Transvenous defibrillating and pacing lead

Claim 2

A transvenous catheter lead for introduction into the right side of the heart of a cardiac patient for delivering defibrillating shocks to the heart, said lead being an elongated member with electrical connector means at a proximal end, electrode means at a distal end, and first conductor means interconnecting the connector means and the electrode means, the lead having an enlarged flexible portion subjacent to the electrode means for supporting the electrode means, the electrode means comprising a defibrillating electrode coil having an electrically conductive surface exposed along a portion of said lead adjacent said distal end, said coil being a continuation of the conductor means connected to the electrical connector means and being wound on the enlarged flexible portion so that its mid-section has a diameter exceeding the diameter of its ends, and means to secure at least said distal end of said lead in the ventricle of the heart whereby said electrode coil extends substantially the entire length of the right ventricle for delivering defibrillating shocks to the ventricular mass.

Claim 3

The lead according to claim 1, wherein said lead further comprises a pacing electrode means positioned at the distal end of said lead and electrically isolated from said electrode coil for use in electrically stimulating myocardial tissue and in sensing the response of the heart to the stimulation and to the delivery of the defibrillating shocks, and second conductor means connecting said pacing electrode means to second connector means at the proximal end of the lead.

Claim 4

The lead according to claim 2, wherein said pacing electrode means comprises a stimulating cathodic electrode coated with a layer of iridium oxide.

Claim 5

The lead according to claim 2, further comprising means forming a passage for a stylet to engage and position said securing means.

Claim 6

The lead according to claim 4, wherein said first and second conductor means are coaxial coils the innermost coil forming said stylet passage.

Claim 7

The lead according to claim 1, wherein the enlarged portion comprises tapered outer end portions leading to a central portion of uniform dimensions.

Claim 8

The lead according to claim 6 wherein the enlarged portion comprises a sleeve having an axial passage.

Claim 9

The lead according to claim 7 wherein the sleeve comprises an elastomeric insulating material.

Claim 10

The lead according to claim 8, wherein said electrode coil comprises a plurality of wires tightly wound in a multi-filar configuration.

Claim 11

The lead according to claim 9, wherein each of said wires is composed of copper-zirconium alloy wrapped with tantalum.

Claim 12

The lead according to claim 10, wherein the surface of said electrode coil exposed along said lead is coated with a layer of iridium oxide.

Claim 13

A transvenous defibrillating lead for use with an implantable cardiac stimulator, said lead being an elongated member with distal and proximal ends and comprising at least first and second electrical connector means at said proximal end of said lead, pacing electrode means at the distal end of said lead, first conductor means connecting said pacing electrode means to said first connector means for use in delivering pacing stimuli to excitable cardiac tissue of a chamber in the right side of the heart, and coil electrode means adjacent to and spaced from said pacing electrode means and comprising tightly wound wire forming an electrically-conductive coil wound on an enlarged flexible support means and exposed along a limited portion of the length of said lead and second conductor means connecting said coil to said second connector means for use in delivering defibrillating stimuli to tissue of a selected chamber of the heart, said exposed limited portion arranged and adapted to be disposed along substantially the entire length of said selected chamber when said pacing electrode means is properly positioned, said flexible support means being flared to provide a greater diameter along the mid-section thereof than the diameter at either end, and means to fix said distal end of said lead with respect to said heart.

Claim 14

A transvenous defibrillating lead for use with an implantable cardiac stimulator, said lead being an elongated member with distal and proximal ends and comprising at least first and second electrical connector means at said proximal end of said lead, pacing electrode means at the distal end of said lead, first conductor means connecting said pacing electrode means to said first connector means for use in delivering pacing stimuli to excitable cardiac tissue of a chamber in the right side of the heart, and coil electrode means adjacent to and spaced from said pacing electrode means and comprising tightly wound wire forming an electrically-conductive coil wound on an enlarged flexible support means and exposed along a limited portion of the length of said lead and second conductor means connecting said coil to said second connector means for use in delivering defibrillating stimuli to tissue of a selected chamber of the heart, said exposed limited portion arranged and adapted to be disposed along substantially the entire length of said selected chamber when said pacing electrode means is properly positioned, said flexible support means being flared to provide a greater diameter along the mid-section thereof than the diameter at either end, and means to fix said distal end of said lead with respect to said heart.

