Cardiac rhythm management system with intramural myocardial pacing leads and electrodes

Abstract

Medical devices and therapeutic methods for use in the field of cardiology, cardiac rhythm management and interventional cardiology, and more specifically to catheter-based systems for implantation of pacing leads and electrodes, or intramural myocardial reinforcement devices, within the myocardial wall of the heart, such as the ventricles, to provide improved cardiac function.

1 . A method for direct localized therapeutic treatment of myocardial tissue in heart having a pathological condition comprising the steps of: 
 a. identifying a target region of the myocardium having an epicardial region and an endocardial region and an intramural space defined between;    b. delivering a lead having an electrode to said intramural space; wherein said electrode is configured to be connected to a therapeutic or diagnostic device, and wherein the mechanical properties of at least a portion of the myocardial tissue of the target region substantially identified in step (a) is physically modified.    
   
   
       2 . The method of  claim 1  wherein the modified mechanical properties include an increase in systolic performance.  
   
   
       3 . The method of  claim 1  wherein the therapeutic or diagnostic device is a pacemaker.  
   
   
       4 . The method of  claim 1  wherein the therapeutic or diagnostic device is a cardioverter/defibrillator.  
   
   
       5 . The method of  claim 1  wherein the therapeutic or diagnostic device is a cardiac resynchronization device.  
   
   
       6 . The method of  claim 2  wherein the modified mechanical properties include substantially no decrease in diastolic performance.  
   
   
       7 . The method of  claim 1 , wherein said target region includes a myocardial infarct or ischemic zone.  
   
   
       8 . The method of  claim 7 , wherein the lead includes an electro active bridge for spanning said infarct or ischemic zone.  
   
   
       9 . The method of  claim 1 , wherein said delivering step further comprises delivering a substantially arcuately curved lead into the intramural space.  
   
   
       10 . The method of  claim 9  wherein said delivering step further comprises using a stylet.  
   
   
       11 . The method of  claim 9  wherein said delivering step further comprises using a guidewire.  
   
   
       12 . The method of  claim 1 , wherein said lead further comprises echo features for aiding visualization.  
   
   
       13 . The method of  claim 1 , wherein said lead further comprises radiopaque features.  
   
   
       14 . The method of  claim 1 , wherein said lead further comprises a drug eluting surface.