Subcutaneous defibrillator implantation with right-side active canister

• US 8,386,037 B2
• Filed: 03/26/2012
• Issued: 02/26/2013
• Est. Priority Date: 09/18/2000
• Status: Expired due to Fees

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Ostroff, Alan H., Erlinger, Paul, Bardy, Gust H.
• Primary Examiner(s): Manuel, George
• Assistant Examiner(s): Wieland, Robert N
• Application Number:
  US13/429,777
• Publication Number:
  US 20120185005A1
• Time in Patent Office: 337 Days
• Field of Search: 607/5, 607/9
• US Class Current: 607/9
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• 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 1/3906 characterised by the form of the shockwave
• 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 1/3975 Power supply A61N1/378 takes precedence

Abstract

A subcutaneous cardiac device includes a subcutaneous electrode and a housing coupled to the subcutaneous electrode by a lead with a lead wire. The subcutaneous electrode is adapted to be implanted in a frontal region of the patient so as to overlap a portion of the patient'"'"'s heart.

Claims

1. A method of surgically implanting a defibrillator having one or more lead electrode assemblies and a canister in a patient comprising:

implanting the canister along the patient'"'"'s right inframammary crease; and

implanting a lead electrode assembly subcutaneously over the ribs of the patient and to the left of the patient'"'"'s sternum;

wherein both the canister and the lead electrode assembly are implanted on the anterior chest of the patient.

2. The method of claim 1 further comprising completing the surgical implantation without using fluoroscopy.

3. The method of claim 1 wherein the defibrillator consists of the canister that is implanted along the patient'"'"'s right inframammary crease and the lead electrode assembly that is implanted to the left of the patient'"'"'s sternum, and no other implantable canister or lead electrode assembly.

4. The method of claim 1 wherein all components of the defibrillator are implanted only subcutaneously.

5. The method of claim 1 further comprising performing defibrillation threshold (DFT) testing using the canister and the lead electrode assembly.

6. The method of claim 5 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering a shock during the vulnerable period of the cardiac cycle.

7. The method of claim 5 wherein performing DFT testing comprises inducing the patient into fibrillation by rapid pacing for several seconds.

8. The method of claim 5 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering alternating current in the range of 20-100 Hz frequency for several seconds.

9. The method of claim 5 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering a direct current for several seconds.

10. A method of implanting a defibrillator in a patient comprising:

implanting a canister subcutaneously along the patient'"'"'s inframammary crease;

implanting a first curvelinear electrode subcutaneously along the patient'"'"'s sternum; and

implanting a second curvelinear electrode subcutaneously along the patient'"'"'s sternum;

wherein the first and second curvelinear electrodes are on opposing sides of the patients'"'"' sternum;

wherein the first and second curvelinear electrodes are on the anterior side of the patient'"'"'s chest;

wherein the first and second curvelinear electrodes are disposed on first and second lead electrode assemblies, respectively; and

wherein, once implanted, the first and second lead electrode assemblies are each coupled to the canister to allow delivery of pacing, induction or defibrillation shocks.

11. The method of claim 10 further comprising completing the surgical implantation without using fluoroscopy.

12. The method of claim 10 wherein the defibrillator consists of the canister that is implanted along the patient'"'"'s inframammary crease and the first and second lead electrode assemblies, and no other implantable canister or lead electrode assembly.

13. The method of claim 10 wherein all components of the defibrillator are implanted only subcutaneously.

14. The method of claim 10 further comprising performing defibrillation threshold (DFT) testing using the canister and the first and second lead electrode assemblies.

15. The method of claim 14 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering a shock during the vulnerable period of the cardiac cycle.

16. The method of claim 14 wherein performing DFT testing comprises inducing the patient into fibrillation by rapid pacing for several seconds.

17. The method of claim 14 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering alternating current in the range of 20-100 Hz frequency for several seconds.

18. The method of claim 14 wherein performing DFT testing comprises inducing the patient into fibrillation by delivering a direct current for several seconds.

19. A method of implanting a defibrillator in a patient comprising:

implanting a first means for delivering therapeutic energy to the patient subcutaneously along the inframammary crease of the patient;

implanting a second means for delivering therapeutic energy to the patient subcutaneously along the patient'"'"'s sternum; and

implanting a third means for delivering therapeutic energy to the patient subcutaneously along the patient'"'"'s sternum;

wherein the second and third means are disposed on opposing sides of the patient'"'"'s sternum relative to one another and both on the anterior side of the patient'"'"'s chest; and

wherein the first means includes circuitry configured to generate therapeutic energy for delivery to the patient and each of the second and third means are coupled to the first means.