Ventritex, Inc.

Benjamin Pless

Michael Sweeney

Roger Winkle

Anthony Wayne Nathan

Michael B Sweeney

Benjamin D Pless

Anthony Nathan

M Elizabeth Bush

Drew A Hoffmann

Steven M Mitchell

Debra S Echt

A lead for use with an implantable cardioverter/defibrillator system is disclosed. In the preferred embodiment, the lead combines a right ventricular endocardial electrode, a superior vena cava electrode and one or more atrial sensing electrodes on a single catheter lead. The distal end of the lead is transvenously implanted, typically through an incision in the cephalic or subclavian vein. The proximal end of the lead is then tunneled below the fascia to the location of the pulse generator. Ventricular sensing and/or pacing electrode(s) may also be included at the distal end of the combined lead to provide ventricular intracardiac electrogram sensing and bradycardia pacing.

Cardiac defibrillation lead having defibrillation and atrial sensing

An electrode configuration for an automatic implantable cardioverter/defibrillator system and method for its use are disclosed. The electrode configuration includes a first catheter transvenously positioned with a first electrode near the distal end of the catheter positioned in the right ventricle of a patient's heart. A second catheter carries second and third electrodes with the second electrode positioned in the superior vena cava region and the third electrode positioned in the left innominate vein. The second and third electrodes of the second catheter are connected together. A fourth electrode at the tip of the first catheter functions as a sensing/pacing electrode. A fifth electrode in the form of a subcutaneous patch is also electrically coupled to the second and third electrodes. The electrode arrangement can be positioned without the need for a thoracotomy. With the method of the invention, the automatic implantable cardioverter/defibrillator senses life-threatening arrhythmic conditions of the heart and issues at least one cardioverting or defibrillating pulse that is applied between the right ventricular electrode and the connected superior vena cava, innominate vein and subcutaneous patch electrodes. The invention provides preferential steering of discharge current through the septum between the right and left ventricles of the heart. The first catheter may also include a pacing tip.

Defibrillation system having innominate vein electrode and method for

The subject apparatus integrates a two-channel defibrillator with a programmable stimulator to provide a means for assessing lethal ventricular tachyarrhythmias and determining defibrillation thresholds during implantable defibrillator procedures. The subject apparatus includes a number of features to aid doctors as well as improve patient care at substantially decreased patient risk. These features include an automatic charging circuit, as well as dual channel high voltage capacitor circuits to reduce the time in which a rescue shock can be delivered to a patient after an initial test defibrillation shock. Parameter storage is provided to allow the unit to be preprogrammed prior to the initiation of an electrophysiologic procedure. A microprocessor controlled display system provides the physician with information parameters regarding defibrillation shocks. This displayed information includes the energy delivered and the resistance in the patient. In addition, the apparatus also displays information regarding energy which is expected to be delivered based on the entered parameters.

Programmable defibrillator with pulse energy and resistance displays and

A method is disclosed for combined cardiac pacing and defibrillating with an implanted pacer/defibrillator having sensing and pacing leads connected to the atrium and the ventricle. P-waves and R-waves are sensed, and a V-V timer and a V-A timer are reset if an R-wave is sensed. If an R-wave is sensed during the V-V timer interval, a pacing stimulus to the ventricle is inhibited. If a P-wave is sensed during the V-A timer interval, a pacing stimulus to the atrium is inhibited. If an R-wave is sensed during the V-V timer interval, arrhythmia therapy is provided if an arrhythmia is determined to be present. If the sensed ventricular rate is greater than a selected tachycardia rate but is less than a selected fibrillation rate, than a determination is made whether the sensed atrial rate is greater than a selected fibrillation rate, and if so, the V-V and V-A timers are reset, but if the sensed atrial rate is not greater than a selected fibrillation rate, then arrhythmia therapy is provided. If an arrhythmia is present, the charging of a capacitor commences but if the arrhythmia ceases, the charging discontinues. If the capacitor is charged and the arrhythmia is still present, then a shock is delivered to the heart during a time period that is outside the vulnerable zones of the atrium and the ventricle.

Method for combined cardiac pacing and defibrillation

The subject invention integrates a two-channel defibrillator with a programmable stimulator to provide a means for assessing lethal ventricular tachyarrhythmias and determining defibrillation thresholds during implantable defibrillator procedures. The subject apparatus includes a number of features to aid doctors as well as improve patient care at substantially decreased patient risk. These features include an automatic charging circuit, as well as dual channel high voltage capacitor circuits to reduce the time in which a rescue shock can be delivered to a patient after an initial test defibrillation shock. Parameter storage is provided to allow the unit to be preprogrammed prior to the initiation of an electrophysiologic procedure. A microprocessor controlled display system provides the physician with information parameters regarding defibrillation shocks. This displayed information includes the energy delivered and the resistance in the patient. In addition, the apparatus also displays information regarding energy which is expected to be delivered based on the entered parameters.

Programmable defibrillator

A method is disclosed for combined cardiac pacing and defibrillating with an implanted pacer/defibrillator having sensing and pacing leads connected to the atrium and the ventricle. P-waves and R-waves are sensed, and V--V timer and a V--A timer are reset if an R-wave is sensed. If an R-wave is sensed during the V--V timer interval, a pacing stimulus to the ventricle is inhibited. If a P-wave is sensed during the V--A timer interval, a pacing stimulus to the atrium is inhibited. In an R-wave is sensed during the V--V timer interval, arrhythmia therapy is provided if an arrhythmia is determined to be present. If the sensed ventricular rate is greater than a selected tachycardia rate but is less than a selected fibrillation rate, then a determination is made whether the sensed atrial rate is greater than a selected fibrillation rate, and if so, the V--V and V--A timers are reset, but if the sensed atrial rate is not greater than a selected fibrillation rate, then arrhythmia therapy is provided. If an arrhythmia is present, the charging of a capacitor commences but if the arrhythmia ceases, the charging discontinues. If the capacitor is charged and the arrhythmia is still present, then a shock is delivered to the heart during a time period that is outside the vulnerable zones of the atrium and the ventricle.

Method for combiner cardiac pacing and defibrillation

A combination two-channel defibrillator and programmable pacing stimulator for assesses lethal ventricular tachyarrhythmias and determine defibrillation thresholds during implantable defibrillator procedures. A pair of switching transistors are provided to protect the pacing circuit when a defibrillation shock is delivered. These switching transistors provide symmetric voltage protection and prevent the defibrillation energy from being shunted back to the patient through the pacing leads.

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Menlo Park, CA, United States of America

Michael B Sweeney