Steerable catheter and method for locating coronary sinus

Abstract

A steerable catheter includes an elongate cannula having a proximal end and a distal end. A blood characteristic sensor, such as an oxygen sensor, is connected to the cannula and disposed to sense percent oxygen saturation of blood at the distal end of the cannula. The blood oxygen sensor generates a signal indicative of percent oxygen saturation. An oximetry display is responsive to the signal and capable of displaying sensed percent oxygen saturation in a form understandable by an operator. A steering mechanism is operably connected to the cannula and is selectively operable by an operator to deflect the distal end of the cannula. A method of locating the coronary sinus of a heart involves endovascularly introducing a catheter into the right atrium, sensing percent oxygen saturation at the distal end of the catheter, and steering the catheter toward a region of lowest percent oxygen saturation.

What is claimed is:  
     
         1 . A method of placing a pacing lead proximate to or through a coronary sinus of a heart, comprising the steps of: 
 introducing a catheter having a distal end into the right atrium of the heart; and    steering the catheter while concurrently monitoring at the distal end of the catheter a characteristic of blood indicative of blood in the coronary sinus to introduce the distal end of the catheter into the coronary sinus; and    introducing a pacing lead into the coronary sinus.    
     
     
         2 . The method of  claim 1  wherein the characteristic is oxygen concentration.  
     
     
         3 . The method of  claim 1  wherein the characteristic is pH.  
     
     
         4 . The method of  claim 1  wherein the pacing lead is fixed to the heart proximate to the coronary sinus.  
     
     
         5 . The method of  claim 1  wherein the catheter is introduced through the coronary sinus and into the great vein.  
     
     
         6 . The method of  claim 1  wherein the pacing lead is fixed in the great vein.  
     
     
         7 . The method of  claim 5  wherein the pacing lead is fixed in a coronary vein extending from the great vein.  
     
     
         8 . The method of  claim 1  wherein a hollow sheath is advanced over the catheter after the distal end of the catheter is introduced into the coronary sinus, the catheter is then removed and the pacing lead is introduced through the hollow sheath.  
     
     
         9 . The method of  claim 1 , wherein the catheter includes a hollow cannula and the pacing lead is introduced through the hollow cannula.  
     
     
         10 . The method of  claim 1 , wherein the catheter includes a hollow cannula and a steering guide disposed therein, the steering guide being withdrawn from the hollow cannula and replaced by a pacing lead after the distal end of the catheter is introduced into the coronary sinus.  
     
     
         11 . A steerable oximetric catheter comprising: 
 an elongate cannula having a proximal end and a distal end; a blood oxygen sensor connected to the cannula and disposed to sense oxygen content of blood at the distal end of the cannula; and    a steering mechanism operably connected to the cannula and selectively operable by an operator to steer the distal end of the cannula.    
     
     
         12 . The catheter of  claim 11 , wherein the blood oxygen sensor includes at least one pair of optical fibers extending from the distal end to the proximal end of the elongate cannula.  
     
     
         13 . The catheter of  claim 12 , wherein the pair of optical fibers have distal ends optically exposed at the distal end of the elongate cannula.  
     
     
         14 . The catheter of  claim 11 , wherein the steering mechanism includes a wire extending from the distal end to the proximal end of the elongate cannula.  
     
     
         15 . The catheter of  claim 14 , wherein the wire is affixed to the elongate cannula proximate the distal end thereof.  
     
     
         16 . The catheter of  claim 15 , wherein the steering mechanism includes a steering control module affixed to the wire and manipulable by an operator.  
     
     
         17 . The catheter of  claim 11  wherein the cannula defines a passageway along its length.  
     
     
         18 . A kit for placing a pacing lead in a patient comprising: 
 a) a steerable catheter having a blood characteristic sensor;    b) a sheath adapted to fit over the catheter; and    c) a container for holding the catheter and sheath in a sterile condition.    
     
     
         19 . The kit of  claim 18 , wherein the blood characteristic sensor is an oxygen sensor.