Cardioverter-defibrillator having a focused shocking area and orientation thereof

US 20020042629A1
Filed: 08/27/2001
Published: 04/11/2002
Est. Priority Date: 09/18/2000
Status: Active Grant

First Claim

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1. An implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising:

a housing;

an electrical circuit located within the housing;

a first electrode coupled to the electrical circuit and located on the housing; and

a second electrode coupled to the electrical circuit.

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Abstract

One embodiment of the present invention provides an implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator including a housing; an electrical circuit located within the housing; a first electrode coupled to the electrical circuit and located on the housing; and a second electrode coupled to the electrical circuit.

Citations

219 Claims

1. An implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising:
- a housing;
  
  an electrical circuit located within the housing;
  
  a first electrode coupled to the electrical circuit and located on the housing; and
  
  a second electrode coupled to the electrical circuit.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52)
- - 2. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing is non-planar.
  - 3. The implantable cardioverter-defibrillator of claim 1, wherein the housing has a length of approximately 3 centimeters to approximately 30 centimeters.
  - 4. The implantable cardioverter-defibrillator of claim 1, wherein the housing has a length of approximately 5 centimeters to approximately 20 centimeters.
  - 5. The implantable cardioverter-defibrillator of claim 1, wherein the housing has a length of approximately 5 centimeters to approximately 12 centimeters.
  - 6. The implantable cardioverter-defibrillator of claim 1, wherein the housing further comprises a depth, wherein the depth of the housing is less than approximately 15 millimeters.
  - 7. The implantable cardioverter-defibrillator of claim 1, wherein the electrical circuit can provide monophasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 8. The implantable cardioverter-defibrillator of claim 1, wherein the electrical circuit can provide multiphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 9. The implantable cardioverter-defibrillator of claim 8, wherein the electrical circuit can provide biphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 10. The implantable cardioverter-defibrillator of claim 8, wherein the electrical circuit can provide triphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 11. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.
  - 12. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 25 J to approximately 50 J.
  - 13. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 50 J to approximately 75 J.
  - 14. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 75 J to approximately 100 J.
  - 15. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 100 J to approximately 125 J.
  - 16. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 125 J to approximately 150 J.
  - 17. The implantable cardioverter-defibrillator of claim 11, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J.
  - 18. The implantable cardioverter-defibrillator of claim 11, wherein the first electrode can further receive physiological information.
  - 19. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode can receive physiological information.
  - 20. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the first electrode is non-planar.
  - 21. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially ellipsoidal in shape.
  - 22. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially thumbnail shaped.
  - 23. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially circular in shape.
  - 24. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially square in shape.
  - 25. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially rectangular in shape.
  - 26. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is substantially spade shaped.
  - 27. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is less than approximately 2000 square millimeters in area.
  - 28. The implantable cardioverter-defibrillator of claim 27, wherein the first electrode is between approximately 750 square millimeters to approximately 1000 square millimeters in area.
  - 29. The implantable cardioverter-defibrillator of claim 27, wherein the first electrode is between approximately 500 square millimeters to approximately 750 square millimeters in area.
  - 30. The implantable cardioverter-defibrillator of claim 27, wherein the first electrode is between approximately 250 square millimeters to approximately 500 square millimeters in area.
  - 31. The implantable cardioverter-defibrillator of claim 27, wherein the first electrode is between approximately 100 square millimeters to approximately 250 square millimeters in area.
  - 32. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing surrounding the electrode is ceramic.
  - 33. The implantable cardioverter-defibrillator of claim 1, wherein the second electrode is located on the housing.
  - 34. The implantable cardioverter-defibrillator of claim 1, wherein the housing further comprises a first end and a second end, wherein the first electrode is located on the first end of the housing and the second electrode is located on the second end of the housing.
  - 35. The implantable cardioverter-defibrillator of claim 1, wherein the second electrode is disposed on a lead.
  - 36. The implantable cardioverter-defibrillator of claim 35, wherein the lead is approximately 5 centimeters to approximately 55 centimeters in length.
  - 37. The implantable cardioverter-defibrillator of claim 36, wherein the lead is approximately 5 centimeters to approximately 15 centimeters in length.
  - 38. The implantable cardioverter-defibrillator of claim 36, wherein the lead is approximately 15 centimeters to approximately 25 centimeters in length.
  - 40. The implantable cardioverter-defibrillator of claim 36, wherein the lead is approximately 35 centimeters to approximately 45 centimeters in length.
  - 41. The implantable cardioverter-defibrillator of claim 36, wherein the lead is approximately 45 centimeters to approximately 55 centimeters in length.
  - 42. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is positioned approximately in the anterior portion of a patient'"'"'s ribcage.
  - 43. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is positioned approximately in a parasternal region of the patient.
  - 44. The implantable cardioverter-defibrillator of claim 43, wherein the first electrode is positioned approximately in a left parasternal region of the patient.
  - 45. The implantable cardioverter-defibrillator of claim 1, wherein the second electrode is positioned approximately in a posterior region of a patient'"'"'s ribcage.
  - 46. The implantable cardioverter-defibrillator of claim 1, wherein the second electrode is positioned approximately in a paraspinal region of the patient.
  - 47. The implantable cardioverter-defibrillator of claim 1, wherein the second electrode is positioned approximately in a parascapular region of the patient.
  - 48. The implantable cardioverter-defibrillator of claim 1, wherein the implantable cardioverter-defibrillator further comprises:
    - a first vector end point defining the position of the first electrode;
      
