US3924639A - Cardiac pacer lead system for interim pacing during pacer changeover - Google Patents
Cardiac pacer lead system for interim pacing during pacer changeover Download PDFInfo
- Publication number
- US3924639A US3924639A US489187A US48918774A US3924639A US 3924639 A US3924639 A US 3924639A US 489187 A US489187 A US 489187A US 48918774 A US48918774 A US 48918774A US 3924639 A US3924639 A US 3924639A
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- US
- United States
- Prior art keywords
- lead
- pacer
- conductive
- pacing
- interim
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- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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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
- This invention relates to cardiac pacing and more particularly to a cardiac pacer lead system permitting cardiac pacing tobe maintained essentially continuously during pacer replacement, especially with unipolar p'acers.
- the pacer unit itself is typically implanted in a location remote from the patients heart. The location is selected so that access to the pacer itself can be obtained by means of a relatively simple surgical procedure as compared with that required when the pacer and stimulating electrode are initially installed or placed. 7
- the battery powered pacer unit is typically connected to the lead and electrode assembly by means of some sort of separable connector so that, after a preselected interval or upon the occurrence of some change indicating battery failure, the pacer circuit itself can be replaced while retaining the originally installed electrode and lead assembly. While such'an'arrangement facilitates the replacement of the pacer unit, some problems have still remained with respect to the patients who require essentially continuous pacing. If pacing is not maintained while the substitute pacer is installed, the attending physician will be under considerable pressure to work quickly. Thus, a danger exists that the connector might not be properly assembled or seale df due 'to the haste required.
- the need for the essentially continuous presence of the pacemaker circuit may render it difficult to test stimulation thresholds or pacer sensitivity in the case of standby pacing.
- a temporary system had to be installed consisting of a pervenous lead and an external pacemaker to provide'stimuli to the heart during the replacement of a permanent pacemaker. This method is employed for those patients who are suspected to suffer from standstill of the heart when stimulation is disrupted.
- a cardiac pacer lead system which facilitates pacer replacement by permitting connection to the cardiac electrode of a-second pacer or monitor unit before the pacer being replaced is disconnected; the provision of such a lead system which permits threshold and sensitivity testing, either with an implantable pacer unit in place or removed; the provision of such a lead system which does not reduce lead reliability; the provision of such a lead system which is readily and easily used to provide interim pacing; and the provision of such a lead system which is of relatively simple and inexpensive construction.
- a lead system in accordance with the present invention is adapted for use with an implantable cardiac pacer having a terminal through which signals are coupled for pacing the heart of a patient.
- a flexible electrical lead is employed which has an insulating sheath over a majority of its length.
- an electrode is provided which is adapted to contact cardiac tissue for applying stimulating pulses thereto.
- a connector adapted to engage the pacer terminal.
- a mass of conductive rubbery material which material is electrically interconnected with the lead.
- An insulating jacket of a nonconductive rubbery material extends over the conductive mass from the lead sheath.
- the jacket is shaped to engage the case of the pacer and form a seal around the contact between the connector and the pacer terminal. .As the conductive mass can be electrically contacted by a needle-like element inserted through the insulating jacket, interim pacing is facilitated during replacement of the pacer.
- FIG. 1 is a side view, with parts broken away, of a lead system in accordance with the present invention, showing the connection of the lead system with a cardiac pacemaker;
- FIG. 2 is a view, taken on the line2-2 of FIG. 1, showing the cross-section of the proximal end of the lead system and showing also the method of connecting to the lead for interim pacing.
- FIG. 1 a conventional cardiac pacemaker.
- a conventional cardiac pacemaker incorporates suitable timing circuits and batteries for energizing of those circuits for an appropriate length of time, e.g. several years.
- pacing can be accomplished with a single electrical lead extending to the patients heart, a metallic portion of the pacemaker case serving as a remote ground or reference potential.
- the invention can also be applied advantageously to bipolar pacing.
- Stimulating pulses generated by the pacer 11 are applied to the patients heart through a suitable electrode l3.'ln the embodiment illustrated, electrode 13 is of the type which is adapted to be surgically attached to the outside of the patients heart, i.e. a so-called epicardial electrode. As indicated previously, an alternative method of applying stimulating pulses is through a pervenous electrode, i.e. an electrode which is inserted through a vein and which is caused to be lodged in one of the chambers of the patients heart. Electrode 13 is coupled with the pacer 11 by means of a flexible insulated electrical lead comprising a coiled wire 15 residing within a tubular insulating sheath 17 of silicone rubber.
- a jack 21 constitutes the output terminal of the pacer l1 and at the proximal end of the lead, the helical conductor 15 is attached to a connector pin 19 which is adapted to establish electrical contact with the jack.
