METHOD FOR DETECTING AND TREATING VENTRICULAR ARRHYTHMIA

• US 20140249604A1
• Filed: 05/12/2014
• Published: 09/04/2014
• Est. Priority Date: 11/22/2000
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation), Medtronic Incorporated (Medtronic Plc)
• Inventors: Brown, Ward M., Heinrich, Stephen D.
• Application Number:
  US14/275,845
• Publication Number:
  US 20140249604A1
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/39624 Pain reduction therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

A system and method for long-term monitoring of cardiac conditions such as arrhythmias is disclosed. The invention includes a pulse generator including means for sensing an arrhythmia. The pulse generator is coupled to at least one subcutaneous electrode or electrode array for providing electrical stimulation such as cardioversion/defibrillation shocks and/or pacing pulses. The electrical stimulation may be provided between multiple subcutaneous electrodes, or between one or more such electrodes and the housing of the pulse generator. In one embodiment, the pulse generator includes one or more electrodes that are isolated from the can. These electrodes may be used to sense cardiac signals.

Claims

1. A method for treating patient arrhythmias, including the methods of:

a) providing a subcutaneous pulse generator in a canister having a conductive surface;

b) providing a monitoring circuit in the canister to monitor the patient'"'"'s cardiac signals for arrhythmias; and

c) providing a subcutaneous electrode array to deliver electrical therapy to a patient without a transvenous, intracardiac, or epicardial electrode.

2. The method of claim 2, wherein the monitoring circuit includes a circuit to sense a bradyarrythmia event, and wherein the subcutaneous electrode array is configured to deliver at least one pacing pulse to the patient upon detection of the bradyarrythmia event.

3. A method of implanting a subcutaneous cardioverter-defibrillator in a patient for treating arrhythmias without a transvenous, intracardiac or epicardial electrode, comprising:

implanting an electrode subcutaneously in the patient; and

placing an electrically active canister subcutaneously in the patient,

wherein the canister contains a source of electrical energy and operational circuitry that senses the presence of potentially fatal heart rhythms and has circuitry for delivering electrical cardioversion-defibrillation energy between the canister and the electrode, and wherein the canister is electrically connected to the electrode.

4. The method of claim 3, wherein the electrode can be subcutaneously implanted at various locations in the body.

5. The method of claim 3, wherein the canister can be subcutaneously implanted at various locations in the body.

6. The method of claim 3, wherein the operational circuitry comprises an impedance detection means for measuring impedance.

7. The method of claim 3, wherein the operational circuitry can measure cardiac output.

8. The method of claim 3, wherein the steps of implanting an electrode subcutaneously in the patient and placing an electrically active canister subcutaneously in the patient are performed without a transvenous, intracardiac or epicardial electrode being implanted.

9. The method of claim 3, wherein the steps of implanting an electrode subcutaneously in the patient and placing an electrically active canister subcutaneously in the patient are performed without venous or epicardial access.

10. A method for providing anti-arrhythmia therapy via a subcutaneous cardioverter-defibrillator and without a transvenous, intracardiac or epicardial electrode, comprising:

implanting a canister subcutaneously in a patient, the housing enclosing and containing cardioversion-defibrillation circuitry and defining at least one electrically conductive electrically connected to the cardioversion-defibrillation circuitry;

implanting a lead subcutaneously, the lead having a lead electrode formed on a distal end thereof and configured to connect to the canister to electrically interface the lead electrode to the cardioversion-defibrillation circuitry; and

delivering an electrical therapy comprising an anti-arrhythmia waveform from the lead electrode to the at least one electrically conductive surface.

11. A method according to claim 10, further comprising:

providing a plurality of sensing electrodes on the lead, each sensing electrode interfacing with sensing circuitry in the cardioversion-defibrillation circuitry; and

monitoring and deriving cardiac physiological measures via the sensing electrodes.

12. The method of claim 10, wherein the steps of implanting a canister and implanting a lead are performed without a transvenous, intracardiac or epicardial electrode being implanted.

13. The method of claim 10, wherein the steps of implanting a canister and implanting a lead are performed without venous or epicardial access.

14. A method of implanting a subcutaneous cardioverter-defibrillator in a patient for treating arrhythmias without a transvenous, intracardiac or epicardial electrode, comprising:

implanting an electrode subcutaneously in the patient;

placing an electrically active canister subcutaneously in the patient,

wherein the canister contains a source of electrical energy and operational circuitry that senses the presence of potentially fatal heart rhythms and has circuitry for delivering electrical cardioversion-defibrillation energy between the canister and the electrode, and wherein the canister is electrically connected to the electrode;

wherein the operational circuitry can detect the presence of bradycardia rhythm and the canister includes circuitry for delivering electrical cardiac pacing energy when the operational circuitry senses the bradycardia rhythm.

15. The method of claim 14, wherein the electrode can be subcutaneously implanted at various locations in the body.

16. The method of claim 14, wherein the canister can be subcutaneously implanted at various locations in the body.

17. The method of claim 14, wherein the operational circuitry comprises an impedance detection means for measuring impedance.

18. The method of claim 14, wherein the operational circuitry can measure cardiac output.

19. The method of claim 14, wherein the steps of implanting an electrode subcutaneously in the patient and placing an electrically active canister subcutaneously in the patient are performed without a transvenous, intracardiac or epicardial electrode being implanted.

20. The method of claim 14, wherein the steps of implanting an electrode subcutaneously in the patient and placing an electrically active canister subcutaneously in the patient are performed without venous or epicardial access.