WO2003030988B1 - Lead system for providing electrical stimulation to the bundle of his - Google Patents

Lead system for providing electrical stimulation to the bundle of his

Info

Publication number
WO2003030988B1
WO2003030988B1 PCT/US2002/033662 US0233662W WO03030988B1 WO 2003030988 B1 WO2003030988 B1 WO 2003030988B1 US 0233662 W US0233662 W US 0233662W WO 03030988 B1 WO03030988 B1 WO 03030988B1
Authority
WO
WIPO (PCT)
Prior art keywords
fixation
lead body
bundle
fixation helix
lead
Prior art date
Application number
PCT/US2002/033662
Other languages
French (fr)
Other versions
WO2003030988A3 (en
WO2003030988A2 (en
Inventor
Jason Alinder
David A Casavant
Douglas N Hess
David A Grenz
Mike Freiborg
William J Clemens
Michael A Ruff
Original Assignee
Medtronic Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medtronic Inc filed Critical Medtronic Inc
Publication of WO2003030988A2 publication Critical patent/WO2003030988A2/en
Publication of WO2003030988A3 publication Critical patent/WO2003030988A3/en
Publication of WO2003030988B1 publication Critical patent/WO2003030988B1/en

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

Abstract

Methods and endocardial screw-in leads for enabling provision of electrical stimulation to the heart, particularly the His Bundle in the intraventricular septal wall. An endocardial screw-in lead having a distal end coupled to a retractable fixation helix wherein a distal portion of the fixation helix extends beyond the lead distal end when the fixation helix is fully retracted or partially extended is positioned in proximity to the His Bundle in the septal wall. The lead body is rotated to attach the distal portion of the fixation helix into the septal wall. The fixation helix is rotated with respect to the lead body to fully extend the fixation helix so that a portion of the fixation helix is in proximity to the His Bundle, enabling provision of electrical stimulation to the His Bundle and/or to sense electrical signals of the heart traversing the His Bundle through the fixation helix.

