US20060142804A1 - Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode - Google Patents
Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode Download PDFInfo
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- US20060142804A1 US20060142804A1 US11/324,474 US32447406A US2006142804A1 US 20060142804 A1 US20060142804 A1 US 20060142804A1 US 32447406 A US32447406 A US 32447406A US 2006142804 A1 US2006142804 A1 US 2006142804A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/37512—Pacemakers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
Definitions
- This invention relates to an implantable cardiac stimulation lead and electrode system for applying electrical energy to an abnormally functioning heart and more particularly to an implantable pulse generator housing having electrically conductive walls serving as a defibrillation discharge electrode.
- Electrodes implanted in the body for electrical stimulation of muscle or body organs are well known. More specifically, electrodes implanted on or about the heart have been used to reverse certain abnormal and life-threatening arrhythmias. Electrical energy is applied to the heart via the electrodes to return the heart to normal sinus rhythm.
- bradycardia slower than normal heartbeat rhythm
- ventricular tachycardia faster than normal heartbeat rhythm
- ventricular fibrillation sporadic and uncoordinated beating of the heart. The latter two arrhythmias generally are fatal if left untreated.
- a multiple electrode unitary intravascular cardiac catheter having a distal electrode for sensing and pacing, an intermediate electrode for sensing, pacing and cardioverting, and a proximal electrode for sensing and cardioverting. This multiple electrode catheter maintains the ability for heart rate sensing and low threshold pacing immediately following cardioversion.
- U.S. Pat. No. 4,825,871 to Cansell discloses a defibrillation/cardioversion shock system in which the box housing the pulse generator circuitry serves as a support for a discharge electrode. Specifically, the metal box is enclosed by a plastics material and a metal plate is attached to the metal box and electrically connected therewith. Charges collected by the metal plate are transmitted to the metal box, which serves as a collector. The metal box itself is not used as an electrode in the Cansell system.
- implantable cardiac stimulation lead system capable of performing standard pacing, such as anti-bradycardia pacing, anti-tachycardia pacing, low-energy cardioversion, and high-energy defibrillation.
- the implantable cardiac stimulation lead system of the present invention comprises a transvenous endocardial or epicardial lead having a plurality of electrodes.
- the lead electrodes are capable of sensing and performing standard anti-bradycardia pacing, anti-tachycardia pacing, cardioversion and defibrillation.
- the transvenous lead is connected to a pulse generator having full-function pacing capabilities as well as cardioversion and defibrillation capabilities.
- the housing of the pulse generator (together with, as desired, electrical discharge surfaces extending therefrom) is conductive and is connected to the pulse generator circuitry so that it may selectively serve as a discharge electrode.
- the outer surface of the pulse generator could be of a special configuration to facilitate its discharge capabilities.
- the pulse generator is implanted in the pectoral or abdominal region of the body proximate the heart.
- a programmable switch or other type of circuitry is provided to select the electrode configuration which may include or exclude the pulse generator housing electrode.
- the electrode surface of the pulse generator housing comprises a portion of the conductive wall of the housing.
- the electrode surface comprises conductive mesh attached to the pulse generator housing.
- the pulse generator housing is a metal housing, all or selective ones of the surfaces of which, together with, as desired, electrical discharge surfaces extending therefrom, are conductive.
- the other surface of the conductive pulse generator housing is platinum.
- the fifth embodiment relates to dedicating isolated conductive surface regions from one mother, such isolated regions may serve for separately sensing, pacing and shocking.
- an insulative mask is disposed over a conductive surface of the pulse generator housing.
- a sensing switch is used to determine when the pulse generator is implanted and when it is outside the body of the patient.
- FIG. 1 is a perspective view illustrating the pulse generator housing serving as a cardiac electrode in accordance with a first embodiment of the present invention.
- FIG. 2 is a cross-sectional view taken through line 2 - 2 of FIG. 1 .
- FIG. 3 is a perspective view illustrating the pulse generator housing having conductive mesh on a face thereof for serving as a cardiac electrode in accordance with the second embodiment of the present invention.
- FIG. 4 is a cross-sectional view taken through line 4 - 4 of FIG. 3 .
- FIG. 5 is a side view of a transvenous electrode and lead used in conjunction with the pulse generator illustrated in FIG. 1 or FIG. 3 .
- FIG. 6 is a diagram illustrating the placement of the pulse generator housing adjacent the heart and connected to the implanted transvenous electrode and lead.
- FIG. 7 is a cross-sectional view of the pulse generator housing according to a third embodiment of the present invention.
- FIG. 8 is a perspective view of the pulse generator housing according to a fourth embodiment.
- FIG. 9 is a cross-sectional view taken through line 9 - 9 of FIG. 8 .
- FIG. 10 is a cross-sectional view of a portion of the pulse generators housing illustrating a fifth embodiment.
- FIG. 11 is a perspective view of the pulse generator housing according to a sixth embodiment.
- FIG. 12 is a perspective view of the pulse generator housing with extending discharge surfaces according to a seventh embodiment.
- FIG. 13 is a perspective view of the pulse generator housing with extending discharge surfaces according to an eighth embodiment.
- FIG. 14 is a perspective view of the pulse generator housing with extending discharge surfaces according to a ninth embodiment.
- FIG. 15 is a front view of a patient illustrating a discharge configuration including the pulse generator according to the seventh embodiment.
- FIG. 16 is a block diagram illustrating the pulse generator.
- FIG. 17 is a block diagram showing the programmable switch.
- housing 10 is of a rectangular box shape having four side walls, a top wall, and a bottom wall. In one embodiment, at least one of the side walls is highly conductive. To this end, housing 10 includes side wall 12 having an outer discharge surface 14 formed of highly electrically conductive material. The conductive surface 14 is connected to the pulse generator circuitry 18 via a programmable switch 16 . The pulse generator circuitry 18 is insulated from the outer discharge surface and electrically connected to electrode lead plug receptacle assembly 20 .
- the number of side walls of housing 10 having conductive discharged surfaces may vary. However, it is envisioned that as many as (or more than) four side walls may be made electrically conductive.
- a pulse generator housing of a second embodiment is illustrated at 10 ′.
- Housing 10 ′ is similar to housing 10 of FIGS. 1 and 2 except the side wall 12 ′ includes a conductive mesh surface 14 ′.
- the term “mesh” includes that as illustrated as well as any other high surface area conductive materials including microtextured materials.
- conductive mesh surface 14 ′ is electrically connected via switch 16 to pulse generator circuitry 18 contained within housing 10 ′.
- a separate conductive patch (not shown) could be added and connected to the bottom of the pulse generator housing to increase the conductive surface area. This patch could attach by a snap or other similar means to the housing.
- the removable pulse generator patch electrode may take several forms.
- One form may be a subcutaneous array comprised of a helical coil which encircles the pulse generator housing, and plugs into a terminal or the housing.
- Another form may be an array of parallel or radiating conductive fingers which are funneled subcutaneously proximate the pulse generator housing.
- a clamp may be provided to connect the patch electrode to the pulse generator housing.
- additional electrical discharge surfaces may be connected to the pulse generator housing 10 .
- a plurality of coiled segment electrodes 14 a tunnelled subcutaneously in the patient, may be connected so as to protrude from and form a contiguous electrical discharge surface with the pulse generator housing 10 .
- This additional discharge surface area increases the efficiency of the combined coil segments/housing electrode by decreasing the impedance and increasing the effective electrode surface area.
- This combination has particular application to counter-shock treatment of tachyarrhythmias.
- FIG. 13 An alternative embodiment is illustrated in FIG. 13 , in which a coiled loop 14 b connected to a header 15 and disposed outside the SQ pocket serves as the additional discharge surface area.
- FIG. 13 An alternative embodiment is illustrated in which a coiled loop 14 b connected to a header 15 and disposed outside the SQ pocket serves as the additional discharge surface area.
- a membrane 14 b e.g. a silicone rubber layer
- Coiled segment electrodes 14 a are joined to and protrude from membrane 14 b , membrane 14 b both supporting and providing structural orientation for coiled segment electrodes 14 a .
- Lead 14 c electrically connects all electrodes 14 a , and is electrically connected via plug 14 d to the plug receptacle of pulse generator 10 .
- FIG. 15 shows a discharge configuration now possible through use of an electrically conductive pulse generator housing of the present invention.
- the pulse generator housing 10 is implanted so as to function as a pectoral electrode (position C).
- Discharge paths are possible from an electrode at position RV to electrodes at positions SVC and C, as well as from electrodes at RV and SVC to electrodes at C and SQ.
- this configuration may be used to terminate atrial arrhythmias with shocks given from SVC to C (or, alternatively, from SVC to SQ, or to C and SQ).
- a pectoral electrode (housing 10 ) at C may be used for effecting atrial defibrillation by using a discharge path between an active electrode at RA and the housing position 10 at position C.
- the plug receptacle assembly 20 comprises a positive port 22 a and a negative port 22 b . This allows connection of implanted electrodes to the pulse generator circuitry, so that one electrode may serve as anode and one electrode may serve as a cathode. If desired, either electrode could be used in combination with the electrically conductive housing.
- a sensor 19 is provided to determine whether the housing 10 is outside the body of a patient or inside the body.
- the purpose of the sensor 19 is to prevent a shock from be delivered while the housing is outside the body and perhaps held in the hand of a physician prior to implant.
- the sensor 19 may be a thermal sensor to detect when the housing is at body temperature, indicative of being inside the body.
- the sensor 19 controls the switch 16 to permit shocking via the pulse generator housing. When the temperature is other than body temperature, the sensor 19 controls the switch 16 so as to prevent discharge via the pulse generator housing by prohibiting connection to the pulse generator circuitry.
- the senor may be embodied as a signal detector to detect some signal for a period of time before shocking. As a result, a shock may not be delivered when the unit is outside the body and not sensing signals from the body.
- Pulse generator circuitry 18 has full-function pacing capabilities including pacing for bradycardia and tachycardia both to inhibit an intrinsic beat or to adapt the rate to a higher or lower rate.
- circuitry 18 has cardioversion and defibrillation capabilities and includes cardiac detection circuitry capable of distinguishing when the heart is in normal sinus rhythm, should be paced, or requires higher energy cardioversion, or defibrillation.
- the switch 16 is selectively activated to include or exclude the conductive surface(s) of the pulse generator housing 10 during the discharge sequence.
- Pulse generator housing 10 or 10 ′ is typically used in conjunction with other cardiac electrodes implanted on or about a human heart.
- One such lead is illustrated in FIG. 5 .
- Lead 30 is provided having a catheter portion 31 supporting electrode 28 on the distal end as well as electrode 29 on a proximate end of catheter portion 31 .
- Lead 30 includes plug connectors 32 - 34 at its proximal end.
- a sensing tip electrode 36 may be provided at the distal tip of catheter portion 31 for sensing cardiac activity. Electrodes 28 and 29 could also have sensing capabilities.
