US3664347A - Electric heart stimulation method and electrode - Google Patents

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Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes
• • 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
  • A61N1/056—Transvascular endocardial electrode systems

Definitions

• a portion of the filament extends beyond the electrode, thereby forming a flexible tail section that helps to hold the electrode at a desired position within the heart.
• the above-described filament is introduced into a vein in the arm so that it is carried to the heart by the ordinary blood flow through the vein.
• the tail section of the filament is carried through the heart into a portion of the lungs in order to stabilize the position of the electrode within the heart.
• This invention relates to heart stimulation techniques, and is more specifically directed to techniques for applying an electric current to the heart through a filament.
• Numerous illnesses such as heart infarct and myocarditis, require an artificial stimulation of the heart for a limited period of time. After the acute stage of the illness is passed, naturally occurring stimulation of the heart is adequate, so that the artificial stimulation may be eliminated.
• a catheter comprising a wire netting which is insulated with a plastic material.
• This catheter is relatively flexible, but is unipolar. That is, the electrode of the catheter is located at the end point thereof. As a result, the electrode is free to move within the ventricle of the heart, so that it may produce dangerous and undesired mechanical irritations.
• such a catheter has a tendency to move in an uncontrolled manner into the right auricle of the heart.
• Another object of the present invention is to provide an improved filament for safely and conveniently introducing electrodes within the heart so that the electrodes have a fixed position in the heart and can be maintained in this position for a relatively long period of time by means of a tail section provided on said filament.
• Another object of the present invention is to provide an improved method of introducing an electrically controlled electrode into a vein so that the electrode is carried to the heart by normal blood flow and is accurately maintained in a predetermined position in the heart.
• Yet another object of the present invention is to provide improved means for fabricating electrodes used in heart stimulation apparatus.
• the present invention in principal apparatus aspect, comprises a filament flexible enough to be carried by the blood flow in a vein, an electrical conductor carried within the filament, and an electrode connected to the conductor and located at the outer surface of the filament.
• the electrode is displaced from the end point of the filament by a tail section of the filament having a predetermined length.
• the electrode By making the filament out of flexible material and by limiting the thickness of the filament, the electrode can be introduced into the heart without X-ray control and without any substantial danger to the patient. Since the thickness of the filament is very small, it can be quickly introduced into a vein e.g., a vein in the arm) in a relatively painless manner even without local anaesthesia. Moreover, the danger of thrombosis, cuts, or punctures of the vein is completely avoided, so that the filament may be easily manipulated by persons who are not specialists.
• the filament When the filament is introduced into a vein in the foregoing manner, the filament is carried along the bloodstream and eventually into the heart.
• the tail section of the filament is carried through the heart into a portion of the lungs, thereby stabilizing the position of the filament so that the electrode is accurately located in a predetermined portion of the heart.
• the filament is fitted with a plastic core that improves the tensile strength of the filament without substantially reducing the requisite flexibility, thereby reducing the danger of rupturing the electrical conductor.
• the filament By constructing the filament in the above-described manner, it is possible to use a portion of the electrical conductor as an electrode in a convenient manner.
• FIG. I is a fragmentary, schematic illustration of a preferred form of filament made in accordance with the'present invention that shows the manner in which the filament is introduced into a heart;
• FIG. 2 is a fragmentary, perspective view of one embodiment of stimulation apparatus made in accordance with the present invention.
• FIG. 3 is a fragmentary, partially schematic illustration of a preferred form of stimulation apparatus made in accordance with the present invention.
• FIG. 3 is a fragmentary, partially schematic illustration of a preferred form of stimulation apparatus made in'accordance with the present invention.
• FIG. 4 is a cross-sectional view taken along line IVIV in FIG. 3;
• FIG. 5 is a fragmentary, partially schematic view of one manner of constructing the electrodes made in accordance with the present invention
• FIG. 6 is a fragmentary, partially schematic view of another method of constructing the electrodes made in accordance with the present invention.
• the electrodes are positioned at a distance from the end 4 of filament 1 so that a tail section 5 is formed.
• filament I is introduced into a vein 6 in the region of the arm bend of a patient by well-known techniques. Thereafter, the filament, including tail 5, is carried along by the bloodstream in the direction of arrow 7 into the rightventricle 8 of the patients heart 9. After entering ventricle 8, tail 5' is diverted by the bloodstream in the direction of arrow 10 through the outlet of the artery of the lungs, and eventually arrives in an artery of the lungs 11. When tail 5 arrives in the lungs, it tightens electrodes 3 and pulls them against a wall 12 of the right ventricle so that the electrodes assume a fixed position favorable for stimulation of the heart. In order to achieve this effect, tail 5 should be 15 to 30 centimeters in length. After electrodes 3 and tail 5 are in place, a current is generated and conducted through conductor 2 by well-known techniques so that the heart is stimulated.
• FIG. 2 illustrates another form of the invention that is somewhat analogous to the embodiment illustrated schematically in FIG. 1. As a result, corresponding parts are provided with the same reference numerals.
• tail 5 is provided with a roughened surface 5a which increases the flow resistance thereof. This additional resistance aids the transportation of the entire filament through a vein by the flow of blood.
• the toughening may conveniently beachieved by coating the tail section with fine plastic particles.
• filament l is hollow and is fitted with two electrodes 3.
• the filament may also be fabricated in other ways. For example, it may comprise a mesh covered by a smooth outer skin.
• the plastic material forming the outer surface of filament 1 is softened by the application of steam, and the electrodes are then applied onto the softened outer surface.
• the provision of two electrodes increases the effective surface area thereof.
• the electrodes are conveniently connected by conductor 2.
• FIG. 3 A preferred form of stimulation apparatus made in accordance with the present invention is illustrated in FIG. 3.
• the apparatus comprises a thin solid filament 13 of polyurethane having a mean diameter of l millimeter or less.
• the filament has a thin, braided plastic core 14 carried at the midline thereof.
• Two flexible wire conductors, l5 and 16, are embedded on opposite sides of core 14 and midway between the outer wall of filament 13 and core 14. Core 14 absorbes all traction forces so that filament 13 does not tend to stretch. As a result, conductors l5 and 16 do not tend to break, and the reliability of the apparatus is significantly increased.
• FIG. 3 is preferably provided with a tail section such as the one shown in FIG. 2.
• FIG. 5 illustrates one manner in which filament 13 may be constructed so that conductors l5 and 16 may be used as electrodes. More specifically, this result may be achieved by providing recesses 17 and 18 in connection with conductor 15, and by providing recesses 19 and 20 in connection with conductor 16. When the recesses are constructed in the manner illustrated, conductors 15 and 16 are partially exposed so that they may be used as electrodes. Naturally, the electrode surface may be increased by pressing rings about the circumference of filament 13 in contact with the electrodes, or by analogous means. The linear extension of recesses 17-20 is relatively small, and the elevated sections 21 and 22 are left standing between recesses 17, 18 and 19, 20, respectively, so that conductors l5 and 16 will not work themselves free even though they are put under considerable strain.
• FIG. 6 illustrates a preferred method of fabricating conductors l5 and 16 so that they may be used as electrodes.
• conductors 15 and 16 are somewhat drawn out and externally wound around filament 13 in the form of windings 23 and 24, respectively.
• the windings are fastened by means of knots 25 and 26 that are secured through applied drops 27 and 28 of dissolved plastic material. Additional drops of plastic material 29 and 30 may be applied to prevent windings 23 and 24 from sliding. Alternatively, windings 23 and 24 may be sewn through the filament.
• the filament may also be used to measure pressure by merely providing a channel 32 in filament 13 that exits to the surface of the filament at the point at which the pressure measurement is desired.
• Apparatus for the electric stimulation of a heart comprismg:
• flexible filament means having an outer surface and an end point for carrying the electrode and the conductor solely by blood flow in a vein to the heart, said electrode being exposed at the outer surface and being supported by the flexible filament means at a predetermined distance from the end point such that the electrode is maintained at a predetermined position in the heart solely by ordinary blood flow.
• said predetermined distance is adapted to extend from the right auricle of the heart to the outlet of the artery of the lungs.
• the flexible filament means comprises solid polyurethane having a means diameter of about 1 millimeter or less.
• Apparatus as claimed in claim 1, wherein a flexible core is carried by the flexible filament means adjacent the midline thereof.
• Apparatus as claimed in claim 9, and further comprising a second conductor carried on the side of the flexible filament means opposite said conductor, the second conductor being exposed at the outer surface of the flexible filament means.
• a method of electrically stimulating a heart by means of an electrode comprising the steps of:

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• Health & Medical Sciences (AREA)
• Heart & Thoracic Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Veterinary Medicine (AREA)
• Animal Behavior & Ethology (AREA)
• Public Health (AREA)
• Biomedical Technology (AREA)
• Engineering & Computer Science (AREA)
• General Health & Medical Sciences (AREA)
• Pulmonology (AREA)
• Hematology (AREA)
• Anesthesiology (AREA)
• Biophysics (AREA)
• Vascular Medicine (AREA)
• Cardiology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Radiology & Medical Imaging (AREA)
• Electrotherapy Devices (AREA)
• Media Introduction/Drainage Providing Device (AREA)

Abstract

Description

Claims (13)

Applications Claiming Priority (2)

Publications (1)

Family

ID=25755392

Family Applications (1)

Country Status (5)

Cited By (40)

Families Citing this family (9)

Citations (8)

• 1969
  • 1969-04-16 DE DE1919246A patent/DE1919246C3/en not_active Expired
  • 1969-07-09 CH CH1045469A patent/CH508401A/en not_active IP Right Cessation
  • 1969-07-10 AT AT663269A patent/AT299437B/en not_active IP Right Cessation
  • 1969-07-25 US US844876A patent/US3664347A/en not_active Expired - Lifetime
  • 1969-07-25 FR FR6924695A patent/FR2013858A1/fr not_active Withdrawn

Patent Citations (8)

Non-Patent Citations (1)

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