Electromedical electrode assembly

Abstract

The present invention relates to an improvement in the technical field of electromedical electrode assemblies. As an improvement, an electromedical electrode assembly (1) is proposed, which comprises at least one implantable cardioversion electrode (2) consisting of an electrically conductive surface formation (3) that is flexible, flat in the undeformed use position, and configured for surface contact with target tissue.

Description

[Technical field]

[0001] The present invention relates to an electro-medical electrode assembly comprising at least one implantable cardioversion electrode for delivering electrical and cardioversion pulses to target tissue, particularly myocardial tissue.

[0002] Such an electromedical electrode assembly is temporarily implanted in a patient, for example after cardiac surgery, and is used to support cardiac activity. Via the implantable cardioversion electrode, it is possible to output a cardioversion pulse to the patient's heart as needed to eliminate conduction disorders. Compared to pacing or pacemaker pulses that are output to set or support a certain cardiac rhythm, this type of cardioversion pulse is strong. To avoid damage in the target tissue, cardioversion pulses must not be output via electrodes that are exclusively provided for outputting pacemaker pulses.

[0003] Furthermore, based on their strength, cardioversion pulses are often perceived by the patient as painful. This is especially true when the cardioversion pulses are delivered via external electrodes. However, cardioversion pulses delivered via implantable cardioversion electrodes may also be perceived by the patient as uncomfortable, if not painful. Another difficulty in delivering cardioversion pulses via implantable cardioversion electrodes is in sufficiently stimulating the target tissue for successful cardioversion. The contact of the cardioversion electrodes with the target tissue may have a significant effect on the effectiveness of the cardioversion pulse.

[0004] The object of the invention is to provide an electrode assembly of the type mentioned at the outset, which has improved properties in use.

[0005] In order to achieve the above-mentioned object, an electromedical electrode assembly is proposed, which comprises at least one implantable cardioversion electrode for delivering cardioversion pulses to a target tissue, in particular myocardial tissue, comprising the means and features of the claims relating to this type of electrode assembly. In order to achieve the above-mentioned object, it is therefore proposed in the electrode assembly defined at the beginning, in particular that the cardioversion electrode of the electromedical electrode assembly consists of an electrically conductive surface structure which is flexible, flat in the undeformed use position, and which is adapted for surface-like application against the target tissue.

[0006] This type of surface structure can be applied particularly reliably to the target tissue of the heart to be treated. The surface structure can be applied, for example, to the outer surface of the heart, for example to the outer surface of the atrium of the heart to be treated, inside the patient to be treated. In this case, the surface structure can form a relatively large contact area with the target tissue to be treated and can be applied reliably to the usually curved surface of the target tissue to be treated. In this way, a sufficient contact can be formed between the cardioversion electrode of the electrode assembly and the tissue to be treated for a reliable cardioversion with less damage. On the one hand, this promotes the efficiency of the cardioversion procedure, and on the other hand, the large contact area allows the output of cardioversion pulses to a relatively large area. This allows the surface structure to promote cardioversion with cardioversion pulses of lower intensity. Cardioversion pulses of lower intensity are generally perceived as less painful and often cause less side effects. In the best case, therefore, pain during the cardioversion procedure can be reduced or even completely avoided. Overall, therefore, the electrode assembly according to the invention facilitates effective and at the same time less traumatic cardioversion with implanted cardioversion electrodes. Furthermore, the electrode assembly according to the invention is characterized by a simple patient treatment and application. The electrode assembly is easily applicable and allows the use of an electromedical pulse generator, i.e. a pacemaker and / or cardioverter, in the patient bed.

[0007] Furthermore, due to the fact that the cardioversion electrode of the electrode assembly is made of a flexible surface structure, it is possible to remove the cardioversion electrode with less damage, for example by pulling at the proximal end of the cardioversion assembly. During removal, the surface structure can be stretched, for example by pulling at the proximal end of the electrode assembly, and in so doing deformed, so that during removal, the spreading of the surface structure oriented transversely to the removal direction is reduced. This facilitates atraumatic removal of the cardioversion electrode.

