Probe implantable in the coronary venus system for stimulating the left heart

• US 6,385,492 B1
• Filed: 10/12/1999
• Issued: 05/07/2002
• Est. Priority Date: 10/13/1998
• Status: Expired due to Term

• Current Assignee: Sorin CRM USA (MicroPort Scientific Corp.)
• Original Assignee: Ela Medical S.A. (LivaNova Plc)
• Inventors: DʼHiver, Philippe, Ollivier, Jean François, Ritter, Philippe, Bessoule, Frédéric
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/416,140
• Time in Patent Office: 938 Days
• Field of Search: 607/122, 607/125, 607/123
• 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

A probe for the stimulation of the left heart which is implantable in the coronary venus system. The probe is particularly useful for an active implantable medical device, in particular, pacemakers of the “multisite” type. The probe has a body, including a hollow sheath which elastically deformable and primarily deprived of any rigid element. The probe body has a distal extremity (34) which supports at least one stimulation electrode (54), and a stylet which is removable, and is able to be introduced inside the probe body and moveable in translation and rotation inside the probe body. The stylet is relatively rigid compared to the sheath and plastically deformable locally. The distal extremity (34) of the probe has, in the absence of stress, two curves, comprised in two distinct surfaces. The first surface (62) corresponds to an orientation curve laid down by a preform of the probe body. The second surface (64) corresponds to a support curve defined by a naturally bent form of the probe distal extremity (34). The probe distal extremity (34) is an auto-orienting extremity. The electrode is a sectoral electrode, having an active surface part (54) extending, in a radial plane, only on one sector of the probe body. This active surface is preferably turned in a direction that is appreciably perpendicular to the plane formed by the bent part (64) of the probe body distal extremity.

Claims

1. A system for the stimulation of the myocardium in the coronary venous system, for an active implantable medical device, comprising:

a probe body, including a hollow sheath, the hollow sheath being elastically deformable, the probe body having a distal extremity having thereon at least one stimulation electrode and having a naturally bent form; and

a removable stylet, adapted to be introduced and movable inside the hollow sheath of the probe body, said stylet being more rigid than the hollow sheath and plastically deformable at any point along its length;

wherein the probe distal extremity in the absence of stress comprises a first curve comprised in a first surface and a second curve comprised in a second surface distinct from the first surface, the first surface corresponding to a support curve in a first plane defined by the naturally bent form of the probe distal extremity, characterized in that the probe distal extremity is an auto-orienting extremity, and wherein the at least one stimulation electrode further comprises a sectoral electrode having an active surface extending in a radial plane on only one sector of the probe body, said radial plane being perpendicular to said first plane, said first curve and said second curve cooperating to position said sectoral electrode against the myocardium when said probe body distal end is in said coronary venous system.

2. The system of claim 1, wherein the active sectoral electrode surface projects a distance above the probe body distal extremity.

3. The system of claim 1, wherein the stylet has a distal extremity and said distal extremity comprises a tapered section having a distal end and a ball at said tapered section distal end.

4. The system of claim 1, wherein the stylet comprises a core and a reinforcement tube (68), the core having a distal part and a proximal part and said reinforcement tube disposed over at least a portion of said core proximal part to form a sheathed core section, wherein the sheathed core section has a rigidity greater than the core distal part, and wherein the core distal part has a flexibility that is greater than the sheathed core section.

5. A system according to claim 1, in which the probe body distal extremity comprises a passageway for axial penetration, said passageway having a sealed condition in the absence of an external or interior stress, and an opened condition allowing the passage therethrough and the progression beyond the probe body distal extremity of an angioplasty stylet.

6. The system of claim 1, in which the probe body distal extremity comprises an elastic system to provide support against a vein, said elastic system being positioned opposite to the electrode active surface.

7. The system of claim 6 wherein the natural bent form of said distal extremity further comprises a curvature in a first plane and the elastic system further comprises a counter-elbow distal of said curvature and extending in a second plane perpendicular to the first plane.

8. The system of claim 7 wherein the counter-elbow is positioned distally of said curvature.

9. The system of claim 7 wherein the curvature further comprises an elbow.

10. The system of claim 6, wherein the elastic system further comprises at least one elastically deformable body projecting from said probe body distal extremity and adapted to be interposed between an interior surface of an external wall of a vein and a myocardium surface.

11. The system of claim 1 wherein the bent form of said probe body distal extremity further comprises a first portion and a second portion connected by a curvature in a first plane.

12. The system of claim 11 wherein the curvature further comprises a radius of between 10 and 20 mm said first and second portions are oriented at 90°

.