- a plug of a conductive silicone rubber is cast around the helical conductor 15 essentially at the point of its juncture with the connector pin 19.
- the conductive silicone rubber is in direct intimate contact with the turns of the coiled wire so that good electrical contact is established.
- the end of the plug is shaped so as to receive the end of the tubular lead sheath 17, as illustrated I
- a jacket 27 of an insulating silicone rubber or plastic substancep Preferably, the jacket '27 extends over and is sealed to the tubular sheath l7 and, at the opposite end, extends partially over the connector pin 19.
- the portion of the jacket 27 around the pin '19 is preferably shaped, as illustrated," so as to contact and effect a seal with the case of the pacer ll.
- the lead system described above facilitates interim cardiac pacing during pacer replacement by permitting an alternative connection to be established to the cardiac electrode 13, using a needle-like element to engage the conductive silicone rubber plug'25. Preferably, this is done utilizing a tool 30"which acts as a templet, guiding the needle-like piercingelement as illustrated in FIG. 2.
- the interim contact device comprises a'yoke-like member 31,' the lower portion'of which isbifurcated so as to straddle the connector portion of the lead system.
- a needle-like element 33 extends from the member 31' into the hollow of the yoke-like portion, so as to piercethe sheath 27 and the plug 25 when the member 31 is placed over the connector portion of the lead assembly.
- the needle like member 33 is preferably'mounted off center, as illustrated in FIG. 2, so that it does not directly contact the coiled wire 25, thereby avoiding any damage to the wire. However, by passing into the conductive plug 25 as illustrated, the needle-like element 33 establishes an electrical connection to the pacing electrode 13.
- a terminal 35 extending from the tool. 30 is provided for connection to external pacing apparatus, e.g. through a suitable clip or connector (not shown).As will be understood by those skilled in the art, external pacers of various types are known, being commonly used for temporary pacing following cardiac surgery and'the like.
- both pacers can operate simultaneously, eithe r pacer responding to naturally occurring heartbeats.
- the first to generate a stimulating pulse will be detected by the other and control its operation.
- the external pacer is appropriately left turned off until the connector is separated, at which time-the external pacer can be turned on without delay since the connection to the stimulating electrode can be pre-established.
- an insulating sheath over said lead, for a, majority of its length, an insulating sheath; I i I at one end of said lead, an electrode adapted to contactv cardiac tissue for applying stimulating pulses thereto;
- a connector adapted to engage said pacer terminal for coupling stimulating signals generated said pacer to said electrode; in the region of the juncture of said lead and said connector, a mass of conductive, rubbery material electrically interconnected with said lead;
- auxiliary. connection means including a needle-like conductiveelement insertable through said jacket to establish electrical contact with said conductive rubbery mass to permit interim pacing of a patients heart during replacement of a pacer; and 1 guide means fordirecting said needle-like element into said conductive rubbery mass without directly contactingsaid lead.
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- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Electrotherapy Devices (AREA)
Abstract
Description
Claims (5)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US489187A US3924639A (en) | 1974-07-17 | 1974-07-17 | Cardiac pacer lead system for interim pacing during pacer changeover |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US489187A US3924639A (en) | 1974-07-17 | 1974-07-17 | Cardiac pacer lead system for interim pacing during pacer changeover |
Publications (1)
Publication Number | Publication Date |
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US3924639A true US3924639A (en) | 1975-12-09 |
Family
ID=23942757
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US489187A Expired - Lifetime US3924639A (en) | 1974-07-17 | 1974-07-17 | Cardiac pacer lead system for interim pacing during pacer changeover |
