WO1994003233A1 - Atrial defibrillator employing transvenous and subcutaneous electrodes and method of use - Google Patents
Atrial defibrillator employing transvenous and subcutaneous electrodes and method of use Download PDFInfo
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- WO1994003233A1 WO1994003233A1 PCT/US1993/006384 US9306384W WO9403233A1 WO 1994003233 A1 WO1994003233 A1 WO 1994003233A1 US 9306384 W US9306384 W US 9306384W WO 9403233 A1 WO9403233 A1 WO 9403233A1
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- Prior art keywords
- defibrillation
- pulse
- patient
- electrode
- occurrence
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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
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
- A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
- A61N1/39622—Pacing therapy
-
- 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
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/395—Heart defibrillators for treating atrial fibrillation
Definitions
- the present invention relates to medical electrical leads generally, and more particularly to implantable defibrillation electrodes and leads.
- Implantable defibrillators such as disclosed in Reissue Patent No. 27,652 by Mirowski, et al, envision an electrode system employing a ventricular endocardial electrode and a plate electrode mounted to the heart directly, subcutaneously, or to the skin.
- U.S. Patent No. 3,942,536 by Mirowski, et al discloses a transvenous lead having electrodes intended for location in the right ventricular apex and in the superior vena cava. This electrode system is disclosed as useful for either ventricular or atrial defibrillation. Such systems were eventually tested in human beings, with some success.
- Implantable defibrillators typically employ epicardial or subcutaneous patch electrodes, alone, or in conjunction with one or more transvenous electrodes.
- the right ventricular electrode carries an elongated coil electrode fabricated of a copper-zirconium alloy coated with iridium oxide.
- the use of biphasic pulses in such a two electrode system is also recommended. However, no recommendation is given as to the preferred polarity for the leading phase of the biphasic pulse.
- the Fine patent states that ventricular defibrillation thresholds as low as 7 - 10 joules may be achieved with such an endocardial lead in conjunction with a subcutaneous electrode, apparently implanted in proximity to the ventricles, rather than pectorally. There is no suggestion to employ this electrode configuration for ventricular defibrillation.
- a second electrode system specifically designed for use in atrial cardioversion is disclosed in the article "Safety and feasibility of transvenous cardioversion in atrial tachycardia", by Blanc et al, published in Cardiac Pacing, edited by Gomez, Futura Pub. Co., 1985, pp 1526-1529.
- This electrode system employed a single lead with electrodes located in the atrium and pulmonary artery. More recently, the use of electrodes located in the right atrium and coronary sinus for atrial defibrillation has been disclosed in allowed U.S. Patent Application No. 07/661,568 by Mehra, filed February 26, 1991, incorporated herein by reference in its entirety.
- the present invention is directed toward the provision of a defibrillation lead system particularly optimized for use in defibrillation or cardioversion of the atrium.
- the lead system includes a right ventricular electrode and a subcutaneous plate electrode located in the left pectoral region, which may optionally take the form of a surface of the defibrillator housing.
- a subcutaneous plate electrode located in the left pectoral region, which may optionally take the form of a surface of the defibrillator housing.
- an electrode system is particularly beneficial in accomplishing ventricular defibrillation.
- this electrode configuration developed originally for ventricular defibrillation, surprisingly is optimized to perform atrial defibrillation as well.
- the invention may usefully be practiced in a device which is intended to perform atrial cardioversion and defibrillation only, or in a device which also performs ventricular defibrillation.
- the ability to provide optimal therapy in both the atria and the ventricles using only a single pair of large surface electrodes is a significant benefit provided by the invention.
- the present invention is preferably practiced in a defibrillator/cardioverter which delivers an asymmetrical biphasic capacitive discharge pulse between the two electrodes.
- the initial phase of the pulse is delivered using the subcutaneous electrode as the cathode (coupled to the negatively charged terminal of the output capacitor during the initial phase) .
- Fig. 1 illustrates the implantable defibrillator and lead
- Fig. 2 illustrates a functional schematic diagram of an implantable pacemaker/cardioverter/defibrillator in which the invention may usefully be practiced.
- Fig. 1 illustrates a defibrillator and lead set according to the present invention.
- the ventricular lead takes the form of the lead disclosed in the above cited patent issued to Bardy, and includes an elongated insulative lead body 16, carrying three concentric coiled conductors, separated from one another by tubular insulative sheaths. Located adjacent the distal end of the lead are a ring electrode 24, an extendable helix electrode 26, mounted retractably within an insulative electrode head 28, and an elongated coil electrode 20. Each of the electrodes is coupled to one of the coiled conductors within the lead body 16. Electrodes 24 and 26 are employed for cardiac pacing and for sensing ventricular 5 depolarizations. At the proximal end of the lead is a
- the defibrillation electrode 20 may be fabricated from platinum, platinum alloy or other materials known to be usable in
- the atrial lead takes the form of includes an elongated insulative lead body 15, carrying two concentric coiled conductors, separated from one another by tubular insulative sheaths. Located adjacent the J-shaped distal end of the lead are a ring electrode 21 and an
- Electrodes 17 and 21 are employed for atrial pacing and for sensing atrial depolarizations. At the proximal end of
- the lead is an in-line connector which carries two electrical connectors, each coupled to one of the coiled conductors.
- An implantable pacemaker/cardioverter/defibrillator 10 is shown in combination with the leads, with the lead connector assemblies 13 and 14 inserted into the connector block 12.
- insulation of the outward facing portion of the housing 11 of the pacemaker/cardioverter/defibrillator 10 may be provided using a plastic coating, for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- a plastic coating for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- the outward facing portion may be provided using a plastic coating, for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- the outward facing portion may be provided using a plastic coating, for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- the outward facing portion may be provided using a plastic coating, for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- the outward facing portion may be provided using a plastic coating, for example parylene or silicone rubber, as is currently employed in some unipolar cardiac pacemakers.
- the outward facing portion may be provided using a plastic coating,
- the uninsulated portion of the housing 11 serves as a subcutaneous defibrillation electrode, used in conjunction with electrode 20 to defibrillate either the atria or ventricles.
- the electrode system and method of the present invention has the important advantages of simplicity of construction and of use. Unlike systems involving subcutaneous electrodes located at approximately the level of the heart, the pectoral location of the electrode of the present invention allows for implant using only a single incision. This benefit is accomplished without the necessity of fabrication of defibrillation leads carrying multiple defibrillation electrodes while still retaining the low defibrillation thresholds attributed to the prior art multiple electrode lead systems.
- the right ventricular lead as a practical matter generally lies along the posterior, inner wall of the right ventricle.
- the pectoral location of the defibrillator is located anterior to the heart.
- the bulk of the mass of the atria and ventricles lies between the electrodes.
- the pectoral site is close to ideal for both atrial and ventricular defibrillation, and eliminates the necessity for separate defibrillation electrode systems for the atria and ventricles.
