Source: http://www.google.com/patents/US20030167081?ie=ISO-8859-1
Timestamp: 2014-11-25 02:18:18
Document Index: 453360493

Matched Legal Cases: ['art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102']

Patent US20030167081 - Coronary sinus lead with thermal sensor and method therefor - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsA lead system is provided including a coronary sinus lead extending from a proximal end to a distal end, where the lead includes at least one thermal sensor, or optionally, a thermistor. The thermal sensor is positionable within a coronary sinus of a heart when the coronary sinus lead is implanted in...http://www.google.com/patents/US20030167081?utm_source=gb-gplus-sharePatent US20030167081 - Coronary sinus lead with thermal sensor and method thereforAdvanced Patent SearchPublication numberUS20030167081 A1Publication typeApplicationApplication numberUS 10/087,377Publication dateSep 4, 2003Filing dateMar 1, 2002Priority dateMar 1, 2002Also published asUS7127291Publication number087377, 10087377, US 2003/0167081 A1, US 2003/167081 A1, US 20030167081 A1, US 20030167081A1, US 2003167081 A1, US 2003167081A1, US-A1-20030167081, US-A1-2003167081, US2003/0167081A1, US2003/167081A1, US20030167081 A1, US20030167081A1, US2003167081 A1, US2003167081A1InventorsQingsheng Zhu, Jeffrey Stahmann, John HatlestadOriginal AssigneeCardiac Pacemakers, Inc.Export CitationBiBTeX, EndNote, RefManReferenced by (12), Classifications (8), Legal Events (3) External Links: USPTO, USPTO Assignment, EspacenetCoronary sinus lead with thermal sensor and method thereforUS 20030167081 A1Abstract A lead system is provided including a coronary sinus lead extending from a proximal end to a distal end, where the lead includes at least one thermal sensor, or optionally, a thermistor. The thermal sensor is positionable within a coronary sinus of a heart when the coronary sinus lead is implanted in the heart to measure the temperature of a myocardium. The method includes coupling at least one thermal sensor with the implantable lead, including coupling a first thermal sensor and a second thermal sensor with the lead, placing the implantable lead and at least one thermal sensor within a coronary sinus of a heart and positioning the first thermal sensor within the coronary sinus, and positioning the second thermal sensor within a right atrium of a heart. The method further includes coupling the implantable lead with the implantable electrical stimulation source, and measuring a myocardium temperature. Images(3) Claims(25)
BRIEF DESCRIPTION OF THE DRAWINGS [0015]FIG. 1 illustrates a lead system constructed in accordance with one embodiment. [0016]FIG. 2 is a block diagram illustrating a method in accordance with one embodiment. DESCRIPTION OF THE EMBODIMENTS [0017] In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that other embodiments may be utilized and that structural changes may be made without departing from the scope of the present invention. Therefore, the following detailed description is not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims and their equivalents. [0018] A lead is provided which measures the temperature of the myocardium. Referring to FIG. 1, the lead 110 is part of a system 100 which includes an implantable electrical source 105, such as a pulse generator. The implantable electrical source 105 provides, for example, electrical pulses that are transmitted by the lead 110 to tissue, as further described below. The implantable electrical source 105 contains electronics to sense various electrical signals of the heart 102 and also produce current pulses for delivery to the heart 102. The implantable electrical source 105 is implanted pectorally, abdominally, or elsewhere within the patient. [0019] The lead 110 is, in one option, a coronary sinus lead that extends from a proximal end 112 to a distal end 114, where the proximal end 112 is electrically coupled with the implantable electrical source 105. In another option, the lead 110 comprises an over-the-wire coronary sinus lead. The lead 110 optionally includes at least one electrode 120. The at least one electrode 120, in one option, is disposed at the distal end 114 of the lead 110. The at least one electrode 120 optionally comprises a pacing electrode, which provides pulses to tissue, such as a portion of the heart 102, as further discussed below. In another option, the lead 110 includes a defibrillation electrode. [0020] The lead 110 includes a lead body 115, for instance a flexible lead body 115, and at least one elongate conductor contained within the lead body 115. The at least one electrode 120 is electrically coupled with the elongate conductor. Optionally, the elongate conductor comprises a coiled conductor and defines a lumen therein and thereby is adapted to receive a stiffening stylet that extends through the length of the lead 110. [0021] The stylet is used to stiffen the lead 110, and is manipulated to facilitate the insertion of the lead 110 into and through a vein to advance the distal end 114 of the lead 110 into, for example, the coronary sinus 108 of the heart 102, or a right atrium 106 of the heart 102. Optionally, a stylet knob is coupled with the stylet for rotating the stylet, advancing the conductor into tissue of the heart, and for manipulating the lead 110. Alternatively, the elongate conductor comprises other forms