Source: http://www.google.es/patents/US7164952
Timestamp: 2013-05-21 21:02:08
Document Index: 142915671

Matched Legal Cases: ['art.\n2', 'art.\n3', 'art.\n4', 'art.\n5', 'art.\n10', 'art.\n11', 'art.\n12', 'art.\n14', 'art.\n15', 'art.\n16', 'art.\n19', 'art.\n20', 'art.\n21', 'art.\n22', 'art.\n23', 'art.\n24', 'art 2', 'art 1']

Patente US7164952 - Cardiac harness for treating congestive heart failure and for defibrillating ... - Google PatentesB�squeda Im�genes Maps Play YouTube Noticias Gmail Drive M�s » B�squeda avanzada de patentes | Historial web | Iniciar sesi�n B�squeda avanzada de patentesPatentesA system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock...http://www.google.es/patents/US7164952?utm_source=gb-gplus-sharePatente US7164952 - Cardiac harness for treating congestive heart failure and for defibrillating and/or pacing/sensing N�mero de publicaci�nUS7164952 B2Tipo de publicaci�nConcesi�n N�mero de solicitud11/002,609 Fecha de publicaci�n16 Ene 2007 Fecha de presentaci�n2 Dic 2004 Fecha de prioridad7 Nov 2003Tambi�n publicado comoEP1687059A1US7146226US7149588US7155295US7187984US7225036US20050102010US20050102011US20050102012US20050102014US20050102015US20050119717US20070106336US20070112390WO2005046789A1 InventoresMatthew G. FishlerLilip LauCraig Mar Cesionario originalParacor Medical, Inc. Clasificaci�n de EE.UU.607/129607/9 Clasificaci�n internacionalA61N1/375A61N1/05 Clasificaci�n cooperativaA61N1/0563A61F2002/2484A61F2/2481A61N1/0587A61N1/3756 Clasificaci�n europeaA61F2/24W2A61N1/05PReferenciasCitas de patentes (106)Otras citas (84)Enlaces externosUSPTO Cesi�n de USPTO EspacenetCardiac harness for treating congestive heart failure and for defibrillating and/or pacing/sensingUS 7164952 B2 Resumen A system for treating the heart includes a cardiac harness associated with a cardiac rhythm management devise which includes at least electrodes and a power source. The cardiac harness applies a compressive force on the heart during diastole and systole. The electrodes will deliver an electrical shock to the heart for defibrillation and/or can be used for pacing/sensing. The cardiac harness and electrodes are delivered and implanted on the heart by minimally invasive access.
1. An apparatus for treating a heart, comprising:
a medical device formed from a metallic alloy and configured to at least partially surround the heart;
a plurality of electrodes attached to the medical device and having a predetermined spacing;
the medical device being coated with a dielectric material to electrically insulate the medical device from the electrodes; and
the medical device and electrodes being compressible to a first delivery configuration small enough to be inserted through an incision in a pericardium, and a second expanded configuration wherein the medical device at least partially surrounds the heart.
2. The apparatus of claim 1, wherein the electrodes have a length, the electrodes being attached to the medical device so that the length is adapted to be substantially aligned with a longitudinal axis of the heart.
3. The apparatus of claim 2, wherein the electrodes are flexible along the length so that the electrodes are adapted to substantially conform to a surface of the heart.
4. The apparatus of claim 3, wherein the flexible electrodes have sufficient column strength to assist in mounting the medical device on the heart.
5. The apparatus of claim 1, wherein the electrodes are spaced on the medical device so that at least one electrode is adapted to be positioned adjacent the left ventricle.
6. The apparatus of claim 1, wherein the electrodes are spaced on the medical device so that at least one electrode is adapted to be positioned adjacent the right ventricle.
7. The apparatus of claim 1, wherein the electrodes are spaced on the medical device so that at least one electrode is adapted to be positioned adjacent the left ventricle and the right ventricle.
8. The apparatus of claim 1, wherein a lead is attached to each electrode.
9. The apparatus of claim 1, wherein at least one electrode is attached to a power source to provide a defibrillating shock to the heart.
10. The apparatus of claim 1, wherein at least one electrode is attached to a power source to provide sensing of the heart.
