System and method for generating pain inhibition pulses using an implantable cardiac stimulation device
First Claim
1. A method for reducing pain associated with an electrical cardiac shock delivered to a patient by a shocking circuit of an implantable cardiac stimulation device, the method comprising:
- detecting an arrhythmia requiring a cardioversion shock;
generating an electrical pre-pulse pain inhibition (PPI) sliver pulse for delivery to the patient, the sliver pulse having a voltage set to a cardioversion shock voltage level and having a duration no greater than 50 microseconds;
delivering the PPI sliver pulse to the patient via at least one electrode located in or on the patient'"'"'s heart;
generating a main electrical cardioversion shock for delivery to the patient to terminate the arrhythmia, the main shock having an initial voltage also set to the cardioversion shock voltage level; and
delivering the main electrical cardioversion shock to the patient.
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Abstract
Improved pre-pulse pain inhibition (PPI) techniques are provided for reducing pain caused by cardioversion shocks, including a technique for determining preferred pulse durations for high voltage PPI pulses. Techniques for generating both low voltage and high voltage PPI pulses are also set forth. In one example, a train of low voltage pre-pulses is delivered to the heart, followed by a single high voltage “sliver” pulse, followed by a main high voltage cardioversion shock. The train of low voltage pre-pulses is delivered while alternating between atrial and ventricular tip electrodes, with the device housing used as a return electrode. The sliver pulse, which may be only 20 or 30 microseconds in duration, is instead delivered between electrodes implanted in the heart, such as between the RV coil and SVC coil. The main shock is delivered between the RV coil and the device housing.
35 Citations
18 Claims
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1. A method for reducing pain associated with an electrical cardiac shock delivered to a patient by a shocking circuit of an implantable cardiac stimulation device, the method comprising:
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detecting an arrhythmia requiring a cardioversion shock; generating an electrical pre-pulse pain inhibition (PPI) sliver pulse for delivery to the patient, the sliver pulse having a voltage set to a cardioversion shock voltage level and having a duration no greater than 50 microseconds; delivering the PPI sliver pulse to the patient via at least one electrode located in or on the patient'"'"'s heart; generating a main electrical cardioversion shock for delivery to the patient to terminate the arrhythmia, the main shock having an initial voltage also set to the cardioversion shock voltage level; and delivering the main electrical cardioversion shock to the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A system for reducing pain associated with an electrical cardiac shock delivered to a patient by an implantable cardiac stimulation device, the system comprising:
means for generating a pre-pulse pain inhibition (PPI) sliver pulse for delivery to the patient'"'"'s heart, the sliver pulse having a voltage set to a cardioversion shock voltage level and having a duration no greater than 50 microseconds; and means for generating a cardioversion shock for delivery to the patient, the main shock having an initial voltage also set to the cardioversion shock voltage level.
Specification