Temporary, post-heart surgery cardioverting and pacing system and lead systems for use therein

• US 5,766,224 A
• Filed: 04/02/1996
• Issued: 06/16/1998
• Est. Priority Date: 04/02/1996
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: InControl, Inc. (Daikin Industries Ltd)
• Inventors: Alferness, Clifton A., Gonzalez, Hugo X., Adams, John M., Ayers, Gregory M.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/627,688
• Time in Patent Office: 805 Days
• Field of Search: 607/4, 607/5, 607/10, 607/33, 607/123, 607/132, 607/130, 607/129
• US Class Current: 607/4
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Abstract

A post-surgical atrial cardioverting, atrial pacing, and ventricular pacing system and lead system provides for cardioverting the atria, pacing the atria, and/or pacing the ventricles of the heart of a post-surgical heart patient. The system includes a first lead and a second lead providing a pair of atrial cardioverting electrodes, an atrial pacing electrode, and a ventricular pacing electrode. The electrodes are electrically isolated from each other. The system further includes at least one anchor releasably disposing the electrodes beneath the skin of the patient with each atrial cardioverting electrode electrically contacting a respective given one of the atria, the atrial pacing electrode electrically contacting one of the atria, and the ventricular pacing electrode electrically contacting a ventricle. The system further includes at least one of an external cardiovertor coupled to the cardioverting electrodes for cardioversion, an external atrial pacer coupled to the atrial pacing electrode and one of the atrial cardioverting electrodes for pacing the atria, and an external ventricular pacer coupled to the ventricular pacing electrode and one of the atrial cardioverting electrodes for pacing the ventricles.

Claims

1. A post-surgical temporary lead kit for applying atrial cardioverting electrical energy and/or pacing energy to the heart of a post-surgical heart patient when connected between a source of cardioverting and/or pacing energy and a patient'"'"'s heart, said kit comprising the combination of:

a first lead and a second lead having distal ends adapted to be used beneath the skin and together including at the distal ends a pair of atrial cardioverting electrodes adapted to receive cardioverting energy from the source of cardioverting energy, an atrial pacing electrode adapted to receive pacing electrical energy from the source of pacing energy, and a ventricular pacing electrode adapted to receive pacing electrical energy from the source of pacing energy, the electrodes being electrically isolated from each other before being coupled to the patient'"'"'s heart; and

anchor means adapted to releasably electrically contact each respective atrial cardioverting electrode with a respective given one of the atria, adapted to releasably electrically contact the atrial pacing electrode with one of the atria, and adapted to releasably electrically contact the ventricular pacing electrode with a ventricle, said anchor means being adapted to provide the releasable contact of the electrodes beneath the skin external to the interior of the heart to permit the first lead and the second lead to be pulled from beneath the skin.

2. A lead kit as defined claim 1 wherein the first and second leads each have a longitudinal dimension and are joined together along the longitudinal dimensions beginning from a point proximal to the cardioverting electrodes and distal to and continuing proximally through and past a point of exit from the patient to provide a single lead body for extraction.

3. A post-surgical temporary lead kit for applying atrial cardioverting electrical energy and/or pacing energy to the heart of a post-surgical heart patient when connected between a pulse generator and patient'"'"'s heart, said kit comprising:

a first lead having an atrial pacing electrode adapted to be connected to the pulse generator, an atrial cardioverting electrode adapted to be coupled to the pulse generator, and a ventricular pacing electrode adapted to be coupled to the pulse generator, the electrodes being electrically isolated from each other before being coupled to the patient'"'"'s heart and spaced apart so that when the atrial pacing and cardioverting electrodes are in electrical contact with an atrium, the ventricular pacing electrode is adapted to be in electrical contact with a ventricle;

a second lead having an atrial cardioverting electrode adapted to be coupled to the pulse generator; and

anchor means adapted to releasably electrically contact the atrial pacing electrode of the first lead with a given one of the atria, adapted to releasably electrically contact the atrial cardioverting electrode of the first lead with the given one of the atria, adapted to releasably electrically contact the ventricular electrode of the first lead with a given one of the ventricles and adapted to releasably electrically contact the atrial cardioverting electrode of the second lead with the other one of the atria, the anchor means being adapted to provide the releasable contact of the electrodes beneath the skin external to the interior of the heart to permit the leads to be pulled from beneath the skin.

