Source: http://www.google.com/patents/US6866044?dq=6322901
Timestamp: 2016-12-09 07:54:50
Document Index: 20240

Matched Legal Cases: ['art.\n24', 'art.\n28', 'art.\n46', 'art.\n48', 'art.\n78', 'art.\n81']

Patent US6866044 - Method of insertion and implantation of implantable cardioverter ... - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsOne embodiment of the present invention provides a method of inserting an implantable cardioverter-defibrillator within a patient, the method including the steps of providing a cardioverter-defibrillator canister having at least a portion of the cardioverter-defibrillator canister being non planar to...http://www.google.com/patents/US6866044?utm_source=gb-gplus-sharePatent US6866044 - Method of insertion and implantation of implantable cardioverter-defibrillator canistersAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS6866044 B2Publication typeGrantApplication numberUS 09/940,377Publication dateMar 15, 2005Filing dateAug 27, 2001Priority dateSep 18, 2000Fee statusPaidAlso published asUS20020049475, WO2003018125A2, WO2003018125A8Publication number09940377, 940377, US 6866044 B2, US 6866044B2, US-B2-6866044, US6866044 B2, US6866044B2InventorsGust H. Bardy, Riccardo Cappato, William J. Rissmann, Gary H. SandersOriginal AssigneeCameron Health, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (109), Non-Patent Citations (70), Referenced by (155), Classifications (13), Legal Events (7) External Links: USPTO, USPTO Assignment, EspacenetMethod of insertion and implantation of implantable cardioverter-defibrillator canisters
US 6866044 B2Abstract
One embodiment of the present invention provides a method of inserting an implantable cardioverter-defibrillator within a patient, the method including the steps of providing a cardioverter-defibrillator canister having at least a portion of the cardioverter-defibrillator canister being non planar to maintain the cardioverter-defibrillator canister in a predetermined relationship with respect to a patient's heart, subcutaneously over a patient's ribcage; making a single incision into the patient; and advancing the cardioverter-defibrillator canister through the single incision and subcutaneously over the patient's ribcage.
providing a cardioverter-defibrillator canister having at least a portion of the cardioverter-defibrillator canister being non planar to maintain the cardioverter-defibrillator canister in a predetermined relationship with respect to a patient's heart, subcutaneously over a patient's ribcage; making an incision into the patient; and advancing the cardioverter-defibrillator canister through the incision and subcutaneously over the patient's ribcage; wherein the incision is made approximately at the level of the cardiac apex. 2. The method of claim 1, wherein the canister has a length of less than 30 centimeters.
3. The method of claim 2, wherein the cardioverter-defibrillator canister has a length of approximately 3 centimeters to approximately 30 centimeters.
4. The method of claim 2, wherein the cardioverter-defibrillator canister has a length of approximately 5 centimeters to approximately 20 centimeters.
5. The method of claim 2, wherein the cardioverter-defibrillator canister has a length of approximately 5 centimeters to approximately 12 centimeters.
6. The method of claim 1, wherein the cardioverter-defibrillator canister has a width of approximately 3 centimeters to approximately 10 centimeters.
7. The method of claim 1, wherein the cardioverter-defibrillator canister has a width of approximately 3 centimeters to approximately 6 centimeters.
8. The method of claim 1, wherein the cardioverter-defibrillator canister has a depth that is less than approximately 15 millimeters.
9. The method of claim 1, wherein the cardioverter-defibrillator canister further comprises a first end and a second end.
10. The method of claim 9, wherein a width of the cardioverter-defibrillator canister between the first end and the second end are substantially similar.
11. The method of claim 9, wherein the first end of the cardioverter-defibrillator canister is rounded.
12. The method of claim 11, wherein the second end of the cardioverter-defibrillator canister is substantially square.
13. The method of claim 11, wherein the second end of the cardioverter-defibrillator canister is rounded.
14. The method of claim 9, wherein the width of the cardioverter-defibrillator canister tapers inwardly between the second end of the cardioverter-defibrillator canister and the first end of the cardioverter-defibrillator canister.
