Source: http://www.google.com/patents/US7065407?dq=7,172,682
Timestamp: 2016-09-01 02:12:13
Document Index: 504842237

Matched Legal Cases: ['art.\n21', 'art.\n22', 'art.\n23', 'art.\n24', 'art.\n25', 'art.\n26', 'art.\n27', 'art.\n31', 'art.\n33', 'art.\n37', 'art.\n70', 'art.\n71', 'art.\n72', 'art.\n73', 'art.\n74', 'art.\n75', 'art.\n91', 'art.\n114', 'art.\n115', 'art.\n116', 'art.\n117', 'art.\n118', 'art.\n119']

Patent US7065407 - Duckbill-shaped implantable cardioverter-defibrillator canister and method ... - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsAn implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and twelfth rib within a patient includes a duck-bill shaped housing. The housing includes a proximal end and distal end, where the width of the proximal end is less than the width of the distal end, and an electrode...http://www.google.com/patents/US7065407?utm_source=gb-gplus-sharePatent US7065407 - Duckbill-shaped implantable cardioverter-defibrillator canister and method of useAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS7065407 B2Publication typeGrantApplication numberUS 09/940,283Publication dateJun 20, 2006Filing dateAug 27, 2001Priority dateSep 18, 2000Fee statusPaidAlso published asUS20020072773, WO2003018122A1Publication number09940283, 940283, US 7065407 B2, US 7065407B2, US-B2-7065407, US7065407 B2, US7065407B2InventorsGust H. Bardy, Riccardo Cappato, William J. Rissmann, Gary H. SandersOriginal AssigneeCameron Health, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (112), Non-Patent Citations (31), Referenced by (69), Classifications (12), Legal Events (8) External Links: USPTO, USPTO Assignment, EspacenetDuckbill-shaped implantable cardioverter-defibrillator canister and method of use
US 7065407 B2Abstract
An implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and twelfth rib within a patient includes a duck-bill shaped housing. The housing includes a proximal end and distal end, where the width of the proximal end is less than the width of the distal end, and an electrode located on the housing.
providing a cardioverter-defibrillator comprising a unitary housing, an electrical circuit located within the housing, and an electrode located on the housing, wherein the unitary housing has an exterior surface that is tapered from a first width at a proximal end to a second, smaller width at a distal end, wherein the cardioverter-defibrillator is configured to maintain the electrode in a predetermined relationship subcutaneously over a patient's ribcage;
making an incision on a patient's thorax; and
advancing the cardioverter-defibrillator through the incision and subcutaneously over a patient's ribcage, wherein the cardioverter-defibrillator is advanced approximately between a patient's third and a patient's twelfth rib.
2. The method of claim 1, wherein at least a portion of the distal end of the housing is rounded.
3. The method of claim 1, wherein at least a portion of the proximal end of the housing is substantially square.
4. The method of claim 1, wherein at least a portion of the proximal end of the housing is rounded.
5. The method of claim 1, wherein the width of the proximal end of the housing is approximately 1 centimeter to approximately 10 centimeters wide.
6. The method of claim 1, wherein the width of the proximal end of the housing is approximately 2 centimeters to approximately 5 centimeters wide.
7. The method of claim 1, wherein the width of the distal end of the housing is approximately 1 centimeter to approximately 10 centimeters wide.
8. The method of claim 1, wherein the width of the distal end of the housing is approximately 2 centimeters to approximately 5 centimeters wide.
9. The method of claim 1, wherein the proximal end of the housing further comprises a depth, wherein the depth of the proximal end of the housing is less than approximately 15 millimeters.
10. The method of claim 1, wherein the distal end of the housing further comprises a depth, wherein the depth of the distal end of the housing is approximately 1 millimeter to approximately 15 millimeters.
11. The method of claim 1, wherein the distal end of the housing further comprises a depth, wherein the depth of the distal end of the housing is approximately 1 millimeter to approximately 3 millimeters.
12. The method of claim 1, wherein the housing further comprises a length, wherein the length of the housing is approximately 3 centimeters to approximately 30 centimeters long.