4. A lead kit as defined in claim 3 wherein the first lead includes a distal end and a proximal end, wherein the atrial pacing electrode of the first lead is at the distal end of the first lead, wherein the atrial cardioverting electrode of the first lead is proximal to the atrial pacing electrode of the first lead, and wherein the ventricular pacing electrode of the first lead is proximal to the atrial cardioverting electrode of the first lead.

5. A lead kit as defined in claim 4 wherein the atrial pacing electrode of the first lead is coaxially disposed in relation to the atrial cardioverting electrode of the first lead.

6. A lead kit as defined in claim 3 wherein the first lead includes a distal end and a proximal end, wherein the atrial cardioverting electrode of the first lead is at the distal end of the first lead, wherein the atrial pacing electrode of the first lead is proximal to the atrial cardioverting electrode of the first lead, and wherein the ventricular pacing electrode of the first lead is proximal to the atrial pacing electrode of the first lead.

7. A lead kit as defined in claim 6 wherein the first lead is a ribbon cable.

8. A post-surgical temporary lead kit for applying atrial cardioverting electrical energy and/or pacing energy to the heart of a post-surgical heart patient when connected between a pulse generator and a patient'"'"'s heart, said lead kit comprising the combination of:

a first lead having a proximal end and a distal end, the distal end having an atrial pacing electrode adapted to be coupled to the pulse generator for receiving pacing electrical energy and an atrial cardioverting electrode adapted to be coupled to the pulse generator for receiving cardioverting electrical energy, the electrodes of the first lead being electrically isolated from each other and spaced apart so that when the cardioverting electrode of the first lead is in electrical contact with an atrium, the atrial pacing electrode of the first lead is adapted for electrical contact with the atrium;

a second lead having a proximal end and a distal end, the distal end having an atrial cardioverting electrode adapted to be coupled to the pulse generator for receiving cardioverting electrical energy and a ventricular pacing electrode adapted to be coupled to the pulse generator for receiving pacing electrical energy, the electrodes of the second lead being electrically isolated from each other and spaced apart so that when the atrial cardioverting electrode of the second lead is in electrical contact with an atrium, the ventricular electrode of the second lead is adapted for electrical contact with a corresponding ventricle,

the distal ends of the leads including the electrodes being adapted to be beneath the skin and the proximal ends of the leads being adapted to be outside the skin for connection to the pulse generator; and

anchor means adapted to releasably electrically contact the atrial cardioverting electrode of the first lead with a given one of the atria, adapted to releasably electrically contact the atrial pacing electrode of the first lead with the given one of the atria, adapted to releasably electrically contact the atrial cardioverting electrode of the second lead with the other one of the atria and adapted to releasably electrically contact the ventricular pacing electrode of the second lead with a ventricle corresponding to the other one of the atria, the anchor means being adapted to provide the releasable contact of the electrodes beneath the skin external to the interior of the heart to permit the leads to be pulled entirely from beneath the skin upon the pulling of the proximal ends of the leads.

9. A lead kit as defined in claim 8 wherein the atrial pacing electrode of the first lead is proximal to the atrial cardioverting electrode of the first lead.

10. A lead kit as defined in claim 9 wherein the first lead is a ribbon cable.

11. A lead kit as defined in claim 8 wherein the atrial cardioverting electrode of the second lead is distal to the ventricular pacing electrode.

12. A lead kit as defined in claim 11 wherein the second lead is a ribbon cable.

13. A lead kit as defined in claim 8 wherein the first and second leads each have a longitudinal dimension and are joined together along the longitudinal dimensions beginning from a point proximal to the cardioverting electrodes and distal to and continuing proximally through and past a point to exit from the patient to provide a single lead body for extraction.