EP2785410A2 - Électrode inerte implantable - Google Patents

Électrode inerte implantable

Info

Publication number
EP2785410A2
EP2785410A2 EP12832760.8A EP12832760A EP2785410A2 EP 2785410 A2 EP2785410 A2 EP 2785410A2 EP 12832760 A EP12832760 A EP 12832760A EP 2785410 A2 EP2785410 A2 EP 2785410A2
Authority
EP
European Patent Office
Prior art keywords
electrode
heart
indifferent
indifferent electrode
silicone
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP12832760.8A
Other languages
German (de)
English (en)
Inventor
Peter Osypka
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP2785410A2 publication Critical patent/EP2785410A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A61N1/0587—Epicardial electrode systems; Endocardial electrodes piercing the pericardium
    • A61N1/0595—Temporary leads
    • 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
    • A61N1/0504—Subcutaneous electrodes
    • 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
    • A61N1/0563—Transvascular endocardial electrode systems specially adapted for defibrillation or cardioversion
    • 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
    • A61N1/3625—External stimulators

Definitions

  • the present invention relates to an electrode assembly, preferably for temporary stimulation or defibrillation of the heart.
  • both the atria and the chambers of the heart are electrically stimulated by an external pacemaker.
  • an external pacemaker For the stimulation of each ventricle, either two unipolar electrodes (heart wires) or one bipolar electrode are required.
  • unipolar electrodes at the attachment of each pole the myocardium of the heart is broken.
  • the outer fatty tissue of the heart often causes difficulties to find a fat-free body necessary for the electrodes.
  • Bipolar electrodes on the heart always require two insulated leads. This is particularly disadvantageous for children's hearts, since the weight, or the mass of the leads must be borne by the relatively small heart.
  • Temporary electrodes attached to the heart following surgery are activated by a battery powered external pacemaker. Each electrode has so far consisted of an indifferent pole and a different pole.
  • the individual indifferent poles are combined into a large-area pole, which is positioned so that direct contact with the heart is avoided.
  • a common indifferent electrode or a series of indifferent electrodes may be placed inside the body so that the heart is in no way directly contacted or hampered in its operation.
  • the present invention thus relates to an electrode arrangement, preferably for temporarily stimulating or defibrillating the heart, comprising at least one unipolar electrode (cathode) (6) fixed to the myocardium of the heart and an indifferent electrode (2a, 2b) attached to the inner wall of the heart Chest space is fixed over its supply line and positioned so that direct contact with the heart is avoided.
  • an electrode arrangement preferably for temporarily stimulating or defibrillating the heart, comprising at least one unipolar electrode (cathode) (6) fixed to the myocardium of the heart and an indifferent electrode (2a, 2b) attached to the inner wall of the heart Chest space is fixed over its supply line and positioned so that direct contact with the heart is avoided.
  • the common large-area indifferent electrode is for stimulation of the four chambers of the heart, only a single Pol - d. H. only one supply line necessary. This means that only five leads are needed to stimulate the four ventricles: one for an indifferent pole and four leads for the four different poles of the ventricles.
  • the lead to the indifferent pole can lead to the temporary opening both separately and together with the other poles through the body opening.
  • the indifferent electrode can also be performed as a permanent implant, and be connected via an adapter temporarily with an external pacemaker.
  • the indifferent electrode is metallic and preferably consists of platinum, Nitinol, MP 35N, a biocompatible stainless steel or conductive plastic.
  • the indifferent electrode may, for example, be a helix or be present as a metal mesh, metal strand, wire, ribbon or fabric.
  • the indifferent electrode may be embedded in a plastic protective tube, preferably made of silicone, which has openings to the outside, so that an electric current can flow between the unipolar electrode (6) and through the openings of the indifferent electrode.
  • the indifferent electrode may either be in the form of a bare metallic helix or the helix may be embedded in an apertured plastic tube. preferably made of silicone (4, 14, 25). The openings are on the side facing the heart. This results in insulation to the chest.
  • the indifferent electrode can also consist of a metal mesh, which optionally has on the side facing the heart an apertured membrane, preferably of silicone.
  • the outer shape, arrangement and size of the metallic coil can be selected according to the anatomy of the patient.
  • the indifferent electrode is located in the interior of the chest wall opposite the ventricles of the heart so that upon delivery of a defibrillation shock, it is fully effective.
  • the indifferent electrode may take various forms. It is, for example, straight-shaped, spiral-shaped, disc-shaped, cloverleaf-shaped, grid-shaped, band-shaped or polygonal executed or it has the shape of a tennis racket.