- a defibrillator/lead system provides effective ventricular defibrillation at pulse energies of approximately eight joules. It is believed that atrial defibrillation using this electrode system may be accomplished at a substantially lower energy level.
- These results for ventricular defibrillation were obtained using a Medtronic right ventricular defibrillation lead, carrying a single platinum coil defibrillation electrode and the inward facing half of the titanium housing of an Medtronic Model 7219 implantable defibrillator.
- the exterior surface of the half-housing has a surface area of somewhat less than 90 square centimeters, the planar, major surface having an area of approximately 60 square centimeters. As tested, the interior surface of the housing was uninsulated.
- the half-housing was located in the left infraclavicular pectoral region and was employed as the cathodal electrode during the initial phase of the biphasic defibrillation pulse.
- FIG. 2 is a functional schematic diagram of an implantable pacemaker/cardioverter/defibrillator in which the present invention may usefully be practiced.
- This diagram should be taken as exemplary of the type of device in which the invention may be embodied, and not as limiting, as it is believed that the invention may usefully be practiced in a wide variety of device implementations, including cardioverter and defibrillators which do not provide antitachycardia pacing therapies.
- Electrode 11 is the uninsulated portion of the housing of the implantable pacemaker/cardioverter/defibrillator.
- Electrode 20 is a defibrillation electrode located in the right ventricle and is coupled to high voltage output circuit 234.
- Electrodes 24 and 26 are located on or in the ventricle and are coupled to the R-wave amplifier 200, which preferably takes the form of an automatic gain controlled amplifier providing an adjustable sensing threshold as a function of the measured R-wave amplitude.
- a signal is generated on R-out line 202 whenever the signal sensed between electrodes 612 and-614 exceeds the present sensing threshold.
- Electrodes 17 and 21 are located on or in the atrium and are coupled to the P-wave amplifier 204, which preferably also takes the form of an automatic gain controlled amplifier providing an adjustable sensing threshold as a function of the measured R-wave amplitude.
- a signal is generated on P-out line 206 whenever the signal sensed between electrodes 618 and 620 exceeds the present sensing threshold.
- the general operation of the R-wave and P-wave amplifiers 200 and 204 may correspond to that disclosed in allowed, commonly assigned, copending U.S. Patent Application Serial No. 07/612,760, by Kei el, et al., filed November 15, for an Apparatus for Monitoring Electrical Physiologic Signals, incorporated herein by reference in its entirety.
- Switch matrix 208 is used to select which of the available electrodes are coupled to wide band (0.5-200 Hz) amplifier 210 for use in digital signal analysis. Selection of electrodes is controlled by the microprocessor 224 via data/address bus 218, which selections may be varied as desired. Signals from the electrodes selected for coupling to bandpass amplifier 210 are provided to multiplexer 220, and thereafter converted to multibit digital signals by A/D converter 222, for storage in random access memory 226 under control of direct memory access circuit 228. Microprocessor 224 may employ digital signal analysis techniques to characterize the digitized signals stored in random access memory 226 to recognize and classify the patient's heart rhythm employing any of the numerous signal processing methodologies known to the art.
- the pacer timing/control circuitry 212 includes programmable digital counters which control the basic time intervals associated with DDD, WI, DVI, VDD, AAI, DDI and other modes of single and dual chamber pacing well known to the art. Circuitry 212 also controls escape intervals associated with antitachyarrhythmia pacing in both the atrium and the ventricle, employing any antitachyarrhythmia pacing therapies known to the art.
- Intervals defined by pacing circuitry 212 include atrial and ventricular pacing escape intervals, the refractory periods during which sensed P-waves and R-waves are ineffective to restart timing of the escape intervals and the pulse widths of the pacing pulses.
- the durations of these intervals are determined by microprocessor 226, in response to stored data in memory- 226 and are communicated to the pacing circuitry 212 via address/data bus 218.
- Pacer circuitry 212 also determines the amplitude of the cardiac pacing pulses under control of microprocessor 224.
- the escape interval counters within pacer timing/control circuitry 212 are reset upon sensing of R-waves and P-waves as indicated by a signals on lines 202 and 206, and in accordance with the selected mode of pacing on timeout trigger generation of pacing pulses by pacer output circuitry 214 and 216, which are coupled to electrodes 118, 120, 112, 114.
- the escape interval counters are also reset on generation of pacing pulses, and thereby control the basic timing of cardiac pacing functions, including anti-tachy pacing.
- the durations of the intervals defined by the escape interval timers are determined by microprocessor 224, via data/address bus 218.
- the value of the count present in the escape interval counters when reset by sensed R-waves and P- waves may be used to measure the durations of R-R intervals, P-P intervals, P-R intervals and R-P intervals, which measurements are stored in memory 226 and used to detect the presence of tachyarrhythmias.
- Microprocessor 224 operates as an interrupt driven device, and is awakened by interrupts from pacer timing/control circuitry 212 corresponding to the occurrence sensed P-waves and R-waves and corresponding to the generation of cardiac pacing pulses. These interrupts are provided via data/address bus 218. Any necessary mathematical calculations to be performed by microprocessor 224 and any updating of the values or intervals controlled by pacer timing/control circuitry 212 take place following such interrupts.
- the intervals separating that R-wave from the immediately preceding R-wave, paced or sensed (R-R interval) and the interval separating the paced or sensed R- wave from the preceding atrial depolarization, paced or sensed (P-R interval) may be stored.
- the intervals separating the sensed P-wave from the immediately preceding paced of sensed atrial contraction (P-P Interval) and the interval separating the sensed P-wave from the immediately preceding sensed or paced ventricular depolarization (R-P interval) may be stored.
- a portion of the memory 226 (Fig. 4) is configured as a plurality of recirculating buffers, capable of holding a preceding series of measured intervals, which may be analyzed in response to the occurrence of a pace or sense interrupt to determine whether the patient's heart is presently exhibiting atrial or ventricular tachyarrhythmia.
- Detection of atrial or ventricular tachyarrhythmias may correspond to tachyarrhythmia detection algorithms known to the art. For example, presence of atrial or ventricular tachyarrhythmia may be confirmed by means of detection of a sustained series of short R-R or P-P intervals of an average rate indicative of tachyarrhythmia or an unbroken series of short R-R or P-P intervals. The suddenness of onset of the detected high rates, the stability of the high rates, or a number of other factors known to the art may also be measured at this time. Appropriate detection methodologies measuring such factors are described in U.S. Patent No. 4,726,380, issued to Vollmann, U.S. Patent No.
- timing intervals for controlling generation of antitachy pacing therapies are loaded from microprocessor 224 into the pacer timing and control circuitry 212, to control the operation of the escape interval counters therein and to define refractory periods during which detection of R-waves and P-waves is ineffective to restart the escape interval counters.
- microprocessor 224 In the event that generation of a cardioversion or defibrillation pulse is required, microprocessor 224 employs the an escape interval counter to control timing of such cardioversion and defibrillation pulses, as well as associated refractory periods. In response to the detection of atrial or ventricular fibrillation or tachyarrhythmia requiring a cardioversion pulse, microprocessor 224 activates cardioversion/defibrillation control circuitry 230, which initiates charging of the high voltage capacitors 246, 248, 250 and 252 via charging circuit 236, under control of high voltage charging control lines 240 and 242.