13. A system for the stimulation in the coronary venous system, for an active implantable medical device, comprising:

a probe body, including a hollow sheath, the hollow sheath being elastically deformable, the probe body having a distal extremity having thereon at least one stimulation electrode and having a naturally bent form; and

a removable stylet, adapted to be introduced and movable inside the hollow sheath of the probe body, said stylet being more rigid than the hollow sheath and plastically deformable at any point along its length, wherein the stylet has a distal extremity and said distal extremity comprises a tapered section having a distal end and a ball at said tapered section distal end;

wherein the probe distal extremity in the absence of stress comprises two curves comprised in a first surface and a second surface distinct from the first surface, the first surface corresponding to a support curve defined by the naturally bent form of the probe distal extremity, characterised in that the probe distal extremity is an auto-orienting extremity, and wherein the at least one stimulation electrode firther comprises a sectoral electrode having an active surface extending in a radial plane on only one sector of the probe body.

14. The system of the claim 13, wherein the probe body distal extremity further comprises an elbow, the elbow defining a plane, wherein the sectoral electrode active surface is oriented in a direction appreciably perpendicular to said plane.

15. The system of claim 13, wherein the active sectoral electrode surface projects a distance above the probe body distal extremity.

16. A system for the stimulation in the coronary venous system, for an active implantable medical device, comprising:

a probe body, including a hollow sheath, the hollow sheath being elastically deformable, the probe body having a distal extremity having thereon at least one stimulation electrode and having a naturally bent form; and

a removable stylet, adapted to be introduced and movable inside the hollow sheath of the probe body, said stylet being more rigid than the hollow sheath and plastically deformable at any point along its length;

wherein the probe distal extremity in the absence of stress comprises two curves comprised in a first surface and a second surface distinct from the first surface, the first surface corresponding to a support curve defined by the naturally bent form of the probe distal extremity, characterised in that the probe distal extremity is an auto-orienting extremity, and wherein the at least one stimulation electrode further comprises a sectoral electrode having an active surface extending in a radial plane on only one sector of the probe body; and

wherein the stylet comprises a core and a reinforcement tube, the core having a distal part and a proximal part and said reinforcement tube disposed over at least a portion of said core proximal part to form a sheathed core section, wherein the sheathed core section has a rigidity greater than the core distal part, and wherein the core distal part has a flexibility that is greater than the sheathed core section.

17. A system for the stimulation in the coronary venous system, for an active implantable medical device, comprising:

a probe body, including a hollow sheath, the hollow sheath being elastically deformable, the probe body having a distal extremity having thereon at least one stimulation electrode and having a naturally bent form; and

a removable stylet, adapted to be introduced and movable inside the hollow sheath of the probe body, said stylet being more rigid than the hollow sheath and plastically deformable at any point along its length;

wherein the probe distal extremity in the absence of stress comprises two curves comprised in a first surface and a second surface distinct from the first surface, the first surface corresponding to a support curve defined by the naturally bent form of the probe distal extremity, characterised in that the probe distal extremity is an auto-orienting extremity, and wherein the at least one stimulation electrode further comprises a sectoral electrode having an active surface extending in a radial plane on only one sector of the probe body, wherein the probe body distal extremity comprises a passageway for axial penetration, said passageway having a sealed condition in the absence of an external or interior stress, and an opened condition allowing the passage therethrough and the progression beyond the probe body distal extremity of an angioplasty stylet.

18. A system for the stimulation in the coronary venous system, for an active implantable medical device, comprising:

a probe body, including a hollow sheath, the hollow sheath being elastically deformable, the probe body having a distal extremity having thereon at least one stimulation electrode and having a naturally bent form; and

a removable stylet, adapted to be introduced and movable inside the hollow sheath of the probe body, said stylet being more rigid than the hollow sheath and plastically deformable at any point along its length;

wherein the probe distal extremity in the absence of stress comprises two curves comprised in a first surface and a second surface distinct from the first surface, the first surface corresponding to a support curve defined by the naturally bent form of the probe distal extremity, characterised in that the probe distal extremity is an auto-orienting extremity, and wherein the at least one stimulation electrode further comprises a sectoral electrode having an active surface extending in a radial plane on only one sector of the probe body, wherein the probe body distal extremity comprises an elastic system to provide support against a vein, said elastic system being positioned opposite to the electrode active surface.

19. The system of claim 18 wherein the natural bent form of said distal extremity further comprises a curvature in a first plane and the elastic system further comprises a counter-elbow distal of said curvature and extending in a second plane perpendicular to the first plane.

21. The system of claim 19 wherein the curvature further comprises an elbow.

22. The system of claim 18, wherein the elastic system further comprises at least one elastically deformable body projecting from said probe body distal extremity and adapted to be interposed between an interior surface of an external wall of a vein and a myocardium surface.

23. The system of claim 18 wherein the bent form of said probe body distal extremity further comprises a first portion and a second portion connected by a curvature in a first plane.

20. The system of claim 20 wherein the counter-elbow is positioned distally of said curvature.