Unitary intravascular defibrillating catheter with separate bipolar sensing
First Claim
1. A unitary intravascular cardioversion device including:
- an elongate, flexible and dielectric catheter body having a proximal end region and a distal end region;
a cardioversion circuit including a first cardioversion electrode mounted on said catheter body along said distal end region;
a first flexible conductor means connected to said first cardioversion electrode for conducting electrical pulses between said first cardioversion electrode and said proximal end region;
a second cardioversion electrode mounted on said catheter body proximally of said first cardioversion electrode, spaced apart from said first cardioversion electrode;
a second flexible conductor means connected to said second cardioversion electrode for transmitting electrical pulse between said second cardioversion electrode and said proximal end region; and
a cardioversion connector means near said proximal end region for electrically coupling said first and second conductor means with a cardioversion pulse generating means, thereby to utilize said first and second cardioversion electrodes as a cardioversion electrode pair; and
a cardiac sensing circuit electrically isolated from the cardioversion circuit and including a first sensing electrode mounted on said catheter body along said distal end region;
a third flexible conductor means connected to said first sensing electrode for transmitting electrical pulses between said first sensing electrode and said proximal end region;
a second sensing electrode, mounted on said catheter body along said distal end region proximally of said first sensing electrode and spaced apart from said first sensing electrode by a predetermined first distance;
a fourth flexible conductor means connected to said second sensing electrode for transmitting electrical pulses between said second sensing electrode and said proximal end region; and
a sensing connector means near said proximal end region for electrically coupling said third and fourth conductor means with a pulse sensing means;
wherein each of said first and second cardioversion electrodes has a surface area at least three times the surface area of each of the first and second sensing electrodes, and the sensing electrodes are separated from each of the cardioversion electrodes by a distance sufficient to isolate tissue proximate and between the cardioversion electrodes from tissue adjacent to said sensing electrodes.
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Accused Products
Abstract
A cardioversion system includes a bipolar sensing circuit with two sensing electrodes, and a cardioversion circuit with two spaced apart spring electrodes. The sensing electrodes are spaced apart from one another but kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm. One preferred version of the system is a unitary catheter including a distal tip electrode and ring electrode as the sensing electrodes, and to substantially larger, more proximal spring electrodes for defibrillation. Alternatively, the defibrillation electrodes and the sensing electrodes can be provided on two separate catheters. Yet another alternative involves providing one or more patch electrodes as defibrillation electrodes.
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Citations
61 Claims
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1. A unitary intravascular cardioversion device including:
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an elongate, flexible and dielectric catheter body having a proximal end region and a distal end region; a cardioversion circuit including a first cardioversion electrode mounted on said catheter body along said distal end region;
a first flexible conductor means connected to said first cardioversion electrode for conducting electrical pulses between said first cardioversion electrode and said proximal end region;
a second cardioversion electrode mounted on said catheter body proximally of said first cardioversion electrode, spaced apart from said first cardioversion electrode;
a second flexible conductor means connected to said second cardioversion electrode for transmitting electrical pulse between said second cardioversion electrode and said proximal end region; and
a cardioversion connector means near said proximal end region for electrically coupling said first and second conductor means with a cardioversion pulse generating means, thereby to utilize said first and second cardioversion electrodes as a cardioversion electrode pair; anda cardiac sensing circuit electrically isolated from the cardioversion circuit and including a first sensing electrode mounted on said catheter body along said distal end region;
a third flexible conductor means connected to said first sensing electrode for transmitting electrical pulses between said first sensing electrode and said proximal end region;
a second sensing electrode, mounted on said catheter body along said distal end region proximally of said first sensing electrode and spaced apart from said first sensing electrode by a predetermined first distance;
a fourth flexible conductor means connected to said second sensing electrode for transmitting electrical pulses between said second sensing electrode and said proximal end region; and
a sensing connector means near said proximal end region for electrically coupling said third and fourth conductor means with a pulse sensing means;
wherein each of said first and second cardioversion electrodes has a surface area at least three times the surface area of each of the first and second sensing electrodes, and the sensing electrodes are separated from each of the cardioversion electrodes by a distance sufficient to isolate tissue proximate and between the cardioversion electrodes from tissue adjacent to said sensing electrodes. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A defibrillator catheter comprising:
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an elongate catheter body comprised of a flexible and dielectric material, and having a proximal end and a distal end; a distal tip sensing electrode mounted to said catheter at said distal end; an annular sensing electrode mounted about said catheter body at a selected first distance proximately of said distal tap electrode; a first defibrillating electrode mounted to said catheter body at a selected second distance proximally of said annular sensing electrode, and a second defibrillating electrode mounted proximally of said first defibrillating electrode and spaced apart from said first defibrillating electrode, each of the defibrillating electrodes having a surface area at least three times the surface area of each of the distal tip sensing electrode and the annular sensing electrode; first, second, third and fourth conductor means connected respectively to said distal tip electrode, annular sensing electrode, first defibrillating electrode and second defibrillating electrode, said conductor means electrically isolated from one another; a defibrillator connector means for electrically coupling said third and fourth conductor means to a defibrillation pulse generating means to form a defibrillation circuit which further includes said defibrillation electrodes; and a sensing connector means for electrically coupling said first and second conductor means with cardiac sensing circuitry from a bipolar pulse sensing circuit independent of said defibrillating circuit. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
