Device for the transvenous cardioversion of atrial fibrillation or atrial flutter including three coil electrodes

• US 6,438,416 B1
• Filed: 03/20/2000
• Issued: 08/20/2002
• Est. Priority Date: 03/01/1996
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Michel, Ulrich
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/528,680
• Time in Patent Office: 883 Days
• Field of Search: 607/122, 607/123, 607/4, 607/5
• US Class Current: 607/5
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems

Abstract

A transvenous catheter for the cardioversion of atrial fibrillation or atrial flutter and/or the stimulation of the heart'"'"'s activity. The catheter has an electrically active section within a heart and an electrically passive section carrying electrical cables. At least two defibrillation electrodes are located in the electrically active section and coupled to the electrical cables of the catheter. Additionally, there are at least one sensing ring electrode positioned between the at least two defibrillation electrodes and coupled to the electrical cables.

Claims

1. A transvenous catheter, where the transvenous catheter includes a first end and a second end, the transvenous catheter comprising:

at least three defibrillation electrodes, including a first defibrillation electrode, a second defibrillation electrode, and a third defibrillation electrode, where each of the first, second and third defibrillation electrodes is coupled to an electrical cable, and where the first defibrillation electrode is located towards the first end of the catheter and the third defibrillation electrode is located towards the second end of the catheter and the second defibrillation electrode is between the first defibrillation electrode and the third defibrillation electrode; and

at least one sensing electrode coupled to an electrical cable, where the at least one sensing is positioned between the first defibrillation electrode and the third defibrillation electrode and coupled to the electrical cables.

2. The transvenous catheter of claim 1, where the second defibrillation electrode is spaced from the first defibrillation electrode a distance that is less than a distance between the second defibrillation electrode and the third defibrillation electrode;

and

the at least one sensing electrode positioned between the second defibrillation electrode and the third defibrillation electrode.

3. The transvenous catheter of claim 1, where the second defibrillation electrode is spaced from the third defibrillation electrode a distance that is less than a distance between the second defibrillation electrode and the first defibrillation electrode;

and

the at least one sensing electrode positioned between the second defibrillation electrode and the first defibrillation electrode.

4. The transvenous catheter of claim 1, including a fourth defibrillation electrode, where the fourth defibrillation electrode is between the first defibrillation electrode and the third defibrillation electrode, and where the second defibrillation electrode is spaced from the first defibrillation electrode a distance that is less than a distance between the fourth defibrillation electrode and the second defibrillation electrode.

5. The transvenous catheter of claim 4, where the fourth defibrillation electrode is spaced from the third defibrillation electrode a distance that is less than a distance between the fourth defibrillation electrode and the second defibrillation electrode.

6. The transvenous catheter of claim 5, where the at least one sensing electrode positioned between the second defibrillation electrode and the fourth defibrillation electrode.

7. The transvenous catheter of claim 1, where the first defibrillation electrode and the third defibrillation electrode have an axial spacing within the range of 10-100 millimeters.

8. The transvenous catheter of claim 7, where the first defibrillation electrode and the third defibrillation electrode have an axial spacing of around 85 millimeters.

9. The transvenous catheter of claim 1, further including a cap, where the cap is spaced distally from the at least three defibrillation electrodes.

10. The transvenous catheter of claim 9, where the cap is connected to a pacing electrical cable.

11. The transvenous catheter of claim 1, where the electrical cables further include external electrical connectors which can be connected to an external analysis, a pacemaker or a defibrillation unit.

12. The transvenous catheter of claim 1, where the electrical cables further include fluid-sealed electrical connectors which can be connected to an implantable analysis, a pacemaker or a defibrillation unit.

13. The transvenous catheter of claim 1, where the catheter further includes a stylet duct which extends along the length of the catheter with a wire which may be moved axially inside this duct and which has a defined malleability.

14. The transvenous catheter of claim 1, where the catheter further includes a duct which has a mechanical feed to an outfeed aperture for administering local doses of medication directly into a heart.

