System for neurally-mediated anti-arrhythmic therapy
First Claim
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1. A method, comprising:
- detecting a predetermined cardiac activity indicated for an antitachycardia shock;
applying neural stimulation with a subcutaneous electrode to lower a defibrillation threshold in preparation for the shock; and
subcutaneously delivering the shock from a subcutaneous non-intrathoracic space, wherein subcutaneously delivering the shock includes delivering energy between at least two electrodes operatively positioned in the subcutaneous space to deliver energy across the heart.
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Abstract
According to an embodiment of a method, a predetermined cardiac activity indicated for an antitachycardia shock is detected. Neural stimulation is applied to lower a defibrillation threshold in preparation for the shock, and the shock is subcutaneously delivered. According to one embodiment, neural stimulation is applied as part of a prophylactic therapy. A predetermined cardiac activity indicated for an antitachycardia shock is detected, and the shock is subcutaneously delivered. Other aspects and embodiments are provided herein.
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Citations
31 Claims
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1. A method, comprising:
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detecting a predetermined cardiac activity indicated for an antitachycardia shock; applying neural stimulation with a subcutaneous electrode to lower a defibrillation threshold in preparation for the shock; and subcutaneously delivering the shock from a subcutaneous non-intrathoracic space, wherein subcutaneously delivering the shock includes delivering energy between at least two electrodes operatively positioned in the subcutaneous space to deliver energy across the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system, comprising:
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a sensor adapted to detect a predetermined cardiac activity indicated for a defibrillation shock; a vagal nerve stimulator adapted to use a subcutaneous electrode to deliver vagal nerve stimulation; and a defibrillator including at least two electrodes configured to be operatively positioned in a subcutaneous non-intrathoracic space to deliver energy across the heart, wherein the defibrillator is configured to subcutaneously deliver the defibrillation shock between the at least two electrodes operatively positioned in the subcutaneous non-intrathoracic space to deliver energy across the heart, wherein the vagal nerve stimulator is adapted to; deliver vagal nerve stimulation to lower a defibrillation threshold for the defibrillation shock;
ordeliver intermittent vagal nerve stimulation as a prophylactic therapy to prevent ventricular fibrillation after a myocardial infarction;
ordeliver intermittent vagal nerve stimulation as a prophylactic therapy to prevent or abate progression of cardiac disease. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
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19. An implantable device, comprising:
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at least one subcutaneous lead with at least one electrode configured to be operatively placed in a subcutaneous non-intrathoracic space; a shock pulse generator configured to subcutaneously deliver an antitachycardia shock between at least two electrodes operatively positioned in the subcutaneous non-intrathoracic space to deliver energy across the heart, wherein the shock pulse generator is configured to use the at least one subcutaneous lead with the at least one electrode to deliver energy across the heart; a cardiac activity sensor adapted to detect cardiac activity signals; a nerve stimulator generator adapted to use a subcutaneous electrode to deliver vagal nerve stimulation; and a microprocessor adapted to detect a predetermined cardiac activity indicated for the antitachycardia shock using the cardiac activity detected by the cardiac activity sensor, to control the shock pulse generator to deliver the antitachycardia shock, and to control the nerve stimulator generator to; deliver vagal nerve stimulation to lower DFT in preparation for the antitachycardia shock, or deliver vagal nerve stimulation to prevent ventricular fibrillation after a myocardial infarction, or deliver vagal nerve stimulation to prevent or abate progression of cardiac disease. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26)
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27. A system, comprising:
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a neural stimulator adapted to use a subcutaneous electrode to deliver vagal nerve stimulation to lower a defibrillation threshold; and a subcutaneous non-intrathoracic implantable cardioverter defibrillator (ICD) including at least two electrodes configured to be operatively positioned in a subcutaneous non-intrathoracic space to deliver energy across the heart, wherein the subcutaneous non-intrathoracic ICD is configured to deliver an antitachycardia shock between the at least two electrodes and across the heart, wherein the neural stimulator and the subcutaneous non-intrathoracic ICD are adapted to communicate allowing the neural stimulator to lower the defibrillation threshold after an antitachycardia event has occurred in preparation for delivery of the antitachycardia shock. - View Dependent Claims (28, 29, 30, 31)
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Specification