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40. A transvenous defibrillating catheter, insertable into a right ventricle of a heart by way of a superior vena cava, comprising:
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an elongate catheter body comprised of a flexible and dielectric material and having a proximal end, a distal end and a lumen means running substantially the length of the catheter body from the proximal end to said distal end; a distal sensing electrode mounted to said catheter at least proximate said distal end, and an annular sensing electrode mounted to said catheter body a selected first distance proximally of said distal sensing electrode; a defibrillating electrode means mounted to said catheter body at a selected second distance proximally of said annular sensing electrode and having a surface area at least three times the combined surface areas of the distal sensing electrode and the annular sensing electrode, and a defibrillator conductor means electrically coupled to said defibrillating electrode means for transmitting cardioversion pulses between said defibrillating electrode means and a defibrillation pulse generating means near said proximal end of said catheter body; a first sensing conductor connected to said distal sensing electrode, and a second sensing conductor connected to said annular sensing electrode, for transmitting electrical signals between said proximal end of the catheter body and said distal sensing electrode and annular sensing electrode, respectively, said sensing conductors being electrically isolated from one another and from said defibrillator conductor means; and a sensing connector means for electrically coupling said first and second sensing conductors with a cardiac sensing circuit to form a bipolar pulse sensing means independent of said defibrillating means. - View Dependent Claims (41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54)
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55. An intravascular cardioversion system including:
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an elongate, flexible and dielectric sensing catheter body having a proximal end region and a distal end region; a cardiac sensing circuit including a first sensing electrode mounted on said sensing catheter body at said distal end region, a flexible first sensing conductor connected to said first sensing electrode for transmitting electrical pulses between said first sensing electrode and the proximal end region, a second sensing electrode mounted on the sensing catheter body at said distal end region and spaced apart proximally of the first sensing electrode by a predetermined sensing distance, a flexible second conductor connected to the second sensing electrode for transmitting electrical pulses between the second sensing electrode and the proximal end region, and a sensing connector means near said proximal end region for electrically coupling the first and second sensing conductors with a pulse sensing means; an elongate, flexible and dielectric cardioversion catheter body having a proximal end region and a distal end region; and a cardioversion circuit including a first cardioversion electrode mounted on said cardioversion catheter body near said distal end region, a flexible first cardioversion conductor connected to the first cardioversion electrode for transmitting electrical pulses between the first cardioversion electrode and the proximal end region, a flexible second cardioversion electrode mounted on the cardioversion catheter body proximally of and spaced part from the first cardioversion electrode, a flexible second cardioversion conductor connected to the second cardioversion electrode for transmitting electrical pulses between the second cardioversion electrode and the proximal end region, and a cardioversion connector means near the proximal end region for electrically coupling the first and second cardioversion conductors with a cardioversion pulse generating means; and
means for mounting said catheters, with their respective electrodes, in spaced relation ship to each other. - View Dependent Claims (56, 57)
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58. An intravascular cardioversion system including:
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an elongate, flexible and dielectric sensing catheter body having a proximal end region and a distal end region; a cardiac sensing circuit including a first sensing electrode mounted on the sensing catheter body at said distal end region, a flexible first sensing conductor connected to the first sensing electrode for transmitting the electrical pulses between the first sensing electrode and the proximal end region, a second sensing electrode mounted on the sensing catheter body at said distal end region and spaced apart proximally of the first sensing electrode by a predetermined sensing distance, a flexible second conductor connected to the second sensing electrode for transmitting electrical pulses between the second sensing electrode and the proximal end region, and a sensing connector means near the proximal end region for electrically coupling the first and second sensing conductors with a cardiac sensing means; an elongate, flexible and dielectric cardioversion catheter body having a proximal end region and a distal end region; a cardioversion circuit including a cardioversion pulse generating means, a first cardioversion electrode mounted on said cardioversion catheter body along its distal end region, a flexible first cardioversion conductor mounted to the first cardioversion electrode and contained within the cardioversion catheter body for transmitting electrical pulses between the first cardioversion electrode and the cardioversion pulse generating means, a second cardioversion electrode mounted on the cardioversion catheter body proximally of and spaced apart from the first cardioversion electrode, a flexible second cardioversion conductor connected to the second cardioversion electrode and contained within the cardioversion catheter body for transmitting electrical pules between the second cardioversion electrode and the cardioversion pulse generating means thereby to utilize the first and second cardioversion electrodes as a cardioversion electrode pair, said first and second cardioversion electrodes having surface areas at least three times the surface areas of said first and second sensing electrodes; and
means for mounting said catheters, with their respective electrodes, in spaced relationship to each other. - View Dependent Claims (59, 60, 61)
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Specification