13. The method of claim 1, wherein the housing further comprises a length, wherein the length of the housing is approximately 5 centimeters to approximately 20 centimeters long.
14. The method of claim 1, wherein the housing is substantially bilaterally symmetrical along the housing's length.
15. The method of claim 1, wherein the proximal end of the housing is contiguous with the distal end of the housing.
16. The method of claim 1, wherein at least a portion of the housing comprises an electrically insulated material.
17. The method of claim 1, wherein at least a portion of the housing comprises an electrically nonconductive material.
18. The method of claim 1, wherein the housing is substantially non planar.
19. The method of claim 1, wherein the housing is substantially planar.
20. The method of claim 1, wherein the electrical circuit can provide cardioversion-defibrillation for the patient's heart.
21. The method of claim 20, wherein the electrical circuit can further provide multiphasic waveform cardiac pacing for the patient's heart.
22. The method of claim 1, wherein the electrical circuit can provide multiphasic waveform cardiac pacing for the patient's heart.
23. The method of claim 22, wherein the electrical circuit can provide biphasic waveform cardiac pacing for the patient's heart.
24. The method of claim 22, wherein the electrical circuit can provide triphasic waveform cardiac pacing for the patient's heart.
25. The method of claim 1, wherein the electrical circuit can provide monophasic waveform cardiac pacing for the patient's heart.
26. The method of claim 1, wherein the electrode can emit an energy for shocking the patient's heart.
27. The method of claim 26, wherein the electrode can receive sensory information.
28. The method of claim 1, wherein the electrode can receive sensory information.
29. The method of claim 1, wherein at least a portion of the electrode is non-planar.
30. The method of claim 1, wherein the cardioverter-defibrillator is advanced proximate the patient's heart.
31. The method of claim 1, wherein the cardioverter-defibrillator is advanced proximate a patient's sternum.
32. The method of claim 1, wherein the cardioverter-defibrillator refrains from directly contacting the patient's heart.
33. The method of claim 1, wherein the cardioverter-defibrillator refrains from directly contacting the patient's intrathoracic vessels.
34. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
providing a cardioverter-defibrillator comprising a housing, an electrical circuit located within the housing, and an electrode located on the housing, wherein the cardioverter-defibrillator is configured to maintain the electrode in a predetermined relationship subcutaneously over a patient's ribcage;
making a single incision on a patient's thorax, wherein the single incision is made approximately at the level of the cardiac apex; and
advancing the cardioverter-defibrillator through the single incision and subcutaneously over a patient's ribcage, wherein the cardioverter-defibrillator is advanced approximately between a patient's third and a patient's twelfth rib.
35. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
making a single incision on a patient's thorax, wherein the singe incision is made approximately in the left anterior axillary line; and
36. An implantable cardioverter-defibrillator comprising:
a main housing section having an exterior surface and a width;
a distal housing section extending distally from the main housing section, wherein the distal housing section has an exterior surface that is contiguous with the exterior surface of the main housing section, and further wherein the distal housing section has a width less than the width of the main housing section;
an electrical circuit located within the main housing section; and
an electrode electrically coupled to the electrical circuit and located on the distal housing section; wherein the electrical circuit provides cardioversion-defibrillation energy to the patient's heart.
37. The implantable cardioverter-defibrillator of claim 36, wherein the length of the implantable cardioverter-defibrillator is approximately 5 centimeters to approximately 20 centimeters long.
38. The implantable cardioverter-defibrillator of claim 36, wherein the length of the implantable cardioverter-defibrillator is less than 30 centimeters long.
39. The implantable cardioverter-defibrillator of claim 36, wherein the implantable cardioverter-defibrillator is substantially bilaterally symmetrical along the cardioverter-defibrillator's length.
40. The implantable cardioverter-defibrillator of claim 36, wherein the distal housing section and the main housing section are made of the same material.
41. The implantable cardioverter-defibrillator of claim 36, wherein the distal housing section is hinged to the main housing section.
42. The implantable cardioverter-defibrillator of claim 36, wherein the distal housing section further includes a distal end, wherein at least a portion of the distal end of the distal housing section is curved.
