Implantable defibrillator apparatus

• US 20010016758A1
• Filed: 04/25/2001
• Published: 08/23/2001
• Est. Priority Date: 01/28/1999
• Status: Active Grant

• Current Assignee: Sorin Biomedica Cardio Srl (LivaNova Plc)
• Original Assignee: Sorin Biomedica Cardio Srl (LivaNova Plc)
• Inventors: Marcelli, Emanuela, Gaggini, Guido, Plicchi, Gianni, Garberoglio, Bruno
• Granted Patent: US 6,405,084 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

An implantable defibrillator apparatus having a plurality of defibrillation electrodes which can be applied to the heart muscle in order to apply electric defibrillation shocks thereto, and defibrillation-control means for selectively applying respective electric defibrillation shocks to the electrodes preferably sequentially in time and in synchronism with the QRS.

Claims

1. An implantable defibrillator apparatus comprising:

a plurality of defibrillation electrodes adapted to be applied to the heart muscle and to deliver electric defibrillation shocks thereto;

the plurality of electrodes in communication with defibrillation-control means capable of selectively supplying voltage pulses to the electrodes; and

wherein the defibrillation control means controls the duration and interval of the voltage pulses and further wherein the voltage pulses produce electric defibrillation shocks sufficient to produce defibrillation.

2. The implantable defibrillator apparatus of

claim 1

wherein the electric defibrillation shocks are sufficient to produce defibrillation synchronized with the heart'"'"'s QRS.

3. An apparatus according to

claim 1

, wherein the control unit is adapted to deliver defibrillation shocks to the electrodes in a desired time sequence.

4. An apparatus according to

claim 1

, wherein the control unit is adapted to selectively vary at least one characteristic of the electric defibrillation shocks, the at least one characteristic selected from the group of waveform of the defibrillation shock, the duration of the defibrillation shock, the interval between successive defibrillation shocks, and the electrodes to which a defibrillation shock is applied at any particular time.

5. An apparatus according to

claim 1

, wherein the apparatus further comprises sensor means for detecting the occurrence of a fibrillation phenomenon, the sensor means being connected to the control unit and adapted to activate the application of defibrillation shocks.

6. An apparatus according to

claim 5

, wherein the sensor means comprise respective sensing lines that connect the plurality of electrodes to the control unit to enable the electrodes to act both as defibrillation electrodes and as sensing electrodes.

7. An apparatus according to

claim 1

, wherein the apparatus further comprises sensor means capable of detecting a ventricular electrogram, and wherein the control unit synchronizes the application of defibrillation shock during the QRS of the electrogram.

8. An implantable defibrillator apparatus comprising:

a plurality of defibrillation electrodes adapted to be applied to the heart muscle and to deliver electric defibrillation shocks thereto;

the plurality of electrodes in communication with electronic switches;

the electronic switches in communication with a power stage capable of supplying voltage pulses to the electrodes; and

wherein the power stage is connected to a control unit that controls the duration and interval of the voltage pulses and further wherein the voltage pulses are applied for a time sufficient to produce defibrillation.

9. An apparatus according to

claim 8

, wherein the control unit is adapted to deliver defibrillation shocks to the electrodes in a desired time sequence.

10. An apparatus according to

claim 8

, wherein the control unit is adapted to selective vary at least one characteristic of the electric defibrillation shocks, the at least one characteristic selected from the group of waveform of the defibrillation shock, the duration of the defibrillation shock, the interval between successive defibrillation shocks, and the electrodes to which a defibrillation shock is applied at any particular time.

11. An apparatus according to

claim 8

, wherein the successive defibrillation shocks are applied at intervals of approximately 100 microseconds.

12. An apparatus according to

claim 8

, wherein the electrodes have a surface area ranging from about 50 mm² to about 100 mm².

13. An apparatus according to

claim 8

, wherein the apparatus further comprises a sensor for detecting the occurrence of a fibrillation phenomenon, the sensor being connected to the control unit and adapted to activate the application of defibrillation shocks.

14. An apparatus according to

claim 13

, wherein the sequence of defibrillation shocks has a duration no greater than approximately 50 milliseconds.

15. An apparatus according to

claim 13

, wherein the sensor comprises respective sensing lines that connect the plurality of electrodes to the control unit to enable the electrodes to act both as defibrillation electrodes and as sensing electrodes.

16. An apparatus according to

claim 8

, wherein the apparatus further comprises a sensor capable of detecting a ventricular electrogram, and wherein the control unit synchronizes the application of defibrillation shock during the QRS of the electrogram.

17. A method of treating atrial fibrillation comprising:

providing a stimulating device having a plurality of electrodes;

inserting the plurality of electrodes at desired locations in the heart; and

applying defibrillation shocks to the plurality of electrodes in a desired sequence, thereby creating an electric field having a geometry designed for the patient'"'"'s anatomy.

18. The method of

claim 17

further comprising the step of sensing atrial fibrillation by means of the plurality of electrodes.

19. The method of

claim 17

further comprising the step of sensing atrial fibrillation by means of a specialized sensor.

20. The method of

claim 17

wherein the step of applying defibrillation shocks further comprises a control unit in communication with plurality of electrodes, the control unit controlling the characteristics of the defibrillation shocks by means of one of the waveform, the duration, the interval between shocks, and the sequence of activating shocks to various electrodes.