Subcutaneous only implantable cardioverter-defibrillator and optional pacer
First Claim
1. A method of implanting a cardiac stimulus system into a patient, the system including a canister and an associated lead assembly having a proximal end for securing to the canister and a distal end including one or more lead electrodes, the method comprising:
- establishing a subcutaneous pocket for receiving the canister at an inferior and lateral position relative to the patient'"'"'s atria on the left side of the patient'"'"'s torso and over the patient'"'"'s ribs;
inserting the canister into the subcutaneous pocket;
establishing a subcutaneous path for receiving the lead assembly extending over one or more of the patient'"'"'s ribs at least partly towards the patient'"'"'s sternum;
inserting at least a distal portion of the lead assembly into the subcutaneous path;
wherein the step of inserting the canister is performed such that the canister is placed in the left posterior axillary line approximately lateral to the tip of the inferior portion of the scapula of the patient; and
wherein the subcutaneous path terminates in a subcutaneous and precordial position on the chest of the patient such that the lead assembly, once inserted, comprises no transvenous, intracardiac, or epicardial electrodes.
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Accused Products
Abstract
A subcutaneous implantable cardioverter-defibrillator is disclosed which has an electrically active canister which houses a source of electrical energy, a capacitor, and operational circuitry that senses the presence of potentially fatal heart rhythms. At least one subcutaneous electrode that serves as the opposite electrode from the canister is attached to the canister via a lead system. Cardioversion-defibrillation energy is delivered when the operational circuitry senses a potentially fatal heart rhythm. There are no transvenous, intracardic, or epicardial electrodes. A method of subcutaneously implanting the cardioverter-defibrillator is also disclosed as well as a kit for conducting the method.
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Citations
23 Claims
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1. A method of implanting a cardiac stimulus system into a patient, the system including a canister and an associated lead assembly having a proximal end for securing to the canister and a distal end including one or more lead electrodes, the method comprising:
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establishing a subcutaneous pocket for receiving the canister at an inferior and lateral position relative to the patient'"'"'s atria on the left side of the patient'"'"'s torso and over the patient'"'"'s ribs; inserting the canister into the subcutaneous pocket; establishing a subcutaneous path for receiving the lead assembly extending over one or more of the patient'"'"'s ribs at least partly towards the patient'"'"'s sternum; inserting at least a distal portion of the lead assembly into the subcutaneous path; wherein the step of inserting the canister is performed such that the canister is placed in the left posterior axillary line approximately lateral to the tip of the inferior portion of the scapula of the patient; and wherein the subcutaneous path terminates in a subcutaneous and precordial position on the chest of the patient such that the lead assembly, once inserted, comprises no transvenous, intracardiac, or epicardial electrodes. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method of implanting a cardiac stimulus system into a patient, the system including means for housing operational circuitry that powers and controls the cardiac stimulus system and an associated lead assembly having a proximal end for securing to the housing means and a distal end including one or more lead electrodes, the method comprising:
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establishing a subcutaneous pocket for receiving the means for housing at an inferior and lateral position relative to the patient'"'"'s atria on the left side of the patient'"'"'s torso and over the patient'"'"'s ribs; inserting the housing means into the subcutaneous pocket; establishing a subcutaneous path for receiving the lead assembly extending over one or more of the patient'"'"'s ribs at least partly towards the patient'"'"'s sternum; inserting at least a distal portion of the lead assembly into the subcutaneous path; wherein the step of inserting the canister is performed such that the canister is placed in the left posterior axillary line approximately lateral to the tip of the inferior portion of the scapula of the patient; and wherein the subcutaneous path terminates in a subcutaneous and precordial position on the chest of the patient such that the lead assembly, once inserted, comprises no transvenous, intracardiac, or epicardial electrodes. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method of implanting a cardiac stimulus system into a patient, the system including a canister and an associated lead assembly having a proximal end adapted for securing to the canister and a distal end including one or more lead electrodes, the method comprising:
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establishing a subcutaneous pocket for receiving the canister at an inferior and lateral position relative to the patient'"'"'s atria on the left side of the patient'"'"'s torso and over the patient'"'"'s ribs; inserting the canister into the subcutaneous pocket; establishing a subcutaneous path for receiving the lead assembly extending over one or more of the patient'"'"'s ribs at least partly towards the patient'"'"'s sternum; inserting at least a distal portion of the lead assembly into the subcutaneous path; activating the cardiac stimulus system; wherein the activated cardiac stimulus system is configured to deliver therapy using a vector defined between a first electrode and a second electrode, wherein the first electrode is disposed on the canister and the second electrode is disposed on or integrated into the lead assembly; wherein the step of inserting the canister is performed such that the canister is placed in the left posterior axillary line approximately lateral to the tip of the inferior portion of the scapula of the patient; and wherein the subcutaneous path terminates in a subcutaneous and precordial position on the chest of the patient such that the lead assembly, once inserted, comprises no transvenous, intracardiac, or epicardial electrodes. - View Dependent Claims (22, 23)
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Specification