      a second vector end point defining the position of the second electrode;
      
      an origin defining a position approximately within the patent'"'"'s heart and between the first vector end point and the second vector end point; and
      
      a depolarization vector, wherein the depolarization vector defines an angle of separation between the first vector end point and the second vector end point with respect to the origin.
  - 49. The implantable cardioverter-defibrillator of claim 48, wherein the angle of separation is between approximately 30 degrees and approximately 90 degrees.
  - 50. The implantable cardioverter-defibrillator of claim 48, wherein the angle of separation is between approximately 90 degrees and approximately 120 degrees.
  - 51. The implantable cardioverter-defibrillator of claim 48, wherein the angle of the separation is between approximately 120 degrees and approximately 150 degrees.
  - 52. The implantable cardioverter-defibrillator of claim 48, wherein the angle of the separation is between approximately 150 degrees and approximately 180 degrees.

39. The implantable cardioverter-defibrillator of claim wherein the lead is approximately 25 centimeters to approximately 35 centimeters in length.

53. An implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising:
- a housing;
  
  an electrical circuit located within the housing;
  
  a first electrode coupled to the electrical circuit, wherein the first electrode is positioned at a first point with respect to the patient'"'"'s heart; and
  
  a second electrode coupled to the electrical circuit, wherein the second electrode is positioned at a second point that is substantially on the opposite side of the patient'"'"'s heart from the first point.
- View Dependent Claims (54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94)
- - 54. The implantable cardioverter-defibrillator of claim 53, wherein at least a portion of the housing is non-planar.
  - 55. The implantable cardioverter-defibrillator of claim 53, wherein the housing has a length of approximately 3 centimeters to approximately 30 centimeters.
  - 56. The implantable cardioverter-defibrillator of claim 53 , wherein the housing has a length of approximately 5 centimeters to approximately 20 centimeters.
  - 57. The implantable cardioverter-defibrillator of claim 53, wherein the housing has a length of approximately 5 centimeters to approximately 12 centimeters.
  - 58. The implantable cardioverter-defibrillator of claim 53, wherein the housing further comprises a depth, wherein the cardioverter-defibrillator is less than approximately 15 millimeters.
  - 59. The implantable cardioverter-defibrillator of claim 53, wherein the electrical circuit can provide monophasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 60. The implantable cardioverter-defibrillator of claim 53, wherein the electrical circuit can provide multiphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 61. The implantable cardioverter-defibrillator of claim 60, wherein the electrical circuit can provide biphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 62. The implantable cardioverter-defibrillator of claim 60, wherein the electrical circuit can provide triphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 63. The implantable cardioverter-defibrillator of claim 53, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.
  - 64. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 25 J to approximately 50 J.
  - 65. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 50 J to approximately 75 J.
  - 66. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 75 J to approximately 100 J.
  - 67. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 100 J to approximately 125 J.
  - 68. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 125 J to approximately 150 J.
  - 69. The implantable cardioverter-defibrillator of claim 63, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J.
  - 70. The implantable cardioverter-defibrillator of claim 63, wherein the first electrode can further receive sensory information.
  - 71. The implantable cardioverter-defibrillator of claim 53, wherein the first electrode can receive sensory information.
  - 72. The implantable cardioverter-defibrillator of claim 53, wherein at least a portion of the first electrode is non-planar.
  - 73. The implantable cardioverter-defibrillator of claim 53, wherein the first electrode is less than approximately 1000 square millimeters in area.
  - 74. The implantable cardioverter-defibrillator of claim 53, wherein at least a portion of the housing surrounding the electrode is ceramic.
  - 75. The implantable cardioverter-defibrillator of claim 53, wherein the second electrode is located on the housing.
  - 76. The implantable cardioverter-defibrillator of claim 53, wherein the housing further comprises a first end and a second end, wherein the first electrode is located on the first end of the housing and the second electrode is located on the second end of the housing.
  - 77. The implantable cardioverter-defibrillator of claim 53, wherein the second electrode is disposed on a lead.
  - 78. The implantable cardioverter-defibrillator of claim 77, wherein the lead is approximately 5 centimeters to approximately 55 centimeters in length.
  - 79. The implantable cardioverter-defibrillator of claim 78, wherein the lead is approximately 5 centimeters to approximately 15 centimeters in length.
  - 80. The implantable cardioverter-defibrillator of claim 78, wherein the lead is approximately 15 centimeters to approximately 25 centimeters in length.
  - 81. The implantable cardioverter-defibrillator of claim 78, wherein the lead is approximately 25 centimeters to approximately 35 centimeters in length.
  - 82. The implantable cardioverter-defibrillator of claim 78, wherein the lead is approximately 35 centimeters to approximately 45 centimeters in length.
  - 83. The implantable cardioverter-defibrillator of claim 78, wherein the lead is approximately 45 centimeters to approximately 55 centimeters in length.
  - 84. The implantable cardioverter-defibrillator of claim 53, wherein the first point is approximately in the anterior portion of a patient'"'"'s ribcage.
  - 85. The implantable cardioverter-defibrillator of claim 53, wherein the first point is approximately in a parasternal region of the patient.
  - 86. The implantable cardioverter-defibrillator of claim 85, wherein the first point is approximately in a left parasternal region of the patient.
  - 87. The implantable cardioverter-defibrillator of claim 53, wherein the second point is approximately in a posterior region of a patient'"'"'s ribcage.
  - 88. The implantable cardioverter-defibrillator of claim 53, wherein the second point is approximately in a paraspinal region of the patient.
  - 89. The implantable cardioverter-defibrillator of claim 53, wherein the second point is approximately in a parascapular region of the patient.
  - 90. The implantable cardioverter-defibrillator of claim 53, wherein the implantable cardioverter-defibrillator further comprises:
    - a first vector end point defining the position of the first electrode;
      
      a second vector end point defining the position of the second electrode;
      
      an origin defining a position approximately within the patient'"'"'s heart and between the first vector end point and the second vector end point; and
      
      a depolarization vector, wherein the depolarization vector defines an angle of separation between the first vector end point and the second vector end point with respect to the origin.
  - 91. The implantable cardioverter-defibrillator of claim 90, wherein the angle of separation is between approximately 30 degrees and approximately 90 degrees.
  - 92. The implantable cardioverter-defibrillator of claim 90, wherein the angle of separation is between approximately 90 degrees and approximately 120 degrees.
  - 93. The implantable cardioverter-defibrillator of claim 90, wherein the angle of separation is between approximately 120 degrees and approximately 150 degrees.
  - 94. The implantable cardioverter-defibrillator of claim 90, wherein the angle of separation is between approximately 150 degrees and approximately 180 degrees.

95. An implantable cardioverter defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising:
- a housing;
  
  an electrical circuit located within the housing;
  
