Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator

• US 7,092,754 B2
• Filed: 11/05/2001
• Issued: 08/15/2006
• Est. Priority Date: 09/18/2000
• Status: Expired due to Term

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Rissmann, William J., Bardy, Gust H., Cappato, Riccardo
• Primary Examiner(s): Pezzuto, Robert E.
• Assistant Examiner(s): DROESCH, KRISTEN L
• Application Number:
  US10/011,860
• Publication Number:
  US 20020091414A1
• Time in Patent Office: 1,744 Days
• Field of Search: 607 4- 5, 607/9, 607/15
• US Class Current: 607/9
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3906 characterised by the form of the shockwave
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3968 Constructional arrangements, e.g. casings A61N1/375 takes precedence
• CPC Class Codes: A61N 1/3975 Power supply A61N1/378 takes precedence

Abstract

A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient'"'"'s heart or reside in the intrathoracic blood vessels and for providing anti-bradycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient'"'"'s heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.

Claims

1. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:

subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;

using a lead system that does not directly contact a patient'"'"'s heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;

generating the anti-bradycardia pawing energy;

storing the anti-bradycardia pacing energy; and

delivering the anti-bradycardia pacing energy to the patient'"'"'s heart;

wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 25 volts and approximately 50 volts.

2. The method of claim 1, wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.

3. The method of claim 2, wherein the monophasic waveform has a tilt of between approximately 5% and approximately 95%.

4. The method of claim 3, wherein the tilt is approximately 50%.

5. The method of claim 1, wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of between approximately 20 and approximately 120 stimuli/minute.

6. The method of claim 5, wherein the monophasic waveform is provided after a patient'"'"'s heart rate is equal or less than approximately 20 beats/minute.

7. The method of claim 1, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the third and fifth ribs.

8. The method of claim 1, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the fourth and sixth ribs.

9. The method of claim 1, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the sixth and eighth ribs.

10. The method of claim 1, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the eight and tenth ribs.

11. The method of claim 1, wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the tenth and twelfth ribs.

12. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:

subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;

using a lead system that does not directly contact the patient'"'"'s heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;

generating anti-bradycardia pacing energy;

storing the anti-bradycardia pacing energy; and

delivering the anti-bradycardia pacing energy to the patient'"'"'s heart;

wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 50 volts and approximately 75 volts.

13. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:

subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;

using a lead system that does not directly contact the patient'"'"'s heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;

generating anti-bradycardia pacing energy;

storing the anti-bradycardia pacing energy; and

delivering the anti-bradycardia pacing energy to the patient'"'"'s heart;

wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between 1 millisecond and approximately 40 milliseconds.

14. The method of claim 13, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 0.1 volts and approximately 100 volts.

15. The method of claim 14, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 0.1 volts and approximately 25 volts.

16. The method of claim 14, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 25 volts and approximately 50 volts.

17. The method of claim 13, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 2 milliseconds and approximately 10 milliseconds.

18. The method of claim 13, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 10 milliseconds and approximately 20 milliseconds.

19. The method of claim 13, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 20 milliseconds and approximately 30 milliseconds.

20. The method of claim 13, wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 30 milliseconds and approximately 40 milliseconds.