Electrosurgical systems and methods for the removal of pacemaker leads
First Claim
1. An apparatus for removing a pacemaker lead attached to heart tissue within a patient'"'"'s body comprising:
- a shaft having a proximal end, a distal end, a distal opening and an inner lumen in communication with the distal opening, the distal opening and the inner lumen being sized to accommodate the pacemaker lead;
an electrode terminal on the shaft adjacent the distal opening;
an electrically insulating support member at the distal end of the shaft supporting the electrode terminal, the support member comprising an inorganic material selected from the group comprising ceramic, glass or combinations thereof; and
a connector extending from the electrode terminal to the proximal end of the shaft for coupling the electrode terminal to a source of high frequency electrical energy.
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Accused Products
Abstract
The present invention is directed to systems, methods and apparatus for removing implanted objects from a patient'"'"'s body, particularly implanted endocardial or epicardial pacemaker leads and transvenous defibrillation leads from a patient'"'"'s heart. In one aspect of the invention, an electrosurgical catheter is advanced to a position within the thoracic cavity adjacent a portion of a pacemaker lead that is affixed to heart tissue. Preferably, the catheter is advanced over the pacemaker lead, i.e., using the pacemaker lead as a guidewire, to facilitate this positioning step. Once the distal end of the catheter reaches a blockage, or a portion of the lead that is attached to fibrous scar tissue, a high frequency voltage difference is applied between one or more electrode terminal(s) at the distal end of the catheter and one or more return electrode(s) to remove the scar tissue around the lead. The catheter is then advanced further along the lead until it reaches another blockage caused by fibrous scar tissue, and the process is continued until the catheter reaches the distal tip of the lead in the myocardium. At this point, the distal tip may be severed from the rest of the lead, or pulled out of the myocardial tissue in a conventional manner. The scar tissue around the pacemaker lead is precisely ablated before removing the lead, which minimizes or eliminates the risks associated with mechanical traction and countertraction, such as disruption of the heart wall, lead breakage with subsequent migration and the like.
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Citations
43 Claims
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1. An apparatus for removing a pacemaker lead attached to heart tissue within a patient'"'"'s body comprising:
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a shaft having a proximal end, a distal end, a distal opening and an inner lumen in communication with the distal opening, the distal opening and the inner lumen being sized to accommodate the pacemaker lead;
an electrode terminal on the shaft adjacent the distal opening;
an electrically insulating support member at the distal end of the shaft supporting the electrode terminal, the support member comprising an inorganic material selected from the group comprising ceramic, glass or combinations thereof; and
a connector extending from the electrode terminal to the proximal end of the shaft for coupling the electrode terminal to a source of high frequency electrical energy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A method for removing a pacemaker lead attached to heart tissue within a patient'"'"'s body comprising:
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positioning a plurality of electrically isolated electrode terminals adjacent a portion of the pacemaker lead attached to the heart tissue;
applying high frequency voltage to the electrically isolated electrode terminals and at least one return electrode in the presence of electrically conductive fluid such that an electrical current flows from each of the electrode terminals, through the electrically conductive fluid, and to the return electrode, the high frequency voltage being sufficient to detach said portion of the pacemaker lead from the heart tissue; and
independently controlling current flow from at least two of the electrode terminals based on impedance between each of the electrode terminals and the return electrode. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A method for removing a pacemaker lead attached to heart tissue within a patient'"'"'s body comprising:
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positioning an electrode terminal adjacent a portion of the pacemaker lead attached to the heart tissue, wherein the pacemaker lead includes a distal tip embedded within the heart tissue and having one or more tines extending radially outward from the lead;
applying a first high frequency voltage to the electrode terminal to detach said portion of the pacemaker lead from the heart tissue; and
removing the distal tip of the pacemaker lead from the heart tissue by applying a second high frequency voltage to the electrode terminal to remove at least a portion of the tissue surrounding the tip and sever the tines. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42, 43)
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Specification