- lead 30 is implanted transvenously in the human heart 38 with electrode 28 in the right ventricle 40 and electrode 29 proximate the right atrium or the superior vena cava 42 .
- a single catheter electrode may be used for placing the electrode in the right ventricle.
- Pulse generator housing 10 or 10 ′ is implanted in the pectoral region proximate but not in contact with the heart, just under the skin.
- the housing 10 or 10 ′ could be implanted in the abdominal region.
- Plug connectors 32 - 34 are inserted into the appropriate ports 22 a , 22 b or 22 c (not shown) of the receptacle assembly 20 .
- the electrode surface of the pulse generator housing may be used in a two electrode or three electrode configuration, and may replace one of the intravascular catheter electrodes.
- the programmable switch 16 determines which electrodes are energized under control of circuitry 18 .
- the switch is programmed so that it can select any combination of three electrodes, such as, for example, any combination of the right ventricular (RV) electrode 28 , pulse generator electrode surface 14 and superior vena cava (SVC) electrode 42 .
- the superior vena cava electrode 42 may be replaced by a subcutaneous electrode.
- the RV electrode is connected to terminal 22 a and the SVC or subcutaneous electrode is connected to terminal 22 b .
- the pulse generator conductive surface would be electrically connected in common with the SVC or subcutaneous electrode.
- the switch 16 may be programmed to discharge the RV electrode against the SVC (or subcutaneous) electrode and/or the pulse generator electrode surface(s).
- the switch 16 is triggered so that the pulse generator circuitry 18 selects only electrode 28 to discharge to the pulse generator housing.
- the switch 16 is triggered so that the pulse generator circuitry 18 selects both distal and proximal electrodes 28 and 29 , respectively, as well as the electrode discharge surface 14 to discharge energy from the conductive wall(s) of housing 10 or 10 ′ for delivering defibrillation electrical energy to the heart 38 .
- a lower energy cardioverting shock can be applied between electrodes 28 and 29 against the conductive wall(s) of the pulse generator housing 10 or 10 ′. Thereafter, if the heart does not revert back to normal sinus rhythm, the higher energy defibrillation pulse is applied across the same electrodes.
- the programmable switch 16 may be programmed to select one of the electrodes 28 and 29 , and the conductive electrode surface(s) of the pulse generator housing 10 or 10 ′. In this way, the electrode discharge surface 14 of the pulse generator housing 10 or 10 ′ will be discharged against only one of the electrodes 28 or 29 . Further, the choice between the electrodes 28 and 29 may be based on certain cardiac conditions.
- FIG. 7 illustrates a pulse generator housing 50 according to a third embodiment.
- the housing 50 is comprised of a titanium body 52 .
- the internal pulse generator circuitry 18 and programmable switch 16 are connected to the body 52 as described in conjunction with FIG. 2 .
- the entire outer surface of the body 52 may be conductive or selective surface portions may be made insulative.
- an insulative ceramic material 70 may be sputtered (e.g. high energy plasma deposition) onto the conductive outer surface of the body 52 . This is useful to create a conductive surface which has a controlled current density, in much the same manner as recently developed defibrillation cardioversion patch electrodes. See, for example, commonly assigned U.S. Pat. No. 5,063,932.
- the insulative material may take the form of a mask or in various patterns known to control current density across a conductive surface.
- the insulative material may also take the form of silicone rubber.
- FIG. 10 illustrates a modification to the embodiment of FIG. 7 in which the outer surfaces of the body 52 of the pulse generator housing 50 are coated with platinum 54 , a metal which does not anodize, thus maintaining performance of the housing walls 52 as an anode.
- the platinum surface may be created by sputtering or high energy plasma deposition and further may be made a microporous surface to minimize kinetic losses (reduce interface impedance).
- FIG. 11 illustrates a sixth embodiment in which regions of the conductive surface of the pulse generator housing are dedicated for certain functions.
- the pulse generator housing 60 comprises electrically isolated conductive regions 62 , 64 and 66 . One or two of these regions may be dedicated for sensing purposes while others may be dedicated for shocking purposes. Each of these regions is connected to the pulse generator circuitry 18 .
- a small isolated conductive surface 80 may be created by sputtering a small region of insulative material onto the body 52 .
- a small region of conductive material such as platinum may be deposited onto the region 80 .
- the region 82 is electrically connected to the pulse generator circuitry through the body 52 .
- Such a small conductive regional may serve as a return (ground) for a pacing configuration, sensing configuration, etc.
- pulse generator circuitry 18 has full-function pacing capabilities (pacer 80 ) including pacing for bradycardia and tachycardia both to inhibit an intrinsic beat or to adapt the rate to a higher or lower rate.
- circuitry 18 has cardioversion and defibrillation capabilities (cardioverter/defibrillator 82 ) and includes cardiac detection circuitry 84 capable of distinguishing when the heart is in normal sinus rhythm, should be paced, or requires higher energy cardioversion, or even higher energy defibrillation.
- the switch 16 is selectively activated to include or exclude the conductive surface of side wall 12 from the discharge sequence.
Abstract
Described is an implantable pulse generator housing for enclosing and containing pulse generator circuitry. The housing is formed of electrically conductive metal defining an electrically conductive outer surface which may be connected to the pulse generator circuitry for delivering electrical energy to the heart. A programmable switch operable by the pulse generator circuitry is provided to discharge electrical pulses between selected electrodes and the conductive pulse generator housing in accordance with whether a first or second cardiac condition is detected.
Description
- This application is a continuation of U.S. patent application Ser. No. 09/884,862, filed on Jun. 19, 2001, which is a continuation of U.S. patent application Ser. No. 09/689,018, filed on Oct. 12, 2000, now issued as U.S. Pat. No. 6,280,462, which is a continuation of U.S. patent application Ser. No. 09/344,843, filed on Jun. 28, 1999, now U.S. Pat. No. 6,157,860, which is a continuation of U.S. patent application Ser. No. 08/964,120, filed Nov. 4, 1997, now U.S. Pat. No. 5,916,238, which is a continuation of U.S. patent application Ser. No. 08/380,538, filed on Jan. 30, 1995, now U.S. Pat. No. 5,713,926, which is a continuation of U.S. patent application Ser. No. 07/917,899, filed Jul. 24, 1992, now U.S. Pat. No. 5,385,574, which is a continuation-in-part of U.S. patent application Ser. No. 07/514,251, filed on Apr. 25, 1990, now U.S. Pat. No. 5,133,353, the specifications of which are incorporated herein by reference.
- This invention relates to an implantable cardiac stimulation lead and electrode system for applying electrical energy to an abnormally functioning heart and more particularly to an implantable pulse generator housing having electrically conductive walls serving as a defibrillation discharge electrode.
- Electrodes implanted in the body for electrical stimulation of muscle or body organs are well known. More specifically, electrodes implanted on or about the heart have been used to reverse certain abnormal and life-threatening arrhythmias. Electrical energy is applied to the heart via the electrodes to return the heart to normal sinus rhythm.
- Common abnormal cardiac arrhythmias include bradycardia (slower than normal heartbeat rhythm), ventricular tachycardia (faster than normal heartbeat rhythm), and ventricular fibrillation (sporadic and uncoordinated beating of the heart). The latter two arrhythmias generally are fatal if left untreated.
- To control the heartbeat rhythm and prevent fatalities from ventricular tachycardia and fibrillation, several devices have been designed having the ability to stimulate the heart according to a sensed cardiac signal such as a sensed ECG signal. See for example U.S. Pat. No. 4,603,705 to Speicher et al. The Speicher et al. patent discloses a multiple electrode unitary intravascular cardiac catheter having a distal electrode for sensing and pacing, an intermediate electrode for sensing, pacing and cardioverting, and a proximal electrode for sensing and cardioverting. This multiple electrode catheter maintains the ability for heart rate sensing and low threshold pacing immediately following cardioversion.
- There are many types of defibrillation cardioversion electrodes in the art. U.S. Pat. No. 4,825,871 to Cansell discloses a defibrillation/cardioversion shock system in which the box housing the pulse generator circuitry serves as a support for a discharge electrode. Specifically, the metal box is enclosed by a plastics material and a metal plate is attached to the metal box and electrically connected therewith. Charges collected by the metal plate are transmitted to the metal box, which serves as a collector. The metal box itself is not used as an electrode in the Cansell system.
- The need therefore exists for implantable cardiac stimulation lead system capable of performing standard pacing, such as anti-bradycardia pacing, anti-tachycardia pacing, low-energy cardioversion, and high-energy defibrillation.
- It is a primary object of this invention to provide an implantable cardiac stimulation lead system having pacemaking, cardioversion and higher energy defibrillation capabilities.
- It is an additional object of this invention to provide an implantable cardiac stimulation lead system having pacemaking, cardioversion and defibrillation capabilities via a selectable defibrillation electrode configuration.
- It is yet a further object of this invention to provide an implantable cardiac stimulation lead system utilizing a relatively small number of implantable parts.
- It is still another object of the present invention to provide an implantable pulse generator housing made entirely or partially but in a selective manner, of electrically conductive material, serving as a defibrillation electrode.
- It is yet a further object of the invention to provide an electrically conductive portion of an implantable pulse generator housing which, together with electrical discharge surfaces extending therefrom, serve as an electrode.
- It is still another object of the present invention to reduce the size of the pulse generator housing by eliminating one terminal on the housing.
- Briefly, the implantable cardiac stimulation lead system of the present invention comprises a transvenous endocardial or epicardial lead having a plurality of electrodes. Typically, the lead electrodes are capable of sensing and performing standard anti-bradycardia pacing, anti-tachycardia pacing, cardioversion and defibrillation. The transvenous lead is connected to a pulse generator having full-function pacing capabilities as well as cardioversion and defibrillation capabilities. The housing of the pulse generator (together with, as desired, electrical discharge surfaces extending therefrom) is conductive and is connected to the pulse generator circuitry so that it may selectively serve as a discharge electrode. The outer surface of the pulse generator could be of a special configuration to facilitate its discharge capabilities. Typically, the pulse generator is implanted in the pectoral or abdominal region of the body proximate the heart. A programmable switch or other type of circuitry is provided to select the electrode configuration which may include or exclude the pulse generator housing electrode. As a result, different electrode configurations can be obtained for specific types of cardiac stimulations.
- In a first embodiment, the electrode surface of the pulse generator housing comprises a portion of the conductive wall of the housing.
- In a second embodiment, the electrode surface comprises conductive mesh attached to the pulse generator housing.
- In a third embodiment, the pulse generator housing is a metal housing, all or selective ones of the surfaces of which, together with, as desired, electrical discharge surfaces extending therefrom, are conductive.
- In accordance with a fourth embodiment, the other surface of the conductive pulse generator housing is platinum.
- The fifth embodiment relates to dedicating isolated conductive surface regions from one mother, such isolated regions may serve for separately sensing, pacing and shocking.
