Multi-site atrial electrostimulation

• US 8,204,605 B2
• Filed: 02/04/2009
• Issued: 06/19/2012
• Est. Priority Date: 02/07/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Hastings, Roger, Lafontaine, Daniel M., Becker, John A., Pikus, Michael J., Edmunds, Kevin D., Willard, Martin R.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US12/365,428
• Publication Number:
  US 20090234407A1
• Time in Patent Office: 1,231 Days
• Field of Search: 607/4, 607/9, 607/30, 607/33, 607/57, 607/60, 607/116, 607/119
• US Class Current: 607/119
• CPC Class Codes: A61N 1/0565 Electrode heads
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• 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 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37223 Circuits for electromagnetic coupling
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

An apparatus and method can receive wireless energy using a wireless electrostimulation electrode assembly. In certain examples, at least some of the received wireless energy can be delivered as an electrostimulation to a heart. In certain examples, the wireless electrostimulation electrode can be mechanically supported at least partially using a ring formed by an annulus of a mitral valve of the heart. In certain examples, the wireless electrostimulation electrode assembly can be configured to be intravascularly delivered to an implant location within a chamber of the heart at the annulus of the mitral valve of the heart, and can fit entirely within the heart.

Claims

1. An apparatus, comprising:

a first wireless electrostimulation electrode assembly comprising;

an electrostimulation circuit;

a wireless receiver configured to receive wireless energy and configured to provide at least some of the received wireless energy to the electrostimulation circuit;

a first expandable support mechanically coupled to the electrostimulation circuit and the wireless receiver and configured to support the first wireless electrostimulation electrode assembly at least partially using a ring formed by an annulus of a mitral valve of the heart; and

wherein the electrostimulation circuit is configured to deliver at least some of the received wireless energy as an electrostimulation to the heart;

wherein the first wireless electrostimulation electrode assembly is configured to be intravascularly delivered to an implant location within a chamber of the heart at the annulus of the mitral valve of the heart; and

wherein the first wireless electrostimulation electrode assembly is configured to fit entirely within the heart.

2. The apparatus of claim 1, wherein the wireless energy includes magnetically-coupled energy, and wherein the wireless receiver is configured to receive the magnetically-coupled energy.

3. The apparatus of claim 2, comprising a transmitter configured to provide the magnetically-coupled energy, and wherein the transmitter is sized and shaped to be located subcutaneously within a patient, or outside a patient body.

4. The apparatus of claim 1, wherein the electrostimulation circuit is configured to deliver an electrostimulation including enough of the received wireless energy to depolarize cardiac tissue near the wireless electrostimulation electrode assembly.

5. The apparatus of claim 1, wherein the first expandable support includes a shape memory material configured to provide an expansion force, and the first expandable support is configured to anchor the first wireless electrostimulation electrode assembly at the implant location at the annulus of the mitral valve at least in part using the expansion force when the first wireless electrostimulation electrode assembly is delivered to the implant location.

6. The apparatus of claim 1, wherein the first wireless electrostimulation electrode assembly includes one or more extending tines configured to controllably extend into tissue when the first wireless electrostimulation electrode assembly is delivered to the implant location at the annulus of the mitral valve of the heart.

7. The apparatus of claim 1, comprising:

a second wireless electrostimulation electrode assembly configured to be intravascularly delivered to an implant location within a blood vessel and configured to provide an electrostimulation to the heart near the blood vessel; and

a controller communicatively coupled to the first and second wireless electrostimulation electrode assemblies and configured to coordinate delivery of the electrostimulation by the first and second wireless electrostimulation electrode assemblies.

8. The apparatus of claim 7, wherein the blood vessel is selected from a list including a pulmonary vein, a coronary sinus, or a vena cava.

9. The apparatus of claim 1, comprising a second electrostimulation electrode assembly configured to be intravascularly delivered to an endocardial location at an atrial appendage of the heart and configured to provide an electrostimulation to the heart;

and

a controller communicatively coupled to the first and second wireless electrostimulation electrode assemblies and configured to coordinate delivery of the electrostimulation by the first and second wireless electrostimulation electrode assemblies.

10. The apparatus of claim 9, wherein the atrial appendage of the heart is a left atrial appendage, and wherein the second electrostimulation electrode assembly includes a second expandable support configured to at least partially block the opening to the left atrial appendage of the heart and configured to anchor the second electrostimulation electrode assembly at the opening of the left atrial appendage when the second expandable support is expanded.

