Source: http://www.google.com/patents/US20040230273?dq=5998925
Timestamp: 2016-09-27 07:10:42
Document Index: 655689575

Matched Legal Cases: ['art 510', 'art 510', 'art 510', 'art 510', 'art 510', 'art 510']

Patent US20040230273 - Subcutaneous electrode and lead with temporary pharmacological agents - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsAn implantable subcutaneous device and method employ a lead and an electrode for cardiac monitoring and intervention. The device includes an implantable lead having a lead body, a subcutaneous electrode coupled to the lead body, and a pharmacological agent provided on the implantable lead and/or electrode....http://www.google.com/patents/US20040230273?utm_source=gb-gplus-sharePatent US20040230273 - Subcutaneous electrode and lead with temporary pharmacological agentsAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS20040230273 A1Publication typeApplicationApplication numberUS 10/703,410Publication dateNov 18, 2004Filing dateNov 7, 2003Priority dateApr 11, 2003Also published asUS7529592Publication number10703410, 703410, US 2004/0230273 A1, US 2004/230273 A1, US 20040230273 A1, US 20040230273A1, US 2004230273 A1, US 2004230273A1, US-A1-20040230273, US-A1-2004230273, US2004/0230273A1, US2004/230273A1, US20040230273 A1, US20040230273A1, US2004230273 A1, US2004230273A1InventorsAdam Cates, Darrell Wagner, Curtis Lindstrom, Ron HeilOriginal AssigneeCates Adam W., Wagner Darrell Orvin, Lindstrom Curtis Charles, Ron HeilExport CitationBiBTeX, EndNote, RefManPatent Citations (99), Referenced by (73), Classifications (17), Legal Events (2) External Links: USPTO, USPTO Assignment, EspacenetSubcutaneous electrode and lead with temporary pharmacological agents
FIELD OF THE INVENTION [0002] The present invention relates generally to leads for subcutaneously implantable cardioverters/defibrillators and monitors, and, more particularly, to subcutaneously implantable leads provided with pharmacological agents. BACKGROUND OF THE INVENTION [0003] Implantable cardiac rhythm management systems have been used as an effective treatment for patients with serious arrhythmias. These systems typically include one or more leads and circuitry to sense signals from one or more interior and/or exterior surfaces of the heart. Such systems also include circuitry for generating electrical pulses that are applied to cardiac tissue at one or more interior and/or exterior surfaces of the heart. For example, leads extending into the patient's heart are connected to electrodes that contact the myocardium for sensing the heart's electrical signals and for delivering pulses to the heart in accordance with various therapies for treating arrhythmias. [0004] Typical implantable cardioverter/defibrillators (ICDs) include one or more endocardial leads to which at least one defibrillation electrode is connected. Such ICDs are capable of delivering high-energy shocks to the heart, interrupting the ventricular tachyarrythmia or ventricular fibrillation, and allowing the heart to resume normal sinus rhythm. ICDs may also include pacing functionality. [0005] Although ICDs are very effective at preventing Sudden Cardiac Death (SCD), most people at risk of SCD are not provided with implantable defibrillators. The primary reasons for this unfortunate reality include the limited number of physicians qualified to perform transvenous lead/electrode implantation, a limited number of surgical facilities adequately equipped to accommodate such cardiac procedures, and a limited number of the at-risk patient population that can safely undergo the required endocardial or epicardial lead/electrode implant procedure. For this reason, subcutaneous ICDs are being developed to overcome these issues. [0006] For reasons stated above, and for other reasons which will become apparent to those skilled in the art upon reading the present specification, there is a need for systems and methods that provide for sensing cardiac activity and delivering defibrillation and/or pacing therapies without the need for endocardial or epicardial leads/electrodes. There is a particular need for subcutaneous leads that improve patient comfort, reduce morbidity, and improve surgical outcomes. The present invention fulfills these and other needs, and addresses deficiencies in known systems and techniques. SUMMARY OF THE INVENTION [0007] The present invention is directed to subcutaneous leads and methods of using subcutaneous leads that improve patient comfort, reduce morbidity, and improve surgical outcomes by incorporating pharmacological agents. The device has an implantable lead including a lead body, a subcutaneous electrode coupled to the lead body and a pharmacological agent provided on the lead and/or electrode. The pharmacological agent provides a temporary therapeutic treatment to subcutaneous non-intrathoracic tissue. An implantable cardioverter/defibrillator system is also disclosed including a can with an implantable lead. One or more pharmacological agents may be provided on the lead and/or electrode and/or can. [0008] An embodiment of the present invention concerns combinations of pharmacological agents on leads, electrodes, and/or device housings (e.g., cans, active or non-active). Pharmacological agents with short temporary activity provided on electrodes are also described in combination with pharmacological agents on the can and/or lead body that can have longer term activity so as not to adversely interfere with electrical properties of the implantable cardioverter/defibrillator system. [0009] A method of implanting subcutaneous leads is described including providing a lead having a lead body, a subcutaneous electrode, and a pharmacological agent and delivering the pharmacological agent to subcutaneous non-intrathoracic tissue. The method may include providing a sheath and inserting the lead into the sheath. [0010] The above summary of the present invention is not intended to describe each embodiment or every implementation of the present invention. Advantages and attainments, together with a more complete understanding of the invention, will become apparent and appreciated by referring to the following detailed description and claims taken in conjunction with the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS [0011] [0011]FIGS. 1A and 1B are views of a transthoracic cardiac monitoring and/or stimulation device as implanted in a patient; [0012] [0012]FIG. 2A illustrates a lead in accordance with the present invention, inserted in a dissected subcutaneous path leading from the can; [0013] [0013]FIG. 2B illustrates various components of a transthoracic cardiac sensing and/or stimulation device positioned in accordance with embodiments of the invention; [0014] [0014]FIG. 3 is a plan view of a lead incorporating pharmacological agents in accordance with the present invention, enclosed within a sheath; [0015] [0015]FIG. 4 is a magnified view