Temporary transvenous endocardial lead
First Claim
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1. A temporary active fixation endocardial pacing lead having distal and proximal ends, comprising:
- (a) a malleable, resilient lead body having a maximum diameter less than about 3.5 French and distal and proximal ends, the lead body comprising;
(i) coaxial inner and outer electrical conductors, the outer conductor having an outer surface, electrically insulative material being disposed between the conductors, the inner conductor comprising at least one wire, the outer conductor comprising a plurality of wires capable of transferring sufficient torque from the proximal end of the lead body to the distal end of the lead body to permit screwable affixation of the distal end of the lead in endocardial tissue;
(ii) an outer sheath formed of biocompatible and electrically insulative material, the sheath extending over and covering at least portions of the outer surface;
(b) first and second electrical connectors attached, respectively, to the proximal ends of the inner and outer electrical conductors;
(c) a helical screw-in retainer for active fixation in endocardial or myocardial tissue, the retainer being formed of biocompatible material, at least a portion of the retainer defining a tip electrode, the tip electrode being electrically and mechanically connected to the distal end of one of the inner and outer electrical conductors, the retainer having a diameter not exceeding about 4 French, the tip electrode having a surface area less than or equal to ten square millimeters;
(d) a ring electrode disposed between the retainer and the distal end of the lead body, the ring electrode being formed of biocompatible material and electrically connected to the distal end of the electrical conductor not attached to the retainer, the ratio of the surface area of the ring electrode to the surface area of the tip electrode being greater than or equal to 2;
1, and(e) a malleable, resilient tube-shaped guide catheter having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter having distal and proximal ends and inner and outer surfaces, the guide catheter sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter having a diameter sufficient to accept the lead body therewithin.
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Abstract
A novel low cost, temporary pacing lead that provides superior torque transfer characteristics and positive affixation to the endocardial wall. The lead system of the present invention provides up to ten times more torque transmission between its proximal and distal ends than may be attained using prior art temporary leads. Additionally, the lead body of the present invention has a ratio of ring electrode surface area to tip electrode surface area that exceeds about 2, and a tip electrode surface area less than or equal to 10 millimeters squared.
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Citations
123 Claims
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1. A temporary active fixation endocardial pacing lead having distal and proximal ends, comprising:
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(a) a malleable, resilient lead body having a maximum diameter less than about 3.5 French and distal and proximal ends, the lead body comprising; (i) coaxial inner and outer electrical conductors, the outer conductor having an outer surface, electrically insulative material being disposed between the conductors, the inner conductor comprising at least one wire, the outer conductor comprising a plurality of wires capable of transferring sufficient torque from the proximal end of the lead body to the distal end of the lead body to permit screwable affixation of the distal end of the lead in endocardial tissue; (ii) an outer sheath formed of biocompatible and electrically insulative material, the sheath extending over and covering at least portions of the outer surface; (b) first and second electrical connectors attached, respectively, to the proximal ends of the inner and outer electrical conductors; (c) a helical screw-in retainer for active fixation in endocardial or myocardial tissue, the retainer being formed of biocompatible material, at least a portion of the retainer defining a tip electrode, the tip electrode being electrically and mechanically connected to the distal end of one of the inner and outer electrical conductors, the retainer having a diameter not exceeding about 4 French, the tip electrode having a surface area less than or equal to ten square millimeters; (d) a ring electrode disposed between the retainer and the distal end of the lead body, the ring electrode being formed of biocompatible material and electrically connected to the distal end of the electrical conductor not attached to the retainer, the ratio of the surface area of the ring electrode to the surface area of the tip electrode being greater than or equal to 2;
1, and(e) a malleable, resilient tube-shaped guide catheter having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter having distal and proximal ends and inner and outer surfaces, the guide catheter sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter having a diameter sufficient to accept the lead body therewithin. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A temporary endocardial pacing lead having distal and proximal ends, comprising:
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(a) a malleable, resilient lead body having a maximum diameter less than about 3.5 French and distal and proximal ends, the lead body comprising; (i) coaxial inner and outer means for conducting electricity, the outer conducting means having an outer surface, electrically insulative material being disposed between the conducting means, the inner conducting means comprising at least one wire, the outer conducting means comprising a plurality of wires capable of transferring sufficient torque from the proximal end of the lead body to the distal end of the lead body to permit screwable affixation of the distal end of the lead in endocardial tissue; (ii) an outer sheathing means formed of biocompatible and electrically insulative material, the sheathing means extending over and covering at least portions of the outer surface; (b) first and second electrical connecting means attached, respectively, to the proximal ends of the inner and outer electrical conducting means; (c) active fixation means for active fixation in endocardial or myocardial tissue, the fixation means being formed of biocompatible material, at least a portion of the fixation means defining a tip electrode means, the tip electrode means being electrically and mechanically connected to the distal end of one of the inner and outer electrical conducting means, the fixation means having a diameter not exceeding about 4 French, the tip electrode having a surface area less than or equal to ten square millimeters; (d) a ring electrode means disposed between the fixation means and the distal end of the lead body, the ring electrode means being formed of biocompatible material and electrically connected to the distal end of the electrical conducting means not attached to the fixation means, the ratio of the surface area of the ring electrode means to the surface area of the tip electrode means being greater than or equal to 2;
1, and(e) a malleable, resilient tube-shaped guide catheter means having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter means having distal and proximal ends and inner and outer surfaces, the guide catheter means sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter means having a diameter sufficient to accept the lead body therewithin. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52)
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53. A temporary active fixation endocardial pacing lead having distal and proximal ends, comprising:
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(a) a malleable, resilient lead body having an outer surface defining a maximum diameter less than about 3.5 French, the lead body comprising distal and proximal ends, an outer sheath, and first and second electrical conductors, electrically insulative material being disposed between the conductors, the outer sheath formed of biocompatible and electrically insulative material, the sheath extending over and covering at least portions of the outer surface; (b) first and second electrical connectors attached, respectively, to the proximal ends of the first and second electrical conductors; (c) an active fixation device for active fixation in endocardial or myocardial tissue, the active fixation device being formed of biocompatible material, at least a portion of the active fixation device defining a tip electrode, the tip electrode being electrically and mechanically connected to the distal end of one of the first and second electrical conductors, the active fixation device having a diameter not exceeding about 4 French, the tip electrode having a surface area less than or equal to ten square millimeters; (d) a ring electrode disposed between the active fixation device and the distal end of the lead body, the ring electrode being formed of biocompatible material and electrically connected to the distal end of the electrical conductor not attached to the active fixation device, the ratio of the surface area of the ring electrode to the surface area of the tip electrode being greater than or equal to 2;
1, and(e) a malleable, resilient tube-shaped guide catheter having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter having distal and proximal ends and inner and outer surfaces, the guide catheter sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter having a diameter sufficient to accept the lead body therewithin. - View Dependent Claims (54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78)
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79. A temporary active fixation endocardial pacing lead having distal and proximal ends, comprising:
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(a) a malleable, resilient lead body means having an outer surface defining a maximum diameter less than about 3.5 French, the lead body means comprising distal and proximal ends, an outer sheath, and first and second electrical conducting means, means for electrically insulating being disposed between the conducting means, the outer sheath formed of biocompatible and electrically insulative material, the sheath extending over and covering at least portions of the outer surface; (b) first and second electrical connecting means attached, respectively, to the proximal ends of the first and second electrical conducting means; (c) means for actively affixing to endocardial or myocardial tissue, the active fixation means being formed of biocompatible material, at least a portion of the active fixation means defining a tip electrode means, the tip electrode means being electrically and mechanically connected to the distal end of one of the first and second electrical conducting, the active fixation means having a diameter not exceeding about 4 French, the tip electrode means having a surface area less than or equal to ten square millimeters; (d) a ring electrode means disposed between the active fixation means and the distal end of the lead body means, the ring electrode means being formed of biocompatible material and electrically connected to the distal end of the electrical conducting means not attached to the active fixation means, the ratio of the surface area of the ring electrode means to the surface area of the tip electrode means being greater than or equal to 2;
1, and(e) a malleable, resilient tube-shaped guide catheter means having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter means having distal and proximal ends and inner and outer surfaces, the guide catheter means sheathing and extending over at least a portion of the lead body means, the inner surface of the guide catheter means having a diameter sufficient to accept the lead body means therewithin. - View Dependent Claims (80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104)
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105. A temporary lead system, comprising:
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(a) a lead body having proximal and distal ends, the outer diameter of the lead body not exceeding about 3.5 French, the lead body comprising at least first and second electrical conductors separated by electrically insulative material, a tip electrode disposed near the distal end of the lead body, a ring electrode disposed proximally of the tip electrode, and an active fixation device mechanically and electrically attached to the tip electrode, the tip electrode having a surface area less than or equal to ten square millimeters, the ratio of the surface area of the ring electrode to the surface area of the tip electrode exceeding about 2;
1, the tip electrode being mechanically and electrically connected to the first conductor, the ring electrode being mechanically and electrically connected to the second conductor, the lead body having first and second electrical connectors disposed at its proximal end, the first and second electrical connectors being mechanically and electrically connected to the first and second electrical conductors, respectively, and(b) a guide catheter forming a resilient tube shape, having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter having distal and proximal ends and inner and outer surfaces, the guide catheter sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter having a diameter sufficient to accept the lead body therewithin, wherein a ten-inch long sample of the guide catheter is capable off transmitting at least about 0.10 ounce-inches of torque between its proximal and distal ends when the proximal end is held in a fixed position and the distal end is rotated through an angular displacement of 30 degrees. - View Dependent Claims (106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122)
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123. A method of making a temporary active fixation endocardial pacing lead having distal and proximal ends, comprising the steps of:
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(a) providing a malleable, resilient lead body having an outer surface defining a maximum diameter less than about 3.5 French, the lead body comprising distal and proximal ends, an outer sheath, and first and second electrical conductors, electrically insulative material being disposed between the conductors, the outer sheath formed of biocompatible and electrically insulative material, the sheath extending over and covering at least portions of the outer surface; (b) providing first and second electrical connectors attached, respectively, to the proximal ends of the first and second electrical conductors; (c) providing an active fixation device for active fixation in endocardial or myocardial tissue, the active fixation device being formed of biocompatible material, at least a portion of the active fixation device defining a tip electrode, the tip electrode being electrically and mechanically connected to the distal end of one of the first and second electrical conductors, the active fixation device having a diameter not exceeding about 4 French, the tip electrode having a surface area less than or equal to ten square millimeters; (d) providing a ring electrode disposed between the active fixation device and the distal end of the lead body, the ring electrode being formed of biocompatible material and electrically connected to the distal end of the electrical conductor not attached to the active fixation device, the ratio of the surface area of the ring electrode to the surface area of the tip electrode being greater than or equal to 2;
1, and(e) providing a malleable, resilient tube-shaped guide catheter having a maximum outside diameter not exceeding about 6 French and formed of biocompatible material, the guide catheter having distal and proximal ends and inner and outer surfaces, the guide catheter sheathing and extending over at least a portion of the lead body, the inner surface of the guide catheter having a diameter sufficient to accept the lead body therewithin.
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Specification