- In accordance with the sixth embodiment, an insulative mask is disposed over a conductive surface of the pulse generator housing.
- In a seventh embodiment, a sensing switch is used to determine when the pulse generator is implanted and when it is outside the body of the patient.
- The above objects and advantages of the present invention can be further understood when reference is made to the following description, taken in conjunction with the accompanying drawings.
-
FIG. 1 is a perspective view illustrating the pulse generator housing serving as a cardiac electrode in accordance with a first embodiment of the present invention. -
FIG. 2 is a cross-sectional view taken through line 2-2 ofFIG. 1 . -
FIG. 3 is a perspective view illustrating the pulse generator housing having conductive mesh on a face thereof for serving as a cardiac electrode in accordance with the second embodiment of the present invention. -
FIG. 4 is a cross-sectional view taken through line 4-4 ofFIG. 3 . -
FIG. 5 is a side view of a transvenous electrode and lead used in conjunction with the pulse generator illustrated inFIG. 1 orFIG. 3 . -
FIG. 6 is a diagram illustrating the placement of the pulse generator housing adjacent the heart and connected to the implanted transvenous electrode and lead. -
FIG. 7 is a cross-sectional view of the pulse generator housing according to a third embodiment of the present invention. -
FIG. 8 is a perspective view of the pulse generator housing according to a fourth embodiment. -
FIG. 9 is a cross-sectional view taken through line 9-9 ofFIG. 8 . -
FIG. 10 is a cross-sectional view of a portion of the pulse generators housing illustrating a fifth embodiment. -
FIG. 11 is a perspective view of the pulse generator housing according to a sixth embodiment. -
FIG. 12 is a perspective view of the pulse generator housing with extending discharge surfaces according to a seventh embodiment. -
FIG. 13 is a perspective view of the pulse generator housing with extending discharge surfaces according to an eighth embodiment. -
FIG. 14 is a perspective view of the pulse generator housing with extending discharge surfaces according to a ninth embodiment. -
FIG. 15 is a front view of a patient illustrating a discharge configuration including the pulse generator according to the seventh embodiment. -
FIG. 16 is a block diagram illustrating the pulse generator. -
FIG. 17 is a block diagram showing the programmable switch. - Referring to
FIGS. 1 and 2 , the pulse generator housing of the present invention is generally shown at 10. Typically,housing 10 is of a rectangular box shape having four side walls, a top wall, and a bottom wall. In one embodiment, at least one of the side walls is highly conductive. To this end,housing 10 includesside wall 12 having anouter discharge surface 14 formed of highly electrically conductive material. Theconductive surface 14 is connected to thepulse generator circuitry 18 via aprogrammable switch 16. Thepulse generator circuitry 18 is insulated from the outer discharge surface and electrically connected to electrode leadplug receptacle assembly 20. - As previously mentioned, the number of side walls of
housing 10 having conductive discharged surfaces may vary. However, it is envisioned that as many as (or more than) four side walls may be made electrically conductive. - Referring now to
FIGS. 3 and 4 , a pulse generator housing of a second embodiment is illustrated at 10′.Housing 10′ is similar tohousing 10 ofFIGS. 1 and 2 except theside wall 12′ includes aconductive mesh surface 14′. It is to be understood that, hereinafter, the term “mesh” includes that as illustrated as well as any other high surface area conductive materials including microtextured materials. As shown inFIG. 4 ,conductive mesh surface 14′ is electrically connected viaswitch 16 topulse generator circuitry 18 contained withinhousing 10′. In addition a separate conductive patch (not shown) could be added and connected to the bottom of the pulse generator housing to increase the conductive surface area. This patch could attach by a snap or other similar means to the housing. - The removable pulse generator patch electrode may take several forms. One form may be a subcutaneous array comprised of a helical coil which encircles the pulse generator housing, and plugs into a terminal or the housing. Another form may be an array of parallel or radiating conductive fingers which are funneled subcutaneously proximate the pulse generator housing. A clamp may be provided to connect the patch electrode to the pulse generator housing.
- In another embodiment, additional electrical discharge surfaces may be connected to the
pulse generator housing 10. Thus, as illustrated inFIG. 12 , a plurality of coiled segment electrodes 14 a, tunnelled subcutaneously in the patient, may be connected so as to protrude from and form a contiguous electrical discharge surface with thepulse generator housing 10. This additional discharge surface area increases the efficiency of the combined coil segments/housing electrode by decreasing the impedance and increasing the effective electrode surface area. This combination has particular application to counter-shock treatment of tachyarrhythmias. An alternative embodiment is illustrated inFIG. 13 , in which a coiled loop 14 b connected to aheader 15 and disposed outside the SQ pocket serves as the additional discharge surface area. In yet another embodiment, illustrated inFIG. 14 , a membrane 14 b, e.g. a silicone rubber layer, is attached to the side ofhousing 10. Coiled segment electrodes 14 a are joined to and protrude from membrane 14 b, membrane 14 b both supporting and providing structural orientation for coiled segment electrodes 14 a. Lead 14 c electrically connects all electrodes 14 a, and is electrically connected via plug 14 d to the plug receptacle ofpulse generator 10. -
FIG. 15 shows a discharge configuration now possible through use of an electrically conductive pulse generator housing of the present invention. In this configuration thepulse generator housing 10 is implanted so as to function as a pectoral electrode (position C). Discharge paths are possible from an electrode at position RV to electrodes at positions SVC and C, as well as from electrodes at RV and SVC to electrodes at C and SQ. Further, this configuration may be used to terminate atrial arrhythmias with shocks given from SVC to C (or, alternatively, from SVC to SQ, or to C and SQ). Similarly, a pectoral electrode (housing 10) at C may be used for effecting atrial defibrillation by using a discharge path between an active electrode at RA and thehousing position 10 at position C. - The
plug receptacle assembly 20 comprises a positive port 22 a and a negative port 22 b. This allows connection of implanted electrodes to the pulse generator circuitry, so that one electrode may serve as anode and one electrode may serve as a cathode. If desired, either electrode could be used in combination with the electrically conductive housing. - A
sensor 19 is provided to determine whether thehousing 10 is outside the body of a patient or inside the body. The purpose of thesensor 19 is to prevent a shock from be delivered while the housing is outside the body and perhaps held in the hand of a physician prior to implant. Thesensor 19 may be a thermal sensor to detect when the housing is at body temperature, indicative of being inside the body. Thesensor 19 controls theswitch 16 to permit shocking via the pulse generator housing. When the temperature is other than body temperature, thesensor 19 controls theswitch 16 so as to prevent discharge via the pulse generator housing by prohibiting connection to the pulse generator circuitry. - Alternatively, the sensor may be embodied as a signal detector to detect some signal for a period of time before shocking. As a result, a shock may not be delivered when the unit is outside the body and not sensing signals from the body.
-
Pulse generator circuitry 18 has full-function pacing capabilities including pacing for bradycardia and tachycardia both to inhibit an intrinsic beat or to adapt the rate to a higher or lower rate. In addition,circuitry 18 has cardioversion and defibrillation capabilities and includes cardiac detection circuitry capable of distinguishing when the heart is in normal sinus rhythm, should be paced, or requires higher energy cardioversion, or defibrillation. Theswitch 16 is selectively activated to include or exclude the conductive surface(s) of thepulse generator housing 10 during the discharge sequence. -
Pulse generator housing FIG. 5 .Lead 30 is provided having acatheter portion 31 supportingelectrode 28 on the distal end as well aselectrode 29 on a proximate end ofcatheter portion 31.Lead 30 includes plug connectors 32-34 at its proximal end. In addition, asensing tip electrode 36 may be provided at the distal tip ofcatheter portion 31 for sensing cardiac activity.Electrodes - Referring to
FIG. 6 , in operation, lead 30 is implanted transvenously in thehuman heart 38 withelectrode 28 in the right ventricle 40 andelectrode 29 proximate the right atrium or thesuperior vena cava 42. Alternatively, a single catheter electrode may be used for placing the electrode in the right ventricle.Pulse generator housing housing receptacle assembly 20. In this implantation position, the electrode surface of the pulse generator housing may be used in a two electrode or three electrode configuration, and may replace one of the intravascular catheter electrodes. - Referring additionally to
FIG. 17 , when an arrhythmia is sensed where it is appropriate for an electrical pulse to be delivered to theheart 38, theprogrammable switch 16 determines which electrodes are energized under control ofcircuitry 18. The switch is programmed so that it can select any combination of three electrodes, such as, for example, any combination of the right ventricular (RV)electrode 28, pulsegenerator electrode surface 14 and superior vena cava (SVC)electrode 42. The superiorvena cava electrode 42 may be replaced by a subcutaneous electrode. The RV electrode is connected to terminal 22 a and the SVC or subcutaneous electrode is connected to terminal 22 b. The pulse generator conductive surface would be electrically connected in common with the SVC or subcutaneous electrode. Theswitch 16 may be programmed to discharge the RV electrode against the SVC (or subcutaneous) electrode and/or the pulse generator electrode surface(s). - In another possible configuration, if the heart activity is slower or faster (bradycardia or tachycardia) than normal, the
switch 16 is triggered so that thepulse generator circuitry 18 selects onlyelectrode 28 to discharge to the pulse generator housing. On the other hand, if the sensed activity is indicative of rapid ventricular tachycardia or fibrillation requiring higher energy stimulation, theswitch 16 is triggered so that thepulse generator circuitry 18 selects both distal andproximal electrodes electrode discharge surface 14 to discharge energy from the conductive wall(s) ofhousing heart 38. - Also, prior to applying a high energy defibrillating shock to the heart, a lower energy cardioverting shock can be applied between
electrodes pulse generator housing - In yet another alternate form, the
programmable switch 16 may be programmed to select one of theelectrodes pulse generator housing electrode discharge surface 14 of thepulse generator housing electrodes electrodes -
FIG. 7 illustrates apulse generator housing 50 according to a third embodiment. Thehousing 50 is comprised of atitanium body 52. The internalpulse generator circuitry 18 andprogrammable switch 16 are connected to thebody 52 as described in conjunction withFIG. 2 . The entire outer surface of thebody 52 may be conductive or selective surface portions may be made insulative. Specifically, as shown inFIGS. 8 and 9 , an insulativeceramic material 70 may be sputtered (e.g. high energy plasma deposition) onto the conductive outer surface of thebody 52. This is useful to create a conductive surface which has a controlled current density, in much the same manner as recently developed defibrillation cardioversion patch electrodes. See, for example, commonly assigned U.S. Pat. No. 5,063,932. The insulative material may take the form of a mask or in various patterns known to control current density across a conductive surface. The insulative material may also take the form of silicone rubber. -
FIG. 10 illustrates a modification to the embodiment ofFIG. 7 in which the outer surfaces of thebody 52 of thepulse generator housing 50 are coated withplatinum 54, a metal which does not anodize, thus maintaining performance of thehousing walls 52 as an anode. The platinum surface may be created by sputtering or high energy plasma deposition and further may be made a microporous surface to minimize kinetic losses (reduce interface impedance). -
FIG. 11 illustrates a sixth embodiment in which regions of the conductive surface of the pulse generator housing are dedicated for certain functions. Specifically, thepulse generator housing 60 comprises electrically isolatedconductive regions pulse generator circuitry 18. - Additionally, a small isolated
conductive surface 80 may be created by sputtering a small region of insulative material onto thebody 52. A small region of conductive material such as platinum may be deposited onto theregion 80. Theregion 82 is electrically connected to the pulse generator circuitry through thebody 52. - Such a small conductive regional may serve as a return (ground) for a pacing configuration, sensing configuration, etc.