[0008] In one embodiment of the electrode assembly, the surface formation has an electrical resistance of less than 150 ohms, preferably less than 70 ohms, which can facilitate the delivery of a sufficiently strong cardioversion pulse and protect the target tissue to be treated from damage.

[0009] The surface structure can have a longitudinal axis, in particular a central longitudinal axis, which extends in a plane when the surface structure is not deformed, and thus is flat in the starting position when it is not deformed, but is deformable due to its flexibility so that it can apply in a planar manner to the target tissue to be treated.

[0010] The surface structure may, in one embodiment of the electrode assembly, consist of an elongate structure, e.g. an electrical conductor, with a variable bending direction and / or may be sinusoidal. The elongate structure may be an electrical conductor, e.g. a Litz wire. The conductor may be curved, e.g. sinusoidally curved, to form the surface structure of the cardioversion electrode. In particular, in the region of the surface structure of the cardioversion electrode, the conductor is preferably not insulated, so that output of the cardioversion pulses via the conductor forming the surface structure is possible.

[0011] By virtue of the fact that the surface structure can be sinusoidally shaped and / or can consist of elongated structures, e.g. conductors that are curved with varying bending directions, the surface structure can be not only flexible but also elastic, the elasticity of which can facilitate a secure application of the surface structure to the target tissue.

[0012] In a preferred embodiment of the electrode assembly, the surface formation is made up of exactly one electrical conductor, however, it is also possible that the surface formation is made up of multiple electrical conductors that output cardioversion pulses.

[0013] Exactly one or at least one conductor from which the sheet structure can be formed can have an electrical resistance of less than 150 ohms, preferably less than 70 ohms. In this way, sheet structures having an electrical resistance of less than 150 ohms, preferably less than 70 ohms, can be formed from the conductor.

[0014] The conductor may have a longitudinal axis, in particular a central longitudinal axis, which extends in the plane of the surface structure, for example in the mid-plane, and / or with a varying bending direction, when the surface structure is not deformed. In this way, a surface structure having a shape that can be described as a zigzag shape can be provided from the electric conductor. In one embodiment of the electrode assembly, the electric conductor may be curved with a varying bending direction relative to the surface structure. The varying bending direction of the electric conductor may give the surface structure its flexibility and / or elasticity. The conductor may be sinusoidally curved to form a sinusoidal surface structure.

[0015] The electrical conductor may for example have a diameter D of 0.1 to 0.5 mm. In one embodiment, the conductor may have a diameter D of 0.1 to 0.3 mm, for example a diameter D of 0.2 mm.

[0016] The electrical conductor may have at least two mutually adjacent and / or mutually coupled conductor sections, which together form an angle α between 10° and 170°. The conductor may have at least two mutually adjacent conductor sections, which together form an angle α between 30° and 90°, or an angle α between 30° and 60°, or an angle α of 35°.

[0017] Two mutually adjacent conductor sections of a conductor may be connected to each other by a bend radius of, for example, 0.3 mm to 2 mm.

[0018] The sheet structure may, in an unstressed state, have a longitudinal extent L1, measurable in the direction of its longitudinal axis, of 10 to 50 mm (both inclusive), in particular 25 to 40 mm (both inclusive). The sheet structure may, in an unstressed state, have an extent L2, measurable transversely to its longitudinal axis, of 5 to 30 mm (both inclusive) and / or may be formed from at least one conductor having a length of 40 to 140 mm.

[0019] The sheet formation may have, as at least one electrical conductor, a stripped Litz wire that outputs the cardioversion pulses.

[0020] The surface structures, in particular the electrical conductors, can be made, for example, of stainless steel, platinum, platinum alloys, gold, gold alloys, magnesium, magnesium alloys, molybdenum or molybdenum alloys. The use of stainless steel is particularly preferred, since this material has been tested on patients for decades and has been found to be harmless to the human body, and, moreover, due to its load-bearing properties, flexibility and elasticity, is particularly suitable for producing the above-mentioned surface structures for this application.