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Country | Link |
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US (1) | US3924639A (en) |
Cited By (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4033355A (en) * | 1975-11-28 | 1977-07-05 | Cardiac Pacemakers, Inc. | Electrode lead assembly for implantable devices and method of preparing same |
US4044774A (en) * | 1976-02-23 | 1977-08-30 | Medtronic, Inc. | Percutaneously inserted spinal cord stimulation lead |
US4072154A (en) * | 1976-05-28 | 1978-02-07 | Cardiac Pacemakers, Inc. | Sealing arrangement for heart pacer electrode leads |
US4198991A (en) * | 1978-05-17 | 1980-04-22 | Cordis Corporation | Cardiac pacer lead |
US4220386A (en) * | 1977-03-10 | 1980-09-02 | Needle Industries Limited | Plug and socket connectors |
US4230127A (en) * | 1978-05-24 | 1980-10-28 | Medtronic, Inc. | Cardiac monitoring apparatus |
US4248237A (en) * | 1978-03-07 | 1981-02-03 | Needle Industries Limited | Cardiac pacemakers |
US4369794A (en) * | 1980-10-30 | 1983-01-25 | Mallinckrodt, Inc. | Probe with electrocardiographic monitoring |
US4469104A (en) * | 1982-07-16 | 1984-09-04 | Cordis Corporation | Multipolar connector for pacing lead |
US4690155A (en) * | 1985-07-03 | 1987-09-01 | Cordis Corporation | Monophasic action potential recording lead |
US5111830A (en) * | 1989-11-30 | 1992-05-12 | Marc Bemurat | Pacemaker lead with auxiliary stimulation pole |
AU660515B2 (en) * | 1991-12-17 | 1995-06-29 | Marc Bemurat | Stimulation lead specially cardiac with auxiliary connection |
US5480419A (en) * | 1991-12-17 | 1996-01-02 | Bemurat; Marc F. | Stimulation lead specially cardiac with auxiliary connection |
US20040215300A1 (en) * | 2003-04-23 | 2004-10-28 | Medtronic, Inc. | Electrical medical leads employing conductive aerogel |
US20050043651A1 (en) * | 2001-12-27 | 2005-02-24 | Medinnova Vs | Use of sensor and system for monitoring heart movements |
US20060009828A1 (en) * | 2004-05-05 | 2006-01-12 | Marc Bemurat | Bipolar cardiac pacing wire with auxiliary pole |
US20120045918A1 (en) * | 2009-04-23 | 2012-02-23 | Pierre-Yves Litzler | Subcutaneous device for electrical percutaneous connection |
US8639353B2 (en) | 2009-04-23 | 2014-01-28 | Centre Hospitalier Universitaire De Rouen | Electrical connection device implantable in the human body |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3216424A (en) * | 1962-02-05 | 1965-11-09 | William M Chardack | Electrode and lead |
US3344391A (en) * | 1964-02-14 | 1967-09-26 | Elastic Stop Nut Corp | Waterproof electrical connections |
US3737579A (en) * | 1971-04-19 | 1973-06-05 | Medtronic Inc | Body tissue electrode and device for screwing the electrode into body tissue |
-
1974
- 1974-07-17 US US489187A patent/US3924639A/en not_active Expired - Lifetime
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3216424A (en) * | 1962-02-05 | 1965-11-09 | William M Chardack | Electrode and lead |
US3344391A (en) * | 1964-02-14 | 1967-09-26 | Elastic Stop Nut Corp | Waterproof electrical connections |
US3737579A (en) * | 1971-04-19 | 1973-06-05 | Medtronic Inc | Body tissue electrode and device for screwing the electrode into body tissue |
Cited By (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4033355A (en) * | 1975-11-28 | 1977-07-05 | Cardiac Pacemakers, Inc. | Electrode lead assembly for implantable devices and method of preparing same |
US4044774A (en) * | 1976-02-23 | 1977-08-30 | Medtronic, Inc. | Percutaneously inserted spinal cord stimulation lead |
US4072154A (en) * | 1976-05-28 | 1978-02-07 | Cardiac Pacemakers, Inc. | Sealing arrangement for heart pacer electrode leads |
US4220386A (en) * | 1977-03-10 | 1980-09-02 | Needle Industries Limited | Plug and socket connectors |
US4262982A (en) * | 1977-03-10 | 1981-04-21 | Needle Industries Ltd. | Electrical socket useful for connecting an electrode catheter to a cardiac pacemaker casing |
US4248237A (en) * | 1978-03-07 | 1981-02-03 | Needle Industries Limited | Cardiac pacemakers |
US4198991A (en) * | 1978-05-17 | 1980-04-22 | Cordis Corporation | Cardiac pacer lead |
US4230127A (en) * | 1978-05-24 | 1980-10-28 | Medtronic, Inc. | Cardiac monitoring apparatus |
US4369794A (en) * | 1980-10-30 | 1983-01-25 | Mallinckrodt, Inc. | Probe with electrocardiographic monitoring |
