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Publication numberUS3902501 A
Publication typeGrant
Publication dateSep 2, 1975
Filing dateJun 21, 1973
Priority dateJun 21, 1973
Publication numberUS 3902501 A, US 3902501A, US-A-3902501, US3902501 A, US3902501A
InventorsCitron Paul, Dickhudt Eugene A
Original AssigneeMedtronic Inc
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Endocardial electrode
US 3902501 A
Abstract
A medical electrode uniquely adapted for use as an endocardial electrode. An electrical conductor is encased in a material which is generally inert to body fluids and terminates at an exposed electrically conductive tip. A plurality of pliant tines extend from the electrode adjacent the tip and form an acute angle with the electrode body. Provision is made for holding the tines against the electrode body during insertion while allowing their release when the tip is in position. The released tines cooperate with the heart tissue, particularly the trabeculae found in the ventricles and the right atrial appendage, to maintain the electrode tip in position.
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Description  (OCR text may contain errors)

United States Patent [191 Citron et al.

[451 Sept. 2, 1975 ENDOCARDIAL ELECTRODE [75] Inventors: Paul Citron, New Brighton; Eugene A. Dickhudt, St. Paul, both of Minn.

[73] Assignee: Medtronic, Inc., Minneapolis, Minn.

[22] Filed: June 21, 1973 [21] Appl. No.: 372,269

[56] References Cited UNITED STATES PATENTS 2,854,983 10/1958 Baskin 128/349 B 3,348,548 10/1967 Chardack..... 128/419 P 3,397,699 8/1968 Kohl 128/243 3,516,410 6/1970 Hakim 128/350 R 3,568,659 3/1971 Karnegis.... 128/243 3,608,555 9/1971 Greyson 128/348 3,717,151 2/1973 Collett 128/350 R 3,719,190 3/1973 Avery.... 128/418 3,815,608 6/1974 Spinosa et al. 128/349 R 3,835,864 9/1974 Rasor et al 128/418 X OTHER PUBLICATIONS Schaldach, New Pacemaker Electrodes, Trans: Am. Society For Artificial Internal Organs, Vol. 17, 1971,

Wende et al., Neve intrakar dicle Schrittmacherelektrode, Deutsche Medizinisch-e Wochenschrift, Nr. 40, 2, Oct. 1970, pp. 2026-2028.

Pieper, Registration of Phesic Changes of Blood Flowby Means of Catheter Type Flowmeter, Review of Sci. Instr., Vol. 29, No. 11, Nov. 1958, pp. 965-967.

Primary ExaminerRichard A. Gaudet Assistant ExaminerLee S. Cohen Attorney, Agent, or Firm-Lew Schwartz; Wayne A. Sivertson [57] ABSTRACT A medical electrode uniquely adapted for use as an endocardial electrode. An electrical conductor is encased in a material which is generally inert to body fluids and terminates at an exposed electrically conductive tip. A plurality of pliant tines extend from the electrode adjacent the tip and form an acute angle with the electrode body. Provision is made for holding the tines against the electrode body during insertion while allowing their release when the tip is in position. The released tines cooperate with the heart tissue, particularly the trabeculae found in the ventricles and the right atrial appendage, to maintain the electrode tip in position.

17 Claims, 13 Drawing Figures PATENTEU 2975 3.902501 SHEET 1 UP 2 1 ENDOCARDIAL ELECTRODE BACKGROUND OF, THE INVENTION Electrical stimulation of heart action is well-known and has been employed to counter a variety of heart dysfunctions. Dependent upon the particular dysfunction, optimal placement of the electrical Contact point or points may vary. However, optimal electrode placement has often been sacrificed to other considerations such as minimization of the surgical risk and reliability of the electrode securement. To date, the greatest number of electrodes have been ventricular electrodes with the transvenous-endocardial approach coming into the fore in recent years.

The advantages of a reliable electrical contact with the atrium are well-known. Such a contact would allow atrial pacing or atrial synchronized pacing thereby preserving the contribution of the atrial contraction in'the overall cardiac output. Additionally, an atrial contact would be advantageously employed for arrhythmia management and other purposes which may not be accomplished through ventricular electrical stimulation.

.For reasons well-known to those skilled in the art, the

greatest advantages can be obtained through an electrical contact with the right atrium, the right atrial appendage providing a suitable site.

An attempt to accomplish transvenous or endocardial atrial pacing is described in Smyth et. al. Permanent Transvenous Atrial Pacing, An Experimental and Clinical Study, The Annals of Thoracic Surgery, Volume II, No. 4, Apr. 19, 1971, pages 360-70. Here, a J-shaped catheter with a flange near the tip was inserted into the right atrial appendage through a transvenous approach. The catheter was straightened by the insertion of a stylet. When the stylet was with drawn, the catheter assumed itspreformed J shape for placement of the electrode tip in the atrial appendage. There was no attempt to artificially secure the electrode tip in position, the atrial trabeculae and shape of the catheter being relied upon to maintain it in location until the heart tissue itself enveloped and fixed the tip. The metal parts of the catheter may be radiopaque to facilitate placement by viewing through fluoroscopy.

A sensing atrial endocardial electrode is described in Portsmann et. al., P Wave Synchronous Pacing Using Anchored Atrial Electrode Implanted Without Thoractomy", The American Journal of Cardiology, Volume 30, July 1 l, 1972, pages 74-76. A .I-shaped applicator catheter was used to direct the electrode tip into the right atrial appendage. The electrode however, had two fine wire hooks positioned at its tip each ending in a relieving loop. The hooks were held back by the applicator catheter to spring out and anchor the electrode in the trabeculae of the right atrial appendage whenthe electrode tip left the end of the applicator catheter.

