US3737579A - Body tissue electrode and device for screwing the electrode into body tissue - Google Patents

Body tissue electrode and device for screwing the electrode into body tissue Download PDF

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Publication number
US3737579A
US3737579A US00135277A US3737579DA US3737579A US 3737579 A US3737579 A US 3737579A US 00135277 A US00135277 A US 00135277A US 3737579D A US3737579D A US 3737579DA US 3737579 A US3737579 A US 3737579A
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conductor
distal end
end portion
body tissue
screwing
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L Bolduc
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Medtronic Inc
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Medtronic Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Definitions

  • a body implantable electrode comprising a flexible insulated conductor having a proximal end adapted for connection to a power supply and a distal end portion comprising an uninsulated, conductive, rigid helix adaptedfor attachment to body tissue. Means located and engageable at substantially the distal end portion are provided for facilitating the screwing of the helix into body tissue.
  • a device is provided with means for firmly holding the means for facilitating the screwing of the helix into bodyv tissue. The device also has means for holding the conductor and for preventing the transmission of torque to the proximal end of the conductor when the helix is being screwed into body tissue.
  • One such technique required a plurality of stab wounds to be made in the myocardium both for the location of the electrode as well as the suturing of the lead to myocardial tissue. Obviously, such wounds are undesirable for a variety of reasons.
  • Other techniques have included the percutaneous insertion through the chest wall or an open wound by means of a hollow needle with the subsequent placement of the electrode into the myocardial tissue.
  • Still another technique involved the deformation or flattening of one convolution of a rigid helix serving as the electrode so that a keyed stylet could engage the deformed convolution to permit the electrode to be screwed into the myocardial tissue.
  • this technique requires that the stylet be in physical contact with the helix during insertion into the myocardium and in addition has the undesirable effect of imparting torque to the proximal end of the coiled conductor.
  • a body implantable electrode assembly in which a flexible insulated electrical conductor has a proximal end thereof adaptable for connection to a power supply and a rigid helix serving as the distal end portion thereof.
  • the rigid helix serves as the electrode to be screwed into the body tissue.
  • a tool or member which is substantially cylindrically-shaped and having a slot located in one end surface thereof, the slot being substantially orthogonal to the longitudinal axis of the member.
  • a groove is located in the outer surface of the member and extends from the end surface opposite the slotted end surface to just short of the slotted end surface and lies in a plane substantially parallel to the longitudinal axis. Also, starting in the same end surface as the groove is a bore extending for the entire length of the member for receiving the proximal end of the conductor.
  • the assembly is used during the implantation of the electrode into body tissue.
  • a raised portion on the conductor near the distal end thereof is fitted into the slotted end of the cylindrically-shaped member.
  • the insulated portion of the conductor is fitted into the groove and the remaining proximal portion of the conductor is inserted into the bore, connector end first.
  • the electrode comprising the rigid helix is securely held by the tool and by applying a twisting or rotation of the tool, the helical electrode may be screwed into the tissue, which in the case of the heart is the myocardium.
  • the portion of the conductor lying in the groove is removed and then the slotted end of thern'embe r is removed from the raised portion of the conductor.
  • the present invention has a number of advantages and features which include: (1') the tool used in facilitating the screwing-in of the electrode into the tissue or organ never contacts the electrode; (2) the configuration of the cylindrically-shaped member and the positioning of the conductor with respect thereto prevents any torque from being imparted to the conductor along its entire length during the rotation of the member; (3) the electrode assembly permits the use of wrapped on tinsel wire, rather than a coiled wire, which has great strength and a very good flex tolerance; (4) the electrode is extremely easy to install, reduces patient trauma, effects a very sound electrical connection description taken in connection with the accompanying drawings.