[0021] In a particularly preferred embodiment of the electrode assembly, the electrode assembly has two fastening means, between which the surface structure is arranged. These fastening means of the electrode assembly are configured to fasten and / or tension the surface structure to the outer surface of the target tissue, in particular the heart. Using the two fastening means of the electrode assembly, the surface structure as a cardioversion electrode can be brought into surface-like contact with the outer surface of the target tissue to be treated and held there. In particular, if the surface structure is not only flexible but also elastic, it can be tensioned to the target tissue to be treated using the two fastening means in its position of use. Due to the elasticity, the surface structure can be automatically brought into contact with the target tissue against the holding force of the two fastening means and held in contact, thus ensuring a reliable contact with the target tissue to be stimulated. The two fastening means thus promote a reliable contact of the surface structure of the electrode assembly, used as a cardioversion electrode, to the beating heart. The surface-like contact of the surface structure under stress can prevent the surface structure from peeling off, or even only a portion of the surface structure from peeling off. This facilitates reliable and less traumatic cardioversion procedures using the electrode assembly.

[0022] In one embodiment of the electrode assembly, the surface formation has a spacing of 10-70 mm (both inclusive) to at least one of the two fixing means or to both fixing means, respectively. As mentioned above, the surface formation may be tensioned to the target tissue, in particular by the above-mentioned fixing means, and / or may be adapted to the size of the atrium of the heart to be treated. The surface formation may be spaced apart, for example, by 30 mm. 2 ~1600mm 2 The area covered by the surface structure can be calculated from the product of the longitudinal and lateral extensions of the stretched surface structure.

[0023] The fixing means distal to the electrode assembly for fixing and / or tensioning the surface formation may be arranged distal to the surface formation, for example the surface formation may be arranged at the distal end of the electrode assembly or between the distal end of the electrode assembly and the surface formation.

[0024] Basically, it is possible to position the fixing means in the target tissue by means of suture material in order to fix the fixing means in the target tissue and thus anchor the electrode assembly, however this can be relatively laborious as the suture material must first be attached to the fixing means.

[0025] To avoid this hassle, the electrode assembly may have at its distal end at least one positioning means, for example a cardiac needle, for positioning the fixing means, in particular the above-mentioned fixing means, in the target tissue. By means of the positioning means, the fixing means can be positioned in the target tissue for anchoring therein. After successful positioning, the positioning means can be separated and removed.

[0026] The electrode assembly may have a connection line by means of which the surface structure can be connected to a stimulation generator. The electrode assembly may have a connection means for this purpose arranged or formed at a proximal end of the connection line. The connection line may be connected to the surface structure at a point located on the longitudinal axis of the surface structure, in particular on the central longitudinal axis.

[0027] The connecting lines can be used as tensioning means, by means of which the sheet structure functioning as a cardioversion electrode can be pulled out from its implanted position of use. If the connecting lines are connected to the sheet structure at a point located on the longitudinal central axis of the sheet structure, the sheet structure can be deformed by pulling during the pulling, resulting in a preferably uniform reduction in the cross-section of the sheet structure oriented transversely to the pulling direction. This can facilitate atraumatic removal of the sheet structure.

[0028] In one embodiment of the electrode assembly, the electrode assembly is provided with at least one lateral electrode that outputs a pacing pulse, which may also be referred to as a pacemaker pulse.

[0029] In this way, for example, the lateral electrodes can be used in cooperation with the cardioversion electrodes to deliver pacing pulses to the heart to be treated. The electrode assembly can thus in this case take on a dual function and deliver not only cardioversion pulses but also pacing pulses to the heart.

[0030] At least one lateral electrode of the electrode assembly may be associated with at least one fixing means for fixing the lateral electrode against or in the target tissue, thus enabling the lateral electrode to be securely anchored in the target tissue for the time the electrode assembly is to be used to support the patient's cardiac function.

[0031] In a particularly advantageous embodiment of the electrode assembly, it is provided that the fastening means associated with the lateral electrode is one of at least two fastening means for fastening and / or tensioning the surface structure.