- VCAP line 244 The voltage on the high voltage capacitors is monitored via VCAP line 244, which is passed through multiplexer 220 and in response to reaching a predetermined value set by microprocessor 224, results in generation of a logic signal on Cap Full (CF) line 254, terminating charging. Thereafter, timing of the delivery of the defibrillation or cardioversion pulse is controlled by pacer timing/control circuitry 212. Following delivery of the fibrillation or tachycardia therapy the microprocessor then returns the device to pacing and awaits the next successive interrupt due to pacing or the occurrence of a sensed atrial or ventricular depolarization.
- VCAP line 244 which is passed through multiplexer 220 and in response to reaching a predetermined value set by microprocessor 224, results in generation of a logic signal on Cap Full (CF) line 254, terminating charging.
- CF Cap Full
- circuitry which may be used to control delivery of monophasic pulses is set forth in commonly assigned copending Patent Application Serial No. 07/612,758, filed by Keimel, for an Apparatus for Delivering Single and Multiple Cardioversion and Defibrillation Pulses, filed November 14, 1990, also incorporated herein by reference in its entirety.
- output control circuitry as disclosed in U.S. Patent No.4,953,551, issued to Mehra et al on September 4, 1990 or U.S. Patent No. 4,800,883, issued to Winstrom on January 31, 1989 both incorporated herein by reference in their entireties, may also be used in conjunction with a device embodying the present invention for delivery of biphasic pulses.
- an antitachycardia pacing therapy may be selected and delivered to the chamber in which the tachycardia is diagnosed or to both chambers.
- a more aggressive antitachy pacing therapy may abe scheduled. If repeated attempts at antitachy pacing therapies fail, a higher level cardioversion pulse may be selected thereafter.
- Therapies for tachycardia termination may also vary with the rate of the detected tachycardia, with the therapies increasing in aggressiveness as the rate of the detected tachycardia increases. For example, fewer attempts at antitachy pacing may be undertaken prior to delivery of cardioversion pulses if the rate of the detected tachycardia is above a preset threshold.
- the references cited above in conjunction with descriptions of prior art tachycardia detection and treatment therapies are applicable here as well.
- the typical therapy will be delivery of a high amplitude defibrillation pulse, typically in excess of 10 joules in the case of ventricular fibrillation and in excess of 5 joules in the case of atrial defibrillation.
- Lower energy levels will be employed for cardioversion.
- the amplitude of the defibrillation pulse may be incremented in response to failure of an initial pulse or pulses to terminate fibrillation.
- Prior art patents illustrating such pre-set therapy menus of antitachyarrhythmia therapies include the above-cited U.S. Patent No. 4,830,006, issued to Haluska, et al, U.S. Patent No. 4,727,380, issued to Vollmann et al and U.S. Patent No. 4,587,970, issued to Holley et al.
- the invention may also be usefully practiced in substantially simpler devices.
- the electrode system illustrated in Fig. 1 may simply be coupled to an implantable atrial cardioverter as disclosed in U.S. Patent No. 3,738,370, issued to Charms, incorporated herein by reference in its entirety.
- a simple device of this type is believed workable in some patients.
- inclusion of the ability to detect and terminate ventricular tachycardias and fibrillation is believed of extreme importance in patients in whom delivery of atrial cardioversion or defibrillation pulses unintentionally in initiates ventricular arrhythmias.
- the surface areas of the defibrillator housings may become small enough to interfere ability of the housing to function efficiently as a subcutaneous defibrillation electrode.
- the surface area of the subcutaneous electrode may be increased by means of a supplemental plate electrode electrically coupled to the defibrillator housing or employed as an electrode in place of the defibrillator housing.
- This supplemental electrode may be simply placed in the pectoral implant site adjacent the defibrillator or may in some cases be clipped or otherwise attached to the inward facing surface of the defibrillator housing.
Abstract
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Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE69309931T DE69309931T2 (en) | 1992-07-30 | 1993-07-06 | Atrial Defibrillator Provided With Intravenous And Subcutaneous Electrodes |
AU46665/93A AU664306B2 (en) | 1992-07-30 | 1993-07-06 | Atrial defibrillator employing transvenous and subcutaneous electrodes and method of use |
EP93916998A EP0652789B1 (en) | 1992-07-30 | 1993-07-06 | Atrial defibrillator employing transvenous and subcutaneous electrodes |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US07/922,587 US5292338A (en) | 1992-07-30 | 1992-07-30 | Atrial defibrillator employing transvenous and subcutaneous electrodes and method of use |
US07/922,587 | 1992-07-30 |
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WO1994003233A1 true WO1994003233A1 (en) | 1994-02-17 |
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Application Number | Title | Priority Date | Filing Date |
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PCT/US1993/006384 WO1994003233A1 (en) | 1992-07-30 | 1993-07-06 | Atrial defibrillator employing transvenous and subcutaneous electrodes and method of use |
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Country | Link |
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US (1) | US5292338A (en) |
EP (1) | EP0652789B1 (en) |
AU (1) | AU664306B2 (en) |
CA (1) | CA2139656A1 (en) |
DE (1) | DE69309931T2 (en) |
WO (1) | WO1994003233A1 (en) |
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EP1057496A2 (en) | 1999-06-02 | 2000-12-06 | BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin | Electrode arrangement |
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Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5549642A (en) * | 1994-08-19 | 1996-08-27 | Medtronic, Inc. | Atrial defibrillator and method of use |
