System with left/right pulmonary artery electrodes

• US 7,734,348 B2
• Filed: 05/10/2005
• Issued: 06/08/2010
• Est. Priority Date: 05/10/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yongxing, Zhang, Yunlong
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): PATEL, NATASHA
• Application Number:
  US11/125,997
• Publication Number:
  US 20060259084A1
• Time in Patent Office: 1,855 Days
• Field of Search: 607/4, 607/9, 607/148, 607/42, 600/529
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

Various embodiments of the present subject matter relate to a lead. Various lead embodiments comprise a lead body including a first portion, a first branch and a second branch. The first portion has an end adapted to connect to an implantable medical device. The first branch and the second branch is connected to the first portion at a bifurcated region. The first branch includes a distal end adapted to be fed into a right pulmonary artery and to securely position at least one electrode within the right pulmonary artery. The second branch includes a distal end adapted to be fed into a left pulmonary artery and to securely position at least one electrode within the left pulmonary artery. Other embodiments are provided herein.

Claims

1. A method, comprising:

positioning at least one electrode in a right pulmonary artery and at least one electrode in a left pulmonary artery; and

applying stimulation using at least one of the electrodes.

2. The method of claim 1, wherein positioning at least one electrode in a right pulmonary artery and at least one electrode in a left pulmonary artery includes:

feeding a first lead and a second lead through a pulmonary valve;

feeding a distal end of the first lead into the right pulmonary artery to position at least one electrode for the first lead in the right pulmonary artery; and

feeding a distal end of the second lead into the left pulmonary artery to position at least one electrode for the second lead in the left pulmonary artery.

3. The method of claim 1, wherein positioning at least one electrode in a right pulmonary artery and at least one electrode in a left pulmonary artery includes:

feeding a bifurcated lead through a pulmonary valve;

feeding a distal end of a first branch of the bifurcated lead into the right pulmonary artery to position at least one electrode for the first branch in the right artery; and

feeding a distal end of a second branch of the bifurcated lead into the left pulmonary artery to position at least one electrode for the second branch in the left artery.

4. The method of claim 1, further comprising sensing an atrial event using at least one of the electrodes.

5. The method of claim 4, wherein sensing the atrial event includes sensing a wave.

6. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes pacing atrial tissue using at least one of the electrodes.

7. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes defibrillating atrial tissue using at least one of the electrodes.

8. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes applying neural stimulation to a neural stimulation target using at least one of the electrodes.

9. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes applying neural stimulation to a right vagus nerve target and a left vagus nerve target using the at least one electrode in the right pulmonary artery and the at least one electrode in the left pulmonary artery.

10. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes capturing right atrial tissue and left atrial tissue using the at least one electrode in the right pulmonary artery and the at least one electrode in the left pulmonary artery.

11. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes applying neural stimulation to a right vagus nerve target and capturing left atrial tissue using the at least one electrode in the right pulmonary artery and the at least one electrode in the left pulmonary artery.

12. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes applying neural stimulation to a left vagus nerve target and capturing right atrial tissue using the at least one electrode in the right pulmonary artery and the at least one electrode in the left pulmonary artery.

13. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes using a common electrode to simultaneously apply neural stimulation to a vagus nerve target and capture atrial tissue.

14. The method of claim 1, wherein applying stimulation using at least one of the electrodes includes using a common electrode to stagger neural stimulation to a vagus nerve target and myocardial stimulation to capture atrial tissue.

15. An implantable medical device, comprising:

at least one lead adapted to extend through a pulmonary valve to securely position at least one electrode within a right pulmonary artery and at least one electrode within a left pulmonary artery;

stimulation circuitry connected to the at least one lead to apply stimulation to at least one of the electrodes; and

a controller connected to the stimulation circuitry to control application of the stimulation.

16. The implantable medical device of claim 15, further comprising sensing circuitry connected to the at least one lead and the controller, the sensing circuit being adapted to use the at least one lead to sense an intrinsic atrial electrical event, and the controller being adapted to use the sensed intrinsic atrial electrical event as feedback to control application of the neural stimulation to the right vagus nerve and the left vagus nerve.