[0032] In this way, the fixing means associated with the lateral electrodes have a dual function: on the one hand, they are used to anchor the lateral electrodes in the target tissue, and on the other hand, they are also used to hold the surface formation used as a cardioversion electrode securely in its position of use. Thus, with this embodiment of the electrode assembly, separate fixing means that are used only to fix the lateral electrodes can be dispensed with.

[0033] In order to provide a reliable fixation of the lateral and cardioversion electrodes, i.e. the surface formation, only a minimum number of fixation means are provided in this embodiment of the electrode assembly, thus limiting lesions in the target tissue caused by the fixation means to a minimum.

[0034] The at least one lateral electrode and the at least one cardioversion electrode may be arranged at a freely selectable angle relative to one another. In a preferred embodiment of the electrode assembly, the lateral electrode and the cardioversion electrode form an angle between 1° and 170°. The above-mentioned connection lines, the lateral electrode and the cardioversion electrode may together form a Y-shape in one embodiment of the electrode assembly in the implanted use position.

[0035] The electrode assembly, in particular the at least one cardioversion electrode and / or the at least one lateral electrode, may be removable by pulling at the proximal end of the electrode assembly, in particular at the proximal end of the above-mentioned connecting line.

[0036] The conductor from which the surface structure can be formed can be an electrical conductor of the connecting line, so that the surface structure can consist of an electrical conductor of the connecting line, in particular a Litz wire.

[0037] In the following, exemplary embodiments of the invention are explained in more detail on the basis of the drawings. The invention is not limited here to the illustrated exemplary embodiments. Further exemplary embodiments of the invention are obtained by combining the features of the claims and / or by combining the features of the illustrated exemplary embodiments. [Brief description of the drawings]

[0038] [Figure 1] FIG. 1 is a side view of a first embodiment of an electrode assembly comprising an implantable cardioversion electrode, the electrode comprising a conductive surface formation that is flexible, flat in an undeformed starting position, and configured to abut target tissue in a surface-like manner. [Diagram 2] FIG. 2 shows a variation of the electrode assembly shown in FIG. 1 that includes lateral electrodes in addition to the cardioversion electrodes, through which pacing pulses can be output to the target tissue. [Diagram 3] FIG. 3 is an enlarged detail view of the surface formation of the electrode assembly shown in FIGS. 1 and 2.

[0039] All figures show at least a portion of an electrical medical electrode assembly, generally designated 1. Each illustrated electrode assembly 1 is configured to deliver electrical pulses to a target tissue, i.e., myocardial tissue. Each illustrated electrode assembly 1 includes an implantable cardioversion electrode 2 that delivers cardioversion pulses.

[0040] The cardioversion electrodes 2 each consist of a flexible, flat, electrically conductive surface formation 3 configured for surface contact with the target tissue in an undeformed starting position. The surface formation 3 is resilient and has an electrical resistance of less than 150 ohms, preferably less than 70 ohms.

[0041] The surface structures 3 have a longitudinal axis 4, i.e. a central longitudinal axis, which extends in a plane when the surface structures 3 are not deformed. The surface structures 3 are formed from longitudinal structures, i.e. electrical conductors 5, which have a variable bending direction and are therefore zigzag-shaped. In the illustrated embodiment of the surface structures 3, they consist of exactly one electrical conductor 5, which is adapted to output cardioversion pulses.

[0042] The conductor 5 has an electrical resistance of less than 150 ohms, preferably less than 70 ohms. In this way, the conductor 5 can provide the surface formation 3 with an electrical resistance that is advantageous for cardioversion, less than 150 ohms, preferably less than 70 ohms.

[0043] The longitudinal axis of the conductor 5 is located in the plane of the planar structure 3, in particular in the mid-plane, when the planar structure 3 is not deformed, and extends through this mid-plane with a varying bending direction. The representation in FIG. 3 in particular makes it clear that the planar structure 3 is formed from a conductor 5 that is curved with a varying bending direction. The conductor 5 has a diameter D of 0.1 to 0.5 mm. The diameter of the conductor 5 may be, for example, 0.1 to 0.3 mm or even 2 mm. The conductor 5 has mutually adjacent conductor sections 6 that are connected to one another and together form an angle α of 10° to 170°.

