Cardiac rhythm management system and method for fetal, neonatal, and/or pediatric patients

• US 20070016276A1
• Filed: 07/12/2005
• Published: 01/18/2007
• Est. Priority Date: 07/12/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hoecke, Kyle, Mains, Beverly, Heil, Ronald, Knapp, Christopher
• Granted Patent: US 7,551,959 B2
• Time in Patent Office: Days
• US Class Current: 607/119
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy

Abstract

This document discusses, among other things a method including inserting an electrode into an umbilical vein, and advancing the electrode through the umbilical vein to a location near or in a heart. In an example, the electrode is inserted into an umbilical vein in utero. In another example, the electrode is inserted into an umbilical vein in a child soon after the child is born. In an example, the electrode is connected to a lead. In an example, a lead is inserted through a catheterized umbilicus.

Claims

1. A method comprising:

inserting an electrode into an umbilical vein; and

advancing the electrode through the umbilical vein to a location near or in a heart.

2. The method of claim 1, wherein inserting an electrode into an umbilical vein includes inserting the electrode in utero.

3. The method of claim 1, wherein inserting an electrode into an umbilical vein includes inserting a lead assembly into the umbilical vein, the lead assembly including the electrode.

4. The method of claim 3, further comprising coupling a pulse generator to the lead assembly and coupling the pulse generator to a placenta or the umbilical vein.

5. The method of claim 3, further comprising forming a coil or loop in the lead assembly, the coil or loop accommodating growth of cardiac or venous anatomy.

6. The method of claim 3, wherein inserting a lead assembly into the umbilical vein includes inserting the lead assembly through a slip suture sleeve.

7. The method of claim 3, further comprising coating a portion of the lead assembly with an adhesion-preventing drug-eluting coating.

8. The method of claim 3, further comprising covering a portion of the lead assembly with ePTFE.

9. The method of claim 1, further comprising delivering a pacing signal or antitachyarrhythmia signal using the electrode.

10. The method of claim 1, wherein inserting an electrode into an umbilical vein includes catheterizing an umbilicus after birth.

11. The method of claim 1, wherein inserting an electrode into an umbilical vein includes surgically accessing an abdominal region and inserting the electrode into the umbilical vein at a location inside the abdomen.

12. A method comprising:

inserting a first defibrillation electrode into an umbilical vein; and

advancing the first defibrillation electrode to a location in or near a heart.

13. The method of claim 12, wherein advancing the first defibrillation electrode to a location in or near a heart includes advancing the first defibrillation electrode to a position that is near the heart but not in the heart.

14. The method of claim 13, further comprising inserting a second defibrillation electrode in the umbilical vein and advancing the second defibrillation electrode to an intrathoracic position.

15. The method of claim 14, wherein advancing the second defibrillation electrode to an intrathoracic position includes advancing the second defibrillation electrode to a location in or near the abdomen.

16. The method of claim 14, further comprising delivering an electrical signal using the first defibrillation electrode and the second defibrillation electrode.

17. The method of claim 14, wherein inserting a first defibrillation electrode into an umbilical vein and inserting a second defibrillation electrode in the umbilical vein include inserting a lead assembly into the umbilical vein, the lead assembly including the first defibrillation electrode and the second defibrillation electrode.

18. The method of claim 12, wherein advancing the first defibrillation electrode to a location in or near a heart includes advancing the first defibrillation electrode through the heart and into the superior vena cava (SVC).

19. The method of claim 12, wherein advancing the defibrillation electrode to a location in or near a heart includes positioning the electrode in the inferior vena cava (IVC).

20. The method of claim 12, further comprising implanting a pulse generator, coupling the pulse generator to the first defibrillation electrode and second defibrillation electrode, and delivering an electrical signal using the first defibrillation electrode and a second defibrillation electrode.

21. The method of claim 20, wherein implanting a pulse generator includes implanting the pulse generator in a left abdominal position.

22. The method of claim 20, further comprising coupling a lead assembly to the pulse generator and positioning a portion of the lead assembly including the second defibrillation electrode superior to the pulse generator.

23. The method of claim 20, further comprising coupling a lead assembly to the pulse generator and positioning a portion of the lead assembly including the second defibrillation electrode in an inferior vena cava (IVC).

24. A method comprising:

delivering an antiarrhythmia therapy using a lead assembly extending through an umbilical vein.

25. The method of claim 24, wherein delivering an antiarrhythmia therapy includes delivering the therapy in utero.

26. The method of claim 24, wherein the lead assembly includes a first defibrillation electrode and delivering an antiarrhythmia therapy includes delivering an antitachyarrhythmia therapy using the first defibrillation electrode.

27. The method of claim 24, wherein delivering an antiarrhythmia therapy using a lead assembly extending through an umbilical vein includes delivering an antiarrhythmia therapy through a catheterized umbilicus after birth.

28. The method of claim 24, wherein delivering an antiarrhythmia therapy using a lead assembly extending through an umbilical vein includes delivering the antiarrhythmia therapy through a lead assembly surgically implanted into the umbilical vein through an abdominal incision.

29. The method of claim 24, wherein delivering an antiarrhythmia therapy includes delivering the antiarrhythmia therapy using a first electrode on the lead assembly and a second electrode on a second lead assembly extending into the inferior vena cava.