of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; [0016] [0016]FIG. 5 is a magnified view of another embodiment of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; [0017] [0017]FIG. 6 is a magnified view of another embodiment of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; [0018] [0018]FIG. 7 is a magnified view of another embodiment of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; [0019] [0019]FIG. 8 is a magnified view of another embodiment of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; [0020] [0020]FIG. 9 is a magnified view of another embodiment of a lead with an electrode incorporating pharmacological agents in accordance with the present invention; and [0021] [0021]FIG. 10 is a view of another embodiment of a can and lead with an electrode incorporating pharmacological agents in accordance with the present invention. [0022] While the invention is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail below. It is to be understood, however, that the intention is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims. DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS [0023] In the following description of the illustrated embodiments, references are made to the accompanying drawings, which form a part hereof, and in which is shown by way of illustration various embodiments in which the invention may be practiced. It is to be understood that other embodiments may be utilized, and structural and functional changes may be made without departing from the scope of the present invention. [0024] A device employing an implantable lead implemented in accordance with the present invention can incorporate one or more of the features, structures, methods, or combinations thereof described herein below. For example, a subcutaneous cardiac monitor or stimulator can be implemented to include one or more of the advantageous features and/or processes described below. It is intended that such a device or method need not include all of the features and functions described herein, but can be implemented to include selected features and functions that provide for unique structures and/or functionality. [0025] In general terms, an implantable lead implemented in accordance with the present invention can be used with a subcutaneous cardiac monitoring and/or stimulation device. One such device is an implantable transthoracic cardiac sensing and/or stimulation (ITCS) device that can be implanted under the skin in the chest region of a patient. The ITCS device may, for example, be implanted subcutaneously such that all or selected elements of the device are positioned on the patient's front, back, side, or other body locations suitable for sensing cardiac activity and delivering cardiac stimulation therapy. It is understood that elements of the ITCS device may be located at several different body locations, such as in the chest, abdominal, or subclavian region with electrode elements respectively positioned at different regions near, around, in, or on the heart. [0026] The primary housing (e.g., the active or non-active can) of the ITCS device, for example, can be configured for positioning outside of the rib cage at an intercostal or subcostal location, within the abdomen, or in the upper chest region (e.g., subclavian location, such as above the third rib). In one implementation, one or more electrodes can be located on the primary housing and/or at other locations about, but not in direct contact with the heart, great vessel or coronary vasculature. [0027] In another implementation, one or more leads incorporating electrodes can be located in direct contact with the heart, great vessel or coronary vasculature, such as via one or more leads implanted by use of conventional transvenous delivery approaches. In another implementation, for example, one or more subcutaneous electrode subsystems or electrode arrays can be used to sense cardiac activity and deliver cardiac stimulation energy in an ITCS device configuration employing an active can or a configuration employing a non-active can. Electrodes can be situated at anterior and/or posterior locations relative to the heart. [0028] Referring now to FIGS. 1A and 1B of the drawings, there is shown a configuration of a transthoracic cardiac sensing and/or stimulation (ITCS) device having components implanted in the chest region of a patient at different locations by use of a dissection tool. In the particular configuration shown in FIGS. 1A and 1B, the ITCS device includes a housing 102 within which various cardiac sensing, detection, processing, and energy delivery circuitry can be housed. The housing 102 is typically configured to include one or more electrodes (e.g., can electrode and/or indifferent electrode). Although the housing 102 is typically configured as an active can, it is appreciated that a non-active can configuration may be implemented, in which case at least two electrodes spaced apart from the housing 102 are employed. An ITCS system according to this approach is distinct from conventional approaches in that it is preferably configured to include a combination of two or more electrode subsystems that are implanted subcutaneously. [0029] In the configuration shown in FIGS. 1A and 1B, a subcutaneous electrode 104 can be positioned under the skin in the chest region and situated distal from the housing 102. The subcutaneous and, if applicable, housing electrode(s) can be positioned about the heart at various locations and orientations, such as at various anterior and/or posterior locations relative to the heart. The subcutaneous electrode 104 is electrically coupled to circuitry within the housing 102 via a lead assembly 106. One or more conductors (e.g., coils or cables) are provided within the lead assembly 106 and electrically couple the subcutaneous electrode 104 with circuitry in the housing 102. One or more sense, sense/pace or defibrillation electrodes can be situated on the elongated structure of the electrode support or the lead body 106, the housing 102, and/or the distal electrode assembly (shown as subcutaneous electrode 104 in the configuration shown in FIGS. 1A and 1B). [0030] In one configuration, the lead assembly 106 is generally flexible. In another configuration, the lead assembly 106 is constructed to be somewhat flexible, yet has an elastic, spring, or mechanical memory that retains a desired configuration after being shaped or manipulated by a clinician. For example, the lead assembly 106 can incorporate a gooseneck or braid system that can be distorted under manual force to take on a desired shape. In this manner, the lead assembly 106 can be shape-fit to accommodate the unique anatomical configuration of a given patient, and generally retains a customized shape after implantation. Shaping of the lead assembly 106 according to this configuration can occur prior to, and during, ITCS device implantation. [0031] In accordance with a further configuration, the lead assembly 106 includes