- Referring to
FIG. 16 ,pulse generator circuitry 18 has full-function pacing capabilities (pacer 80) including pacing for bradycardia and tachycardia both to inhibit an intrinsic beat or to adapt the rate to a higher or lower rate. In addition,circuitry 18 has cardioversion and defibrillation capabilities (cardioverter/defibrillator 82) and includescardiac detection circuitry 84 capable of distinguishing when the heart is in normal sinus rhythm, should be paced, or requires higher energy cardioversion, or even higher energy defibrillation. Theswitch 16 is selectively activated to include or exclude the conductive surface ofside wall 12 from the discharge sequence. - It is considered that the above description is intended by way of example only, and is not intended to limit the present invention in any way except as set forth in the following claims.
Claims (20)
1. An apparatus, comprising:
a lead having proximal and distal electrodes for disposition near the heart;
an implantable pulse generator including pulse generator circuitry for delivering electrical pulses to the heart;
wherein the pulse generator circuitry includes cardiac detection circuitry for detecting cardiac conditions based upon cardiac rhythm;
a conductive pulse generator housing enclosing the pulse generator circuitry;
a programmable switch operable by the pulse generator circuitry to discharge electrical pulses between selected ones of the proximal and distal electrodes and the conductive pulse generator housing in accordance with whether a first or second cardiac condition is detected.
2. The apparatus of claim 1 wherein the programmable switch is operable to discharge a first type of electrical pulse between the proximal and distal electrodes when a first cardiac condition is detected and to discharge a second type of electrical pulse between the conductive pulse generator housing and the proximal electrode when a second cardiac condition is detected.
3. The apparatus of claim 2 wherein the first and second types of electrical pulses are both pacing pulses.
4. The apparatus of claim 2 wherein the first type of electrical pulse is a pacing pulse and the second type of electrical pulse is a defibrillation pulse.
5. The apparatus of claim 4 wherein the first heart condition is bradycardia and the second heart condition is fibrillation.
6. The apparatus of claim 4 wherein the first heart condition is tachycardia and the second heart condition is fibrillation.
7. The apparatus of claim 1 wherein the programmable switch is operable to discharge a first type of electrical pulse between the proximal and distal electrodes when a first cardiac condition is detected and to discharge a second type of electrical pulse between the conductive pulse generator housing and the distal electrode when a second cardiac condition is detected.
8. The apparatus of claim 7 wherein the first and second types of electrical pulses are both pacing pulses.
9. The apparatus of claim 7 wherein the first type of electrical pulse is a pacing pulse and the second type of electrical pulse is a defibrillation pulse.
10. The apparatus of claim 9 wherein the first heart condition is bradycardia and the second heart condition is fibrillation.
11. The apparatus of claim 9 wherein the first heart condition is tachycardia and the second heart condition is fibrillation
12. The apparatus of claim 1 wherein the programmable switch is operable to discharge a first type of electrical pulse between the proximal and distal electrodes when a first cardiac condition is detected and to discharge a second type of electrical pulse between the conductive pulse generator housing and the proximal and distal electrodes connected in common when a second cardiac condition is detected.
13. The apparatus of claim 12 wherein the first and second types of electrical pulses are both pacing pulses.
14. The apparatus of claim 12 wherein the first type of electrical pulse is a pacing pulse and the second type of electrical pulse is a defibrillation pulse.
15. The apparatus of claim 14 wherein the first heart condition is bradycardia and the second heart condition is fibrillation.
16. The apparatus of claim 14 wherein the first heart condition is tachycardia and the second heart condition is fibrillation.
17. A method comprising:
sensing cardiac activity in order to detect a first or second cardiac condition; and,
operating a programmable switch so that an electrical pulse is delivered between selected ones of a first electrode, a second electrode, and a conductive housing enclosing pulse generator circuitry in accordance with whether a first or second cardiac condition is detected.
18. The method of claim 17 further comprising operating the programmable switch to discharge a first type of electrical pulse between the first and second electrodes when a first cardiac condition is detected and to discharge a second type of electrical pulse between the conductive pulse generator housing and the first electrode when a second cardiac condition is detected.
19. The method of claim 18 wherein the first and second types of electrical pulses are both pacing pulses.
20. The method of claim 18 wherein the first type of electrical pulse is a pacing pulse and the second type of electrical pulse is a defibrillation pulse.
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US11/324,474 US20060142804A1 (en) | 1990-04-25 | 2006-01-03 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
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US07/514,251 US5133353A (en) | 1990-04-25 | 1990-04-25 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US07/917,899 US5301503A (en) | 1991-07-26 | 1992-07-24 | Vehicle internal combustion engine exhaust system |
US08/380,538 US5713926A (en) | 1990-04-25 | 1995-01-30 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US08/964,120 US5916238A (en) | 1990-04-25 | 1997-11-04 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/344,843 US6157860A (en) | 1990-04-25 | 1999-06-28 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/689,018 US6280462B1 (en) | 1990-04-25 | 2000-10-12 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/884,862 US6999814B2 (en) | 1990-04-25 | 2001-06-19 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US11/324,474 US20060142804A1 (en) | 1990-04-25 | 2006-01-03 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
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US09/884,862 Continuation US6999814B2 (en) | 1990-04-25 | 2001-06-19 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
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US08/380,538 Expired - Lifetime US5713926A (en) | 1990-04-25 | 1995-01-30 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US08/964,120 Expired - Lifetime US5916238A (en) | 1990-04-25 | 1997-11-04 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/344,843 Expired - Lifetime US6157860A (en) | 1990-04-25 | 1999-06-28 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/689,018 Expired - Fee Related US6280462B1 (en) | 1990-04-25 | 2000-10-12 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/884,862 Expired - Fee Related US6999814B2 (en) | 1990-04-25 | 2001-06-19 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US11/026,707 Expired - Fee Related US7522959B2 (en) | 1990-04-25 | 2004-12-30 | Subcutaneous cardiac rhythm management |
US11/324,474 Abandoned US20060142804A1 (en) | 1990-04-25 | 2006-01-03 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
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US08/380,538 Expired - Lifetime US5713926A (en) | 1990-04-25 | 1995-01-30 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US08/964,120 Expired - Lifetime US5916238A (en) | 1990-04-25 | 1997-11-04 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/344,843 Expired - Lifetime US6157860A (en) | 1990-04-25 | 1999-06-28 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/689,018 Expired - Fee Related US6280462B1 (en) | 1990-04-25 | 2000-10-12 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US09/884,862 Expired - Fee Related US6999814B2 (en) | 1990-04-25 | 2001-06-19 | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US11/026,707 Expired - Fee Related US7522959B2 (en) | 1990-04-25 | 2004-12-30 | Subcutaneous cardiac rhythm management |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9022962B2 (en) | 2000-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Apparatus for detecting and treating ventricular arrhythmia |
Families Citing this family (217)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5713926A (en) * | 1990-04-25 | 1998-02-03 | Cardiac Pacemakers, Inc. | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US6148233A (en) | 1997-03-07 | 2000-11-14 | Cardiac Science, Inc. | Defibrillation system having segmented electrodes |
US6067471A (en) * | 1998-08-07 | 2000-05-23 | Cardiac Pacemakers, Inc. | Atrial and ventricular implantable cardioverter-defibrillator and lead system |
US6152954A (en) | 1998-07-22 | 2000-11-28 | Cardiac Pacemakers, Inc. | Single pass lead having retractable, actively attached electrode for pacing and sensing |
US6501994B1 (en) * | 1997-12-24 | 2002-12-31 | Cardiac Pacemakers, Inc. | High impedance electrode tip |
US5928272A (en) * | 1998-05-02 | 1999-07-27 | Cyberonics, Inc. | Automatic activation of a neurostimulator device using a detection algorithm based on cardiac activity |
US6240320B1 (en) | 1998-06-05 | 2001-05-29 | Intermedics Inc. | Cardiac lead with zone insulated electrodes |
US6134478A (en) | 1998-06-05 | 2000-10-17 | Intermedics Inc. | Method for making cardiac leads with zone insulated electrodes |
US6463334B1 (en) | 1998-11-02 | 2002-10-08 | Cardiac Pacemakers, Inc. | Extendable and retractable lead |
US6501990B1 (en) * | 1999-12-23 | 2002-12-31 | Cardiac Pacemakers, Inc. | Extendable and retractable lead having a snap-fit terminal connector |
