ANTERIOR ACTIVE HOUSING SUBCUTANEOUS POSITIONING METHODS

• US 20070060960A1
• Filed: 11/01/2006
• Published: 03/15/2007
• 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: ERLINGER, PAUL, BARDY, GUST, OSTROFF, ALAN
• Granted Patent: US 7,835,790 B2
• Time in Patent Office: Days
• US Class Current: 607/6
• 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 on a lead assembly;

the second implanted electrode is on a housing for an implantable cardioverter defibrillator;

the lead assembly is coupled to the implantable cardioverter defibrillator;

the housing is disposed on the left side of the patient'"'"'s ribcage under the arm; and

the first implanted electrode is subcutaneously disposed at a substantially vertical subcutaneous position generally over the patient'"'"'s heart, adjacent to the sternum.

2. The method of claim 1, wherein the lead assembly includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode, the main electrode corresponding to the first implanted electrode, the distalmost electrode and intermediate electrode being coupled to operational circuitry in the housing for use in sensing cardiac electrical activity, and the intermediate electrode being the smallest of these electrodes.

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

4. The method of claim 1, wherein the first implanted electrode is disposed on the left side of the sternum.

5. The method of claim 1, wherein each implanted electrode used in the delivery of the electrical stimulus is disposed outside of the patient'"'"'s ribcage.

6. 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 on a lead assembly;

the second implanted electrode is on a housing for an implantable cardioverter defibrillator;

the lead assembly is coupled to the implantable cardioverter defibrillator;

the housing is disposed at about the left inframammary crease of the patient; and

the first implanted electrode is subcutaneously disposed at a substantially horizontal position generally over the heart of the patient, generally superior to the housing.

7. The method of claim 6, wherein the lead assembly includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode, the main electrode corresponding to the first implanted electrode, the distalmost electrode and intermediate electrode being coupled to operational circuitry in the housing for use in sensing cardiac electrical activity, and the intermediate electrode being the smallest of these electrodes.

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

9. The method of claim 6, wherein each implanted electrode used in delivery of the electrical stimulus is disposed outside of the patient'"'"'s ribcage.

10. 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 on a lead assembly;

the second implanted electrode is on a housing for an implantable cardioverter defibrillator;

the lead assembly is coupled to the implantable cardioverter defibrillator;

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

the housing is disposed inferior of the patient'"'"'s clavicle on the left side of the patient'"'"'s body; and

the housing is disposed generally superior to the first implanted electrode.

11. The method of claim 10, wherein the lead assembly includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode, the main electrode corresponding to the first implanted electrode, the distalmost electrode and intermediate electrode being coupled to operational circuitry in the housing for use in sensing cardiac electrical activity, and the intermediate electrode being the smallest of these electrodes.

12. The method of claim 10, further comprising sensing cardiac activity in the patient.

13. The method of claim 10, wherein each implanted electrode used in the delivery of the electrical stimulus is disposed outside of the patient'"'"'s ribcage.

14. 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 on a lead assembly;

the second implanted electrode is on a housing for an implantable cardioverter defibrillator;

the lead assembly is coupled to the implantable cardioverter defibrillator;

the housing is disposed at about the left inframammary crease;

the first implanted electrode is subcutaneously disposed at a substantially vertical subcutaneous position over the heart, adjacent to the sternum;

the housing is generally inferior to and left of the first implanted electrode.

15. The method of claim 14, wherein the lead assembly includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode, the main electrode corresponding to the first implanted electrode, the distalmost electrode and intermediate electrode being coupled to operational circuitry in the housing for use in sensing cardiac electrical activity, and the intermediate electrode being the smallest of these electrodes.

16. The method of claim 14, further comprising sensing cardiac activity in the patient.

17. The method of claim 14, wherein the second implanted electrode is disposed on the left side of the sternum.

18. The method of claim 14, wherein each implanted electrode used in the delivery of the electrical stimulus is disposed outside of the patient'"'"'s ribcage.

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 on a lead assembly;

the second implanted electrode is on a housing for an implantable cardioverter defibrillator;

the lead assembly is coupled to the implantable cardioverter defibrillator;

the housing is disposed on the left side of the patient'"'"'s ribcage under the arm;

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

the housing is generally superior to and left of the first implanted electrode.

20. The method of claim 19, wherein the lead assembly includes a distal portion having a segmented electrode with a distalmost electrode, an intermediate electrode, and a main electrode, the main electrode corresponding to the first implanted electrode, the distalmost electrode and intermediate electrode being coupled to operational circuitry in the housing for use in sensing cardiac electrical activity, and the intermediate electrode being the smallest of these electrodes.

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

22. The method of claim 19, wherein each implanted electrode used in the delivery of the electrical stimulus is disposed outside of the patient'"'"'s ribcage.