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

• US 20050277990A1
• Filed: 08/17/2005
• Published: 12/15/2005
• 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 8,412,320 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• 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 1/3956 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-tachycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-tachycardia pacing energy for delivery to the patient'"'"'s heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-tachycardia pacing energy to the capacitor subsystem.

Claims

1. A method of treatment comprising:

implanting a stimulus device comprising a canister and a lead, the lead including a stimulus delivery electrode, the canister and the lead being disposed in non-vascular and non-cardiac locations;

detecting an arrhythmia; and

delivering electrical stimulus to the heart using only the stimulus delivery electrode and one or more electrodes disposed on the canister.

2. The method of claim 1, wherein the stimulus delivery electrode is a coil electrode.

3. The method of claim 1, wherein the stimulus delivery electrode is a coil electrode having a length of about 5-10 cm.

4. The method of claim 1, wherein the canister and the lead are disposed such that neither extends beneath the ribs.

5. The method of claim 1, wherein the canister and the lead are disposed at a non-intra-thoracic location.

6. The method of claim 1, wherein the step of delivering the electrical stimulus includes providing a series of electrical impulses, wherein the method also includes timing the delivery of the series of electrical impulses in a manner achieving a pacing function.

7. The method of claim 1, wherein the step of delivering the electrical stimulus includes providing an electrical stimulus at an amplitude and for a duration selected for achieving a defibrillation function.

8. The method of claim 1, wherein the longitudinally extending stimulus delivery electrode is a coil electrode disposed outside the ribs and disposed in a generally linear fashion.

9. A method of treatment comprising:

implanting a stimulus device comprising a canister housing stimulus delivery circuitry and a lead including one or more electrodes, the canister and lead being disposed in non-vascular and non-cardiac locations;

detecting an arrhythmia; and

delivering electrical stimulus using a first single electrode and a second single electrode, both electrodes being disposed outside the person'"'"'s heart and vasculature;

wherein the stimulus delivery circuitry generates an output current between only the first single electrode and the second single electrode.

10. The method of claim 9, wherein the first electrode is disposed on a lead assembly associated with the canister, and the second electrode is disposed on the canister.

11. The method of claim 9, wherein at least one of the first single electrode and/or the second single electrode is a coil electrode.

12. The method of claim 9, wherein at least one of the first single electrode and/or the second single electrode is a coil electrode having a length of about 5-10 cm.

13. The method of claim 9, wherein each of the first single electrode and the second single electrode are disposed such that neither extends beneath the ribs of the person.

14. The method of claim 9, wherein each of the first single electrode and the second single electrode are disposed in the person at a nontransthoracic location.

15. The method of claim 9, wherein the step of delivering the electrical stimulus includes providing a series of electrical impulses, wherein the method also includes timing the delivery of the series of electrical impulses in a manner achieving a pacing function.

16. The method of claim 9, wherein the step of delivering the electrical stimulus includes providing an electrical stimulus at an amplitude and for a duration selected for achieving a defibrillation function.

17. The method of claim 9, wherein the electrical stimulus has a biphasic waveform.

18. A method of treatment comprising:

implanting in the person a cardiac stimulus device comprising a canister and a lead electrode assembly, the canister housing output circuitry for providing output electrical stimulus to the person between first and second outputs, a first stimulus electrode disposed on the lead electrode assembly, the first output being coupled to the first stimulus electrode and no other electrode, the second output being coupled to one or more stimulus electrodes disposed on the canister and no other electrode, the canister and the lead electrode assembly being implanted such that neither extends into or resides within the thoracic cavity of the person; and

delivering electrical cardiac stimulus to the patient via the output circuitry.

19. The method of claim 18, wherein the output circuitry is adapted to reverse the polarity of the first and second outputs to generate a biphasic waveform.

20. The method of claim 18, wherein the first stimulus electrode is a coil electrode having a length of about 5-10 cm.