15. A method comprising:

implanting a transvenous catheter, where the transvenous catheter includes at least two defibrillation coil electrodes, and where implanting the transvenous catheter includes positioning at least two defibrillation coil electrodes in a right ventricle;

monitoring a first cardiac potential at an atrial position with the transvenous catheter;

monitoring a second cardiac potential at a ventricular position with the transvenous catheter;

analyzing the first cardiac potential and the second cardiac potential for an occurrence of an arrhythmia; and

delivering defibrillation energy in the right ventricle with the transvenous catheter after the occurrence of the arrhythmia.

16. The method of claim 15, including providing pacing at the ventricular position with the transvenous catheter.

17. A method comprising:

implanting a transvenous catheter;

where the transvenous catheter includes at least three defibrillation coil electrodes and a first pacing electrode, and where implanting the transvenous catheter includes positioning at least two defibrillation coil electrodes and the first pacing electrode in a right ventricle and at least one defibrillation coil electrode in a right atrium;

monitoring a first cardiac potential at an atrial position with the transvenous catheter;

monitoring a second cardiac potential at a ventricular position with the transvenous catheter;

analyzing the first cardiac potential and the second cardiac potential for an occurrence of an arrhythmia;

monitoring the second cardiac potential between the first pacing electrode and a first electrode of the at least two defibrillation coil electrodes in the right ventricle;

analyzing the second cardiac potential for the occurrence of a ventricular arrhythmia;

delivering defibrillation energy with the transvenous catheter after the occurrence of the arrhythmia; and

delivering defibrillation energy through at least one of the at least two defibrillation coil electrodes in the right ventricle and the at least one defibrillation coil electrode in the right atrium after the ventricular arrhythmia occurs.

18. A method comprising:

implanting a transvenous catheter;

where the transvenous catheter includes at least three defibrillation coil electrodes, and where implanting the transvenous catheter includes positioning at least two defibrillation coil electrodes in a right ventricle and at least one defibrillation coil electrode in a right atrium;

monitoring a first cardiac potential at an atrial position with the transvenous catheter, including monitoring the first cardiac potential between the at least one defibrillation coil electrode in the right atrium and a second electrode of the at least two defibrillation coil electrodes in the right ventricle;

monitoring a second cardiac potential at a ventricular position with the transvenous catheter;

analyzing the first cardiac potential and the second cardiac potential for an occurrence of an arrhythmia, including analyzing the first cardiac potential for the occurrence of an atrial arrhythmia; and

delivering defibrillation energy with the transvenous catheter after the occurrence of the arrhythmia, where delivering includes delivering defibrillation energy through at least one of the at least two defibrillation coil electrodes in the right atrium after the atrial arrhythmia occurs.

19. A method comprising:

implanting a transvenous catheter, where the transvenous catheter includes at least four defibrillation coil electrodes and a first pacing electrode, where implanting the transvenous catheter includes positioning at least two defibrillation coil electrodes and the first pacing electrode in a right ventricle and at least two defibrillation coil electrode in a right atrium;

monitoring a first cardiac potential at an atrial position with the transvenous catheter;

monitoring a second cardiac potential at a ventricular position with the transvenous catheter;

monitoring the first cardiac potential between at least one of the at least two defibrillation coil electrodes positioned in the right ventricle and at least one of the at least two defibrillation coil electrodes positioned in the right atrium;

monitoring the second cardiac potential between the first pacing electrode and a first electrode of the at least two defibrillation coil electrodes in the right ventricle;

analyzing the first cardiac potential and the second cardiac potential for an occurrence of an arrhythmia including analyzing the first cardiac potential for the occurrence of an atrial arrhythmia;

analyzing the second cardiac potential for the occurrence of a ventricular arrhythmia;

delivering defibrillation energy with the transvenous catheter after the occurrence of the arrhythmia;

delivering defibrillation energy through at least one of the at least two defibrillation coil electrodes in the right ventricle and the at least one defibrillation coil electrode in the right atrium after the ventricular arrhythmia occurs; and

delivering defibrillation energy through at least one of the at least two defibrillation coil electrodes positioned in the right atrium after the atrial arrhythmia occurs.