In the applicator catheter technique described above, the applicator catheter was radiopaque so that it could be viewed as it was inserted into the right atrial appendage. It is imperative with the double hook tip that the electrode be properly placed before the hooks are released. The placement was checked not only through fluoroscopy but also by extending the tip slightly beyond the end of the applicator catheter to take a threshold measurement. The tip had-to be extended sufficiently to take an accurate measurementwhile still I retaining the hooks within the applicator catheter. Be-

SUMMARY OF THE PRESENT INVENTION The present invention provides an electrode uniquely adapted for use as an atrial endocardial electrode. The electrode may be positioned in the right atrial appendage through the use of a .I-shaped catheter known to the prior art. Alternatively, a J-shaped stylet may be employed which is held in a straightened position by thewalls of the vein used to approach the heart, the stylet assuming its J-shape upon entry into the right atrium. A plurality of pliant non-conductive tines are provided at the tip of the electrode to cooperate with the heart tissue, particularly the trabeculae found in the right atrial appendage, to maintain the electrode tip in electrical contact with the heart tissue while allowing a removal of the electrode should that prove necessary. Provision is also made for holding the tines against the electrode body during insertion while allowing their release when the tip is in position and after a test threshold measurement. Although the electrode is discussed inthe context of the right atrial appendage, it is suitable for use in any portion of the heart having the requisite cooperating tissue and may be employed as either a sensing or pacing electrode.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. I shows a preferred embodiment of the present invention.

FIG. 2 shows a cross section of the preferred embodiment of FIG. Itaken along the line 22 in FIG. 1.

FIG. 3 shows a cross section of another preferred embodiment taken-along the line 2-2 in FIG. 1.

FIG. 4 illustrates apparatus which may be used with the preferred embodiment of FIG. I.

FIG. 5 shows acomponentof another preferred embodiment of the present invention.

FIG. 6 shows'a preferred embodiment of the present invention whichutilizes the component of FIG. 5, the tines being in a restrained position.

FIG. 7 shows the embodiment. of FIG. 6 with the tines unrestrained.

FIG. '8 shows another preferred embodiment of the present invention.

FIG. 9 shows still another preferred embodiment of the present invention.

FIG. 10 shows a further preferred embodiment of the present invention.

FIG. 11 shows a portion of the preferred embodiment of FIG.- 10.

FIG. 12 shows a portion of the preferred embodiment of FIG. 10.

FIG. 13 shows anadditional preferred embodiment of the present invention.

DETAILED. DESCRIPTION GFTHE DRAWINGS tive tip 11 and a plurality of tines 12 extending at an acute angle from the body member from a position adjacent the tip 11. The electrically conductive tip 11 may be of any material suitable for the environment; platinum-iridium, for example. The tines 12 are ofa pliant material which is generally inert to body fluids; silicone rubber or polyurethane, for example. The tines 12 may be attached to the body member 10 in any convenient manner. For example, the tines may extend from, and be unitary with, a disc 13 which disc is held in position between the body member 10 and tip 11. Alternatively, the member 13 may be in the form of a ring which lies over either the body member 10 or tip 11 and is adhered thereto in any convenient manner. The tines 12 may take any angle with the body member 10, their purpose being to cooperate with the body tissue, particularly the trabeculae of the right atrial appendage, to maintain the tip 11 in electrical contact with the body tissue. It can be seen that an acute angle formed by the tines l2 and the body member 10 will have the greatest tendency to push against and become involved with the cooperating trabeculae and maintain the tip 11 in electrical contact. It has been found, that an angle of approximately 45 maintains the necessary electrical contact is a very efficient manner. Further, any number of tines may be used; three having proven to be adequate in most situations.

Referring now to FIG. 2 wherein there is shown a cross section of a preferred embodiment of the body member 10 of FIG. 1 taken along the line 22. In this embodiment, an elongated electrical conductor 15 runs substantially the length of the body member 10 and makes electrical contact with the tip 11. The conductor 15 is encased within a catheter 16 of a material which is generally inert to body fluids.

It is desirable that the catheter conductor combination be made as flexible as possible. To accomplish this purpose while providing the necessary rigidity for insertion of the electrode, a stylet lumen 19 is provided, the stylet being within the lumen 19 during insertion of the electrode and being withdrawn after placement is accomplished. In a preferred embodiment, the stylet which is placed into the lumen 19 has a J configuration similar to that of the prior art applicator catheters. During insertion, the stylet is maintained in a straightened configuration by the walls of the vessel through which insertion is accomplished. When the electrode tip reaches the atrium, the stylet assumes its J configuration thereby allowing an easy insertion into the appendage. When the placement of the electrode tip is accomplished, the stylet is withdrawn. In this embodiment, the electrical conductor can be of any known type, one preferred form being a multistrand wire of platinum, for example, commonly referred to as tinsel wire. I

A second preferred form for the body member 10 is illustrated in FIG. 3. Here, the electrical conductor is a coiled member 17 which again runs substantially the length of the body member 10. The coil 17 is encased in a catheter 16 substantially identical to that shown in FIG. 2. The central portion of the coil 17 is left at least partially void to forma lumen 18 for the insertion of a stylet, the stylet serving essentially the same function in this embodiment as in the embodiment of FIG. 2. Further, in both the embodiments of FIG. 2 and FIG. 3, the lumens l9 and 18 may be lined with Teflon or any other appropriate material to facilitate the insertion and removal of the stylet.

Referring now to FIG. 4, there is again shown an electrode body portion 10 this time at the end farthest from the tip 11. In some applications, a pin type connection to an external stimulator or sensing device is desired. For this purpose, the body portion 10 commonly has an enlarged segment 20 from which extends the connecting pin 21. If it is desired to insert the electrode through the use of the J-shaped applicator catheter known to the prior art, the catheter must be made suffieiently large to slide back over the enlarged portion 20 or, alternatively, some other system for removal of the catheter must be provided. Here, the applicator catheter is shown at 22 of a size not sufficiently large to be withdrawn over the enlarged portion 20. A cutting tool 23 is shown adjacent the enlarged portion 20 and extending forward of the enlarged portion with a wedge 24 and a knife blade 25. The cutting tool 23 may be separate from the electrode body 10 or may be attached thereto in any convenient manner. In operation, the wedge portion 24 slips under the edge of the applicator catheter 22 and, as the applicator catheter 22 is drawn toward the cutting tool 23, the wedge will direct the catheter 22 into contact with the knife blade which will then cut and separate it thus allowing the removal of the applicator catheter over the enlarged portion 20.