[0044] 3, the angle α is approximately 35°. The mutually adjacent conductor sections 6 are connected to each other via a bend radius R. The bend radius R may be, for example, 0.3 mm to 2 mm.

[0045] In the untensioned state, the surface structure 3 may have a longitudinal extent L1, measurable in the direction of its longitudinal axis 4, of, for example, 10 to 50 mm, both values ​​inclusive. In the untensioned state, the surface structure has an extent L2, measurable transversely to its longitudinal axis 4, of, for example, 5 to 30 mm, both values ​​inclusive.

[0046] The electrical conductor 5 from which the sheet structure 3 is produced may have a length of, for example, 40 to 140 mm. Figure 3 also shows the longitudinal extent L3 which the sheet structure 3 may have in the tensioned, stretched state. Here, the longitudinal extent L3 is greater than the longitudinal extent L1 and may be a multiple of the longitudinal extent L1 of the sheet structure 3 in the untensioned state, for example 1.5, 2, 2.5 or 3 times.

[0047] The sheet structure 3 has a stripped Litz wire as an electrical conductor 5 for outputting the cardioversion pulses. The sheet structure 3, i.e. its electrical conductor 5, is made of stainless steel.

[0048] In the second embodiment of the electrode assembly 1 shown in Fig. 2, it can be seen that the electrode assembly 1 has two fixing means 7, 8, and the surface structure 3 is arranged between these two fixing means 7, 8. The fixing means 7, 8 are used to stretch the surface structure 3 on the outer surface of the heart and to fix it in the stretched state. The surface structure 3 has a distance of 10 to 70 mm from at least one of the two fixing means 7, 8.

[0049] 1, the surface structure 3 is also arranged between two comparable fixing means 7 and 8 of the electrode assembly 1, which are also used for fixing and / or tensioning the surface structure 3 to the target tissue, for example the outer surface of the heart.

[0050] The surface formation 3 is tensionable by two fixing means 7 and 8, and by tensioning and stretching the surface formation 3 it can be adapted to the size of the atrium of the heart to be treated. 2 ~1600mm 2 This area can correspond to the product of the above-mentioned extents L2 and L3 of the stretched, extended surface structure 3.

[0051] The distal fixing means 8 of the two fixing means 7 and 8 of the electrode assembly 1 is here arranged distal to the surface formation 3, i.e. for example between the distal end 9 of the electrode assembly 1 and the surface formation 3. The electrode assembly 1 has a locking means 10 in the form of a cardiac needle at its distal end 9. The locking means 10 can be used to lock the electrode assembly 1 in the target tissue. The positioning means 10 is then used to move the distal fixing means 8 to its use position in the target tissue. The positioning means 10 can then be separated and removed.

[0052] The electrode assembly 1 further has at its proximal end 11 another needle 12 by means of which the electrode assembly 1, i.e. the connecting line 13 of the electrode assembly 1, can be pierced through the patient's body wall and led to the outside.

[0053] The surface structure 3 can be coupled to a stimulus generator via a connection line 13. The connection line 13 is here coupled to the surface structure 3 at a point 14 which is located on the central longitudinal axis 4 of the surface structure 3. The point 14 can also be referred to as a connection point.

[0054] The conductor 5 can be an electrical conductor of the connecting line 13, in particular a Litz wire. The surface structure 3 can therefore consist of an electrical conductor of the connecting line 13, in particular a Litz wire. In this case, the above-mentioned point 14 defines the transition between the connecting line 13 and the surface structure 3.

[0055] Each of the illustrated electrode assemblies 1 has at its proximal end 11 a connection means 16 by means of which each connection line 13 can be connected to a stimulus generator. The connection means 16 can be, for example, a mating connector.

[0056] The electrode assembly 1 shown in Fig. 2 additionally comprises an implantable lateral electrode 15 in addition to the cardioversion electrode 2. The lateral electrode 15 is used for delivering pacing pulses to the target tissue, where the delivery of pacing pulses can occur in interaction with the cardioversion electrode 2.

