Systems and methods for placing heart leads

Abstract

Devices, systems, and methods for the localization of body lumen junctions and other intraluminal structure are disclosed. Various embodiments permit clinicians to identify and locate lesions and/or anatomical structures within a lumen and accurately place leads and/or devices within a lumen, through determining the intralumen conductance and/or cross-sectional area at a plurality of locations within the body lumen.

1 . A method for placing at least one lead within a heart, comprising the steps of:
 providing a system, comprising:
 a catheter having a proximal end and a distal end, the distal end of the catheter for placement into a blood vessel, the catheter comprising a first electrode and a second electrode, each of the first and second electrodes having a proximal end and a distal end, the distal ends of the first and second electrodes located between the proximal and distal ends of the catheter, 
 a lead for placement in a targeted area in a heart, the lead having a proximal end and a distal end, and wherein the distal end of the lead is removably coupled with the catheter; and 
 a processor connected to the first and second electrodes of the catheter, the processor capable of collecting conductance data to determine a profile of a blood vessel, the conductance data collected at a plurality of locations within the blood vessel and determined at each of the plurality of locations when the distal ends of the first and second electrodes are immersed in a fluid within the blood vessel; 
   determining the profile of the blood vessel through operation of the catheter and the processor;   using the profile of the blood vessel to identify the location of the targeted area; and   advancing the distal end of the catheter and the distal end of the lead through the blood vessel to the targeted area.   
   
   
       2 . The method of  claim 1 , further comprising the steps of:
 positioning the distal end of the lead within the targeted area; and   withdrawing the catheter from the blood vessel.   
   
   
       3 . The method of  claim 2 , wherein the step of positioning the distal end of the lead within the targeted area further comprises steering the distal end of the lead into a bifurcation. 
   
   
       4 . The method of  claim 1 , wherein the step of determining the profile of the blood vessel through operation of the catheter and the processor further comprises the steps of:
 providing constant electrical current flow to the blood vessel through the catheter;   measuring a first conductance value at a first location in the blood vessel;   moving the catheter to a second location in the blood vessel;   measuring a second conductance value at a second location in the blood vessel;   determining a profile of the blood vessel based on the first conductance value of the first location and the second conductance value of the second location.   
   
   
       5 . The method of  claim 1 , wherein the blood vessel comprises a coronary sinus. 
   
   
       6 . The method of  claim 5 , further comprising the steps of:
 inserting the distal end of the catheter and the distal end of the lead into a femoral vein;   advancing the catheter and the lead through the vascular system to a right atrium of a heart;   determining a profile of the right atrium through operation of the catheter and the processor;   using the proof of the right atrium to identify the location of an ostium of the coronary sinus; and   advancing the distal end of the catheter and the distal end of the lead through the ostium and into the coronary sinus.   
   
   
       7 . The method of  claim 1 , wherein the processor further comprises a computational program capable of detecting the dimensions of the blood vessel or organ in real time. 
   
   
       8 . The method of  claim 1 , wherein the fluid comprises blood. 
   
   
       9 . The method of  claim 1 , wherein the profile of the blood vessel comprises relative conductances. 
   
   
       10 . The method of  claim 1 , wherein the profile of the blood vessel comprises relative cross-sectional areas. 
   
   
       11 . The method of  claim 1 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes;   the fluid within the blood vessel comprises a first fluid having a first conductivity and a second fluid having a second conductivity; and   the conductance data is determined at each of the plurality of locations when the distal ends of the first and second electrodes are immersed in each of the first fluid and the second fluid.   
   
   
       12 . The method of  claim 11 , further comprising:
 injecting a known volume of a first solution having a first conductivity into the blood vessel;   injecting a second solution having a second conductivity into the blood vessel, wherein the second solution has a second volume and wherein the second conductivity does not equal the first conductivity;   measuring a second conductance value at the first location in the blood vessel;   calculating the conductance at the first location in the blood vessel;   measuring a first conductance value at the second location in the blood vessel; and   calculating the conductance at the second location in the blood vessel.   
   
   
       13 . The method of  claim 12 , wherein the step of determining a profile of the blood vessel comprises determining a profile of the blood vessel based on the conductance of the first location, the conductance of the second location, and the conductivities of the first and second solutions. 
   
   
       14 . The method of  claim 13 , wherein the profile of the blood vessel comprises cross-sectional areas of the plurality of locations. 
   
   
       15 . The method of  claim 13 , wherein:
 the catheter further comprises a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter, and the proximal ends of the third and fourth electrodes coupled with the processor;   the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes; and   the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes.   
   
   
       16 . A kit for inserting at least one lead into a heart comprising:
 a catheter having a proximal end and a distal end, the distal end of the catheter for placement into a blood vessel, the catheter comprising a first electrode and a second electrode, each of the first and second electrodes having a proximal end and a distal end, the distal ends of the first and second electrodes located between the proximal and distal ends of the catheter; and   at least one lead for placement in a targeted area, the lead having a proximal end and a distal end, and wherein the distal end of the lead may be removably coupled with the catheter;   wherein tie first and second electrodes of the catheter are capable of receiving data for determining a profile of a blood vessel and the first and second electrodes of the catheter are configured to be coupled with a processor for processing conductance data received from the catheter.   
   
   
       17 . The kit of  claim 16 , wherein the catheter further comprises a conductance wire. 
   
   
       18 . The kit of  claim 16 , wherein the catheter further comprises:
 a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter, and the proximal ends of the third and fourth electrodes coupled with the processor;   wherein the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes and the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes.   
   
   
       19 . The kit of  claim 16 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes; and   the catheter is capable of determining conductance data when the distal ends of the first and second electrodes are immersed in a first fluid and a second fluid.   
   
   
       20 . The kit of  claim 18 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes; and   the catheter is capable of determining conductance data when the distal ends of the first and second electrodes are immersed in a first fluid and a second fluid.   
   
   
       21 . The kit of  claim 19 , further comprising:
 a syringe containing an amount of a first fluid; and   a syringe containing an amount of a second fluid.   
   
   
       22 . A kit for inserting at least one lead into a heart, the kit comprising:
 a catheter having a proximal end and a distal end, the distal end of the catheter for placement into a blood vessel, the catheter comprising:
 a first electrode and a second electrode, each of the first and second electrodes having a proximal end and a distal end, the distal ends of the first and second electrodes located between the proximal and distal ends of the catheter; 
 a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter; 
 at least one lead for placement in a targeted area, the lead having a proximal end and a distal end, and wherein the distal end of the lead may be removably coupled with the catheter; and 
 a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes; 
   wherein the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes and the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes;   wherein the first and second electrodes of the catheter are capable of receiving data for determining a profile of a blood vessel and the first and second electrodes of the catheter are configured to be coupled with a processor for processing conductance data received from the catheter;   wherein and the proximal ends of the third and fourth electrodes coupled with the processor; and   wherein the catheter is capable of determining conductance data when the distal ends of the first and second electrodes are immersed in a first fluid and a second fluid.