a rigid electrode support assembly, such as a rigid elongated structure that positionally stabilizes the subcutaneous electrode 104 with respect to the housing 102. In this configuration, the rigidity of the elongated structure maintains a desired spacing between the subcutaneous electrode 104 and the housing 102, and a desired orientation of the subcutaneous electrode 104/housing 102 relative to the patient's heart. The elongated structure can be formed from a structural plastic, composite or metallic material, and comprises, or is covered by, a biocompatible material. Appropriate electrical isolation between the housing 102 and the subcutaneous electrode 104 is provided in cases where the elongated structure is formed from an electrically conductive material, such as metal. [0032] In one configuration, the rigid electrode support assembly and the housing 102 define a unitary structure (i.e., a single housing/unit). The electronic components and electrode conductors/connectors are disposed within or on the unitary ITCS device housing/electrode support assembly. At least two electrodes are supported on the unitary structure near opposing ends of the housing/electrode support assembly. The unitary structure can have, for example, an arcuate or angled shape. [0033] According to another configuration, the rigid electrode support assembly defines a physically separable unit relative to the housing 102. The rigid electrode support assembly includes mechanical and electrical couplings that facilitate mating engagement with corresponding mechanical and electrical couplings of the housing 102. For example, a header block arrangement can be configured to include both electrical and mechanical couplings that provide for mechanical and electrical connections between the rigid electrode support assembly and housing 102. The header block arrangement can be provided on the housing 102 or the rigid electrode support assembly, or both the housing 102 and the rigid electrode support assembly. Alternatively, a mechanical/electrical coupler can be used to establish mechanical and electrical connections between the rigid electrode support assembly and the housing 102. In such a configuration, a variety of different electrode support assemblies of varying shapes, sizes, and electrode configurations can be made available for physically and electrically connecting to a standard ITCS device. [0034] It is noted that the electrodes and the lead assembly 106 can be configured to assume a variety of shapes. For example, the lead assembly 106 can have a wedge, chevron, flattened oval, or a ribbon shape, and the subcutaneous electrode 104 can comprise a number of spaced electrodes, such as an array or band of electrodes. Moreover, two or more subcutaneous electrodes 104 can be mounted to multiple electrode support assemblies 106 to achieve a desired spaced relationship amongst the subcutaneous electrodes 104. Accordingly, subcutaneous leads of the present invention can be shaped appropriately for specific electrodes or families of electrodes and electrode support assemblies. [0035] Referring now to FIG. 2A, an ITCS system 200 is illustrated including a can 250 with a lead 240 inserted into a dissection path 220. The lead 240 includes an electrode 230, here illustrated at the distal end of the lead 240. The dissection path 220 lies within the subcutaneous tissue of a patient as illustrated in FIGS. 1A and 1B. [0036] Referring to FIG. 2B, a can electrode 502 is positioned on a housing 501 that encloses the ITCS device electronics. In one embodiment, the can electrode 502 comprises the entirety of the external surface of housing 501. In other embodiments, various portions of the housing 501 may be electrically isolated from the can electrode 502 or from tissue. For example, the active area of the can electrode 502 may comprise all or a portion of either the anterior or posterior surface of the housing 501 to direct current flow in a manner advantageous for cardiac sensing and/or stimulation. [0037] The housing 501 may resemble that of a conventional implantable ICD, is approximately 20-100 cc in volume, with a thickness of 0.4 to 2 cm and with a surface area on each face of approximately 30 to 100 cm2. As previously discussed, portions of the housing may be electrically isolated from tissue to optimally direct current flow. For example, portions of the housing 501 may be covered with a non-conductive, or otherwise electrically resistive, material to direct current flow. Suitable non-conductive material coatings include those formed from silicone rubber, polyurethane, or parylene, for example. These coating materials can be infused with one or more pharmacological agents as described below in greater detail. [0038] In addition, or alternatively, all or portions of the housing 501 may be treated to change the electrical conductivity characteristics thereof for purposes of optimally directing current flow. Various known techniques can be employed to modify the surface conductivity characteristics of the housing 501, such as by increasing or decreasing surface conductivity, to optimize current flow. Such techniques can include those that mechanically or chemically alter the surface of the housing 501 to achieve desired electrical conductivity characteristics. [0039] In the configuration shown in FIG. 2B, the ITCS device housing 501 containing the electronics (i.e., the can) is not used as an electrode. In this case, an electrode system comprising two electrode subsystems 508, 509 coupled to the housing 501 may be implanted subcutaneously in the chest region of the body, such as in the anterior thorax. The first and the second electrode subsystems 508, 509 are placed in opposition with respect to the ventricles of a heart 510, with the majority of the ventricular tissue of the heart 510 included within a volume defined between the electrode subsystems 508, 509. As illustrated in FIG. 2B, the first electrode system 508 is positioned superior to the heart 510 relative to a superior aspect of the heart 510, e.g., parallel to the left ventricular free wall. The second electrode system 509 is located inferior to the heart 510 and positioned in relation to an inferior aspect of the heart 510, e.g., parallel to the right ventricular free wall. A cable or wiring 506 conductively couples the electrode subsystems 508, 509 to the housing 501. [0040] In this configuration, the first and the second electrode subsystems 508 and 509 may comprise any combination of electrodes used for sensing and/or electrical stimulation. In various configurations, the electrode subsystems 508, 509 may each be comprised of a single electrode or a combination of electrodes. The electrode or electrodes comprising the first and second electrode subsystems 508, 509 may include any combination of one or more coil electrodes, tip electrodes, ring electrodes, multi-element coils, spiral coils, spiral coils mounted on non-conductive