Single-pass atrial ventricular lead with multiple atrial ring electrodes and a selective atrial electrode adaptor for the coronary sinus region

• US 6,295,475 B1
• Filed: 10/27/1999
• Issued: 09/25/2001
• Est. Priority Date: 10/27/1999
• Status: Expired due to Fees

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Morgan, Kevin L.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US09/428,622
• Time in Patent Office: 699 Days
• Field of Search: 607/38, 607/119, 607/122, 607/123, 607/124, 607/148
• US Class Current: 607/122
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

An implantable cardiac device having a control unit and a single-pass lead adapted to be implanted within the coronary sinus region so as to provide therapeutic electrical stimulation, such as stimulation pulses, to the left atrium and the left ventricle. The single-pass lead includes a ventricular electrode and a plurality of atrial electrodes spaced along the lead. One of the atrial electrodes can be selected as the atrial pacing electrode by manipulating a connector that interconnects the single-pass lead to the control unit. In one embodiment, a pacing electrode/sensing electrode combination can be selected by manipulating a connector that interconnects the single-pass lead to the control unit.

Claims

1. An implantable lead adapted for use with an implantable cardiac device having pulse generating means for generating stimulation pulses to the left atrium of a patient'"'"'s heart, the implantable lead comprising:

proximal coupling means, having at least one terminal, for connecting at least one electrode to the pulse generating means;

a lead body having a plurality of electrodes positioned along the lead body such that at least one of the electrodes can deliver stimulation pulses to the left atrium of the patient'"'"'s heart, each of the plurality of electrodes being connected to a respective conductor; and

selection means, located between the lead body and the proximal coupling means, for selectively connecting at least one of the plurality of electrodes on the lead body to the at least one terminal on the proximal coupling means.

2. The lead of claim 1, wherein the lead body further comprises:

at least one ventricular electrode, located at a distal end of the lead body, suitable for delivering stimulation pulses to the left ventricle of the patient'"'"'s heart; and

means for electrically interconnecting the at least one ventricular electrode with the pulse generating means.

3. The lead of claim 2, wherein the lead body comprises:

a single-pass lead body adapted to be implanted within the coronary sinus;

wherein the plurality of electrodes are spaced over a portion of the length of the single-pass lead body so as to be distributed through the coronary sinus region; and

wherein the at least one ventricular electrode is positioned at a distal end of the lead body suitable for stimulating the left heart when the single-pass lead body is implanted within the patient'"'"'s coronary sinus region.

4. The lead of claim 1, wherein the lead body comprises:

a plurality of lumens extending the length of the lead body; and

a conductor contained within each of the plurality of lumens, each conductor being electrically connected to a respective electrode.

5. The lead of claim 1, wherein the selection means comprises:

a proximal connector having a first electrical contact coupled to the at least one terminal by a conductor; and

a distal connector having a plurality of electrical contacts coupled to the plurality of electrodes by a respective conductor, and adapted for selective engagement with the proximal connector such that a plurality of combinations of electrode configurations may be selected by rotating the proximal connector before engaging the distal connector.

6. The lead of claim 5, wherein:

the proximal connector comprises a first geometric shape having a plurality of faces, wherein a first electrical contact is positioned on a first face of the plurality of faces on the proximal connector; and

the distal connector has a plurality of faces corresponding to the plurality of faces on the proximal connector, the distal connector having an electrical contact respectively connected to each of the plurality of electrodes such that a different pair of the electrodes may be selected.

7. The lead of claim 6, wherein:

the distal and proximal connectors are configured so as to further define a front face on each of the connectors; and

the front faces on each of the connectors are always positioned in contact with each other in each of the plurality of combinations of electrode configurations.

8. The lead of claim 7, wherein at least one of the plurality of electrodes comprises a return electrode for the delivery of stimulation pulses to the left atrium.

9. The lead of claim 8, wherein the proximal coupling means further comprises a second terminal for electrically connecting the return electrode to the pulse generating means.