  • FIG. 1 shows a diagram of an implantable lead in accordance with the present invention
  • FIG. 2 illustrates an embodiment of the device used in conjunction with the lead of FIG. 1 for screwing the electrode into body tissue
  • FIG. 3 is a cross-sectional view of the device shown in FIG. 2;
  • FIG. 4 illustrates the lead of FIG. 1 and the device of FIGS. 2 and 3 in operative relationship for the insertion of the electrode into body tissue.
  • FIG. 1 shows an implantable lead 10 which includes a flexible electrical conductor 12.
  • Conductor 12 may, for example, be made of wrapped platinum wire or other suitable conducting material adaptable to the intemal environment of a human or animal body. Wrapped platinum wire is generally comprised of a pluv rality of platinum ribbons each helically wound around a separate electrically non-conductive core and then all the platinum ribbons are helically wound around a central electrically non-conductive core. A specific description of this type of conductor may be found in my US. Pat. No. 3,572,344, issued Mar.
  • Electrode Apparatus With Novel Lead Construction Affixed to the proximal end of conductor 12 is an electrical connector 14 having a tip orextension 16 which may be connected to a suitable implantable or external power supply. Affixed to and serving as the distal end portion of conductor 12 is a rigid helical electrode 18 having several convolutions. Helical electrode 18 is a rigid coil which may, for example, be made of platinum irridium, and terminates in a sharply pointed end 19. Electrode 18 serves as the distal end portion of conductor 12 which may be screwed into body tissue as will be explained later. Electrode l8 and of projection 24 are three spaced, substantially vertical ribs 25 which are adapted to permit projection 24 to be more securely engaged as will be explained.
  • the distal portion of casing 22 is terminated and shaped as a circular disc 26 through which helical electrode 18 projects.
  • Helical electrode 18 projects through disc 26 at substantially a right angle to conductor 12.
  • Affixed to the under surface of disc 26 is a circular sheet of netting 28, which may, for example, be made of Dacron which is a trademark of E. I. Du Pont De Nemours and Company for a type of polyester fiber. Netting 28 enhances fibroticgrowth, further insuring a secure connection of the electrode to the tissue.
  • FIGS. 2 and 3 illustrate the device used in conjunction with lead to facilitate the screwing of electrode 18 into body tissue.
  • Device 40 comprises a substantially cylindrically-shaped member or tool having a longitudi- I nal axis 42 and end surfaces 44 and 46.
  • Member 40 may be made, for example, of a hard plastic material such as Delrin which is a trademark of the E. I. Du Pont De Nemours and Company for acetal resins.
  • Preferably member 40 should be made of a autoclavable material.
  • Formed in end surface 44 is a slot 48. Slot 48 is shaped so as to be adapted to substantially conform to and securely-engage ribs 25 of raised portion 24 of lead 10.
  • end surface 46 is rounded in order to permit member 40 to be used for surgically producing a tunnel in subcutaneous tissue without causing severe tissue damage.
  • a groove 50 Formed in the outer surface of member 40, lying in a plane substantially parallel to axis 42, and extending from end surface 46 for substantially the entire length of member 40 is a groove 50. Groove 40 is substantially aligned with slot 48. Groove 50 is adaptable to receive and securely engage at least a portionof the length of the insulated portion of lead 10 housed in casing 22.
  • Also formed in end surface 46 is an axial opening or bore 52 extending the entire length of member 40 from end surface 46 to slot 48. Bore 52 is adapted to receive at least a portion of the proximal end of lead 10 including connector 14 and tip 16.
  • FIG. 4 illustrates the operative relationship between lead 10 and member 40 as will now be described.
  • Raised portion 24 is first inserted into slot 48 so that the surfaces defining slot 48 firmly grip ribs 25 to pro vide a friction fit and securely hold projection 24 in the slot.
  • a small loop is left in the portion of casing 22 im- Pointed end 19 is placed against the tissue or organ and member 40 is rotated as indicated by the curved arrow-The diameter of the wound is confined to the diameter of the wire of which helical electrode 18 is formed.
  • helical electrode 18 is firmly screwed into the tissue or organ until netting 2'8 firmly contacts the outer-surface of the organ. Netting 28 helps to provide a more secure and permanent placement of electrode 18 in the tissues in that the netting promotes more rapid fibrosis in andaround the netting, as well as around disc 26 and raised portion 24 of casing 22.
