Source: http://www.google.com/patents/US7502645?dq=6650327
Timestamp: 2017-07-23 04:06:45
Document Index: 83041045

Matched Legal Cases: ['art.\n6', 'art.\n9', 'art.\n12', 'art.\n16', 'art.\n19', 'art.\n21', 'art.\n24']

Patent US7502645 - Current waveforms for anti-bradycardia pacing for a subcutaneous implantable ... - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsA power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathoracic blood vessels and for providing anti-bradycardia pacing energy to...http://www.google.com/patents/US7502645?utm_source=gb-gplus-sharePatent US7502645 - Current waveforms for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillatorAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS7502645 B2Publication typeGrantApplication numberUS 11/060,869Publication dateMar 10, 2009Filing dateFeb 18, 2005Priority dateSep 18, 2000Fee statusPaidAlso published asUS20020107544, US20050143778, WO2003039666A1Publication number060869, 11060869, US 7502645 B2, US 7502645B2, US-B2-7502645, US7502645 B2, US7502645B2InventorsAlan H. Ostroff, William J. Rissmann, Gary R. Mezack, Gust H. BardyOriginal AssigneeCameron Health, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (106), Non-Patent Citations (17), Referenced by (7), Classifications (14), Legal Events (4) External Links: USPTO, USPTO Assignment, EspacenetCurrent waveforms for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US 7502645 B2Abstract
1. A method of treating the heart of a patient comprising applying a first constant current defibrillation stimulus across a portion of patient tissue between first and second electrodes both disposed subcutaneously, nonvascularly, and exclusive of the heart; wherein the first electrode is disposed on a canister containing circuitry for generating the first constant current, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister.
2. The method of claim 1, further comprising determining whether the patient's cardiac rhythm is normal, wherein the step of applying a first constant current is performed if the patient's cardiac rhythm is abnormal.
3. The method of claim 1, wherein the first constant current is provided at a time to convert the patient into normal cardiac rhythm.
4. The method of claim 1, further comprising applying a second constant current across the portion of tissue using the first and second electrodes, wherein the second constant current is of opposite sign from the first constant current.
5. The method of claim 1, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
6. A method of treating the heart of a patient comprising applying a first constant current defibrillation stimulus across a portion of patient tissue between first and second electrodes both disposed subcutaneously, nonvascularly, and exclusive of the heart, wherein the first electrode is disposed along the left axillary line of the patient, and the second electrode is disposed medial from the first electrode.
7. The method of claim 6, wherein the first electrode is disposed along the inframammary crease of the patient.
8. The method of claim 7, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
9. A method of treating the heart of a patient comprising applying a first constant current across a portion of patient tissue between first and second electrodes both disposed subcutaneously, nonvascularly, and exclusive of the heart, wherein the first electrode is disposed along the inframammary crease of the patient.
10. The method of claim 9, wherein the first electrode is disposed on a canister containing circuitry for generating the first constant current, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister.
11. The method of claim 9, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
12. A method of treating the heart of a patient comprising providing a biphasic constant current defibrillation stimulus across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient's heart or reside in the patient's vasculature;
wherein the first electrode is disposed on a canister containing circuitry for generating the biphasic constant current defibrillation stimulus, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister, and the lead assembly does not reside in any intrathoracic blood vessel of the patient.
13. The method of claim 12, further comprising determining whether the patient's cardiac rhythm is normal, wherein the step of applying a biphasic constant current defibrillation stimulus is performed if the patient's cardiac rhythm is abnormal.
14. The method of claim 12, wherein biphasic constant current defibrillation stimulus is provided at a time to convert the patient into normal cardiac rhythm.
15. The method of claim 12, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
16. A method of treating the heart of a patient comprising providing a biphasic constant current defibrillation stimulus across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient's heart or reside in the patient's vasculature, wherein the first electrode is disposed along the left axillary line of the patient, and the second electrode is disposed medial from the first electrode.
17. The method of claim 16, wherein the first electrode is disposed along the inframammary crease of the patient.
18. The method of claim 17, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
19. A method of treating the heart of a patient comprising providing a biphasic constant current signal across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient's heart or reside in the patient's vasculature, wherein the first electrode is disposed along the inframammary crease of the patient.
