Travenously placed defibrillation leads
First Claim
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1. A cardiac defibrillation system comprising:
- an epicardial electrode for making physical contact with the epicardium of a human heart from a position within the pericardial space of the heart;
means for transvenously inserting said epicardial electrode into the pericardial space;
an endocardial electrode for making physical contact with the endocardium of the heart; and
means for selectively placing a momentary electrical potential between said epicardial and endocardial electrodes, said momentary electrical potential being sufficient to cause a momentary pulse of electrical energy to be delivered to the myocardial tissue intermediate said epicardial and endocardial electrodes;
said electrical energy being sufficient to cause the myocardium of the heart to depolarize.
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Abstract
A cardiac defibrillation system and method includes an epicardial electrode for making electrical contact with the epicardium from a position within the pericardial space, an endocardial electrode for making electrical contact with the endocardium of the heart, and means for making electrical contact with the epicardial and endocardial electrodes. The endocardial electrode is inserted transvenously into the heart in conventional manner. The epicardial electrode is also inserted transvenously into the heart, through the heart wall, and into the pericardial space. No open chest surgery is required.
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Citations
30 Claims
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1. A cardiac defibrillation system comprising:
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an epicardial electrode for making physical contact with the epicardium of a human heart from a position within the pericardial space of the heart; means for transvenously inserting said epicardial electrode into the pericardial space; an endocardial electrode for making physical contact with the endocardium of the heart; and means for selectively placing a momentary electrical potential between said epicardial and endocardial electrodes, said momentary electrical potential being sufficient to cause a momentary pulse of electrical energy to be delivered to the myocardial tissue intermediate said epicardial and endocardial electrodes;
said electrical energy being sufficient to cause the myocardium of the heart to depolarize. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac defibrillation system comprising:
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an endocardial electrode for making physical contact with the endocardium of a heart; a plurality of spaced-apart epicardial electrodes for making physical contact with the epicardium of a human heart from a position within the pericardial space of the heart, said epicardial electrodes being transvenously insertable into the pericardial space; and lead means for making electrical contact with said epicardial electrodes from a location removed from said heart, said lead means comprising an elongate flexible electrical conductor having an electrically insulating sheath therearound, said electrical conductor and sheath comprising a lead body, said spaced-apart electrodes being positioned near a distal end of said lead body, and further wherein said epicardial electrodes comprise a segment of conductive material having a circumference not substantially greater than the circumference of said lead body; whereby an electrical potential of sufficient magnitude placed between said endocardial and epicardial electrodes by way of said electrical contact means triggers the depolarization of myocardial tissue proximate said electrodes. - View Dependent Claims (10, 11)
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12. An implantable defibrillation lead system comprising:
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a plurality of spaced-apart epicardial electrodes for making physical contact with the epicardium of a human heart from a position within the pericardial space of the heart, said epicardial electrodes being transvenously insertable into the pericardial space; and a plurality of spaced-apart endocardial electrodes for making physical contact with the endocardium of the heart; and first and second elongate flexible electrical conductors, each having an electrically insulating sheath therearound, said electrical conductor and sheath of each comprising a first and second lead body, respectively, said spaced-apart epicardial electrodes being positioned near a distal end of said first lead body, and said spaced-apart endocardial electrodes being positioned near a distal end of said second lead body;
said spaced-apart epicardial electrodes comprising segments of conductive material in electrical contact with said first elongate flexible conductor and having a circumference not substantially greater than the circumference of said first lead body;whereby an electrical potential of sufficient magnitude placed between said epicardial and endocardial electrodes through said first and second elongate flexible electrical conductors triggers the depolarization of myocardial tissue proximate said endocardial and epicardial electrodes. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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19. An implantable endocardial defibrillation lead comprising:
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a plurality of spaced-apart endocardial electrodes for making physical and electrical contact proximate the septum of a heart; a lead body having a plurality of branches spitting off from said body near a distal end thereof, each of said branches having a length, at least one of said plurality of endocardial electrodes being positioned along the length of each branch, and anchoring means for anchoring said branches near the apex of the heart so as to place said spaced-apart endocardial electrodes in contact with the septum of the heart, wherein said anchoring means comprises screw-in helixes, fins or porous electrodes.
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20. A method of defibrillating a human heart comprising the steps of:
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(a) transvenously inserting an epicardial electrode into the pericardial space surrounding the heart; (b) positioning said epicardial electrode so that it makes electrical contact with a desired area of the epicardium; (c) transvenously inserting an endocardial electrode inside of the heart; (d) positioning said endocardial electrode so that it makes electrical contact with a desired area of the endocardium; and (e) applying an electrical potential between said epicardial and endocardial electrodes;
said electrical potential triggering the depolarization of myocardial tissue proximate said epicardial and endocardial electrodes. - View Dependent Claims (21, 22, 23, 24, 25, 26)
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27. A method of defibrillating a human heart comprising the steps of:
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(a) transvenously inserting a plurality of spaced-apart epicardial electrodes into the pericardial space surrounding the heart; (b) positioning at least a plurality of said epicardial electrodes so that they contact epicardial tissue of the left ventricle; (c) transvenously inserting an endocardial electrode inside of the heart; (d) positioning said endocardial electrode so that it makes electrical contact with the septum of the heart from a position within the right ventricle; and (e) applying an electrical potential between said epicardial and endocardial electrodes;
said electrical potential triggering the depolarization of myocardial tissue proximate said epicardial and endocardial electrodes. - View Dependent Claims (28, 29, 30)
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Specification