of conductors, such as a cable conductor. [0022] The lead body 115 includes an elongate body formed of, for example, at least one polymer such as a medical grade silicone rubber for translumenal insertion and access within a living organism such as a patient. In one option, the lead body 115 is tubular and has an outer diameter that is small enough for translumenal insertion into the coronary sinus 108. [0023] The lead 110, in one option, is implanted within the heart such that the lead extends into the coronary sinus 108. The lead 110 further includes one or more thermal sensors 140 coupled thereto. The one or more thermal sensors 140 is coupled with one of the conductors, and sends information from its location within the coronary sinus 108 to the implantable electrical source 105, or another data collection source, such as an external source. Optionally, at least one of the one or more thermal sensors 140 comprises a thermistor, where thermistors are passive semiconductors which produce resistance values dependent on temperature. The thermistor is sized small enough for suitable use on the lead, and can be configured for lower power consumption. [0024] In one option, at least one of the one or more thermal sensors 140 is positioned within the coronary sinus 108 of the heart 102. Positioning the thermal sensor within the coronary sinus 108 allows for the temperature of the myocardium to be more directly measured, monitored, and reacted to as further described below. In another option, the lead 110 includes multiple thermal sensors 140, including a first thermal sensor 142 and a second thermal sensor 144. The first thermal sensor 142 and the second thermal sensor 144 are positioned on the lead 110 such that the first thermal sensor 142 is positioned within the right atrium 106 while the second thermal sensor 144 is positioned within the coronary sinus 108. Having the ability to monitor the temperature within the coronary sinus 108 provides information regarding the myocardium, and compare it to the temperature within the atrium. Furthermore, the second thermal sensor 144 allows for the core temperature of a patient to be monitored. [0025]FIG. 2 illustrates a block diagram of a method 200. The method includes the above-described embodiments of the lead, and the variations are combinable to form further variations of the method and/or lead. During use of the lead, the lead is implanted within the heart, for example using an over-the-wire technique, and/or using a stylet. The lead is moved through the vasculature of a patient and the distal end of the lead, in one option, is positioned within the coronary sinus, such that one of the thermal sensors is positioned within the coronary sinus 210. In another option, at least one of the thermal sensors is disposed along an intermediate portion of the lead, and the thermal sensor is positioned within the coronary sinus. [0026] Within the coronary sinus, the myocardium temperature is monitored 212 and information regarding the temperature readings is sent back to the electrical source and optionally stored. In one option, temperature change in the coronary sinus is used as an indicator of change in the functional status of the heart. As heart failure progresses, the body's core temperature will trend lower over time, indicating the patient is becoming more ill. The temperature of the blood in the coronary sinus is a measure of the work being performed by the heart. As the heart does work, it generates �waste heat� since it is not 100% efficient. This waste heat is transferred to the circulating blood returning in the coronary sinus. Ischemia, for example, impairs the heart's ability to do work. As the work rate of the heart falls, the amount of waste heat falls, leading to a drop in temperature in the myocardium and ultimately in the blood returning via the coronary sinus. [0027] The temperature change in the coronary sinus and/or change in functional status of the heart is reported to the physician so that changes in therapy can occur to improve the patient's condition. The report to the physician occurs, in one option, when a patient's device is coupled with a programmer, for example, directly with hard wires, over a phone line, or over the internet. [0028] In another option, a second thermal sensor is coupled with the lead, and the lead is positioned within the heart such that the first thermal sensor is positioned within the coronary sinus, and the second thermal sensor is positioned within the right atrium. Within the right atrium, the second thermal sensor monitors the temperature of the right atrium 216, as further discussed below. [0029] In one option, the lead takes a first temperature reading and a consecutive second temperature reading within the coronary sinus. Optionally, additional consecutive temperature readings within the coronary sinus are taken and stored. The first temperature reading and the second temperature reading are compared to one another to determine whether the temperature of the coronary sinus is changing, 214 (dTCS). If no change in temperature occurs, the temperature of the coronary sinus is continually monitored, 212. If a change in the temperature occurs, one or more of several options is chosen. For instance, the change in temperature is analyzed for a decrease or increase in temperature, and it is further determined whether a decrease or increase in temperature is appropriate, for example, if the patient is exercising. Exercise or work is monitored, in one option, by an activity sensor (e.g. an accelerometer to sense patient motion) and/or a minute ventilation sensor to sense increased respiration, indicating increased metabolic demand. [0030] Furthermore, in another option, if a change in the temperature occurs in the coronary sinus, the right atrium is monitored for a change in temperature 216. If temperature readings within the right atrium indicate that the temperature of the right atrium is changing (dTRA) 218, the rate of the temperature change in the coronary sinus is determined (dTCS′), and the rate of the temperature change in the right atrium is determined (dTRA′). [0031] The rate of the temperature change in the coronary sinus (dTCS′) is compared to the rate of the temperature change in the right atrium (dTRA′), 220. This is done to determine if the amount of work being performed by the myocardium is appropriate to provide the needs of the body. Furthermore, if it is determined that the rate of temperature change in the coronary sinus (dTCS′) is different than the rate of temperature change in the right atrium (dTRA′), it may signal an imbalance in the amount of work being done by the heart. For instance, if the temperature in the right atrium is increasing, and the temperature in the coronary sinus is decreasing, it may indicate decreased cardiac output despite increased metabolic demand. If it is determined that the temperature of the myocardium is not changing or decreasing during exercise, a possible ischemic condition is present, 222, and appropriate therapy is applied to the patient, 224. [0032] The above-described apparatus and method provides for the myocardium temperature to be more closely and accurately monitored. More precise data of the myocardium temperature can be developed, monitored, where the data is not skewed by variations of temperatures occurring in distal body parts or vasculature. The therapy given in light of the data collection is more responsive to actual conditions of the myocardium, where the temperature of the coronary sinus comes from the temperature of the myocardium, and it is well insulated from the rest of the body. This is in contrast with temperatures monitored from the right ventricle, where the right ventricle temperatures represents an average temperature from several locations within the body. Thus, monitoring the temperature of the coronary sinus monitors the temperature of the myocardium, and work done by the heart is accurately measured by the temperature of the coronary sinus and myocardium. Data comparison with temperatures from the coronary sinus and the right atrium allows for another way of determining whether heart failure is present or the degree of heart failure is changing. [0033] It is to be understood that the above description is intended to be illustrative, and not restrictive. Many other embodiments will be apparent to those of skill in the art upon reading and understanding the above description. It should be noted that embodiments discussed in different portions of the description or referred to in different drawings can be combined to form additional embodiments of the present invention. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. Referenced byCiting PatentFiling datePublication dateApplicantTitleUS7037273 *May 22, 2002May 2, 2006Cardiac Pacemakers, Inc.Core body temperature monitoring in heart failure patientsUS7479107Oct 25, 2005Jan 20, 2009Cardiac Pacemakers, Inc.Core body temperature monitoring in heart failure patientsUS7711436Apr 24, 2007May 4, 2010Medtronic, Inc.Medical device electrical lead design for preventing transmittance of unsafe currents to a patientUS7729761Jul 14, 2004Jun 1, 2010Cardiac Pacemakers, Inc.Method and apparatus for controlled gene or protein deliveryUS7764995 *Jun 7, 2004Jul 27, 2010Cardiac Pacemakers, Inc.Method and apparatus to modulate cellular regeneration post myocardial infarctUS7909769Jan 12, 2009Mar 22, 2011Cardiac Pacemakers, Inc.Carbon dioxide and activity monitoringUS8219207Mar 8, 2007Jul 10, 2012Medtronic, Inc.Thermal switch for implantable medical devicesUS8388670Jan 16, 2007Mar 5, 2013Pacesetter, Inc.Sensor/lead systems for use with implantable medical devicesUS8709631Apr 19, 2007Apr 29, 2014Pacesetter, Inc.Bioelectric battery for implantable device applicationsUS20110160790 *Mar 8, 2011Jun 30, 2011Medtronic, Inc.Measurement of coronary sinus parameters to optimize left ventricular performanceUS20130172882 *Feb 19, 2013Jul 4, 2013Boston Scientific Scimed, Inc.Control of arterial smooth muscle toneWO2005000091A2 *May 28, 2004Jan 6, 2005Cassells Samuel W IiiMethod and apparatus for detecting ischemia* Cited by examinerClassifications U.S. Classification607/122International ClassificationA61N1/08, A61N1/05Cooperative ClassificationA61N1/056, A61N1/08, A61N2001/0585European ClassificationA61N1/08, A61N1/05NLegal EventsDateCodeEventDescriptionJun 6, 2014REMIMaintenance fee reminder mailedApr 14, 2010FPAYFee paymentYear of fee payment: 4Mar 1, 2002ASAssignmentOwner name: CARDIAC PACEMAKERS, INC., MINNESOTAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:ZHU, QINGSHENG;STAHMANN, JEFFREY E.;HATLESTAD, JOHN;REEL/FRAME:012671/0385;SIGNING DATES FROM 20020218 TO 20020219RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services©2012 Google