US5630834A (en) * | 1995-05-03 | 1997-05-20 | Medtronic, Inc. | Atrial defibrillator with means for delivering therapy in response to a determination that the patient is likely asleep |
US5662689A (en) * | 1995-09-08 | 1997-09-02 | Medtronic, Inc. | Method and apparatus for alleviating cardioversion shock pain |
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US20040199209A1 (en) * | 2003-04-07 | 2004-10-07 | Hill Michael R.S. | Method and system for delivery of vasoactive drugs to the heart prior to and during a medical procedure |
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US6449507B1 (en) * | 1996-04-30 | 2002-09-10 | Medtronic, Inc. | Method and system for nerve stimulation prior to and during a medical procedure |
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US7269457B2 (en) * | 1996-04-30 | 2007-09-11 | Medtronic, Inc. | Method and system for vagal nerve stimulation with multi-site cardiac pacing |
US6735471B2 (en) * | 1996-04-30 | 2004-05-11 | Medtronic, Inc. | Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure |
US5683429A (en) * | 1996-04-30 | 1997-11-04 | Medtronic, Inc. | Method and apparatus for cardiac pacing to prevent atrial fibrillation |
US6628987B1 (en) | 2000-09-26 | 2003-09-30 | Medtronic, Inc. | Method and system for sensing cardiac contractions during vagal stimulation-induced cardiopalegia |
US6006131A (en) * | 1996-08-13 | 1999-12-21 | Uab Research Foundation | Dual current pathway atrial defibrillation apparatus |
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US6112117A (en) * | 1997-05-06 | 2000-08-29 | Cardiac Pacemakers, Inc. | Method and apparatus for treating cardiac arrhythmia using electrogram features |
US5978704A (en) * | 1997-06-03 | 1999-11-02 | Uab Research Foundation | Method and apparatus for treating cardiac arrhythmia |
US6067471A (en) | 1998-08-07 | 2000-05-23 | Cardiac Pacemakers, Inc. | Atrial and ventricular implantable cardioverter-defibrillator and lead system |
US6479523B1 (en) | 1997-08-26 | 2002-11-12 | Emory University | Pharmacologic drug combination in vagal-induced asystole |
US6134470A (en) * | 1998-11-09 | 2000-10-17 | Medtronic, Inc. | Method and apparatus for treating a tachyarrhythmic patient |
US6205357B1 (en) | 1998-12-04 | 2001-03-20 | Uab Research Foundation | Methods and apparatus for detecting and treating medical conditions of the heart |
US8064997B2 (en) * | 1999-05-21 | 2011-11-22 | Cardiac Pacemakers, Inc. | Method and apparatus for treating irregular ventricular contractions such as during atrial arrhythmia |
US6430438B1 (en) * | 1999-05-21 | 2002-08-06 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with atrial shock timing optimization |
JP2003503119A (en) * | 1999-06-25 | 2003-01-28 | エモリ ユニバーシティ | Vagal nerve stimulation device and method |
DE19930267B4 (en) | 1999-06-25 | 2006-10-05 | Biotronik Gmbh & Co. Kg | defibrillator |
US7039461B1 (en) * | 2000-05-13 | 2006-05-02 | Cardiac Pacemakers, Inc. | Cardiac pacing system for prevention of ventricular fibrillation and ventricular tachycardia episode |
US6754528B2 (en) | 2001-11-21 | 2004-06-22 | Cameraon Health, Inc. | Apparatus and method of arrhythmia detection in a subcutaneous implantable cardioverter/defibrillator |
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 |
US7194302B2 (en) | 2000-09-18 | 2007-03-20 | Cameron Health, Inc. | Subcutaneous cardiac stimulator with small contact surface electrodes |
US6866044B2 (en) * | 2000-09-18 | 2005-03-15 | Cameron Health, Inc. | Method of insertion and implantation of implantable cardioverter-defibrillator canisters |
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 |
US7076296B2 (en) * | 2000-09-18 | 2006-07-11 | Cameron Health, Inc. | Method of supplying energy to subcutaneous cardioverter-defibrillator and pacer |
US7065407B2 (en) * | 2000-09-18 | 2006-06-20 | Cameron Health, Inc. | Duckbill-shaped implantable cardioverter-defibrillator canister and method of use |
US7120495B2 (en) * | 2000-09-18 | 2006-10-10 | Cameron Health, Inc. | Flexible subcutaneous implantable cardioverter-defibrillator |
US7146212B2 (en) * | 2000-09-18 | 2006-12-05 | Cameron Health, Inc. | Anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator |
US6487446B1 (en) * | 2000-09-26 | 2002-11-26 | Medtronic, Inc. | Method and system for spinal cord stimulation prior to and during a medical procedure |
US8417334B2 (en) * | 2000-10-26 | 2013-04-09 | Medtronic, Inc. | Method and apparatus for electrically stimulating the nervous system to improve ventricular dysfunction, heart failure, and other cardiac conditions |
US20030004549A1 (en) * | 2000-10-26 | 2003-01-02 | Medtronic, Inc. | Method and apparatus to minimize the effects of a cardiac insult |
US7369890B2 (en) * | 2000-11-02 | 2008-05-06 | Cardiac Pacemakers, Inc. | Technique for discriminating between coordinated and uncoordinated cardiac rhythms |
US6689117B2 (en) * | 2000-12-18 | 2004-02-10 | Cardiac Pacemakers, Inc. | Drug delivery system for implantable medical device |
US6484057B2 (en) | 2000-12-21 | 2002-11-19 | Uab Research Foundation | Pacing methods and devices for treating cardiac arrhythmias and fibrillation |
US6556865B2 (en) | 2001-01-29 | 2003-04-29 | Uab Research Foundation | Method for improving cardiac function following delivery of a defibrillation shock |
US6571125B2 (en) | 2001-02-12 | 2003-05-27 | Medtronic, Inc. | Drug delivery device |
US6453195B1 (en) | 2001-03-19 | 2002-09-17 | Medtronic, Inc. | Closed loop drug delivery system and remote management thereof |
CA2450376A1 (en) * | 2001-04-20 | 2002-10-31 | The Board Of Regents Of The University Of Oklahoma | Cardiac neuromodulation and methods of using same |
US20070191895A1 (en) * | 2001-04-20 | 2007-08-16 | Foreman Robert D | Activation of cardiac alpha receptors by spinal cord stimulation produces cardioprotection against ischemia, arrhythmias, and heart failure |
EP1385575A1 (en) | 2001-04-30 | 2004-02-04 | Medtronic, Inc. | Transcutaneous monitor and method of use, using therapeutic output from an implanted medical device |
CA2447643A1 (en) | 2001-05-29 | 2002-12-05 | Medtronic, Inc. | Closed-loop neuromodulation for prevention and treatment of cardiac conditions |
US6438420B1 (en) | 2001-05-29 | 2002-08-20 | Medtronic, Inc. | High voltage switch isolation for implantable cardioverters/defibrillators |
