Guiding catheter for the coronary sinus

• US 5,775,327 A
• Filed: 05/19/1997
• Issued: 07/07/1998
• Est. Priority Date: 06/07/1995
• Status: Expired due to Term

• Current Assignee: Cardima, Inc.
• Original Assignee: Cardima, Inc.
• Inventors: Dickens, Duane, Randolph, Yvonne
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/858,297
• Time in Patent Office: 414 Days
• Field of Search: 128/642, 128/657, 128/658, 128/772, 604/96, 604/280-282, 606/41
• US Class Current: 600/374
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61M 2025/0081 Soft tip
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0054 with regions for increasing flexibility
• CPC Class Codes: A61M 25/0141 having flexible regions as a result of using materials with different mechanical properties
• CPC Class Codes: A61M 25/0152 with pre-shaped mechanisms, e.g. pre-shaped stylets or pre-shaped outer tubes
• CPC Class Codes: A61M 25/0662 Guide tubes
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart

Abstract

A guiding catheter for delivery of intravascular devices to a patient'"'"'s coronary sinus. The guiding catheter has a relatively stiff proximal section and a relatively flexible distal section, the latter being about 1 to about 6 inches in length and being configured to subselect a branch cardiac vein leading to the coronary sinus. The guiding catheter is particularly suitable for delivering an intravascular device for sensing electrical activity into a cardiac vein to detect such activity from within the blood vessel.

Claims

1. A guiding catheter for directing an intravascular device within a patient'"'"'s coronary sinus comprising:

a) an elongated shaft having a proximal and distal ends, a port in the distal end and guidewire receiving lumen extending to and in fluid communication with the port in the distal end;

b) a relatively stiff proximal shaft section of the elongated shaft;

c) a relatively flexible distal shaft section of the elongated shaft having a length of about 2 to about 7 centimeters and being shaped with a bend to facilitate entry into the patient'"'"'s coronary sinus;

d) an expandable occluding member mounted on the flexible distal section; and

e) an adapter on the proximal end of the elongated shaft to provide access to the quidewire receiving lumen extending within the elongated shaft.

2. The guiding catheter of claim 1 wherein the elongated shaft has an inflation lumen extending from the proximal end to a location spaced proximally from the distal end and the expandable occluding member is an inflatable balloon having an interior in fluid communication with the inflation lumen.

3. The guiding catheter of claim 1 wherein the distal section of the elongated shaft has a length of about 3 to about 6 centimeters.

4. The guiding catheter of claim 1 wherein the proximal shaft section is formed of a polymer material having a hardness of about 60 to about 85D (Shore).

5. The guiding catheter of claim 1 wherein the distal shaft section is formed of a polymer material having a hardness of about 80A to about 30D (Shore).

6. The guiding catheter of claim 1 including an intermediate section having a flexibility greater than the proximal shaft section and less than the distal shaft section.

7. The guiding catheter of claim 6 wherein the intermediate shaft section has a hardness of about 30 to about 60 (Shore).

8. The guiding catheter of claim 6 wherein the intermediate shaft section has a length of about 1 to about 8 centimeters.

9. The guiding catheter of claim 1 wherein the relatively flexible distal shaft section includes a proximal portion having a flexibility greater than that of the proximal shaft section, and a nontraumatic distal portion having a flexibility greater than that of the proximal portion, wherein at least one of the portions of the distal section is being shaped with a bend to facilitate entry within the patient'"'"'s coronary sinus.

10. An intravascular assembly including

a) a guiding catheter for directing an intravascular device within a patient'"'"'s coronary sinus, comprising:

an elongated shaft having a proximal and distal ends, a port in the distal end and a guidewire receiving lumen extending to and in fluid communication with the port in the distal end,

a relatively stiff proximal shaft section of the elongated shaft,

a relatively flexible distal section of the elongated shaft having a length of about 2 to about 7 centimeters and having a proximal portion having a flexibility greater than that of the proximal shaft section, and a nontraumatic distal portion having a flexibility greater than that of the proximal portion, wherein at least one of the portions of the distal section is being shaped with a bend to facilitate entry within the patient'"'"'s coronary sinus;

an expandable occluding member mounted on the flexible distal shaft section; and

an adapter on the proximal end of the elongated shaft to provide access to the guidewire receiving lumen extending within the elongated shaft; and

b) slidably disposed within the guidewire receiving lumen of the guiding catheter, an intravascular device for detecting electrical activity of a patient'"'"'s heart from within a cardiac vein thereof which includes an elongated shaft, a plurality of sensing electrodes on a distal extremity of the intravascular device and individual electrical conductors electrically connected to the sensing electrodes.

11. The intravascular assembly of claim 10 wherein the intravascular device has a length greater than a length of the guiding catheter so that the proximal end of the intravascular device extends out the proximal end of the guiding catheter when the distal extremity of the intravascular device having sensing electrodes thereon extends out the distal end of the guiding catheter.

12. A method of detecting electrical activity within a patient'"'"'s heart, comprising:

a) providing a guiding catheter having

an elongated shaft having a proximal and distal ends, a port in the distal end and guidewire receiving lumen extending to and in fluid communication with the port in the distal end,

a relatively stiff proximal shaft section of the elongated shaft,

a relatively flexible distal section of the elongated shaft having a length of about 2 to about 7 centimeters and having a proximal portion having a flexibility greater than that of the proximal shaft section, and a nontraumatic distal portion having a flexibility greater than that of the proximal portion, wherein at least one of the portions of the distal section is being shaped with a bend to facilitate entry within the patient'"'"'s coronary sinus;

an expandable occluding member mounted on the flexible distal shaft section; and

an adapter on the proximal end of the elongated shaft to provide access to the guidewire receiving lumen extending within the elongated shaft;

b) advancing the guiding catheter through the patient'"'"'s peripheral venous system into a right atrium of the patient'"'"'s heart;

c) guiding the distal end of the guiding catheter through the coronary sinus ostium into the coronary sinus and into a branch vein which drains into the coronary sinus;

d) advancing an intravascular device having sensing electrodes on a distal portion thereof through the guidewire receiving lumen of the guiding catheter under the distal portion of the intravascular device having sensing electrodes thereon extends out the port in the distal end of the guiding catheter; and

e) detecting electrical activity by means of the sensing electrodes on the distal portion of the intravascular device.

13. The method of claim 12 including ablating heart tissue causing or involved with the sensed electrical activity.

14. The method of claim 14 further including the step of inflating the expandable occluding member before the detection of electrical activity.

15. A guiding catheter for directing an intravascular device within a patient'"'"'s;

coronary sinus, comprising;

a) an elongated shaft having proximal and distal ends, a port in the distal end and a guidewire receiving lumen extending to and in fluid communication with the port in the distal end;

b) a relatively stiff proximal shaft section of the elongated shaft,

c) a relatively flexible distal section of the elongated shaft having a length of about 2 to about 7 centimeters and having a proximal portion having a flexibility greater than that of the proximal shaft section, and a nontraumatic distal portion having a flexibility greater than that of the proximal portion, wherein at least one of the portions of the distal section is being shaped with a bend to facilitate entry within the patient'"'"'s coronary sinus;

d) an intermediate section of the elongated shaft having a flexibility greater than the proximal shaft section and less than the distal shaft section, and having an expandable occluding member; and

e) an adapter on the proximal end of the elongated shaft to provide access to the guidewire receiving lumen extending within the elongated shaft.

16. The guiding catheter of claim 15 wherein the elongated shaft has an inflation lumen extending from the proximal end to a location spaced proximally form the distal end and the expandable occluding member is an inflatable balloon having an interior in fluid communication with the inflation lumen.