METHODS FOR USING A PULMONARY ARTERY ELECTRODE

• US 20130218221A1
• Filed: 04/02/2013
• Published: 08/22/2013
• Est. Priority Date: 05/10/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yongxing, Zhang, Yunlong
• Granted Patent: US 9,149,639 B2
• Time in Patent Office: Days
• US Class Current: 607/7
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• 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

According to some method embodiments, a left pulmonary artery electrode is positioned in a left pulmonary artery, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation. According to some method embodiments, a right pulmonary artery electrode is positioned in a right pulmonary artery and a left pulmonary artery electrode is positioned in a left pulmonary artery, the right pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation, and the left pulmonary artery electrode is used to sense atrial activity, or capture cardiac tissue, or deliver neural stimulation.

Claims

1. A lead, comprising:

a lead body having an end adapted to connect to an implantable medical device and a distal portion adapted to be securely positioned in a pulmonary artery;

the lead body being adapted to be fed into the right atrium, through a tricuspid valve, into a right ventricle, and through a pulmonary valve; and

the distal portion of the lead body being adapted to be secured within a pulmonary artery, the distal portion including at least one electrode adapted to be positioned within the pulmonary artery when the distal portion is secured within the pulmonary artery, the at least one electrode to be positioned in the pulmonary artery being adapted for use to apply neural stimulation to a neural stimulation target and to provide an atrial rhythm management activity, the atrial rhythm management activity including at least one of capturing atrial tissue and sensing an intrinsic atrial electrical event.

2. The lead of claim 1, wherein the distal portion of the lead body includes a pre-formed, biased shape adapted to passively fixate the distal end of the lead body within the pulmonary artery.

3. The lead of claim 2, wherein the pre-formed, biased shape includes an S-shaped configuration.

4. The lead of claim 2, wherein the pre-formed, biased shape includes a C-shaped configuration.

5. The lead of claim 2, wherein the pre-formed, biased shape includes a spiral configuration.

6. The lead of claim 2, wherein the pre-formed, biased shape includes a J-shaped configuration.

7. The lead of claim 2, wherein the pre-formed, biased shape includes at least one curve in the lead body dimensioned to provide at least two surfaces positioned to contact opposing walls of the pulmonary artery.

8. The lead of claim 1, wherein the at least one electrode includes a defibrillation coil electrode.

9. The lead of claim 1, wherein the at least one electrode includes a stent-like electrode adapted to expand into contact with a pulmonary artery wall, the expanded stent-like electrode being passively-fixed within the pulmonary artery.

10. The lead of claim 1, wherein the at least one electrode includes a ring electrode or a tip electrode.

11. The lead of claim 1, wherein the lead body includes a lumen through an entire length of the lead body to allow the lead to be implanted over a guide wire.

12. An implantable medical device, comprising:

at least one port to connect to at least one lead adapted to extend through a pulmonary valve to securely position at least one electrode within a pulmonary artery;

stimulation circuitry connected to the at least one port and adapted to use the at least one lead to apply neural stimulation to a vagal neural pathway and to apply myocardial stimulation to capture atrial tissue; and

a controller connected to the stimulation circuitry to control application of the neural stimulation and the myocardial stimulation.

13. The device of claim 12, wherein the controller is adapted to apply neural stimulation to the vagal neural pathway to lower a stimulation threshold of the atrial tissue in preparation to apply myocardial stimulation to capture the atrial tissue.

14. The device of claim 12, further comprising an atrial intrinsic event detector connected to the at least one port and to the controller, the detector being adapted to use the at least one lead to sense atrial events.

15. The device of claim 14, wherein the controller is adapted to use sensed atrial events as feedback for the neural stimulation to the vagal neural pathway to control atrial rhythm.

16. The device of claim 12, further comprising an atrial intrinsic event detector connected to the at least one port and to the controller, the detector being adapted to use the at least one lead to sense atrial events, wherein the stimulation circuitry includes a pace generator connected to the controller and to the at least one port to pace atrial tissue using the at least one lead, and the controller is adapted to use sensed atrial events as feedback for pacing the atrial tissue.

17. The device of claim 12, further comprising an atrial intrinsic event detector connected to the at least one port and to the controller, the detector being adapted to use the at least one lead to sense an atrial tachycardia, wherein the stimulation circuitry includes shock generator connected to the controller and to the at least one port to shock atrial tissue using the at least one lead, and the controller is adapted to respond to a sensed atrial tachycardia from the detector to control the stimulation circuitry to apply a shock to the atrial tissue.

18. The device of claim 12, further comprising an atrial intrinsic event detector connected to the at least one port and to the controller, the detector being adapted to use the at least one lead to sense an atrial fibrillation, wherein the stimulation circuitry includes shock generator connected to the controller and to the at least one port to shock atrial tissue using the at least one lead, and the controller is adapted to respond to a sensed atrial fibrillation from the detector to control the stimulation circuitry to apply a shock to the atrial tissue.

19. The device of claim 12, wherein:

at least one electrode is securely positioned within a right pulmonary artery and adapted to capture right atrial tissue, and at least one electrode is securely positioned within a left pulmonary artery and adapted to capture left atrial tissue;

the stimulation circuitry is adapted to use the at least one lead to apply neural stimulation to apply myocardial stimulation to capture both the right and left atrial tissue; and

the controller is adapted to control application of the myocardial stimulation to the left and right atrial tissue.

20. The device of claim 12, wherein:

the at least one port is adapted to connect to a bifurcated lead having a lead body connected to a first branch and a second branch;

the lead body being adapted to be fed into a right atrium, through a tricuspid valve, into a right ventricle, and through the pulmonary valve;

the first branch including a distal end adapted to securely position at least one electrode in a right pulmonary artery; and

the second branch including a distal end adapted to securely position at least one electrode in a left pulmonary artery.