Implantable cardioverter defibrillator system having independently controllable electrode discharge pathway
First Claim
1. A method for controlling a plurality of independent electrical discharge pathways to a human heart in an implantable cardioversion defibrillator system comprising the steps for:
- a) implanting at least three physically separate discharge electrodes within the human;
b) selecting at least two electrical discharge pathways between the at least three physically separate discharge electrodes through which to deliver electrical energy to the heart;
c) independently selecting the polarity of the electrical energy to be delivered to each of said selected discharge pathways; and
d) independently selecting the phase of the electrical energy to be delivered to each of said selected discharge pathways.
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Accused Products
Abstract
An implantable multichamber cardioversion and defibrillation system is provided with multiple independently controllable and programmable switched electrode discharge pathways. This independently controlled switching arrangement provides for control over the polarity, phase, direction and timing of all cardioversion and defibrillation countershocks, and allows for the varying of subsequent countershocks after an initial countershock. The switching arrangement is, preferably, both programmable prior to implantation of the system and re-programmable after implantation of the system.
204 Citations
28 Claims
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1. A method for controlling a plurality of independent electrical discharge pathways to a human heart in an implantable cardioversion defibrillator system comprising the steps for:
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a) implanting at least three physically separate discharge electrodes within the human; b) selecting at least two electrical discharge pathways between the at least three physically separate discharge electrodes through which to deliver electrical energy to the heart; c) independently selecting the polarity of the electrical energy to be delivered to each of said selected discharge pathways; and d) independently selecting the phase of the electrical energy to be delivered to each of said selected discharge pathways. - View Dependent Claims (2, 3, 4)
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5. An implantable cardioverter defibrillator system for generating and delivering cardioversion or defibrillation countershocks of greater than about 0.1 joules to a human patient in response to a sensing of a myocardial dysrhythmia in the patient, comprising:
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at least three implantation electrodes for implantation in the patient in which the at least three implantation electrodes comprise two intravascular electrodes for implantation within the heart and one electrode for implantation in the subcutaneous space proximate to the heart; an implantable housing to which the implantation electrodes are electrically connected, the implantable housing including; capacitor means for storing an electrical charge; means for charging the capacitor means to produce the electrical charge; and means for selectively controlling a discharge of the electrical charge stored in the capacitor means in response to the sensing of the myocardial dysrhythmia to generate a cardioversion/defibrillation countershock waveform, including; switch means for each implantation electrode for selectively electrically connecting the implantation electrode to either polarity of the capacitor means independent of the switch means for any other implantation electrode; and control means for selectively controlling all of the switch means to create in response to the sensing of the myocardial dysrhythmia one or more selected discharge pathways through which to deliver all or part of the waveform. - View Dependent Claims (6, 7, 8, 9, 10, 11, 12)
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13. An implantable cardioverter defibrillator apparatus for generating and delivering cardioversion or defibrillation countershocks of greater than about 0.1 joules to a human patient in response to a sensing of a myocardial dysrhythmia in the patient, comprising:
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at least three implantation electrodes for implantation in the patient; an implantable housing to which the implantation electrodes are electrically connected, the implantable housing including; capacitor means for storing an electrical charge; means for charging the capacitor means to produce the electrical charge; and means for selectively controlling a discharge of the electrical charge stored in the capacitor means in response to the sensing of the myocardial dysrhythmia to generate a cardioversion/defibrillation countershock waveform, including; switch means for each implantation electrode for selectively electerically connecting the implantation electrode to either polarity of the capacitor means independent of the switch means for any other implantation electrode in which each switch means comprises a silicon controlled rectifier switch and an insulated gate bipolar transistor switch; and control means for selectively controlling all of the switch means to create in response to the sensing of the myocardial dysrhythmia one or more selected discharge pathways through which to deliver all or part of the waveform. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20)
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21. An implantable cardioverter defibrillator apparatus for generating and delivering cardioversion or defibrillation countershocks of greater than about 0.1 joules to a human patient in response to a sensing of a myocardial dysrhythmia in the patient, comprising:
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a) at least three implantation electrodes for implantation in the patient in which the at least three implantation electrodes comprise a right supraventricular electrode, a right ventricular electrode, and a pacing/sensing electrode; b) capacitor means for storing an electrical charge; c) means for charging the capacitor means to produce the electrical charge; and d) means for selectively controlling a discharge of the electrical charge stored in the capacitor means in response to the sensing of the myocardial dysrhythmia to generate a cardioversion/defibrillation countershock waveform, including; d1) switch means for each implantation electrode for selectively electrically connecting the implantation electrode to either polarity of the capacitor means independent of the switch means for any other implantation electrode; and d2) control means for selectively controlling all of the switch means to create in response to the sensing of the myocardial dysrhythmia one or more selected discharge pathways through which to deliver all or part of the waveform. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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Specification