The electrode shown in the embodiment of FIG. 1 may be successfully inserted into the right atrial appendage through a transvenous approach using the stylet technique of either FIGS. 2 or 3 or the .I-shaped applicator catheter technique. In the applicator catheter technique, the tines 12 are not exposed during insertion. In the stylet technique of either FIGS. 2 or 3, however, the tines are non-restrained or extended during the entire operation. Although the electrode may be successfully positioned in this condition, it is found that the blood flow tends to draw the electrode tip into the ventrical. For this reason, some means of restraining the tines during insertion is desirable.

Referring now to FIG. 5, there is shown a balloon catheter similar to the balloon catheters used for other applications. Specifically, the catheter body 10 has a portion 30 which is inflatable from an end 32. The inflation is accomplished through a lumen similar to the stylet lumen 19 and 18 of FIGS. 2 and 3 respectively. Indeed, the inflation can be accomplished through the stylet lumens 19 and 18, the lumens being made sufficiently large to accomodate the stylet while allowing a passage for air to inflate the balloon. The ballooning feature of the electrode body 10 may be accomplished in any known manner. Referring now to FIG. 6, there is shown an electrode having a body 10 and a tip 11 as described with reference to the embodiment of FIG. 1. The body 10 is composed of a balloon catheter as illustrated in FIG. 5 with the ballooning or inflatable part lying adjacent the tip 1 l. A hold down shroud 31 is positioned near the tip 11 and is adapted to receive at least the ends of the tines 12 to restrain them in a position wherein they overlie the inflatable portion 30 of the electrode body 10. With the tines in this restrained position, a stylet may be inserted into a lumen such as that illustrated in FIGS. 2 or 3 and the electrode inserted through a transvenous approach without any interference from the extended tines. When the electrode tip is believed to be in an acceptable position as viewed by fluoroscopy, a test measurement can be made. If the site of the electrode tip proves satisfactory, the balloon 30 can be inflated from the end of the electrode still outside the body causing the tines to withdraw from the shroud 31 and extend into their normal unrestrained position as illustrated in FIG. 7. With the tines freed from the shroud 31 the inflating pressure can be released and the balloon 30 will deflate to a normal configuration. The shroud 31 may take any shape which can accept at least the end portions of the tines 12. A ring which is attached to the body by spaced tethers is an example of an obvious modification of the shroud 31.

An alternative shroud to the shroud 31 of FIG. 7 is illustrated at 35 in FIG. 8. This shroud 35 again is adapted to accept at least the end portion of the tines 12 to restrain them in a position wherein they overlie the body of the electrode 10. A line 36 is attached to the shroud 35 at 37, and when the tip is properly positioned, a force on the line 36 will cause the shroud 35 to withdraw thus freeing the tines 12 to assume their extended unrestrained position. A similar approach is illustrated in FIG. 9 wherein a stylet 40 is shown having a coiled portion 41 which coiled portion is wrapped around the tines causing them to lie flat against the body member 10. Again, when the tip 11 is properly positioned, the stylet will be withdrawn thereby freeing the tines for interaction with the trabeculae of the right atrial appendage, for example.

Referring now to FIG. 10, there is shown another preferred embodiment of the present invention. Specifically, there is shown an electrode body 10 composed of a connecting portion 50, a central portion 51 and an end portion 52 which lies between the tip 11 and the shroud 53. The cross section of the central portion 51 may be as illustrated in FIG. 3. That is, the electrical conductor is a coiled member 17 having a void lumen forming central portion 18, the conductor extending from the tip 11 back to the connecting portion 50. The connecting portion 50 is similar to that illustrated in FIG. 4 with the connecting pin 54 making an electrical contact with the electrical conductor 17 and having a lumen coincident with the lumen 18 of the conductor 17. With this configuration, it is possible to insert a stylet 55 through the end of the connecting pin 54 to abut the tip 11. Inasmuch as the electrical conductor is a coiled member it can be stretched or elongated by applying a pressure against the tip 11 with the stylet 55. Since the electrical conductor is typically uniform throughout its length, the location at which the elec trode body will give or elongate can be controlled to the durometer or diameter of the electrode body, or both. For reasons to be explained more fully below, it is desired that the portion 52 of the electrode body 10 give before the central portion 51 or the connecting portion 50. Therefore, the portion 52 is illustrated as having a smaller diameter than either the central portion 51 or the connecting portion 50. Alternatively, the material comprising the portion 52 may have a lower durometer than either of the other portions of the electrode body 10 or it may have a lower durometer and diameter, as desired.

FIG. 11 illustrates the embodiment of FIG. 10 with the tines 12 having at least their ends restrained by the shroud 53 in a manner substantially identical to that illustrated in FIG. 6. With the tines in their restrained position, the electrode can be inserted and positioned and, when a proper positioning is obtained as described above, the stylet is forced against the tip 11 causing the portion 52 to stretch as illustrated in FIG. 12 thereby releasing the tines 12 from the shroud 53. With the tines released, the stylet is removed thereby allowing the portion 52 to assume its normal shape as illustrated in phantom at FIG. 12.

As stated with regard to the shroud 31 of FIGS. 6 and 7, the shroud 53 of FIGS. 10-12 may take the form of a ring connected to the electrode body by means of a plurality of tethers. Such a ring shroud is illustrated at in FIG. 13. As can be seen, the shroud 60 has a ring or a doughnut configuration and is held in place by means of tethers 61 which perform essentially as the spokes of a wheel, the tethers 61 being positioned so as not to interfere with the restraining and release of the tines 12.

