Apparatus for lead placement on a surface of the heart

Abstract

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.