Implantable cardiac stimulus methods

• US 7,627,375 B2
• Filed: 06/12/2006
• Issued: 12/01/2009
• 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:
  US11/451,241
• Publication Number:
  US 20060235479A1
• Time in Patent Office: 1,268 Days
• Field of Search: 607/10
• US Class Current: 607/14
• 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-bradycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient'"'"'s heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.

Claims

1. A method of treating a patient comprising:

providing an implanted cardiac stimulus system having a canister and a lead assembly, the system being provided such that it does not contact or enter the heart;

detecting cardiac activity by capturing electrical signals from the heart using electrodes which do not contact or enter the heart;

determining whether cardiac stimulus appears to be indicated; and

, if so,

delivering cardiac stimulus using electrodes which do not contact or enter the heart, the cardiac stimulus having a peak amplitude in the range of 25-50 volts.

2. The method of claim 1, wherein the step of delivery cardiac stimulus is performed such that the cardiac stimulus has a duration in the range of 1-40 milliseconds.

3. A method of treating bradycardia comprising performing the method of claim 2.

4. A method of treating tachyarrhythmia comprising performing the method of claim 2.

5. The method of claim 1 wherein the system includes a canister and the lead assembly includes only a single elongate member having a first end secured at the canister and a second end, the single elongate member comprising at least a coil electrode and a sense electrode disposed nearer the second end than the first end and a plurality of conductors providing electrical connection between the electrodes and lead connectors at the canister.

6. A method of treating a patient comprising:

providing an implanted cardiac stimulus system having a canister and a lead assembly, the system being provided such that it does not contact or enter the heart;

detecting cardiac activity by capturing electrical signals from the heart using electrodes which do not contact or enter the heart;

determining whether cardiac stimulus appears to be indicated; and

, if so,

delivering cardiac stimulus using electrodes which do not contact or enter the heart, the cardiac stimulus having a peak amplitude in the range of 50-75 volts.

7. The method of claim 6, wherein the step of delivery cardiac stimulus is performed such that the cardiac stimulus has a duration in the range of 1-40 milliseconds.

8. A method of treating bradycardia comprising performing the method of claim 7.

9. A method of treating tachyarrhythmia comprising performing the method of claim 7.

10. The method of claim 6 wherein the system includes a canister and the lead assembly includes only a single elongate member having a first end secured at the canister and a second end, the single elongate member comprising at least a coil electrode and a sense electrode disposed nearer the second end than the first end and a plurality of conductors providing electrical connection between the electrodes and lead connectors at the canister.

11. A method of treating a patient comprising:

providing an implanted cardiac stimulus system having a canister and a lead assembly, the system being provided such that it does not contact or enter the heart;

detecting cardiac activity by capturing electrical signals from the heart using electrodes which do not contact or enter the heart;

determining whether cardiac stimulus appears to be indicated; and

, if so,

delivering cardiac stimulus using electrodes which do not contact or enter the heart, the cardiac stimulus having a peak amplitude in the range of 0.1-25 volts.

12. The method of claim 11, wherein the step of delivery cardiac stimulus is performed such that the cardiac stimulus has a duration in the range of 1-40 milliseconds.

13. A method of treating bradycardia comprising performing the method of claim 12.

14. A method of treating tachyarrhythmia comprising performing the method of claim 12.

15. The method of claim 11 wherein the system includes a canister and the lead assembly includes only a single elongate member having a first end secured at the canister and a second end, the single elongate member comprising at least a coil electrode and a sense electrode disposed nearer the second end than the first end and a plurality of conductors providing electrical connection between the electrodes and lead connectors at the canister.

16. A method of treating a patient comprising:

providing an implantable cardiac stimulus system consisting of;

a) a canister housing operational circuitry and a battery;

b) a lead assembly consisting of a single elongate member coupled to the canister at a first end thereof and having a plurality of electrodes disposed at or near a second end thereof, with a plurality of electrical conductors extending therein;

implanting the implantable cardiac stimulus system into a patient such that neither the canister nor the lead electrode assembly touches or enters the heart or resides in an intrathoracic blood vessel;

detecting cardiac activity by the observation of electrical signals generated in the patient'"'"'s heart;

determining whether cardiac stimulus appears to be indicated; and

, if so,

delivering cardiac stimulus.

17. The method of claim 16, wherein the canister further includes an electrode disposed thereon and the step of delivering cardiac stimulus includes using the electrode disposed on the canister.

18. The method of claim 16, wherein the cardiac stimulus has a duration in the range of 1-40 milliseconds.

19. The method of claim 16, wherein the cardiac stimulus has a peak amplitude in the range of 25-50 volts.

20. The method of claim 16, wherein the cardiac stimulus has a peak amplitude in the range of 50-75 volts.

21. The method of claim 16, wherein the cardiac stimulus has a peak amplitude in the range of 1-25 volts.