From the above, it can be seen that the present invention provides a new medical electrode uniquely adapted for use as an endocardial electrode. The electrode provides means for cooperating with the heart tissue, particularly the trabeculae of the ventricles and right atrial appendage, to provide an artificial fixation until such time as a natural fixation has occurred. The tines are of a pliant material which is sufficiently rigid to accomplish their purpose without having the snapping action and sharp points attendant in the prior art devices. Further, the present invention provides a system for positioning the electrode and making any necessary test measurements prior to its being finally posi tioned, the position of the tip with regard to the inserting devices being much less critical in the present invention than in the prior art devices because the tines may be selectively released independently of the insertion device.

Obviously, many modifications and variations of the present invention are possible in light of the above teaching. An example of such a modification would be to make the body member 10 or the tines 12, or both, radiopaque to facilitate the positioning by observation of the electrode through Xray., fluoroscopy, etc. We have found that this can be accomplished through impregnation with carbon, barium sulfate or Tantalum. Of course, any suitable substance and method will be acceptable for this purpose. It is therefore to be understood that, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.

What is claimed is:

1. In an endocardial lead of the type having an electrical conductor encased in a material which is generally inert to body fluids, the conductor terminating at an exposed electrically conductive electrode tip, the improvement which comprises:

nonconducting tine means extending from said encasing material and away from said tip from a location adjacent said tip for cooperating with heart tissue, to hold the tip in position, said tine means forming a generally acute angle with said encasing material and being entirely of a pliant material having sufficient rigidity to maintain said angle when said tine means are unrestrained, but sufficiently pliant to prevent penetration of said heart tissue, said pliant material being generally inert to body fluids.

2. The lead of claim 1 wherein the improvement fur ther comprises means external to said encasing mate- 7 rial for releasably restraining said tinc means in a position overlying said encasing material.

3. The lead of claim 2 wherein said restraining means comprises shroud means for accepting at least the end portion of said tine means.

4. The lead of claim 3 wherein said restraining means further comprise means cooperating with said shroud means for effecting the release of said tine means at a point spaced from said shroud means.

5. The lead of claim 3 wherein the improvement further comprises:

inflatable means underlying said tine means when said tine means are in said restrained position; and means spaced from said inflatable means for selectively inflating said inflatable means.

6. The lead of claim 4 wherein said tine means are non-metallic.

7. An endocardial lead which comprises:

elongated electrically conductive means;

flexible catheter means surrounding said electrically conductive means and having a lumen substantially parallel to and coextensive with said electrically conductive means;

electrically conductive tip means at one end of said catheter means and electrically connected to said electrically conductive means; and

nonconducting tine means extending from said catheter means and away from said tip from a point adjacent said tip means for cooperation with heart tissue, to hold the tip in position, said tine means forming a generally acute angle with said catheter means and being entirely of a pliant material having sufficient rigidity to maintain said angle when said tine means are unrestrained, but sufficiently pliant to prevent penetration of said heart tissue, said pliant material being generally inert to body fluids.

8. The lead of claim 7 further comprising means for releasable restraining said tines in a position wherein they overlie said catheter means.

9. The lead of claim 8 wherein said restraining means comprises shroud means for accepting at least the end portion of said tine means. 7

10. The lead of claim 9 wherein said restraining means further comprises means cooperating with said shroud means for effecting the release of said tine means at a point spaced from said shroud means.

1 l. The lead of claim 9 wherein said catheter means comprises a balloon catheter, the balloon underlying the tines when the tines are in the restrained position.

12. The lead of claim 11 wherein said elongated electrically conductive means comprises a coiled electrical conductor having a void central portion, said lumen coinciding with said void central portion.

13. The lead of claim 11 wherein said elongated electrically conductive means is positioned substantially at the center of the cross section of said catheter means and said lumen lies off the center of said cross section.

14. In a medical lead of the type in which an electrical conductor is positioned within a catheter and terminates at an exposed electrically conductive electrode tip, the improvement which comprises:

nonconducting tine means including a plurality of tines each extending from said catheter and away from said tip from a point adjacent said tip and forming an acute angle with said catheter for cooperating with heart tissue to hold the tip in position, said tine means being entirely of a pliant material having sufficient rigidity to maintain said angle when said tine means are unrestrained, but sufficiently pliant to prevent penetration of said heart tissue; means for releasably restraining said tine means in a position wherein said tine means overlie said catheter; and I means underlying said tine means when said tine means are in said restrained position and inflatable from a point spaced from said restraining means for releasing said tine means from said restraining means upon inflation.

15. The medical lead of-claim 14 wherein the angle formed by said tine means and said catheter is approximately 45.

16. The medical lead of claim 14 wherein said pliant tine means material comprises a material which is relatively inert to body fluids, at least a portion of said material being radiopaque.

