CARDIAC STIMULATION AND SENSING WITH ENDOLYMPHATICALLY IMPLANTED LEAD

• US 20070282380A1
• Filed: 02/16/2007
• Published: 12/06/2007
• Est. Priority Date: 06/06/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers
• Inventors: Shuros, Allan C., Brooke, M. Jason
• Granted Patent: US 7,761,157 B2
• Time in Patent Office: Days
• US Class Current: 607/6
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/358 Detecting ST segments
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes
• CPC Class Codes: A61M 2202/0405 Lymph
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes

Abstract

A technique utilizing an endolymphatically implanted lead having one or more electrodes that may be used for sensing cardiac activity and/or delivering cardiac electrical stimulation by an implantable cardiac device. An electrode disposed in the thoracic duct is in close proximity to the left ventricle and generates an electrogram especially suitable for ischemia detection and/or discriminating between ventricular tachycardias and supraventricular tachycardias.

Claims

1. A method for operating a cardiac rhythm management device, comprising:

configuring an endolymphatic sensing channel with an electrode implanted in the thoracic duct; and

,

recording an endolymphatic electrogram generated from the endolymphatic sensing channel.

2. The method of claim 1 further comprising wirelessly transmitting the recorded endolymphatic electrogram to an external programmer.

3. The method of claim 1 further comprising analyzing the morphology of the recorded endolymphatic electrogram to detect cardiac ischemia.

4. The method of claim 1 further comprising analyzing the morphology of the recorded endolymphatic electrogram to discriminate between a ventricular tachycardia and a supraventricular tachycardia.

5. The method of claim 1 wherein the endolymphatic sensing channel is configured with the endolymphatically implanted electrode and a conductive implantable housing.

6. The method of claim 1 wherein the endolymphatic sensing channel is configured with the endolymphatically implanted electrode and an intra-cardiac electrode.

7. The method of claim 1 wherein the endolymphatic sensing channel is configured with the endolymphatically implanted electrode and a right ventricular electrode.

8. The method of claim 1 wherein the endolymphatic sensing channel is configured with the endolymphatically implanted electrode and a subcutaneously implanted electrode.

9. The method of claim 1 further comprising:

configuring an endolymphatic shock channel with an electrode implanted in the thoracic duct; and

,

delivering a cardiac shock via the endolymphatic shock channel upon detection of a shockable tachyarrhythmia.

10. The method of claim 1 further comprising:

configuring an endolymphatic pacing channel with an electrode implanted in the thoracic duct; and

,

delivering pacing pulses via the endolymphatic pacing channel in accordance with a programmed pacing mode.

11. A method for operating a cardiac rhythm management device, comprising:

configuring an endolymphatic shock channel with an electrode implanted in the thoracic duct;

monitoring for the occurrence of a tachyarrhythmia via a cardiac sensing channel; and

,

delivering a cardiac shock via the endolymphatic shock channel upon detection of a shockable tachyarrhythmia.

12. The method of claim 11 wherein the endolymphatic shock channel is configured with the endolymphatically implanted electrode and a conductive implantable housing.

13. The method of claim 11 wherein the endolymphatic shock channel is configured with the endolymphatically implanted electrode and an intra-cardiac electrode.

14. The method of claim 11 wherein the endolymphatic shock channel is configured with the endolymphatically implanted electrode and a right ventricular electrode.

15. The method of claim 11 wherein the endolymphatic shock channel is configured with the endolymphatically implanted electrode and a subcutaneously implanted electrode.

16. A cardiac device, comprising:

an endolymphatic sensing channel configured with an electrode adapted for implantation in the thoracic duct;

a controller programmed to record an endolymphatic electrogram generated from the endolymphatic sensing channel; and

,

wherein the controller is further programmed to analyze the morphology of the recorded endolymphatic electrogram by comparing the recorded endolymphatic electrogram with a reference endolymphatic electrogram or features derived therefrom.

17. The device of claim 16 wherein the controller is further programmed to analyze the morphology of the recorded endolymphatic electrogram in order to detect cardiac ischemia.

18. The device of claim 16 wherein the controller is further programmed to analyze the morphology of the recorded endolymphatic electrogram in order to discriminate between SVT and VT.

19. The device of claim 16 further comprising:

an endolymphatic shock channel with the electrode adapted for implantation in the thoracic duct;

wherein the controller is programmed to monitor for the occurrence of a tachyarrhythmia and deliver a cardiac shock via the endolymphatic shock channel upon detection of a shockable tachyarrhythmia.

20. The device of claim 16 further comprising:

an endolymphatic pacing channel configured with the electrode adapted for implantation in the thoracic duct; and

,

wherein the controller is configured to deliver pacing pulses via the endolymphatic pacing channel in accordance with a programmed pacing mode.