backing, and screen patch electrodes, for example. [0041] Referring to FIGS. 2A and 2B, the lead 240 and/or the electrode subsystems 508, 509 may be inserted into the dissection path 220 (FIG. 2A) by themselves, or may also be inserted with use of a sheath 320 as illustrated in FIG. 3. In FIG. 3, a proximal end of the lead 240 extends from the sheath 320, with the electrode 230 enclosed within the lumen of the sheath 320. The electrode 230 is illustrated with pharmacological agents 232 and 234 provided at distal and proximal ends of the electrode 230 respectively. It is understood that one, two, or more than two pharmacological agents can be provided at the electrode, and that provision of agents 232 and 234 is for illustrative purposes only. [0042] The pharmacological agents 232 and 234 may be incorporated with the lead 240 via, for example, a collar, a porous region, a coating, or other suitable means. The lead 240 may be inserted into the dissection path 220 (FIG. 2A) inside the sheath 320. After properly locating the lead 240 within the subcutaneous tissue, the sheath 320 may be retracted from the subcutaneous tunnel thereby exposing the pharmacological agents 232 and 234 to the surrounding tissue and initiating a period of pharmacological activity by allowing drug(s) within pharmacological agents 232 and 234 to diffuse into the tissue surrounding the lead 240. [0043] A non-limiting, non-exhaustive list of suitable pharmacological agents 232 and 234 includes analgesics, anesthetics, antibiotics, antiseptics, steroids, anti-inflammatory drugs, agents that promote hemostasis, agents that provide vasoconstriction, collagen, and agents that increase the rate of healing. Suitable analgesics or anesthetics may be, for example, aspirin, IBUPFOFEN, BUPIVACAINE, LIDOCAINE, MAPRIVACAINE and PROCAINE. Suitable steroids may be, for example, DEXAMETHASONE and BETAMETHASONE. A suitable pharmacological agent that provides vasoconstriction may be, for example, EPINEPHRINE. Suitable antibiotics or antiseptics may be, for example, VANCOMYCIN and CEFALOZIN. A suitable pharmacological agent that can increase the rate of healing may be, for example, stomach submucosa derived tissue such as disclosed in U.S. Pat. No. 6,099,567, which is hereby incorporated herein by reference. [0044] [0044]FIG. 4 illustrates an embodiment of the lead 240 with an electrode 230 and a coating 420. The coating 420 contains a pharmacological agent that is desired near the distal end of the lead 240. The coating 420 may be placed on the lead 240 by, for example, painting, spraying, dipping, vapor deposition, or other suitable means. [0045] The lead 240 may be masked before applying the coating 420. For example, it may be desirable to place the coating 420 close to the electrode 230, as illustrated in FIG. 4, without covering the electrode 230. This may be accomplished by masking the electrode 230, spraying or dipping the coating 420, and then removing the masking, leaving the coating 420 in place without covering the electrode 230. It may be desirable to mask the electrode 230 if, for example, the pharmacological agent has an activity lasting more than one day. However, provision of the coating 420 covering the electrode 230 may alter the operating characteristics of the electrode 230. [0046] Referring now to FIG. 5, another embodiment of the lead 240 is illustrated, now with a second application 440 and a third application 460 of pharmacological agents in addition to the coating 420. It may be useful, for example, to periodically provide pharmacological agents along a portion of the length of the lead 240 to provide analgesia. Pharmacological agents may be applied at discrete locations, as illustrated in FIG. 5, or may be continuous along all or part of the lead 240. For example, an analgesic may be applied along a major portion (e.g. more than 25%) of lead 240, except on the electrode 230 where it may hinder electrical performance. [0047] It may also be useful to apply a coating along a portion of the entire length of the lead 240 with, for example, an antiseptic, and also provide the coating 420 and/or second application 440 and/or third application 460 with, for example, an analgesic. This combination provides analgesia that diffuses locally to the dissected tissue surrounding the lead 240, while simultaneously providing an inhibition of infection along the dissection path. A temporary combination such as this may provide improved patient comfort and acceptance of the implant with improved outcomes and less morbidity from the procedure. [0048] Pharmacological agents for use in accordance with the present invention provide a temporary effectiveness within the patient. The term temporary may have both quantitative and qualitative meanings. For example, direct analgesia may be desirable to tissue surrounding the dissection path immediately following the implantation procedure, to provide improved patient comfort between anesthesia during the procedure and any post-procedure medication. The quantitative time period of interest may be about one hour in this case. Qualitatively, for example, it would be beneficial to provide site-specific anesthesia or analgesia for the duration of time between when the general anesthesia wears off and when a post-operative oral analgesic has reached an effective concentration level to provide pain relief, or to provide sufficient time duration such that oral analgesia is not necessary. [0049] Another qualitative example of the term temporary as presently contemplated includes the use of an antiseptic agent delivered during the implantation procedure, and for a time period thereafter sufficient to reduce the morbidity of sepsis. The quantitative time frame for antisepsis may be on the order of hours, whereas for antibiotics, for example, a course of treatment often lasts ten days to several weeks. Qualitatively, it may be desirable to provide an antibiotic treatment from a portion of, or all of, the implanted device from the time of implantation until the probability of morbidity is diminished. Depending on patient variability and disease state, quantitatively, antibiosis may be desirable from about three days to more than about three weeks. [0050] Other pharmacological agents in accordance with the present invention may have different quantitative and qualitative time frames associated with their effectiveness. For example, a xenograft collagen membrane that may be used to decrease the time necessary to heal from a tissue dissection, may be implanted as a permanent graft. However, the body will use the xenograft tissue as a scaffolding to increase the healing rate, but over time remodel the graft tissue to native tissue. The determination of when xenographic tissue is converted to native tissue is too imprecise to provide a precise quantitative time-frame applicable to all patients. [0051] Therefore, for purposes herein, the term temporary is meant to encompass both