  • the indifferent electrode may have a membrane of soft plastic (18, 22, 26) on the side facing away from the heart.
  • a membrane of soft plastic (18, 22, 26) on the side facing away from the heart.
  • the membrane material is suitable. This results in insulation to the chest.
  • the fixation of the allocations for the indifferent electrode and the supply line for the unipolar electrode takes place for example via plastic parts, preferably molded parts made of silicone, which are fixed by means of ligatures.
  • the fixation is also possible by a surgical glue.
  • the line to the indifferent pole can be guided both separately and together with the supply line to the unipolar electrode through the body opening.
  • a further advantage of this electrode arrangement is that when removing the indifferent electrode through the temporary opening in the chest, the electrodes (preferably coils) can be arranged in parallel and thus easily pulled out of the body.
  • FIG. 1 shows the field strength distribution of an exemplary arrangement of a stimulation of the Heart with an indifferent electrode outside the heart
  • Fig. 2 is an exemplary view of a passage of an indifferent electrode through the chest wall.
  • Fig. 3 An exemplary large-area indifferent electrode in disc shape.
  • FIG. 4 shows another exemplary large-area indifferent electrode as metal mesh.
  • Fig. 5 shows another exemplary large-area indifferent electrode.
  • FIG. 6 shows another exemplary large-area indifferent electrode in the form of a tennis racket.
  • Fig. 1 shows the field strength distribution (1) of an inventive arrangement, wherein the indifferent electrode (2a, 2b) is positioned outside the heart.
  • the indifferent electrode is formed in part (2a) as a metallic bare coil (3).
  • the helix may also be embedded in a protective tube made of plastic, preferably made of silicone (4), which has openings (5) to the outside, so that between the unipolar electrode (cathode) (6) and the indifferent electrode through the openings
  • the indifferent electrode is positioned so as to avoid direct electrode contact with the heart.
  • Fig. 2 shows an exemplary fixation of the indifferent electrode through the chest wall (7).
  • the passage of the indifferent electrode through the chest wall (7) can take place via a molded part made of silicone, wherein the molded part made of silicone is fixed on the side of the lead of the electrode by means of a ligature (20).
  • the indifferent electrode With the help of the breast needle (9), the indifferent electrode is pulled from inside to outside through the chest wall.
  • the silicone part (8) is by its wavy shape (10) able to adapt to the anatomical conditions of the chest wall thickness.
  • the silicone part (8) can also be connected together with the indifferent electrode (4) to form a common molded part.
  • Fig. 3 shows an exemplary large-area indifferent electrode (11) in disk form. It can be used as a temporary indifferent electrode to stimulate the heart, but it can also be used as a permanent indifferent electrode for implanted pacemakers or defibrillators (ICDs).
  • ICDs implanted pacemakers or defibrillators
  • the coil (12) can here also the coil (12), as shown in Fig. 1st be integrated in a silicone tube with openings or in a silicone membrane with openings (14). The openings are necessary for the flow of current.
  • the temporary connection to the external pacemaker via a cable (15) which is connected to a releasable coupling (16) and is pierced by means of a breast needle (30) to the outside.
  • FIG. 4 shows another exemplary large-area indifferent electrode (17) made of a metal mesh. It is a highly flexible screen made of single wires of nitinol (13). The shield is insulated against the breast side by a silicone layer (18) and covered with a perforated silicone membrane (19) against the heart side. The temporary connection to the external pacemaker is also made here via a cable (15) which is connected to a releasable coupling (16).
  • Fig. 5 shows another exemplary large-area indifferent electrode (20).
  • the perforated silicone sections (21) are straight and may be connected as desired as one or more indifferent electrodes.
  • the silicone membrane (22) can be reinforced by fabric made of plastic material (eg Dacron).
  • the fixation of the electrode to the inner wall of the thorax is done by placing ligatures, by medical glue or other common surgical fixations.
  • Metallic coils made of platinum, MP35N or other biocompatible conductive materials are used as poles.
  • the lead for the helix is made by an inner highly flexible metallic strand, which is welded at the end of the helix.
  • metal braids, mesh, strand, tapes, hemispheres or poles made of conductive plastic can also be used.
  • the outer shape of the indifferent electrode can also be carried out in many different forms depending on the anatomical conditions (circular, rectangular, clover-like, grid-shaped, bands, checks, polygons, etc.).
  • membrane material is in addition to silicone, polyurethane, PTFE,
  • 6a and 6b show another exemplary large-area indifferent electrode made of metal coils (24) which are arranged in the form of a tennis racket (23).
  • the coils are insulated against the chest by a silicone membrane (26) and covered with a perforated silicone tube (25) towards the heart.
  • Connection to the external pacemaker is also made here via a cable (27) which is connected to a releasable coupling (not shown here).