43. The duckbill-shaped implantable cardioverter-defibrillator of claim 36, wherein the main housing member further includes a proximal end, wherein at least a portion of the proximal end of the main housing member is substantially square.
44. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section further includes a proximal end, wherein at least a portion of the proximal end of the main housing section is rounded.
45. The implantable cardioverter-defibrillator of claim 36, wherein the width of the main housing section is approximately 3 centimeters to approximately 30 centimeters wide.
46. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section is approximately 3 centimeters to approximately 20 centimeters wide.
47. The implantable cardioverter-defibrillator of claim 36, wherein the distal housing section further comprises a shoulder region, wherein the shoulder region extends distally from the main housing section.
48. The implantable cardioverter-defibrillator of claim 47, wherein the shoulder region of the distal housing section has a width that is less than the width of the main housing section.
49. The implantable cardioverter-defibrillator of claim 48, wherein at least a portion of the width of the shoulder region decreases as the shoulder region extends distally from the main housing section.
50. The implantable cardioverter-defibrillator of claim 49, wherein the width of the shoulder region decreases proportionally as the shoulder region extends distally from the main housing section.
51. The implantable cardioverter-defibrillator of claim 47, wherein the distal housing section further comprises a distal head, wherein the distal head extends distally from the shoulder region and defines a distal end of the distal housing section.
52. The implantable cardioverter-defibrillator of claim 51, wherein the distal head of the distal housing section has a width that is less than the width of the shoulder region of the distal housing section.
53. The implantable cardioverter-defibrillator of claim 51, wherein the distal head of the distal housing section has a width that is greater than the width of the shoulder region of the distal housing section.
54. The implantable cardioverter-defibrillator of claim 36, wherein the depth of the distal housing section is less than the depth of the main housing section.
55. The implantable cardioverter-defibrillator of claim 36, wherein the depth of the distal housing section is less than approximately 15 millimeters.
56. The implantable cardioverter-defibrillator of claim 36, wherein the depth of the main housing section is approximately 1 millimeter to approximately 15 millimeters.
57. The implantable cardioverter-defibrillator of claim 36, wherein the depth of the main housing section is approximately 1 millimeter to approximately 10 millimeters.
58. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the distal housing section is substantially non-planar.
59. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the main housing section is substantially planar.
60. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the main housing section is substantially non-planar.
61. The implantable cardioverter-defibrillator of claim 36, wherein the distal housing section is bilaterally symmetrical along its length.
62. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the distal housing section comprises an electrically insulated material.
63. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the distal housing section comprises an electrically nonconductive material.
64. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section comprises a ceramic material.
65. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section comprises a titanium alloy.
66. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section comprises a stainless steel alloy.
67. The implantable cardioverter-defibrillator of claim 36, wherein the main housing section comprises a polymeric material.
68. The implantable cardioverter-defibrillator of claim 67, wherein the polymeric material is selected from the group consisting essentially of a polyurethane, a polyamide, a polyetheretherketone (PEEK), a polyether block amide (PEBA), a polytetrafluoroethylene (PTFE), a silicone, and mixtures thereof.
69. The implantable cardioverter-defibrillator of claim 36, wherein the electrical circuit can provide multiphasic waveform cardiac pacing for the patient's heart.
70. The implantable cardioverter-defibrillator of claim 36, wherein the electrical circuit can provide multiphasic waveform cardiac pacing for the patient's heart.
71. The implantable cardioverter-defibrillator of claim 70, wherein the electrical circuit can provide biphasic waveform cardiac pacing for the patient's heart.
72. The implantable cardioverter-defibrillator of claim 70, wherein the electrical circuit can provide triphasic waveform cardiac pacing for the patient's heart.
73. The implantable cardioverter-defibrillator of claim 36, wherein the electric circuit can provide monophasic waveform cardiac pacing for the patient's heart.
74. The implantable cardioverter-defibrillator of claim 36, wherein the electrode can emit an energy for shocking the patient's heart.
75. The implantable cardioverter-defibrillator of claim 74, wherein the energy for shocking the patient's heart is approximately 50 joules to approximately 75 joules.
