Current waveforms for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator

• US 20050143778A1
• Filed: 02/18/2005
• Published: 06/30/2005
• Est. Priority Date: 09/18/2000
• Status: Active Grant

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Ostroff, Alan H., Rissmann, William J., Bardy, Gust H., Mezack, Gary P.
• Granted Patent: US 7,502,645 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• 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 1/39622 Pacing therapy
• 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 power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient'"'"'s heart or reside in the intrathoracic blood vessels and for providing anti-bradycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient'"'"'s heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.

Claims

1. A method of treating the heart of a patient comprising applying a first constant current across a portion of patient tissue between first and second electrodes both disposed subcutaneously, nonvascularly, and exclusive of the heart.

2. The method of claim 1, wherein the first electrode is disposed on a canister containing circuitry for generating the first constant current, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister.

3. The method of claim 2, further comprising determining whether the patient'"'"'s cardiac rhythm is normal, wherein the step of applying a first constant current is performed if the patient'"'"'s cardiac rhythm is abnormal.

4. The method of claim 1, wherein the first constant current is provided at a time during the patient'"'"'s cardiac rhythm to induce fibrillation of the heart as part of testing an implantable cardiac stimulus device.

5. The method of claim 1, wherein the first constant current is provided at a time to convert the patient into normal cardiac rhythm.

6. The method of claim 1, further comprising applying a second constant current across the portion of tissue using the first and second electrodes, wherein the second constant current is of opposite sign from the first constant current.

7. The method of claim 1, wherein the first electrode is disposed along the left axillary line of the patient, and the second electrode is disposed medial from the first electrode.

8. The method of claim 7, wherein the first electrode is disposed along the inframammary crease of the patient.

9. The method of claim 8, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

10. The method of claim 1, wherein the first electrode is disposed along the inframammary crease of the patient.

11. The method of claim 10, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

12. The method of claim 1, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

13. A method of treating the heart of a patient comprising providing a biphasic constant current signal across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient'"'"'s heart or reside in the patient'"'"'s vasculature.

14. The method of claim 13, wherein the first electrode is disposed on a canister containing circuitry for generating the biphasic constant current signal, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister.

15. The method of claim 14, further comprising determining whether the patient'"'"'s cardiac rhythm is normal, wherein the step of applying a biphasic constant current signal is performed if the patient'"'"'s cardiac rhythm is abnormal.

16. The method of claim 13, wherein biphasic constant current signal is provided at a time during the patient'"'"'s cardiac rhythm to induce fibrillation of the heart as part of testing an implantable medical device.

17. The method of claim 13, wherein biphasic constant current signal is provided at a time to convert the patient into normal cardiac rhythm.

18. The method of claim 13, wherein the first electrode is disposed along the left axillary line of the patient, and the second electrode is disposed medial from the first electrode.

19. The method of claim 18, wherein the first electrode is disposed along the inframammary crease of the patient.

20. The method of claim 19, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

21. The method of claim 13, wherein the first electrode is disposed along the inframammary crease of the patient.

22. The method of claim 21, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

23. The method of claim 13, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

24. The method of claim 13, wherein the biphasic constant current signal includes a first portion having a first duration and a first magnitude, and a second portion having a second duration and a second magnitude, wherein the first portion and the second portion have magnitudes in the range of about one to two-hundred fifty milliamps and durations in the range of about one to forty milliseconds.

25. A method of treating the heart of a patient comprising providing a constant current signal across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient'"'"'s heart or reside in the patient'"'"'s vasculature;

wherein;

the first electrode is disposed on a canister containing circuitry for generating the biphasic constant current signal, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister;

the first electrode is disposed along the left axillary line of the patient and the second electrode is disposed medial from the first electrode;

the first electrode is disposed along the inframammary crease of the patient; and

a line drawn from the first electrode to the second electrode intersects a portion of the patient'"'"'s heart.

26. The method of claim 25, wherein the constant current signal is provided at a time during the patient'"'"'s cardiac rhythm to induce fibrillation of the heart as part of testing an implantable medical device incorporating the canister.

27. The method of claim 25, wherein the constant current signal is provided at a time to convert the patient into normal cardiac rhythm.

28. The method of claim 25, further comprising determining whether the patient'"'"'s cardiac rhythm is normal, wherein the step of applying a constant current signal is performed if the patient'"'"'s cardiac rhythm is abnormal.