APPARATUS FOR LEAD PLACEMENT ON A SURFACE OF THE HEART
The methods and apparatus for lead placement on a surface of the heart are employed using an elongated body having proximal and distal end portions. The body defines a lead receiving passageway extending between a proximal inlet and a distal outlet for receiving a lead therethrough for contact with the heart surface. The elongated body is adapted for insertion between a pericardium and an epicardial surface. At least a portion of the body may have a non-circular cross-sectional shape adapted to retain the body orientation between the pericardium and the epicardial surface.
1 . An apparatus for placing a lead on a surface of a human heart, the apparatus comprising:
an elongated body including a proximal end portion and a distal end portion, the elongated body having a length adapted to permit minimally invasive access to the heart, the distal end portion of the elongated body defining a longitudinal axis and having a contact surface generally parallel to the longitudinal axis;
a lead receiving passageway extending through the elongated body to a distal outlet on the contact surface; and
a vacuum lumen extending through the elongated body and having a proximal opening and a distal opening, wherein the distal opening is disposed on the contact surface.
2 . The apparatus of claim 1 wherein the contact surface is concave in a direction transverse to the longitudinal axis.
3 . The apparatus of claim 1 wherein the contact surface is planar in a direction transverse to the longitudinal axis.
4 . The apparatus of claim 1 wherein the distal portion of the elongated body has an upper surface and a lower surface, and the contact surface is on the lower surface.
5 . The apparatus of claim 4 wherein the upper surface is convex in a direction transverse to the longitudinal axis and the contact surface is shaped to generally conform to an epicardial surface of the heart.
6 . The apparatus of claim 1 wherein the distal portion of the elongated body has a non-circular cross section in a direction transverse to the longitudinal axis.
7 . The apparatus of claim 6 wherein the elongated body has a width that is greater than a height of the elongated body in a direction transverse to the longitudinal axis.
8 . The apparatus of claim 1 wherein a portion of the lead receiving passageway proximally adjacent the distal outlet extends at an acute angle with respect to the longitudinal axis.
9 . The apparatus of claim 1 further comprising a viewing lumen extending through the elongated body, the viewing lumen having a distal end adjacent the distal outlet.
10 . The apparatus of claim 1 further comprising a steering member for steering the distal end portion of the elongated body.
11 . The apparatus of claim 10 wherein the steering member is adapted to steer the distal end portion of the elongated body in a plane parallel to the longitudinal axis of the elongated body.
12 . The apparatus of claim 1 wherein a portion of the elongated body is curved relative to the longitudinal axis.
13 . The apparatus of claim 1 wherein the vacuum lumen and the lead receiving passageway are non-concentric.
14 . An apparatus for placing a lead on a surface of a human heart, the apparatus comprising:
an elongated body including a proximal end portion and a distal end portion, the elongated body having a length adapted to permit minimally invasive access to the heart, the distal end portion of the elongated body defining a longitudinal axis and having a contact surface generally parallel to the longitudinal axis;
a lead receiving passageway extending through the elongated body to a distal outlet on the contact surface;
a vacuum lumen extending through the elongated body and having a proximal opening and a distal opening, wherein the distal opening is disposed on the contact surface; and
a temporary pacing electrode positioned on the distal end portion of the elongated body.
15 . The apparatus of claim 14 wherein the temporary pacing electrode is positioned adjacent the distal outlet.
16 . The apparatus of claim 14 wherein the temporary pacing electrode is adapted for bipolar pacing and sensing.
17 . An apparatus for placing a lead on a surface of a human heart, the apparatus comprising:
an elongated body including a proximal end portion and a distal end portion, the elongated body having sufficient length to allow minimally invasive access to the heart, the distal end portion of the elongated body defining a longitudinal axis and having a contact surface generally parallel to the longitudinal axis;
a lead receiving passageway extending through the elongated body to a distal outlet on the contact surface; and
temporary and non-invasive means for holding the distal outlet to the surface of the heart.
18 . The apparatus of claim 17 wherein the temporary and non-invasive means comprises a vacuum lumen extending through the elongated body and having a proximal opening and a distal opening, wherein the distal opening is adjacent the distal outlet.
19 . The apparatus of claim 17 further comprising means for pacing the surface of the heart adjacent the distal outlet.
20 . The apparatus of claim 17 further comprising means for electrically mapping the surface of the heart.