  a first electrode coupled to the electrical circuit; and
  
  a second electrode coupled to the electrical circuit, wherein the second electrode is positioned approximately 30 degrees to approximately 180 degrees, with respect to the patient'"'"'s heart, apart from the first electrode.
- View Dependent Claims (96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 211, 212, 213, 214, 215, 216, 217, 218, 219)
- - 96. The implantable cardioverter-defibrillator of claim 95, wherein at least a portion of the housing is non-planar.
  - 97. The implantable cardioverter-defibrillator of claim 95, wherein the housing has a length of approximately 3 centimeters to approximately 30 centimeters.
  - 98. The implantable cardioverter-defibrillator of claim 95, wherein the housing has a length of approximately 5 centimeters to approximately 20 centimeters.
  - 99. The implantable cardioverter-defibrillator of claim 95, wherein the housing has a length of approximately 5 centimeters to approximately 12 centimeters.
  - 100. The implantable cardioverter-defibrillator of claim 95, wherein the housing further comprises a depth, wherein the cardioverter-defibrillator is less than approximately 15 millimeters.
  - 101. The implantable cardioverter-defibrillator of claim 95, wherein the electrical circuit can provide monophasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 102. The implantable cardioverter-defibrillator of claim 95, wherein the electrical circuit can provide multiphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 103. The implantable cardioverter-defibrillator of claim 102, wherein the electrical circuit can provide biphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 104. The implantable cardioverter-defibrillator of claim 102, wherein the electrical circuit can provide triphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 105. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.
  - 106. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 25 J to approximately 50 J.
  - 107. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 50 J to approximately 75 J.
  - 108. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 75 J to approximately 100 J.
  - 109. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 100 J to approximately 125 J.
  - 110. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 125 J to approximately 150 J.
  - 111. The implantable cardioverter-defibrillator of claim 105, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J.
  - 112. The implantable cardioverter-defibrillator of claim 105, wherein the first electrode can further receive sensory information.
  - 113. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode can receive sensory information.
  - 114. The implantable cardioverter-defibrillator of claim 95, wherein at least a portion of the first electrode is non-planar.
  - 115. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is less than approximately 2000 square millimeters in area.
  - 116. The implantable cardioverter-defibrillator of claim 95, wherein at least a portion of the housing surrounding the electrode is ceramic.
  - 117. The implantable cardioverter-defibrillator of claim 95, wherein the second electrode is located on the housing.
  - 118. The implantable cardioverter-defibrillator of claim 95, wherein the housing further comprises a first end and a second end, wherein the first electrode is located on the first end of the housing and the second electrode is located on the second end of the housing.
  - 119. The implantable cardioverter-defibrillator of claim 95, wherein the second electrode is disposed on a lead.
  - 120. The implantable cardioverter-defibrillator of claim 119, wherein the lead is approximately 5 centimeters to approximately 55 centimeters in length.
  - 122. The implantable cardioverter-defibrillator of claim 120, wherein the lead is approximately 15 centimeters to approximately 25 centimeters in length.
  - 123. The implantable cardioverter-defibrillator of claim 120, wherein the lead is approximately 25 centimeters to approximately 35 centimeters in length.
  - 124. The implantable cardioverter-defibrillator of claim 120, wherein the lead is approximately 35 centimeters to approximately 45 centimeters in length.
  - 125. The implantable cardioverter-defibrillator of claim 120, wherein the lead is approximately 45 centimeters to approximately 55 centimeters in length.
  - 126. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is positioned approximately in the anterior portion of a patient'"'"'s ribcage.
  - 127. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is positioned approximately in a parasternal region of the patient.
  - 128. The implantable cardioverter-defibrillator of claim 127, wherein the first electrode is positioned approximately in a left parasternal region of the patient.
  - 129. The implantable cardioverter-defibrillator of claim 95, wherein the second electrode is positioned approximately in a posterior region of a patient'"'"'s ribcage.
  - 130. The implantable cardioverter-defibrillator of claim 95, wherein the second electrode is positioned approximately in a paraspinal region of the patient.
  - 131. The implantable cardioverter-defibrillator of claim 95, wherein the second electrode is positioned approximately in a parascapular region of the patient.