17. The medical lead of claim 16 wherein the radiopaque material portion is a material treated with a material selected from the group consisting of carbon, barium sulfate or Tantalum.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2854983 *Oct 31, 1957Oct 7, 1958Arnold M BaskinInflatable catheter
US3348548 *Apr 26, 1965Oct 24, 1967Chardack William MImplantable electrode with stiffening stylet
US3397699 *May 5, 1966Aug 20, 1968Gerald C. KohlRetaining catheter having resiliently biased wing flanges
US3516410 *Jan 3, 1968Jun 23, 1970Hakim SalomonCerebro-ventricular catheter
US3568659 *Sep 24, 1968Mar 9, 1971Karnegis James NDisposable percutaneous intracardiac pump and method of pumping blood
US3608555 *Dec 31, 1968Sep 28, 1971Chemplast IncRadio opaque and optically transparent tubing
US3717151 *Mar 11, 1971Feb 20, 1973R CollettFlesh penetrating apparatus
US3719190 *Mar 9, 1971Mar 6, 1973Avery Lab IncHeart stimulation electrode with a conical positioning parachute
US3815608 *Mar 10, 1972Jun 11, 1974East West Med ProdRetaining catheter
US3835864 *Sep 21, 1970Sep 17, 1974Rasor Ass IncIntra-cardiac stimulator
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US4007732 *Sep 2, 1975Feb 15, 1977Robert Carl KvavleMethod for location and removal of soft tissue in human biopsy operations
US4030508 *Feb 4, 1976Jun 21, 1977Vitatron Medical B.V.Low output electrode for cardiac pacing
US4033357 *Feb 17, 1976Jul 5, 1977Medtronic, Inc.Non-fibrosing cardiac electrode
US4106512 *Dec 16, 1976Aug 15, 1978Medtronic, Inc.Transvenously implantable lead
US4135518 *May 21, 1976Jan 23, 1979Medtronic, Inc.Body implantable lead and electrode
US4136703 *Mar 9, 1978Jan 30, 1979Vitatron Medical B.V.Atrial lead and method of inserting same
US4141365 *Feb 24, 1977Feb 27, 1979The Johns Hopkins UniversityEpidural lead electrode and insertion needle
US4144890 *Dec 19, 1976Mar 20, 1979Cordis CorporationContact device for muscle stimulation
US4166469 *Dec 13, 1977Sep 4, 1979Littleford Philip OApparatus and method for inserting an electrode
US4257428 *Oct 16, 1978Mar 24, 1981Barton Steven ARetractable stimulation electrode apparatus and method
US4269198 *Dec 26, 1979May 26, 1981Medtronic, Inc.Body implantable lead
US4289144 *Jan 10, 1980Sep 15, 1981Medtronic, Inc.A-V Sidearm lead
US4402328 *Apr 28, 1981Sep 6, 1983Telectronics Pty. LimitedCrista terminalis atrial electrode lead
US4407303 *Apr 9, 1981Oct 4, 1983Siemens AktiengesellschaftEndocardial electrode arrangement
US4465079 *Oct 13, 1982Aug 14, 1984Medtronic, Inc.Biomedical lead with fibrosis-inducing anchoring strand
US4467817 *May 18, 1983Aug 28, 1984Cordis CorporationSmall diameter lead with introducing assembly
US4473067 *Apr 28, 1982Sep 25, 1984Peter SchiffIntroducer assembly for intra-aortic balloons and the like incorporating a sliding, blood-tight seal
US4475560 *Apr 29, 1982Oct 9, 1984Cordis CorporationTemporary pacing lead assembly
US4549557 *Nov 1, 1983Oct 29, 1985Hakki A Hadi IPacemaker electrode
US4564023 *Mar 28, 1983Jan 14, 1986Cordis CorporationRetention skirt for pacing electrode assembly
US4581019 *Apr 22, 1982Apr 8, 1986Curelaru JohanDevice for introducing a catheter-cannula into a blood vessel
US4590949 *Nov 1, 1984May 27, 1986Cordis CorporationNeural stimulating lead with stabilizing mechanism and method for using same
US4631059 *Mar 26, 1985Dec 23, 1986Datascope Corp.Sheath remover
US4641656 *Jun 20, 1985Feb 10, 1987Medtronic, Inc.Cardioversion and defibrillation lead method
US4641664 *Apr 15, 1985Feb 10, 1987Siemens AktiengesellschaftEndocardial electrode arrangement
US4669488 *Oct 7, 1985Jun 2, 1987Cordis CorporationRetention skirt for pacing electrode assembly
US4687469 *May 31, 1985Aug 18, 1987Peter OsypkaDevice for slitting introducers for pacemaker electrodes
US4722353 *Sep 16, 1985Feb 2, 1988Intermedics, Inc.Stabilizer for implantable electrode
US4730389 *Aug 15, 1986Mar 15, 1988Medtronic, Inc.Method for fabrication of an implantable hermetic transparent container
US4791935 *Aug 15, 1986Dec 20, 1988Medtronic, Inc.Implantable lead
US4807629 *Nov 19, 1987Feb 28, 1989Medtronic, Inc.Oxygen sensing pacemaker
US4841971 *Mar 29, 1988Jun 27, 1989Cordis Leads, Inc.Endocardial lead with projections having saw tooth formation
US4892102 *Sep 26, 1986Jan 9, 1990Astrinsky Eliezer ACardiac pacing and/or sensing lead and method of use
US4913147 *Sep 23, 1987Apr 3, 1990Siemens AktiengesellschaftHeart pacemaker system with shape-memory metal components
US4913164 *Sep 27, 1988Apr 3, 1990Intermedics, Inc.Extensible passive fixation mechanism for lead assembly of an implantable cardiac stimulator
US4945922 *Mar 13, 1989Aug 7, 1990Vitatron Medical B.V.Pacing lead
US4997424 *Apr 5, 1989Mar 5, 1991Medamicus, Inc.Catheter introducer and introducer slitter
US5111828 *Sep 18, 1990May 12, 1992Peb Biopsy CorporationDevice for percutaneous excisional breast biopsy
US5179962 *Jun 20, 1991Jan 19, 1993Possis Medical, Inc.Cardiac lead with retractible fixators
US5197484 *May 8, 1992Mar 30, 1993Peb Biopsy CorporationMethod and device for precutaneous excisional breast biopsy
US5207226 *Jan 25, 1991May 4, 1993Regents Of The University Of MinnesotaDevice and method for measurement of blood flow
