Bradycardia pacing in a subcutaneous device

• US 7,751,885 B2
• Filed: 10/27/2006
• Issued: 07/06/2010
• Est. Priority Date: 09/18/2000
• Status: Expired due to Fees

• Current Assignee: Cameron Incorporated (Schlumberger NV)
• Original Assignee: Cameron Incorporated (Schlumberger NV)
• Inventors: Rissmann, William J., Bardy, Gust H., Cappato, Riccardo
• Primary Examiner(s): Manuel; George
• Assistant Examiner(s): Wieland; Robert N
• Application Number:
  US11/553,785
• Publication Number:
  US 20070049979A1
• Time in Patent Office: 1,348 Days
• Field of Search: 607/9, 607 1- 5, 607/17, 607/20, 607/23, 607/31, 607/37, 607/119, 607/129, 607/132, 600/365
• US Class Current: 607/9
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings
• 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 1/39622 Pacing therapy
• 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

Methods of medically treating a patient by the use of anti-bradycardia pacing using a totally subcutaneous, non-transvenous system. Some examples include the application of pacing pulses to a patient at a pacing rate that is above a predetermined level. One example of a totally subcutaneous, non-transvenous system includes 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 medically treating a person comprising:

estimating the person'"'"'s cardiac rate;

determining whether the person'"'"'s cardiac rate is at or below a predetermined level;

if so, applying a series of electrical pacing pulses to the person between a first electrode disposed at a subcutaneous location over the person'"'"'s ribs as part of a lead assembly, and a second electrode disposed on a canister implanted in the person, the lead assembly being coupled to the canister; and

wherein the series of pacing pulses is applied at a pacing rate that is faster than the predetermined level, and the pacing pulses are applied via a totally subcutaneous, non-transvenous system.

2. The method of claim 1, wherein the predetermined level is in the range of approximately 20 to approximately 40 beats per minute.

3. The method of claim 2, wherein the series of pacing pulses is applied at a rate of approximately 50 stimuli/minute.

4. The method of claim 1, wherein the series of pacing pulses is applied at a rate in the range of approximately 40 to approximately 120 stimuli/minute.

5. The method of claim 1, wherein the series of pacing pulses includes pulses having peak amplitudes greater than 5 volts.

6. The method of claim 1, wherein the series of pacing pulses includes pulses having peak amplitudes in the range of 5-500 volts.

7. The method of claim 1, wherein the canister is disposed at about the level of the inframammary crease of the person and over the person'"'"'s ribs.

8. The method of claim 1, wherein:

the predetermined level is in the range of approximately 20 to approximately 40 beats per minute;

the series of pacing pulses is applied at a rate in the range of approximately 40 to approximately 120 stimuli/minute;

the series of pacing pulses includes pulses having peak amplitudes in the range of 5-500 volts; and

the canister is disposed at about the level of the inframammary crease of the person and over the person'"'"'s ribs.

9. A method of medically treating a person comprising:

estimating the person'"'"'s cardiac rate;

determining whether the person'"'"'s cardiac rate is at or below a predetermined level; and

,

if so, applying a series of electrical pacing pulses to the person;

wherein;

the pacing pulses are applied using a totally subcutaneous, non-transvenously located means for stimulating the heart; and

the series of pacing pulses is applied at a rate that exceeds the predetermined level.

10. The method of claim 9, wherein the means for stimulating the heart includes a canister having an electrode disposed thereon, the electrode being used as one of an anode or a cathode for at least one of the pacing pulses.

11. The method of claim 9, wherein the means for stimulating the heart are disposed subcutaneously over the person'"'"'s ribs on the left side of the person'"'"'s body.

12. The method of claim 9, wherein the predetermined level is in the range of approximately 20 to approximately 40 beats per minute.

13. The method of claim 9, wherein the series of pacing pulses is applied at a rate of approximately 50 stimuli/minute.

14. The method of claim 9, wherein the series of pacing pulses is applied at a rate in the range of approximately 40 to approximately 120 stimuli/minute.

15. The method of claim 9, wherein the series of pacing pulses includes pulses having peak amplitudes in the range of 5-500 volts.

16. The method of claim 9, wherein:

the predetermined level is in the range of approximately 20 to approximately 40 beats per minute;

the series of pacing pulses is applied at a rate in the range of approximately 40 to approximately 120 stimuli/minute; and

the series of pacing pulses includes pulses having peak amplitudes in the range of 5-500 volts.

17. A method of medically treating a person comprising:

detecting that the person is likely experiencing an arrhythmia using totally subcutaneously, non-transvenously implanted cardiac stimulus system that does not directly contact the heart; and

performing a step for stimulating the person'"'"'s heart to beat at a higher rate by applying electrical pacing stimuli using said cardiac stimulus system having a subcutaneously implanted electrode disposed on a lead assembly and an electrode disposed on a canister coupled to the lead assembly.

18. The method of claim 17, wherein:

the stimuli include a series of pacing pulses is applied at a rate in the range of approximately 40 to approximately 120 stimuli/minute;

the series of pacing pulses includes pulses having peak amplitudes in the range of 5-500 volts; and

the canister is disposed at about the level of the inframammary crease of the person and over the person'"'"'s ribs.