  - 132. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is approximately 30 degrees to approximately 60 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 133. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is approximately 60 degrees to approximately 90 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 134. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is approximately 90 degrees to approximately 120 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 135. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is approximately 120 degrees to approximately 150 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 136. The implantable cardioverter-defibrillator of claim 95, wherein the first electrode is approximately 150 degrees to approximately 180 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 138. The method of claim 137, wherein at least a portion of the cardioverter-defibrillator is non-planar.
  - 139. The method of claim 137, wherein the cardioverter-defibrillator has a length of approximately 3 centimeters to approximately 30 centimeters.
  - 140. The method of claim 137, wherein the cardioverter-defibrillator has a length of approximately 5 centimeters to approximately 20 centimeters.
  - 141. The method of claim 137, wherein the cardioverter-defibrillator has a length of approximately 5 centimeters to approximately 12 centimeters.
  - 142. The method of claim 137, wherein the cardioverter-defibrillator further comprises a depth, wherein the cardioverter-defibrillator is less than approximately 15 millimeters.
  - 143. The method of claim 137, wherein the electrical circuit can provide monophasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 144. The method of claim 137, wherein the electrical circuit can provide multiphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 145. The method of claim 144, wherein the electrical circuit can provide biphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 146. The method of claim 144, wherein the electrical circuit can provide triphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 147. The method of claim 137, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.
  - 148. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 25 J to approximately 50 J.
  - 149. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 50 J to approximately 75 J.
  - 150. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 75 J to approximately 100 J.
  - 151. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 100 J to approximately 125 J.
  - 152. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 125 J to approximately 150 J.
  - 153. The method of claim 147, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J.
  - 154. The method of claim 147, wherein the first electrode can further receive sensory information.
  - 155. The method of claim 137, wherein the first electrode can receive sensory information.
  - 156. The method of claim 137, wherein at least a portion of the first electrode is non-planar.
  - 157. The method of claim 137, wherein the first electrode is less than approximately 2000 square millimeters in area.
  - 158. The method of claim 137, wherein at least a portion of the housing surrounding the electrode is ceramic.
  - 159. The method of claim 137, wherein the second electrode is located on the housing.
  - 160. The method of claim 137, wherein the housing further comprises a first end and a second end, wherein the first electrode is located on the first end of the housing and the second electrode is located on the second end of the housing.
  - 161. The method of claim 137, wherein the second electrode is disposed on a lead.
  - 162. The method of claim 161, wherein the lead is approximately 5 centimeters to approximately 55 centimeters in length.
  - 163. The method of claim 161, wherein the lead is approximately 5 centimeters to approximately 15 centimeters in length.
  - 164. The method of claim 161, wherein the lead is approximately 15 centimeters to approximately 25 centimeters in length.
  - 165. The method of claim 161, wherein the lead is approximately 25 centimeters to approximately 35 centimeters in length.
  - 166. The method of claim 161, wherein the lead is approximately 35 centimeters to approximately 45 centimeters in length.
  - 167. The method of claim 161, wherein the lead is approximately 45 centimeters to approximately 55 centimeters in length.
  - 168. The method of claim 137, wherein the single incision is made approximately at the level of the cardiac apex.
  - 169. The method of claim 137, wherein the single incision is made approximately in the left anterior axillary line.
  - 170. The method of claim 137, wherein the first electrode is advanced approximately in a parasternal region of the patient.
  - 171. The method of claim 170, wherein the first electrode is advanced approximately in a left parasternal region of the patient.
  - 172. The method of claim 137, wherein the second electrode is oriented approximately in a posterior region of a patient'"'"'s ribcage.
  - 173. The method of claim 137, wherein the second electrode is oriented approximately in a paraspinal region of the patient.
  - 174. The method of claim 137, wherein the second electrode is oriented approximately in a parascapular region of the patient.
