Intermedics Inc.

Sulzer Intermedics, Inc.

John P Rosborough

D Curtis Deno

Timothy J Cox

Chris A Bonnerup

M Zafar Munshi

Edward A Schroeppel

Lawrence J Stotts

Xintao Wang

Mohammed Z Munshi

An apparatus and method for treating post-defibrillation electromechanical dissociation (&ldquo;EMD&rdquo;) or pulseless electrical activity (&ldquo;PEA&rdquo;). A first embodiment comprises an implantable defibrillator with the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes and at least one electrode for defibrillation. A sense circuit senses the electrical condition of the heart of the patient. A second sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects and terminates ventricular tachyarrhythmia or fibrillation. If the stimulator/defibrillator detects the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life (EMD), the device provides an output to stimulate the heart to overcome EMD. The device may also be an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and inducing or re-inducing ventricular fibrillation and subsequently applying defibrillating shocks to terminate the fibrillation.

Method and apparatus for treatment of cardiac electromechanical dissociation

An apparatus and method for treating post-defibrillation electromechanical dissociation (&ldquo;EMD&rdquo;). A first embodiment comprises an implantable defibrillator, which may include cardioversion and pacemaker capabilities, which has the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes. At least one electrode for defibrillation may be an endocardial or epicardial electrode or other suitable defibrillation electrode. A sense circuit senses the electrical condition of the heart of the patient. A hemodynamic sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects ventricular tachyarrhythmia including fibrillation and terminates ventricular tachyarrhythmia. After termination of the ventricular tachyarrhythmia, the stimulator/defibrillator can detect the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life. Under such conditions, the device provides an output to stimulate the heart to overcome electromechanical dissociation and restore adequate blood flow. The device may also be an external therapy device, as part of, or in conjunction with an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and providing electrical therapy, the therapy comprising a series of packets of electrical pulses.

A medical system comprising a control device (referred to as a 'planet') and a plurality of sensing and stimulating devices (referred to as 'satellites') is disclosed. The satellites are relatively small devices that can be thoracoscopically attached to an exterior surface of the heart. The planet can be implanted if desired or, alternatively, externally retained. The planet is capable of wirelessly communicating (i.e., without a direct electrical connection) to each satellite. The planet individually commands each satellite to deliver pacing energy to the heart. Additionally, each satellite is capable of determining when a sense event has occurred at the site of that satellite and transmitting an encoded signal to the planet indicating that a sense event has occurred, along with an identifying code indicating to the planet which satellite detected the sense event. The planet processes the encoded signals received from the network of satellites, assigns time values to each satellite when that satellite detects a sense event, compares the time values to a template of normal values, and determines if an arrhythmia has occurred if the time values do not match the template. Further, the planet selects and implements an appropriate pacing protocol to terminate the arrhythmia. The satellites derive their needed power from signals received from the planet via the wireless communication path.

Cardiac simulation system having multiple stimulators for

A self-cooling transcutaneous energy transfer system is provided for transmitting power to an implantable medical device, such as a defibrillator. The system includes a housing that is supported above the human body by a base so as to define a space between the housing and the body. A primary induction coil is disposed within the housing for transferring electromagnetic energy to the implantable medical device. A cooling fan is attached to the housing for providing forced convective heat transfer from the body. Various power and control circuitry are provided. The system can transfer away heat generated by eddy currents induced in the implantable device by the magnetic flux produced by the induction coil.

Self-cooling transcutaneous energy transfer system for battery powered

An implantable cardiac stimulator delivers a first electrical shock via implantable stimulating electrodes at a time when there is substantially no flow of blood. At least one of the stimulating electrodes is disposed in a blood flow path of the cardiovascular system. The first shock is of insufficient energy level to cause defibrillation. An electrical potential is measured as a function of time between the blood-contacting electrode and a reference electrode following delivery of the first shock to obtain a first potential equilibration function under no-flow conditions. A second therapeutic electrical shock, of sufficient energy level to effect defibrillation, is delivered via the stimulating electrodes. A second potential equilibration function is measured following delivery of the second shock. The first and second potential equilibration functions are compared, and if the two functions are sufficiently different in morphology, it is determined that blood is flowing.

Apparatus and method for discriminating flow of blood in a

The invention relates to an improved stimulation electrode for cardiac pacing and defibrillating, methods of manufacturing same, and methods of using same. Specifically, the electrodes of the invention by virtue of the methods of manufacturing and using, demonstrate improved capabilities of stimulating and sensing neuromuscular tissues. The electrodes have enhanced electrically-accessible surface areas which are coated with oxides of valve metals.

Implantable stimulation electrodes with non-native metal oxide coating

A system for lead removal of both heart pacemaker leads and cardioverter-defibrillator endocardial leads comprising a flexible coil of flattened ribbon. Preferably, the ribbon is comprised of polyethylene or another suitable biologically compatible material. At a distal end of the coil, a cutting surface may be provided, such as a chisel-like edge at the distal end of the coil. A handle may be provided for twisting the coil onto the lead. The coil should be at least partially radiopaque or provided with a surface which is radiopaque so that its use may be observed in the body by fluoroscopy or other suitable means.

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Houston, TX, United States of America

John P Rosborough