Method of defibrillating a heart with electrode configurations including a left ventricular defibrillation electrode

• US 20020103507A1
• Filed: 01/26/2001
• Published: 08/01/2002
• Est. Priority Date: 01/26/2001
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Helland, John R.
• Granted Patent: US 6,735,472 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61N 1/0563 specially adapted for defibrillation or cardioversion
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

An implantable universal pacing and defibrillating system provides efficacious sensing, pacing, and cardioversion/defibrillation in all four chambers of the heart. The system includes three leads with one lead being configured for implant in the coronary sinus for sensing, pacing, and defibrillating in both the left atrium and left ventricle. The leads also provide a plurality of different electrode configurations for both ventricular and atrial defibrillation. Sequential primary and secondary defibrillation shocks may be employed to advantage for depolarizing essentially all of the ventricular or atrial myocardium.

Claims

1. A method of stimulating a heart with an implantable cardiac stimulation system, the method including the steps of:

applying a stimulation pulse with a first electrode configuration between a first chamber of the heart and third and fourth chambers of the heart; and

simultaneously applying the stimulation pulse with a second electrode configuration between a second chamber of the heart and the third and fourth chambers of the heart, one of the chambers of the heart being the left ventricle.

2. The method of claim 1 wherein the first chamber is the right atrium, the second chamber is the right ventricle, the third chamber is the left atrium and the fourth chamber is the left ventricle.

3. The method of claim 1 wherein the first chamber is the right atrium, the second chamber is the left atrium, the third chamber is the right ventricle and the fourth chamber is the left ventricle.

4. The method of claim 1 wherein the implantable cardiac stimulation system includes a stimulation device having a conductive case and wherein the method further includes the step of simultaneously applying the stimulation pulse with a third electrode configuration between the first and second chambers and the case.

5. The method of claim 4 wherein the first chamber is the right atrium, the second chamber is the left ventricle, the third chamber is the left atrium and the fourth chamber is the left ventricle.

6. The method of claim 1 wherein the implantable cardiac stimulation system includes a stimulation device having a conductive case and wherein the method further includes the step of simultaneously applying the stimulation pulse with a third electrode configuration between the case and the third and fourth chambers.

7. The method of claim 6 wherein the first chamber is the right atrium, the second chamber is the left atrium, the third chamber is the right ventricle and the fourth chamber is the left ventricle.

8. A method of stimulating a heart with an implantable cardiac stimulation system including a stimulation device having a conductive case, the method including the steps of:

applying a stimulation pulse with a first electrode configuration between the left ventricle of the heart and the case; and

simultaneously applying the stimulation pulse with a second electrode configuration between a further chamber of the heart other than the left ventricle and the case.

9. The method of claim 8 wherein the further chamber is the right ventricle.

10. A method of stimulating the ventricles of a heart with an implantable cardiac stimulation system, the method including the steps of:

placing a right atrial defibrillation electrode in electrical contact with the right atrium of the heart, a right ventricular defibrillation electrode in electrical contact with the right ventricle of the heart, a left atrial defibrillation electrode in electrical contact with the left atrium of the heart and a left ventricular defibrillation electrode in electrical contact with the left ventricle of the heart;

forming a first common connection of a first plurality of the defibrillation electrodes;

forming a second common connection of a second plurality of the defibrillation electrodes including the left ventricular defibrillation electrode; and

delivering a stimulation pulse between the first and second common connections.

11. The method of claim 10 wherein the first plurality of the defibrillation electrodes is the right atrial defibrillation electrode and the right ventricular defibrillation electrode and the second plurality of the defibrillation electrodes further includes the left atrial defibrillation electrode.

12. The method of claim 11 wherein the stimulation system includes a stimulation device having a conductive case and wherein the second plurality of the defibrillation electrodes further includes the conductive case.

13. The method of claim 10 wherein the first plurality of the defibrillation electrodes is the right atrial defibrillation electrode and the left atrial defibrillation electrode and the second plurality of the defibrillation electrodes further includes the right ventricular defibrillation electrode.

14. The method of claim 13 wherein the stimulation system includes a stimulation device including a conductive case and wherein the first plurality of the defibrillation electrodes further includes the conductive case.

15. The method of claim 10 wherein the step of placing a left ventricular defibrillation electrode in electrical contact with the left ventricular of the heart includes placing the left ventricular defibrillation electrode within the coronary sinus region of the heart adjacent the left ventricle.

16. The method of claim 10 wherein the step of placing a left atrial defibrillation electrode in electrical contact with the left atrium of the heart includes placing the left atrial defibrillation electrode with the coronary sinus of the heart adjacent the left atrium.

18. The method of claim 17 wherein the further electrode is a right ventricular defibrillation electrode, wherein the second recited placing step includes placing the right ventricular defibrillation electrode in electrical contact with the right ventricle of the heart and wherein the delivering step includes delivering the stimulation pulse between the conductive case and the right and left ventricular defibrillation electrodes.

19. The method of claim 17 wherein the first recited placing step includes the step of placing the left ventricular defibrillation electrode within the coronary sinus region of the heart adjacent the left ventricle of the heart.

17. A method of stimulating the ventricles of a heart with an implantable cardiac stimulation system including a stimulation device having a conductive case stimulation, the method including the steps of:

placing a left ventricular defibrillation electrode in electrical contact with the left ventricle of the heart;

placing a further defibrillation electrode in electrical contact with a further chamber of the heart different than the left ventricle; and

delivering a stimulation pulse between the conductive case and the further and left ventricular electrode.