US5231996 *Jan 28, 1992Aug 3, 1993Medtronic, Inc.Removable endocardial lead
US5238007 *Dec 12, 1991Aug 24, 1993Vitatron Medical B.V.Pacing lead with improved anchor mechanism
US5300107 *Oct 22, 1992Apr 5, 1994Medtronic, Inc.Universal tined myocardial pacing lead
US5344439 *Oct 30, 1992Sep 6, 1994Medtronic, Inc.Catheter with retractable anchor mechanism
US5353804 *Mar 17, 1993Oct 11, 1994Peb Biopsy CorporationMethod and device for percutaneous exisional breast biopsy
US5354327 *Apr 7, 1993Oct 11, 1994Medtronic, Inc.Conductor coil with specific ratio of torque to bending stiffness
US5360441 *Oct 30, 1992Nov 1, 1994Medtronic, Inc.Epidural lead
US5364337 *Apr 14, 1993Nov 15, 1994Medtronic, Inc.Muscle powered cardiac assist system
US5383922 *Mar 15, 1993Jan 24, 1995Medtronic, Inc.RF lead fixation and implantable lead
US5476500 *Dec 20, 1993Dec 19, 1995Ventritex, Inc.Endocardial lead system with defibrillation electrode fixation
US5480421 *Aug 5, 1994Jan 2, 1996Medtronic, Inc.Lead with stylet capture member
US5545206 *Dec 22, 1994Aug 13, 1996Ventritex, Inc.Low profile lead with automatic tine activation
US5571162 *Jun 7, 1995Nov 5, 1996Intermedics, Inc.Transvenous defibrillation lead with side hooks
US5683447 *Dec 19, 1995Nov 4, 1997Ventritex, Inc.Lead with septal defibrillation and pacing electrodes
US5693081 *Oct 11, 1995Dec 2, 1997Pacesetter, Inc.Endocardial lead system with defibrillation electrode fixation
US5713945 *Jun 13, 1996Feb 3, 1998Pacesetter, Inc.Implantable lead modified to reduce tissue ingrowth
US5755761 *Apr 26, 1996May 26, 1998Pharmatarget, Inc.Atrial pacing catheter and method having multiple electrodes in the right atrium and coronary sinus
US5755767 *Aug 2, 1996May 26, 1998Pacesetter, Inc.Anti-dislodgment and anti-perforation distal tip design for transvenous lead
US5759202 *Apr 28, 1997Jun 2, 1998Sulzer Intermedics Inc.Cardiac lead assembly
US5769881 *May 22, 1997Jun 23, 1998Sulzer Intermedics Inc.Endocardial lead with multiple branches
US5807399 *Oct 23, 1996Sep 15, 1998Medtronic, Inc.Method for removal of chronically implanted leads and leads optimized for use therewith
US5871532 *May 22, 1997Feb 16, 1999Sulzer Intermedics Inc.Epicardial lead for minimally invasive implantation
US5897585 *Dec 18, 1997Apr 27, 1999Medtronic, Inc.Stretchable pacing lead
US5931864 *Feb 20, 1998Aug 3, 1999Cardiac Pacemakers, Inc.Coronary venous lead having fixation mechanism
US5971967 *Aug 19, 1997Oct 26, 1999Abbeymoor Medical, Inc.Urethral device with anchoring system
US6026567 *May 11, 1995Feb 22, 2000Medtronic, Inc.Medical lead with stranded conductors
US6173206May 7, 1999Jan 9, 2001Ethicon, Inc.Temporary pacing wire anchor
US6178356Mar 26, 1999Jan 23, 2001Cardiac Pacemakers, Inc.Coronary venous lead having fixation mechanism
US6181973Jul 7, 1999Jan 30, 2001Claudio CeronAnchoring structure for implantable electrodes
US6183505Mar 11, 1999Feb 6, 2001Medtronic Ave, Inc.Method of stent retention to a delivery catheter balloon-braided retainers
US6221060Oct 4, 1999Apr 24, 2001Abbeymoor Medical, Inc.Urethral device with anchoring system
US6258060Jun 30, 1999Jul 10, 2001Abbeymoon Medical, Inc.Urethral apparatus with position indicator and methods of use thereof
US6315778Sep 10, 1999Nov 13, 2001C. R. Bard, Inc.Apparatus for creating a continuous annular lesion
US6331189Oct 18, 1999Dec 18, 2001Medtronic, Inc.Flexible medical stent
US6334871Sep 3, 1996Jan 1, 2002Medtronic, Inc.Radiopaque stent markers
US6402777Aug 22, 2000Jun 11, 2002Medtronic, Inc.Radiopaque stent markers
US6405091Jul 20, 1999Jun 11, 2002Pacesetter, Inc.Lead assembly with masked microdisk tip electrode and monolithic controlled release device
US6489562Apr 1, 1997Dec 3, 2002Medtronic, IncMedical electrical lead having variable stiffness tip-ring spacer
US6516230Apr 26, 2000Feb 4, 2003Medtronic, Inc.Medical electrical lead with fiber core
US6730116Apr 16, 1999May 4, 2004Medtronic, Inc.Medical device for intraluminal endovascular stenting
US6792318Jun 13, 2002Sep 14, 2004Pacesetter, Inc.Technique for fixating a lead
US6805699 *May 8, 2003Oct 19, 2004Peter ShimmLaparoscopic specimen retrieval shoehorn
US6814746Nov 1, 2002Nov 9, 2004Ev3 Peripheral, Inc.Implant delivery system with marker interlock
US6837848Jan 15, 2003Jan 4, 2005Medtronic, Inc.Methods and apparatus for accessing and stabilizing an area of the heart
US6887255 *Apr 19, 2002May 3, 2005Peter ShimmLaparoscopic specimen extraction port
US6918908Jul 17, 2003Jul 19, 2005Medtronic, Inc.Methods and apparatus for accessing and stabilizing an area of the heart
US6918928Feb 28, 2003Jul 19, 2005Medtronic, Inc.Medical device for intraluminal endovascular stenting
US6999819Nov 9, 2001Feb 14, 2006Medtronic, Inc.Implantable medical electrical stimulation lead fixation method and apparatus
US7029460Feb 15, 2002Apr 18, 2006Medtronic, Inc.Slitting tool
US7092764Apr 30, 2002Aug 15, 2006Medtronic, Inc.Helix rotation by traction
US7276057Apr 30, 2004Oct 2, 2007Medtronic, Inc.Method, system and device for treating disorders of the pelvic floor by drug delivery to the pudendal and sacral nerves
US7277762 *Oct 25, 2002Oct 2, 2007Belden Elisabeth LRadiopague marking of lead electrode zone in a continuous conductor construction
