WO2008139384A2 - Bobines de stimulation à deux chambres pour la défibrillation auriculaire et la stimulation ventriculaire - Google Patents

Bobines de stimulation à deux chambres pour la défibrillation auriculaire et la stimulation ventriculaire Download PDF

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Publication number
WO2008139384A2
WO2008139384A2 PCT/IB2008/051808 IB2008051808W WO2008139384A2 WO 2008139384 A2 WO2008139384 A2 WO 2008139384A2 IB 2008051808 W IB2008051808 W IB 2008051808W WO 2008139384 A2 WO2008139384 A2 WO 2008139384A2
Authority
WO
WIPO (PCT)
Prior art keywords
stimulation
defibrillator
coils
external apparatus
implantable
Prior art date
Application number
PCT/IB2008/051808
Other languages
English (en)
Other versions
WO2008139384A3 (fr
Inventor
Vakeriy Khursenko
Original Assignee
Chamed Srl
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 Chamed Srl filed Critical Chamed Srl
Priority to EP08751162A priority Critical patent/EP2155331A2/fr
Publication of WO2008139384A2 publication Critical patent/WO2008139384A2/fr
Publication of WO2008139384A3 publication Critical patent/WO2008139384A3/fr

Links

Classifications

    • 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
    • A61N1/3975—Power supply
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37211—Means for communicating with stimulators
    • A61N1/37217—Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
    • A61N1/37223—Circuits for electromagnetic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/378—Electrical supply
    • A61N1/3787—Electrical supply from an external energy source
    • 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
    • A61N1/3987—Heart defibrillators characterised by the timing or triggering of the shock

Definitions

  • the present invention relates to a defibrillator having an internal implantable component and an external coupled component equipped with output radio-frequency (RF) antenna.
  • the internal component is equipped with two coils and two corresponding stimulation electrodes for enabling simultaneous stimulation or stimulation in sequence of the two cardiac chambers (atrium and ventricle).
  • Defibrillator technology is based upon that of the pacemaker, which was invented some twenty years before. Precisely on account of the advantages obtained in the field of pacemakers, the defibrillator has been able to evolve with a surprising rapidity from 1980 to the present day.
  • the aspects to be considered are, on the one hand, the possibility of reducing the effects deriving from the toxicity of drugs and, on the other, the period of post-operative convalescence.
  • the internal cardiac defibrillator is usually constituted by a generator implanted subcutaneously and by one or more electro-catheters positioned in the cardiac chambers, capable of detecting, interpreting, and storing the intrinsic electrical activity of the heart and, if need be, of supplying .stimulations (antibradycardial therapy) or electric shocks (antitachycardial therapy).
  • the implantable cardiac defibrillator is the only device capable of recognizing a malignant ventricular tachyarrhythmia and of providing automatically an immediate electrical therapy in patients running the risk of sudden cardiac death.
  • On the basis of the stimulation modalities there may be distinguished single-chamber, dual-chamber, and biventricular (three-chamber) ICDs.
  • Single-chamber devices which were the first to be launched on the market and are still in use, have a single electrode implanted in the right ventricle with functions of stimulation and registration (pacing/sensing) of the activity of a cardiac chamber.
  • Dual-chamber ICDs require the implantation of two electrodes, one in the atrium and one in the ventricle, and enable stimulation, analysis and classification of both the ventricular rhythm and the atrial rhythm.
  • the presence of an electrocatheter in the right atrium enables more precise classification of the cardiac rhythms and, in some models, also interruption of some forms of supraventricular tachycardia, such as for example atrial flutter.
  • the various models produced by the various manufacturers differ from one another substantially on the basis of programmability, algorithms and parameters of stimulation and of storage of data.
  • Biventricular ICDs unite in a single device a biventricular pacemaker and a defibrillator.
  • the function of biventricular pacemaker is obtained through the insertion of an electrode in the coronary sinus capable of stimulating the left ventricle.
  • an electrode in the coronary sinus capable of stimulating the left ventricle.
  • it enables the atrial- ventricular re-synchronization and re-synchronization between right ventricle and left ventricle, with an improvement in the contractile function of the heart.
  • These ICDs are indicated in the therapy of congestional cardiac decompensation.
  • the main aim of the present invention is consequently to provide an implantable system of very small dimensions that will enable atrial defibrillation and at the same time ventricular stimulation, without the two types of stimulation interfering with one another.
  • a second aim of the present invention is to provide a system for atrial and ventricular stimulation that will enable distinct management of the two types of stimulation.
  • Figure 1 illustrates implantable RF coils with corresponding stimulation electrodes
  • Figure 2 illustrates an external apparatus with RF output antenna.
  • the implantable defibrillator according to the present invention consequently comprises: - two implantable RF coils 10 equipped with a circuit for generating the stimulation signal, connected to each of which is a stimulation electrode 20; and
  • each coil is set at a frequency that is different from that of the other coil so that activation of one will not create any signals or interference on the other, and moreover in that the external apparatus 2 has separate control means for managing each of the two coils independently such as to enable distinct atrial and ventricular stimulation.
  • the stimulation electrode is directed in the atrium for a low-energy defibrillation, of between 5 and 10 joule. Said coils will receive the energy transmitted by the external apparatus ( Figure 2), reconstructing the modality of low-energy atrial defibrillation.
  • Each reception coil 10 is equipped with a stimulation-signal-forming circuit, thanks to which said signal is sent to the corresponding stimulation electrode 20.
  • the second component is constituted by the external apparatus with RF output antenna that can be coupled with the implanted one ( Figure 2) to which it is possible to transmit the desired type of stimulation.
  • the apparatus may set the functions that are deemed necessary so as to be able to execute interventions of atrial defibrillation and ventricular stimulation. Given that it is equipped with distinct controls 21, 22 for each of the coils, it is hence possible to govern each of them separately, without interference occurring between the two.
  • the apparatus can operate either asynchronously or synchronously with the QRS signals detected on the patient. Said apparatus is also equipped with an input for ECG.
  • the transmission antenna of the external apparatus is single and can transmit according to which chamber it is intended to stimulate.
  • the external apparatus can also function in a way synchronizable with the ECG signal for those patients who have in any case a cardiac activity of their own or are carriers of pacemakers, but above all can associate a ventricular stimulation to an atrial defibrillation with low level of energy so as to not to create any trauma to the cardiac cells.

