Pacing guidewire
Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes. A corewire can extend the length of the elongate body, can at least partially form the first conductor, and can be at least partially surrounded by the second conductor.
1. A pacing guidewire, comprising:
an elongate body having an outer diameter ranging from 0.014 in to 0.038 in, inclusive, and configured to receive and to support delivery of an elongate treatment device over the pacing guidewire, the elongate body extending from a proximal end portion of the pacing guidewire to a distal end portion of the pacing guidewire and having an intermediate portion therebetween, the distal end portion including a preformed bias shape in the form of a pigtail-shaped region that turns through 540 degrees or more, the preformed bias shape extending distally to a tip of the distal end portion of the pacing guidewire; and
at least first and second electrodes spaced apart on the preformed bias shape, one of the electrodes serving as an anode and the other electrode serving as a cathode for delivering pacing pulses to a heart of a patient while supporting delivery of the elongate treatment device to the heart of the patient,
the elongate body including a first elongate conductor extending from a proximal end portion to a distal end portion that is electrically connected to the first electrode, and a second elongate conductor, insulated from the first elongate conductor, extending from a proximal end portion to a distal end portion that is electrically connected to the second electrode.
2. The pacing guidewire of claim 1 , wherein the second electrode has a non- cylindrical, strip-like shape axially extending for a length between 5 cm and 10 cm, inclusive.
3. The pacing guidewire of claim 1 , wherein the first elongate conductor is slidable relative to the second elongate conductor such that spacing between the first and second electrodes is adjustable.
4. The pacing guidewire of claim 1 , wherein the elongate body further comprises a V-shaped region that is configured to conform to a ventricular apex of a heart.
5. The pacing guidewire of claim 1 , wherein the preformed bias shape is non-coplanar relative to the intermediate portion of the elongate body.
6. The pacing guidewire of claim 1 , further comprising a connector body removably couplable to the proximal end portion of the elongate body and electrically couplable to the proximal end portions of the first and second elongate conductors.
7. The pacing guidewire of claim 6 , wherein the connector body includes a seal member between a first terminal, electrically couplable with the first elongate conductor, and a second terminal, electrically couplable with the second elongate conductor.
8. The pacing guidewire of claim 6 , wherein the connector body includes first and second pulse generator connector portions electrically couplable to the first and second elongate conductors, the pulse generator connector portions being color-coded for identification of each conductor's polarity.
9. The pacing guidewire of claim 1 , wherein the pigtail-shaped region has a curve height of between about 20 mm and about 40 mm.
10. The pacing guidewire of claim 9 , wherein at least one of the first and second elongate conductors is formed of two or more structures that are electrically connected.
11. The pacing guidewire of claim 10 , wherein the two or more structures include a first structure in the form of a corewire and a second structure in the form of a helical coil.
12. The pacing guidewire of claim 10 , wherein the two or more structures include a first structure in the form of a hypotube or a braid and a second structure in the form of a helical coil.
13. The pacing guidewire of claim 12 , wherein the hypotube or the braid surrounds a portion of a corewire.
14. The pacing guidewire of claim 9 , wherein each of the first and second elongate conductors is at least partially in the form of a helical coil.
15. The pacing guidewire of claim 14 , wherein the helical coil includes a single helically-wound flat wire.
16. The pacing guidewire of claim 14 , further comprising insulation surrounding an outer surface of the helical coil.
17. The pacing guidewire of claim 16 , wherein at least one of the first and second electrodes is an exposed, non-insulated portion of the helical coil.
18. A pacing guidewire, comprising:
an elongate body having an outer diameter ranging from 0.014 in to 0.038 in, inclusive, and configured to receive and to support delivery of an elongate treatment device over the pacing guidewire, the elongate body extending from a proximal end portion of the pacing guidewire to a distal end portion of the pacing guidewire and having an intermediate portion therebetween, the distal end portion of the pacing guidewire including a preformed bias shape that turns through 360 degrees or more and extends distally to a tip of the pacing guidewire such that the tip is configured to curve away from a ventricular wall; and
at least first, second, third, and fourth electrodes spaced apart on the preformed bias shape, one of the electrodes serving as a first polarity and the other electrodes serving as a second polarity, which is opposite of the first polarity, for delivering pacing pulses to a heart of a patient while supporting delivery of the elongate treatment device to the heart of the patient,
the elongate body including a first elongate conductor extending from a proximal end portion to a distal end portion that is electrically connected to the first electrode, and a second elongate conductor, insulated from the first elongate conductor, extending from a proximal end portion to a distal end portion that is electrically connected to the second, third and fourth electrodes.
19. The pacing guidewire of claim 18 , wherein each of the second, third and fourth electrodes has a cylindrical shape and serves as a cathode, and wherein a collective length of the second, third and fourth electrodes is 15 mm or less.
20. A left ventricular pacing guidewire, comprising:
an elongate body having an outer diameter ranging from 0.014 in to 0.038 in, inclusive, and configured to receive and to support delivery of an elongate treatment device over the pacing guidewire, the elongate body extending from a proximal end portion of the pacing guidewire to a distal end portion of the pacing guidewire and having an intermediate portion therebetween, the distal end portion including a first region configured to contact a ventricular wall on a first side of a ventricular apex, a second region configured to span across the ventricular apex, a third region configured to contact a ventricular wall on a second side of the ventricular apex, and a fourth region configured to curve away from the ventricular wall on the second side of the ventricular apex;
a first electrode disposed on the fourth region; and
a second electrode, a third electrode and a fourth electrode disposed on one of the first region, the second region or the third region,
the elongate body including a first elongate conductor extending from a proximal end portion to a distal end portion that is electrically connected to the first electrode, and a second elongate conductor, insulated from the first elongate conductor, extending from a proximal end portion to a distal end portion that is electrically connected to the second, third and fourth electrodes.
21. The left ventricular pacing guidewire of claim 20 , further comprising a connector body removably couplable to the proximal end portion of the elongate body and electrically couplable to the proximal end portions of the first and second elongate conductors.
22. The left ventricular pacing guidewire of claim 21 , wherein the connector body includes a seal member between a first terminal, electrically couplable with the first elongate conductor, and a second terminal, electrically couplable with the second elongate conductor.