Leadless cardiac stimulation device employing distributed logic

• US 20060135999A1
• Filed: 12/16/2004
• Published: 06/22/2006
• Est. Priority Date: 12/16/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Bodner, Jeff, Bierwerth, Randy
• Granted Patent: US 8,818,504 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• 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 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/37518 Anchoring of the implants, e.g. fixation
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Systems and methods involve an intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery. The cardiac stimulation device includes a housing configured for intrathoracic placement relative to a patient'"'"'s heart. A fixation arrangement of the housing is configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature. An electrode arrangement supported by the housing is configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature. Energy delivery circuitry in the housing is coupled to the electrode arrangement. Detection circuitry is provided in the housing and coupled to the electrode arrangement. Communications circuitry may optionally be supported by the housing. A controller in the housing coordinates delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

Claims

1. An intrathoracic cardiac stimulation device operable to provide autonomous cardiac sensing and energy delivery, comprising:

a housing configured for intrathoracic placement relative to a patient'"'"'s heart;

a fixation arrangement supported by the housing and configured to affix the housing at an implant location within cardiac tissue or cardiac vasculature;

an electrode arrangement supported by the housing and configured to sense cardiac activity and deliver stimulation energy to the cardiac tissue or cardiac vasculature;

energy delivery circuitry provided in the housing and coupled to the electrode arrangement;

detection circuitry provided in the housing and coupled to the electrode arrangement; and

a controller provided in the housing and coupled to the energy delivery circuitry and detection circuitry, the controller coordinating delivery of energy to the cardiac tissue or cardiac vasculature in accordance with an energy delivery protocol appropriate for the implant location.

2. The device of claim 1, wherein the electrode arrangement comprises an epicardial or endocardial electrode arrangement.

3. The device of claim 1, wherein the electrode arrangement comprises an intravenous electrode arrangement.

4. The device of claim 1, wherein the electrode arrangement comprises one or more annular electrodes supported circumferentially about a portion of the housing.

5. The device of claim 1, wherein the housing comprises one or more recesses configured for one or both of receiving a distal portion of an implantation drive member and receiving an explant member attachment mechanism.

6. The device of claim 1, wherein the energy delivery protocol comprises a pacing protocol appropriate for a specific chamber of the heart.

7. The device of claim 1, wherein the energy delivery protocol comprises a multiple chamber pacing protocol.

8. The device of claim 1, wherein the energy delivery protocol comprises a defibrillation or cardioversion protocol.

9. The device of claim 1, further comprising communications circuitry coupled to the controller, wherein the controller coordinates communication with a patient-external system via the communications circuitry.

10. The device of claim 1, further comprising communications circuitry coupled to the controller, wherein the controller coordinates communication with one or more other intrathoracic cardiac stimulation devices via the communications circuitry.

11. A system comprising a plurality of the cardiac stimulation devices according to claim 1, each of the cardiac stimulation devices configured for intrathoracic placement relative to the patient'"'"'s heart, wherein the controller of each of the plurality of cardiac stimulation devices coordinates delivery of energy in accordance with an energy delivery protocol appropriate for the implant location at which each of the plurality of cardiac stimulation devices is affixed.

12. An intrathoracic cardiac stimulation method, comprising:

sensing cardiac activity from a plurality of intrathoracic locations;

delivering, from the plurality of intrathoracic locations, energy to cardiac tissue or cardiac vasculature responsive to the sensed cardiac activity; and

coordinating, at the plurality of intrathoracic locations, the energy delivery in accordance with a distributed energy delivery protocol.

13. The method of claim 12, wherein the energy delivery protocol comprises a pacing protocol.

14. The method of claim 12, wherein the energy delivery protocol comprises a resynchronization pacing protocol or a pacing protocol to effect multisite pacing with a common heart chamber.

15. The method of claim 12, wherein the energy delivery protocol comprises a stimulation energy delivery protocol, the stimulation energy associated with the stimulation energy delivery protocol insufficient to effect capture.

16. The method of claim 12, wherein the energy delivery protocol comprises a defibrillation or cardioversion protocol.

17. The method of claim 12, wherein coordinating the energy delivery comprises effecting communication between the plurality of intrathoracic locations to facilitate coordination of the energy delivery.

18. The method of claim 12, further comprising establishing a communication link between at least one of the plurality of intrathoracic locations and a patient-external location.

19. An intrathoracic cardiac stimulation system, comprising:

means for sensing cardiac activity from each of a plurality of intrathoracic locations;

means for delivering energy to cardiac tissue or cardiac vasculature from each of the plurality of intrathoracic locations; and

means for coordinating the energy delivery from each of the plurality of intrathoracic locations in accordance with a distributed energy delivery protocol.

20. The system of claim 19, further comprising means for establishing a communication link between the plurality of intrathoracic locations.