JP2002522103A (en) * | 1998-08-07 | 2002-07-23 | インフィニット バイオメディカル テクノロジーズ インコーポレイテッド | Method for detecting, indicating and operating implantable myocardial ischemia |
DE19930267B4 (en) * | 1999-06-25 | 2006-10-05 | Biotronik Gmbh & Co. Kg | defibrillator |
WO2001037931A1 (en) * | 1999-11-24 | 2001-05-31 | Cardiac Pacemakers, Inc. | Method and apparatus for termination of cardiac tachyarrhythmias |
US6456876B1 (en) | 2000-02-28 | 2002-09-24 | Pacesetter, Inc. | Dual-chamber implantable cardiac stimulation system and device with selectable arrhythmia termination electrode configurations and method |
US7756584B2 (en) | 2000-07-13 | 2010-07-13 | Advanced Neuromodulation Systems, Inc. | Methods and apparatus for effectuating a lasting change in a neural-function of a patient |
US7672730B2 (en) | 2001-03-08 | 2010-03-02 | Advanced Neuromodulation Systems, Inc. | Methods and apparatus for effectuating a lasting change in a neural-function of a patient |
US7010351B2 (en) | 2000-07-13 | 2006-03-07 | Northstar Neuroscience, Inc. | Methods and apparatus for effectuating a lasting change in a neural-function of a patient |
US7305268B2 (en) | 2000-07-13 | 2007-12-04 | Northstar Neurscience, Inc. | Systems and methods for automatically optimizing stimulus parameters and electrode configurations for neuro-stimulators |
US7024247B2 (en) | 2001-10-15 | 2006-04-04 | Northstar Neuroscience, Inc. | Systems and methods for reducing the likelihood of inducing collateral neural activity during neural stimulation threshold test procedures |
US7236831B2 (en) * | 2000-07-13 | 2007-06-26 | Northstar Neuroscience, Inc. | Methods and apparatus for effectuating a lasting change in a neural-function of a patient |
US7831305B2 (en) | 2001-10-15 | 2010-11-09 | Advanced Neuromodulation Systems, Inc. | Neural stimulation system and method responsive to collateral neural activity |
US7751885B2 (en) * | 2000-09-18 | 2010-07-06 | Cameron Health, Inc. | Bradycardia pacing in a subcutaneous device |
US7039465B2 (en) * | 2000-09-18 | 2006-05-02 | Cameron Health, Inc. | Ceramics and/or other material insulated shell for active and non-active S-ICD can |
US6954670B2 (en) * | 2001-11-05 | 2005-10-11 | Cameron Health, Inc. | Simplified defibrillator output circuit |
US20020107544A1 (en) * | 2000-09-18 | 2002-08-08 | Cameron Health, Inc. | Current waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator |
US7120495B2 (en) * | 2000-09-18 | 2006-10-10 | Cameron Health, Inc. | Flexible subcutaneous implantable cardioverter-defibrillator |
US20020035378A1 (en) * | 2000-09-18 | 2002-03-21 | Cameron Health, Inc. | Subcutaneous electrode for transthoracic conduction with highly maneuverable insertion tool |
US6778860B2 (en) | 2001-11-05 | 2004-08-17 | Cameron Health, Inc. | Switched capacitor defibrillation circuit |
US6988003B2 (en) * | 2000-09-18 | 2006-01-17 | Cameron Health, Inc. | Implantable cardioverter-defibrillator having two spaced apart shocking electrodes on housing |
US6866044B2 (en) * | 2000-09-18 | 2005-03-15 | Cameron Health, Inc. | Method of insertion and implantation of implantable cardioverter-defibrillator canisters |
US6927721B2 (en) * | 2001-11-05 | 2005-08-09 | Cameron Health, Inc. | Low power A/D converter |
US20020035377A1 (en) * | 2000-09-18 | 2002-03-21 | Cameron Health, Inc. | Subcutaneous electrode for transthoracic conduction with insertion tool |
US7043299B2 (en) | 2000-09-18 | 2006-05-09 | Cameron Health, Inc. | Subcutaneous implantable cardioverter-defibrillator employing a telescoping lead |
US7194309B2 (en) * | 2000-09-18 | 2007-03-20 | Cameron Health, Inc. | Packaging technology for non-transvenous cardioverter/defibrillator devices |
US6856835B2 (en) * | 2000-09-18 | 2005-02-15 | Cameron Health, Inc. | Biphasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator |
US7194302B2 (en) | 2000-09-18 | 2007-03-20 | Cameron Health, Inc. | Subcutaneous cardiac stimulator with small contact surface electrodes |
US7149575B2 (en) * | 2000-09-18 | 2006-12-12 | Cameron Health, Inc. | Subcutaneous cardiac stimulator device having an anteriorly positioned electrode |
US6865417B2 (en) | 2001-11-05 | 2005-03-08 | Cameron Health, Inc. | H-bridge with sensing circuit |
US20020035381A1 (en) * | 2000-09-18 | 2002-03-21 | Cameron Health, Inc. | Subcutaneous electrode with improved contact shape for transthoracic conduction |
US7065407B2 (en) * | 2000-09-18 | 2006-06-20 | Cameron Health, Inc. | Duckbill-shaped implantable cardioverter-defibrillator canister and method of use |
US6721597B1 (en) * | 2000-09-18 | 2004-04-13 | Cameron Health, Inc. | Subcutaneous only implantable cardioverter defibrillator and optional pacer |
US7069080B2 (en) | 2000-09-18 | 2006-06-27 | Cameron Health, Inc. | Active housing and subcutaneous electrode cardioversion/defibrillating system |
US6937907B2 (en) * | 2000-09-18 | 2005-08-30 | Cameron Health, Inc. | Subcutaneous electrode for transthoracic conduction with low-profile installation appendage and method of doing same |
US6788974B2 (en) * | 2000-09-18 | 2004-09-07 | Cameron Health, Inc. | Radian curve shaped implantable cardioverter-defibrillator canister |
US6950705B2 (en) * | 2000-09-18 | 2005-09-27 | Cameron Health, Inc. | Canister designs for implantable cardioverter-defibrillators |
US6952610B2 (en) * | 2000-09-18 | 2005-10-04 | Cameron Health, Inc. | Current waveforms for anti-tachycardia pacing for a subcutaneous implantable cardioverter- defibrillator |
US20020095184A1 (en) * | 2000-09-18 | 2002-07-18 | Bardy Gust H. | Monophasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator |
US20020035379A1 (en) | 2000-09-18 | 2002-03-21 | Bardy Gust H. | Subcutaneous electrode for transthoracic conduction with improved installation characteristics |
US6834204B2 (en) | 2001-11-05 | 2004-12-21 | Cameron Health, Inc. | Method and apparatus for inducing defibrillation in a patient using a T-shock waveform |
US7090682B2 (en) | 2000-09-18 | 2006-08-15 | Cameron Health, Inc. | Method and apparatus for extraction of a subcutaneous electrode |
US6754528B2 (en) | 2001-11-21 | 2004-06-22 | Cameraon Health, Inc. | Apparatus and method of arrhythmia detection in a subcutaneous implantable cardioverter/defibrillator |
US6952608B2 (en) * | 2001-11-05 | 2005-10-04 | Cameron Health, Inc. | Defibrillation pacing circuitry |
US7146212B2 (en) * | 2000-09-18 | 2006-12-05 | Cameron Health, Inc. | Anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator |
US7076296B2 (en) * | 2000-09-18 | 2006-07-11 | Cameron Health, Inc. | Method of supplying energy to subcutaneous cardioverter-defibrillator and pacer |
US6647292B1 (en) * | 2000-09-18 | 2003-11-11 | Cameron Health | Unitary subcutaneous only implantable cardioverter-defibrillator and optional pacer |
US6904315B2 (en) | 2000-12-14 | 2005-06-07 | Medtronic, Inc. | Atrial aware VVI: a method for atrial synchronous ventricular (VDD/R) pacing using the subcutaneous electrode array and a standard pacing lead |
SE0100661D0 (en) | 2001-02-27 | 2001-02-27 | St Jude Medical | Implantable heart stimulator |
SE0100669D0 (en) * | 2001-02-27 | 2001-02-27 | St Jude Medical | Implantable device |
SE0100668D0 (en) * | 2001-02-27 | 2001-02-27 | St Jude Medical | Implantable heart stimulator |
US6751502B2 (en) * | 2001-03-14 | 2004-06-15 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with defibrillation threshold prediction |
US7386344B2 (en) * | 2004-08-11 | 2008-06-10 | Cardiac Pacemakers, Inc. | Pacer with combined defibrillator tailored for bradycardia patients |
US6702857B2 (en) | 2001-07-27 | 2004-03-09 | Dexcom, Inc. | Membrane for use with implantable devices |
AU2007216692B2 (en) * | 2001-11-05 | 2009-01-29 | Cameron Health, Inc. | Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator |
ES2425838T3 (en) * | 2001-11-05 | 2013-10-17 | Cameron Health, Inc. | Optional use of a conductive cable for a unit subcutaneous implantable cardioverter defibrillator |
US7330757B2 (en) * | 2001-11-21 | 2008-02-12 | Cameron Health, Inc. | Method for discriminating between ventricular and supraventricular arrhythmias |
US7392085B2 (en) * | 2001-11-21 | 2008-06-24 | Cameron Health, Inc. | Multiple electrode vectors for implantable cardiac treatment devices |
US7248921B2 (en) * | 2003-06-02 | 2007-07-24 | Cameron Health, Inc. | Method and devices for performing cardiac waveform appraisal |
US6985777B2 (en) * | 2001-11-26 | 2006-01-10 | Terumo Kabushiki Kaisha | Implantable electrode lead |
US20050131475A1 (en) * | 2001-12-07 | 2005-06-16 | Smits Karel F. | Precordial-superior vena cava electrode arrangement for an implantable cardioverter defibrillator |
US8364229B2 (en) | 2003-07-25 | 2013-01-29 | Dexcom, Inc. | Analyte sensors having a signal-to-noise ratio substantially unaffected by non-constant noise |
US7613491B2 (en) | 2002-05-22 | 2009-11-03 | Dexcom, Inc. | Silicone based membranes for use in implantable glucose sensors |
US7221981B2 (en) | 2002-03-28 | 2007-05-22 | Northstar Neuroscience, Inc. | Electrode geometries for efficient neural stimulation |
US20050038474A1 (en) * | 2002-04-30 | 2005-02-17 | Wool Thomas J. | Implantable automatic defibrillator with subcutaneous electrodes |
US6987999B1 (en) | 2002-05-02 | 2006-01-17 | Pacesetter, Inc. | Implantable defibrillator with alternating counter electrode |
US7027862B2 (en) * | 2002-07-25 | 2006-04-11 | Medtronic, Inc. | Apparatus and method for transmitting an electrical signal in an implantable medical device |
US6717804B1 (en) * | 2002-09-30 | 2004-04-06 | Hewlett-Packard Development Company, L.P. | Light-emitting lock device control element and electronic device including the same |
US7062329B2 (en) * | 2002-10-04 | 2006-06-13 | Cameron Health, Inc. | Implantable cardiac system with a selectable active housing |