US6711437B2 (en) | 2001-07-30 | 2004-03-23 | Medtronic, Inc. | Pacing channel isolation in multi-site cardiac pacing systems |
US6714817B2 (en) * | 2001-08-31 | 2004-03-30 | Medtronic Physio-Control Manufacturing Corp. | Hard paddle for an external defibrillator |
US8396568B2 (en) * | 2002-04-11 | 2013-03-12 | Medtronic, Inc. | Medical electrical lead body designs incorporating energy dissipating shunt |
US7904178B2 (en) * | 2002-04-11 | 2011-03-08 | Medtronic, Inc. | Medical electrical lead body designs incorporating energy dissipating shunt |
US7657482B1 (en) * | 2002-07-15 | 2010-02-02 | Paymentech, L.P. | System and apparatus for transaction fraud processing |
US7139608B2 (en) * | 2002-07-31 | 2006-11-21 | Uab Research Foundation | Pacing methods and devices using feedback controlled timing |
US20040049118A1 (en) * | 2002-09-10 | 2004-03-11 | Ideker Raymond E. | Methods, systems and computer program products for treating fibrillation in a patient based on the presence of fibrillation following administration of defibrillation therapy |
US8560063B2 (en) * | 2002-09-10 | 2013-10-15 | Uab Research Foundation | Post-defibrillation pacing methods and devices |
US7162298B2 (en) * | 2002-09-10 | 2007-01-09 | Uab Research Foundation | Devices for detecting the presence of cardiac activity following administration of defibrillation therapy |
CA2442352A1 (en) * | 2002-09-26 | 2004-03-26 | Reg Macquarrie | Poly-(vinyl alcohol) based meat processing films |
US20040158289A1 (en) * | 2002-11-30 | 2004-08-12 | Girouard Steven D. | Method and apparatus for cell and electrical therapy of living tissue |
US7627373B2 (en) * | 2002-11-30 | 2009-12-01 | Cardiac Pacemakers, Inc. | Method and apparatus for cell and electrical therapy of living tissue |
US7189204B2 (en) * | 2002-12-04 | 2007-03-13 | Cardiac Pacemakers, Inc. | Sleep detection using an adjustable threshold |
US7031139B1 (en) * | 2002-12-05 | 2006-04-18 | Pacesetter, Inc. | Stackable capacitor having opposed contacts for an implantable electronic medical device |
US7392081B2 (en) * | 2003-02-28 | 2008-06-24 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac stimulator employing post-shock transthoracic asystole prevention pacing |
US7522958B2 (en) * | 2003-03-13 | 2009-04-21 | Uab Research Foundation | Methods and systems for reducing discomfort from cardiac defibrillation shocks |
US7555335B2 (en) | 2003-04-11 | 2009-06-30 | Cardiac Pacemakers, Inc. | Biopotential signal source separation using source impedances |
US20040204734A1 (en) * | 2003-04-11 | 2004-10-14 | Wagner Darrell Orvin | Tunneling tool with subcutaneous transdermal illumination |
US7499750B2 (en) * | 2003-04-11 | 2009-03-03 | Cardiac Pacemakers, Inc. | Noise canceling cardiac electrodes |
US8116868B2 (en) | 2003-04-11 | 2012-02-14 | Cardiac Pacemakers, Inc. | Implantable device with cardiac event audio playback |
US20040220628A1 (en) * | 2003-04-11 | 2004-11-04 | Wagner Darrell Orvin | Subcutaneous defibrillation timing correlated with induced skeletal muscle contraction |
US7979122B2 (en) * | 2003-04-11 | 2011-07-12 | Cardiac Pacemakers, Inc. | Implantable sudden cardiac death prevention device with reduced programmable feature set |
US7117035B2 (en) | 2003-04-11 | 2006-10-03 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac stimulation system with patient activity sensing |
US7493175B2 (en) | 2003-04-11 | 2009-02-17 | Cardiac Pacemakers, Inc. | Subcutaneous lead with tined fixation |
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 |
US7236819B2 (en) | 2003-04-11 | 2007-06-26 | Cardiac Pacemakers, Inc. | Separation of a subcutaneous cardiac signal from a plurality of composite signals |
US20050004615A1 (en) * | 2003-04-11 | 2005-01-06 | Sanders Richard S. | Reconfigurable implantable cardiac monitoring and therapy delivery device |
US7702399B2 (en) * | 2003-04-11 | 2010-04-20 | Cardiac Pacemakers, Inc. | Subcutaneous electrode and lead with phoresis based pharmacological agent delivery |
US20040230230A1 (en) * | 2003-04-11 | 2004-11-18 | Lindstrom Curtis Charles | Methods and systems involving subcutaneous electrode positioning relative to a heart |
US7349742B2 (en) * | 2003-04-11 | 2008-03-25 | Cardiac Pacemakers, Inc. | Expandable fixation elements for subcutaneous electrodes |
US7529592B2 (en) | 2003-04-11 | 2009-05-05 | Cardiac Pacemakers, Inc. | Subcutaneous electrode and lead with temporary pharmacological agents |
US20040215240A1 (en) * | 2003-04-11 | 2004-10-28 | Lovett Eric G. | Reconfigurable subcutaneous cardiac device |
US7499758B2 (en) * | 2003-04-11 | 2009-03-03 | Cardiac Pacemakers, Inc. | Helical fixation elements for subcutaneous electrodes |
US7570997B2 (en) | 2003-04-11 | 2009-08-04 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac rhythm management with asystole prevention therapy |
US7047071B2 (en) | 2003-04-11 | 2006-05-16 | Cardiac Pacemakers, Inc. | Patient stratification for implantable subcutaneous cardiac monitoring and therapy |
US20040204735A1 (en) * | 2003-04-11 | 2004-10-14 | Shiroff Jason Alan | Subcutaneous dissection tool incorporating pharmacological agent delivery |
US7218966B2 (en) * | 2003-04-11 | 2007-05-15 | Cardiac Pacemakers, Inc. | Multi-parameter arrhythmia discrimination |
US7566318B2 (en) * | 2003-04-11 | 2009-07-28 | Cardiac Pacemakers, Inc. | Ultrasonic subcutaneous dissection tool incorporating fluid delivery |
US7389138B2 (en) | 2003-04-11 | 2008-06-17 | Cardiac Pacemakers, Inc. | Electrode placement determination for subcutaneous cardiac monitoring and therapy |
US20040230272A1 (en) * | 2003-04-11 | 2004-11-18 | Cates Adam W. | Subcutaneous lead with temporary pharmacological agents |
US7865233B2 (en) | 2003-04-11 | 2011-01-04 | Cardiac Pacemakers, Inc. | Subcutaneous cardiac signal discrimination employing non-electrophysiologic signal |
US20040210256A1 (en) * | 2003-04-17 | 2004-10-21 | Medtronic, Inc. | Methods and apparatus for decreasing incidences of early recurrence of atrial fibrillation |
US8239045B2 (en) * | 2003-06-04 | 2012-08-07 | Synecor Llc | Device and method for retaining a medical device within a vessel |
US7617007B2 (en) * | 2003-06-04 | 2009-11-10 | Synecor Llc | Method and apparatus for retaining medical implants within body vessels |
US7082336B2 (en) | 2003-06-04 | 2006-07-25 | Synecor, Llc | Implantable intravascular device for defibrillation and/or pacing |
