Body implantable defibrillation system

• US 5,545,202 A
• Filed: 08/04/1994
• Issued: 08/13/1996
• Est. Priority Date: 06/06/1990
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lang, Douglas J., Swanson, David K., Hahn, Stephen J., Dahl, Roger W., Heil, John E.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US08/285,802
• Time in Patent Office: 740 Days
• Field of Search: 607/119, 607/129, 607/116, 607/148, 607/152, 607/5, 128/642
• US Class Current: 607/129
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence

Abstract

Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.

Claims

1. A body implantable defibrillation system, including:

a defibrillation pulse generator;

a first defibrillation electrode implanted at least proximate the thoracic region, said first electrode including a plurality of compliant, electrically conductive electrode segments, each segment having a nominal width and a length exceeding the nominal width;

a connecting means for electrically coupling the electrode segments for substantially simultaneous reception of defibrillation pulses from the defibrillation pulse generator;

said electrode segments being arranged in spaced apart and side-by-side relation such that each of the electrode segments, over most of its length, is spaced apart from each of the other electrode segments by a distance of at least 1.5 cm;

each of the electrode segments being free of electrically insulative material at and along its periphery over the entire length and periphery of the electrode segment;

said electrode segments when receiving the defibrillation pulses cooperating to define an effective electrode area incorporating all of the electrode segments;

a first coupling means electrically coupling the first defibrillation electrode and the defibrillation pulse generator;

a second defibrillation electrode implanted at least proximate the thoracic region and spaced apart from the first defibrillation electrode; and

a second coupling means electrically coupling the defibrillation pulse generator and the second electrode.

2. The defibrillation system of claim 1 further including:

an intravascular catheter positioned to locate a distal region thereof in the right atrium and the right ventricle of the heart, with a distal end thereof proximate the apex of the right ventricle, wherein the second electrode is mounted at said distal region.

3. The defibrillation system of claim 2 further including:

a means for securing the first defibrillation electrode to epicardial tissue.

4. The defibrillation system of claim 3 further including:

a means for fixing the first defibrillation electrode inside of the pleural cavity, to the left of and anterior with respect to the heart.

5. The defibrillation system of claim 3 further including:

a means for fixing the first defibrillation electrode at the sternum.

6. The defibrillation system of claim 3 further including:

a means for fixing the first defibrillation electrode subcutaneously, proximate the pleural cavity and outside of the rib cage to the left of and anterior with respect to the heart.

7. The defibrillation system of claim 1 wherein:

said second electrode is of a construction substantially identical to that of the first defibrillation electrode, and wherein the first and second defibrillation electrodes are subcutaneous, proximate the pleural cavity, outside of the rib cage and on opposite sides of the heart.

8. The defibrillation system of claim 7 further including:

a means for fixing the first defibrillation electrode to the left of and anterior with respect to the heart, and a means for fixing the second defibrillation electrode to the right of and posterior with respect to the heart.

9. The defibrillation system of claim 1 wherein:

said defibrillation pulse generator includes sensing circuitry for sensing cardiac electrical activity, and a means for electrically coupling the first defibrillation electrode to the sensing circuitry, whereby said first defibrillation electrode, when not receiving the defibrillation pulses, is used with said circuitry in sensing cardiac electrical activity.