Claim 15

The lead according to claim 12, wherein the flexible support means comprises tapered outer end portions leading to a central portion of uniform dimensions.

Claim 16

The lead according to claim 13 wherein the flexible support means comprises a sleeve having an axial passage.

Claim 17

The lead according to claim 14 wherein the sleeve comprises an elastomeric insulating material.

Claim 18

The invention according to claim 15, wherein said coil comprises a plurality of wires tightly wound side-by-side to form a multi-filar coil.

Claim 19

The invention according to claim 16, wherein each of said conductor means are composed of copper-zirconium alloy wrapped with tantalum.

Claim 20

The invention according to claim 17, wherein the exposed surfaces of said second conductor means is coated with a layer of iridium oxide.

Claim 21

The invention according to claim 12, wherein the exposed surface of said coil along said limited portion is coated with iridium oxide.

Claim 22

The invention according to claim 19, wherein said pacing electrode means comprises a stimulating cathodic electrode coated with a layer of iridium oxide.

Claim 23

The invention according to claim 12, wherein a distal end of said coil is spaced from said pacing electrode means by approximately one centimeter, and said coil has an exposed length in the range of from six to ten centimeters.

Claim 24

The invention according to claim 12, wherein one of said conductor means is in the form of a coil extending between said first electrical connector means and said pacing electrode means further comprising a stylet capable of passing through said conductive coil to engage and position said fixation means.

Claim 25

A defibrillating lead comprising flexible elongate electrically conductive means of predetermined length and enclosed within an insulative sheath for transvenous introduction into the heart, electrical connector means on a proximal end of said conductive means, a flexible tightly wound electrically conductive coil integral with said elongate conductive means and adjacent a distal end thereof, said coil having an exposed length sufficient to be disposed along substantially the entire length of a chamber of the heart to be defibrillated when said lead is positioned for defibrillation, a first insulative sleeve enclosing said conductive means and a second flexible insulative sleeve received on said first sleeve and supporting said coil, said second insulative sleeve being flared from a first smaller diameter at either end thereof to a second larger diameter intermediate its ends whereby a relatively large electrically conductive surface area is exposed within said chamber.

Claim 26

A defibrillating lead comprising flexible elongate electrically conductive means of predetermined length and enclosed within an insulative sheath for transvenous introduction into the heart, electrical connector means on a proximal end of said conductive means, a flexible tightly wound electrically conductive coil integral with said elongate conductive means and adjacent a distal end thereof, said coil having an exposed length sufficient to be disposed along substantially the entire length of a chamber of the heart to be defibrillated when said lead is positioned for defibrillation, a first insulative sleeve enclosing said conductive means and a second flexible insulative sleeve received on said first sleeve and supporting said coil, said second insulative sleeve being flared from a first smaller diameter at either end thereof to a second larger diameter intermediate its ends whereby a relatively large electrically conductive surface area is exposed within said chamber.

Claim 27

The lead of claim 23, wherein said conductive means and said coil are fabricated from wire composed of copper-zirconium alloy clad with tantalum.

Claim 28

The lead of claim 24, wherein said wire is coated with iridium oxide at least along the exposed length thereof.

Claim 29

The lead of claim 23, wherein said coil length is sufficient for the coil to extend as well into a adjacent chamber on the same side of the heart.

Claim 30

The lead of claim 23, further comprising fixation means to secure at least the distal end of said lead to cardiac tissue.

Claim 31

The lead according to claim 23, wherein the second insulative sleeve comprises tapered outer end portions leading to a central portion of uniform dimensions.

Claim 32

The lead of claim 28, wherein said conductive means and said coil are composed of a multi-filar winding.