ANTERIOR POSITIONING INACTIVE HOUSING

• US 20070060958A1
• Filed: 11/01/2006
• Published: 03/15/2007
• Est. Priority Date: 09/18/2000
• Status: Active Grant

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: ERLINGER, PAUL, BARDY, GUST, OSTROFF, ALAN
• Granted Patent: US 7,774,059 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• 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 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• 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 subcutaneous cardiac device includes a subcutaneous electrode and a housing coupled to the subcutaneous electrode by a lead with a lead wire. The subcutaneous electrode is adapted to be implanted in a frontal region of the patient so as to overlap a portion of the patient'"'"'s heart.

Claims

1. A method of terminating a cardiac arrhythmia in a patient comprising delivering an electrical stimulus between at least first and second implanted electrodes wherein:

the first implanted electrode is disposed in a substantially vertical anterior position adjacent the patient'"'"'s sternum;

the second implanted electrode disposed in a substantially vertical anterior position to the left of the first implanted electrode;

each of the first and second implanted electrodes are disposed subcutaneously in the patient, with no portion thereof extending into the patient'"'"'s ribcage or residing in the patient'"'"'s vasculature; and

the first and second implanted electrodes are electrically coupled to circuitry housed in a canister, the circuitry adapted for generating and controlling the electrical stimulus; and

the canister is disposed at about the patient'"'"'s left inframammary crease.

2. The method of claim 1, wherein the first and second implanted electrodes are disposed on a single lead assembly.

3. The method of claim 1, wherein the first and second implanted electrodes are disposed on separate lead assemblies.

4. The method of claim 1, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode

the distalmost electrode and intermediate electrode are coupled to the circuitry in the canister for use in sensing cardiac electrical activity; and

the intermediate electrode is the smallest of the three implanted electrodes.

5. The method of claim 1, further comprising sensing cardiac activity in the patient, wherein at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a compound electrode with a first portion for delivering cardiac stimulus and a second portion for use in sensing cardiac activity.

6. The method of claim 1, further comprising sensing cardiac activity in the patient.

7. A method of terminating a cardiac arrhythmia in a patient comprising delivering an electrical stimulus between at least first and second implanted electrodes wherein:

the first implanted electrode is disposed in a substantially horizontal anterior position over the patient'"'"'s heart;

the second implanted electrode disposed in a substantially horizontal anterior position over the patient'"'"'s heart, inferior to the first implanted electrode;

each of the first and second implanted electrodes are disposed subcutaneously in the patient, with no portion thereof extending into the patient'"'"'s ribcage or residing in the patient'"'"'s vasculature;

the first and second implanted electrodes are electrically coupled to circuitry housed in a canister, the circuitry adapted for generating and controlling the electrical stimulus; and

the canister is disposed on the left side of the patient'"'"'s ribcage under the arm.

8. The method of claim 7, wherein the first and second implanted electrodes are disposed on a single lead assembly.

9. The method of claim 7, wherein the first and second implanted electrodes are disposed on separate lead assemblies.

10. The method of claim 7, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode

the distalmost electrode and intermediate electrode are coupled to the circuitry in the canister for use in sensing cardiac electrical activity; and

the intermediate electrode is the smallest of the three implanted electrodes.

11. The method of claim 7, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a compound electrode with a first portion for delivering cardiac stimulus and a second portion for use in sensing cardiac activity.

12. The method of claim 7, further comprising sensing cardiac activity in the patient.

13. A method of terminating a cardiac arrhythmia in a patient comprising delivering an electrical stimulus between at least first and second implanted electrodes wherein:

the first implanted electrode is disposed in a substantially vertical anterior position over the patient'"'"'s heart, adjacent the sternum;

the second implanted electrode disposed in a substantially vertical anterior position over the patient'"'"'s heart, to the left of the first implanted electrode;

each of the first and second implanted electrodes are disposed subcutaneously in the patient, with no portion thereof extending into the patient'"'"'s ribcage or residing in the patient'"'"'s vasculature; and

the first and second implanted electrodes are electrically coupled to circuitry housed in a canister, the circuitry adapted for generating and controlling the electrical stimulus; and

the canister is disposed at a pectoral position inferior to the clavicle.

14. The method of claim 13, wherein the first and second implanted electrodes are disposed on a single lead assembly.

15. The method of claim 13, wherein the first and second implanted electrodes are disposed on separate lead assemblies.

16. The method of claim 13, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode

the distalmost electrode and intermediate electrode are coupled to the circuitry in the canister for use in sensing cardiac electrical activity; and

the intermediate electrode is the smallest of the three implanted electrodes.

17. The method of claim 13, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a compound electrode with a first portion for delivering cardiac stimulus and a second portion for use in sensing cardiac activity.

18. The method of claim 13, further comprising sensing cardiac activity in the patient.

19. A method of terminating a cardiac arrhythmia in a patient comprising delivering an electrical stimulus between at least first and second implanted electrodes wherein:

the first implanted electrode is disposed in a substantially horizontal anterior position over the patient'"'"'s heart;

the second implanted electrode disposed in a substantially horizontal anterior position over the patient'"'"'s heart, inferior to the first implanted electrode;

each of the first and second implanted electrodes are disposed subcutaneously in the patient, with no portion thereof extending into the patient'"'"'s ribcage or residing in the patient'"'"'s vasculature;

the first and second implanted electrodes are electrically coupled to circuitry housed in a canister, the circuitry adapted for generating and controlling the electrical stimulus; and

the canister is disposed inferior and lateral to the first implanted electrode and superior and lateral to the second implanted electrode.

20. The method of claim 19, wherein the first and second implanted electrodes are disposed on a single lead assembly.

21. The method of claim 19, wherein the first and second implanted electrodes are disposed on separate lead assemblies.

22. The method of claim 19, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode

the distalmost electrode and intermediate electrode are coupled to the circuitry in the canister for use in sensing cardiac electrical activity; and

the intermediate electrode is the smallest of the three implanted electrodes.

23. The method of claim 19, further comprising sensing cardiac activity in the patient, wherein:

at least one of the first and second implanted electrodes is disposed on a lead assembly that includes a distal portion having a compound implanted electrode with a first portion for delivering cardiac stimulus and a second portion for use in sensing cardiac activity.

24. The method of claim 19, further comprising sensing cardiac activity in the patient.