Assembly and method of communicating electrical signals between electrical therapeutic systems and body tissue

• US 5,143,089 A
• Filed: 05/01/1990
• Issued: 09/01/1992
• Est. Priority Date: 05/03/1989
• Status: Expired due to Term

• Current Assignee: Advanced Medical Optics Incorporated (Johnson & Johnson)
• Original Assignee: Eckhard Alt
• Inventors: Alt, Eckhard
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US07/517,186
• Time in Patent Office: 854 Days
• Field of Search: 128/639, 128/640, 128/641, 128/642, 128/784, 128/785, 128/786, 128/419 P, 128/419 D
• US Class Current: 607/121
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration

Abstract

This invention provides improved electrode structures for electrically communicating between electrical therapeutic equipment and internal body tissue. Bundles of highly flexible, highly electrically conductive, preferably non-metallic carbon based, isotropically conductive fibers of diameters of the individual fibers in the micron range provide very large surface areas to apply electrical energy to the body tissue. Substantially non-electrically polarizing properties, particularly of carbon, and a substantially non-thrombogenic surface (present in carbon) represent critical features of the tissue to electrode interface in biomedical applications. Thus, more reliable-longer life implants of heart defibrillators, neurostimulators and the like result. This electrode structure with accompanying integrated electrical lead is implantable by puncture through body tissue thereby avoiding major surgery and general anesthesia required in the prior art. Accordingly the invention relates to the electrode and accompanying more effective therapeutic equipment as well as methods of therapeutic treatment with electrical current technology.

Claims

1. A method of therapeutic treatment of a living body, comprising the steps of:

implanting into the body a flexible electrode consisting of multiple woven strands of tiny individual elongate uninsulated fibers composed of non-metallic substantially isotropic electrically conductive material electrically connected to a current-carrying lead, to form an electron-ion interface with blood and/or body tissue for efficient transfer of electrical energy along an entire substantial length of uninsulated surface of the fibers, in which the cumulative fiber surface presents an effective surface area considerably greater than the apparent actual surface area calculated from the linear dimensions of the electrode, and

transmitting electrical impulses through the lead to the electrode at one side of said electron-ion interface to deliver electrical energy from the impulses to the other side of the interface with rapid initial rise times as a consequence of the electrical characteristics of the interface.

2. The method of claim 1, wherein

the therapeutic treatment is defibrillation of the heart,

the implanting step includes positioning the electrode adjacent to the epicardium of the heart,

detecting ventricular fibrillation of the heart, and

the transmitting step includes applying a defibrillating impulse to the lead in response to the detection of ventricular fibrillation of the heart to deliver a high energy shock to the heart with optimum efficiency across said electron-ion interface.

3. The method of claim 2, wherein

the electrode is deployable in substantially two-dimensional shape, and

the implanting step includes:

puncturing the skin of the body, and

introducing the electrode and the lead through

the puncture for positioning the electrode in the desired location within the body, and

deploying the electrode for optimum exposure of the surface area thereof in tissue excitable relation to a portion of the epicardium which is preselected to enhance the likelihood of defibrillation.

4. The method of claim 3, wherein

the fibers of the electrode are interspersed with fibers composed of material opaque to radiation of the type employed for viewing the progress of a medical procedure within the body from a point external to the body, and

the steps of introducing and deploying are performed while utilizing said viewing to observe the progress of positioning the electrode.

5. The method of claim 3, wherein

the steps of introducing and deploying are performed to position the electrode inside the pericardium sac.

6. The method of claim 2, further comprising

the step of intravenously introducing a second electrode, deployable in substantially three-dimensional shape of generally tubular configuration connected to a second current-carrying lead and otherwise having substantially the same composition and electrical properties as the first-mentioned electrode, into the heart to act as a counter electrode to the first-mentioned electrode during defibrillation.

7. The method of claim 6, wherein

the detecting of ventricular fibrillation of the heart is performed using one of the first-mentioned electrode and the second electrode.