AU2004251673B2 (en) | 2003-06-04 | 2010-01-28 | Synecor Llc | Intravascular electrophysiological system and methods |
US7006864B2 (en) * | 2003-06-17 | 2006-02-28 | Ebr Systems, Inc. | Methods and systems for vibrational treatment of cardiac arrhythmias |
US7887493B2 (en) | 2003-09-18 | 2011-02-15 | Cardiac Pacemakers, Inc. | Implantable device employing movement sensing for detecting sleep-related disorders |
US8002553B2 (en) | 2003-08-18 | 2011-08-23 | Cardiac Pacemakers, Inc. | Sleep quality data collection and evaluation |
US7184830B2 (en) * | 2003-08-18 | 2007-02-27 | Ebr Systems, Inc. | Methods and systems for treating arrhythmias using a combination of vibrational and electrical energy |
US8606356B2 (en) | 2003-09-18 | 2013-12-10 | Cardiac Pacemakers, Inc. | Autonomic arousal detection system and method |
EP1670547B1 (en) * | 2003-08-18 | 2008-11-12 | Cardiac Pacemakers, Inc. | Patient monitoring system |
US7396333B2 (en) | 2003-08-18 | 2008-07-08 | Cardiac Pacemakers, Inc. | Prediction of disordered breathing |
US20050107838A1 (en) * | 2003-09-18 | 2005-05-19 | Lovett Eric G. | Subcutaneous cardiac rhythm management with disordered breathing detection and treatment |
US7050849B2 (en) * | 2003-11-06 | 2006-05-23 | Ebr Systems, Inc. | Vibrational therapy device used for resynchronization pacing in a treatment for heart failure |
US7734344B2 (en) | 2003-12-02 | 2010-06-08 | Uab Research Foundation | Methods, systems and computer program products to inhibit ventricular fibrillation during cardiopulmonary resuscitation |
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 |
US7747335B2 (en) * | 2003-12-12 | 2010-06-29 | Synecor Llc | Implantable medical device having pre-implant exoskeleton |
US8521284B2 (en) * | 2003-12-12 | 2013-08-27 | Cardiac Pacemakers, Inc. | Cardiac response classification using multisite sensing and pacing |
KR101114585B1 (en) * | 2004-02-05 | 2012-03-14 | 이데미쓰 고산 가부시키가이샤 | Adamantane derivatives and process for producing the same |
AU2005212341B2 (en) * | 2004-02-10 | 2011-11-24 | Synecor, Llc. | Intravascular delivery system for therapeutic agents |
US7765001B2 (en) | 2005-08-31 | 2010-07-27 | Ebr Systems, Inc. | Methods and systems for heart failure prevention and treatments using ultrasound and leadless implantable devices |
US7706866B2 (en) * | 2004-06-24 | 2010-04-27 | Cardiac Pacemakers, Inc. | Automatic orientation determination for ECG measurements using multiple electrodes |
US7917196B2 (en) | 2005-05-09 | 2011-03-29 | Cardiac Pacemakers, Inc. | Arrhythmia discrimination using electrocardiograms sensed from multiple implanted electrodes |
US7509170B2 (en) * | 2005-05-09 | 2009-03-24 | Cardiac Pacemakers, Inc. | Automatic capture verification using electrocardiograms sensed from multiple implanted electrodes |
US7457664B2 (en) * | 2005-05-09 | 2008-11-25 | Cardiac Pacemakers, Inc. | Closed loop cardiac resynchronization therapy using cardiac activation sequence information |
US7805185B2 (en) * | 2005-05-09 | 2010-09-28 | Cardiac Pacemakers, In. | Posture monitoring using cardiac activation sequences |
US7797036B2 (en) * | 2004-11-30 | 2010-09-14 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring for ischemia detection |
US7890159B2 (en) * | 2004-09-30 | 2011-02-15 | Cardiac Pacemakers, Inc. | Cardiac activation sequence monitoring and tracking |
US7981065B2 (en) | 2004-12-20 | 2011-07-19 | Cardiac Pacemakers, Inc. | Lead electrode incorporating extracellular matrix |
US8060219B2 (en) * | 2004-12-20 | 2011-11-15 | Cardiac Pacemakers, Inc. | Epicardial patch including isolated extracellular matrix with pacing electrodes |
WO2006069327A2 (en) * | 2004-12-21 | 2006-06-29 | Ebr Systems, Inc. | Implantable transducer devices |
US7558631B2 (en) * | 2004-12-21 | 2009-07-07 | Ebr Systems, Inc. | Leadless tissue stimulation systems and methods |
EP1835964B1 (en) * | 2004-12-21 | 2016-03-09 | EBR Systems, Inc. | Leadless cardiac system for pacing and arrhythmia treatment |
US7996072B2 (en) | 2004-12-21 | 2011-08-09 | Cardiac Pacemakers, Inc. | Positionally adaptable implantable cardiac device |
US7680534B2 (en) | 2005-02-28 | 2010-03-16 | Cardiac Pacemakers, Inc. | Implantable cardiac device with dyspnea measurement |
US7881782B2 (en) * | 2005-04-20 | 2011-02-01 | Cardiac Pacemakers, Inc. | Neural stimulation system to prevent simultaneous energy discharges |
US7392086B2 (en) * | 2005-04-26 | 2008-06-24 | Cardiac Pacemakers, Inc. | Implantable cardiac device and method for reduced phrenic nerve stimulation |
US20070049975A1 (en) * | 2005-09-01 | 2007-03-01 | Cates Adam W | Active can with dedicated defibrillation and sensing electrodes |
US7702392B2 (en) | 2005-09-12 | 2010-04-20 | Ebr Systems, Inc. | Methods and apparatus for determining cardiac stimulation sites using hemodynamic data |
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 |
US20080004665A1 (en) * | 2006-06-29 | 2008-01-03 | Mccabe Aaron R | Determination of cardiac pacing parameters based on non-localized sensing |
US8527048B2 (en) * | 2006-06-29 | 2013-09-03 | Cardiac Pacemakers, Inc. | Local and non-local sensing for cardiac pacing |
US8209013B2 (en) * | 2006-09-14 | 2012-06-26 | Cardiac Pacemakers, Inc. | Therapeutic electrical stimulation that avoids undesirable activation |
US8718773B2 (en) | 2007-05-23 | 2014-05-06 | Ebr Systems, Inc. | Optimizing energy transmission in a leadless tissue stimulation system |
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 |
US7953493B2 (en) | 2007-12-27 | 2011-05-31 | Ebr Systems, Inc. | Optimizing size of implantable medical devices by isolating the power source |
CN101939051B (en) | 2008-02-14 | 2013-07-10 | 心脏起搏器公司 | Method and apparatus for phrenic stimulation detection |
EP2265166B1 (en) | 2008-03-25 | 2020-08-05 | EBR Systems, Inc. | Temporary electrode connection for wireless pacing systems |
EP2211978A1 (en) * | 2008-04-30 | 2010-08-04 | Medtronic, Inc. | Techniques for placing medical leads for electrical stimulation of nerve tissue |
US20100016911A1 (en) | 2008-07-16 | 2010-01-21 | Ebr Systems, Inc. | Local Lead To Improve Energy Efficiency In Implantable Wireless Acoustic Stimulators |
US8560064B2 (en) * | 2008-07-31 | 2013-10-15 | Medtronic, Inc. | Extravascular arrhythmia induction |
US8359094B2 (en) | 2008-07-31 | 2013-01-22 | Medtronic, Inc. | Extravascular arrhythmia induction |