Claims

AMENDED CLAIMS
[received by the International Bureau on 09.06.03 (09.06.03); original claims 1, 8, 14, 15, 17, 18, 20 and 21 amended (5 pages)]
1. A lead for providing electrical stimulation to a His Bundle of a heart, characterized by: a lead body (102) having a distal end (156); a conductor (132) residing within the lead body (102) and having a distal end; a fixation mechanism (110) coupled to the distal end of the conductor (132), the fixation mechanism (110) having a length selected to allow a distal end of the fixation mechanism (110) to be proximal to the Bundle of His (40) when the fixation mechanism ( 10) is affixed to tissue surrounding the Bundle of His.
2. A lead according to claiml, wherein the fixation mechanism comprises a fixation helix.
3. A lead according to claim 2, wherein the fixation helix is substantially between 2.5 and 7 millimeters in length.
4. A lead according to claim 2, wherein the fixation helix is substantially between 3 and 5 millimeters in length.
5. A lead according to claim 3, wherein substantially the entire length of the fixation helix resides within the lead body when the fixation helix is in a fully retracted state.
6. A lead according to claim 3, wherein a distal end of the fixation helix extends beyond the distal end of the lead body when the fixation helix is fully retracted.
7. A lead according to claim 1, and further comprising: a second conductor residing within the lead body; and a ring electrode coupled to the second conductor. 18
8. An electrode system for providing electrical stimulation to a His Bundle of a heart, characterized by: a housing member (156); and a fixation member (110) positioned within the housing member (156), the fixation member (110) being adapted to penetrate tissue of a heart (10) to contact a portion of the His Bundle (40).
9. An electrode system according to claim 8, wherein the fixation member comprises a fixation helix.
10. An electrode system according to claim 9, wherein the fixation helix is i substantially between 2.5 and 7 millimeters in length.
11. An electrode system according to claim 9, wherein the fixation helix is substantially between 3 and 5 millimeters in length.
12. An electrode system according to claim 9, wherein substantially the entire length jof the fixation helix resides within the housing member when the fixation helix jis in a fully retracted state,
13. An electrode system according to claim 9, wherein a distal end of the fixation helix extends beyond the housing member when the fixation helix is fully retracted.
1 . A method for enabling provision of electrical stimulation to a heart and sensing of heart signals via a endocardial screw-in lead having a lead body distal end supporting an extendable and retractable fixation helix operable as a stimulation and sensing electrode, the method characterized by: advancing a catheter containing a lead body (102) into a ventricular heart chamber (18,22); positioning a distal end of the lead body (102) in proximity to the His Bundle (40) in the septal wall of the ventricle (18,22); 19
rotating the lead body (102) to attach a distal portion of an electrically conducting fixation member (110) into the septal wall of the heart (10); and rotating the fixation member (110) with respect to the lead body (102) to extend the fixation member (110) into the septal wall to dispose the fixation helix in proximity to the His Bundle (40) to enable provision of electrical sensing and stimulation through the fixation member (110) to the His Bundle (40).
15. A method according to claim 14, wherein the positioning step further includes iteratively mapping dynamic electrical activity of the septal wall employing the distal fixation helix to ascertain the His Bundle location.
16. A method according to claim 14, further including the step of performing pacing and sensing threshold tests following attachment of the distal portion of the fixation helix.
17. A method for enabling provision of electrical stimulation to a heart via an endocardial screw-in lead having a lead body distal end supporting an extendable and retractable fixation helix operable as a sensing and stimulation electrode, a distal portion of the fixation helix extending distally beyond the lead body distal end when a proximal portion of the fixation helix is fully retracted into a chamber of the lead body, the method comprising: inserting a lead body (102) through a catheter lumen to dispose a distal portion of the fixation member (110) within said lumen; advancing the catheter and lead body (102) into a ventricular heart chamber (18,22); positioning a distal end portion of the lead body (102) in proximity to the His Bundle (40) in the septal wall of the ventricle (18,22); rotating the lead body (102) to attach the distal end portion of the fixation member (110) into the septal wall of the heart; and rotating the fixation member (110) with respect to the lead body (102) to extend an end of the fixation member (110) into the septal wall to dispose the fixation member (110) in proximity to the His Bundle (40) to enable 20
provision of electrical sensing and stimulation through the fixation member (110) to the His Bundle (40).
18. A method according to claim 17, wherein the positioning step further comprises iteratively mapping dynamic electrical activity of the septal wall employing the distal fixation helix to ascertain the His Bundle location.
19. A method according to claim 17, further including the step of performing pacing and sensing threshold tests following attachment of the distal portion of the fixation helix.
20. A method for enabling provision of electrical stimulation to a heart and sensing of heart signals via a endocardial screw-in lead having a lead body distal end supporting an extendable and retractable fixation helix operable as a stimulation;and sensing electrode, the method comprising: advancing a catheter, having a lead body (102) disposed therein, into a ventricular heart chamber (18,22); positioning the a distal end portion of the lead body (102) in proximity to the His Bundle (40) in the septal wail of the ventricle (18,22); rotating a fixation member (110) with respect to the lead body (102) to extend a distal portion of the fixation member (110) from the distal end portion of the lead body (102); rotating the lead body (102) to attach the distal portion of the fixation member (110) into the septal wall of the heart (10); and rotating the fixation member (110) with respect to the lead body (102) to extend a proximal portion of the fixation member (110) into the septal wall to dispose the fixation member (110) in proximity to the His Bundle (40) to enable provision of electrical stimulation and sensing through the fixation member ( 10) to the His Bundle (40).
21. A method according to claim 20, wherein the positioning step further includes the step of iteratively mapping dynamic electrical activity of the septal wall employing the distal fixation helix to ascertain the His Bundle location. 21
22. A method according to claim 20, further including the step of performing pacing and sensing threshold tests following attachment of the distal portion of the fixation helix.
PCT/US2002/033662 2001-10-12 2002-10-07 Lead system for providing electrical stimulation to the bundle of his WO2003030988A2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US32917201P 2001-10-12 2001-10-12
US60/329,172 2001-10-12

Publications (3)

Publication Number Publication Date
WO2003030988A2 WO2003030988A2 (en) 2003-04-17
WO2003030988A3 WO2003030988A3 (en) 2003-05-22
WO2003030988B1 true WO2003030988B1 (en) 2003-08-07

Family

ID=23284184

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2002/033662 WO2003030988A2 (en) 2001-10-12 2002-10-07 Lead system for providing electrical stimulation to the bundle of his

Country Status (2)

Country Link
US (1) US7027876B2 (en)
WO (1) WO2003030988A2 (en)

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Also Published As

Publication number Publication date
WO2003030988A3 (en) 2003-05-22
WO2003030988A2 (en) 2003-04-17
US20030083727A1 (en) 2003-05-01
US7027876B2 (en) 2006-04-11

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