  • end surface 46 of member 40 may be used to provide a tunnel in the subcutaneous layers.
  • the connector-end oflead 10 may then be inserted into bore 52 and member 40 guided back through the tunnel in order to facilitate connecting tip 16 of conductor 14 to a power supplyv to be implanted under the skin.
  • a body implantable electrode assembly that includes a flexible electrical conductor means having a proximal end thereof adaptable for connection to a power supply and wherein the distal end portion of the conductor comprises an uninsulated, conductive, rigid helix adapted for attachment to body tissue, the improvement which comprises:
  • said means located and engageable at substantially said distal end portion for facilitating the screwing of said helix into body tissue and for preventing the transmission of torque to said proximal end of said conductor means when said helix is being screwed into body tissue, said means including further friction increasing means adapted to be firmly held by means used for screwing said helix into body tissue, said means and said further means being substantially inert to body fluids and tissue; and
  • said means located and engageable at the distal end portion comprises a raised section of insulation surrounding the conductor, and wherein;
  • said further means comprises at least one rib on the outer surface of said raised section adapted to frictionally fit with a member having a slot defined therein for receiving said raised section and said at least one rib.
  • said conductor comprises a plurality of electrically non-conducting cores, a plurality of conductive metal ribbons, each of said ribbons being helically wound around a separate one of said electrically non-conducting cores, and a central electrically non-conducting core, said plurality of ribbons wound on said cores being helically wound around said central core.
  • first means for firmly holding a portion of said electrode assembly near said uninsulated distal end portion thereof, said first means contacting only an insulated portion of said electrical conductor;
  • second means adapted to contact an insulated portion of said insulated conductor for holding said conductor to facilitate the screwing of said distal end portion into body tissue and for preventing the transmission of torque to said proximal end of said conductor means when said distal end portion is being screwed into body tissue.
  • one end surface of said member having a slot defined therein for engagement with a portion of said electrode assembly located proximally with respect to said distal end portion thereof; and the outer surface of said member having a groove formed therein, said groove lying substantially parallel to the longitudinal axis of said member, said groove being engageable with a portion of said insulated conductor, whereby rotation of said member about said longitudinal axis permits said distal end portion to be screwed into body tissue without said member contacting said distal end portion and without imparting any torque to said conductor along its length.
  • said member has an axially-extending opening extending from said one end surface to said other end surface.
  • said groove extends from said other end surface toward said one end surface.
  • a body implantable electrode assembly including a flexible insulated electrical conductor means having a proximal end thereof adaptable for connection to a power supply and a conductive uninsulated distal end portion and a device for use in screwing the conductive, uninsulated distal end portion of said assembly into body tissue, said combination comprising:
  • an electrical conductor having its uninsulated distal end portion formed as a rigid helix
  • said device for screwing comprises a substantially cylindrically-shaped member having an axiallyextending bore, said bore extending from said one end surface to said other end surface of said member, said bore being adapted to receive the proximal end of said conductor;
  • said first means comprises one end surface of said member having said slot formed therein;
  • said second means comprises the outer surface of said member having a groove formed therein, said groove lying substantially parallel to the longitudinal axis of said member and extending from the other end surface of said member toward said one end surface.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)
  • Prostheses (AREA)
US00135277A 1971-04-19 1971-04-19 Body tissue electrode and device for screwing the electrode into body tissue Expired - Lifetime US3737579A (en)