76. The implantable cardioverter-defibrillator of claim 74, wherein the energy for shocking the patient's heart is approximately 75 joules to approximately 100 joules.
77. The implantable cardioverter-defibrillator of claim 74, wherein the energy for shocking the patient's heart is approximately 100 joules to approximately 125 joules.
78. The implantable cardioverter-defibrillator of claim 74, wherein the energy for shocking the patient's heart is approximately 125 joules to approximately 150 joules.
79. The implantable cardioverter-defibrillator of claim 78, wherein the energy for shocking the patient's heart is approximately 150 J.
80. The implantable cardioverter-defibrillator of claim 74, wherein the electrode can receive sensory information.
81. The implantable cardioverter-defibrillator of claim 36, wherein the electrode can receive sensory information.
82. The implantable cardioverter-defibrillator of claim 36, wherein at least a portion of the electrode is non-planar.
83. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially circular in shape.
84. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially ellipsoidal in shape.
85. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially square in shape.
86. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially rectangular in shape.
87. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially triangular in shape.
88. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially thumbnail shaped.
89. The implantable cardioverter-defibrillator of claim 36, wherein the electrode is substantially spade shaped.
90. An implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising:
a housing having a distal section and a proximal section, a top exterior surface, a proximal end and a distal end, wherein the top exterior surface along the distal section is contiguous with the top exterior surface along the proximal section, wherein the housing is substantially bilaterally symmetrical along a length of the housing's top exterior surface, wherein a width of the housing's top exterior surface at the distal section of the housing is less than a width of the top exterior surface at the proximal section of the housing, the width of the housing tapering from the proximal section to the distal section;
an electrode electrically coupled to the electrical circuit and located on the housing; wherein the electrical circuit provides cardioversion-defibrillation energy to the patient's heart.
91. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the distal end of the housing is rounded.
92. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the proximal end of the housing is substantially square.
93. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the proximal end of the housing is rounded.
94. The implantable cardioverter-defibrillator of claim 1, wherein the width of the proximal end of the housing is approximately 1 centimeter to approximately 10 centimeters wide.
95. The implantable cardioverter-defibrillator of claim 1, wherein the width of the proximal end of the housing is approximately 2 centimeters to approximately 5 centimeters wide.
96. The implantable cardioverter-defibrillator of claim 1, wherein the width of the distal end of the housing is approximately 1 centimeter to approximately 10 centimeters wide.
97. The implantable cardioverter-defibrillator of claim 1, wherein the width of the distal end of the housing is approximately 2 centimeters to approximately 5 centimeters wide.
98. The implantable cardioverter-defibrillator of claim 1, wherein the proximal end of the housing further comprises a depth, wherein the depth of the proximal end of the housing is less than approximately 15 millimeters.
99. The implantable cardioverter-defibrillator of claim 1, wherein the distal end of the housing further comprises a depth, wherein the depth of the distal end of the housing is approximately 1 millimeter to approximately 15 millimeters.
100. The implantable cardioverter-defibrillator of claim 1, wherein the distal end of the housing further comprises a depth, wherein the depth of the distal end of the housing is approximately 1 millimeter to approximately 3 millimeters.
101. The implantable cardioverter-defibrillator of claim 1, wherein the housing further comprises a length, wherein the length of the housing is approximately 3 centimeters to approximately 30 centimeters long.
102. The implantable cardioverter-defibrillator of claim 1, wherein the housing further comprises a length, wherein the length of the housing is approximately 5 centimeters to approximately 20 centimeters long.
103. The implantable cardioverter-defibrillator of claim 1, wherein the proximal end of the housing is hinged to the distal end of the housing.
104. The implantable cardioverter-defibrillator of claim 1, wherein the proximal end of the housing is contiguous with the distal end of the housing.
105. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing comprises an electrically insulated material.
106. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing comprises an electrically nonconductive material.