11. The apparatus of claim 1, wherein at least one electrode is attached to a power source to provide pacing of the heart.
12. The apparatus of claim 1, wherein the dielectric material is taken from the group of materials consisting of silicone rubber, parylene, polyurethanes, PTFE, TFE, and ePTFE.
13. The apparatus of claim 1, wherein the medical device is configured to be self-anchoring on the heart.
14. The apparatus of claim 1, wherein the medical device is configured to be self-adjusting on the heart.
15. The apparatus of claim 1, wherein the medical device is configured to be repositioned on the heart.
16. The apparatus of claim 1, wherein the electrodes are configured as electrode rings.
17. An apparatus for treating a heart, comprising:
an electrode attached to the medical device;
the medical device and electrode being compressible to a first delivery configuration small enough to be inserted through an incision in a pericardium, and a second expanded configuration.
18. The apparatus of claim 17, wherein the electrode has a length, the electrode being attached to the medical device so that the length is adapted to be substantially aligned with a longitudinal axis of the heart.
19. The apparatus of claim 18, wherein the electrode is flexible along the length so that the electrode is adapted to substantially conform to a surface of the heart.
20. The apparatus of claim 17, wherein the electrode is attached to a power source to provide a defibrillating shock to the heart or is adapted to be used for pacing and sensing the heart.
21. The apparatus of claim 17, wherein the medical device is configured to be self-anchoring on the heart.
22. The apparatus of claim 17, wherein the medical device is configured to be self-adjusting on the heart.
23. The apparatus of claim 17, wherein the medical device is configured to be repositioned on the heart.
24. The apparatus of claim 17, wherein the electrodes are configured as electrode rings.
This application is a division of U.S. Ser. No. 10/704,376 filed Nov. 7, 2003, and is co-pending with U.S. Ser. No. 10/777,451 filed Feb. 12, 2004; U.S. Ser. No. 10/793,549 filed Mar. 3, 2004; U.S. Ser. No. 10/795,574 filed Mar. 5, 2004; and U.S. Ser. No. 10/858,995 filed Jun. 2, 2004.
Historically, congestive heart failure has been managed with a variety of drugs. Devices have also been used to improve cardiac output. For example, left ventricular assist pumps help the heart to pump blood. Multi-chamber pacing has also been employed to optimally synchronize the beating of the heart chambers to improve cardiac output. Various skeletal muscles, such as the latissimus dorsi, have been used to assist ventricular pumping. Researches and cardiac surgeons have also experimented with prosthetic �girdles� disposed around the heart. One such design is a prosthetic �sock� or �jacket� that is wrapped around the heart.
In another embodiment, the electrodes have a first surface and a second surface, the first surface being in contact with the outer surface of the heart, such as the epicardium, and the second surface faces away from the heart. Both the first surface and the second surface do not have a dielectric coating so that an electrical charge can be delivered to the outer surface of the heart for defibrillating or for pacing. In this embodiment, at least a portion of the electrodes are coated with a dielectric coating, such as silicone rubber, parylene or polyurethane. The dielectric coating serves to insulate the bare metal portions of the electrode from the cardiac harness, and also to provide attachment means for attaching the electrodes to the panels of the cardiac harness.
Sometimes a patient's heart begins fibrillating during heart surgery or other open-chest surgeries. In such instances, a special type of defibrillating device is used. An open-chest defibrillator includes special electrode paddles that are configured to be applied to the heart on opposite sides of the heart. A strong electric field is created between the paddles, and an electric current passes though the heart to defibrillate the heart and restore the heart to regular pumping.
