Subcutaneous defibrillation timing correlated with induced skeletal muscle contraction
First Claim
1. A method of delivering a subcutaneous defibrillation therapy, comprising:
- delivering, from a subcutaneous non-intrathoracic location relative to a patient'"'"'s heart, a pre-shock waveform sufficient in energy such that contraction of skeletal musculature occurs in the patient'"'"'s thorax, but insufficient in energy for defibrillating the patient'"'"'s heart; and
delivering, from the subcutaneous non-intrathoracic location or other subcutaneous non-intrathoracic location, a defibrillation waveform to the patient'"'"'s heart during contraction of the skeletal musculature.
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Accused Products
Abstract
Methods and systems for defibrillation therapy involve delivering a pre-shock waveform to cause contraction of skeletal musculature in the patient'"'"'s thorax before delivering a defibrillation waveform. A shock is delivered to the patient'"'"'s heart during contraction of the skeletal musculature for a reduction in defibrillation threshold. The pre-shock waveform is sufficient in energy to cause one or both of deflation of the patient'"'"'s lungs and muscle fiber shortening of the skeletal musculature. A delay interval may be initiated relative to delivery of the pre-shock waveform, wherein the defibrillation waveform is delivered following expiration of the delay interval. Motion of the patient'"'"'s thorax and/or expiration of the patient'"'"'s lungs may be detected, responsive to the pre-shock waveform. The defibrillation waveform may be delivered in coordination with the detected parameter, such as in relation to detection of a peak in the thoracic motion or minimum in transthoracic impedance.
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Citations
57 Claims
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1. A method of delivering a subcutaneous defibrillation therapy, comprising:
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delivering, from a subcutaneous non-intrathoracic location relative to a patient'"'"'s heart, a pre-shock waveform sufficient in energy such that contraction of skeletal musculature occurs in the patient'"'"'s thorax, but insufficient in energy for defibrillating the patient'"'"'s heart; and
delivering, from the subcutaneous non-intrathoracic location or other subcutaneous non-intrathoracic location, a defibrillation waveform to the patient'"'"'s heart during contraction of the skeletal musculature. - 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)
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26. A system for delivering a subcutaneous defibrillation therapy, comprising:
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a housing configured for subcutaneous non-intrathoracic placement relative to a patient'"'"'s heart;
detection circuitry provided in the housing;
energy delivery circuitry provided in the housing;
one or more electrodes configured for subcutaneous non-intrathoracic placement relative to the patient'"'"'s heart, the one or more electrodes coupled to the detection and energy delivery circuitry; and
a controller provided in the housing and coupled to the detection and energy delivery circuitry, the controller, in response to detection of a cardiac fibrillation event, coordinating delivery of a pre-shock waveform sufficient in energy such that contraction of skeletal musculature occurs in the patient'"'"'s thorax but insufficient in energy for defibrillating the patient'"'"'s heart, and delivery of a defibrillation waveform to the patient'"'"'s heart during contraction of the skeletal musculature. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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49. A system for delivering a subcutaneous defibrillation therapy, comprising:
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means for delivering, from a subcutaneous non-intrathoracic location relative to a patient'"'"'s heart, a pre-shock waveform sufficient in energy such that contraction of skeletal musculature occurs in the patient'"'"'s thorax but insufficient in energy for defibrillating the patient'"'"'s heart; and
means for delivering, from the subcutaneous non-intrathoracic location or other subcutaneous non-intrathoracic location, a defibrillation waveform to the patient'"'"'s heart during contraction of the skeletal musculature. - View Dependent Claims (50, 51, 52, 53, 54, 55, 56, 57)
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Specification