US20040073261A1 (en) * | 2002-10-09 | 2004-04-15 | Kroll Mark W. | Methods and systems for treating ventricular fibrillation |
US7236830B2 (en) | 2002-12-10 | 2007-06-26 | Northstar Neuroscience, Inc. | Systems and methods for enhancing or optimizing neural stimulation therapy for treating symptoms of Parkinson's disease and/or other movement disorders |
US7069075B2 (en) * | 2002-11-22 | 2006-06-27 | Medtronic, Inc. | Subcutaneous implantable cardioverter/defibrillator |
US20050075680A1 (en) | 2003-04-18 | 2005-04-07 | Lowry David Warren | Methods and systems for intracranial neurostimulation and/or sensing |
US7189204B2 (en) | 2002-12-04 | 2007-03-13 | Cardiac Pacemakers, Inc. | Sleep detection using an adjustable threshold |
US7392081B2 (en) * | 2003-02-28 | 2008-06-24 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac stimulator employing post-shock transthoracic asystole prevention pacing |
US20040199082A1 (en) * | 2003-04-03 | 2004-10-07 | Ostroff Alan H. | Selctable notch filter circuits |
US7555335B2 (en) | 2003-04-11 | 2009-06-30 | Cardiac Pacemakers, Inc. | Biopotential signal source separation using source impedances |
US8116868B2 (en) | 2003-04-11 | 2012-02-14 | Cardiac Pacemakers, Inc. | Implantable device with cardiac event audio playback |
US20040204735A1 (en) * | 2003-04-11 | 2004-10-14 | Shiroff Jason Alan | Subcutaneous dissection tool incorporating pharmacological agent delivery |
US7865233B2 (en) | 2003-04-11 | 2011-01-04 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac signal discrimination employing non-electrophysiologic signal |
US7499758B2 (en) * | 2003-04-11 | 2009-03-03 | Cardiac Pacemakers, Inc. | Helical fixation elements for subcutaneous electrodes |
US7117035B2 (en) | 2003-04-11 | 2006-10-03 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac stimulation system with patient activity sensing |
US7389138B2 (en) * | 2003-04-11 | 2008-06-17 | Cardiac Pacemakers, Inc. | Electrode placement determination for subcutaneous cardiac monitoring and therapy |
US20040230229A1 (en) * | 2003-04-11 | 2004-11-18 | Lovett Eric G. | Hybrid transthoracic/intrathoracic cardiac stimulation devices and methods |
US7349742B2 (en) | 2003-04-11 | 2008-03-25 | Cardiac Pacemakers, Inc. | Expandable fixation elements for subcutaneous electrodes |
US7218966B2 (en) * | 2003-04-11 | 2007-05-15 | Cardiac Pacemakers, Inc. | Multi-parameter arrhythmia discrimination |
US20040230272A1 (en) * | 2003-04-11 | 2004-11-18 | Cates Adam W. | Subcutaneous lead with temporary pharmacological agents |
US7493175B2 (en) * | 2003-04-11 | 2009-02-17 | Cardiac Pacemakers, Inc. | Subcutaneous lead with tined fixation |
US20040230230A1 (en) * | 2003-04-11 | 2004-11-18 | Lindstrom Curtis Charles | Methods and systems involving subcutaneous electrode positioning relative to a heart |
US7236819B2 (en) | 2003-04-11 | 2007-06-26 | Cardiac Pacemakers, Inc. | Separation of a subcutaneous cardiac signal from a plurality of composite signals |
US7566318B2 (en) * | 2003-04-11 | 2009-07-28 | Cardiac Pacemakers, Inc. | Ultrasonic subcutaneous dissection tool incorporating fluid delivery |
US7979122B2 (en) | 2003-04-11 | 2011-07-12 | Cardiac Pacemakers, Inc. | Implantable sudden cardiac death prevention device with reduced programmable feature set |
US20040220626A1 (en) * | 2003-04-11 | 2004-11-04 | Wagner Darrell Orvin | Distributed subcutaneous defibrillation system |
US7302294B2 (en) * | 2003-04-11 | 2007-11-27 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac sensing and stimulation system employing blood sensor |
US20040220628A1 (en) * | 2003-04-11 | 2004-11-04 | Wagner Darrell Orvin | Subcutaneous defibrillation timing correlated with induced skeletal muscle contraction |
US7529592B2 (en) * | 2003-04-11 | 2009-05-05 | Cardiac Pacemakers, Inc. | Subcutaneous electrode and lead with temporary pharmacological agents |
US7047071B2 (en) | 2003-04-11 | 2006-05-16 | Cardiac Pacemakers, Inc. | Patient stratification for implantable subcutaneous cardiac monitoring and therapy |
US7570997B2 (en) | 2003-04-11 | 2009-08-04 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac rhythm management with asystole prevention therapy |
US7702399B2 (en) * | 2003-04-11 | 2010-04-20 | Cardiac Pacemakers, Inc. | Subcutaneous electrode and lead with phoresis based pharmacological agent delivery |
US20040204734A1 (en) * | 2003-04-11 | 2004-10-14 | Wagner Darrell Orvin | Tunneling tool with subcutaneous transdermal illumination |
US20050021093A1 (en) * | 2003-06-17 | 2005-01-27 | Team Brown, Llc | Subcutaneous lead system for detection and treatment of malignant ventricular arrhythmia |
US9763609B2 (en) | 2003-07-25 | 2017-09-19 | Dexcom, Inc. | Analyte sensors having a signal-to-noise ratio substantially unaffected by non-constant noise |
JP2007501067A (en) * | 2003-08-01 | 2007-01-25 | ノーススター ニューロサイエンス インコーポレイテッド | Apparatus and method for applying neural stimulation to patient |
US7396333B2 (en) | 2003-08-18 | 2008-07-08 | Cardiac Pacemakers, Inc. | Prediction of disordered breathing |
US7887493B2 (en) | 2003-09-18 | 2011-02-15 | Cardiac Pacemakers, Inc. | Implantable device employing movement sensing for detecting sleep-related disorders |
US20050107838A1 (en) * | 2003-09-18 | 2005-05-19 | Lovett Eric G. | Subcutaneous cardiac rhythm management with disordered breathing detection and treatment |
US7757690B2 (en) | 2003-09-18 | 2010-07-20 | Cardiac Pacemakers, Inc. | System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep |
ATE413902T1 (en) | 2003-08-18 | 2008-11-15 | Cardiac Pacemakers Inc | PATIENT MONITORING SYSTEM |
US8606356B2 (en) | 2003-09-18 | 2013-12-10 | Cardiac Pacemakers, Inc. | Autonomic arousal detection system and method |
US8002553B2 (en) | 2003-08-18 | 2011-08-23 | Cardiac Pacemakers, Inc. | Sleep quality data collection and evaluation |
US7920906B2 (en) | 2005-03-10 | 2011-04-05 | Dexcom, Inc. | System and methods for processing analyte sensor data for sensor calibration |
US9247900B2 (en) | 2004-07-13 | 2016-02-02 | Dexcom, Inc. | Analyte sensor |
US20060247693A1 (en) | 2005-04-28 | 2006-11-02 | Yanting Dong | Non-captured intrinsic discrimination in cardiac pacing response classification |
US7774064B2 (en) | 2003-12-12 | 2010-08-10 | Cardiac Pacemakers, Inc. | Cardiac response classification using retriggerable classification windows |
US8521284B2 (en) | 2003-12-12 | 2013-08-27 | Cardiac Pacemakers, Inc. | Cardiac response classification using multisite sensing and pacing |
US7364592B2 (en) | 2004-02-12 | 2008-04-29 | Dexcom, Inc. | Biointerface membrane with macro-and micro-architecture |
KR100601953B1 (en) * | 2004-05-03 | 2006-07-14 | 삼성전자주식회사 | Capacitor of memory device and fabrication method thereof |
DE102004028176B4 (en) * | 2004-06-04 | 2007-05-31 | Niehaus, Michael, Prof. Dr. | Electrodeless implantable defibrillator |
US7706866B2 (en) | 2004-06-24 | 2010-04-27 | Cardiac Pacemakers, Inc. | Automatic orientation determination for ECG measurements using multiple electrodes |
US20060020192A1 (en) | 2004-07-13 | 2006-01-26 | Dexcom, Inc. | Transcutaneous analyte sensor |
US20060270922A1 (en) | 2004-07-13 | 2006-11-30 | Brauker James H | Analyte sensor |
WO2006019764A2 (en) | 2004-07-15 | 2006-02-23 | Northstar Neuroscience, Inc. | Systems and methods for enhancing or affecting neural stimulation efficiency and/or efficacy |
US7191009B2 (en) * | 2004-08-09 | 2007-03-13 | Medtronic, Inc. | Means for increasing implantable medical device electrode surface area |
US7797036B2 (en) | 2004-11-30 | 2010-09-14 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring for ischemia detection |
US7917196B2 (en) | 2005-05-09 | 2011-03-29 | Cardiac Pacemakers, Inc. | Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes |
US7805185B2 (en) | 2005-05-09 | 2010-09-28 | Cardiac Pacemakers, In. | Posture monitoring using cardiac activation sequences |
US7509170B2 (en) | 2005-05-09 | 2009-03-24 | Cardiac Pacemakers, Inc. | Automatic capture verification using electrocardiograms sensed from multiple implanted electrodes |
US7890159B2 (en) | 2004-09-30 | 2011-02-15 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring and tracking |
US7457664B2 (en) | 2005-05-09 | 2008-11-25 | Cardiac Pacemakers, Inc. | Closed loop cardiac resynchronization therapy using cardiac activation sequence information |
US20060089681A1 (en) * | 2004-10-21 | 2006-04-27 | Cameron Health, Inc. | Implantable medical device |
US7565200B2 (en) | 2004-11-12 | 2009-07-21 | Advanced Neuromodulation Systems, Inc. | Systems and methods for selecting stimulation sites and applying treatment, including treatment of symptoms of Parkinson's disease, other movement disorders, and/or drug side effects |
US7477935B2 (en) * | 2004-11-29 | 2009-01-13 | Cameron Health, Inc. | Method and apparatus for beat alignment and comparison |
US7376458B2 (en) * | 2004-11-29 | 2008-05-20 | Cameron Health, Inc. | Method for defining signal templates in implantable cardiac devices |
US7655014B2 (en) * | 2004-12-06 | 2010-02-02 | Cameron Health, Inc. | Apparatus and method for subcutaneous electrode insertion |
US9089691B2 (en) * | 2004-12-07 | 2015-07-28 | Cardiac Pacemakers, Inc. | Stimulator for auricular branch of vagus nerve |
US7996072B2 (en) | 2004-12-21 | 2011-08-09 | Cardiac Pacemakers, Inc. | Positionally adaptable implantable cardiac device |
US8160697B2 (en) | 2005-01-25 | 2012-04-17 | Cameron Health, Inc. | Method for adapting charge initiation for an implantable cardioverter-defibrillator |
US8229563B2 (en) * | 2005-01-25 | 2012-07-24 | Cameron Health, Inc. | Devices for adapting charge initiation for an implantable cardioverter-defibrillator |
US7680534B2 (en) | 2005-02-28 | 2010-03-16 | Cardiac Pacemakers, Inc. | Implantable cardiac device with dyspnea measurement |
US7392086B2 (en) | 2005-04-26 | 2008-06-24 | Cardiac Pacemakers, Inc. | Implantable cardiac device and method for reduced phrenic nerve stimulation |