the quantitative and qualitative aspects of pharmacological agents having an effectiveness for a limited time-period, the time period varying depending on the particular pharmacological activity desired. A non-exhaustive, non-limiting list of pharmacological activities includes: antisepsis, antibiosis, analgesia, anesthesia, vasoconstriction, and hemostasis. [0052] [0052]FIG. 6 illustrates another embodiment of the present invention. In FIG. 6, the lead 240 is shown to have a groove 610 providing a fixation point for a collar 620. Collar 620 may be, for example, a silicone collar impregnated with a pharmacological agent. Collars impregnated with pharmacological agents are known in the art such as, for example, collars described in U.S. Pat. No. 6,361,780 ('780) hereby incorporated herein by reference. Activity periods and dosage delivery of pharmacological agents can be tailored to the application by appropriate manufacture of the collar 620. [0053] Although the width of groove 610 is illustrated in FIG. 6 to be significantly larger than the width of the collar 620, any desirable relationship may be provided. For example, the collar 620 may be provided with a plurality of layers incorporating a plurality of pharmacological agents, and/or a plurality of pharmological activities. This would provide the potential for a tiered delivery of drug activity. For example, the outer layer may provide an acute high dosage for a short duration, while subsequent layers provide a longer term delivery. [0054] In another embodiment of the present invention, an outermost layer of the collar 620 may provide analgesia while subsequent layers provide antibiosis and healing accelerators. By varying the width of the groove 610, and fitment of the collar 620, diffusion of the pharmacological agents from the layers of the collar 620 can be controlled to provide combinations of tiered therapy. [0055] Yet another embodiment of the present invention is illustrated in FIG. 7. An encapsulation 720 encloses the collar 620 within the encapsulation 720. The encapsulation 720 may include a first pharmacological treatment wherein the encapsulation 720 dissolves away from the lead 240 over time. After a period of time, the encapsulation 720 is removed from the collar 620, exposing the collar 620 and providing a second pharmacological treatment. The first and second pharmacological treatments may vary by, for example, dosage intensities, pharmacological activities, therapy type, or other desired treatment. For example, the encapsulation 720 may be a non-dissolving semi-permeable membrane with the intent being the regulation of the diffusion rate from the collar 620 while protecting the collar 620 from the host body foreign object response. [0056] In yet another embodiment, the lead 240 body material itself may be used to deliver a pharmacological agent. The normal lead 240 insulation may be used as the drug carrier. In practice, the polymeric insulation such as, for example, silicone can be swollen in an appropriate chemical agent such as, for example, alcohol, hexane, and/or Freon that also contains the pharmacological agent. By so treating the insulation, the pharmacological agent would diffuse into the insulation only to become trapped therein when the swelling agent is removed by, for example, evaporation, vacuum or other means known in the art. The treated insulation would then be used in the fabrication of the lead 240. Upon implantation of that lead 240, the superficial trapped pharmacological agent would first be released into the tissue, allowing deeper trapped pharmacological agents to migrate to the surface of the polymeric insulation for subsequent release into the tissue. [0057] Referring now to FIG. 8, a three layer tiered pharmacological delivery approach is illustrated. The lead 240 is illustrated having a first layer 810, a second layer 820, and a third layer 830 on the lead 240. The layers 810, 820, and 830 are configured such that the pharmacological agent in the third layer 830 is delivered first as the third layer 830 is dissolved away and the pharmacological agent diffuses into the tissue and delivers its activity. After the third layer 830 is effectively removed, the second layer 820 is revealed. The pharmacological agent in the second layer 820 is delivered second as the second layer 820 is dissolved away and the pharmacological agent diffuses into the tissue and delivers its activity. After the second layer 820 is effectively removed, the first layer 810 is revealed. The pharmacological agent in the first layer 810 is delivered last as the first layer 810 is dissolved away and the pharmacological agent diffuses into the tissue and delivers its activity. [0058] The layers 810, 820, and 830 may, for example, be continuous or discretely applied at one or a plurality of locations on the length of the lead 240, and have one or more drugs within each of the layers 810, 820 and 830. The layers 810, 820 and 830 may dissolve and/or may remain as a permanent scaffolding after releasing their pharmacological agents. [0059] [0059]FIG. 9 illustrates an embodiment of the present invention that differs from FIG. 6 by the addition of an electrode coating 920 applied over the electrode 230. It may be advantageous to provide a pharmacological delivery to the area of tissue surrounding the electrode 230 of the subcutaneous lead 240. For example, the electrode coating 920 may include an analgesic that is adapted to quickly dissolve off the electrode 230 and diffuse quickly into the surrounding tissue. This would provide an acute reduction in post-operative pain, while not adversely affecting the electrical capabilities of the electrode 230 for use quickly after lead 240 placement into the dissected tissue. [0060] Another application of the electrode coating 920 may be to provide a pharmacological agent that increases the effectiveness of the electrode 230. For example, the electrode coating 920 may include a pharmacological agent that reduces the threshold necessary for pacing, cardioversion, or other activity, such as is disclosed in U.S. Pat. Nos. 4,819,661 and 6,168,801, both of which are hereby incorporated herein by reference. [0061] The electrode coating 920 may be used as the only pharmacological delivery arrangement, and/or may be used in combination with other pharmacological delivery arrangements such as the collar 620 illustrated in FIG. 9 and/or the delivery arrangements illustrated in FIG. 8 and/or other arrangements contemplated herein. As previously discussed, a lead, electrode, and/or can may employ one or more pharmacological agent delivery arrangements on one or more lead, electrode, and/or can component. [0062] [0062]FIG. 10 illustrates another embodiment of the present invention, with the active can 250 having a pharmacological agent delivery means 930 disposed on the can 250 as well as a tiered pharmacological delivery means 950 disposed on the electrode 230. The lead 240 