Methods and apparatus for lead placement on a surface of the heart
First Claim
1. An apparatus adapted for placing a lead at a target site on an epicardial surface of a heart using a minimally-invasive delivery procedure, the epicardial surface of the heart having a generally convex shape and being surrounded by a pericardial sac, an inner surface of the pericardial sac generally conforming to the epicardial surface and defining a generally concave shape, the apparatus comprising:
- an elongated body including a longitudinal axis, a proximal end portion and a distal end portion and defining a lead receiving passageway extending between a proximal inlet and a distal lead outlet for receiving a lead therethrough for contact with the epicardial surface of the heart, the elongated body being sufficiently flexible along the longitudinal axis to conform to the epicardial surface and sufficiently stiff to allow movement of the distal end in at least one plane upon application of a force to the proximal end of the lead body, the elongated body having a length sufficient to enable access to the target site using a sub-xyphoid approach,wherein the distal end portion includes an upper surface and a lower surface opposed to the upper surface and configured to contact and generally conform to the epicardial surface, the distal lead outlet being located on the lower surface, the distal end portion having a cross-section with a width and a thickness, the width being greater than the thickness, the width and thickness tapering distally along the distal end portion such that the distal end portion has a tapered leading end,wherein the tapered leading end is adapted to facilitate advancement of the distal end portion through a pericardial space located between the convex epicardial surface and the concave pericardial inner surface, andwherein the distal end portion further defines a guidewire outlet, the guidewire outlet being smaller than the distal lead outlet, the guidewire outlet providing a pathway from the distal lead outlet to a distal end of the elongated body and being adapted to track the distal end portion on a guidewire along a pathway between the epicardial and pericardial surfaces to the target site.
6 Assignments
0 Petitions
Accused Products
Abstract
The methods and apparatus for lead placement on a surface of the heart are employed using an elongated body having proximal and distal end portions. The body defines a lead receiving passageway extending between a proximal inlet and a distal outlet for receiving a lead therethrough for contact with the heart surface. The elongated body is adapted for insertion between a pericardium and an epicardial surface. At least a portion of the body may have a non-circular cross-sectional shape adapted to retain the body orientation between the pericardium and the epicardial surface.
319 Citations
25 Claims
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1. An apparatus adapted for placing a lead at a target site on an epicardial surface of a heart using a minimally-invasive delivery procedure, the epicardial surface of the heart having a generally convex shape and being surrounded by a pericardial sac, an inner surface of the pericardial sac generally conforming to the epicardial surface and defining a generally concave shape, the apparatus comprising:
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an elongated body including a longitudinal axis, a proximal end portion and a distal end portion and defining a lead receiving passageway extending between a proximal inlet and a distal lead outlet for receiving a lead therethrough for contact with the epicardial surface of the heart, the elongated body being sufficiently flexible along the longitudinal axis to conform to the epicardial surface and sufficiently stiff to allow movement of the distal end in at least one plane upon application of a force to the proximal end of the lead body, the elongated body having a length sufficient to enable access to the target site using a sub-xyphoid approach, wherein the distal end portion includes an upper surface and a lower surface opposed to the upper surface and configured to contact and generally conform to the epicardial surface, the distal lead outlet being located on the lower surface, the distal end portion having a cross-section with a width and a thickness, the width being greater than the thickness, the width and thickness tapering distally along the distal end portion such that the distal end portion has a tapered leading end, wherein the tapered leading end is adapted to facilitate advancement of the distal end portion through a pericardial space located between the convex epicardial surface and the concave pericardial inner surface, and wherein the distal end portion further defines a guidewire outlet, the guidewire outlet being smaller than the distal lead outlet, the guidewire outlet providing a pathway from the distal lead outlet to a distal end of the elongated body and being adapted to track the distal end portion on a guidewire along a pathway between the epicardial and pericardial surfaces to the target site. - 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. An apparatus adapted for placing a lead at a target site on an epicardial surface of a heart using a minimally-invasive delivery procedure, the epicardial surface of the heart having a generally convex shape and being surrounded by a pericardial sac, an inner surface of the pericardial sac generally conforming to the epicardial surface and defining a generally concave shape, the apparatus comprising:
- an elongated body including a longitudinal axis, a proximal end portion and a distal end portion and defining a passageway which includes at least one inlet adapted to receive an elongated guide wire and a lead, the distal end portion having a cross-section with a width and a thickness, the width being greater than the thickness, the width and thickness tapering distally along the distal end portion such that the distal end portion has a tapered leading end, the tapered leading end being adapted to facilitate advancement of the distal end portion through a pericardial space located between the convex epicardial surface and the concave pericardial inner surface, the passageway having a lead outlet and a guide wire outlet which is distally located on the elongated body in relation to the lead outlet and non-concentric with the lead outlet, the lead outlet being sufficiently sized to allow passage of the lead for contact with the surface of the heart, the guide wire outlet being sufficiently sized and oriented to allow passage of the guide wire forward of the distal end portion of the elongated body, the guide wire outlet being smaller than the lead outlet to avoid extension of the lead beyond of the distal end portion of the elongated body, wherein the distal end portion includes an upper surface and a lower surface opposed to the upper surface and configured to contact and generally conform to the epicardial surface, and the lead and guide wire outlets are located on the lower surface.
- View Dependent Claims (20, 21, 22, 23, 24, 25)
Specification