Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator

• US 20060036289A1
• Filed: 10/14/2005
• Published: 02/16/2006
• 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 7,359,754 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

One embodiment of the present invention provides an implantable cardioverter-defibrillator for subcutaneous positioning over a patient'"'"'s ribcage, the implantable cardioverter-defibrillator includes a housing having a first end and a second end; a first electrode disposed upon the first end of the housing; a second electrode disposed upon the second end of the housing; an electrical circuit located within the housing, wherein the electrical circuit is electrically coupled to the first electrode and the second electrode; and a lead electrode electrically coupled to the electrical circuit located within the housing.

Claims

1. An implantable cardioverter-defibrillator comprising:

a housing having first and second ends;

a first electrode disposed on the housing toward the first end;

a second electrode disposed on the housing toward the second end;

a lead having a third electrode thereon, the lead being coupled to the housing;

operational circuitry in the housing, the operational circuitry having output circuitry for providing a defibrillation output, the output circuitry coupled to each of the first, second and third electrodes such that the operational circuitry can deliver therapy using a plurality of electrode pairs including at least the combinations of the first and second or first and third electrodes.

2. The implantable cardioverter-defibrillator of claim 1, wherein the plurality of electrode pairs includes a combination of the second and third electrodes.

3. The implantable cardioverter-defibrillator of claim 1, wherein the housing has a curvature and a taper extending from the first end toward the second end.

4. The implantable cardioverter-defibrillator of claim 1, wherein the operational circuitry is adapted to select which of the combinations of electrodes to use to deliver therapy.

5. The implantable cardioverter-defibrillator of claim 1, wherein the operational circuitry is adapted to detect cardiac signals by use of one or more sensing electrode pairs.

6. The implantable cardioverter-defibrillator of claim 5, wherein the operational circuitry is adapted to select between the one or more sensing electrode pairs including combinations of the first, second and third electrodes.

7. The implantable cardioverter-defibrillator of claim 5, wherein the lead includes a fourth electrode.

8. The implantable cardioverter-defibrillator of claim 7, wherein the operational circuitry is adapted to select between the one or more sensing electrode pairs including combinations of the first, second and fourth electrodes.

9. The implantable cardioverter-defibrillator of claim 8, wherein the operational circuitry is adapted to sense cardiac signals by assuming that each of the first, second and fourth electrodes are implanted subcutaneously.

10. An implantable cardioverter-defibrillator comprising:

a housing having first and second ends;

a first electrode disposed on the housing toward the first end;

a second electrode disposed on the housing toward the second end;

a lead having a third electrode thereon, the lead being coupled to the housing;

operational circuitry in the housing, the operational circuitry having sensing and detection circuitry for observing cardiac activity, the sensing and detection circuitry coupled to each of the first, second and third electrodes such that the operational circuitry can select from a plurality of sensing pairs including combinations of the first and second electrodes and the first and third electrodes.

11. The implantable cardioverter-defibrillator of claim 10, wherein the plurality of sensing pairs further includes a combination of the second and third electrodes.

12. The implantable cardioverter-defibrillator of claim 10, wherein the housing has a curvature and a taper extending from the first end toward the second end.

13. The implantable cardioverter-defibrillator of claim 10, wherein the operational circuitry is adapted to select which of the combinations of electrodes to use for sensing cardiac activity.

14. The implantable cardioverter-defibrillator of claim 10, wherein the operational circuitry is adapted to provide therapeutic energy by use of one or more therapy delivery electrode pairs.

15. The implantable cardioverter-defibrillator of claim 14, wherein the lead includes a fourth electrode.

16. The implantable cardioverter-defibrillator of claim 15, wherein the operational circuitry is adapted to select between the one or more therapy delivery electrode pairs including combinations of the first, second and fourth electrodes.

17. The implantable cardioverter-defibrillator of claim 15, wherein the operational circuitry is adapted to sense cardiac signals by assuming that each of the first, second and third electrodes are implanted subcutaneously.

18. An implantable cardioverter-defibrillator comprising:

a housing having first and second ends;

a first electrode disposed on the housing toward the first end;

a second electrode disposed on the housing toward the second end;

a lead having one or more lead electrodes thereon, the lead being coupled to the housing;

operational circuitry in the housing, the operational circuitry having output circuitry for outputting a cardioversion/defibrillation stimulus to a patient, the output circuitry coupled to each of the first and second electrodes and at least one lead electrode such that the operational circuitry can select from a plurality of therapy delivery electrode pairs including combinations of the first and second electrodes and the at least one lead electrode.

19. The implantable cardioverter-defibrillator of Claim 18, wherein the operational circuitry includes sensing and detection circuitry coupled to the first and second electrodes and at least one lead electrode such that the operational circuitry can select from a plurality of sensing and detection electrode pairs including combinations of the first and second electrodes and the at least one lead electrode.

20. The implantable cardioverter-defibrillator of claim 19, wherein the operational circuitry is adapted to perform sensing of cardiac signals by assuming that each of the first and second electrodes and the one or more lead electrodes are implanted subcutaneously.