 27, 28)
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29. A defibrillation lead system comprising:
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a sheath; means for passing said sheath through to a pericardium surrounding a heart from a position within the inferior vena cava (IVC) adjacent said heart; 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 is in contact with the pericardium; and holding means for holding said distal electrode in contact with the pericardium. - View Dependent Claims (30, 31, 32, 33, 34)
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Specification