  - 175. The method of claim 137, wherein the first electrode is approximately 30 degrees to approximately 60 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 176. The method of claim 137, wherein the first electrode is approximately 60 degrees to approximately 90 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 177. The method of claim 137, wherein the first electrode is approximately 90 degrees to approximately 120 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 178. The method of claim 137, wherein the first electrode is approximately 120 degrees to approximately 150 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 179. The method of claim 137, wherein the first electrode is approximately 150 degrees to approximately 180 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 181. The method of claim 180, wherein at least a portion of the cardioverter-defibrillator is non-planar.
  - 182. The method of claim 180, wherein the cardioverter-defibrillator has a length of approximately 3 centimeters to approximately 30 centimeters.
  - 183. The method of claim 180, wherein the cardioverter-defibrillator has a length of approximately 5 centimeters to approximately 20 centimeters.
  - 184. The method of claim 180, wherein the cardioverter-defibrillator has a length of approximately 5 centimeters to approximately 12 centimeters.
  - 185. The method of claim 180, wherein the cardioverter-defibrillator further comprises a depth, wherein the cardioverter-defibrillator is less than approximately 15 millimeters.
  - 186. The method of claim 180, wherein the electrical circuit can provide monophasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 187. The method of claim 180, wherein the electrical circuit can provide multiphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 188. The method of claim 187, wherein the electrical circuit can provide biphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 189. The method of claim 187, wherein the electrical circuit can provide triphasic waveform cardioversion-defibrillation for a patient'"'"'s heart.
  - 190. The method of claim 180, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.
  - 191. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 25 J to approximately 50 J.
  - 192. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 50 J to approximately 75 J.
  - 193. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 75 J to approximately 100 J.
  - 194. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 100 J to approximately 125 J.
  - 195. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 125 J to approximately 150 J.
  - 196. The method of claim 190, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J.
  - 197. The method of claim 190, wherein the first electrode can further receive sensory information.
  - 198. The method of claim 180, wherein the first electrode can receive sensory information.
  - 199. The method of claim 180, wherein at least a portion of the first electrode is non-planar.
  - 200. The method of claim 180, wherein the first electrode is less than approximately 100 square millimeters in area.
  - 201. The method of claim 180, wherein at least a portion of the housing surrounding the electrode is ceramic.
  - 202. The method of claim 180, wherein the second electrode is located on the housing.
  - 203. The method of claim 180, wherein the housing further comprises a first end and a second end, wherein the first electrode is located on the first end of the housing and the second electrode is located on the second end of the housing.
  - 204. The method of claim 180, wherein the second electrode is disposed on a lead.
  - 205. The method of claim 204, wherein the lead is approximately 5 centimeters to approximately 55 centimeters in length.
  - 206. The method of claim 204, wherein the lead is approximately 5 centimeters to approximately 15 centimeters in length.
  - 207. The method of claim 204, wherein the lead is approximately 15 centimeters to approximately 25 centimeters in length.
  - 208. The method of claim 204, wherein the lead is approximately 25 centimeters to approximately 35 centimeters in length.
  - 209. The method of claim 204, wherein the lead is approximately 35 centimeters to approximately 45 centimeters in length.
  - 210. The method of claim 204, wherein the lead is approximately 45 centimeters to approximately 55 centimeters in length.
  - 211. The method of claim 180, wherein the first electrode is advanced approximately in a paraspinal region of the patient.
  - 212. The method of claim 180, wherein the first electrode is advanced approximately in a parascapular region of the patient.
  - 213. The method of claim 180, wherein the second electrode is oriented approximately in a parasternal region of the patient.
  - 214. The method of claim 213, wherein the second electrode is oriented approximately in a left parasternal region of the patient.
  - 215. The method of claim 180, wherein the first electrode is approximately 30 degrees to approximately 60 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 216. The method of claim 180, wherein the first electrode is approximately 60 degrees to approximately 90 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 217. The method of claim 180, wherein the first electrode is approximately 90 degrees to approximately 120 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 218. The method of claim 180, wherein the first electrode is approximately 120 degrees to approximately 150 degrees apart from the second electrode, with respect to the patent'"'"'s heart.
  - 219. The method of claim 180, wherein the first electrode is approximately 150 degrees to approximately 180 degrees apart from the second electrode, with respect to the patent'"'"'s heart.