15. The method of claim 9, wherein the depth of the cardioverter-defibrillator canister decreases from the second end of the cardioverter-defibrillator canister to the first end of the cardioverter-defibrillator canister.
16. The method of claim 1, wherein a length of the cardioverter-defibrillator canister is greater than a width of the cardioverter-defibrillator canister.
17. The method of claim 1, wherein a length of the cardioverter-defibrillator canister is substantially similar to a width of the cardioverter-defibrillator canister.
18. The method of claim 1, wherein the cardioverter-defibrillator canister further comprises an electrode located on a portion of the cardioverter-defibrillator canister.
19. The method of claim 18, wherein the electrode can emit a shocking energy.
20. The method of claim 1, wherein at least a portion of the cardioverter-defibrillator canister comprises an electrically insulated material.
21. The method of claim 1 wherein the incision is made approximately in the left anterior axillary line.
22. The method of claim 1, further comprising the step of shaping a passageway within the patient for the cardioverter-defibrillator canister to navigate.
23. The method of claim 1, wherein the cardioverter-defibrillator canister is advanced proximate the patient's heart.
24. The method of claim 1, wherein the cardioverter-defibrillator canister is advanced medially along approximately a patient's left inframammary crease.
25. The method of claim 1, wherein the cardioverter-defibrillator canister is advanced toward a patient's sternum.
26. The method of claim 1, wherein the cardioverter-defibrillator canister is advanced approximately between a patient's third and a patient's twelfth rib.
27. The method of claim 1, wherein the cardioverter-defibrillator canister refrains from directly contacting the patient's heart.
28. The method of claim 1, wherein the cardioverter-defibrillator canister refrains from directly contacting a patient's intrathoracic vasculature.
29. The method of claim 1, further comprising the step of orienting a length of the cardioverter-defibrillator canister along a length of the ribs in the ribcage.
30. The method of claim 1, further comprising the step of orienting a length of the cardioverter-defibrillator canister perpendicularly to a length of the ribs in the ribcage.
31. The method of claim 1, wherein the incision is made approximately in the left anterior axillary line, and the cardioverter-defibrillator is advanced medially toward approximately a patient's left inframammary crease between the patient's third and the patient's twelfth rib.
32. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
providing the implantable cardioverter-defibrillator comprising a housing and an electrode located on the housing, wherein the implantable cardioverter-defibrillator is configured to provide a shocking energy to a patient's heart by the electrode; making an incision into the patient approximately in the left anterior axillary line; and advancing the implantable cardioverter-defibrillator through the incision and subcutaneously in the area defined between approximately a patient's third rib and approximately a patient's twelfth rib. 33. The method of claim 32, wherein the cardioverter-defibrillator has a length of less than 30 centimeters.
34. The method of claim 32, wherein the cardioverter-defibrillator has a length of approximately 3 centimeters to approximately 30 centimeters.
35. The method of claim 32, wherein the cardioverter-defibrillator canister has a length of approximately 5 centimeters to approximately 20 centimeters.
36. The method of claim 32, wherein the cardioverter-defibrillator has a length of approximately 5 centimeters to approximately 12 centimeters.
37. The method of claim 32, wherein the cardioverter-defibrillator has a width of approximately 3 centimeters to approximately 10 centimeters.
38. The method of claim 32, wherein the cardioverter-defibrillator has a width of approximately 3 centimeters to approximately 6 centimeters.
39. The method of claim 32, wherein the cardioverter-defibrillator has a depth that is less than approximately 15 millimeters.
40. The method of claim 32, wherein a length of the cardioverter-defibrillator is greater than a width of the cardioverter-defibrillator.
41. The method of claim 32, wherein the length of the cardioverter-defibrillator is substantially similar to the width of the cardioverter-defibrillator.