may also be provided with pharmacological delivery as previously disclosed. The means 930 may partially or completely cover or coat the can 250. Illustrated here in FIG. 10, as described also in earlier embodiments, combinations of pharmacological activity provided with ITCS devices may provide significantly improved outcomes, less morbidity, and improved patient comfort and acceptance. [0063] Various modifications and additions can be made to the preferred embodiments discussed hereinabove without departing from the scope of the present invention. Accordingly, the scope of the present invention should not be limited by the particular embodiments described above, but should be defined only by the claims set forth below and equivalents thereof. Patent CitationsCited PatentFiling datePublication dateApplicantTitleUS4146029 *May 31, 1977Mar 27, 1979Ellinwood Jr Everett HSelf-powered implanted programmable medication system and methodUS4506680 *Mar 17, 1983Mar 26, 1985Medtronic, Inc.Drug dispensing body implantable leadUS4819661 *Oct 26, 1987Apr 11, 1989Cardiac Pacemakers, Inc.Positive fixation cardiac electrode with drug elution capabilitiesUS4819662 *Oct 26, 1987Apr 11, 1989Cardiac Pacemakers, Inc.Cardiac electrode with drug delivery capabilitiesUS5020544 *Nov 1, 1989Jun 4, 1991Cardiac Pacemakers, Inc.Low energy defibrillation electrodeUS5041107 *Oct 6, 1989Aug 20, 1991Cardiac Pacemakers, Inc.Electrically controllable, non-occluding, body implantable drug delivery systemUS5090422 *Apr 19, 1990Feb 25, 1992Cardiac Pacemakers, Inc.Implantable electrode pouchUS5282785 *Oct 5, 1992Feb 1, 1994Cortrak Medical, Inc.Drug delivery apparatus and methodUS5324324 *Oct 13, 1992Jun 28, 1994Siemens Pacesetter, Inc.Coated implantable stimulation electrode and leadUS5405362 *Dec 20, 1993Apr 11, 1995The Board Of Regents For The University Of Texas SystemInteractive external defibrillation and drug injection systemUS5411525 *Jan 30, 1992May 2, 1995Cardiac Pacemakers, Inc.Dual capacitor biphasic defibrillator waveform generator employing selective connection of capacitors for each phaseUS5411539 *Aug 31, 1993May 2, 1995Medtronic, Inc.Active can emulator and method of useUS5439482 *Sep 23, 1993Aug 8, 1995Angeion CorporationProphylactic implantable cardioverter-defibrillatorUS5441518 *Jul 22, 1993Aug 15, 1995Angeion CorporationImplantable cardioverter defibrillator system having independently controllable electrode discharge pathwayUS5468254 *Jul 26, 1993Nov 21, 1995Cardiac Pacemakers, Inc.Method and apparatus for defibrillation using a multiphasic truncated exponential waveformUS5531779 *Jan 24, 1995Jul 2, 1996Cardiac Pacemakers, Inc.Stent-type defibrillation electrode structuresUS5545202 *Aug 4, 1994Aug 13, 1996Cardiac Pacemakers, Inc.Body implantable defibrillation systemUS5603732 *Nov 6, 1995Feb 18, 1997Cardiac Pacemakers, Inc.Subcutaneous defibrillation electrodesUS5620466 *Aug 14, 1995Apr 15, 1997Cardiac Pacemakers, Inc.Digital AGC using separate gain control and threshold templatingUS5628730 *Jul 18, 1994May 13, 1997Cortrak Medical, Inc.Phoretic balloon catheter with hydrogel coatingUS5634938 *Oct 25, 1995Jun 3, 1997Cardiac Pacemakers, Inc.Defibrillator waveform generator for generating waveform of long durationUS5641326 *Dec 13, 1993Jun 24, 1997Angeion CorporationMethod and apparatus for independent atrial and ventricular defibrillationUS5662688 *Aug 14, 1995Sep 2, 1997Cardiac Pacemakers, Inc.Slow gain controlUS5683447 *Dec 19, 1995Nov 4, 1997Ventritex, Inc.Lead with septal defibrillation and pacing electrodesUS5704365 *Nov 14, 1995Jan 6, 1998Cambridge Heart, Inc.Using related signals to reduce ECG noiseUS5724984 *Jul 17, 1996Mar 10, 1998Cambridge Heart, Inc.Multi-segment ECG electrode and systemUS5749909 *Nov 7, 1996May 12, 1998Sulzer Intermedics Inc.Transcutaneous energy coupling using piezoelectric deviceUS5788979 *Feb 10, 1997Aug 4, 1998Inflow Dynamics Inc.Biodegradable coating with inhibitory properties for application to biocompatible materialsUS5807306 *Aug 16, 1994Sep 15, 1998Cortrak Medical, Inc.Polymer matrix drug delivery apparatusUS5827326 *Mar 29, 1995Oct 27, 1998Angeion CorporationImplantable cardioverter defibrillator having a smaller energy storage capacityUS5895414 *Apr 10, 1997Apr 20, 1999Sanchez-Zambrano; SergioPacemaker housingUS5916243 *Mar 1, 1996Jun 29, 1999Cardiac Pacemakers, Inc.Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillationUS5957956 *Nov 3, 1997Sep 28, 1999Angeion CorpImplantable cardioverter defibrillator having a smaller massUS5987746 *Feb 21, 1996Nov 23, 1999Medtronic, Inc.Method of making medical electrical leadUS6044298 *Oct 13, 1998Mar 28, 2000Cardiac Pacemakers, Inc.Optimization of pacing parameters based on measurement of integrated acoustic noiseUS6055454 *Jul 27, 1998Apr 25, 2000Cardiac Pacemakers, Inc.Cardiac pacemaker with automatic response optimization of a physiologic sensor based on a second sensorUS6099567 *Dec 10, 1997Aug 8, 2000Purdue Research FoundationStomach submucosa derived tissue graftUS6134470 *Nov 9, 1998Oct 17, 2000Medtronic, Inc.Method and apparatus for treating a tachyarrhythmic patientUS6144879 *Oct 1, 1997Nov 7, 2000Gray; Noel DesmondHeart pacemakerUS6148230 *Jan 30, 1998Nov 14, 2000Uab Research FoundationMethod for the monitoring and treatment of spontaneous cardiac arrhythmiasUS6168801 *Mar 19, 1999Jan 2, 2001Cardiac Pacemakers, Inc.Controlled release drug deliveryUS6178349 *Apr 15, 1999Jan 23, 2001Medtronic, Inc.Drug delivery neural stimulation device for treatment of cardiovascular disordersUS6280462 *Oct 12, 2000Aug 28, 2001Cardiac Pacemakers, Inc.Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrodeUS6282444 *Aug 31, 1999Aug 28, 2001Pacesetter, Inc.Implantable device with electrical infection controlUS6295474 *Mar 13, 1998Sep 25, 2001Intermedics Inc.Defibrillator housing with conductive polymer coatingUS6304786 *Mar 29, 1999Oct 16, 2001Cardiac Pacemakers, Inc.Implantable lead with dissolvable coating for improved fixation and extractionUS6360129 *Dec 13, 1999Mar 19, 2002Cardiac Pacemakers, Inc.Mannitol/hydrogel cap for tissue-insertable connectionsUS6361780 *Nov 12, 1998Mar 26, 2002Cardiac Pacemakers, Inc.Microporous drug delivery systemUS6409675 *Nov 10, 1999Jun 25, 2002Pacesetter, Inc.Extravascular hemodynamic monitorUS6415174 *Nov 5, 1999Jul 2, 2002Board Of Regents The University Of Texas SystemECG derived respiratory rhythms for improved diagnosis of sleep apneaUS6416510 *Oct 13, 1999Jul 9, 2002Biocardia, Inc.Drug delivery catheters that attach to tissue and methods for their useUS6436068 *Aug 24, 2000Aug 20, 2002Gust H. BardyInstrument for implanting sensors and solid materials in a subcutaneous location and method thereofUS6438410 *May 3, 2001Aug 20, 2002Cardiac Pacemakers, Inc.System and method for a classifying cardiac complexesUS6475232 *Dec 10, 1997Nov 5, 2002Purdue Research FoundationStent with reduced thrombogenicityUS6478776 *Apr 5, 2000Nov 12, 2002Biocardia, Inc.Implant delivery