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Method of making an atrial defibrillation catheter

  • US 5,697,965 A
  • Filed: 04/01/1996
  • Issued: 12/16/1997
  • Est. Priority Date: 04/01/1996
  • Status: Expired due to Term
First Claim
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1. A method for manufacturing a catheter adapted for temporary placement in the body of a patient to treat atrial fibrillation, comprising the steps of:

  • fabricating a small diameter, elongated, flexible member having a proximal end, a distal end, and a central portion between said proximal end and said distal end, wherein said member has a diameter, length, and flexibility adapted to permit it to be introduced into the patient'"'"'s vascular system and maneuvered so that its distal end may be advanced along a path including the right atrium, tricuspid valve, right ventricle, pulmonary valve, and into a predetermined position in the left pulmonary artery adjacent the left atrium of the patient'"'"'s heart;

    forming a plurality of lumens in said member, each extending from a respective port at the proximal end and through at least a portion of the length of said member including the central portion thereof and generally axially thereof;

    connecting said lumens to a manifold attached at the proximal end of said member;

    attaching a plurality of tubes to the proximal end of said manifold such that each tube is connected with a respective lumen;

    forming adjacent the distal end of said member an opening into one of said plurality of lumens that terminates at a point short of said distal end;

    sealing a balloon envelope to said member adjacent the distal end thereof to place said opening within the envelope, whereby the balloon envelope may be selectively inflated and exhausted from a port and tube at the proximal end of the member via the lumen connected to said opening, so that the balloon may be sufficiently inflated during advancement of said member along said path to aid in floating the distal end of said member into said predetermined position in the pulmonary artery, and fully inflated to anchor the distal end in said predetermined position;

    forming one of said plurality of lumens to extend completely through said member from the respective port and tube at the proximal end to a port at the distal end thereof, and with a diameter suitable to accommodate a guide wire to facilitate maneuvering said member along said path, and, when the guide wire is not present after the distal end of said member is anchored in said predetermined position in the pulmonary artery by the inflated balloon, to enable blood sampling, drug infusion or pressure measurement at the distal end of the member via the port thereat;

    providing first and second arrays of defibrillation electrodes on said member, each of said arrays including a plurality of axially substantially uniformly spaced-apart electrically conductive relatively low impedance bands circumferentially encircling a respective segment of and conforming in shape to said central portion to maintain a substantially smooth continuous surface therewith without adversely affecting the flexibility of said member, wherein the first electrode array is located relatively more proximally along said central portion and the second electrode array is located relatively more distally along said central portion, and said first and second electrode arrays are spaced apart by a predetermined distance between the respective bands closest to one another in the two arrays, said predetermined distance being selected to place said first electrode array in the right atrium and said second electrode array in the pulmonary artery adjacent the left atrium when the distal end of said member is in said predetermined position in the pulmonary artery, and wherein the plurality of bands of said first electrode array are electrically interconnected for energization from a single source of electrical power and the plurality of bands of said second electrode array are electrically interconnected for energization from a single source of electrical power located external to the patient'"'"'s body;

    running at least a first relatively low resistance lead electrically connected to a band of said first electrode array through a lumen in said member for exit through the respective lumen port and tube at the proximal end thereof, running at least a second relatively low resistance lead electrically connected to a band of said second electrode array through a lumen in said member for exit through the respective lumen port and tube at the proximal end thereof, and connecting said first and second exiting leads to respective first and second electrical connectors adapted to be connected to a power source for application of electrical defibrillating shocks across said first and second electrode arrays when said member is in said path with the distal end in said predetermined position and the patient'"'"'s heart is detected to be in atrial fibrillation;

    providing on the central portion of said member additional first and second electrodes comprising respective electrically conductive relatively low impedance bands circumferentially encircling a respective segment of and conforming in shape to said central portion to maintain a substantially smooth continuous surface therewith, wherein said additional first and second electrodes are positioned and axially spaced apart on said central portion such that when the member is in place along said path with its distal end in said predetermined position in the pulmonary artery the additional first electrode will be positioned in the right atrium and the additional second electrode will be positioned in the right ventricle of the patient'"'"'s heart, for use in pacing and sensing intracardiac activity of the patient'"'"'s heart; and

    running an additional first relatively low resistance lead electrically connected to the additional first electrode band through a lumen in said member for exit through the respective lumen port and tube at the proximal end thereof, running an additional second relatively low resistance lead electrically connected to the additional second electrode band through a lumen in said member for exit through the respective lumen port and tube at the proximal end thereof, and connecting the additional first and second exiting leads to respective first and second electrical connectors adapted to be connected to pacing and sensing circuitry located external to the patient'"'"'s body.

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