US7328068Nov 26, 2003Feb 5, 2008Medtronic, Inc.Method, system and device for treating disorders of the pelvic floor by means of electrical stimulation of the pudendal and associated nerves, and the optional delivery of drugs in association therewith
US7328069Apr 30, 2004Feb 5, 2008Medtronic, Inc.Method, system and device for treating disorders of the pelvic floor by electrical stimulation of and the delivery of drugs to the left and right pudendal nerves
US7330764Apr 28, 2004Feb 12, 2008Medtronic, Inc.Implantable medical electrical stimulation lead fixation method and apparatus
US7338481Feb 14, 2003Mar 4, 2008Medtronic, Inc.Slitting tool
US7349742Dec 23, 2003Mar 25, 2008Cardiac Pacemakers, Inc.Expandable fixation elements for subcutaneous electrodes
US7369894Apr 30, 2004May 6, 2008Medtronic, Inc.Method, system and device for treating disorders of the pelvic floor by electrical stimulation of the sacral and/or pudendal nerves
US7418292Apr 8, 2004Aug 26, 2008Medtronic, Inc.Device and method for attenuating an immune response
US7427280Apr 30, 2004Sep 23, 2008Medtronic, Inc.Method, system and device for treating disorders of the pelvic floor by delivering drugs to various nerves or tissues
US7473224May 22, 2002Jan 6, 2009Ethicon Endo-Surgery, Inc.Deployable ultrasound medical transducers
US7473250May 21, 2004Jan 6, 2009Ethicon Endo-Surgery, Inc.Ultrasound medical system and method
US7493175Dec 18, 2003Feb 17, 2009Cardiac Pacemakers, Inc.Subcutaneous lead with tined fixation
US7494467Apr 16, 2004Feb 24, 2009Ethicon Endo-Surgery, Inc.Medical system having multiple ultrasound transducers or an ultrasound transducer and an RF electrode
US7499758Dec 18, 2003Mar 3, 2009Cardiac Pacemakers, Inc.Helical fixation elements for subcutaneous electrodes
US7610106Nov 6, 2003Oct 27, 2009Yacoubian Vahe SEpicardial heartwire with chest tube
US7615057Feb 12, 2004Nov 10, 2009Cardiac Pacemakers, Inc.Notched cutter for guide catheter removal from lead
US7620454May 19, 2003Nov 17, 2009Medtronic, Inc.Gastro-electric stimulation for reducing the acidity of gastric secretions or reducing the amounts thereof
US7628780Nov 30, 2004Dec 8, 2009Medtronic, Inc.Devices and methods for interstitial injection of biologic agents into tissue
US7695436May 21, 2004Apr 13, 2010Ethicon Endo-Surgery, Inc.Transmit apodization of an ultrasound transducer array
US7740623Jun 23, 2005Jun 22, 2010Medtronic, Inc.Devices and methods for interstitial injection of biologic agents into tissue
US7742818May 19, 2003Jun 22, 2010Medtronic, Inc.Gastro-electric stimulation for increasing the acidity of gastric secretions or increasing the amounts thereof
US7744562Oct 10, 2006Jun 29, 2010Medtronics, Inc.Devices and methods for interstitial injection of biologic agents into tissue
US7761167Oct 2, 2006Jul 20, 2010Medtronic Urinary Solutions, Inc.Systems and methods for clinician control of stimulation systems
US7769442Aug 29, 2006Aug 3, 2010Medtronic, Inc.Device and method for inhibiting release of pro-inflammatory mediator
US7801624 *Jan 16, 2007Sep 21, 2010Pacesetter, Inc.Reduced perforation distal tip for an implantable cardiac electrotherapy lead
US7806839Jun 14, 2004Oct 5, 2010Ethicon Endo-Surgery, Inc.System and method for ultrasound therapy using grating lobes
US7806892May 22, 2002Oct 5, 2010Ethicon Endo-Surgery, Inc.Tissue-retaining system for ultrasound medical treatment
US7813809Jun 10, 2005Oct 12, 2010Medtronic, Inc.Implantable pulse generator for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue
US7840281Jul 21, 2006Nov 23, 2010Boston Scientific Scimed, Inc.Delivery of cardiac stimulation devices
US7846096Nov 24, 2003Dec 7, 2010Ethicon Endo-Surgery, Inc.Method for monitoring of medical treatment using pulse-echo ultrasound
US7848821Jul 11, 2006Dec 7, 2010Pacesetter, Inc.Apparatus and method for electrode insertion in heart tissue
US7848823Aug 28, 2006Dec 7, 2010Boston Scientific Scimed, Inc.Cardiac stimulation system
US7865250 *Nov 30, 2005Jan 4, 2011Medtronic Urinary Solutions, Inc.Methods for electrical stimulation of nerves in adipose tissue regions
US7881783 *Apr 28, 2006Feb 1, 2011Medtronics, Inc.Implantable medical electrical stimulation lead, such as a PNE lead, and method of use
US7883468May 18, 2004Feb 8, 2011Ethicon Endo-Surgery, Inc.Medical system having an ultrasound source and an acoustic coupling medium
US7890191Feb 28, 2008Feb 15, 2011Medtronic, Inc.Implantable medical device system with fixation member
US7904179Feb 28, 2008Mar 8, 2011Medtronic, Inc.Implantable medical device system with fixation member
US7912555Jan 31, 2008Mar 22, 2011Medtronic, Inc.Implantable medical electrical stimulation lead fixation method and apparatus
US7925358Aug 29, 2007Apr 12, 2011Medtronic, Inc.Radiopaque marking of lead electrode zone in a continuous conductor construction
US7951095May 20, 2004May 31, 2011Ethicon Endo-Surgery, Inc.Ultrasound medical system
US8000805Oct 30, 2006Aug 16, 2011Medtronic, Inc.Implantable medical lead including tine markers
US8036756Feb 13, 2006Oct 11, 2011Medtronics IncImplantable medical electrical stimulation lead fixation method and apparatus
