Leadless cardiac stimulation systems

• US 8,332,036 B2
• Filed: 03/08/2007
• Issued: 12/11/2012
• Est. Priority Date: 10/20/2004
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Hastings, Roger N., Drassler, William J., Lafontaine, Daniel M., Smith, Scott R., Sadasiva, Anupama
• Primary Examiner(s): Heller, Tammie K
• Application Number:
  US11/683,584
• Publication Number:
  US 20070150038A1
• Time in Patent Office: 2,105 Days
• Field of Search: 607/30, 607/32, 607/33, 607/60, 607/61
• US Class Current: 607/32
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/059 Anchoring means
• 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 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• 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 1/37241 providing test stimulations
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/37512 Pacemakers
• 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

Various configurations of systems that employ leadless electrodes to provide pacing therapy are provided. In one example, a system that provides multiple sites for pacing of myocardium of a heart includes wireless pacing electrodes that are implantable at sites proximate the myocardium using a percutaneous, transluminal, catheter delivery system. Each of the electrodes contains a source of electrical energy for pacing the myocardium and is adapted to receive electromagnetic energy from a source outside the myocardium. The system also includes a source adapted for placement outside the myocardium and that uses locally measured electrocardiograms to synchronize pacing of the heart by sending electromagnetic commands to the electrodes to pace the myocardium surrounding the electrodes. Also disclosed is various configurations of such systems, wireless electrode assemblies, and delivery catheters for delivering and implanting the electrode assemblies.

Claims

1. A body implantable wireless electrode assembly comprising:

a charge storage device operatively coupled to discharge stored charge across a pair of electrodes that are positionable to be in contact with myocardial tissue;

a receiver coil that inductively couples an externally provided charging signal to charge the charge storage device and that receives externally provided wireless control signals;

control circuitry that triggers the discharge of stored charge from the charge storage device upon receipt of a wireless control signal that indicates that a storage capacitor is to be discharged and that includes information that identifies the body implantable electrode assembly from among other such body implantable electrode assemblies;

a mechanism configured to secure the wireless electrode assembly entirely within myocardial tissue within a heart; and

wherein the wireless electrode assembly is sized, shaped, and positionable;

(1) for delivery to the interior of the heart via an intravascular route, and (2) for implant entirely within the myocardial tissue of the heart wall.

2. The electrode assembly of claim 1 wherein the electrode assembly is tuned to respond to a particular frequency of wireless control signal.

3. The electrode assembly of claim 2 wherein the electrode assembly has a filter that filters all but a selected frequency.

4. The electrode assembly of claim 1 wherein the mechanism that secures the assembly entirely within the myocardial tissue includes one or more tines.

5. The electrode assembly of claim 4, wherein at least one of the tines is configured to controllably extend from within a housing of the wireless electrode assembly into the surrounding tissue.

6. The electrode assembly of claim 5, wherein at least one of the tines is configured to extend radially outward from the wireless electrode assembly in response to actuation by an intravascularly-deliverable elongate member coupled to the wireless electrode assembly.

7. The electrode assembly of claim 1 wherein the electrode assembly does not include an internally generated power source.

8. A method of controlling the delivery of electrical signals from a plurality of wireless electrode assemblies that each have a pair of electrodes that are in contact with myocardial tissue, wherein each of the electrode assemblies may be charged by inductive coupling and subsequently discharged to deliver electrical energy across the pair of electrodes in contact with myocardial tissue, wherein each electrode assembly includes a mechanism configured to secure the electrode assembly entirely within myocardial tissue within a heart, and wherein the wireless electrode assembly is sized, shaped, and positionable:

(1) for delivery to the interior of the heart via an intravascular route, and (2) for implant entirely within the myocardial tissue of the heart wall, the method comprising;

wirelessly transmitting a charging signal that is received by each of the plurality of the wireless electrode assemblies to charge a respective storage capacitor of each of the plurality of wireless electrode assemblies at the same time; and

wirelessly transmitting control signals that are received by the wireless electrode assemblies to trigger the discharge of the storage capacitor in a selected one of the wireless electrode assemblies.

9. The method of claim 8 wherein the wirelessly transmitted control signals are transmitted at different frequencies, wherein one of the different frequencies identifies the selected one of the wireless electrode assemblies.

10. The method of claim 8, comprising securing the wireless electrode assembly entirely within myocardial tissue using one or more tines.

11. The method of claim 10, wherein the securing the wireless electrode assembly includes controllably extending at least one of the tines from within a housing of the wireless electrode assembly into the surrounding tissue.

12. The method of claim 11, wherein the securing the wireless electrode assembly includes extending at least one of the tines radially outward from the wireless electrode assembly in response to actuation by an intravascularly-deliverable elongate member coupled to the wireless electrode assembly.

13. A wireless electrode assembly, comprising:

a charge storage device configured to discharge stored charge across a pair of electrodes that are positionable to be in contact with myocardial tissue;

a receiver coil configured to inductively couples an externally provided charging signal to charge the charge storage device and that receives externally provided wireless control signals;

control circuitry configured to trigger the discharge of stored charge from the charge storage device in response to a wireless control signal including information that identifies the wireless electrode assembly from among other such wireless electrode assemblies;

a mechanism including one or more tines configured to secure the wireless electrode assembly entirely within myocardial tissue within a heart;

wherein the wireless electrode assembly is sized, shaped, and positionable;

(1) for delivery to the interior of the heart via an intravascular route, and (2) for implant entirely within the myocardial tissue of the heart wall; and

wherein at least one of the tines is configured to extend radially outward from within a housing of the wireless electrode assembly in response to actuation by an intravascularly-deliverable elongate member coupled to the wireless electrode assembly.