42. The method of claim 32, wherein at least a portion of the cardioverter-defibrillator is substantially non planar.
43. The method of claim 32, wherein at least a portion of the cardioverter-defibrillator comprises an electrically insulated material.
44. The method of claim 32, further comprising the step of shaping a passageway within the patient for the cardioverter-defibrillator to navigate.
45. The method of claim 32, wherein the cardioverter-defibrillator is advanced proximate the patient's heart.
46. The method of claim 32, wherein the cardioverter-defibrillator is advanced proximate a patient's sternum.
47. The method of claim 32, wherein the cardioverter-defibrillator refrains from directly contacting the patient's heart.
48. The method of claim 32, wherein the cardioverter-defibrillator refrains from directly contacting a patient's intrathoracic vasculature.
49. The method of claim 32, further comprising the step of orienting a length of the cardioverter-defibrillator along a length of the ribs in the ribcage.
50. The method of claim 32, further comprising the step of orienting a length of the cardioverter-defibrillator perpendicularly to a length of the ribs in the ribcage.
51. The method of claim 32, wherein the cardioverter-defibrillator further comprises a first end and a second end.
52. The method of claim 51, wherein the width of the cardioverter-defibrillator between the first end and the second end are substantially similar.
53. The method of claim 51, wherein the first end of the cardioverter-defibrillator is rounded.
54. The method of claim 53, wherein the second end of the cardioverter-defibrillator is substantially square.
55. The method of claim 53, wherein the second end of the cardioverter-defibrillator is rounded.
56. The method of claim 51, wherein the width of the cardioverter-defibrillator tapers inwardly between the second end of the cardioverter-defibrillator and the first end of the cardioverter-defibrillator.
57. The method of claim 51, wherein the depth of the cardioverter-defibrillator decreases from the second end of the cardioverter-defibrillator to the first end of the cardioverter-defibrillator.
58. The method of claim 32, wherein the cardioverter-defibrillator further comprises an electric circuit located in a portion of the cardioverter-defibrillator.
59. The method of claim 58, wherein the electric circuit may provide multiphasic cardiac pacing.
60. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
providing the implantable cardioverter-defibrillator comprising a housing and an electrode located on the housing, wherein the implantable cardioverter-defibrillator is configured to provide a shocking energy to a patient's heart by the electrode; making an incision into the patient; and advancing the implantable cardioverter-defibrillator through the incision and subcutaneously in the area defined between approximately a patient's third rib and approximately a patient's twelfth rib; wherein the incision is made approximately at the level of the cardiac apex. 61. The method of claim 60, wherein the incision is made approximately in the left anterior axillary line.
62. A method of inserting an implantable cardioverter-defibrillator within a patient, the method comprising the steps of:
providing the implantable cardioverter-defibrillator comprising a housing and an electrode located on the housing, wherein the implantable cardioverter-defibrillator is configured to provide a shocking energy to a patient's heart by the electrode; making an incision into the patient; and advancing the implantable cardioverter-defibrillator through the incision and subcutaneously in the area defined between approximately a patient's third rib and approximately a patient's twelfth rib; wherein the cardioverter-defibrillator is advanced medially toward approximately a patient's left inframammary crease. 63. 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 incision into the patient; and advancing the cardioverter-defibrillator through the incision and subcutaneously over the patient's ribcage; wherein the cardioverter-defibrillator is advanced medially toward approximately a patient's left inframammary crease. 64. The method of claim 63, wherein the housing has a length of less than 30 centimeters.
65. The method of claim 64, wherein the housing has a length of approximately 3 centimeters to approximately 30 centimeters.
66. The method of claim 64, wherein the housing has a length of approximately 5 centimeters to approximately 20 centimeters.
67. The method of claim 64, wherein the housing has a length of approximately 5 centimeters to approximately 12 centimeters.
68. The method of claim 63, wherein the housing has a width of approximately 3 centimeters to approximately 10 centimeters.
69. The method of claim 63, wherein the housing has a width of approximately 3 centimeters to approximately 6 centimeters.