catheter system and methods for its useUS6480733 *Dec 17, 1999Nov 12, 2002Pacesetter, Inc.Method for monitoring heart failureUS6512940 *Oct 31, 2000Jan 28, 2003Medtronic, Inc.Subcutaneous spiral electrode for sensing electrical signals of the heartUS6522915 *Oct 26, 2000Feb 18, 2003Medtronic, Inc.Surround shroud connector and electrode housings for a subcutaneous electrode array and leadless ECGSUS6564106 *Dec 13, 2000May 13, 2003Medtronic, Inc.Thin film electrodes for sensing cardiac depolarization signalsUS6584363 *Jul 16, 2001Jun 24, 2003Cardiac Pacemakers, Inc.Implantable lead with dissolvable coating for improved fixation and extractionUS6607509 *Apr 20, 2001Aug 19, 2003Medtronic Minimed, Inc.Insertion device for an insertion set and method of using the sameUS6615083 *Apr 27, 2001Sep 2, 2003Medtronic, Inc.Implantable medical device system with sensor for hemodynamic stability and method of useUS6622046 *May 7, 2001Sep 16, 2003Medtronic, Inc.Subcutaneous sensing feedthrough/electrode assemblyUS7190997 *Jun 4, 2000Mar 13, 2007Impulse Dynamics NvDrug delivery deviceUS20020035376 *Aug 27, 2001Mar 21, 2002Cameron Health, Inc.Biphasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillatorUS20020035377 *Aug 27, 2001Mar 21, 2002Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with insertion toolUS20020035378 *Aug 27, 2001Mar 21, 2002Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with highly maneuverable insertion toolUS20020035379 *Aug 27, 2001Mar 21, 2002Bardy Gust H.Subcutaneous electrode for transthoracic conduction with improved installation characteristicsUS20020035380 *Aug 27, 2001Mar 21, 2002Cameron Health, Inc.Power supply for an implantable subcutaneous cardioverter-defibrillatorUS20020035381 *Aug 27, 2001Mar 21, 2002Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthoracic conductionUS20020042629 *Aug 27, 2001Apr 11, 2002Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereofUS20020042630 *Aug 27, 2001Apr 11, 2002Cameron Health, Inc.Canister designs for implantable cardioverter-defibrillatorsUS20020042634 *Aug 27, 2001Apr 11, 2002Cameron Health, Inc.Ceramics and/or other material insulated shell for active and non-active S-ICD canUS20020049475 *Aug 27, 2001Apr 25, 2002Cameron Health, Inc.Method of insertion and implantation of implantable cardioverter-defibrillator canistersUS20020049476 *Aug 27, 2001Apr 25, 2002Cameron Health, Inc.Biphasic waveform anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillatorUS20020052636 *Aug 27, 2001May 2, 2002Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with low-profile installation appendage and method of doing sameUS20020068958 *Aug 27, 2001Jun 6, 2002Cameron Health, Inc.Radian curve shaped implantable cardioverter-defibrillator canisterUS20020072773 *Aug 27, 2001Jun 13, 2002Cameron Health, Inc.Duckbill-shaped implantable cardioverter-defibrillator canister and method of useUS20020082658 *Nov 21, 2001Jun 27, 2002Heinrich Stephen D.Apparatus for detecting and treating ventricular arrhythmiaUS20020091414 *Nov 5, 2001Jul 11, 2002Cameron Health, Inc.Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillatorUS20020095184 *Nov 5, 2001Jul 18, 2002Bardy Gust H.Monophasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillatorUS20020103510 *Nov 5, 2001Aug 1, 2002Cameron Health, Inc.Flexible subcutaneous implantable cardioverter-defibrillatorUS20020107544 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Current waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillatorUS20020107545 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Power supply for a subcutaneous implantable cardioverter-defibrillatorUS20020107547 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Subcutaneous implantable cardioverter-defibrillator employing a telescoping leadUS20020107548 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereofUS20020107549 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthorasic conductionUS20020107559 *Nov 5, 2001Aug 8, 2002Cameron Health, Inc.Method and device for insertion and implantation of a subcutaneous electrodeUS20020120299 *Nov 5, 2001Aug 29, 2002Cameron Health, Inc.Current waveforms for anti-tachycardia pacing for a subcutaneous implantable cardioverter- defibrillatorUS20020138123 *Nov 28, 2001Sep 26, 2002Medtronic, Inc.Medical electrical leads and indwelling catheters with enhanced biocompatibility and biostabilityUS20030004546 *Jul 8, 2002Jan 2, 2003Casey Don E.Subcutaneously implantable power supplyUS20030004552 *Jun 29, 2001Jan 2, 2003Medtronic, Inc.Implantable cardioverter/defibrillatorUS20030023175 *May 22, 2002Jan 30, 2003Arzbaecher Robert C.Implantable cardiac arrest monitor and alarm systemUS20030036778 *May 17, 2002Feb 20, 2003Ostroff Alan H.Subcutaneous cardiac stimulator device having an anteriorly positioned electrodeUS20030045904 *Apr 17, 2002Mar 6, 2003Bardy Gust H.Subcutaneous cardiac stimulator device and method generating uniform electric field through the heartUS20030069609 *Oct 9, 2001Apr 10, 2003Medtronic, Inc.Method and apparatus for affecting atrial defibrillation with bi-atrial pacingUS20030088278 *Nov 5, 2001May 8, 2003Cameron Health, Inc.Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillatorUS20030088279 *Nov 5, 2001May 8, 2003Cameron Health, Inc.H-bridge with sensing circuitUS20030088280 *Nov 5, 2001May 8, 2003Cameron Health, Inc.Low power A/D converter* Cited by examinerReferenced byCiting PatentFiling datePublication dateApplicantTitleUS7337005Sep 7, 2005Feb 26, 2008Spinal Modulations, Inc.Methods for stimulating a nerve root ganglionUS7337006 *Sep 7, 2005Feb 26, 2008Spinal Modulation, Inc.Methods and systems for modulating neural tissueUS7386350Jan 11, 2005Jun 10, 2008Vilims Bradley DCombination electrical stimulating and infusion medical deviceUS7447546Sep 7, 2005Nov 4, 2008Spinal Modulation, Inc.Methods of neurostimulating targeted neural tissueUS7450993Sep 7, 2005Nov 11, 2008Spinal Modulation, Inc.Methods for selective stimulation of a ganglionUS7502651 *Sep 7, 2005Mar 10, 2009Spinal Modulation, Inc.Methods for stimulating a dorsal root ganglionUS7580753Sep 7, 2005Aug 25, 2009Spinal Modulation, Inc.Method and system for stimulating a dorsal root ganglionUS7660634Jan 19, 2007Feb 9, 2010Vilims Bradley DCombination electrical stimulating and infusion medical deviceUS7840262Mar 10, 2004Nov 23, 2010Impulse Dynamics NvApparatus and method for delivering electrical signals to modify gene expression in cardiac tissueUS7945331Feb 23, 2007May 17, 2011Bradley D. VilimsCombination electrical stimulating and infusion medical device and methodUS8066702Nov 29, 2011Rittman Iii William JCombination electrical stimulating and infusion medical device and methodUS8082039Sep 7, 2005Dec 20, 2011Spinal Modulation, Inc.Stimulation systemsUS8195307Dec 19, 2008Jun 5, 2012Vilims Bradley DCombination electrical stimulating and infusion device and methodUS8229565Feb 11, 2009Jul 24, 2012Spinal Modulation, Inc.Methods for stimulating a dorsal root