Defibrillating or cardioverting electric shock system including electrodes

• US 4,825,871 A
• Filed: 05/18/1987
• Issued: 05/02/1989
• Est. Priority Date: 03/27/1984
• Status: Expired due to Fees

• Current Assignee: Societe Anonyme DBA
• Original Assignee: Societe Anonyme DBA
• Inventors: Cansell, Albert
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US07/054,095
• Time in Patent Office: 715 Days
• Field of Search: 128/419 D, 128/784-788
• US Class Current: 607/2
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration

Abstract

A device for a defibrillating or cardioverting electric shock to a patient for correcting securement tachyarrhythmias features of a catheter for insertion through the right atrium and into the right ventricle for locating a heartbeat sensor inside the heart and at least one discharge electrode in the right ventricle spaced from the interior surface of the heart, another discharge electrode external to the heart and circuitry connected by the catheter between the sensor and discharge electrodes for supplying electric shock to the discharge electrodes in response to a signal from the heartbeat sensor.

Claims

1. A device for delivering a defibrillating or cardioverting electric shock to a patient with recurrent cardiac tachyarrhythmias, comprising:

a catheter of insulating material and having a distal end for insertion through the right atrium and into the right ventricle of said patient'"'"'s heart;

sensor means for sensing the rhythm of the patient'"'"'s heart beat and transmitting internal cardiac signals corresponding thereto, said sensor means being mounted on said distal end of said catheter;

at least one discharge electrode for discharging electric current including a first discharge electrode being mounted on said catheter at a first distance from said distal end of said catheter to lie in the right ventricle of said patient'"'"'s heart away from the interior surface of the heart wall;

exterior electrode means fitted for sensing the rhythm of the patient'"'"'s heart beat and creating external and external to internal cardiac sigansl corresponding thereto, and for discharging electric current between said external electrodes and at least one of the internal electrodes in order to perform electrical defibrillation or cardioversion;

control means including energy means for providing cardioverting or defibrillating energy, and conductor means for operably connecting said sensor means, said discharge electrodes and said exterior electrode means to said control means, said control means including means for receiving said internal and external cardiac signals through said conductor means and means for transmitting, through said conductor means to said exterior electrode means and said first discharge electrode, upon determining a state of ventricular tachycardia or fibrillation, either said cardioverting or defibrillation energy to deliver, respectively, a cardioverting or defibrillating electrical shock.

3. The device of claim 1 or 2, wherein a second discharge electrode is mounted on said catheter at a second distance greater than said first distance from said distal end such that it is adapted to lie in the right atrium or superior vena cava of the patient'"'"'s heart, and wherein said control means is further adapted, upon determining a state of ventricular tachycardia, to transmit an electrical discharge between the first and second discharge electrode to correct said ventricular tachycardia.

5. The device of claim 3 wherein said exterior electrode means includes at least two exterior electrodes, at least one of which both senses the rhythm of the patient'"'"'s heart and discharge electric current.

6. The device of claim 5 further including at least one spark gap element disposed between at least two of said exterior electrodes to provide an electrical connection therebetween

7. The device of claim 1 or 2, wherein said exterior electrode means comprises a metal box for containing said control means.

8. The device of claim 7, further including an electrically conductive plastic material enclosing said metal box.

9. The device of claim 1 or 2, wherein said exterior electrode means comprises a flexible metal plate.

10. The device of claim 9 further including an electrically conductive plastic material enclosing said flexible metal plate.

11. The device of claim 1 or 2, wherein said exterior electrode means comprises a plastic material which is metallized on at least one side.

12. The device of claim 1 or 2, wherein said exterior electrode means comprises carbon fibers.

13. The device of claim 1 or 2, wherein said sensor means includes means for stimulating the heart.

2. A device for delivering a defibrillating or cardioverting electric shock to a patient with recurrent cardiac tachyarrhythmias, comprising:

a catheter of insulating material and having a distal end for insertion through the right atrium and into the right ventricle of said patient'"'"'s heart;

sensor means for sensing the rhythm of the patient'"'"'s heart beat and transmitting internal cardiac signals corresponding thereto, said sensor means being mounted on said distal end of said catheter;

at least one discharge electrode for discharging electric current including a first discharge electrode being mounted on said catheter at a first distance from said distal end of said catheter to lie in the right ventricle of said patient'"'"'s heart;

spacing means mounted on said catheter for spacing said first discharge electrode from the interior surface of the heart wall;

exterior electrode means fitted for sensing the rhythm of the patient'"'"'s heart beat and creating external and external to internal cardiac signals corresponding thereto, and for discharging electric current between said external electrodes and at least one of the internal electrodes in order to perform electrical defibrillation or cardioversion;

control means including energy means for providing cardioverting or defibrillating energy, and conductor means for operably connecting said sensor means, said discharge electrodes and said exterior electrode means to said control means, said control means including means for receiving said internal and external cardiac signals through said conductor means and means for transmitting, through said conductor means to said exterior electrode means and said first discharge electrode, upon determining a state of ventricular tachycardia or fibrillation, either said cardioverting or defibrillation energy to deliver, respectively, a cardioverting or defibrillating electrical shock.