US4469104A (en) * | 1982-07-16 | 1984-09-04 | Cordis Corporation | Multipolar connector for pacing lead |
US4690155A (en) * | 1985-07-03 | 1987-09-01 | Cordis Corporation | Monophasic action potential recording lead |
US5111830A (en) * | 1989-11-30 | 1992-05-12 | Marc Bemurat | Pacemaker lead with auxiliary stimulation pole |
AU660515B2 (en) * | 1991-12-17 | 1995-06-29 | Marc Bemurat | Stimulation lead specially cardiac with auxiliary connection |
US5480419A (en) * | 1991-12-17 | 1996-01-02 | Bemurat; Marc F. | Stimulation lead specially cardiac with auxiliary connection |
US20050043651A1 (en) * | 2001-12-27 | 2005-02-24 | Medinnova Vs | Use of sensor and system for monitoring heart movements |
US20040215300A1 (en) * | 2003-04-23 | 2004-10-28 | Medtronic, Inc. | Electrical medical leads employing conductive aerogel |
US7065411B2 (en) | 2003-04-23 | 2006-06-20 | Medtronic, Inc. | Electrical medical leads employing conductive aerogel |
US20060009828A1 (en) * | 2004-05-05 | 2006-01-12 | Marc Bemurat | Bipolar cardiac pacing wire with auxiliary pole |
US20120045918A1 (en) * | 2009-04-23 | 2012-02-23 | Pierre-Yves Litzler | Subcutaneous device for electrical percutaneous connection |
US8545255B2 (en) * | 2009-04-23 | 2013-10-01 | Centre Hospitalier Universitaire De Rouen | Subcutaneous device for electrical percutaneous connection |
US8639353B2 (en) | 2009-04-23 | 2014-01-28 | Centre Hospitalier Universitaire De Rouen | Electrical connection device implantable in the human body |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: SOUTHEAST BANK, N.A., MIDLAD BANK PLC (SINGAPORE B Free format text: SECURITY INTEREST;ASSIGNOR:CORDIS LEADS, INC., A CORP. OF DE;REEL/FRAME:004747/0320 Effective date: 19870612 |
|
AS | Assignment |
Owner name: SOUTHEAST BANK, N.A., MIDLAND BANK PLC (SINGAPORE Free format text: SECURITY INTEREST;ASSIGNOR:CORDIS HEADS, INC.;REEL/FRAME:004734/0550 Effective date: 19870630 |
|
AS | Assignment |
Owner name: CORDIS LEADS, INC., 10555 WEST FLAGLER STREET, MIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:CORDIS CORPORATION, A CORP. OF FLORIDA;REEL/FRAME:004747/0313 Effective date: 19870430 Owner name: CORDIS LEADS, INC., FLORIDA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:CORDIS CORPORATION, A CORP. OF FLORIDA;REEL/FRAME:004747/0313 Effective date: 19870430 |
|
AS | Assignment |
Owner name: SOUTHEAST BANK, N.A. Free format text: SECURITY INTEREST;ASSIGNOR:CORDIS LEADS, INC., A DE CORP.;REEL/FRAME:004896/0205 Effective date: 19880602 |
|
AS | Assignment |
Owner name: SOUTHEAST BANK, N.A., AS SECURITY AGENT Free format text: SECURITY INTEREST;ASSIGNOR:CORDIS LEADS, INC., A CORP. OF DE;REEL/FRAME:004896/0372 Effective date: 19880610 |
|
AS | Assignment |
Owner name: CORDIS LEADS, INC., 10555 W. FLAGLER STR., MIAMI, Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:SOUTHEAST BANK, N.A., MIDLAND BANK PLC AND CREDIT LYONNAIS;REEL/FRAME:004996/0829 Effective date: 19880615 Owner name: TPL-CORDIS, INC., A DE CORP., FLORIDA Free format text: NUNC PRO TUNC ASSIGNMENT;ASSIGNOR:CORDIS LEADS, INC.;REEL/FRAME:005003/0158 Effective date: 19881130 Owner name: TELECTRONICS, INC., A DE CORP., CONNECTICUT Free format text: NUNC PRO TUNC ASSIGNMENT;ASSIGNOR:TPL-CORDIS, INC.;REEL/FRAME:005003/0166 Effective date: 19881130 |
|
AS | Assignment |
Owner name: TELECTRONICS, U.S.A., INC., CONNECTICUT Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:SOUTHEAST BANK N.A.;REEL/FRAME:005181/0530 Effective date: 19890831 |
|
AS | Assignment |
Owner name: TELECTRONICS PACING SYSTEMS, INC., COLORADO Free format text: ASSIGNORS HEREBY CONFIRMS THE ENTIRE INTEREST IN SAID INVENTIONS TO ASSIGNEE ELECUTED ON SEPT. 16,1988;ASSIGNORS:TELECTRONICS PTY. LTD.;MEDICAL TELECTRONICS HOLDING & FINANCE CO.;TELECTRONIC NV;AND OTHERS;REEL/FRAME:006172/0028 Effective date: 19920622 |
|
AS | Assignment |
Owner name: TELECTRONICS PACING SYSTEMS, INC., COLORADO Free format text: CORRECTIVE ASSIGNMENT TO CORRECT ASSIGNEE S STATE OF INCORPORATION. AN ASSIGNMENT WAS PREVIOUSLY RECORDED AT REEL 6172, FRAME 0028;ASSIGNORS:TELECTRONICS PTY. LTD., AN AUSTRALIAN COMPANY;MEDICAL TELECTRONICS HOLDING & FINANCE CO. (BV), A DUTCH COMPANY;TELECTRONICS NV, A COMPANY OF THE NETHERLANDS ANTILLES;AND OTHERS;REEL/FRAME:008321/0072 Effective date: 19961101 |