20. The method of claim 19, wherein a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
21. A method of treating the heart of a patient comprising providing a biphasic constant current signal across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient's heart or reside in the patient's vasculature, the first and second electrodes being part of an implantable medical system comprising a canister and a single lead assembly which does not reside in any intrathoracic blood vessel of the patient;
wherein the biphasic constant current signal includes a first portion having a first duration and a first magnitude and a second portion having a second duration and a second magnitude; and
wherein the first portion has a magnitude in the range of about one to two-hundred fifty milliamps, and the second portion has a magnitude in the range of about one to two-hundred fifty milliamps and the biphasic constant current signal, from the start of the first portion to the end of the second portion, has a duration in the range of about one to forty milliseconds.
22. The method of claim 21, wherein the first electrode is disposed on a canister containing circuitry for generating the biphasic constant current signal, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister.
23. A method of treating the heart of a patient comprising providing a constant current signal across a portion of patient tissue including heart tissue between first and second electrodes implanted in the torso of the patient such that the first and second electrodes do not contact the patient's heart or reside in the patient's vasculature; wherein:
the first electrode is disposed on a canister containing circuitry for generating the constant current signal, and the second electrode is disposed on a lead electrode assembly electrically coupled to the circuitry in the canister;
the first electrode is disposed along the left axillary line of the patient and the second electrode is disposed medial from the first electrode;
the first electrode is disposed along the inframammary crease of the patient; and
a line drawn from the first electrode to the second electrode intersects a portion of the patient's heart.
24. The method of claim 23, wherein the constant current signal is provided at a time to convert the patient into normal cardiac rhythm.
25. The method of claim 23, further comprising determining whether the patient's cardiac rhythm is normal, wherein the step of applying a constant current signal is performed if the patient's cardiac rhythm is abnormal. Description
This application is a continuation of U.S. application Ser. No. 10/011,506, filed Nov. 5, 2001, abandoned; which is a continuation-in-part of U.S. application Ser. No. 09/663,607, filed Sep. 18, 2000, now U.S. Pat. No. 6,721,597; and U.S. application Ser. No. 09/663,606, filed Sep. 18, 2000, now U.S. Pat. No. 6,647,292, the disclosures of which are all incorporated herein by reference.
In addition, this application is related to U.S. application Ser. No. 10/011,860, filed Nov. 5, 2001, now U.S. Pat. No. 7,092,754; U.S. application Ser. No. 10/011,958, filed Nov. 5, 2001, abandoned; and U.S. application Ser. No. 10/015,202, filed Nov. 5, 2001, now U.S. Pat. No. 6,952,610; the disclosures of which applications are hereby incorporated by reference.
The present invention relates to an apparatus and method for performing electrical cardioversion/defibrillation and optional pacing of the heart via a non-transvenous system.
FIG. 19 is a graph that shows an example of a biphasic waveform for use in anti-bradycardia pacing in an embodiment of the present invention; and
FIG. 20 is a graph that shows an example of a monophonic waveform for use in anti-bradycardia pacing in an embodiment of the present invention.
The canister of the present invention can be made out of titanium alloy or other presently preferred electrically active canister designs. However, it is contemplated that a malleable canister that can conform to the curvature of the patient's chest will be preferred. In this way the patient can have a comfortable canister that conforms to the shape of the patient's rib cage. Examples of conforming canisters are provided in U.S. Pat. No. 5,645,586, the entire disclosure of which is herein incorporated by reference. Therefore, the canister can be made out of numerous materials such as medical grade plastics, metals, and alloys. In the preferred embodiment, the canister is smaller than 60 cc volume having a weight of less than 100 gms for long term wearability, especially in children. The canister and the lead of the S-ICD can also use fractal or wrinkled surfaces to increase surface area to improve defibrillation capability. Because of the primary prevention role of the therapy and the likely need to reach energies over 40 Joules, a feature of one embodiment is that the charge time for the therapy is intentionally left relatively long to allow capacitor charging within the limitations of device size. Examples of small ICD housings are disclosed in U.S. Pat. Nos. 5,597,956 and 5,405,363, the entire disclosures of which are herein incorporated by reference.
FIG. 19 is a graph that shows an embodiment of the example of a biphasic waveform for use in anti-bradycardia pacing applications in subcutaneous implantable cardioverter-defibrillators (“S-ICD”) in an embodiment of the present invention. As shown in FIG. 19, the biphasic waveform is plotted as a function of current versus time.
FIG. 20 is a graph that shows an embodiment of the example of a monophasic waveform for use in anti-bradycardia pacing applications in subcutaneous implantable cardioverter-defibrillators (“S-ICD”) in an embodiment of the present invention. As shown in FIG. 20, the monophasic waveform is plotted as a function of current versus time.
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