Low profile, ventricular, transvenous, epicardial defibrillation lead

Abstract

A cardiac lead designed for implantation in the vasculature of the left side of the heart comprising a flexible lead body having a central lumen, a removable terminal pin, electrodes electrically coupled to the removable terminal pin, a mechanism for securing the electrodes in the proper position in the vasculature and a mechanism for sealing the central lumen after implantation to prevent body fluids from invading the lumen. The cardiac lead can be implanted or explanted using either a guidewire, a guide catheter or both.

What is claimed is:  
     
         1 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode comprising a soft, flexible material doped with conductive particles and being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin;    (e) means for retaining said electrode in the coronary vein; and    (f) means for sealing said opening through the outer wall of said body member.    
     
     
         2 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode comprising a braided wire screen and being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin;    (e) means for retaining said electrode in the coronary vein; and    (f) means for sealing said opening through the outer wall of said body member.    
     
     
         3 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode comprising a plurality of small ring spaces of a soft, flexible material and being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin;    (e) means for retaining said electrode in the coronary vein; and    (f) means for sealing said opening through the outer wall of said body member.    
     
     
         4 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, said outer wall having at least one area incorporating microtexturing to permit fibrotic attachment to the wall of the coronary vein, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin; and    (e) means for sealing said opening through the outer wall of said body member.    
     
     
         5 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member comprising a conductive coil extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin, said conductive coil having a biased area for retaining the electrode in the coronary vein; and    (e) means for sealing said opening through the outer wall of said body member.    
     
     
         6 . For use with a cardiac rhythm management device, a low profile, ventricular, transvenous, epicardial lead having: 
 (a) an elongated, flexible body member made of an electrically insulative material, said body member having a proximal section, a distal section, an outer wall extending the length of the body member, an opening through said outer wall in said distal section and a lumen extending from said opening through said outer wall, said proximal section being stiffer than the distal section, said proximal section possessing adequate axial stiffness and said distal section being sized and sufficiently flexible to permit the distal section to be advanced through the right atrium and coronary sinus into the coronary vein;    (b) an electrode capable of delivering defibrillating pulses to the left ventricle of the heart and coupled to the distal section of said body member, said electrode being of a size and flexibility to be advanced along with the distal section of the body member through the right atrium and coronary sinus into the coronary veins to a location adjacent the wall of the left ventricle;    (c) a terminal pin;    (d) a conductive member extending within said body member from said electrode for providing an electrical path between said electrode and said terminal pin;    (e) deployable tines coupled to the body member for retaining said electrode in the coronary vein, said tines being detachable from said body member to permit explantation of the lead; and    (f) means for sealing said opening through the outer wall of said body member.    
     
     
         7 . The lead of  claim 5  wherein said means for sealing said opening includes a silicone flap.  
     
     
         8 . The lead of  claim 5  wherein said means for sealing said opening includes a hydrophilic material that swells when in contact with body fluids.  
     
     
         9 . The lead of  claim 5  wherein said means for sealing said opening includes a plug deployable through said lumen.