US7555338B2 (en) * | 2005-04-26 | 2009-06-30 | Cameron Health, Inc. | Methods and implantable devices for inducing fibrillation by alternating constant current |
US8116867B2 (en) * | 2005-08-04 | 2012-02-14 | Cameron Health, Inc. | Methods and devices for tachyarrhythmia sensing and high-pass filter bypass |
US20070049975A1 (en) * | 2005-09-01 | 2007-03-01 | Cates Adam W | Active can with dedicated defibrillation and sensing electrodes |
US7729773B2 (en) | 2005-10-19 | 2010-06-01 | Advanced Neuromodualation Systems, Inc. | Neural stimulation and optical monitoring systems and methods |
US8929991B2 (en) | 2005-10-19 | 2015-01-06 | Advanced Neuromodulation Systems, Inc. | Methods for establishing parameters for neural stimulation, including via performance of working memory tasks, and associated kits |
US7856264B2 (en) | 2005-10-19 | 2010-12-21 | Advanced Neuromodulation Systems, Inc. | Systems and methods for patient interactive neural stimulation and/or chemical substance delivery |
US20070118180A1 (en) | 2005-11-18 | 2007-05-24 | Quan Ni | Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection |
US20070135847A1 (en) * | 2005-12-12 | 2007-06-14 | Kenknight Bruce H | Subcutaneous defibrillation system and method using same |
US7761158B2 (en) * | 2005-12-20 | 2010-07-20 | Cardiac Pacemakers, Inc. | Detection of heart failure decompensation based on cumulative changes in sensor signals |
US8175710B2 (en) * | 2006-03-14 | 2012-05-08 | Boston Scientific Neuromodulation Corporation | Stimulator system with electrode array and the method of making the same |
US7769452B2 (en) | 2006-03-29 | 2010-08-03 | Medtronic, Inc. | Method and apparatus for detecting arrhythmias in a medical device |
US7941214B2 (en) * | 2006-03-29 | 2011-05-10 | Medtronic, Inc. | Method and apparatus for detecting arrhythmias in a subcutaneous medical device |
US7991471B2 (en) * | 2006-03-29 | 2011-08-02 | Medtronic, Inc. | Method and apparatus for detecting arrhythmias in a subcutaneous medical device |
US7894894B2 (en) | 2006-03-29 | 2011-02-22 | Medtronic, Inc. | Method and apparatus for detecting arrhythmias in a subcutaneous medical device |
US8788023B2 (en) | 2006-05-26 | 2014-07-22 | Cameron Health, Inc. | Systems and methods for sensing vector selection in an implantable medical device |
US8200341B2 (en) | 2007-02-07 | 2012-06-12 | Cameron Health, Inc. | Sensing vector selection in a cardiac stimulus device with postural assessment |
US7783340B2 (en) | 2007-01-16 | 2010-08-24 | Cameron Health, Inc. | Systems and methods for sensing vector selection in an implantable medical device using a polynomial approach |
US7623909B2 (en) | 2006-05-26 | 2009-11-24 | Cameron Health, Inc. | Implantable medical devices and programmers adapted for sensing vector selection |
US20070276452A1 (en) * | 2006-05-26 | 2007-11-29 | Cameron Health, Inc. | Implantable medical device systems having initialization functions and methods of operation |
US20070282376A1 (en) * | 2006-06-06 | 2007-12-06 | Shuros Allan C | Method and apparatus for neural stimulation via the lymphatic system |
US8527048B2 (en) | 2006-06-29 | 2013-09-03 | Cardiac Pacemakers, Inc. | Local and non-local sensing for cardiac pacing |
US20080015644A1 (en) * | 2006-07-14 | 2008-01-17 | Cameron Health, Inc. | End of life battery testing in an implantable medical device |
US8718793B2 (en) | 2006-08-01 | 2014-05-06 | Cameron Health, Inc. | Electrode insertion tools, lead assemblies, kits and methods for placement of cardiac device electrodes |
US7623913B2 (en) | 2006-08-01 | 2009-11-24 | Cameron Health, Inc. | Implantable medical devices using heuristic filtering in cardiac event detection |
US8209013B2 (en) | 2006-09-14 | 2012-06-26 | Cardiac Pacemakers, Inc. | Therapeutic electrical stimulation that avoids undesirable activation |
US7877139B2 (en) | 2006-09-22 | 2011-01-25 | Cameron Health, Inc. | Method and device for implantable cardiac stimulus device lead impedance measurement |
US8014851B2 (en) * | 2006-09-26 | 2011-09-06 | Cameron Health, Inc. | Signal analysis in implantable cardiac treatment devices |
US8068920B2 (en) | 2006-10-03 | 2011-11-29 | Vincent A Gaudiani | Transcoronary sinus pacing system, LV summit pacing, early mitral closure pacing, and methods therefor |
US8983598B2 (en) * | 2006-10-04 | 2015-03-17 | Cardiac Pacemakers, Inc. | System for neurally-mediated anti-arrhythmic therapy |
US7623916B2 (en) | 2006-12-20 | 2009-11-24 | Cameron Health, Inc. | Implantable cardiac stimulus devices and methods with input recharge circuitry |
US8755892B2 (en) * | 2007-05-16 | 2014-06-17 | Cardiac Pacemakers, Inc. | Systems for stimulating neural targets |
US20200037874A1 (en) | 2007-05-18 | 2020-02-06 | Dexcom, Inc. | Analyte sensors having a signal-to-noise ratio substantially unaffected by non-constant noise |
US20080294228A1 (en) * | 2007-05-23 | 2008-11-27 | Cardiac Pacemakers | Method and device for controlled stimulation of lymphatic flow |
US8265736B2 (en) | 2007-08-07 | 2012-09-11 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
US9037239B2 (en) | 2007-08-07 | 2015-05-19 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
WO2009092055A1 (en) | 2008-01-18 | 2009-07-23 | Cameron Health, Inc. | Data manipulation following delivery of a cardiac stimulus in an implantable cardiac stimulus device |
EP2254661B1 (en) | 2008-02-14 | 2015-10-07 | Cardiac Pacemakers, Inc. | Apparatus for phrenic stimulation detection |
EP2268357B1 (en) | 2008-03-07 | 2016-11-02 | Cameron Health, Inc. | Devices for accurately classifying cardiac activity |
CA2717442C (en) | 2008-03-07 | 2017-11-07 | Cameron Health, Inc. | Accurate cardiac event detection in an implantable cardiac stimulus device |
US8583204B2 (en) | 2008-03-28 | 2013-11-12 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
US11730407B2 (en) | 2008-03-28 | 2023-08-22 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
US8682408B2 (en) | 2008-03-28 | 2014-03-25 | Dexcom, Inc. | Polymer membranes for continuous analyte sensors |
WO2009137726A2 (en) | 2008-05-07 | 2009-11-12 | Cameron Health, Inc. | Methods and devices for accurately classifying cardiac activity |
US8321014B2 (en) | 2008-10-06 | 2012-11-27 | Cardiac Pacemakers, Inc. | Dynamic cardiac resynchronization therapy by tracking intrinsic conduction |
WO2010068934A1 (en) | 2008-12-12 | 2010-06-17 | Cameron Health, Inc. | Implantable defibrillator systems and methods with mitigations for saturation avoidance and accommodation |
WO2011008550A1 (en) | 2009-06-29 | 2011-01-20 | Cameron Health, Inc. | Adaptive confirmation of treatable arrhythmia in implantable cardiac stimulus devices |
US20110093042A1 (en) * | 2009-10-21 | 2011-04-21 | Medtronic, Inc. | Stimulation with utilization of case electrode |
US8996123B2 (en) * | 2009-10-21 | 2015-03-31 | Medtronic, Inc. | Managing electrical stimulation therapy based on variable electrode combinations |
US8571677B2 (en) * | 2009-10-21 | 2013-10-29 | Medtronic, Inc. | Programming techniques for stimulation with utilization of case electrode |
US8744555B2 (en) | 2009-10-27 | 2014-06-03 | Cameron Health, Inc. | Adaptive waveform appraisal in an implantable cardiac system |
US8265737B2 (en) | 2009-10-27 | 2012-09-11 | Cameron Health, Inc. | Methods and devices for identifying overdetection of cardiac signals |
US8538538B2 (en) * | 2009-11-25 | 2013-09-17 | Medtronic, Inc. | Medical electrical stimulation with implantable simulated case electrode |
US8855784B2 (en) * | 2009-12-31 | 2014-10-07 | Cardiac Pacemakers, Inc. | Implantable medical device including controllably isolated housing |
US8548573B2 (en) | 2010-01-18 | 2013-10-01 | Cameron Health, Inc. | Dynamically filtered beat detection in an implantable cardiac device |
US9320901B2 (en) | 2010-04-28 | 2016-04-26 | Medtronic, Inc. | Stimulation with utilization of non-selected electrode |
US8560080B2 (en) | 2010-06-11 | 2013-10-15 | Medtronic, Inc. | Programming techniques for controlling rate of change of electrical stimulation therapy |
US9402550B2 (en) | 2011-04-29 | 2016-08-02 | Cybertronics, Inc. | Dynamic heart rate threshold for neurological event detection |
CN104114231B (en) * | 2011-12-13 | 2016-09-07 | 心脏起搏器股份公司 | Implantable device header and method |
US10905884B2 (en) | 2012-07-20 | 2021-02-02 | Cardialen, Inc. | Multi-stage atrial cardioversion therapy leads |
EP2967404B1 (en) | 2013-03-11 | 2019-05-22 | Cameron Health, Inc. | Device implementing dual criteria for arrhythmia detection |
US9579065B2 (en) | 2013-03-12 | 2017-02-28 | Cameron Health Inc. | Cardiac signal vector selection with monophasic and biphasic shape consideration |
US9554714B2 (en) | 2014-08-14 | 2017-01-31 | Cameron Health Inc. | Use of detection profiles in an implantable medical device |
US10391325B2 (en) | 2016-05-04 | 2019-08-27 | Cardiac Pacemakers, Inc. | Electrode designs in implantable defibrillator systems |
US11235145B2 (en) | 2016-11-17 | 2022-02-01 | Cardiac Pacemakers, Inc. | Directional subcutaneous implantable cardioverter defibrillator electrode |
WO2018118818A1 (en) | 2016-12-21 | 2018-06-28 | Cardiac Pacemakers, Inc. | Lead with integrated electrodes |
WO2019118247A1 (en) | 2017-12-15 | 2019-06-20 | Boston Scientific Neuromodulation Corporation | Use of charge imbalanced pulses in an implantable stimulator to effect a pseudo-constant dc current bias |
US11648397B1 (en) | 2018-10-12 | 2023-05-16 | Vincent Gaudiani | Transcoronary sinus pacing of posteroseptal left ventricular base |
US11577075B1 (en) | 2018-10-12 | 2023-02-14 | Vincent A. Gaudiani | Transcoronary sinus pacing of his bundle |
US11413461B2 (en) | 2019-11-25 | 2022-08-16 | Medtronic, Inc. | Independent control of electrical stimulation amplitude for electrodes for delivery of electrical stimulation therapy |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4481953A (en) * | 1981-11-12 | 1984-11-13 | Cordis Corporation | Endocardial lead having helically wound ribbon electrode |