[0057] The transverse electrode 15 of the electrode assembly 1 shown in Fig. 2 is assigned the fixing means 7 of the two fixing means 7 and 8. The fixing means 7 is therefore also used to fix the transverse electrode 15 in the target tissue. The fixing means 7 associated with the transverse electrode 15 is therefore one of the two fixing means 7 and 8 used for fixing and / or tensioning the sheet structure 3. This fixing means 7 can be introduced into the target tissue by means of a locking means 10 arranged distal to the transverse electrode 15. This positioning means 10 is also formed as a cardiac needle.

[0058] 2 shows that the lateral electrode 15 and the at least one cardioversion electrode 2, i.e. the planar structure 3, can be arranged at a freely selectable angle relative to one another, for example at an angle between 1° and 170°. By arranging the lateral electrode 15 and the cardioversion electrode 2 at an angle between one another in the range of 1° to 170°, preferably less than 90°, a less damaging, preferably atraumatic, removal of the electrode assembly can be facilitated. In this case, a Y-shape is formed by the lateral electrode 15, the cardioversion electrode 2 and the connecting line 13.

[0059] The electrode assembly 1, i.e. the cardioversion electrode 2 and the lateral electrode 15, can be removed by pulling at the proximal end 11 of the electrode assembly 1, i.e. by pulling at the proximal end 11 of the connecting lines 13 of the electrode assembly 1. The electrode assembly 1 shown in FIG. 1 can be removed in the same way by pulling at the connecting lines 13.

[0060] The present invention relates to an improvement in the technical field of electromedical electrode assemblies, in which an electromedical electrode assembly 1 is proposed, which comprises at least one implantable cardioversion electrode 2, which consists of an electrically conductive surface formation 3, which is flexible, flat in the undeformed use position, and which is adapted for surface contact with the target tissue. [Explanation of symbols]

[0061] 1. Electromedical electrode assembly 2 Cardioversion electrodes 3-sided formation 4 3 Longitudinal axis 5 Longitudinal structure, electrical conductor 6 Adjacent conductor sections 7 Fixing means 8 Distal fixation means Distal end of 9 1 10 Positioning means, cardiac needle 11 Proximal end 12 Needle installed at 11 13 Connecting lines 14 points 15 Lateral electrode 16 Connection means

Claims

1. An electromedical electrode assembly (1) comprising at least one implantable cardioversion electrode (2) that outputs a cardioversion pulse to target tissue, particularly myocardial tissue, The cardioversion electrode (2) consists of a conductive surface formation (3) configured to be flexible, flat in an undeformed position of use, and to contact the target tissue in a planar manner. Electrode assembly for electromedical use (1).

2. The electrode assembly (1) according to claim 1, wherein the surface formed (3) is elastic.

3. The electrode assembly (1) according to claim 1 or 2, wherein the surface formation (3) has a longitudinal axis (4) extending in a plane, in particular a longitudinal central axis, when the surface formation (3) is not deformed, and / or the surface formation (3) consists of a longitudinal structure (5) in which the bending direction changes, in particular an electrical conductor, and / or is sinusoidal.

4. The electrode assembly (1) according to claim 1 or 2, wherein the surface formation (3) is formed from at least one, in particular, strictly one electrical conductor (5) that outputs a cardioversion pulse.

5. The electrode assembly (1) according to claim 4, wherein the at least one electrical conductor (5) has an electrical resistance of less than 150 ohms, preferably less than 70 ohms.

6. The electrode assembly (1) according to claim 4, wherein the longitudinal axis of at least one conductor (5), in particular the longitudinal central axis, extends to the plane of the undeformed surface formation (3), in particular the central plane, and / or with a changing bending direction, and / or the surface formation (3) is formed from the conductor (5) which is curved sinusoidally with a changing bending direction.

7. The electrode assembly (1) according to claim 5, wherein the at least one conductor (5) has a diameter D of 0.1 to 0.5 mm, particularly 0.1 to 0.3 mm, particularly 0.2 mm, and / or the conductor (5) has at least two adjacent and / or coupled conductor sections (6), the conductor sections (6) together form an angle α of 10° to 170°, particularly 30° to 90°, or 30° to 60°, or 35°, and / or are coupled to each other via a bending radius R, particularly a bending radius of 0.3 to 2 mm.