107. The implantable cardioverter-defibrillator of claim 1, wherein the housing comprises a ceramic material.
108. The implantable cardioverter-defibrillator of claim 1, wherein the housing comprises a titanium alloy.
109. The implantable cardioverter-defibrillator of claim 1, wherein the housing comprises a polymeric material.
110. The implantable cardioverter-defibrillator of claim 109, wherein the polymeric material is selected from the group consisting essentially of a polyurethane, a polyamide, a polyetheretherketone (PEEK), a polyether block amide (PEBA), a polytetrafluoroethylene (PTFE), a silicone, and mixtures thereof.
111. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing is substantially non planar.
112. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the housing is substantially planar.
113. The implantable cardioverter-defibrillator of claim 1 wherein the electrical circuit can further provide multiphasic waveform cardiac pacing for the patient's heart.
114. The implantable cardioverter-defibrillator of claim 1, wherein the electrical circuit can provide multiphasic waveform cardiac pacing for the patient's heart.
115. The implantable cardioverter-defibrillator of claim 114, wherein the electrical circuit can provide biphasic waveform cardiac pacing for the patient's heart.
116. The implantable cardioverter-defibrillator of claim 114, wherein the electrical circuit can provide triphasic waveform cardiac pacing for the patient's heart.
117. The implantable cardioverter-defibrillator of claim 114, wherein the electrical circuit can further provide monophasic waveform cardiac pacing for the patient's heart.
118. The implantable cardioverter-defibrillator of claim 1, wherein the electrode can emit an energy for shocking the patient's heart.
119. The implantable cardioverter-defibrillator of claim 118, wherein the energy for shocking the patient's heart is approximately 50 joules to approximately 75 joules.
120. The implantable cardioverter-defibrillator of claim 118, wherein the energy for shocking the patient's heart is approximately 75 joules to approximately 100 joules.
121. The implantable cardioverter-defibrillator of claim 118, wherein the energy for shocking the patient's heart is approximately 100 joules to approximately 125 joules.
122. The implantable cardioverter-defibrillator of claim 118, wherein the energy for shocking the patient's heart is approximately 125 joules to approximately 150 joules.
123. The implantable cardioverter-defibrillator of claim 122, wherein the energy for shocking the patient's heart is approximately 150 J.
124. The implantable cardioverter-defibrillator of claim 118, wherein the electrode can receive sensory information.
125. The implantable cardioverter-defibrillator of claim 1, wherein the electrode can receive sensory information.
126. The implantable cardioverter-defibrillator of claim 1, wherein at least a portion of the electrode is non-planar.
127. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially circular in shape.
128. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially ellipsoidal in shape.
129. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially square in shape.
130. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially rectangular in shape.
131. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially triangular in shape.
132. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially thumbnail shaped.
133. The implantable cardioverter-defibrillator of claim 1, wherein the electrode is substantially spade shaped.
In addition, the present application is filed concurrently herewith U.S. patent application Ser. No. 09/940,371 entitled “CERAMICS AND/OR OTHER MATERIAL INSULATED SHELL FOR ACTIVE AND NON-ACTIVE S-ICD CAN,” filed Aug. 27, 2001, pending, U.S. patent application Ser. No. 09/940,468 entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH IMPROVED INSTALLATION CHARACTERISTICS,” filed Aug. 27, 2001, now abandoned, U.S. patent application Ser. No. 09/941,814 entitled “ELECTRODE WITH IMPROVED CONTACT SHAPE FOR TRANSTHORACIC CONDUCTION,” filed Aug. 27, 2001, now abandoned, U.S. patent application Ser. No. 09/940,356 entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH HIGHLY MANEUVERABLE INSERTION TOOL,” filed Aug. 27, 2001, now abandoned, U.S. patent application Ser. No. 09/940,340 entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH LOW-PROFILE INSTALLATION APPENDAGE AND METHOD OF DOING SAME,” filed Aug. 27, 2001, now U.S. Pat. No. 6,937,907, U.S. patent application Ser. No. 09/940,287 entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH INSERTION TOOL,” filed Aug. 27, 2001, now abandoned, U.S. patent application Ser. No. 09/940,377 entitled “METHOD OF INSERTION AND IMPLANTATION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR CANISTERS,” filed Aug. 27, 2001, now U.S. Pat. No. 6,866,044, U.S. patent application Ser. No. 09/940,599 entitled “CANISTER DESIGNS FOR IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS,” filed Aug. 27, 2001, now U.S. Pat. No. 6,950,705, U.S. patent application Ser. No. 09/940,373 entitled “RADIAN CURVE SHAPED IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR CANISTER,” filed Aug. 27, 2001, now U.S. Pat. No. 6,788,974, U.S. patent application Ser. No. 09/940,273 entitled “CARDIOVERTER-DEFIBRILLATOR HAVING A FOCUSED SHOCKING AREA AND ORIENTATION THEREOF,” filed Aug. 27, 2001, pending, U.S. patent application Ser. No. 09/940,378 entitled “BIPHASIC WAVEFORM FOR ANTI-BRADYCARDIA PACING FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” filed Aug. 27, 2001, pending, U.S. patent application Ser. No. 09/940,266 entitled “BIPHASIC WAVEFORM FOR ANTI-TACHYCARDIA PACING FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” filed Aug. 27, 2001, now U.S. Pat. No. 6,856,835, and U.S. patent application Ser. No. 09/940,471 entitled “POWER SUPPLY FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” filed Aug. 27, 2001, pending, the disclosures of which applications are hereby incorporated by reference.