US8050774Dec 22, 2005Nov 1, 2011Boston Scientific Scimed, Inc.Electrode apparatus, systems and methods
US8108054 *Feb 4, 2009Jan 31, 2012Pacesetter, Inc.Active fixation implantable medical lead configured to indicate via fluoroscopy embedment of helical anchor in cardiac tissue
US8165692Jul 3, 2007Apr 24, 2012Medtronic Urinary Solutions, Inc.Implantable pulse generator power management
US8185213Oct 22, 2010May 22, 2012Boston Scientific Scimed, Inc.Delivery of cardiac stimulation devices
US8195304Oct 12, 2007Jun 5, 2012Medtronic Urinary Solutions, Inc.Implantable systems and methods for acquisition and processing of electrical signals
US8204605Feb 4, 2009Jun 19, 2012Cardiac Pacemakers, Inc.Multi-site atrial electrostimulation
US8273072Nov 18, 2009Sep 25, 2012Medtronic, Inc.Devices and methods for interstitial injection of biologic agents into tissue
US8290600Jul 21, 2006Oct 16, 2012Boston Scientific Scimed, Inc.Electrical stimulation of body tissue using interconnected electrode assemblies
US8332036Mar 8, 2007Dec 11, 2012Boston Scientific Scimed, Inc.Leadless cardiac stimulation systems
US8340780 *May 7, 2007Dec 25, 2012Scimed Life Systems, Inc.Leadless cardiac stimulation systems
US8388541Nov 25, 2008Mar 5, 2013C. R. Bard, Inc.Integrated system for intravascular placement of a catheter
US8388546Apr 21, 2009Mar 5, 2013Bard Access Systems, Inc.Method of locating the tip of a central venous catheter
US8437833Oct 7, 2009May 7, 2013Bard Access Systems, Inc.Percutaneous magnetic gastrostomy
US8467875Mar 28, 2007Jun 18, 2013Medtronic, Inc.Stimulation of dorsal genital nerves to treat urologic dysfunctions
US8478382Feb 11, 2009Jul 2, 2013C. R. Bard, Inc.Systems and methods for positioning a catheter
US8478408Mar 8, 2007Jul 2, 2013Boston Scientific Scimed Inc.Leadless cardiac stimulation systems
US8489189 *Oct 29, 2004Jul 16, 2013Medtronic, Inc.Expandable fixation mechanism
US8512256Sep 9, 2010Aug 20, 2013Bard Access Systems, Inc.Method of locating the tip of a central venous catheter
US8626314Jul 14, 2011Jan 7, 2014Medtronic, Inc.Implantable medical lead including a plurality of tine elements
US8644934Sep 13, 2007Feb 4, 2014Boston Scientific Scimed Inc.Cardiac stimulation using leadless electrode assemblies
US8644953Aug 10, 2012Feb 4, 2014Greatbatch Ltd.Lead with braided reinforcement
US8694128Jan 25, 2008Apr 8, 2014Medtronic, Inc.Medical electrical lead
US8696729Mar 31, 2008Apr 15, 2014Covidien LpImplant delivery system with marker interlock
US8706252Jul 1, 2010Apr 22, 2014Medtronic, Inc.Systems and methods for clinician control of stimulation system
US8715295Jul 18, 2012May 6, 2014Interrad Medical, Inc.Temporary retention device
US8721558 *Jul 24, 2009May 13, 2014Biotronik Crm Patent AgDevice for determining the flow rate of a blood flow, and cardiovascular assist device
US8738147Jan 29, 2009May 27, 2014Cardiac Pacemakers, Inc.Wireless tissue electrostimulation
US20100022899 *Jul 24, 2009Jan 28, 2010Gernot KolbergDevice for determining the flow rate of a blood flow, and cardiovascular assist device
US20100217346 *May 6, 2010Aug 26, 2010Shuros Allan CMethod and apparatus for gastrointestinal stimulation via the lymphatic system
US20100268310 *Jun 30, 2010Oct 21, 2010Medtronic, Inc.Implantable medical electrical stimulation lead, such as pne lead, and method of use
US20110190786 *Jan 21, 2011Aug 4, 2011Medtronic, Inc.Introduction of medical lead into patient
US20110301543 *Aug 17, 2011Dec 8, 2011Interrad Medical, Inc.Anchor Device and Method
USH1905 *Mar 21, 1997Oct 3, 2000Medtronic, Inc.Mechanism for adjusting the exposed surface area and position of an electrode along a lead body
DE3048805A1 *Dec 23, 1980Sep 17, 1981Medtronic IncImplantierbare leitung
DE3300050A1 *Jan 3, 1983Jul 5, 1984Siemens AgIntravenous pacemaker electrode
EP0004967A2 *Apr 17, 1979Oct 31, 1979Werner Dr.Dr. MohlAnchoring means for a probe head, particularly a cardiac probe
EP0009530A1 *Mar 9, 1979Apr 16, 1980Vitatron Medical B.V.Atrial lead
EP0617978A2 *Mar 31, 1994Oct 5, 1994Medtronic, Inc.Torque indicator for fixed screw leads
EP1034752A1Mar 13, 2000Sep 13, 2000Medtronic, Inc.Method of stent retention to a delivery catheter balloon - braided retainers
EP2044972A1Sep 25, 2003Apr 8, 2009Medtronic, Inc.Implantable medical device lead conductor
WO1992012668A1 *Jan 24, 1992Aug 6, 1992Univ MinnesotaDevice and method for measurement of blood flow
WO1999008741A1 *Aug 19, 1998Feb 25, 1999Abbeymoor Medical IncUrethral device with anchoring system
WO1999042171A1 *Feb 11, 1999Aug 26, 1999Cardiac Pacemakers IncCoronary venous lead having fixation mechanism
WO2000067836A1Apr 19, 2000Nov 16, 2000Ethicon IncTemporary pacing wire anchor
WO2001080941A2Apr 24, 2001Nov 1, 2001Medtronics IncMedical electrical lead with fiber core
WO2004091717A2 *Apr 9, 2004Oct 28, 2004Cardiac Pacemakers IncSubcutaneous cardiac lead with fixation
WO2007027506A2 *Aug 23, 2006Mar 8, 2007Medtronic IncTrans-septal pressure sensor
WO2007038646A1 *Sep 26, 2006Apr 5, 2007Medtronic IncTrans-septal anchoring system and method
Classifications
U.S. Classification607/126
International ClassificationA61N1/05
Cooperative ClassificationA61N1/057
European ClassificationA61N1/05N4