70. The method of claim 63, wherein the housing has a depth that is less than approximately 15 millimeters.
71. The method of claim 63, wherein a length of the housing is greater than a width of the housing.
72. The method of claim 63, wherein the length of the housing is substantially similar to the width of the housing.
73. The method of claim 63, wherein at least a portion of the housing is substantially non planar.
74. The method of claim 63, wherein at least a portion of the housing comprises an electrically insulated material.
75. The method of claim 63, wherein the incision is made approximately at the level of the cardiac apex.
76. The method of claim 63, further comprising the step of shaping a passageway within the patient for the cardioverter-defibrillator to navigate.
77. The method of claim 63, wherein the cardioverter-defibrillator is advanced proximate the patient's heart.
78. The method of claim 63, wherein the cardioverter-defibrillator is advanced proximate a patient's sternum.
79. The method of claim 63, wherein the cardioverter-defibrillator is advanced approximately between a patient's third and a patient's twelfth rib.
80. The method of claim 63, wherein the cardioverter-defibrillator refrains from directly contacting the patient's heart.
81. The method of claim 63, wherein the cardioverter-defibrillator refrains from directly contacting a patient's intrathoracic vasculature.
82. The method of claim 63, further comprising the step of orienting a length of the cardioverter-defibrillator along a length of the ribs in the ribcage.
83. The method of claim 63, further comprising the step of orienting a length of the cardioverter-defibrillator perpendicularly to a length of the ribs in the ribcage.
84. The method of claim 63, wherein the housing further comprises a first end and a second end.
85. The method of claim 84, wherein the width of the housing between the first end and the second end are substantially similar.
86. The method of claim 84, wherein the width of the housing tapers inwardly between the second end of the housing and the first end of the housing.
87. The method of claim 84, wherein the depth of the housing decreases from the second end of the housing to the first end of the housing.
88. The method of claim 84, wherein the electrode is located on a portion of the first end of the housing.
89. The method of claim 88, further comprising a second electrode being electrically coupled to the electrical circuit within the housing.
90. The method of claim 89, wherein the second electrode is located upon a portion of the second end of the housing.
91. The method of claim 84, wherein the first end of the housing is rounded.
92. The method of claim 91, wherein the second end of the housing is substantially square.
93. The method of claim 91, wherein the second end of the housing is rounded.
94. 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 an incision into the patient; and advancing the cardioverter-defibrillator through the incision and subcutaneously over the patient's ribcage, wherein the incision is made approximately in the left anterior axillary line. 95. The method of claim 94 wherein said housing has an elongated shape with two opposed ends, and wherein said electrode is disposed adjacent to one end.
96. The method of claim 95 wherein said electrode is disposed at one end.
97. The method of claim 96 wherein said electrode is generally rectangular.
98. The method of claim 97 wherein said electrode has rounded corners.
99. The method of claim 97 wherein said electrode is disposed transversally to a longitudinal axis of the housing.
100. The method of claim 99 wherein said housing has a width and said electrode is disposed substantially along said width.