4. The device of claim 2 wherein said spacing means comprises a crown of radial petals mounted on said catheter at a position directly adjacent to said first discharge electrode such that said crown lies in the right ventricle of said patient'"'"'s heart, said petals being angularly directed from the catheter axis so that said petals space said first discharge electrode from the interior surface of the heart wall and are elastically collapsible toward the axis to allow the introduction or extraction of said catheter into or from the patient'"'"'s heart.

14. The device of claim 2 wherein said spacing means comprises an elongated ribbon mounted on and wound around said catheter so that when unwound said ribbon contacts the heart wall to space said first discharge electrode from the interior surface of said heart wall.

15. The device of claim 14 wherein said elongated ribbon includes an internal and exterior surface wherein at least one of said surfaces is metallized.

16. The device of claim 15 wherein said metallized surface includes at least one non-metallized strip along the periphery of said surface.

17. The device of claim 16 wherein said metallized surface further includes a plurality of re-enforced metallization areas.

18. A cardiac defibrillator for delivering a defibrillating or cardioverting electric shock to a patient with recurrent cardiac tachyarrhythmias, comprising:

a catheter of insulating material and having a distal end, said catheter for insertion through the right atrium and into the right ventricle of a patient'"'"'s heart;

a pluraity of electrodes including at least one exterior electrode and including a first discharge electrode being mounted on said catheter at a first distance from said distal end of said catheter to lie in the right ventricle of said patient'"'"'s heart;

spacer means for spacing said first discharge electrode from the interior surface of the heart wall; and

control means including energy means for providing cardioverting or defibrillating energy; and

conductor means for operably connecting said electrodes to said control means, said control means further including means for transmitting said energy to deliver respectively, through said conductor means to said exterior and first discharge electrodes a cardioverting or defibrillating electrical shock.

19. The device of claim 18, wherein a second discharge electrode is mounted on said catheter at a second distance greater than said first distance from said distal end of said catheter to lie in the right atrium or superior vena cava of the patient'"'"'s heart, and wherein said control means further includes means for transmitting said energy to deliver, respectively, through said conductor means to said first and second discharge electrode, upon determining a state of ventricular tachycardia, an electrical discharge between the first and second electrode to correct said ventricular tachycardia.

20. The device of claim 18, further including sensor means mounted on the catheter at a second distance greater than said first distance from said distal end to lie in the right atrium or superior vena cava of the patient'"'"'s heart, and wherein said conductor means further operably connects said exterior electrode and said sensor means to said control means, and wherein said control means further includes means for receiving internal and external cardiac signals transmitted by said sensor means and said exterior electrode, respectively, and means for transmitting said energy to delivery, respectively, through said conductor means to said exterior electrode and said first discharge electrode, upon determining a state of ventricular tachycardia or fibrillation, a cardioverting or defibrillating electrical shock.

21. The device of claim 20, wherein said sensor means further includes means for discharging electric current, and wherein said control means further including means for transmitting said energy to deliver through said conductor means to said first electrode and sensor means, upon determining a state of ventricular tachycardia, and electrical discharge between the first electrode and sensor means to correct said ventricular tachycardia.

22. The device of claim 18, further including sensor means for sensing the rhythm of the patient'"'"'s heart beat and transmitting cardiac signals corresponding thereto, said sensor means having at least two elements each being mounted on said catheter, at least two to lie, respectively, in the right ventricle and in the right atria of the patient'"'"'s heart and wherein said control means uses the time comparison of the cardiac signals for detecting cardiac disorders.

23. A device for delivering a defibrillating or cardioverting electric shock to a patient with recurrent cardiac tachyarrhythmias, comprising:

a catheter of insulating material and having a distal end for insertion through the right atrium and into the right ventricle of a patient'"'"'s heart;

a plurality of discharge electrodes including a first discharge metallic ring shaped electrode being mounted on said catheter at a first distance from said distal end of said catheter to lie in the right ventricle of said patient'"'"'s heart;

spacing means mounted on said catheter for spacing said first discharge electrode from the interior surface of the heart wall.