Improved lead configuration for an atrial defibrillator

• US 5,304,139 A
• Filed: 08/03/1992
• Issued: 04/19/1994
• Est. Priority Date: 04/12/1991
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: InControl, Inc. (Daikin Industries Ltd)
• Inventors: Alferness, Clifton A., Adams, John M.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US07/924,109
• Time in Patent Office: 624 Days
• Field of Search: 128/419 D, 128/642, 128/783, 128/784, 128/786
• US Class Current: 607/122
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• 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
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

An implantable atrial defibrillator provides a pulse of defibrillating electrical energy to the atria of the heart in synchronism with sensed R waves in response to non-coincident sensing of an R wave at first and second areas of the heart. The defibrillating pulse is provided after a predetermined number of consecutive R waves are non-coincidently sensed to assure reliable synchronization. The atrial defibrillator is also operational in a marker mode wherein a number of synchronization marker pulses are delivered to the heart for detection on an externally generated electrocardiogram. The atrial fibrillation detector of the defibrillator is normally disabled and is activated when the sensed ventricular activity indicates a probability of atrial fibrillation to conserve a depletable power source. An endocardial lead is also described which ensures that the delivered atrial defibrillating electrical energy is substantially confined to the atria of the heart.

Claims

1. A lead for use in association with an atrial defibrillator of the type arranged to cardiovert the atria of the human heart, said lead comprising:

a distal end and a proximal end, said proximal end including connector means arranged to be received by said atrial defibrillator, said connector means including first, second, and third contacts;

a first electrode at said distal end;

a second electrode proximal to said first electrode;

a third electrode proximal to said second electrode;

conductor means for electrically connecting said first contact to said first electrode, said second contact to said second electrode, and said third contact to said third electrode; and

said lead being flexible so as to be arranged to be passed down the superior vena cava of the heart, into the right atrium, into the coronary sinus ostium, and advanced into the coronary sinus or great cardiac vein of the heart near the left ventricle, and wherein said electrodes are spaced apart such that when said first electrode is within the great cardiac vein adjacent the left ventricle, said second electrode is within the great cardiac vein or the coronary sinus adjacent the left atrium.

2. A lead as defined in claim 1 wherein said conductor means are coaxially disposed with said first conductor being a center conductor, said second conductor being an inner conductor, and said third conductor forming an outer conductor.

3. A lead as defined in claim 1 wherein the distal end beyond said third electrode is preshaped to generally conform to the shape of the coronary sinus of the heart.

4. A lead as defined in claim 1 wherein said second and third electrodes are cardioverting electrodes.

5. A lead for use in association with an atrial defibrillator of the type arranged to cardiovert the atria of the human heart, said lead comprising:

a distal end and a proximal end;

a first cardioverting electrode; and

a second cardioverting electrode proximal to said first electrode,

said lead being flexible so as to be arranged to be passed down the superior vena cava of the heart, into the right atrium, into the coronary sinus ostium, and advanced into the coronary sinus or great cardiac vein, and wherein said electrodes are spaced apart such that when said first electrode is within the coronary sinus or great cardiac vein adjacent the left atrium, said second electrode is within the right atrium or the superior vena cava and wherein the distal end of said lead beyond said second electrode is preshaped to generally conform to the shape of the coronary sinus of the heart.