10. The lead of claim 9, wherein:

the proximal connector comprises a first electrical contact positioned on a front face of the proximal connector; and

the distal connector comprises a second electrical contact positioned on a front face of the distal connector so that the first electrical contact on the front face of the proximal connector mates with the first electrical contact positioned on the front face of the distal connector.

11. The lead of claim 9, wherein:

the proximal connector comprises a first electrical contact positioned on a front face of the proximal connector; and

the distal connector comprises a plurality of electrical contacts positioned on a front face of the distal connector so that the first electrical contact mates with a selected one of the plurality of electrical contacts on the front face of the distal connector.

12. The lead of claim 1, wherein the lead body is configurable so that one of the plurality of electrodes can be selected as an atrial pacing electrode to deliver the stimulation pulses to the left atrium.

13. An implantable lead for use with an implantable cardiac device having a pulse generator that is configured to deliver therapeutic electrical stimulation to a patient'"'"'s heart, the lead comprising:

a first lead body adapted at a proximal end for connecting an atrial pacing electrode to the pulse generator;

a second lead body having a plurality of electrodes located along the second lead body in locations wherein at least one of the plurality of electrodes is positioned within the coronary sinus region; and

a connector, located between the first and second lead bodies, which is configurable so that at least one of the plurality of electrodes can be selected as the atrial pacing electrode to deliver the stimulation pulses to the left atrium.

14. The lead of claim 13, wherein the connector can be selectively connected in a plurality of configurations corresponding to the plurality of electrodes.

15. The lead of claim 14, wherein the connector comprises:

a proximal connector, electrically connected to the pulse generator, having a first shape with a plurality of faces associated therewith, wherein a pacing contact is positioned on a first face of the plurality of faces; and

a distal connector, configured to engage with the proximal connector, having the first shape with a plurality of mating faces, wherein each of the plurality of mating faces includes an electrode contact that is respectively connected to one of the plurality of electrodes; and

wherein the proximal connector can be coupled to the distal connector in a first of a plurality of electrode configurations which electrically connects the pacing contact of the proximal connector to a different one of the plurality of electrode contacts of the distal connector.

16. The lead of claim 14, wherein:

the first lead body is further adapted for connecting a atrial return electrode to the pulse generator;

at least one of the plurality of electrodes attached to the lead body is configured so as to provide a return electrode.

17. The lead of claim 16, wherein:

the return electrode is coupled to an electrode contact located in the center of a front face of the distal connector; and

the return electrode contact on the distal connector mates to a corresponding return electrode contact located in the center of the front face of the proximal connector;

wherein the return electrode is a dedicated return electrode independent of the selected atrial pacing electrode.

18. The lead of claim 14, wherein:

the proximal connector comprises a shaped-post having a plurality of side walls and a front face; and

the distal connector comprises a recess that is adapted to receive the first shaped-post, the distal connector having side walls and a front face corresponding to the shaped-post.

19. The lead of claim 14, wherein:

the proximal connector comprises a rectangular post having four side walls and a front face; and

the distal connector comprises a rectangular recess having four side walls and a front face.

20. The lead of claim 14, wherein:

the proximal connector comprises a polygonal post having at least five side walls and a front face; and

the distal connector comprises a polygonal recess having at least five side walls and a front face.

21. The lead of claim 13, wherein the second lead body comprises a single-pass lead body having a plurality of lumens extending the length of the single-pass lead body, each lumen having a respective conductor contained that can be used to electrically interconnect a respective electrode to the connector.

22. The lead of claim 21, further comprising:

a ventricular pacing electrode attached to the single-pass lead body at a distal end so that the ventricular pacing electrode can be positioned within the coronary sinus region so as to deliver stimulation pulses to the left ventricle of the patient'"'"'s heart; and

wherein the single-pass lead body is further adapted at a proximal end to connect the ventricle pacing electrode to the pulse generator.