Subcutaneous cardiac stimulator employing post-shock transthoracic asystole prevention pacing
First Claim
1. A method of providing subcutaneous cardiac stimulation, comprising:
- detecting from a subcutaneous, non-intrathoracic vector, cardiac asystole subsequent to delivery of a defibrillation therapy, energy for the defibrillation therapy provided by a subcutaneous, non-intrathoracic defibrillation energy storage source; and
delivering, from the same or different subcutaneous, non-intrathoracic vector, a pacing therapy to terminate the detected cardiac asystole using residual energy from the defibrillation energy storage source.
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Accused Products
Abstract
Transthoracic cardiac stimulation therapies provide for detection and treatment of cardiac asystole subsequent to delivery of a defibrillation therapy. A pacing therapy is transthoracicly delivered to terminate detected cardiac asystole using residual energy from a defibrillation energy storage source. The residual energy usable for the pacing therapy is sufficient to transthoracicly deliver at least one pacing pulse, and is typically sufficient to deliver a series of pacing pulses, prior to depletion of the defibrillation energy storage source. Detection of cardiac asystole is performed following delivery of each pacing pulse, and subcutaneous pacing support is terminated in response to detecting cardiac asystole termination.
145 Citations
83 Claims
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1. A method of providing subcutaneous cardiac stimulation, comprising:
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detecting from a subcutaneous, non-intrathoracic vector, cardiac asystole subsequent to delivery of a defibrillation therapy, energy for the defibrillation therapy provided by a subcutaneous, non-intrathoracic defibrillation energy storage source; and delivering, from the same or different subcutaneous, non-intrathoracic vector, a pacing therapy to terminate the detected cardiac asystole using residual energy from the defibrillation energy storage source. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A method of providing subcutaneous cardiac stimulation, comprising:
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detecting, from within a patient, cardiac asystole subsequent to delivery of a defibrillation therapy; and transthoracicly delivering, from within the patient, a non-physiologic, life sustaining pacing therapy at a rate substantially lower than a bradycardia pacing rate to terminate the detected cardiac asystole. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
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35. A method of providing subcutaneous cardiac stimulation, comprising:
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detecting, from with a patient, cardiac asystole subsequent to delivery of a defibrillation therapy; and transthoracicly delivering, from within the patient, a life sustaining pacing therapy at a rate insufficient to restore full patient consciousness to terminate the detected cardiac asystole. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42)
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43. A method of providing subcutaneous cardiac stimulation, comprising:
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delivering, from a subcutaneous, non-intrathoracic vector, a pacing therapy in response to detecting a condition necessitating pacing therapy delivery, energy for the pacing therapy delivery provided by a subcutaneous, non-intrathoracic cardioversion/defibrillation energy storage source; and delivering, from the same or a different subcutaneous, non-intrathoracic vector, a cardioversion or defibrillation therapy in response to detecting a cardiac arrhythmia necessitating the cardioversion or defibrillation therapy, energy for the cardioversion or defibrillation therapy provided by the subcutaneous, non-intrathoracic cardioversion/defibrillation energy storage source. - View Dependent Claims (44, 45)
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46. An apparatus for providing subcutaneous cardiac stimulation, comprising:
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an implantable housing; energy delivery circuitry provided in the housing, the energy delivery circuitry comprising a defibrillation energy storage source; first and second electrodes respectively coupled to the energy delivery circuitry and arranged in a spaced relationship with respect to cardiac tissue and vasculature for subcutaneous, non-intrathoracic cardiac sensing and energy delivery; and
detectionlcontrol circuitry provided in the housing and coupled to the energy delivery circuitry, the detection/control circuitry detecting cardiac asystole subsequent to delivery of a defibrillation therapy and transthoracicly delivering a pacing therapy via the energy delivery circuitry to terminate the detected cardiac asystole using residual energy from the defibrillation energy storage source, wherein the residual energy used for delivering the pacing therapy is sufficient to transthoracicly deliver a single pacing pulse, and the detection/control circuitry, following delivery of the single pacing pulse, initiates recharging of the defibrillation energy storage source to a recharge level less than a level associated with defibrillation therapy delivery. - View Dependent Claims (47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69)
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70. An apparatus for providing subcutaneous cardiac stimulation, comprising:
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an implantable housing; energy delivery circuitry provided in the housing; first and second electrodes respectively coupled to the energy delivery circuitry and arranged in a spaced relationship with respect to cardiac tissue and vasculature for subcutaneous, non-intrathoracic cardiac sensing and energy delivery, one or both of the first and second electrodes provided on a support structure outwardly extending from the housing, all or a portion of the support structure comprises a shape adjustable arrangement, whereby an orientation between the first and second electrodes is alterable in response to manual manipulation of the shape adjustable arrangement; and a detection/control circuitry provided in the housing and coupled to the energy delivery circuitry, the detection/control circuitry detecting cardiac asystole subsequent to delivery of a defibrillation therapy and transthoracicly delivering a non-physiologic, life sustaining pacing therapy to terminate the detected cardiac asystole. - View Dependent Claims (71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83)
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Specification