8. The method of claim 6, further comprising:

shaping the second electrode, prior to the introducing step, by selectively interweaving the fiber strands thereof into said tubular configuration to allow the second electrode to flex by expansion and compression along the axis of the tubular configuration, whereby to permit the second electrode to expand axially to a reduced diameter for ease of introduction into the heart, and to relieve stresses on the second electrode when positioned within the heart which would otherwise subject it to fatigue and potential fracture.

9. The method of claim 1, further comprising:

prior to the implanting step, shaping the configuration of the electrode by selectively interweaving the fiber strands thereof according to the general shape of the body tissue with which the electrode is to interact electrically at the desired location within the body.

10. The method of claim 9, wherein

the shaping step comprises the step of interweaving the fiber strands into a two-dimensional configuration.

11. The method of claim 9, wherein

the shaping step comprises the step of interweaving the fiber strands into a three-dimensional configuration.

12. The method of claim 1, wherein

substantially all of the fibers comprise a carbon derivative possessing the property of substantially isotropic electrical conductivity, rendering the surface of the electrode substantially non-thrombogenic and said electron-ion interface of relatively low polarization, low capacitance, low resistance and low impedance.

13. An implantable lead assembly for biomedical use in a living body to stimulate and/or sense electrical excitation of selected excitable tissue in the body when the lead assembly is implanted, comprising:

an electrically conductive lead,

electrode means conductively connected to a distal end of the lead for providing a low polarization, low capacitance, low resistance and low impedance electrical interface with body fluid and/or excitable tissue in contact with or in the immediate vicinity of the electrode means when the lead assembly is implanted in a desired location in the body, said electrode means comprising

a multiplicity of uninsulated, individual, nonmetallic, substantially isotropic electrical current conducting fibers, and

maintaining means for holding the multiplicity of fibers in a flexible configuration adapted to form the said electrical interface along an entire substantial length of electrically uninsulated surface of the flexible configuration created by said multiplicity of fibers, said flexible configuration having a shape and size selected according to the site of the said electrical interface when the lead assembly is implanted in the desired location in the body, said multiplicity of fibers together providing an effective surface area for the said electrical interface which is considerably larger than the apparent actual surface area of the flexible configuration determined from the linear dimensions of the flexible configuration.

14. The invention of claim 13, wherein

said maintaining means includes the fibers themselves.

15. The invention of claim 14, wherein

said maintaining means comprises an interweaving of the fibers.

16. The invention of claim 15, wherein

the fibers are interwoven to form a substantially two-dimensional shape of the flexible configuration.

17. The invention of claim 16, wherein the biomedical use of the lead assembly is for defibrillation of the heart, and

the fibers are interwoven to form a substantially flat patch electrode means, in which the large effective surface area of the said electrical interface is adapted to enhance the efficiency of electrical energy transfer across the electron-ion boundary of the fibers and the body fluid and/or excitable tissue at the said electrical interface.

18. The invention of claim 15, wherein

the fibers are interwoven to form a three-dimensional shape of the flexible configuration.

19. The invention of claim 18, wherein the biomedical use of the lead assembly is for defibrillation of the heart, and

the fibers are interwoven to form an at least partially tubular transvenous electrode means, in which the large effective surface area of the said electrical interface is adapted to enhance the efficiency of electrical energy transfer across the electron-ion boundary of the fibers and the body fluid and/or excitable tissue at the said electrical interface, and the smaller apparent actual surface area of the flexible configuration is adapted to facilitate the introduction of the electrode means transvenously into the body.

20. The invention of claim 19, wherein

the interwoven fibers of the tubular transvenous electrode means cross over and under each other to enable axial expansion and contraction of the flexible configuration and thereby enhance the strength of the tubular transvenous electrode means against fatigue while implanted for defibrillation over time.

21. The invention of claim 13, wherein

the fibers are composed of a substantially isotropic electrically conductive carbon derivative, and have thicknesses less than about 40 microns.