Cardioverter-defibrillator having a focused shocking area and orientation thereof

• US 20020107548A1
• Filed: 11/05/2001
• Published: 08/08/2002
• Est. Priority Date: 09/18/2000
• Status: Active Grant

• 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 7,039,459 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/37518 Anchoring of the implants, e.g. fixation
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3906 characterised by the form of the shockwave
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3968 Constructional arrangements, e.g. casings A61N1/375 takes precedence
• CPC Class Codes: A61N 1/3975 Power supply A61N1/378 takes precedence

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.

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.

2. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.

3. The implantable cardioverter-defibrillator of claim 2, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 350 J.

4. The implantable cardioverter-defibrillator of claim 3, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 25 J.

5. The implantable cardioverter-defibrillator of claim 3, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J to approximately 200 J.

6. The implantable cardioverter-defibrillator of claim 3, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 200 J to approximately 250 J.

7. The implantable cardioverter-defibrillator of claim 3, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 250 J to approximately 300 J.

8. The implantable cardioverter-defibrillator of claim 3, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 300 J to approximately 350 J.

9. The implantable cardioverter-defibrillator of claim 1, wherein the first electrode is less than approximately 5000 square millimeters in area.

10. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 2000 square millimeters to approximately 2500 square millimeters in area.

11. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 2500 square millimeters and 3000 square millimeters.

12. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 3000 square millimeters and 3500 square millimeters.

13. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 3500 square millimeters and 4000 square millimeters.

14. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 4000 square millimeters and 4500 square millimeters.

15. The implantable cardioverter-defibrillator of claim 9, wherein the first electrode is between approximately 4500 square millimeters and 5000 square millimeters.

17. The implantable cardioverter-defibrillator of claim 16, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.

18. The implantable cardioverter-defibrillator of claim 17, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 350 J.

19. The implantable cardioverter-defibrillator of claim 18, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 25 J.

20. The implantable cardioverter-defibrillator of claim 18, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J to approximately 200 J.

21. The implantable cardioverter-defibrillator of claim 18, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 200 J to approximately 250 J.

22. The implantable cardioverter-defibrillator of claim 18, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 250 J to approximately 300 J.

23. The implantable cardioverter-defibrillator of claim 18, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 300 J to approximately 350 J.

24. The implantable cardioverter-defibrillator of claim 16, wherein the first electrode is less than approximately 5000 square millimeters in area.

25. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is approximately 2000 square millimeters to approximately 2500 square millimeters.

26. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is between approximately 2500 square millimeters and 3000 square millimeters.

27. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is between approximately 3000 square millimeters and 3500 square millimeters.

28. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is between approximately 3500 square millimeters and 4000 square millimeters.

29. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is between approximately 4000 square millimeters and 4500 square millimeters.

30. The implantable cardioverter-defibrillator of claim 24, wherein the first electrode is between approximately 4500 square millimeters and 5000 square millimeters.

16. 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.

31. 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.

32. The implantable cardioverter-defibrillator of claim 31, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.

33. The implantable cardioverter-defibrillator of claim 32, wherein the effective field strength for shocking the patient '"'"'s heart is approximately 0.5 J to approximately 350 J.

34. The implantable cardioverter-defibrillator of claim 33, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 25 J.

35. The implantable cardioverter-defibrillator of claim 33, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J to approximately 200 J.

36. The implantable cardioverter-defibrillator of claim 33, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 200 J to approximately 250 J.

37. The implantable cardioverter-defibrillator of claim 33, wherein the effective field strength for shocking the patient '"'"'s heart is approximately 250 J to approximately 300 J.

38. The implantable cardioverter-defibrillator of claim 33, wherein the effective field strength for shocking the patient '"'"'s heart is approximately 300 J to approximately 350 J.

39. The implantable cardioverter-defibrillator of claim 31, wherein the first electrode is less than approximately 5000 square millimeters in area.

40. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is approximately 2000 square millimeters to approximately 2500 square millimeters.

41. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is between approximately 2500 square millimeters and 3000 square millimeters.

42. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is between approximately 3000 square millimeters and 3500 square millimeters.

43. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is between approximately 3500 square millimeters and 4000 square millimeters.

44. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is between approximately 4000 square millimeters and 4500 square millimeters.

45. The implantable cardioverter-defibrillator of claim 39, wherein the first electrode is between approximately 4500 square millimeters and 5000 square millimeters.

47. The method of claim 46, wherein the first electrode can emit an effective field strength for shocking the patient'"'"'s heart.

48. The method of claim 47, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 350 J.

49. The method of claim 48, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 0.5 J to approximately 25 J.

50. The method of claim 48, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 150 J to approximately 200 J.

51. The method of claim 48, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 200 J to approximately 250 J.

52. The method of claim 48, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 250 J to approximately 300 J.

53. The method of claim 48, wherein the effective field strength for shocking the patient'"'"'s heart is approximately 300 J to approximately 350 J.

54. The method of claim 46, wherein the first electrode is less than approximately 5000 square millimeters in area.

55. The method of claim 54, wherein the first electrode is approximately 2000 square millimeters to approximately 2500 square millimeters.

56. The method of claim 54, wherein the first electrode is between approximately 2500 square millimeters and 3000 square millimeters.

57. The method of claim 54, wherein the first electrode is between approximately 3000 square millimeters and 3500 square millimeters.

58. The method of claim 54, wherein the first electrode is between approximately 3500 square millimeters and 4000 square millimeters.

59. The method of claim 54, wherein the first electrode is between approximately 4000 square millimeters and 4500 square millimeters.

60. The method of claim 54, wherein the first electrode is between approximately 4500 square millimeters and 5000 square millimeters.

61. The method of claim 46, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the third and fifth ribs.

62. The method of claim 46, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the fourth and sixth ribs.

63. The method of claim 46, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the sixth and eighth ribs.

64. The method of claim 46, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the eighth and tenth ribs.

65. The method of claim 46, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the tenth and twelfth ribs.

66. The method of claim 46, wherein the implantable cardioverter-defibrillator provides anti-tachycardia pacing energy to the heart for treatment of atrial fibrillation.

67. The method of claim 46, wherein the implantable cardioverter-defibrillator provides anti-tachycardia pacing energy to the heart for treatment of ventricular tachycardia.

46. 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.