Abstract

La présente invention concerne un défibrillateur qui comprend un élément implantable interne constitué par deux bobines qui sont chacune reliées à une électrode de stimulation et un élément couplé externe pourvu d'une antenne de sortie radiofréquence (RF) unique. Les fonctions de défibrillation auriculaire et de stimulation ventriculaire sont produites par une connexion RF qui associe à chaque bobine un fréquence différente de sorte que, par l'intermédiaire de l'appareil externe, il peut être possible de stimuler de manière distincte les deux cavités cardiaques.
PCT/IB2008/051808 2007-05-11 2008-05-08 Bobines de stimulation à deux chambres pour la défibrillation auriculaire et la stimulation ventriculaire WO2008139384A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP08751162A EP2155331A2 (fr) 2007-05-11 2008-05-08 Bobines de stimulation à deux chambres pour la défibrillation auriculaire et la stimulation ventriculaire

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007022062.8 2007-05-11
DE102007022062 2007-05-11

Publications (2)

Publication Number Publication Date
WO2008139384A2 true WO2008139384A2 (fr) 2008-11-20
WO2008139384A3 WO2008139384A3 (fr) 2009-01-08

Family

ID=39876511

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2008/051808 WO2008139384A2 (fr) 2007-05-11 2008-05-08 Bobines de stimulation à deux chambres pour la défibrillation auriculaire et la stimulation ventriculaire

Country Status (3)

Country Link
EP (1) EP2155331A2 (fr)
DE (1) DE202007018531U1 (fr)
WO (1) WO2008139384A2 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2520332A1 (fr) * 2011-05-05 2012-11-07 Magnetic Pacing Technologies GmbH Dispositif de stimulation implantable pour défribilisation et stimulation
US8321021B2 (en) 2006-01-13 2012-11-27 Universität Duisburg-Essen Stimulation system, in particular a cardiac pacemaker
CN110638601A (zh) * 2019-10-10 2020-01-03 南方医科大学第五附属医院 一种耳鼻喉综合诊疗台

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000067843A1 (fr) * 1999-05-06 2000-11-16 Uutech Limited Defibrillation cardiaque
US6301504B1 (en) * 1999-10-08 2001-10-09 Pacesetter, Inc. High speed telemetry system using transmission medium as a component of a telemetry link
US7155284B1 (en) * 2002-01-24 2006-12-26 Advanced Bionics Corporation Treatment of hypertension
WO2007027940A2 (fr) * 2005-08-31 2007-03-08 Ebr Systems, Inc. Procedes et systemes pour la prevention et des traitements de l'insuffisance cardiaque au moyen d'ultrasons ainsi que dispositifs implantables sans fil

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000067843A1 (fr) * 1999-05-06 2000-11-16 Uutech Limited Defibrillation cardiaque
US6301504B1 (en) * 1999-10-08 2001-10-09 Pacesetter, Inc. High speed telemetry system using transmission medium as a component of a telemetry link
US7155284B1 (en) * 2002-01-24 2006-12-26 Advanced Bionics Corporation Treatment of hypertension
WO2007027940A2 (fr) * 2005-08-31 2007-03-08 Ebr Systems, Inc. Procedes et systemes pour la prevention et des traitements de l'insuffisance cardiaque au moyen d'ultrasons ainsi que dispositifs implantables sans fil

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8321021B2 (en) 2006-01-13 2012-11-27 Universität Duisburg-Essen Stimulation system, in particular a cardiac pacemaker
EP2520332A1 (fr) * 2011-05-05 2012-11-07 Magnetic Pacing Technologies GmbH Dispositif de stimulation implantable pour défribilisation et stimulation
WO2012150000A3 (fr) * 2011-05-05 2013-08-22 Magnetic Pacing Technologies Gmbh Dispositif de stimulation implantable pour défibrillation et entraînement
CN110638601A (zh) * 2019-10-10 2020-01-03 南方医科大学第五附属医院 一种耳鼻喉综合诊疗台

Also Published As

Publication number Publication date
DE202007018531U1 (de) 2008-10-30
WO2008139384A3 (fr) 2009-01-08
EP2155331A2 (fr) 2010-02-24

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