Turning now to FIG. 1, the S-ICD of the present invention is illustrated. The S-ICD consists of an electrically active canister 11 and a subcutaneous electrode 13 attached to the canister. The canister has an electrically active surface 15 that is electrically insulated from the electrode connector block 17 and the canister housing 16 via insulating area 14. The canister can be similar to numerous electrically active canisters commercially available in that the canister will contain a battery supply, capacitor and operational circuitry. Alternatively, the canister can be thin and elongated to conform to the intercostal space. The circuitry will be able to monitor cardiac rhythms for tachycardia and fibrillation, and if detected, will initiate charging the capacitor and then delivering cardioversion /defibrillation energy through the active surface of the housing and to the subcutaneous electrode. Examples of such circuitry are described in U.S. Pat. Nos. 4,693,253 and 5,105,810, the entire disclosures of which are herein incorporated by reference. The canister circuitry can provide cardioversion/ defibrillation energy in different types of waveforms. In the preferred embodiment, a 100 uF biphasic waveform is used of approximately 10–20 ms total duration and with the initial phase containing approximately ⅔ of the energy, however, any type of waveform can be utilized such as monophasic, biphasic, multiphasic or alternative waveforms as is known in the art.
In addition to use of the sense circuitry for detection of V-Fib or V-Tach by examining the QRS waves, the sense circuitry can check for the presence or the absence of respiration. The respiration rate can be detected by monitoring the impedance across the thorax using subthreshold currents delivered across the active can and the high voltage subcutaneous lead electrode and monitoring the frequency in undulation in the waveform that results from the undulations of transthoracic impedance during the respiratory cycle. If there is no undulation, then the patent is not respiring and this lack of respiration can be used to confirm the QRS findings of cardiac arrest. The same technique can be used to provide information about the respiratory rate or estimate cardiac output as described in U.S. Pat. Nos. 6,095,987, 5,423,326, 4,450,527, the entire disclosures of which are incorporated herein by reference
The most distal electrode on the composite subcutaneous electrode is a coil electrode 27 that is used for delivering the high voltage cardioversion/defibrillation energy across the heart. The coil cardioversion/defibrillation electrode is about 5–10 cm in length. Proximal to the coil electrode are two sense electrodes, a first sense electrode 25 is located proximally to the coil electrode and a second sense electrode 23 is located proximally to the first sense electrode. The sense electrodes are spaced far enough apart to be able to have good QRS detection. This spacing can range from 1 to 10 cm with 4 cm being presently preferred. The electrodes may or may not be circumferential with the preferred embodiment. Having the electrodes non-circumferential and positioned outward, toward the skin surface, is a means to minimize muscle artifact and enhance QRS signal quality. The sensing electrodes are electrically isolated from the cardioversion/defibrillation electrode via insulating areas 29. Similar types of cardioversion/defibrillation electrodes are currently commercially available in a transvenous configuration. For example, U.S. Pat. No. 5,534,022, the entire disclosure of which is herein incorporated by reference, discloses a composite electrode with a coil cardioversion/defibrillation electrode and sense electrodes. Modifications to this arrangement are contemplated within the scope of the invention. One such modification is illustrated in FIG. 2 where the two sensing electrodes 25 and 23 are non-circumferential sensing electrodes and one is located at the distal end, the other is located proximal thereto with the coil electrode located in between the two sensing electrodes. In this embodiment the sense electrodes are spaced about 6 to about 12 cm apart depending on the length of the coil electrode used. FIG. 3 illustrates yet a further embodiment where the two sensing electrodes are located at the distal end to the composite electrode with the coil electrode located proximally thereto. Other possibilities exist and are contemplated within the present invention. For example, having only one sensing electrode, either proximal or distal to the coil cardioversion/defibrillation electrode with the coil serving as both a sensing electrode and a cardioversion/defribillation electrode.
