Modular antitachyarrhythmia therapy system

• US 9,352,164 B2
• Filed: 06/01/2015
• Issued: 05/31/2016
• Est. Priority Date: 05/18/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Smith, Joseph M., Dujmovic, Richard Milton Jr.
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/726,688
• Publication Number:
  US 20150258345A1
• Time in Patent Office: 365 Days
• Field of Search: 607/4, 607/32, 607/60
• US Class Current: 1/1
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• 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 1/3987 characterised by the timing or triggering of the shock

Abstract

This document discusses, among other things, a modular antitachyarrhythmia therapy system. In an example, a modular antitachyarrhythmia system includes at least two separate modules that coordinate delivery an antitachyarrhythmia therapy, such as defibrillation therapy. In another example, a modular antitachyarrhythmia therapy system includes a sensing module, an analysis module, and a therapy module.

Claims

1. A subcutaneous implantable defibrillator (SID), the SID comprising:

a housing configured to be implanted subcutaneously in a patient external to the heart of the patient;

one or more electrodes configured to be disposed external to the heart;

a shock module configured to at least partially deliver anti-tachyarrhythmia shock therapy to a patient via the one or more electrodes;

a communication module configured to at least one of transmit or receive communication messages with a second therapy device having a pacing therapy capability and configured to be implanted within a heart of the patient;

a sensing module configured to sense an electrical signal from the heart of the patient via the one or more electrodes; and

a controller circuit configured to;

detect a tachyarrhythmia within the sensed electrical signal;

determine, based on the detected tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected tachyarrhythmia; and

transmit, via the communication module, a communication message to the second therapy device requesting the second therapy device deliver anti-tachycardia pacing to the heart of the patient.

2. The SID of claim 1 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device before delivering a shock.

3. The SID of claim 1 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device to coordinate therapy therewith.

4. The SID of claim 1 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device to direct therapy delivery of the anti-tachycardia pacing.

5. The SID of claim 1 wherein the second therapy device is a leadless device.

6. The SID of claim 1 wherein the communication module is configured for wireless communication using conduction through the body.

7. The SID of claim 1 wherein the communication module is configured for wireless communication using a radio frequency signal.

8. The SID of claim 1 wherein the communication module is configured for wireless communication using inductive coupling.

9. The SID of claim 1 wherein the housing is configured to be implanted subcutaneously between the ribs of the patient.

10. A subcutaneous implantable cardioverter defibrillator (SICD), the SICD comprising:

a housing configured to be implanted in a patient external to a rib cage of the patient;

one or more electrodes configured to be disposed external to the patient'"'"'s heart;

a shock module configured to at least partially deliver anti-tachyarrhythmia shock therapy to a patient via the one or more electrodes;

a communication module configured to at least one of transmit or receive communication messages between a leadless pacing device (LPD) configured to be implanted within a heart of the patient;

a sensing module configured to sense an electrical signal from the heart of the patient via the one or more electrodes; and

a processor configured to;

detect a tachyarrhythmia within the sensed electrical signal;

determine, based on the detected tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected tachyarrhythmia; and

transmit, via the communication module and prior to delivering anti-tachyarrhythmia shock therapy, a communication message to the LPD requesting the LPD deliver anti-tachycardia pacing to the heart of the patient.

11. The SICD of claim 10 wherein the housing is configured to be implanted subcutaneously between the ribs of the patient.

12. The SICD of claim 10 wherein the one or more electrodes are configured to be disposed external to the rib cage of the patient.

13. The SICD of claim 10 wherein the one or more electrodes are configured to be disposed between the ribs of the patient.

15. The method of claim 13 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device before delivering a shock.

16. The method of claim 13 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device to coordinate therapy therewith.

17. The method of claim 13 wherein the controller circuit is further configured such that it will transmit, via the communication module, the communication message to the second therapy device to direct therapy delivery of the anti-tachycardia pacing.

18. The method of claim 13 wherein the second therapy device is a leadless device.

19. The method of claim 13 wherein the communication module is configured for wireless communication using conduction through the body.

20. The method of claim 13 wherein the communication module is configured for wireless communication using a radio frequency signal.

21. The method of claim 13 wherein the communication module is configured for wireless communication using inductive coupling.

22. The method of claim 13 wherein the second therapy device is configured to receive the transmitted communication from the communication module and deliver anti-tachycardia pacing in response thereto.

23. The method of claim 13 wherein the SID is further configured to schedule delivery of the anti-tachyarrhythmia shock relative to the anti-tachycardia pacing of the second therapy device.

14. A method of treating a patient comprising:

implanting a first module comprising a subcutaneous implantable defibrillator (SID) at a predetermined subcutaneous location outside of the heart of the patient; and

implanting a second therapy device within the heart of the patient;

wherein the SICD comprises;

a housing configured to be implanted subcutaneously in a patient external to the heart of the patient;

one or more electrodes configured to be disposed external to the heart;

a shock module configured to at least partially deliver anti-tachyarrhythmia shock therapy to a patient via the one or more electrodes;

a communication module configured to at least one of transmit or receive communication messages with a second therapy device having a pacing therapy capability and configured to be implanted within a heart of the patient;

a sensing module configured to sense an electrical signal from the heart of the patient via the one or more electrodes; and

a controller circuit configured to direct operations of the first module; and

further wherein the controller circuit of the SID is configured to;

detect a tachyarrhythmia within the electrical signal sensed by the sensing module;

determine, based on the detected tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected tachyarrhythmia; and

transmit, via the communication module, a communication message to the second therapy device requesting the second therapy device deliver anti-tachycardia pacing to the heart of the patient.