Leads for pacing and/or sensing the heart from within the coronary veins

• US 6,584,362 B1
• Filed: 08/30/2000
• Issued: 06/24/2003
• Est. Priority Date: 08/30/2000
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Tockman, Bruce, Westlund, Randy, Scheiner, Avram, Warren, Jay A., Heil, Ronald W. Jr., Kelley, Peter T.
• Primary Examiner(s): Schaetzle, Kennedy
• Assistant Examiner(s): DROESCH, KRISTEN L
• Application Number:
  US09/651,340
• Time in Patent Office: 1,028 Days
• Field of Search: 603/72--75, 603/77, 603/81, 603/93, 607/115, 607/116, 607/119, 607/122-123, 607/126, 607/125
• US Class Current: 607/122
• 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
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A lead for monitoring or stimulating cardiac activity is provided. The lead is adapted for implantation on or about the heart within the coronary vasculature and for connection to a signal generator. The lead body has one or more electrodes associated therewith. The lead is constructed and arranged so that when it is implanted, the electrodes are housed in the coronary vasculature and urged into intimate contact a vessel wall. A method for implanting the lead into the coronary vasculature is also provided, the method comprising the steps of inserting a stylet into the lead, inserting the lead into the coronary sinus, advancing the lead from the coronary sinus toward the toward the left atrium and into a coronary vein, removing the stylet, and sensing and pacing the heart. Alternatively, the method comprises placing a guide catheter into the coronary sinus, threading a guide wire into the coronary veins, pushing the lead over the guide wire and into the coronary sinus or the coronary vein, and sensing and pacing the heart via the lead in its implanted site in the coronary sinus or the coronary vein.

Claims

1. A lead comprising:

a lead body adapted to carry signals to and from a heart, the lead body having a proximal portion and a distal portion;

a connector located at a proximal end of the lead, the lead adapted for connection to a signal generator, the lead constructed and arranged for implantation within a coronary vein, the distal portion of the lead body having a helical portion adapted to be implanted within the coronary vein; and

at least one electrode coupled with the helical portion of the lead body; and

a plurality of electrodes are disposed on the helical portion, and the plurality of electrodes are spaced about 120 degrees apart along the helical portion.

2. A lead comprising:

a lead body adapted to carry signals to and from a heart, the lead body having a proximal portion and a distal portion;

a connector located at a proximal end of the lead, the lead adapted for connection to a signal generator, the lead constructed and arranged for implantation within a coronary vein, the distal portion of the lead body having a helical portion adapted to be implanted within the coronary vein; and

at least one electrode coupled with the helical portion of the lead body; and

apical electrodes, mid ventricular electrodes, and ventricular electrodes on the helical portion.

3. A method for inserting a coronary vein lead into a coronary vein, the method comprising:

providing the coronary vein lead including;

a lead body adapted to carry signals to and from a heart, the lead body having a proximal portion and a distal portion, and an intermediate portion therebetween;

a connector located at a proximal end of the lead, the lead adapted for connection to a signal generator for monitoring or stimulating cardiac activity, the distal portion of the lead body constructed and arranged to hug an interior wall of the coronary vein upon implantation;

the distal portion of the lead body having a tapered outer diameter, and the outer diameter of the distal portion includes a first diameter that is equal to a diameter of the intermediate portion;

a first electrode associated with the distal portion of the lead body, the first electrode including a first electrode contact area; and

a second electrode associated with the distal portion of the lead body, the second electrode including a second electrode contact area, the first and second electrodes upon implantation in a body being housed in the coronary vein;

inserting the coronary vein lead into a coronary sinus;

sensing and pacing the heart via the coronary vein lead in its implanted site in the coronary vein; and

providing the distal portion of the lead with a helical configuration, and urging the first and second electrodes toward the wall of the coronary vein.

4. The method as recited in claim 3, further comprising advancing the lead from the coronary sinus toward a left atrium and into a coronary branch vein.

5. The method as recited in claim 4, wherein sensing and pacing comprises providing pacing and sensing of a left ventricle.

6. The method as recited in claim 3, further comprising rotating the lead while inserting the lead in the coronary sinus.