Referring to FIG. 5C, the non-conductive member 34 extends beyond the coil wire 33 for a distance. The non-conductive member preferably is made from the same material as the dielectric material 37, typically a silicone rubber or similar material. While it is preferred that the dielectric material be made from silicone rubber, or a similar material, it also can be made from parylene (Union Carbide), polyurethanes, PTFE, TFE, and ePTFE. As can be seen, the non-conductive member provides support for the dielectric material to attach the bar arms 30 of the undulating strands 22 in order to connect the strands to the electrode 32. A conductive wire 35 extends through the non-conducting member and attaches to the proximal end of the coil wire 33 so that when an electrical current is delivered from the power source 36 through conductive wire 35, the electrode coil 33 will be energized. The conductive wire 35 is also covered by non-conducting material 34. Referring to FIG. 5D, it can be seen that the non-conductive member 34 continues to extend beyond the bottom (apex) of the cardiac harness and that conductive wire 35 continues to extend out of the non-conductive member and into the power source 36. In the embodiment shown in FIGS. 5B�5D, the cardiac harness is insulated from the electrodes by the dielectric material 37 so that there is no shunting of electrical currents by the cardiac harness 20 from the electrical shock delivered by the electrodes during defibrillation or pacing functions.
It may be desired to reduce the likelihood of the development of fibrotic tissue over the cardiac harness so that the elastic properties of the harness are not compromised. Also, as fibrotic tissue forms over the cardiac harness and electrodes over time, it may become necessary to increase the power of the pacing stimuli. As fibrotic tissue increases, the right and left ventricular thresholds may increase, commonly referred to as �exit block.� When exit block is detected, the pacing therapy may have to be adjusted. Certain drugs such as steriods, have been found to inhibit cell growth leading to scar tissue or fibrotic tissue growth. Examples of therapeutic drugs or pharmacologic compounds that may be loaded onto the cardiac harness or into a polymeric coating on the harness, on a polymeric sleeve, on individual undulating strands on the harness, or infused through the lumens in the electrodes and delivered to the epicardial surface of the heart include steroids, taxol, aspirin, prostaglandins, and the like. Various therapeutic agents such as antithrombogenic or antiproliferative drugs are used to further control scar tissue formation. Examples of therapeutic agents or drugs that are suitable for use in accordance with the present invention include 17-beta estradiol, sirolimus, everolimus, actinomycin D (ActD), taxol, paclitaxel, or derivatives and analogs thereof. Examples of agents include other antiproliferative substances as well as antineoplastic, antiinflammatory, antiplatelet, anticoagulant, antifibrin, antithrombin, antimitotic, antibiotic, and antioxidant substances. Examples of antineoplastics include taxol (paclitaxel and docetaxel). Further examples of therapeutic drugs or agents include antiplatelets, anticoagulants, antifibrins, antinflammatories, antithrombins, and antiproliferatives. Examples of antiplatelets, anticoagulants, antifibrins, and antithrombins include, but are not limited to, sodium heparin, low molecular weight heparin, hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclin analogs, dextran, D-phe-pro-arg-chloromethylketone (synthetic antithrombin), dipyridamole, glycoprotein IIb/IIIa platelet membrane receptor antagonist, recombinant hirudin, thrombin inhibitor (available from Biogen located in Cambridge, Mass.), and 7E-3B� (an antiplatelet drug from Centocor located in Malvern, Pa.). Examples of antimitotic agents include methotrexate, azathioprine, vincristine, vinblastine, fluorouracil, adriamycin, and mutamycin. Examples of cytostatic or antiproliferative agents include angiopeptin (a somatostatin analog from Ibsen located in the United Kingdom), angiotensin converting enzyme inhibitors such as Captopril� (available from Squibb located in New York, N.Y.), Cilazapril� (available from Hoffman-LaRoche located in Basel, Switzerland), or Lisinopril� (available from Merck located in Whitehouse Station, N.J.); calcium channel blockers (such as Nifedipine), colchicine, fibroblast growth factor (FGF) antagonists, fish oil (omega 3-fatty acid), histamine antagonists, Lovastatin� (an inhibitor of HMG-CoA reductase, a cholesterol lowering drug from Merck), methotrexate, monoclonal antibodies (such as PDGF receptors), nitroprusside, phosphodiesterase inhibitors, prostaglandin inhibitor (available from GlaxoSmithKline located in United Kingdom), Seramin (a PDGF antagonist), serotonin blockers, steroids, thioprotease inhibitors, triazolopyrimidine (a PDGF antagonist), and nitric oxide. Other therapeutic drugs or agents which may be appropriate include alpha-interferon, genetically engineered epithelial cells, and dexamethasone.
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