Modular antitachyarrhythmia therapy system

• US 8,903,500 B2
• Filed: 01/27/2014
• Issued: 12/02/2014
• Est. Priority Date: 05/18/2005
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Smith, Joseph M., Dujmovic, Richard Milon Jr.
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/164,447
• Publication Number:
  US 20140142648A1
• Time in Patent Office: 309 Days
• Field of Search: 607/4, 607/32, 607/60
• US Class Current: 607/60
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as a defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Claims

1. An implantable cardiac rhythm management system comprising:

a first module configured for subcutaneous implantation and having a controller and communications circuitry; and

a second module configured for implantation in the heart of a patient, comprising a housing having first and second electrodes thereon and including communications circuitry for communicating with the first module and which is configured for attachment to cardiac tissue, the second module being entirely separate from the first module;

wherein the first module is configured to identify a tachyarrhythmia and direct the second module to deliver antitachyarrhythmia therapy;

wherein the first module is further configured to also deliver antitachyarrhythtnia therapy as needed; and

wherein the communications circuitry of each of the first and second modules is configured to use the body of the patient as a conductive medium for communication.

2. The implantable cardiac rhythm management system of claim 1 further comprising a third implantable module configured for atrial sensing from an implanted location in the heart.

3. The implantable cardiac rhythm management system of claim 1 wherein the third implantable module also includes communication circuitry configured to use the body of the patient as a conductive medium for communications.

4. The implantable cardiac rhythm management system of claim 1 further comprising a third module configured for detecting blood pressure of the patient and reporting blood pressure measurements to the first module, wherein the first module is configured to use information relating to blood pressure to manage antitachyarrhythmia therapy delivery.

5. The implantable cardiac rhythm management system of claim 1, further comprising a third module configured for detecting heart sounds and reporting heart sound data to the first module, wherein the first module is configured to use information relating to heart sounds to manage antitachyarrhythmia therapy delivery.

6. The implantable cardiac rhythm management system of claim 1, further comprising a third module configured for detecting respiration and reporting respiration information to the first module, wherein the first module is configured to use information relating to respiration to manage antitachyarrhythmia therapy delivery.

7. The implantable cardiac rhythm management system of claim 1, further comprising a third module configured for implantation in the heart of a patient, comprising a housing having first and second electrodes thereon and which is configured for attaching to cardiac tissue, wherein the first module is configured to receive sensory information from the third module.

8. The implantable cardiac rhythm management system of claim 7 wherein the third module is configured to deliver therapy in response to a signal from the first module.

9. A method of operating an implantable cardiac rhythm management system, the implantable cardiac rhythm management system including:

a first module implanted in a subcutaneous position of the patient and having a controller and communications circuitry, the first module being configured to deliver antitachyarrhythmia therapy as needed; and

a second module configured for implantation in the heart of a patient, comprising a housing having first and second electrodes thereon and including communications circuitry for communicating with the first module and which is configured for attachment to cardiac tissue, the second module being entirely separate from the first module;

the method comprising;

the first module identifying a tachyarrhythmia;

the first module directing the second module to deliver antitachyarrhythmia therapy including communicating via the body of the patient as a conductive medium for communication; and

the second module delivering the antitachyarrhythmia therapy.

10. The method of claim 9 further comprising:

the first module determining that the second module has delivered antitachyarrhythmia therapy;

the first module determining that the antitachyarrhythmia therapy delivered by the second module was not successful; and

the first module delivering antitachyarrhythmia therapy.

11. The method of claim 9 further comprising:

the first module, after directing the second module to deliver antitachyarrhythmia therapy, determining that the patient requires therapy; and

the first module delivering antitachyarrhythmia therapy.

12. The method of claim 9 wherein the second module is implanted in a ventricular location and the implantable cardiac rhythm management system further includes a third implantable module configured for atrial sensing from an implanted location in the heart;

the method further comprising the third module sensing one or more parameters related to the atria of the patient.

13. The method of claim 12 wherein the third implantable module also includes communication circuitry configured to use the body of the patient as a conductive medium for communications, and the method further comprises the third module communicating to at least one of the first and second modules.

14. The method of claim 9 wherein the implantable cardiac rhythm management system includes a third module configured for detecting blood pressure, the method further comprising:

the third module reporting blood pressure measurements to the first module; and

the first module using data relating to blood pressure to manage antitachyarrhythmia therapy delivery.

15. The method of claim 9 wherein the implantable cardiac rhythm management system further includes a third module configured for detecting heart sounds;

wherein the method further comprises;

the third module reporting heart sound data to the first module; and

the first module using data relating to heart sounds to manage antitachyarrhythmia therapy delivery.

16. The method of claim 9 wherein the implantable cardiac rhythm management system further includes a third module configured for detecting respiration;

wherein the method further comprises;

the third module reporting respiration information to the first module; and

the first module using data relating to respiration to manage antitachyarrhythmia therapy delivery.