US8321014B2 (en) * | 2008-10-06 | 2012-11-27 | Cardiac Pacemakers, Inc. | Dynamic cardiac resynchronization therapy by tracking intrinsic conduction |
US9026206B2 (en) * | 2008-10-31 | 2015-05-05 | Medtronic, Inc. | Therapy system including cardiac rhythm therapy and neurostimulation capabilities |
US8688210B2 (en) * | 2008-10-31 | 2014-04-01 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8532779B2 (en) * | 2008-10-31 | 2013-09-10 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8612020B2 (en) * | 2008-10-31 | 2013-12-17 | Medtronic, Inc. | Implantable therapeutic nerve stimulator |
US8560060B2 (en) * | 2008-10-31 | 2013-10-15 | Medtronic, Inc. | Isolation of sensing and stimulation circuitry |
US8301263B2 (en) * | 2008-10-31 | 2012-10-30 | Medtronic, Inc. | Therapy module crosstalk mitigation |
US8249708B2 (en) * | 2008-10-31 | 2012-08-21 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
EP2370173A2 (en) * | 2008-10-31 | 2011-10-05 | Medtronic, Inc. | Interference mitigation for implantable device recharging |
US9192769B2 (en) * | 2008-10-31 | 2015-11-24 | Medtronic, Inc. | Shunt-current reduction techniques for an implantable therapy system |
US8452394B2 (en) * | 2008-10-31 | 2013-05-28 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
EP2367596A1 (en) * | 2008-10-31 | 2011-09-28 | Medtronic, Inc. | Shunt-current reduction housing for an implantable therapy system |
US9775987B2 (en) * | 2008-10-31 | 2017-10-03 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8260412B2 (en) * | 2008-10-31 | 2012-09-04 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US9289613B2 (en) | 2008-10-31 | 2016-03-22 | Medtronic, Inc. | Interdevice impedance |
US8498698B2 (en) * | 2008-10-31 | 2013-07-30 | Medtronic, Inc. | Isolation of sensing and stimulation circuitry |
US9597505B2 (en) * | 2008-10-31 | 2017-03-21 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US20100114209A1 (en) * | 2008-10-31 | 2010-05-06 | Medtronic, Inc. | Communication between implantable medical devices |
US8611996B2 (en) * | 2008-10-31 | 2013-12-17 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
WO2010051485A1 (en) * | 2008-10-31 | 2010-05-06 | Medtronic Inc | Interference mitigation for implantable device recharging |
US8005539B2 (en) * | 2008-10-31 | 2011-08-23 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8774918B2 (en) * | 2008-10-31 | 2014-07-08 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8712523B2 (en) * | 2008-12-12 | 2014-04-29 | Cameron Health Inc. | Implantable defibrillator systems and methods with mitigations for saturation avoidance and accommodation |
WO2010088539A1 (en) | 2009-01-30 | 2010-08-05 | Medtronic, Inc. | Detecting and treating electromechanical dissociation of the heart |
US8620425B2 (en) | 2010-04-29 | 2013-12-31 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
US8639327B2 (en) | 2010-04-29 | 2014-01-28 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
US8406868B2 (en) | 2010-04-29 | 2013-03-26 | Medtronic, Inc. | Therapy using perturbation and effect of physiological systems |
US8781582B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
US8725259B2 (en) | 2011-01-19 | 2014-05-13 | Medtronic, Inc. | Vagal stimulation |
US8781583B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
US8706223B2 (en) | 2011-01-19 | 2014-04-22 | Medtronic, Inc. | Preventative vagal stimulation |
US8718763B2 (en) | 2011-01-19 | 2014-05-06 | Medtronic, Inc. | Vagal stimulation |
US10905884B2 (en) | 2012-07-20 | 2021-02-02 | Cardialen, Inc. | Multi-stage atrial cardioversion therapy leads |
US9717923B2 (en) | 2013-05-06 | 2017-08-01 | Medtronic, Inc. | Implantable medical device system having implantable cardioverter-defibrillator (ICD) system and substernal leadless pacing device |
US10471267B2 (en) | 2013-05-06 | 2019-11-12 | Medtronic, Inc. | Implantable cardioverter-defibrillator (ICD) system including substernal lead |
US10532203B2 (en) | 2013-05-06 | 2020-01-14 | Medtronic, Inc. | Substernal electrical stimulation system |
US10556117B2 (en) | 2013-05-06 | 2020-02-11 | Medtronic, Inc. | Implantable cardioverter-defibrillator (ICD) system including substernal pacing lead |
AU2015218603B2 (en) | 2014-02-24 | 2019-12-05 | Element Science, Inc | External defibrillator |
US10219718B2 (en) | 2014-10-22 | 2019-03-05 | Medtronic, Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
EP3247453B1 (en) | 2015-01-23 | 2020-11-25 | Medtronic Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
US10004418B2 (en) | 2015-01-23 | 2018-06-26 | Medtronic, Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
US10213125B2 (en) | 2015-01-23 | 2019-02-26 | Medtronic, Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
US9486155B2 (en) | 2015-02-18 | 2016-11-08 | Medtronic, Inc. | Method and apparatus for atrial arrhythmia episode detection |
US9901276B2 (en) | 2015-02-18 | 2018-02-27 | Medtronic, Inc. | Method and apparatus for identifying sick sinus syndrome in an implantable cardiac monitoring device |
JP6981966B2 (en) | 2015-08-26 | 2021-12-17 | エレメント サイエンス, インクElement Science, Inc | Wearable device |
US10039469B2 (en) | 2016-03-30 | 2018-08-07 | Medtronic, Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
US10045710B2 (en) | 2016-03-30 | 2018-08-14 | Medtronic, Inc. | Atrial arrhythmia episode detection in a cardiac medical device |
AU2019357613B2 (en) | 2018-10-10 | 2021-12-09 | Element Science, Inc. | Wearable medical device with disposable and reusable components |
Citations (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4403614A (en) * | 1979-07-19 | 1983-09-13 | Medtronic, Inc. | Implantable cardioverter |
EP0281219A1 (en) * | 1987-01-14 | 1988-09-07 | Medtronic, Inc. | Cardiac defibrillator |
EP0324604A1 (en) * | 1988-01-11 | 1989-07-19 | Telectronics N.V. | Apparatus and method for controlling pulse energy in antitachyarrhythmia and bradycardia pacing device |
EP0347353A1 (en) * | 1988-06-15 | 1989-12-20 | ATESYS, société anonyme | High performance defibrillator with several electrodes outside the heart |
EP0373953A2 (en) * | 1988-12-15 | 1990-06-20 | Medtronic, Inc. | Endocardial defibrillation electrode system |
EP0401962A2 (en) * | 1989-06-06 | 1990-12-12 | Ventritex, Inc. | Device for combined cardiac pacing and defibrillation |