ganglionUS8244371Mar 16, 2006Aug 14, 2012Metacure LimitedPancreas leadUS8260416Sep 4, 2012Impulse Dynamics, N.V.Electrical muscle controllerUS8301247Oct 30, 2012Impulse Dynamics, N.V.Electrical muscle controllerUS8306616Nov 6, 2012Impulse Dynamics, N.V.Electrical muscle controllerUS8306617Nov 6, 2012Impulse Dynamics N.V.Electrical muscle controllerUS8311629Nov 13, 2012Impulse Dynamics, N.V.Electrical muscle controllerUS8321013Nov 27, 2012Impulse Dynamics, N.V.Electrical muscle controller and pacing with hemodynamic enhancementUS8326416Oct 25, 2010Dec 4, 2012Impulse Dynamics NvApparatus and method for delivering electrical signals to modify gene expression in cardiac tissueUS8352031Jan 8, 2013Impulse Dynamics NvProtein activity modificationUS8380318Mar 24, 2010Feb 19, 2013Spinal Modulation, Inc.Pain management with stimulation subthreshold to paresthesiaUS8463399Oct 28, 2009Jun 11, 2013Cardiac Pacemakers, Inc.Overmolded components for implantable medical leads and related methodsUS8518092Jul 1, 2011Aug 27, 2013Spinal Modulation, Inc.Hard tissue anchors and delivery devicesUS8527067Oct 15, 2010Sep 3, 2013Cardiac Pacemakers, Inc.Tapered drug-eluting collar for a medical electrical leadUS8548583May 4, 2006Oct 1, 2013Impulse Dynamics NvProtein activity modificationUS8655444Oct 29, 2012Feb 18, 2014Impulse Dynamics, N.V.Electrical muscle controllerUS8666495Mar 18, 2005Mar 4, 2014Metacure LimitedGastrointestinal methods and apparatus for use in treating disorders and controlling blood sugarUS8700161Sep 4, 2003Apr 15, 2014Metacure LimitedBlood glucose level controlUS8712546Mar 19, 2008Apr 29, 2014Spinal Modulation, Inc.Neurostimulation systemUS8792985Jan 20, 2006Jul 29, 2014Metacure LimitedGastrointestinal methods and apparatus for use in treating disorders and controlling blood sugarUS8825152Apr 3, 2002Sep 2, 2014Impulse Dynamics, N.V.Modulation of intracellular calcium concentration using non-excitatory electrical signals applied to the tissueUS8934975Feb 1, 2011Jan 13, 2015Metacure LimitedGastrointestinal electrical therapyUS8958872Feb 17, 2014Feb 17, 2015Impulse Dynamics, N.V.Electrical muscle controllerUS8977353Aug 20, 2013Mar 10, 2015Impulse Dynamics NvProtein activity modificationUS8983624Dec 6, 2007Mar 17, 2015Spinal Modulation, Inc.Delivery devices, systems and methods for stimulating nerve tissue on multiple spinal levelsUS9044592Jan 29, 2008Jun 2, 2015Spinal Modulation, Inc.Sutureless lead retention featuresUS9056197Oct 27, 2009Jun 16, 2015Spinal Modulation, Inc.Selective stimulation systems and signal parameters for medical conditionsUS9101765Feb 16, 2006Aug 11, 2015Metacure LimitedNon-immediate effects of therapyUS9186514Feb 13, 2015Nov 17, 2015Impulse Dynamics NvElectrical muscle controllerUS9205259Feb 22, 2012Dec 8, 2015The Board Of Trustees Of The Leland Stanford Junior UniversityNeurostimulation systemUS9205260Jul 16, 2012Dec 8, 2015The Board Of Trustees Of The Leland Stanford Junior UniversityMethods for stimulating a dorsal root ganglionUS9205261Dec 5, 2012Dec 8, 2015The Board Of Trustees Of The Leland Stanford Junior UniversityNeurostimulation methods and systemsUS9259569May 14, 2010Feb 16, 2016Daniel M. BrounsteinMethods, systems and devices for neuromodulating spinal anatomyUS9289618Oct 23, 2001Mar 22, 2016Impulse Dynamics NvElectrical muscle controllerUS9314618Dec 6, 2007Apr 19, 2016Spinal Modulation, Inc.Implantable flexible circuit leads and methods of useUS9327110Feb 2, 2012May 3, 2016St. Jude Medical Luxembourg Holdings SMI S.A.R.L. (“SJM LUX SMI”)Devices, systems and methods for the targeted treatment of movement disordersUS9409021May 29, 2015Aug 9, 2016St. Jude Medical Luxembourg Holdings SMI S.A.R.L.Selective stimulation systems and signal parameters for medical conditionsUS9427570Dec 6, 2007Aug 30, 2016St. Jude Medical Luxembourg Holdings SMI S.A.R.L. (“SJM LUX SMI”)Expandable stimulation leads and methods of useUS9440080Mar 9, 2015Sep 13, 2016Impulse Dynamics NvProtein activity modificationUS20060052826 *Sep 7, 2005Mar 9, 2006Kim Daniel HPulse generator for high impedance electrodesUS20060052828 *Sep 7, 2005Mar 9, 2006Kim Daniel HMethods for stimulating a nerve root ganglionUS20060052835 *Sep 7, 2005Mar 9, 2006Kim Daniel HMethods for stimulating the spinal cord and nervous systemUS20060052836 *Sep 7, 2005Mar 9, 2006Kim Daniel HNeurostimulation systemUS20060052837 *Sep 7, 2005Mar 9, 2006Kim Daniel HMethods and systems for modulating neural tissueUS20060052838 *Sep 7, 2005Mar 9, 2006Kim Daniel HMethods of neurostimulating targeted neural tissueUS20060052839 *Sep 7, 2005Mar 9, 2006Kim Daniel HMethods for stimulating a dorsal root ganglionUS20060052856 *Sep 7, 2005Mar 9, 2006Kim Daniel HStimulation componentsUS20060155342 *Jan 11, 2005Jul 13, 2006Vilims Bradley DCombination electrical stimulating and infusion medical deviceUS20060155343 *Apr 14, 2005Jul 13, 2006Vilims Bradley DCombination electrical stimulating and infusion medical device and methodUS20070135881 *Feb 23, 2007Jun 14, 2007Vilims Bradley DCombination Electrical Stimulating And Infusion Medical Device and MethodUS20070179536 *Jan 19, 2007Aug 2, 2007Vilims Bradley DCombination Electrical Stimulating and Infusion Medical DeviceUS20080009927 *Jun 29, 2007Jan 10, 2008Vilims Bradley DCombination Electrical Stimulating and Infusion Medical Device and MethodUS20080200972 *Feb 19, 2008Aug 21, 2008Rittman William JCombination electrical stimulating and infusion medical device and methodUS20090099613 *Dec 19, 2008Apr 16, 2009Vilims Bradley DCombination electrical stimulating and infusion device and methodUS20100125320 *Oct 28, 2009May 20, 2010Polkinghorne Jeannette COvermolded components for implantable medical leads and related methodsUS20110125241 *May 26, 2011Medtronic, Inc.Lead including composite device for eluting a steroid and an antimicrobialWO2006076200A2 *Jan 6, 2006Jul 20, 2006Vilims, Bradley, D.Combination electrical stimulating and infusion medical device and methodWO2006076200A3 *Jan 6, 2006Sep 21, 2006Vilims Bradley DCombination electrical stimulating and infusion medical device and methodWO2006097934A2 *Mar 16, 2006Sep 21, 2006Metacure LimitedPancreas leadWO2011065991A1 *May 3, 2010Jun 3, 2011Medtronic, Inc.Lead including composite device for eluting a steroid and an antimicrobial* Cited by examinerClassifications U.S. Classification607/120International ClassificationA61N1/39, A61N1/05, A61N1/365Cooperative ClassificationA61N1/3962, A61N1/36585, A61N1/0587, A61N1/05, A61N1/0504, A61N1/3956, A61N1/0568, A61N1/36542European ClassificationA61N1/39M2, A61N1/05, A61N1/39M, A61N1/365C, A61N1/05N2DLegal EventsDateCodeEventDescriptionApr 19, 2004ASAssignmentOwner name: CARDIAC PACEMAKERS, INC., MINNESOTAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CATES, ADAM W.;WAGNER, DARRELL ORVIN;LINDSTROM, CURTIS CHARLES;AND OTHERS;REEL/FRAME:015221/0912Effective date: 20040330Sep 28, 2012FPAYFee paymentYear of fee payment: 4RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services