Electrode spacing in a subcutaneous implantable cardiac stimulus device

• US 9,079,035 B2
• Filed: 06/06/2013
• Issued: 07/14/2015
• Est. Priority Date: 12/12/2008
• Status: Active Grant

• Current Assignee: Cameron Health Inc (Boston Scientific Corporation)
• Original Assignee: Cameron Health Inc (Boston Scientific Corporation)
• Inventors: Sanghera, Rick, King, Eric F., Scheck, Don E., Sudam, Abdulkader O., Warren, Jay A.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): Patel, Natasha
• Application Number:
  US13/911,308
• Publication Number:
  US 20130268013A1
• Time in Patent Office: 768 Days
• Field of Search: 607 5- 7, 607/115, 600/377, 600/509
• US Class Current: 1/1
• CPC Class Codes: A61N 1/048 Electrodes characterised by a specific connection between lead and electrode
• CPC Class Codes: A61N 1/0504 Subcutaneous electrodes
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3968 Constructional arrangements, e.g. casings A61N1/375 takes precedence
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Methods and implantable cardiac stimulus devices that include leads designed to avoid post-shock afterpotentials. Some examples are directed toward lead-electrode designs that reduce the impact of an applied stimulus on sensing attributes. These examples may find particular use in systems that provide both sensing and therapy delivery from subcutaneous location.

Claims

1. An implantable defibrillator system for subcutaneous placement comprising:

an implantable canister housing operational circuitry for sensing electrical cardiac activity and delivering electrical stimulus to correct arrhythmia; and

a lead electrode assembly comprising;

a proximal connector end for coupling to the implantable canister;

a distal end having a distal tip with a distal tip electrode;

an elongated body extending between the proximal connector end and the distal end; and

a defibrillation electrode;

wherein the distal tip electrode is spaced from the defibrillation electrode by a portion of the elongated body having a length of at least nineteen (19) millimeters, with no other electrode therebetween;

wherein the implantable canister is configured to enable insertion of the lead electrode assembly for operation therewith.

2. The implantable defibrillator system of claim 1 wherein:

the lead electrode assembly further comprises a proximal sensing electrode proximal of the defibrillation electrode such that the defibrillation electrode is disposed between the proximal sensing electrode and the distal tip electrode; and

the proximal sensing electrode is spaced from the defibrillation electrode by a portion of the elongated body having a length of at least nineteen (19) millimeters, with no other electrode therebetween.

3. The implantable defibrillator system of claim 2 wherein the spacing between the defibrillation electrode and the distal tip and proximal sensing electrodes is sized such that, following delivery of a defibrillation therapy to a patient, afterpotential is minimized.

4. The implantable defibrillator system of claim 2 wherein the spacing between the defibrillation electrode and the distal tip and proximal sensing electrodes is sized to prevent motion artifact following delivery of defibrillation therapy.

5. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized such that, following delivery of a defibrillation therapy to a patient, afterpotential is minimized.

6. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized to prevent motion artifact following delivery of defibrillation therapy.

7. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized such that, following delivery of an 80 Joule defibrillation therapy to a patient, afterpotential is minimized.

8. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized to prevent motion artifact following delivery of an 80 Joule defibrillation therapy.

9. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized such that, following delivery of a defibrillation therapy having a peak voltage of about 1350 volts to a patient, afterpotential is minimized.

10. The implantable defibrillator system of claim 1 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized to prevent motion artifact following delivery of a defibrillation therapy having a peak voltage of about 1350 volts to a patient.

11. An implantable defibrillator system for subcutaneous placement comprising:

an implantable canister housing operational circuitry for sensing electrical cardiac activity and delivering electrical stimulus to correct arrhythmia; and

a lead electrode assembly comprising;

a proximal connector end for coupling to the implantable canister;

a distal end having a distal tip;

an elongated body extending between the proximal connector end and the distal end;

a defibrillation electrode; and

a proximal sensing electrode proximal of the defibrillation electrode;

wherein the proximal sensing electrode is spaced from the defibrillation electrode by a portion of the elongated body having a length of nineteen (19) millimeters up to twenty-nine (29) millimeters, with no other electrode therebetween;

wherein the implantable canister is configured to enable insertion of the lead electrode assembly for operation therewith.

12. The implantable defibrillator system of claim 11 wherein:

the lead electrode assembly further comprises a distal tip electrode at the distal end such that the defibrillation electrode is disposed between the proximal sensing electrode and the distal tip electrode; and

the distal tip electrode is spaced from the defibrillation electrode by a portion of the elongated body having a length of nineteen (19) millimeters up to twenty-nine (29) millimeters, with no other electrode therebetween.

13. The implantable defibrillator system of claim 12 wherein the spacing between the defibrillation electrode and the distal tip and proximal sensing electrodes is sized such that, following delivery of a defibrillation therapy to a patient, afterpotential is minimized.

14. The implantable defibrillator system of claim 12 wherein the spacing between the defibrillation electrode and the distal tip and proximal sensing electrodes is sized to prevent motion artifact following delivery of defibrillation therapy.

15. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the proximal sensing electrode is sized such that, following delivery of a defibrillation therapy to a patient, afterpotential is minimized.

16. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the proximal sensing electrode is sized to prevent motion artifact following delivery of defibrillation therapy.

17. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the proximal sensing electrode is sized such that, following delivery of an 80 Joule defibrillation therapy to a patient, afterpotential is minimized.

18. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the proximal sensing electrode is sized to prevent motion artifact following delivery of an 80 Joule defibrillation therapy.

19. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the distal tip electrode is sized such that, following delivery of a defibrillation therapy having a peak voltage of about 1350 volts to a patient, afterpotential is minimized.

20. The implantable defibrillator system of claim 11 wherein the spacing between the defibrillation electrode and the proximal sensing electrode is sized to prevent motion artifact following delivery of a defibrillation therapy having a peak voltage of about 1350 volts to a patient.