US4603705A (en) * | 1984-05-04 | 1986-08-05 | Mieczyslaw Mirowski | Intravascular multiple electrode unitary catheter |
US4787389A (en) * | 1987-07-16 | 1988-11-29 | Tnc Medical Devices Pte. Ltd. | Using an implantable antitachycardia defibrillator circuit |
US4796630A (en) * | 1987-03-23 | 1989-01-10 | Telectronics N.V. | Cardiac pacemaker with combined defibrillation and electrosurgery protection |
US4922927A (en) * | 1987-12-30 | 1990-05-08 | Intermedics, Inc. | Transvenous defibrillating and pacing lead |
US4940054A (en) * | 1988-04-29 | 1990-07-10 | Telectronics N.V. | Apparatus and method for controlling multiple sensitivities in arrhythmia control system including post therapy packing delay |
Family Cites Families (51)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3602229A (en) | 1967-09-08 | 1971-08-31 | George Gustav Jaros | A method of fibrillating a heart and apparatus therefor |
US3614955A (en) * | 1970-02-09 | 1971-10-26 | Medtronic Inc | Standby defibrillator and method of operation |
US3614954A (en) | 1970-02-09 | 1971-10-26 | Medtronic Inc | Electronic standby defibrillator |
US3683933A (en) | 1970-06-22 | 1972-08-15 | Peter B Mansfield | Implantable tissue stimulator with a porous anchoring enclosure |
US3835864A (en) | 1970-09-21 | 1974-09-17 | Rasor Ass Inc | Intra-cardiac stimulator |
US3738369A (en) | 1971-04-22 | 1973-06-12 | Gen Electric | Body organ stimulator function control switch |
US3822707A (en) | 1972-04-17 | 1974-07-09 | Cardiac Pacemakers Inc | Metal-enclosed cardiac pacer with solid-state power source |
US3866616A (en) | 1973-07-12 | 1975-02-18 | Coratomic | Heart pacer |
US3926198A (en) | 1974-06-10 | 1975-12-16 | Arco Med Prod Co | Cardiac pacer |
US4010759A (en) | 1975-08-29 | 1977-03-08 | Vitatron Medical B.V. | Insulated, corrosion resistant medical electronic devices and method for producing same |
GB1598791A (en) | 1977-03-10 | 1981-09-23 | Needle Industries Ltd | Plug and socket connectors |
US4157720A (en) | 1977-09-16 | 1979-06-12 | Greatbatch W | Cardiac pacemaker |
US4291699A (en) | 1978-09-21 | 1981-09-29 | Purdue Research Foundation | Method of and apparatus for automatically detecting and treating ventricular fibrillation |
US4291707A (en) | 1979-04-30 | 1981-09-29 | Mieczyslaw Mirowski | Implantable cardiac defibrillating electrode |
US4375817A (en) | 1979-07-19 | 1983-03-08 | Medtronic, Inc. | Implantable cardioverter |
US4289134A (en) | 1979-07-23 | 1981-09-15 | Electro-Catheter Corporation | Tripolar catheter apparatus |
US4310000A (en) | 1980-01-23 | 1982-01-12 | Medtronic, Inc. | Implantable pulse generator having separate passive sensing reference electrode |
EP0038080B1 (en) | 1980-04-16 | 1985-08-28 | Medtronic, Inc. | Patient interactive stimulator |
US4548203A (en) * | 1982-06-01 | 1985-10-22 | Purdue Research Foundation | Sequential-pulse, multiple pathway defibrillation method |
DE3247264A1 (en) | 1982-12-21 | 1984-06-28 | Siemens AG, 1000 Berlin und 8000 München | BIFOCAL PACEMAKER WITH TWO UNIPOLAR ELECTRODES |
US4558702A (en) | 1983-01-21 | 1985-12-17 | Cordis Corporation | Cardiac pacer having input/output circuit programmable for use with unipolar and bipolar pacer leads |
US4549548A (en) | 1983-09-14 | 1985-10-29 | Vitafin N.V. | Pacemaker system with automatic event-programmed switching between unipolar and bipolar operation |
FR2561929B1 (en) | 1984-03-27 | 1989-02-03 | Atesys | IMPLANTED AUTOMATIC APPARATUS FOR VENTRICULAR DEFIBRILLATION |
US4727877A (en) * | 1984-12-18 | 1988-03-01 | Medtronic, Inc. | Method and apparatus for low energy endocardial defibrillation |
US5111811A (en) * | 1985-06-20 | 1992-05-12 | Medtronic, Inc. | Cardioversion and defibrillation lead system with electrode extension into the coronary sinus and great vein |
US4662377A (en) * | 1985-11-07 | 1987-05-05 | Mieczyslaw Mirowski | Cardioverting method and apparatus utilizing catheter and patch electrodes |
US4741342A (en) | 1986-03-11 | 1988-05-03 | Intermedics, Inc. | Cardiac pacemaker with selective unipolar/bipolar pacing |
US4790318A (en) | 1986-06-16 | 1988-12-13 | Siemens Aktiengesellschaft | Cardiac pacer for pacing a human heart |
US4991583A (en) | 1986-08-13 | 1991-02-12 | Siemens-Pacesetter, Inc. | Pacemaker having independently programmable electrode configuration for pacing and sensing and method for operation thereof |
IT1214738B (en) | 1986-11-11 | 1990-01-18 | Sbm Soc Brevetti Medicina | IMPROVEMENT IN CARDIAC STIMULATION SYSTEMS VIA PACEMAKER |
US4953551A (en) * | 1987-01-14 | 1990-09-04 | Medtronic, Inc. | Method of defibrillating a heart |
US4944300A (en) * | 1987-04-28 | 1990-07-31 | Sanjeev Saksena | Method for high energy defibrillation of ventricular fibrillation in humans without a thoracotomy |
US4817608A (en) * | 1987-05-29 | 1989-04-04 | Mieczyslaw Mirowski | Cardioverting transvenous catheter/patch electrode system and method for its use |
DE68925218T2 (en) | 1988-01-19 | 1996-07-25 | Telectronics Nv | Method and apparatus for the application of asymmetric, two-phase, cut off exponential counter shocks |
US5083562A (en) * | 1988-01-19 | 1992-01-28 | Telectronics Pacing Systems, Inc. | Method and apparatus for applying asymmetric biphasic truncated exponential countershocks |
US4865036A (en) * | 1988-06-10 | 1989-09-12 | Raul Chirife | Antitachyarrythmia pacemaker using pre-ejection period to distinguish physiologic from pathologic tachycardia |
US5063932A (en) | 1989-10-03 | 1991-11-12 | Mieczyslaw Mirowski | Controlled discharge defibrillation electrode |
US5133353A (en) * | 1990-04-25 | 1992-07-28 | Cardiac Pacemakers, Inc. | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US5713926A (en) | 1990-04-25 | 1998-02-03 | Cardiac Pacemakers, Inc. | Implantable intravenous cardiac stimulation system with pulse generator housing serving as optional additional electrode |
US5050601A (en) * | 1990-05-29 | 1991-09-24 | Joel Kupersmith | Cardiac defibrillator electrode arrangement |
US5105810A (en) * | 1990-07-24 | 1992-04-21 | Telectronics Pacing Systems, Inc. | Implantable automatic and haemodynamically responsive cardioverting/defibrillating pacemaker with means for minimizing bradycardia support pacing voltages |
US5107834A (en) * | 1991-01-30 | 1992-04-28 | Cardiac Pacemakers, Inc. | Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration |
US5209229A (en) * | 1991-05-20 | 1993-05-11 | Telectronics Pacing Systems, Inc. | Apparatus and method employing plural electrode configurations for cardioversion of atrial fibrillation in an arrhythmia control system |
US5261400A (en) * | 1992-02-12 | 1993-11-16 | Medtronic, Inc. | Defibrillator employing transvenous and subcutaneous electrodes and method of use |
US5306291A (en) * | 1992-02-26 | 1994-04-26 | Angeion Corporation | Optimal energy steering for an implantable defibrillator |
EP0559932A1 (en) * | 1992-03-10 | 1993-09-15 | Pacesetter AB | Implantable assembly for defibrillating or cardioverting a heart |
US5376103A (en) * | 1992-03-19 | 1994-12-27 | Angeion Corporation | Electrode system for implantable defibrillator |
US5383908A (en) * | 1993-06-16 | 1995-01-24 | Ventritex, Inc. | Defibrillation system having innominate vein electrode and method for its use |
US6314955B1 (en) * | 2000-01-20 | 2001-11-13 | Richard C. Boetcker | Collapsible barbeque and cooking stove |
US6647292B1 (en) | 2000-09-18 | 2003-11-11 | Cameron Health | Unitary subcutaneous only implantable cardioverter-defibrillator and optional pacer |
US6522915B1 (en) | 2000-10-26 | 2003-02-18 | Medtronic, Inc. | Surround shroud connector and electrode housings for a subcutaneous electrode array and leadless ECGS |
-
1995
- 1995-01-30 US US08/380,538 patent/US5713926A/en not_active Expired - Lifetime
-
1997
- 1997-11-04 US US08/964,120 patent/US5916238A/en not_active Expired - Lifetime
-
1999
- 1999-06-28 US US09/344,843 patent/US6157860A/en not_active Expired - Lifetime
-
2000
- 2000-10-12 US US09/689,018 patent/US6280462B1/en not_active Expired - Fee Related
-
2001
- 2001-06-19 US US09/884,862 patent/US6999814B2/en not_active Expired - Fee Related
-
2004
- 2004-12-30 US US11/026,707 patent/US7522959B2/en not_active Expired - Fee Related
-
2006
- 2006-01-03 US US11/324,474 patent/US20060142804A1/en not_active Abandoned
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4481953A (en) * | 1981-11-12 | 1984-11-13 | Cordis Corporation | Endocardial lead having helically wound ribbon electrode |
US4603705A (en) * | 1984-05-04 | 1986-08-05 | Mieczyslaw Mirowski | Intravascular multiple electrode unitary catheter |
US4796630A (en) * | 1987-03-23 | 1989-01-10 | Telectronics N.V. | Cardiac pacemaker with combined defibrillation and electrosurgery protection |
US4787389A (en) * | 1987-07-16 | 1988-11-29 | Tnc Medical Devices Pte. Ltd. | Using an implantable antitachycardia defibrillator circuit |
US4922927A (en) * | 1987-12-30 | 1990-05-08 | Intermedics, Inc. | Transvenous defibrillating and pacing lead |
US4940054A (en) * | 1988-04-29 | 1990-07-10 | Telectronics N.V. | Apparatus and method for controlling multiple sensitivities in arrhythmia control system including post therapy packing delay |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9022962B2 (en) | 2000-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Apparatus for detecting and treating ventricular arrhythmia |
Also Published As
Publication number | Publication date |
---|---|
US5916238A (en) | 1999-06-29 |
US7522959B2 (en) | 2009-04-21 |
US6157860A (en) | 2000-12-05 |
US6999814B2 (en) | 2006-02-14 |
US5713926A (en) | 1998-02-03 |
US6280462B1 (en) | 2001-08-28 |
US20020091418A1 (en) | 2002-07-11 |
US20050119707A1 (en) | 2005-06-02 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |