MODULAR ANTITACHYARRHYTHMIA THERAPY SYSTEM

• US 20190329059A1
• Filed: 06/25/2019
• Published: 10/31/2019
• Est. Priority Date: 05/18/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: SMITH, JOSEPH M., DUJMOVIC, Jr., RICHARD MILON
• Granted Patent: US 11,083,898 B2
• Time in Patent Office: Days
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• 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 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• 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 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Claims

1. An implantable cardiac therapy system comprising:

an implantable analysis and therapy module (IATM) including a controller circuit, a first communication circuit, and a therapy circuit comprising electrodes for outputting defibrillation energy and a pulse generator including a battery, a capacitor, and circuitry for charging the capacitor and delivering a defibrillation therapy via the electrodes; and

an implantable module comprising a sensing circuit for sensing a physiologic parameter and a second communication circuit configured to send information about the sensed physiological parameters to the implantable defibrillator;

wherein the first communication circuit is configured to receive physiologic data from the second communication circuit and relay the physiologic data to the controller circuit, and the controller circuit is configured to analyze the physiologic data to determine whether a defibrillation therapy is needed.

2. The implantable cardiac therapy system of claim 1 wherein the sensing circuit is a heart sound sensor, the physiologic data comprises information about the heart sound.

3. The implantable cardiac therapy system of claim 1 wherein the sensing circuit comprises a sense amplification circuit to detect an intrinsic electrical heart signal, the physiological data comprises information about the intrinsic electrical heart signal, and the controller is configured to use the physiological data to determine whether a tachyarrhythmia is present.

4. The implantable cardiac therapy system of claim 3 wherein the implantable module further comprises cardiac pacing circuitry, and the controller is configured, in response to determining that a tachyarrhythmia is present, to use the second communication circuit to issue a command for anti-tachycardia pacing to the implantable module.

5. The implantable cardiac therapy system of claim 1 wherein the sensing circuit is a respiration sensor, and the physiological data related to respiration.

6. The implantable cardiac therapy system of claim 5 wherein the implantable module further comprises diaphragm pacing circuitry, and the controller is configured, in response to analysis of the physiological data related to respiration, to use the second communication circuit to issue a command for anti-tachycardia pacing to the implantable module.

7. The implantable cardiac therapy system of claim 1 wherein the sensing circuit is a blood pressure sensor, and the physiological data is related to blood pressure.

8. The implantable cardiac therapy system of claim 1 wherein the implantable module is sized and shaped for implantation in the heart.

9. The implantable cardiac therapy system of claim 1 wherein the implantable module is sized and shaped for implantation in vasculature near the heart.

10. The implantable cardiac therapy system of claim 1 wherein the implantable module is sized and shaped for implantation in the pulmonary vasculature.

11. The implantable cardiac therapy system of claim 1 wherein the IATM comprises a lead that carries at least one of the electrodes.

12. The implantable cardiac therapy system of claim 11 wherein the IATM is a defibrillator implanted outside the heart.

13. A method of delivering electrical therapy to the heart of a patient using a system having each of:

an implantable defibrillator module including a battery, a capacitor, pulse generator circuitry for charging the capacitor and delivering a defibrillation therapy via the electrodes, first communication circuitry, and a controller for controlling the pulse generator and for sending and receiving information via the first communication circuitry;

an implantable sensing module having electrodes for receiving cardiac electrical signals and a sense amplification circuit to detect an intrinsic electrical heart signal, as well as second communication circuitry for communicating data related to the intrinsic electrical heart signal to the first communication circuitry;

the method comprising;

receiving a cardiac signal at the electrodes of the implantable sensing module;

communicating, via the second communication circuitry, data related to the intrinsic electrical heart signal to the implantable defibrillator module;

receiving, via the first communication circuitry, the data related to the intrinsic electrical heart signal;

the controller analyzing the received data related to the intrinsic electrical heart signal and determining that a tachyarrhythmia is present; and

the controller commanding delivery of an antitachyarrhythmia therapy by the pulse generator.

14. The method of claim 13 wherein the implantable sensing module is configured to sense atrial cardiac signals from an implantation position in or on one of the patient'"'"'s atria.

15. The method of claim 13 wherein the implantable sensing module is configured to sense ventricular cardiac signals from an implantation position in or on one of the patient'"'"'s ventricles.

16. The method of claim 13 wherein the implantable defibrillator further comprises sensing circuitry for sensing cardiac signals separate from the implantable sensing module.

17. The method of claim 13 wherein the implantable defibrillator module is a subcutaneous defibrillator having a lead.

18. The method of claim 13 wherein the antitachyarrhythmia therapy is a defibrillation therapy.

19. The method of claim 13 wherein the antitachyarrhythmia therapy is an anti-tachycardia pacing therapy.

20. A method of delivering electrical therapy to the heart of a patient using a system having each of:

an implantable defibrillator module including a battery, a capacitor, pulse generator circuitry for charging the capacitor and delivering a defibrillation therapy via the electrodes, first communication circuitry, and a controller for controlling the pulse generator and for sending and receiving information via the first communication circuitry;

a sensing means, remote from the implantable defibrillator module, comprising a sense amplification circuit to detect an intrinsic electrical heart signal, and as second communication circuitry for communicating data related to the intrinsic electrical heart signal to the first communication circuitry;

the method comprising;

receiving a cardiac signal at the electrodes of the sensing means;

communicating, via the second communication circuitry, data related to the intrinsic electrical heart signal to the implantable defibrillator module;

receiving, via the first communication circuitry, the data related to the intrinsic electrical heart signal;

the controller analyzing the received data related to the intrinsic electrical heart signal and determining that a tachyarrhythmia is present; and

the controller commanding delivery of a defibrillation therapy by the pulse generator.