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L'invention concerne un ensemble d'électrodes destiné de préférence à la stimulation temporaire ou à la défibrillation du coeur, constitué d'au moins une électrode unipolaire (cathode) (6) fixée sur le myocarde du coeur et d'une électrode inerte (2a, 2b) fixée sur la paroi intérieure de la cage thoracique par sa conduite d'alimentation et positionnée de manière à éviter un contact direct avec le coeur.
EP12832760.8A 2011-12-03 2012-11-21 Électrode inerte implantable Withdrawn EP2785410A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE202011108639U DE202011108639U1 (de) 2011-12-03 2011-12-03 Implantierbare indifferente Elektrode
PCT/DE2012/001108 WO2013079048A2 (fr) 2011-12-03 2012-11-21 Électrode inerte implantable

Publications (1)

Publication Number Publication Date
EP2785410A2 true EP2785410A2 (fr) 2014-10-08

Family

ID=45596011

Family Applications (1)

Application Number Title Priority Date Filing Date
EP12832760.8A Withdrawn EP2785410A2 (fr) 2011-12-03 2012-11-21 Électrode inerte implantable

Country Status (4)

Country Link
US (1) US20140316504A1 (fr)
EP (1) EP2785410A2 (fr)
DE (2) DE202011108639U1 (fr)
WO (1) WO2013079048A2 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2674189B1 (fr) * 2012-06-11 2016-04-20 Peter Osypka Stiftung Pôle d'électrodes implantables
DE202013011345U1 (de) 2013-12-19 2014-03-06 Peter Osypka Implantierbare indifferente Elektrode

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5241957A (en) * 1991-11-18 1993-09-07 Medtronic, Inc. Bipolar temporary pacing lead and connector and permanent bipolar nerve wire
US5391200A (en) * 1992-09-30 1995-02-21 Cardiac Pacemakers, Inc. Defibrillation patch electrode having conductor-free resilient zone for minimally invasive deployment
DE202010016681U1 (de) * 2010-12-16 2011-05-05 Osypka, Peter, Dr.-Ing. Implantierbare Myokardiale Elektroden

Family Cites Families (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4817608A (en) * 1987-05-29 1989-04-04 Mieczyslaw Mirowski Cardioverting transvenous catheter/patch electrode system and method for its use
US5016646A (en) * 1988-11-29 1991-05-21 Telectronics, N.V. Thin electrode lead and connections
US4972846A (en) * 1989-01-31 1990-11-27 W. L. Gore & Associates, Inc. Patch electrodes for use with defibrillators
US5107834A (en) * 1991-01-30 1992-04-28 Cardiac Pacemakers, Inc. Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration
US5191901A (en) * 1991-08-29 1993-03-09 Mieczyslaw Mirowski Controlled discharge defibrillation electrode
US5496362A (en) * 1992-11-24 1996-03-05 Cardiac Pacemakers, Inc. Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation
US20010044619A1 (en) * 1998-04-08 2001-11-22 Peter A. Altman Cardiac drug delivery system and method for use
US6321123B1 (en) * 1999-03-08 2001-11-20 Medtronic Inc. J-shaped coronary sinus lead
US6687545B1 (en) * 2001-10-23 2004-02-03 Pacesetter, Inc. Cardiac stimulation system and method for performing automatic capture verification during bipolar stimulation
US7496408B2 (en) * 2004-12-03 2009-02-24 Medtronic, Inc. Electrodes array for a pacemaker
EP1898999A4 (fr) * 2005-07-01 2011-10-19 Proteus Biomedical Inc Ensemble d'electrodes et de capteurs epicardique deployable
US7856260B1 (en) * 2006-09-06 2010-12-21 Pacesetter, Inc. Implantable cardiac patch for measuring physiologic information
US7894914B2 (en) * 2007-08-28 2011-02-22 Cardiac Pacemakers, Inc. Medical device electrodes including nanostructures

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5241957A (en) * 1991-11-18 1993-09-07 Medtronic, Inc. Bipolar temporary pacing lead and connector and permanent bipolar nerve wire
US5391200A (en) * 1992-09-30 1995-02-21 Cardiac Pacemakers, Inc. Defibrillation patch electrode having conductor-free resilient zone for minimally invasive deployment
DE202010016681U1 (de) * 2010-12-16 2011-05-05 Osypka, Peter, Dr.-Ing. Implantierbare Myokardiale Elektroden

Also Published As

Publication number Publication date
DE202011108639U1 (de) 2012-01-16
US20140316504A1 (en) 2014-10-23
DE112012005047A5 (de) 2014-09-11
WO2013079048A2 (fr) 2013-06-06
WO2013079048A3 (fr) 2013-08-29

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