WO1992011062A1 - Implantable endocardial lead with retractable fixation apparatus - Google Patents
Implantable endocardial lead with retractable fixation apparatus Download PDFInfo
- Publication number
- WO1992011062A1 WO1992011062A1 PCT/US1991/009306 US9109306W WO9211062A1 WO 1992011062 A1 WO1992011062 A1 WO 1992011062A1 US 9109306 W US9109306 W US 9109306W WO 9211062 A1 WO9211062 A1 WO 9211062A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- lead
- electrode
- assembly according
- tube
- distal end
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N1/0573—Anchoring means; Means for fixing the head inside the heart chacterised by means penetrating the heart tissue, e.g. helix needle or hook
Definitions
- the present invention relates generally to cardiac stimulation, and mo particularly to an implantable endocardial lead which stimulates or senses electric activity of the heart and which employs a retractable fixation mechanism which c be repeatedly exposed to or shielded from tissue during the process of securing t lead to cardiac tissue.
- the endocardia! lead is often secured to the heart through th endothelial lining by a sharpened helix affixed to a distal end of the lead.
- th end of the lead contacts the lining of the heart at a desired location, the lead m be secured in place by rotating the lead, thus screwing the helix into the hea tissue.
- a helix system has been relatively effective in securing an endocardial lea once the initial location of the lead has been achieved.
- it is undesirabl to expose the sharpened helix while the lead is being inserted through a bloo vessel into the heart.
- it is difficult to precisely place an endocardial lea on the first attempt.
- various apparatus have been proposed for achieving the desired res
- 3,974,834 to Lawrence M. Kane discloses implantable intervascular lead having an accordion-fold sleeve surrounding a he The sleeve is retractable to expose the helix and re-expandable to cover the h in the event the helix is unscrewed and withdrawn.
- An object of the invention is permit the lead to be inserted into and guided through a body vessel with snagging the body vessel.
- the fixation mea comprises a sharpened helix which can be repeatedly both retracted within electrode at a distal end of the lead and displaced outside the electrode.
- the le defines an lumen from its proximal to its distal end.
- a specialized stylet can inserted into the lumen at the proximal end and passed through the lead to t distal end.
- Located at the distal end of the lead is a piston supporting a sharpen helix.
- the piston can be either free to rotate with respect to the lead, or constrain to slide along the axis of the lead.
- the piston has a central bore for receiving t specialized stylet.
- the stylet comprises a flexible wire having an enlarged distal end or tip.
- elastomeric sliding sleeve preferably of polyamide, fits over the wire.
- the wire can withdrawn slightly, pulling the enlarged tip into the tube, and wedging the tu against the walls of the bore.
- the helix can be expose outside of the lead or retracted into the lead, as desired.
- a further object of our invention is to provide a lead wherein the fixatio means is selectively shielded within an electrode located at the distal end of the lea and wherein the fixation means is selectively exposed and shielded by the action a two-part, removable stylet.
- FIG. 1 is a prospective view of an implantable endocardial lead accordin our invention.
- FIG. 2 is a sectional view of a distal tip of the lead taken along line 2-2 of F 1.
- FIG. 1 shows an endocardial lead, generally designated 10.
- T lead 10 has a suture sleeve 12 which slides along the lead 10 and which can attached at an entrance into a vein of a patient in a conventional manner.
- the 10 also has an electrode 14 located at a distal end 16 of the lead.
- the lead 10 comprises a silicon or polyurethane she 18 which defines a lumen 20 along a longitudinal axis of the lead 10.
- a coil conductor 22 for transmitting electrical impulses betwe the electrode 14 and a proximal end 24 of the lead 10.
- a tri-filar conductor is shown as the coil conductor 22.
- the c conductor 22 wraps around a crimp slug 26 at the distal end 16 of the lead 10.
- the electrode 14 comprises a ring contact 28 and a conductive sleeve 3
- the conductive sleeve 30 fits over the crimp slug 26 and the coil conductor 22 a the three elements just mentioned are secured together by a crimp 32 in t conductive sleeve 30.
- the sheath 18 encloses the conductive sleeve 30 of t electrode 14 to the ring contact 28.
- a fixation means is illustrated by a sharpene helix 34.
- a piston 36 supports the helix 34 in relatively constant alignment along th longitudinal axis of the lead 10.
- the piston 36 comprises a sliding member 38 whic slidably engages the conductive sleeve 30.
- th sliding member 38 forms an cylinder 40 on which the helix 34 is mounted.
- the sliding member 38 has an hexagonal oute edge 39 which engages an hexagonal inner edge 41 of the electrode 14.
- Thi permits the helix 34 to be rotated by rotating the entire lead.
- Th piston further comprises an interior bore 42 for receiving a stylet 44.