The S-ICD will have prophylactic use in adults where chronic transvenous/epicardial LCD lead systems pose excessive risk or have already resulted in difficulty, such as sepsis or lead fractures. It is also contemplated that a major use of the S-ICD system of the present invention will be for prophylactic use in children who are at risk for having fatal arrhythmias, where chronic transvenous lead systems pose significant management problems. Additionally, with the use of standard transvenous LCDs in children, problems develop during patient growth in that the lead system does not accommodate the growth. FIG. 9 illustrates the placement of the S-ICD subcutaneous lead system such that he problem that growth presents to the lead system is overcome. The distal end of the subcutaneous electrode is placed in the same location as described above providing a good location for the coil cardioversion/defibrillation electrode 27 and the sensing electrodes 23 and 25. The insulated lead 21, however is no longer placed in a taut configuration. Instead, the lead is serpiginously placed with a specially designed introducer trocar and sheath such that it has numerous waves or bends. As the child grows, the waves or bends will straighten out lengthening the lead system while maintaining proper electrode placement. Although it is expected that fibrous scarring especially around the defibrillation coil will help anchor it into position to maintain its posterior position during growth, a lead system with a distal tine or screw electrode anchoring system 52 can also be incorporated into the distal tip of the lead to facilitate lead stability (see FIG. 1). Other anchoring systems can also be used such as hooks, sutures, or the like.
The two cardioversion/defibrillation electrodes on the housing are used for delivering the high voltage cardioversion/defibrillation energy across the heart. In the preferred embodiment, the cardioversion/defibrillation electrodes are coil electrodes, however, other cardioversion/defibrillation electrodes could be used such as having electrically isolated active surfaces or platinum alloy electrodes. The coil cardioversion/defibrillation electrodes are about 5–10 cm in length. Located on the housing between the two cardioversion/defibrillation electrodes are two sense electrodes 1425 and 1427. The sense electrodes are spaced far enough apart to be able to have good QRS detection. This spacing can range from 1 to 10 cm with 4 cm being presently preferred. The electrodes may or may not be circumferential with the preferred embodiment. Having the electrodes non-circumferential and positioned outward, toward the skin surface, is a means to minimize muscle artifact and enhance QRS signal quality. The sensing electrodes are electrically isolated from the cardioversion/defibrillation electrode via insulating areas 1423. Analogous types of cardioversion/defibrillation electrodes are currently commercially available in a transvenous configuration. For example, U.S. Pat. No. 5,534,022, the entire disclosure of which is herein incorporated by reference, discloses a composite electrode with a coil cardioversion/defibrillation electrode and sense electrodes. Modifications to this arrangement are contemplated within the scope of the invention. One such modification is to have the sense electrodes at the two ends of the housing and to have the cardioversion/defibrillation electrodes located in between the sense electrodes. Another modification is to have three or more sense electrodes spaced throughout the housing and allow for the selection of the two best sensing electrodes. If three or more sensing electrodes are used, the ability to change which electrodes are used for sensing would be a programmable feature of the US-ICD to adapt to changes in the patient physiology and size over time. The programming could be done via the use of physical switches on the canister, or as presently preferred, via the use of a programming wand or via a wireless connection to program the circuitry within the canister.