101. The method of claim 96 wherein said electrode is triangular.
102. The method of claim 101 wherein said electrode has rounded corners.
103. The method of claim 101 wherein said housing has at least one corner and said electrode is disposed at said corner.
104. The method of claim 103 wherein said electrode has a right angle disposed at the corner of the housing.
105. The method of claim 95 wherein said electrode has a generally square shape.
106. The method of claim 105 wherein said electrode has rounded corners.
107. The method of claim 105 wherein said electrode is spaced away from the longitudinal sides of the housing.
In addition, the present application is filed concurrently herewith U.S. patent application entitled “DUCKBILL-SHAPED IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR AND METHOD OF USE,” U.S. patent application entitled “CERAMICS AND/OR OTHER MATERIAL INSULATED SHELL FOR ACTIVE AND NON-ACTIVE S-ICD CAN,” U.S. patent application entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH IMPROVED INSTALLATION CHARACTERISTICS,” U.S. patent application entitled “SUBCUTANEOUS ELECTRODE WITH IMPROVED CONTACT SHAPE FOR TRANSTHORACIC CONDUCTION,” U.S. patent application entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH HIGHLY MANEUVERABLE INSERTION TOOL,” U.S. patent application entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH LOW-PROFILE INSTALLATION APPENDAGE AND METHOD OF DOING SAME,” U.S. patent application entitled “SUBCUTANEOUS ELECTRODE FOR TRANSTHORACIC CONDUCTION WITH INSERTION TOOL,” U.S. patent application entitled “CANISTER DESIGNS FOR IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS,” U.S. patent application entitled “RADIAN CURVED IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR CANISTER,” U.S. patent application entitled “CARDIOVERTER-DEFIBRILLATOR HAVING A FOCUSED SHOCKING AREA AND ORIENTATION THEREOF,” U.S. patent application entitled “BIPHASIC WAVEFORM FOR ANTI-BRADYCARDIA PACING FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” U.S. patent application entitled “BIPHASIC WAVEFORM FOR ANTI-TACHYCARDIA PACING FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” and U.S. patent application entitled “POWER SUPPLY FOR A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR,” the disclosures of which applications are hereby incorporated by reference.
The S-LCD canister 11 is then placed subcutaneously at the location of the incision or medially at the subcutaneous region at the left inframammary crease. The subcutaneous electrode 13 is placed with a specially designed curved introducer set 40 (see FIG. 8 ). The introducer set comprises a curved trocar 42 and a stiff curved peel away sheath 44. The peel away sheath is curved to allow for placement around the rib cage of the patient in the subcutaneous space created by the trocar. The sheath has to be stiff enough to allow for the placement of the electrodes without the sheath collapsing or bending. Preferably the sheath is made out of a biocompatible plastic material and is perforated along its axial length to allow for it to split apart into two sections. The trocar has a proximal handle 41 and a curved shaft 43. The distal end 45 of the trocar is tapered to allow for dissection of a subcutaneous path 33 in the patient. Preferably, the trocar is cannulated having a central Lumen 46 and terminating in an opening 48 at the distal end. Local anesthetic such as lidocaine can be delivered, if necessary, through the lumen or through a curved and elongated needle designed to anesthetize the path to be used for trocar insertion should general anesthesia not be employed. The curved peel away sheath 44 has a proximal pull tab 49 for breaking the sheath into two halves along its axial shaft 47. The sheath is placed over a guidewire inserted through the trocar after the subcutaneous path has been created. The subcutaneous pathway is then developed until it terminates subcutaneously at a location that, if a straight line were drawn from the canister location to the path termination point the line would intersect a substantial portion of the left ventricular mass of the patient. The guidewire is then removed leaving the peel away sheath. The subcutaneous lead system is then inserted through the sheath until it is in the proper location. Once the subcutaneous lead system is in the proper location, the sheath is split in half using the pull tab 49 and removed. If more than one subcutaneous electrode is being used, a new curved peel away sheath can be used for each subcutaneous electrode.
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EventsDateCodeEventDescriptionJan 4, 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:012426/0421Effective date: 20011112Mar 13, 2003ASAssignmentOwner name: COMERICA BANK-CALIFORNIA, CALIFORNIAFree format text: SECURITY INTEREST;ASSIGNOR:CAMERON HEALTH, INC.;REEL/FRAME:013848/0266Effective date: 20030121May 31, 2005CCCertificate of correctionApr 4, 2008ASAssignmentOwner name: CAMERON HEALTH INC., CALIFORNIAFree format text: RELEASE BY SECURED PARTY;ASSIGNOR:COMERICA BANK;REEL/FRAME:020758/0413Effective date: 20080401Sep 5, 2008FPAYFee paymentYear of fee payment: 4Sep 13, 2012FPAYFee paymentYear of fee payment: 8Sep 1, 2016FPAYFee paymentYear of fee payment: 12RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services