- a chamfered edge 46 At the proxim side of the piston 36 we have provided a chamfered edge 46 so that the lanyard 4 can be repeatedly inserted into the piston.
- the stylet 44 passes through the lumen 20 in the lead 10 from the proxim end 24 to the distal end 16 thereof.
- the stylet 4 comprises a flexible wire 56 within a tube 58 of elastomeric material.
- th tube is comprised of a material such as polyamide which is relatively incompressibl and inextensible but flexible.
- the wire 56 has an enlarged distal tip 60.
- the enlarged tip 60 is formed by soldering additional met onto the end of the wire.
- An enlarged tip could also be formed by other means such as flattening the wire.
- the outer diameter of the flattened section should b comparable to the outer diameter of the tube 58 and both should be sized to fi relatively easily into the bore 42 in the piston 36.
- the enlarged tip 60 should tape to the diameter of the wire 56 on at least the proximal side of the tip so that the ti can be forced into the tube with a wedging action whereby the stylet can be mad to grip interior walls 62 of the bore 42.
- the sharpened helix 34 can be repeatedly moved int and out of the electrode 14 until proper placement has been achieved. Then th physician can withdraw the stylet 44.
- the stylet 44 can be replaced in the lead withdrawn therefrom as often as desired. It can also be replaced in the lead af the lead has be implanted for a period of time, should it become necessary reposition the lead and if it is desired to retract the sharpened helix within the le
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP92503170A JPH05505756A (en) | 1990-12-21 | 1991-12-06 | Implantable intracardiac lead with retractable fixation device |
EP92903179A EP0516820B1 (en) | 1990-12-21 | 1991-12-06 | Implantable endocardial lead with retractable fixation apparatus |
DE69116866T DE69116866T2 (en) | 1990-12-21 | 1991-12-06 | IMPLANTABLE ENDOCARDIAL LINE WITH A RETRACTABLE CONNECTING DEVICE |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US635,760 | 1990-12-21 | ||
US07/635,760 US5129404A (en) | 1990-12-21 | 1990-12-21 | Implantable endocardial lead with retractable fixation apparatus |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1992011062A1 true WO1992011062A1 (en) | 1992-07-09 |
Family
ID=24549014
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1991/009306 WO1992011062A1 (en) | 1990-12-21 | 1991-12-06 | Implantable endocardial lead with retractable fixation apparatus |
Country Status (7)
Country | Link |
---|---|
US (1) | US5129404A (en) |
EP (1) | EP0516820B1 (en) |
JP (1) | JPH05505756A (en) |
CA (1) | CA2075966C (en) |
DE (1) | DE69116866T2 (en) |
ES (1) | ES2083155T3 (en) |
WO (1) | WO1992011062A1 (en) |
Families Citing this family (76)
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US5228455A (en) * | 1991-05-20 | 1993-07-20 | Siemens Pacesetter, Inc. | Implant tool for extendable/retractable positive fixation lead |
US5291896A (en) * | 1991-08-21 | 1994-03-08 | Baxter International Inc. | Cardiac output probe assembly |
US5496362A (en) * | 1992-11-24 | 1996-03-05 | Cardiac Pacemakers, Inc. | Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation |
US5300108A (en) * | 1993-01-05 | 1994-04-05 | Telectronics Pacing Systems, Inc. | Active fixation lead with a dual-pitch, free spinning compound screw |
US5593433A (en) * | 1994-12-19 | 1997-01-14 | Intermedics, Inc. | Implantable endocardial lead with self-healing retractable fixation apparatus |
US5571161A (en) * | 1995-04-12 | 1996-11-05 | Starksen; Niel F. | Apparatus and method for implanting electrical leads in the heart |
US5716391A (en) * | 1995-08-23 | 1998-02-10 | Medtronic, Inc. | Medical electrical lead having temporarily rigid fixation |
DE29603805U1 (en) * | 1996-03-01 | 1997-07-03 | Michel Ulrich Dipl Ing | Device for transvenous cardioversion of atrial fibrillation or atrial flutter |
US5843153A (en) * | 1997-07-15 | 1998-12-01 | Sulzer Intermedics Inc. | Steerable endocardial lead using magnetostrictive material and a magnetic field |
US6324415B1 (en) | 1997-07-30 | 2001-11-27 | Intermedics Inc. | Cardiac lead with minimized inside diameter of sleeve |