17. The implantable medical device of claim 15, wherein the controller is adapted to control the stimulator to independently apply neural stimulation to the right vagus nerve and apply neural stimulation to the left vagus nerve.

18. The implantable medical device of claim 15, wherein at least one of the electrodes is positioned to capture atrial tissue and at least one of the electrodes is positioned to apply vagal stimulation;

the stimulation circuitry is adapted to apply myocardial stimulation and neural stimulation; and

a controller connected to the stimulation circuitry to control application of the myocardial stimulation and neural stimulation.

19. The implantable medical device of claim 15, wherein:

the at least one electrode within the right pulmonary artery is positioned to capture right atrial tissue;

the at least one electrode within the left pulmonary artery is positioned to capture left atrial tissue; and

the stimulation circuitry is adapted to use the at least one lead to apply an electrical signal to capture the right and left atrial tissue.

20. The implantable medical device of claim 19, further comprising sensing circuitry connected to the at least one lead and the controller, the sensing circuit being adapted to use the at least one lead to sense an intrinsic atrial electrical event, and the controller being adapted to use the sensed intrinsic atrial electrical event as feedback to control application of the electrical signal to capture the right and left atrial tissue.

21. The implantable medical device of claim 19, wherein the controller is adapted to control the stimulator to simultaneously capture the right and left atrial tissue.

22. The implantable medical device of claim 19, wherein the controller is adapted to control the stimulator to independently capture the right and left atrial tissue.

23. The implantable medical device of claim 15, wherein the at least one lead includes a bifurcated lead with a first portion adapted to extend through the pulmonary valve, a first branch extending from the first portion having a distal end to be fed into the right pulmonary artery to securely position the at least one electrode within the right pulmonary artery, and a second branch extending from the first portion having a distal portion to be fed into the left pulmonary artery to securely position the at least one electrode within a left pulmonary artery.

24. The implantable medical device of claim 23, wherein the bifurcated lead includes a lead body with the first portion, the first branch and the second branch, the first portion having an end adapted to connect to an implantable medical device, and the first branch and the second branch connected to the first portion at a bifurcated region.

25. The implantable medical device of claim 24, wherein the first portion of the lead is adapted to be fed into the right atrium, through a tricuspid valve, into a right ventricle, and through a pulmonary valve.

26. The implantable medical device of claim 24, wherein the lead body includes a first lumen through an entire length of the first portion and the first branch of the lead body, and a second lumen through an entire length of the first portion and the second branch of the lead body to allow the lead to be implanted over a guide wire.

27. The implantable medical device of claim 24, wherein at least one of the distal end of the first branch and the distal end of second branch includes a pre-formed, biased shape adapted to passively fixate the distal end within vasculature.

28. The implantable medical device of claim 27, wherein the pre-formed, biased shape includes an S-shaped configuration.

29. The implantable medical device of claim 27, wherein the pre-formed, biased shape includes a C-shaped configuration.

30. The implantable medical device of claim 27, wherein the pre-formed, biased shape includes a spiral configuration.

31. The implantable medical device of claim 27, wherein the pre-formed, biased shape includes a J-shaped configuration.

32. The implantable medical device of claim 27, wherein the pre-formed, biased shape includes at least one curve in the lead body dimensioned to provide at least two surfaces positioned to contact opposing walls of the pulmonary artery.

33. The implantable medical device of claim 27, wherein the at least one electrode includes a defibrillation coil electrode.

34. The implantable medical device of claim 27, wherein the at least one electrode includes a stent-like electrode adapted to expand into contact with a pulmonary artery wall, the expanded stent-like electrode being passively-fixed within the pulmonary artery.

35. The implantable medical device of claim 27, wherein the at least one electrode includes a ring electrode.

36. The implantable medical device of claim 27, wherein the at least one electrode includes a tip electrode.