Nonvascular implantable defibrillator and method

• US 7,536,222 B2
• Filed: 11/09/2004
• Issued: 05/19/2009
• Est. Priority Date: 09/18/2000
• Status: Expired due to Term

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Rissmann, William J., Bardy, Gust H., Cappato, Riccardo
• Primary Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US10/984,585
• Publication Number:
  US 20050065559A1
• Time in Patent Office: 1,652 Days
• Field of Search: None
• US Class Current: 607/4
• CPC Class Codes: A61N 1/37512 Pacemakers
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3906 characterised by the form of the shockwave
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3968 Constructional arrangements, e.g. casings A61N1/375 takes precedence
• CPC Class Codes: A61N 1/3975 Power supply A61N1/378 takes precedence

Abstract

A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient'"'"'s heart or reside in the intrathoracic blood vessels and for providing anti-tachycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-tachycardia pacing energy for delivery to the patient'"'"'s heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-tachycardia pacing energy to the capacitor subsystem.

Claims

1. A method of treating a patient comprising providing a voltage difference between two electrodes placed in the torso of the patient at non-vascular locations, the two electrodes disposed such that a first electrode is placed on an implanted canister containing circuitry for providing the voltage difference, and a second electrode is disposed as part of a lead system coupled to the canister;

wherein the two electrodes are placed in the torso of the patient at locations exclusive of the heart, such locations being non-epicardial and non-intracardiac, and all electrodes and leads of the system are disposed between the patient'"'"'s ribcage and skin.

2. The method of claim 1, wherein the electrodes are disposed such that a line drawn between the first and second electrodes intersects a portion of the heart.

3. The method of claim 2, wherein the first electrode is disposed along the inframammary crease.

4. The method of claim 1, further comprising sensing a portion of the patient'"'"'s cardiac rhythm using the first electrode and a third electrode also disposed in the patient exclusive of the patient'"'"'s heart and between the patient'"'"'s ribcage and skin.

5. The method of claim 4, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to induce fibrillation.

6. The method of claim 4, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to alleviate fibrillation.

7. The method of claim 4, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to improve pacing of the cardiac rhythm.

8. The method of claim 7 wherein the voltage difference is provided to treat tachyarrhythmia by artificially pacing the cardiac rhythm.

9. The method of claim 1, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to induce fibrillation.

10. The method of claim 1, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to alleviate fibrillation.

11. The method of claim 1, wherein the voltage difference is provided at a time in the patient'"'"'s cardiac rhythm chosen to improve pacing of the cardiac rhythm.

12. The method of claim 11 wherein the voltage difference is provided to treat a tachyarrhythmia by artificially pacing the cardiac rhythm.

13. The method of claim 1, wherein the first electrode is disposed along the left axillary line.

14. A method of treating a patient comprising:

implanting an electrical stimulus device into the torso of the patient; and

implanting a lead system into the torso of the patient;

wherein;

the electrical stimulus device includes a housing and circuitry contained in the housing, the housing including an electrode;

the lead system is implanted such that the patient'"'"'s heart is not contacted or entered by the lead system; and

the circuitry is adapted to provide a stimulus to the patient'"'"'s heart using a first electrode disposed as part of the lead system and the electrode on the housing.

15. The method of claim 14, wherein the circuitry is adapted to operate in a number of modes, wherein a first mode is configured to induce fibrillation of the patient'"'"'s heart.

16. The method of claim 15, wherein the first mode includes a configuration for sensing at least a part of the patient'"'"'s cardiac rhythm and providing a stimulus corresponding to the patient'"'"'s T-wave.

17. The method of claim 15, wherein the first mode includes a configuration for outputting a stimulus for a duration approximating a period of the patient'"'"'s cardiac rhythm.

18. The method of claim 14, wherein the circuitry is adapted to operate in a number of modes, wherein a first mode is configured to provide a pacing output to control the patient'"'"'s heart rate.

19. The method of claim 18, wherein the first mode is adapted to treat tachycardia.

20. The method of claim 14, wherein the circuitry is adapted to operate in a number of modes, wherein a first mode is configured to provide a defibrillation output to cause fibrillation of the patient'"'"'s heart to stop.

21. The method of claim 14, wherein the circuitry is adapted to operate in a number of modes including:

a first mode configured to induce fibrillation of the patient'"'"'s heart; and

a second mode configured to provide cardiac therapy.

22. The method of claim 21, wherein the second mode is adapted to treat bradycardia.

23. The method of claim 21, wherein the second mode is adapted to treat tachycardia.

24. The method of claim 21, wherein the second mode is adapted to treat fibrillation.

25. The method of claim 14, wherein the circuitry is adapted to operate in a number of modes including:

a first mode configured to induce fibrillation of the patient'"'"'s heart;

a second mode configured to provide pacing therapy; and

a third mode configured to treat fibrillation of the patient'"'"'s heart.