US5876431A (en) * | 1997-07-30 | 1999-03-02 | Sulzer Intermedics Inc. | Small cable endocardial lead with exposed guide tube |
US5851227A (en) * | 1997-07-30 | 1998-12-22 | Sulzer Intermedics Inc. | Cardiac pacemaker cable lead |
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US6097986A (en) * | 1997-12-17 | 2000-08-01 | Cardiac Pacemakers, Inc. | Retractable lead with mesh screen |
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US6047217A (en) * | 1998-01-15 | 2000-04-04 | Intermedics Inc. | Cardiac lead with improved polymer-to-metal joint |
US5908447A (en) * | 1998-02-06 | 1999-06-01 | Intermedics Inc. | Breakaway structure for body implantable medical device |
US6148237A (en) | 1998-03-06 | 2000-11-14 | Intermedics Inc. | Cardiac pacemaker lead with swaged distal electrode |
US6167314A (en) * | 1998-04-14 | 2000-12-26 | Intermedics Inc. | Cardiac pacemaker lead with pacemaker connector |
US6108582A (en) * | 1998-07-02 | 2000-08-22 | Intermedics Inc. | Cardiac pacemaker lead with extendable/retractable fixation |
US6463334B1 (en) | 1998-11-02 | 2002-10-08 | Cardiac Pacemakers, Inc. | Extendable and retractable lead |
US6501990B1 (en) | 1999-12-23 | 2002-12-31 | Cardiac Pacemakers, Inc. | Extendable and retractable lead having a snap-fit terminal connector |
US6129751A (en) * | 1998-07-28 | 2000-10-10 | Intermedics Inc. | Cardiac lead with active fixation and biocompatible lubricant |
US6002969A (en) * | 1998-08-05 | 1999-12-14 | Intermedics Inc. | Cardiac lead with shape-memory structure |
US6083216A (en) * | 1999-01-05 | 2000-07-04 | Intermedics Inc. | Bent cardiac lead with shape memory torque coil |
US7013182B1 (en) * | 2000-05-04 | 2006-03-14 | Cardiac Pacemakers, Inc. | Conductive polymer sheath on defibrillator shocking coils |
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US6512959B1 (en) | 2000-11-28 | 2003-01-28 | Pacesetter, Inc. | Double threaded stylet for extraction of leads with a threaded electrode |
US6611710B2 (en) | 2000-11-29 | 2003-08-26 | Pacesetter, Inc. | Double threaded stylet for extraction of leads with a threaded electrode |
US6763270B1 (en) | 2001-08-07 | 2004-07-13 | Pacesetter, Inc. | Lead extraction mechanism for active fixation leads |
US6842649B2 (en) | 2001-12-14 | 2005-01-11 | Cardiac Pacemakers, Inc. | Snap-spin lead assembly and method therefor |
FR2835189B1 (en) | 2002-01-25 | 2004-03-19 | Ela Medical Sa | NECESSARY TO SET UP AN INTRACARDIAC STIMULATION OR DEFIBRILLATION PROBE OF THE RETRACTABLE SCREW TYPE |
US6970748B2 (en) | 2002-04-04 | 2005-11-29 | Cardiac Pacemakers, Inc. | Method of using finishing wire with large ball-nose tip |
US7509172B2 (en) * | 2003-04-23 | 2009-03-24 | Cardiac Pacemakers, Inc. | Stabilizing guide wire apparatus for use with implantable device |
US20040260371A1 (en) * | 2003-06-19 | 2004-12-23 | John Greenland | Stabilizing apparatus for use with implantable leads |
US7245973B2 (en) | 2003-12-23 | 2007-07-17 | Cardiac Pacemakers, Inc. | His bundle mapping, pacing, and injection lead |
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US8005544B2 (en) | 2004-12-20 | 2011-08-23 | Cardiac Pacemakers, Inc. | Endocardial pacing devices and methods useful for resynchronization and defibrillation |
US8010192B2 (en) | 2004-12-20 | 2011-08-30 | Cardiac Pacemakers, Inc. | Endocardial pacing relating to conduction abnormalities |
US8423139B2 (en) | 2004-12-20 | 2013-04-16 | Cardiac Pacemakers, Inc. | Methods, devices and systems for cardiac rhythm management using an electrode arrangement |
US8326423B2 (en) | 2004-12-20 | 2012-12-04 | Cardiac Pacemakers, Inc. | Devices and methods for steering electrical stimulation in cardiac rhythm management |
US8010191B2 (en) | 2004-12-20 | 2011-08-30 | Cardiac Pacemakers, Inc. | Systems, devices and methods for monitoring efficiency of pacing |
US8290586B2 (en) | 2004-12-20 | 2012-10-16 | Cardiac Pacemakers, Inc. | Methods, devices and systems for single-chamber pacing using a dual-chamber pacing device |
AR047851A1 (en) | 2004-12-20 | 2006-03-01 | Giniger Alberto German | A NEW MARCAPASOS THAT RESTORES OR PRESERVES THE PHYSIOLOGICAL ELECTRIC DRIVING OF THE HEART AND A METHOD OF APPLICATION |
US7983764B2 (en) * | 2005-08-12 | 2011-07-19 | Cardiac Pacemakers, Inc. | Co-radial lead with extendable/retractable fixation mechanism and apparatus therefor |
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US7881808B2 (en) * | 2006-03-29 | 2011-02-01 | Cardiac Pacemakers, Inc. | Conductive polymeric coating with optional biobeneficial topcoat for a medical lead |
US8204569B2 (en) * | 2006-04-27 | 2012-06-19 | Medtronic, Inc. | Implantable medical electrical stimulation lead fixation method and apparatus |
US8145323B2 (en) * | 2006-04-27 | 2012-03-27 | Medtronic, Inc. | Implantable medical electrical stimulation lead fixation method and apparatus |
US8135476B2 (en) | 2006-04-27 | 2012-03-13 | Medtronic, Inc. | Implantable medical electrical stimulation lead fixation method and apparatus |
US8200343B2 (en) * | 2006-04-27 | 2012-06-12 | Medtronic, Inc. | Implantable medical electrical stimulation lead fixation method and apparatus |
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US20080065029A1 (en) * | 2006-09-11 | 2008-03-13 | Racz N S | Nerve block needle and related methods |
US7657326B2 (en) * | 2006-11-08 | 2010-02-02 | Cardiac Pacemakers, Inc. | Cardiac lead with a retractable helix |
US8690832B2 (en) | 2007-06-13 | 2014-04-08 | Custom Medical Applications | Retrofitted neural injection system and related methods |
US20090259283A1 (en) * | 2008-04-09 | 2009-10-15 | Brandt Michael S | Sheathed lead for pacing or defibrillation |
US8108052B2 (en) | 2008-05-29 | 2012-01-31 | Nervo Corporation | Percutaneous leads with laterally displaceable portions, and associated systems and methods |
JP2012512727A (en) | 2008-12-19 | 2012-06-07 | カーディアック ペースメイカーズ, インコーポレイテッド | Apparatus, method and system including cardiac pacing |
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US9308022B2 (en) | 2012-12-10 | 2016-04-12 | Nevro Corporation | Lead insertion devices and associated systems and methods |
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US10980999B2 (en) | 2017-03-09 | 2021-04-20 | Nevro Corp. | Paddle leads and delivery tools, and associated systems and methods |
US10835638B2 (en) | 2017-08-17 | 2020-11-17 | Cardiac Pacemakers, Inc. | Photocrosslinked polymers for enhanced durability |
WO2019143629A1 (en) | 2018-01-17 | 2019-07-25 | Cardiac Pacemakers, Inc. | End-capped polyisobutylene polyurethane |
EP3758793A4 (en) | 2018-03-29 | 2021-12-08 | Nevro Corp. | Leads having sidewall openings, and associated systems and methods |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0013605A1 (en) * | 1979-01-05 | 1980-07-23 | Medtronic, Inc. | Stylet insertion assembly for body implantable lead |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4217913A (en) * | 1977-10-10 | 1980-08-19 | Medtronic, Inc. | Body-implantable lead with protected, extendable tissue securing means |
US5003992A (en) * | 1989-08-23 | 1991-04-02 | Holleman Timothy W | Atraumatic screw-in lead |
-
1990
- 1990-12-21 US US07/635,760 patent/US5129404A/en not_active Expired - Lifetime
-
1991
- 1991-12-06 ES ES92903179T patent/ES2083155T3/en not_active Expired - Lifetime
- 1991-12-06 DE DE69116866T patent/DE69116866T2/en not_active Expired - Fee Related
- 1991-12-06 CA CA002075966A patent/CA2075966C/en not_active Expired - Fee Related
- 1991-12-06 WO PCT/US1991/009306 patent/WO1992011062A1/en active IP Right Grant
- 1991-12-06 JP JP92503170A patent/JPH05505756A/en active Pending
- 1991-12-06 EP EP92903179A patent/EP0516820B1/en not_active Expired - Lifetime
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0013605A1 (en) * | 1979-01-05 | 1980-07-23 | Medtronic, Inc. | Stylet insertion assembly for body implantable lead |
Also Published As
Publication number | Publication date |
---|---|
DE69116866T2 (en) | 1996-09-05 |
CA2075966C (en) | 1997-01-07 |
US5129404A (en) | 1992-07-14 |
DE69116866D1 (en) | 1996-03-14 |
CA2075966A1 (en) | 1992-06-22 |
EP0516820A1 (en) | 1992-12-09 |
JPH05505756A (en) | 1993-08-26 |
ES2083155T3 (en) | 1996-04-01 |
EP0516820B1 (en) | 1996-01-31 |
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