Leadless cardiac pacemaker system for usage in combination with an implantable cardioverter-defibrillator

• US 9,409,033 B2
• Filed: 10/16/2015
• Issued: 08/09/2016
• Est. Priority Date: 10/14/2005
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Jacobson, Peter M.
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US14/885,853
• Publication Number:
  US 20160030757A1
• Time in Patent Office: 298 Days
• US Class Current: 1/1
• CPC Class Codes: A61M 25/0662 Guide tubes
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/059 Anchoring means
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• 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 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/3704 Circuits specially adapted therefor, e.g. for sensitivity control
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/3708 for power depletion
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37217 characterised by the communication link, e.g. acoustic or tactile
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/3727 characterised by the modulation technique
• CPC Class Codes: A61N 1/37288 : Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/37512 : Pacemakers
• CPC Class Codes: A61N 1/37518 : Anchoring of the implants, e.g. fixation
• 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 2001/058 : Fixing tools
• CPC Class Codes: H04B 13/005 : Transmission systems in which the medium consists of the human body

Abstract

A cardiac pacing system comprising one or more leadless cardiac pacemakers configured for implantation in electrical contact with a cardiac chamber and configured to perform cardiac pacing functions in combination with a co-implanted implantable cardioverter-defibrillator (ICD). The leadless cardiac pacemaker comprises at least two leadless electrodes configured for delivering cardiac pacing pulses, sensing evoked and/or natural cardiac electrical signals, and bidirectionally communicating with the co-implanted ICD.

Claims

1. A method of operating a cardiac pacing system comprising:

using electrodes of a leadless cardiac pacemaker to deliver cardiac pacing pulses to a cardiac chamber and to sense evoked or natural cardiac electrical signals in the cardiac chamber;

using one or more electrodes of a subcutaneous implantable cardioverter-defibrillator (SICD) to sense cardiac signals in one or more chambers of the patient'"'"'s heart;

detecting a tachycardia from the sensed cardiac signals using an electrical circuit of the SICD; and

communicating a command to the leadless cardiac pacemaker to deliver overdrive anti-tachycardia pacing in response to a detected tachyarrhythmia using the electrical circuit of the SICD.

2. The method of claim 1 further comprising communicating a code to the SICD signifying the occurrence of sensed cardiac electrical signals or delivered pacing pulses, identifying at least one of an event type or location, using the same electrodes of the leadless cardiac pacemaker used to deliver cardiac pacing pulses.

3. The method of claim 2, wherein the SICD is used only to sense far-field signals.

4. The method of claim 2, wherein the code is delivered to the SICD using a coded pulse with a code assigned according to the leadless pacemaker location.

5. The method of claim 2, wherein the code is delivered to the SICD using a coded pulse triggered by a sensed heartbeat in a natural refractory period following the heartbeat.

6. A cardiac therapy system comprising:

a leadless cardiac pacemaker configured for implantation in electrical contact with a cardiac chamber of a patient'"'"'s heart and configured to deliver cardiac pacing pulses to the cardiac chamber and to sense evoked and/or natural cardiac electrical signals in the cardiac chamber;

a subcutaneous implantable cardioverter-defibrillator (SICD) configured for implantation within a torso of the patient, the SICD including a housing, an electrical circuit contained within the housing and a subcutaneous lead having one or more electrodes coupled to the electrical circuit, the one or more electrodes being configured to sense cardiac signals in one or more chambers of the patient'"'"'s heart;

the electrical circuit being configured to detect a tachycardia from the sensed cardiac signals, wherein the electrical circuit is further configured to communicate a command to the leadless cardiac pacemaker to deliver overdrive anti-tachycardia pacing in response to a detected tachyarrhythmia.

7. The cardiac therapy system of claim 6, wherein the leadless cardiac pacemaker is configured to:

deliver cardiac pacing pulses to the cardiac chamber using electrodes; and

communicate coded information to the SICD using the same electrodes.

8. A method of operating a cardiac pacing system comprising:

using electrodes of a leadless cardiac pacemaker to deliver cardiac pacing pulses to a cardiac chamber and to sense evoked or natural cardiac electrical signals in the cardiac chamber;

detecting a tachycardia using an electrical circuit of a subcutaneous implantable cardioverter-defibrillator (SICD); and

using the electrical circuit of the SICD to communicate a therapy command to the leadless cardiac pacemaker that configures the leadless pacemaker to deliver overdrive anti-tachycardia pacing in response to the detected tachycardia.

9. The method of claim 8, further comprising communicating a code to the SICD signifying the occurrence of sensed cardiac electrical signals or delivered pacing pulses, identifying at least one of an event type or location, using the same electrodes of the leadless cardiac pacemaker used to deliver cardiac pacing pulses.

10. The method of claim 9, wherein the code is delivered to the SICD using a coded pulse with a code assigned according to the leadless pacemaker location.

11. The method of claim 9, wherein the code is delivered to the SICD using a coded pulse triggered by a sensed heartbeat in a natural refractory period following the heartbeat.

12. The method of claim 9, wherein the electrical circuit of the SICD uses the code to detect the tachycardia.