One factor in minimizing current diversion is in maintaining an equal current density distribution throughout an electrode's 204 conductive surface. A controlling factor in an electrode's 204 current density distribution is the electrode's 204 overall shape. Certain electrode 204 shapes draw current to particular areas on the electrode's 204 conductive surface (e.g., sharp angles). As a result, these electrodes 204 create an unequal current density distribution. Electrodes 204 possessing sharp corners, for example, may have higher current densities in the regions defined by the sharp corner. This unequal current density distribution results in confined “hot spots”. The formation of hot spots may be desirable and intentional, such as when attempting to increase current density adjacent to the sternum. On the other hand, hot spots may be undesirable as these high current density locations may scorch or singe surrounding tissue during the electrode's 204 emission of electrical energy. Moreover, electrodes 204 possessing numerous hot spots on the electrode's 204 conductive surface to consequently generate areas of low current density—or “cold spots”. This unequal distribution may render the electrode 204, as a whole, highly ineffective.
Referring back to the embodiment depicted in FIG. 21, the curvatures between the top surface 194 and the bottom surface 196 are shown differing toward the distal end 200 of the rug canister housing 192. At the S-ICD canister's distal end 200, the canister housing's top surface 194 curvature tapers downwardly toward the canister's bottom surface 196. This tapering causes the distal end 200 of the canister housing 192 to be narrower (of a decreased depth) than the canister's proximal end 202. In certain embodiments, this tapering in depth may be gradual throughout the length of the canister's housing 192, or alternatively, the tapering may be confined to a particular area.
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in an implantable cardiac stimulus or monitoring deviceWO2012170868A1Jun 8, 2012Dec 13, 2012Cameron Health, Inc.Antitachycaradia pacing pulse from a subcutaneous defibrillator* Cited by examinerClassifications U.S. Classification607/36, 607/5International ClassificationA61N1/375, A61N1/39Cooperative ClassificationA61N1/3968, A61N1/3906, A61N1/375, A61N1/3975, A61N1/3756, A61N1/3956European ClassificationA61N1/39M, A61N1/375Legal EventsDateCodeEventDescriptionJan 17, 2002ASAssignmentOwner name: CAMERON HEALTH, INC., CALIFORNIAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BARDY, GUST H.;CAPPATO, RICCARDO;RISSMANN, WILLIAM J.;AND OTHERS;REEL/FRAME:012493/0933Effective date: 20011112Oct 30, 2002ASAssignmentOwner name: CAMERON HEALTH, INC., CALIFORNIAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BARDY, GUST H.;CAPPATO, RICCARDO;RISSMANN, WILLIAM J.;AND OTHERS;REEL/FRAME:013440/0365Effective date: 20011112Feb 10, 2003ASAssignmentOwner name: CAMERON HEALTH, INC., CALIFORNIAFree format text: DOCUMENT RE-RECORDED TO CORRECT ERRORS CONTAINED IN PROPERTY NUMBER 09/940,377 IN THE DOCUMENT PREVIOUSLY RECORDED ON REEL 012493, FRAME 0933. ASSIGNOR HEREBY CONFIRMS THE ASSIGNMENT OF THE ENTIRE INTEREST.;ASSIGNORS:BARDY, GUST H;CAPPATO, RICCARDO;RISSMANN, WILLIAM J;AND OTHERS;REEL/FRAME:013736/0464Effective date: 20021112Mar 13, 2003ASAssignmentOwner name: COMERICA BANK-CALIFORNIA, CALIFORNIAFree format text: SECURITY INTEREST;ASSIGNOR:CAMERON HEALTH, INC.;REEL/FRAME:013848/0266Effective date: 20030121Apr 4, 2008ASAssignmentOwner name: CAMERON HEALTH INC., CALIFORNIAFree format text: RELEASE BY SECURED PARTY;ASSIGNOR:COMERICA BANK;REEL/FRAME:020758/0413Effective date: 20080401Apr 8, 2008CCCertificate of correctionDec 14, 2009FPAYFee paymentYear of fee payment: 4Nov 20, 2013FPAYFee paymentYear of fee payment: 8RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services