Modular antitachyarrhythmia therapy system

• US 10,363,428 B2
• Filed: 05/11/2018
• Issued: 07/30/2019
• Est. Priority Date: 05/18/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Smith, Joseph M., Dujmovic, Jr., Richard Milon
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US15/977,475
• Publication Number:
  US 20180256909A1
• Time in Patent Office: 445 Days
• Field of Search: 607 4, 607 32, 607 60
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Claims

1. An implantable cardiac rhythm management system comprising:

an implantable defibrillator module (IDM) comprising a controller, battery, a capacitor, and circuitry for charging the capacitor and delivering a defibrillation therapy, and IDM communication circuitry capable of communicating with at least an external device and another implantable device, the implantable defibrillator adapted for use with a lead; and

an implantable pacing module (IPM) having at least two electrodes coupled to pacing circuitry for delivery of pacing therapy, the IPM including IPM communications circuitry for communicating with at least the IDM;

wherein the IDM is configured to identify a tachyarrhythmia and direct the IPM to deliver antitachyarrhythmia therapy.

2. The system of claim 1 wherein the IDM is a subcutaneous implantable defibrillator implanted outside the heart.

3. The system of claim 1 wherein the IPM is configured to deliver antitachycardia pacing therapy when directed by the IDM.

4. The system of claim 1 wherein the IPM is a leadless module adapted for placement in the heart of a patient.

5. The system of claim 4 wherein the IPM comprises a fixation structure adapted to affix the IPM to heart tissue.

6. The system of claim 1 wherein the IPM is adapted for placement in the coronary vasculature.

7. The system of claim 1 further comprising a lead for use with the IDM, wherein the IDM comprises a housing hermetically sealing the controller, therapy circuitry, and communication circuitry therein, and a header configured to couple to the lead.

8. An implantable cardiac rhythm management system comprising:

an implantable defibrillator module (IDM) comprising a controller, a battery, a capacitor, and circuitry for charging the capacitor and delivering a defibrillation therapy, and communication circuitry capable of communicating with at least an external device and at least one other implantable device, a housing to contain the controller, battery, capacitor, circuitry for charging the capacitor, and communication circuitry, and a header adapted for use with an implantable lead;

a lead having a plurality of electrodes thereon, at least one electrode adapted for delivering defibrillation therapy to a patient, the lead adapted for coupling with the header of the IDM;

wherein the IDM is configured to identify a tachyarrhythmia and direct a separate device to deliver antitachyarrhythmia therapy.

9. The system of claim 8 wherein the IDM is a subcutaneous implantable defibrillator implanted outside the heart.

10. The system of claim 8 further comprising an implantable pacing module (IPM) having at least two electrodes coupled to pacing circuitry for delivery of pacing therapy, the IPM including IPM communications circuitry for communicating with at least the IDM, wherein the IPM is configured to deliver antitachycardia pacing therapy when directed by the IDM.

11. The system of claim 10 wherein the IPM is a leadless module adapted for placement in the heart of a patient.

12. The system of claim 11 wherein the IPM comprises a fixation structure adapted to affix the IPM to heart tissue.

13. The system of claim 10 wherein the IPM is adapted for placement in the coronary vasculature.

14. A method of treating a patient, the patient having received an implanted cardiac rhythm management system comprising:

an implantable defibrillator module (IDM) comprising a controller, battery, a capacitor, and circuitry for charging the capacitor and delivering a defibrillation therapy, and IDM communication circuitry capable of communicating with at least an external device and another implantable device, the implantable defibrillator adapted for use with a lead, the IDM being implanted outside of the heart of the patient;

an implantable pacing module (IPM) having at least two electrodes coupled to pacing circuitry for delivery of pacing therapy, the IPM including IPM communications circuitry for communicating with at least the IDM, the IPM being implanted either in the heart of the patient or in cardiac vasculature of the patient;

the method comprising;

the IDM detecting a tachyarrhythmia; and

the IDM issuing a command to the IPM to deliver anti-tachycardia pacing to the heart of the patient.

15. The method of claim 14 further comprising the IPM delivering anti-tachycardia pacing to the heart of the patient in response to the command issued by the IDM.

16. The method of claim 15 further comprising the IDM delivering a defibrillation shock to the patient.

17. The method of claim 14 further comprising the IDM delivering a defibrillation shock to the patient.

18. The method of claim 14 wherein the IPM is a leadless module implanted in the heart of a patient.

19. The method of claim 14 wherein the IPM comprises a fixation structure adapted to affix the IPM to heart tissue.

20. The method of claim 14 wherein the IPM is adapted for placement in the coronary vasculature.