8. The electrode assembly (1) according to claim 1 or 2, wherein the surface formation (3), when not stretched, has a longitudinal spread L1 of 10 to 50 mm (including the values ​​at both ends), particularly 25 to 40 mm (including the values ​​at both ends), measurable in the direction of its longitudinal axis (4), and / or the surface formation (3), when not stretched, has a spread L2 of 5 to 30 mm (including the values ​​at both ends), measurable laterally with respect to its longitudinal axis (4), and / or is formed from at least one electrical conductor (5) having a length of 40 to 140 mm.

9. The electrode assembly (1) according to claim 1 or 2, wherein the at least one electrical conductor (5) is a deinsulated Litz wire that outputs a cardioversion pulse.

10. The electrode assembly (1) according to claim 1 or 2, wherein the surface formation (3), in particular the electrical conductor (5) of the surface formation (3), is made of stainless steel, platinum, platinum alloy, gold, gold alloy, magnesium, magnesium alloy, molybdenum, or molybdenum alloy.

11. The electrode assembly (1) according to claim 1 or 2, wherein the electrode assembly (1) has two fixing means (7, 8), the surface forming material (3) is positioned between the two fixing means (7, 8), and the two fixing means (7, 8) are used to fix and / or stretch the surface forming material (3) to a target tissue, for example, the outer surface of the heart.

12. The electrode assembly (1) according to claim 11, wherein the surface forming (3) is spaced 10 to 70 mm (including the values ​​at both ends) from at least one of the two fixing means (7, 8).

13. The surface formation (3) is particularly stretchable by the fixing means (7, 8) and / or adaptable to the size of the atrial of the heart to be treated and / or particularly 30 mm ２ ~1600mm ２ The electrode assembly (1) according to claim 1 or 2, which is stretched to cover the area of ​​the electrode assembly.

14. The electrode assembly (1) according to claim 1 or 2, wherein the distal fixing means (8) of the electrode assembly (1) for fixing and / or tensioning the surface formation (3) is located distal to the surface formation (3), particularly at the distal end (9) of the electrode assembly (1), or between the distal end (9) of the electrode assembly (1) and the surface formation (3).

15. The electrode assembly (1) according to claim 1 or 2, wherein the electrode assembly (1) has at least one positioning means (10), in particular a cardiac needle for positioning the fixing means (8) of the electrode assembly (1) in target tissue at its distal end (9).

16. The electrode assembly (1) according to claim 1 or 2, wherein the electrode assembly (1) has a connecting line (13) that can connect the surface formation (3) to a stimulus generator, and in particular, the connecting line (13) is connected to the surface formation (3) at a point (14) located on the longitudinal central axis (4) of the surface formation (3).

17. The electrode assembly (1) according to claim 1 or 2, wherein the electrode assembly (1) has at least one implantable lateral electrode (15) that outputs a pacing pulse.

18. The electrode assembly (1) according to claim 17, wherein at least one fixing means (7, 8) for fixing the lateral electrode (15) in target tissue is associated with at least one lateral electrode (15).

19. The electrode assembly (1) according to claim 18, wherein the fixing means (7, 8) associated with the lateral electrode (15) is one of at least two fixing means (7, 8) for fixing and / or stretching the surface forming material (3).

20. The electrode assembly (1) according to claim 1 or 2, wherein the at least one lateral electrode (15) and the at least one cardioversion electrode (2) can be positioned at an angle that can be freely selected relative to each other, and in particular at an angle of 1° to 170°.

21. The electrode assembly (1) according to claim 1 or 2, wherein the electrode assembly (1), in particular the at least one cardioversion electrode (2) and / or the at least one lateral electrode (15), is removable by pulling at the proximal end (11) of the electrode assembly (1), in particular by pulling at the proximal end (11) of the connecting line (13) of the electrode assembly (1).

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