Subcutaneous implantable cardioverter/defibrillator

• US 7,383,085 B2
• Filed: 05/19/2006
• Issued: 06/03/2008
• Est. Priority Date: 11/22/2002
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Olson, Walter H.
• Primary Examiner(s): Layno; Carl H.
• Assistant Examiner(s): Heller; Tammie K.
• Application Number:
  US11/419,284
• Publication Number:
  US 20060217770A1
• Time in Patent Office: 746 Days
• Field of Search: 607/4, 607/36, 607/129, 607/152
• US Class Current: 607/4
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/37518 Anchoring of the implants, e.g. fixation
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• 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 1/3981 High voltage charging circuitry

Abstract

Implantable cardioverter-defibrillators (ICDs) are disclosed that are entirely implantable subcutaneously with minimal surgical intrusion into the body of the patient and provide distributed cardioversion/defibrillation and pace/sense electrodes for delivery of cardioversion/defibrillation shock and pacing therapies across the heart when necessary. At least two hermetically sealed housings forming first and second hermetically sealed housings coupled together by a cable support first, second and, optionally, third cardioversion/defibrillation electrodes. The relatively bulky high voltage battery and high voltage capacitors, and circuitry powered by a low voltage power source for detecting a tachyarrhythmia, charging the high voltage capacitor, and discharging the high voltage capacitor to provide a cardioversion/defibrillation shock are distributed between the first and second hermetically sealed housings.

Claims

1. A method of implanting an implantable cardioverter-defibrillator having a first hermetically sealed housing having a first cardioversion/defibrillation electrode, a second hermetically sealed housing having a second cardioversion/defibrillation electrode and an electrical cable interconnecting the first and second hermetically sealed housings within a patient, comprising:

making a surgical incision into subcutaneous space between the patient'"'"'s skin and ribcage;

inserting the first hermetically sealed housing through the incision and advancing the first hermetically sealed housing subcutaneously to a first subcutaneous implantation site; and

inserting the second hermetically sealed housing through the incision and advancing the second hermetically sealed housing subcutaneously to a second subcutaneous implantation site spaced from the first subcutaneous implantation site so that the electrical cable is disposed subcutaneously between the first and second hermetically sealed housings wherein the patient'"'"'s heart is disposed between the first and second hermetically sealed housings.

2. The method of claim 1, wherein:

the first and second hermetically sealed housings have a length extending from a housing free end and a housing end attached to one end of the electrical cable, a housing width and a nominal housing thickness; and

the housing free ends are tapered from the nominal housing thickness to a lesser thickness to ease the subcutaneous advancement of the housing free ends to the first and second implantation sites.

3. A method of implanting and operating an implantable cardioverter-defibrillator having a first hermetically sealed housing having a first cardioversion/defibrillation electrode, a second hermetically sealed housing having a second cardioversion/defibrillation electrode and an electrical cable interconnecting the first and second hermetically sealed housings within a patient,:

making a surgical incision into subcutaneous space between the patient'"'"'s skin and ribcage;

inserting the first hermetically sealed housing through the incision and advancing the first hermetically sealed housing subcutaneously to a first subcutaneous implantation site;

inserting the second hermetically sealed housing through the incision and advancing the second hermetically sealed housing subcutaneously to a second subcutaneous implantation site spaced from the first subcutaneous implantation site so that the electrical cable is disposed subcutaneously between the first and second hermetically sealed housings wherein the patient'"'"'s heart is disposed between the first and second hermetically sealed housings;

closing the incision;

detecting a tachyarrhythmia; and

delivering a cardioversion/defibrillation shock between the first and second cardioversion/defibrillation electrodes.

4. The method of claim 3, wherein:

the first and second hermetically sealed housings have a length extending from a housing free end and a housing end attached to one end of the electrical cable, a housing width and a nominal housing thickness; and

the housing free ends are tapered from the nominal housing thickness to a lesser thickness to ease the subcutaneous advancement of the housing free ends to the first and second implantation sites.