JPH066170B2 - Pacemaker pacing leads - Google Patents

Description

Detailed Description of the Invention

[0001]

FIELD OF THE INVENTION The present invention relates to pacing leads for use in permanent pacemakers implanted in the human body or temporary pacing leads for use in temporary pacing external pacemakers.

[0002]

2. Description of the Related Art A pacemaker is a device in which an electrode is attached to the inner surface of the heart, and an electric current is sent from a generator placed at a distant site to the heart via the electrode repeatedly at regular time intervals.

For atrial pacing, permanent pacing uses a method of inserting an electrode-equipped lead into the right atrial appendage, a method of contacting the right atrial wall or the atrial septum (screw-in electrode), and temporary pacing at the right atrial appendage. The general method is to insert it into. However, the fixation of the electrodes is poor,
It is not uncommon for pacing to be abandoned due to cases where insertion is difficult and threshold rises due to early electrode movement.

For temporary pacing for treatment, in addition to the method of contacting the right atrial appendage or the wall of the right atrium, transesophageal pacing and a method of inserting an electrode from the coronary sinus to the vicinity of the left atrium are performed. However, it is not suitable for long-term pacing due to the problem of the indwelling site. With atrial ventricular pacing,
The method of inserting two leads with electrodes into the atrium and the ventricle is common. In the case of temporary pacing, one lead is used to bring the electrode-equipped lead into contact with the walls of the atrium and ventricle, but there is a drawback in that the electrode easily moves due to the body movement of the patient.

[0005]

SUMMARY OF THE INVENTION It is an object of the present invention to make it possible to bring the electrodes of the pacing lead into contact with the inner wall of the superior vena cava or the inner wall of the right atrium near the junction of the right atrium of the superior vena cava. There is.

[0006]

According to the pacing lead of the pacemaker of the present invention, a conductor is covered with a flexible resin capable of restoring a predetermined shape, and a special shape portion such as a predetermined spiral is formed at a predetermined position. The above problem is solved by means of exposing the conducting wire as an electrode.

It is preferable to insert a stylet or a shape memory alloy into the special shape portion such as the predetermined spiral to extend the shape.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT An embodiment of the pacemaker pacing lead of the present invention will be described with reference to FIGS.

As shown in FIGS. 1 and 2, the pacing lead 1 of the present invention is composed of a spiral portion 11, straight portions 12, 13, an electrode terminal portion 14, and an electrode portion 15.

The entire pacing lead is flexible,
The spiral-shaped portion 11 can be stretched linearly, but when the external force is removed, the spiral-shaped portion 11 is restored to the original spiral shape.

The pacing lead 1 is made of a conductor 16 covered with a flexible resin 17 as shown in FIG. If necessary, the shape memory alloy 2 or the stylet 3 described later may be provided in the coating resin 17, or the shape memory alloy 2 or the stylet 3 may be inserted into the hole inside the conductor 16.

The electrode 15 and the electrode terminal 14 are electrically connected to the conductor 16. The electrode 15 is provided in the tip portion of the lead 1 and the spiral-shaped portion 11 at one place or at several places.

FIG. 3 shows an example of a shape other than a spiral in a special shape portion such as a spiral. (A) is an Ω shape, (B) is an α shape, (C) is a spiral shape with a plurality of continuous windings, and (D) is a shape in which the straight portions 12 and 13 are wound in a vertical plane. .

[0014]

As shown in FIGS. 1 and 2, the pacing of the present invention
The lead 1 has a spiral shape portion 11 formed in the middle thereof. As shown in FIG. 3, there are various shapes of the special shape part such as the spiral shape. In principle, the electrode 15 is contacted with the inner wall of the superior vena cava or the inner wall 4 of the right atrium (FIG. 6) near the junction of the right atrium of the superior vena cava. It has a shape that can be installed. At the time of insertion, make the pacing lead 1 almost straight with the stylet 3 and place it at the intended insertion position (under fluoroscopy).
Is removed to restore the shape to a predetermined shape.

As the material to be restored, a flexible resin suitable for medical use, such as polyurethane, silicone rubber, and fluorine rubber, is preferable. This material is manufactured in a predetermined shape in advance, or is placed in a special shape such as an embedded spiral in the pacing lead lumen, material or wall thickness. Instead of the stylet 3, a shape memory alloy or a shape memory resin 2 that restores its shape at a temperature (36 ° C. to 38 ° C.) may be used.
Since this is in a flexible state other than the set temperature, the lead can be easily extended.

The shape memory alloy, the resin or the like 2 may be provided on the entire pacing lead 1 or at one place or at several places. The diameter of the spiral portion 11 of the pacing lead 1 can be set to an arbitrary diameter according to the patient. In general,
About 5 to 80 mm is suitable.

[0017]

According to the pacing lead of the present invention,
Due to the specially shaped portion such as the spiral of the lead, the electrode smoothly contacts the inner wall of the superior vena cava or the inner wall of the right atrium in the vicinity of the right atrium junction of the superior vena cava, and long-term stable atrial pacing is possible. In addition, by adjusting the distance from the special shaped part such as the spiral of the lead to the tip, the lead tip can be inserted into the ventricle (atrial chamber), so by providing an electrode on the lead tip, one pacing lead can be used. Atrial ventricle dual chamber pacing is also possible.

[Brief description of drawings]

FIG. 1 is a plan view of a pacing lead of the present invention.

FIG. 2 is a front view seen from the line II-II in FIG.

FIG. 3 is a plan view showing various modified examples of a special shape portion such as a spiral of the lead shown in FIG. 1;

FIG. 4 is a plan view of a part of the lead.

5 is a cross-sectional view taken along the line VV of FIG.

FIG. 6 is an explanatory diagram showing a usage example of the pacing lead of the present invention.

[Explanation of symbols]

 1: Pacing lead 2: Shape memory alloy 3: Stylet 4: Inner wall of superior vena cava 11: Special shaped part such as spiral 12, 13: Straight part 14: Electrode terminal part 15: Electrode 16: Conductive wire 17: Flexible resin

Claims (3)

[Claims] 1. In a pacing lead of a pacemaker, a conducting wire is covered with a flexible resin capable of restoring a prescribed shape, a special shape portion such as a prescribed spiral is formed, and the conducting wire is exposed at a prescribed position. Pacing lead used as an electrode. 2. The pacing lead according to claim 1, wherein a stylet is inserted into the special shape portion such as the spiral and extended. 3. The pacing lead according to claim 1, wherein a shape memory alloy is inserted into and stretched in the special shape portion such as the predetermined spiral.