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US13527771A 1971-04-19 1971-04-19

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US3737579A true US3737579A (en) 1973-06-05

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US (1) US3737579A (nl)
AR (1) AR193381A1 (nl)
BR (1) BR7202331D0 (nl)
CA (1) CA994869A (nl)
DE (2) DE2219044C3 (nl)
FR (1) FR2133843B1 (nl)
NL (1) NL153756B (nl)

Cited By (90)

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US3875947A (en) * 1974-02-19 1975-04-08 James L Jula Device for screwing body tissue electrode into body tissue
US3910271A (en) * 1973-06-04 1975-10-07 Theodore C Neward Method of making a bipolar electrode structure
US3924639A (en) * 1974-07-17 1975-12-09 Cordis Corp Cardiac pacer lead system for interim pacing during pacer changeover
US3943936A (en) * 1970-09-21 1976-03-16 Rasor Associates, Inc. Self powered pacers and stimulators
US3964473A (en) * 1972-09-21 1976-06-22 Telectronics Pty. Limited Bone prosthesis
USRE28990E (en) * 1972-12-04 1976-10-05 Corometrics Medical Systems, Inc. Bipolar electrode structure for monitoring fetal heartbeat and the like
US4010757A (en) * 1974-02-19 1977-03-08 Jula James L Auxiliary tool for removing electrode from holder
US4010758A (en) * 1975-09-03 1977-03-08 Medtronic, Inc. Bipolar body tissue electrode
US4011861A (en) * 1974-04-03 1977-03-15 Case Western Reserve University Implantable electric terminal for organic tissue
US4026300A (en) * 1975-03-14 1977-05-31 Liberty Mutual Method and apparatus for interfacing to nerves
US4026301A (en) * 1975-04-21 1977-05-31 Medtronic, Inc. Apparatus and method for optimum electrode placement in the treatment of disease syndromes such as spinal curvature
US4030509A (en) * 1975-09-30 1977-06-21 Mieczyslaw Mirowski Implantable electrodes for accomplishing ventricular defibrillation and pacing and method of electrode implantation and utilization
US4031882A (en) * 1975-07-14 1977-06-28 Liberty Mutual Insurance Company Apparatus for interfacing to anatomic signal sources
US4046141A (en) * 1975-07-14 1977-09-06 Liberty Mutual Insurance Company Method and apparatus for interfacing to anatomic signal sources
US4058128A (en) * 1976-08-26 1977-11-15 Frank Howard A Electrode
US4066085A (en) * 1975-01-14 1978-01-03 Cordis Corporation Contact device for muscle stimulation
US4094321A (en) * 1977-02-07 1978-06-13 Rudolph Muto Shallow, dome-shaped pacer with bottom storage means for catheter
US4149542A (en) * 1976-03-26 1979-04-17 Siemens Aktiengesellschaft Endocardial electrode
DE2917173A1 (de) * 1978-04-28 1979-11-08 Medtronic Inc Vorrichtung zum anbringen einer elektrode an koerpergewebe
US4235246A (en) * 1979-02-05 1980-11-25 Arco Medical Products Company Epicardial heart lead and assembly and method for optimal fixation of same for cardiac pacing
US4270549A (en) * 1979-04-30 1981-06-02 Mieczyslaw Mirowski Method for implanting cardiac electrodes
US4271846A (en) * 1979-04-23 1981-06-09 Daig Corporation Lead installation tool
US4282886A (en) * 1979-11-13 1981-08-11 Medtronic, Inc. Adhesive bonded positive fixation epicardial lead
US4282885A (en) * 1978-08-21 1981-08-11 Bisping Hans Juergen Electrode for implantation in the heart
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FR2378529A1 (fr) * 1975-10-28 1978-08-25 Univ Case Western Reserve Electrode en matiere inerte, destinee a etre implantee dans un tissu organique
DE2922354A1 (de) * 1979-06-01 1980-12-11 Bisping Hans Juergen Transvenoese herzschrittmacher-elektrode
SE422885B (sv) * 1980-04-11 1982-04-05 Ursus Konsult Ab Elektrodanordning
DE3015260A1 (de) * 1980-04-21 1981-10-22 Siemens AG, 1000 Berlin und 8000 München Endocard-elektrodenanordnung
DE202012001945U1 (de) 2012-02-24 2012-04-03 Peter Osypka Myokardiale Herzschrittmacher Elektrode

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Cited By (133)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3943936A (en) * 1970-09-21 1976-03-16 Rasor Associates, Inc. Self powered pacers and stimulators
US3964473A (en) * 1972-09-21 1976-06-22 Telectronics Pty. Limited Bone prosthesis
USRE28990E (en) * 1972-12-04 1976-10-05 Corometrics Medical Systems, Inc. Bipolar electrode structure for monitoring fetal heartbeat and the like
US3910271A (en) * 1973-06-04 1975-10-07 Theodore C Neward Method of making a bipolar electrode structure
US4010757A (en) * 1974-02-19 1977-03-08 Jula James L Auxiliary tool for removing electrode from holder
US3875947A (en) * 1974-02-19 1975-04-08 James L Jula Device for screwing body tissue electrode into body tissue
US4011861A (en) * 1974-04-03 1977-03-15 Case Western Reserve University Implantable electric terminal for organic tissue
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FR2133843A1 (nl) 1972-12-01
CA994869A (en) 1976-08-10
DE7214841U (de) 1972-09-28
DE2219044A1 (de) 1972-11-23
DE2219044B2 (de) 1977-11-10
NL153756B (nl) 1977-06-15
BR7202331D0 (pt) 1973-05-24
AR193381A1 (es) 1973-04-23
FR2133843B1 (nl) 1975-03-21
DE2219044C3 (de) 1978-06-29
NL7204868A (nl) 1972-10-23

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