Subcutaneous cardiac stimulator device having an anteriorly positioned electrode

• US 20030036778A1
• Filed: 05/17/2002
• Published: 02/20/2003
• Est. Priority Date: 09/18/2000
• Status: Active Grant

• Current Assignee: Alan H. Ostroff, Gust H. Bardy, Paul Erlinger
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Ostroff, Alan H., Bardy, Gust H., Erlinger, Paul
• Granted Patent: US 7,149,575 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• CPC Class Codes: A61N 1/37512 Pacemakers
• 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 1/3918 characterised by shock pathway, e.g. by electrode configuration
• 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

A subcutaneous cardiac device includes a subcutaneous electrode and a housing coupled to the subcutaneous electrode by a lead with a lead wire. The subcutaneous electrode is adapted to be implanted in a frontal region of the patient so as to overlap a portion of the patient'"'"'s heart.

Claims

1. A method of implanting a cardiac device, the method comprising:

implanting an electrode subcutaneously within a frontal region of a patient'"'"'s chest; and

implanting a housing within the frontal region of the patient'"'"'s chest, the housing and the subcutaneous electrode cooperating to provide selective antiarrhythmic, sensing and induction therapy.

2. The method of claim 1, wherein the housing is an active housing, and further wherein the housing and the electrode cooperate to provide selective antiarrhythmic, sensing and induction therapy between the housing and the subcutaneous electrode.

3. The method of claim 1, wherein the subcutaneous electrode is positioned within the frontal region of the patient'"'"'s chest such that is selected to overlap a peripheral region of a patient'"'"'s heart.

4. The method of claim 1, wherein the subcutaneous electrode is substantially curvilinear in shape.

5. The method of claim 1, further comprising implanting a second subcutaneous electrode.

6. The method of claim 5, wherein the second subcutaneous electrode is positioned within the frontal region of the patient'"'"'s chest.

7. The method of claim 5, wherein the second subcutaneous electrode is positioned within the lateral region of the patient'"'"'s chest.

8. The method of claim 5, wherein the housing is inactive, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the second subcutaneous electrode.

9. The method of claim 5, wherein the housing is inactive, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the housing.

10. The method of claim 5, wherein the housing is active, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the second subcutaneous electrode.

11. The method of claim 5, wherein the housing is active, further providing selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the housing and selective antiarrhythmic, sensing and induction therapy between the second subcutaneous electrode and the housing.

12. The method of claim 1, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the housing and applies shocks between the subcutaneous electrode and the housing.

13. The method of claim 1, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the second subcutaneous electrode part.

14. The method of claim 5, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the second subcutaneous electrode.

15. The method of claim 12, wherein the subcutaneous electrode includes a first segment and a second segment, the first segment and the second segment being collinear.

16. The method of claim 12, wherein the subcutaneous electrode includes a first element and a second element, the first element and the second element being spaced from each other and substantially parallel.

17. A method of applying therapy to a patient comprising:

implanting a first electrode in a first subcutaneous electrode position; and

implanting a housing, wherein the first electrode and the housing cooperate to apply selective antiarrhythmic, sensing and induction therapy;

wherein the first subcutaneous electrode position is disposed in a frontal region of the patient'"'"'s chest, the first subcutaneous electrode position being selected from one of a sternum, a lateral, an upper and a lower position.

18. The method of claim 17, wherein the housing is implanted in a position that is selected from one of a side, an inframammary and a pectoral position.

19. The method of claim 17, wherein the first subcutaneous electrode position is selected on one side of a heart and the housing position is selected on the other side of the heart in the frontal region of the patient.

20. The method of claim 17, wherein the first subcutaneous electrode position and the housing positions are selected perpendicular to each other.

21. The method of claim 17, the method further comprising implanting a second electrode implanted in a second subcutaneous electrode position in the frontal region of the patient.

22. The method of claim 21, wherein the first subcutaneous electrode position and the second subcutaneous electrode position are selected on opposite sides of a heart in the frontal region of the patient.

23. The method of claim 21, wherein selective antiarrhythmic, sensing and induction therapy is applied between the first electrode and the second electrode.

24. The method of claim 21, wherein selective antiarrhythmic, sensing and induction therapy is applied between the first electrode and the housing and selective antiarrhythmic, sensing and induction therapy is applied between the second electrode and the housing.

25. A cardiac device adapted to provide therapy to a patient with a frontal region defined in the chest area, said cardiac device comprising:

a subcutaneous electrode adapted to be disposed in the frontal region;

a housing; and

a lead electrically coupling the subcutaneous electrode and the housing to generate an electrical field therebetween, the subcutaneous electrode and the housing providing selective antiarrhythmic, sensing and induction therapy.

26. The device of claim 25, wherein the subcutaneous electrode is adapted to be implanted in the frontal region of the patient'"'"'s chest in a position selected to overlap a peripheral region of the heart.

27. The device of claim 25, wherein the subcutaneous electrode is adapted to be implanted in one of a sternum, a lateral, an upper and a lower position selected in the frontal region.

28. The device of claim 25, wherein the housing is adapted to be implanted in one of a side, an inframammary and a pectoral position.

29. The device of claim 25, further comprising implanting a second subcutaneous electrode.

30. The device of claim 29, wherein the second subcutaneous electrode is positioned within the frontal region of the patient'"'"'s chest.

31. The device of claim 29, wherein the second subcutaneous electrode is positioned within the lateral region of the patient'"'"'s chest.

32. The device of claim 29, wherein the housing is inactive, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the second subcutaneous electrode.

33. The device of claim 29, wherein the housing is inactive, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the housing.

34. The device of claim 29, wherein the housing is active, further comprising applying selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the second subcutaneous electrode.

35. The device of claim 29, wherein the housing is active, further providing selective antiarrhythmic, sensing and induction therapy between the subcutaneous electrode and the housing and selective antiarrhythmic, sensing and induction therapy between the second subcutaneous electrode and the housing.

36. The device of claim 25, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the housing and applies shocks between the subcutaneous electrode and the housing.

37. The device of claim 25, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the second subcutaneous electrode part.

38. The device of claim 29, wherein the subcutaneous electrode further comprises a first part and a second part, wherein the subcutaneous electrode senses intrinsic cardiac activity between the first subcutaneous electrode part and the second subcutaneous electrode.

39. The device of claim 36, wherein the subcutaneous electrode includes a first segment and a second segment, the first segment and the second segment being collinear.

40. The device of claim 36, wherein the subcutaneous electrode includes a first element and a second element, the first element and the second element being spaced from each other and substantially parallel.