| 摘要 |
An electrical lead has a cardioverting/defibrillating electrode composed of a multiplicity of tiny flexible elongate metallic fibers, for implantation in a patient. One embodiment of the lead is implanted by puncturing the chest/abdominal wall of the patient and inserting the lead, fiber electrode first, into the body through the puncture site followed by maneuvering the lead by endoscopy to position the electrode adjacent the epicardium of the heart for electrical interaction with the ventricles. The fibers may be interwoven to form a thin tube prestressed to assume a flat spiral shape to permit it to be straightened with a stiffening wire for maneuvering to return to its flat spiral shape after proper positioning and removal of the wire. In other embodiments, the lead has multiple conductors electrically connected to respective electrodes arranged on the lead for positioning transvenously relative to selected regions of the heart. For ventricular fibrillation, the arrangement is such that one electrode is positioned in the right ventricle and another in either the subclavian vein or pulmonary artery at the left side of the heart when the lead is fully implanted. For atrial fibrillation, the arrangement is such that one electrode is positioned in the right ventricle and another in the pulmonary artery adjacent the left atrium when the lead is fully implanted. The fibers of the electrode have a surface layer composed of electrically conductive carbon which may include a substance to inhibit thrombosis, inflammation and/or coagulation at the exposed surface of the electrode when the lead is implanted in the patient's body.
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