121. The implantable cardioverter-defibrillator of claim wherein the lead is approximately 5 centimeters to approximately 15 centimeters in length.

137. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
- providing a cardioverter-defibrillator comprising a housing, an electrical circuit located within the housing, a first electrode located on the housing, and a second electrode;
  
  making a single incision into the patient;
  
  advancing the cardioverter-defibrillator through the single incision and subcutaneously over approximately the anterior portion of a patient'"'"'s ribcage; and
  
  orienting the second electrode on substantially the opposite side of a patient'"'"'s heart from the first electrode.

180. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
- providing a cardioverter-defibrillator comprising a housing, an electrical circuit located within the housing, a first electrode located on the housing, and a second electrode;
  
  making a single incision into the patient;
  
  advancing the cardioverter-defibrillator through the single incision and subcutaneously over approximately the posterior portion of a patient'"'"'s ribcage; and
  
  orienting the second electrode on substantially the opposite side of a patient'"'"'s heart from the first electrode.

Specification

Resources

Litigation Campaign Assessment

Current Assignee
Cameron Health Inc (Boston Scientific Corporation)
Original Assignee
Cameron Health Inc (Boston Scientific Corporation)
Inventors
Rissmann, William J., Bardy, Gust H., Sanders, Gary H., Cappato, Riccardo

Granted Patent

US 7,069,080 B2
Time in Patent Office

Days
Field of Search
US Class Current

607/5
CPC Class Codes

A61N 1/375   Constructional arrangements...

A61N 1/37512   Pacemakers

A61N 1/37518   Anchoring of the implants, ...

A61N 1/3756   Casings with electrodes the...

A61N 1/3906   characterised by the form o...

A61N 1/3956   Implantable devices for app...

A61N 1/3968   Constructional arrangements...

A61N 1/3975   Power supply A61N1/378 take...

Cardioverter-defibrillator having a focused shocking area and orientation thereof

First Claim

3 Assignments

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Abstract

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219 Claims

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Cardioverter-defibrillator having a focused shocking area and orientation thereof

First Claim

3 Assignments

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0 Petitions

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Accused Products

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Abstract

Citations

219 Claims

Specification

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Solutions

Use Cases

Quick Links