EP0409591A1 (en) * | 1989-07-18 | 1991-01-23 | Rey S Reyes | Interface cable for connecting bedside electrocardiograph monitor to portable defibrillator/electrocardiograph machine |
EP0469817A2 (en) * | 1990-07-30 | 1992-02-05 | Telectronics N.V. | Arrhythmia control system employing arrhythmia recognition algorithm |
US5107834A (en) * | 1991-01-30 | 1992-04-28 | Cardiac Pacemakers, Inc. | Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration |
WO1992018198A2 (en) * | 1991-04-12 | 1992-10-29 | Incontrol, Inc. | Improved atrial defibrillator, lead systems, and method |
Family Cites Families (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
USRE27652E (en) * | 1970-02-09 | 1973-05-29 | M Mirowski | Electronic standby defibrillator |
US3738370A (en) * | 1971-01-18 | 1973-06-12 | B Charms | Method of defibrillating a malfunctioning heart by means of electrodes located within the atrium |
US3942536A (en) * | 1971-03-15 | 1976-03-09 | Mieczyslaw Mirowski | Cardioverting device having single intravascular catheter electrode system and method for its use |
US3952750A (en) * | 1974-04-25 | 1976-04-27 | Mieczyslaw Mirowski | Command atrial cardioverting device |
US4161952A (en) * | 1977-11-01 | 1979-07-24 | Mieczyslaw Mirowski | Wound wire catheter cardioverting electrode |
US4375817A (en) * | 1979-07-19 | 1983-03-08 | Medtronic, Inc. | Implantable cardioverter |
US4384585A (en) * | 1981-03-06 | 1983-05-24 | Medtronic, Inc. | Synchronous intracardiac cardioverter |
US4481953A (en) * | 1981-11-12 | 1984-11-13 | Cordis Corporation | Endocardial lead having helically wound ribbon electrode |
US4726380A (en) * | 1983-10-17 | 1988-02-23 | Telectronics, N.V. | Implantable cardiac pacer with discontinuous microprocessor, programmable antitachycardia mechanisms and patient data telemetry |
US4577633A (en) * | 1984-03-28 | 1986-03-25 | Medtronic, Inc. | Rate scanning demand pacemaker and method for treatment of tachycardia |
US4727380A (en) * | 1984-05-31 | 1988-02-23 | Seiko Epson Corporation | Photosensitive printing apparatus |
US4727877A (en) * | 1984-12-18 | 1988-03-01 | Medtronic, Inc. | Method and apparatus for low energy endocardial defibrillation |
US4587970A (en) * | 1985-01-22 | 1986-05-13 | Telectronics N.V. | Tachycardia reversion pacer |
CA1290813C (en) * | 1985-08-12 | 1991-10-15 | Michael B. Sweeney | Pacemaker for detecting and terminating a tachycardia |
US4800883A (en) * | 1986-04-02 | 1989-01-31 | Intermedics, Inc. | Apparatus for generating multiphasic defibrillation pulse waveform |
US4830006B1 (en) * | 1986-06-17 | 1997-10-28 | Intermedics Inc | Implantable cardiac stimulator for detection and treatment of ventricular arrhythmias |
US4953551A (en) * | 1987-01-14 | 1990-09-04 | Medtronic, Inc. | Method of defibrillating a heart |
US4922927A (en) * | 1987-12-30 | 1990-05-08 | Intermedics, Inc. | Transvenous defibrillating and pacing lead |
US5099838A (en) * | 1988-12-15 | 1992-03-31 | Medtronic, Inc. | Endocardial defibrillation electrode system |
US4949719A (en) * | 1989-04-26 | 1990-08-21 | Ventritex, Inc. | Method for cardiac defibrillation |
US4934049A (en) * | 1989-07-07 | 1990-06-19 | Medtronic, Inc. | Method for fabrication of a medical electrode |
US5042143A (en) * | 1990-02-14 | 1991-08-27 | Medtronic, Inc. | Method for fabrication of implantable electrode |
US5165403A (en) * | 1991-02-26 | 1992-11-24 | Medtronic, Inc. | Difibrillation lead system and method of use |
-
1992
- 1992-07-30 US US07/922,587 patent/US5292338A/en not_active Expired - Lifetime
-
1993
- 1993-07-06 DE DE69309931T patent/DE69309931T2/en not_active Expired - Lifetime
- 1993-07-06 CA CA002139656A patent/CA2139656A1/en not_active Abandoned
- 1993-07-06 WO PCT/US1993/006384 patent/WO1994003233A1/en active IP Right Grant
- 1993-07-06 AU AU46665/93A patent/AU664306B2/en not_active Ceased
- 1993-07-06 EP EP93916998A patent/EP0652789B1/en not_active Expired - Lifetime
Patent Citations (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4403614A (en) * | 1979-07-19 | 1983-09-13 | Medtronic, Inc. | Implantable cardioverter |
EP0281219A1 (en) * | 1987-01-14 | 1988-09-07 | Medtronic, Inc. | Cardiac defibrillator |
EP0324604A1 (en) * | 1988-01-11 | 1989-07-19 | Telectronics N.V. | Apparatus and method for controlling pulse energy in antitachyarrhythmia and bradycardia pacing device |
EP0347353A1 (en) * | 1988-06-15 | 1989-12-20 | ATESYS, société anonyme | High performance defibrillator with several electrodes outside the heart |
EP0373953A2 (en) * | 1988-12-15 | 1990-06-20 | Medtronic, Inc. | Endocardial defibrillation electrode system |
EP0401962A2 (en) * | 1989-06-06 | 1990-12-12 | Ventritex, Inc. | Device for combined cardiac pacing and defibrillation |
EP0409591A1 (en) * | 1989-07-18 | 1991-01-23 | Rey S Reyes | Interface cable for connecting bedside electrocardiograph monitor to portable defibrillator/electrocardiograph machine |
EP0469817A2 (en) * | 1990-07-30 | 1992-02-05 | Telectronics N.V. | Arrhythmia control system employing arrhythmia recognition algorithm |
US5107834A (en) * | 1991-01-30 | 1992-04-28 | Cardiac Pacemakers, Inc. | Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration |
WO1992018198A2 (en) * | 1991-04-12 | 1992-10-29 | Incontrol, Inc. | Improved atrial defibrillator, lead systems, and method |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1057497A2 (en) | 1999-06-02 | 2000-12-06 | BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin | Cardioversion arrangement |
EP1057496A2 (en) | 1999-06-02 | 2000-12-06 | BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin | Electrode arrangement |
DE19925853A1 (en) * | 1999-06-02 | 2000-12-07 | Biotronik Mess & Therapieg | Cardioversion arrangement |
US6516231B1 (en) | 1999-06-02 | 2003-02-04 | Daniel Flammang | Endocardial electrode lead with multiple branches |
US6889093B1 (en) | 1999-06-02 | 2005-05-03 | Biotronik Mes-und Therpiegeräte GmbH & Co. Ingenieurbüro Berlin | Electrode lead with multiple branches |
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 |
---|---|
EP0652789A1 (en) | 1995-05-17 |
DE69309931T2 (en) | 1997-10-23 |
EP0652789B1 (en) | 1997-04-16 |
US5292338A (en) | 1994-03-08 |
AU4666593A (en) | 1994-03-03 |
AU664306B2 (en) | 1995-11-09 |
CA2139656A1 (en) | 1994-02-17 |
DE69309931D1 (en) | 1997-05-22 |
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