11. The apparatus of claim 1, comprising:

a plurality of separate wireless electrostimulation electrode assemblies, each configured to be intravascularly delivered to a respective implant location and each configured to provide an electrostimulation to the heart at the respective implant location;

a controller communicatively coupled to the plurality of separate wireless electrostimulation electrode assemblies and configured to coordinate delivery of the electrostimulation to the heart at each respective implant location; and

wherein the plurality of separate wireless electrostimulation electrode assemblies includes the first wireless electrostimulation electrode assembly.

12. The apparatus of claim 11, wherein the plurality of separate wireless electrostimulation electrode assemblies includes one or more wireless electrostimulation electrode assemblies selected from a list including:

a second wireless electrostimulation electrode assembly configured to be intravascularly delivered to an endocardial location at an atrial septum of the heart and configured to provide an electrostimulation to the heart;

a third wireless electrostimulation electrode assembly configured to be intravascularly delivered to an endocardial location at an atrial appendage of the heart and configured to provide an electrostimulation to the heart; and

a fourth wireless electrostimulation electrode assembly configured to be intravascularly delivered to an implant location within a pulmonary vein and configured to provide an electrostimulation to the heart;

a fifth wireless electrostimulation electrode assembly configured to be intravascularly delivered to an implant location within a vena cava and configured to provide an electrostimulation to the heart;

a sixth wireless electrostimulation electrode assembly configured to be intravascularly delivered to an implant location within a coronary sinus and configured to provide an electrostimulation to the heart;

wherein the controller is communicatively coupled to each corresponding wireless electrostimulation electrode assembly and the controller is configured to coordinate delivery of the electrostimulation to the heart at each respective implant location by each respective wireless electrostimulation electrode assembly.

13. The apparatus of claim 11, wherein the controller includes an arrhythmia detector configured to detect an arrhythmia, and wherein the controller is configured to coordinate delivery of the electrostimulation to the heart at each respective implant location to terminate the arrhythmia in response to information provided by the arrhythmia detector.

14. The apparatus of claim 13, wherein the arrhythmia includes an atrial tachyarrhythmia selected from a list including an atrial fibrillation, an atrial tachycardia, an atrial flutter, an atrioventricular nodal reentrant tachycardia, or an atrioventricular reentrant tachycardia.

15. The apparatus of claim 13, wherein the controller is configured to coordinate delivery of the electrostimulation to the heart at each respective implant location to terminate the arrhythmia without exceeding a pain threshold of a patient.

16. A method, comprising:

receiving wireless energy using a first wireless electrostimulation electrode assembly;

delivering at least some of the received wireless energy as an electrostimulation to a heart;

mechanically supporting the first wireless electrostimulation electrode assembly at least partially using a ring formed by an annulus of a mitral valve of the heart;

wherein the first wireless electrostimulation electrode assembly is configured to be intravascularly delivered to an implant location within a chamber of the heart at the annulus of the mitral valve of the heart; and

wherein the first wireless electrostimulation electrode assembly is configured to fit entirely within the heart.

17. The method of claim 16, comprising:

receiving wireless energy using a plurality of separate wireless electrostimulation electrode assemblies, the plurality including the first wireless electrostimulation electrode assembly, and wherein the plurality of separate wireless electrostimulation electrode assemblies are each configured to be intravascularly delivered to a respective implant location;

delivering one or more coordinated electrostimulations to the heart at the respective implant location using at least one of the plurality of electrostimulation electrode assemblies and using at least some of the received wireless energy.

18. The method of claim 17, including:

detecting an arrhythmia;

terminating the detected arrhythmia using the delivering one or more coordinated electrostimulations and using information provided by the detecting the arrhythmia; and

wherein the delivering one or more coordinated electrostimulations includes delivering enough received wireless energy to depolarize cardiac tissue at each respective implant location where the one or more coordinated electrostimulations are delivered.

19. The method of claim 18, wherein the detecting the arrhythmia includes detecting an atrial arrhythmia selected from a list including an atrial fibrillation, an atrial tachycardia, an atrial flutter, an atrioventricular nodal reentrant tachycardia, or an atrioventricular reentrant tachycardia.

20. The method of claim 18, wherein the terminating the arrhythmia using the delivering one or more coordinated electrostimulations includes depolarizing enough cardiac tissue to terminate the arrhythmia without exceeding a pain threshold of a patient.