EP0206248A1
Expired / Lapsed
EP
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Epicardial electrode arrangements and system for applying electrical energy to a human heart
Assignee: Medtronic Inc
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Filing: 1986-06-19
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Granted: —
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Expires: 2006-06-19
Abstract
Abstract System for applying electrical energy to a human heart, particularly an epicardial electrode arrangement (150) comprising means for facilitating movement of a plurality of electrodes (152) relative to one another, a J-shaped endocardial lead - (9,29,59,69), and systems for applying electrical pulses in conformity with optimized pulse regimes.
Inventors
- 👤 Karel F.A.A. Smits
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 05:10
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/05; A61N1/056; A61N1/0587; A61N1/18; A61N1/32; A61N1/38; A61N1/39; A61N1/3918; A61N2001/0585
Claims Analysis
Total Claims: 45
Claim 1
Independent Claim
85 words
An epicardial electrode arrangement of the type comprising a plurality of electrodes (100, 100A, 100B, 130, 152) mounted to a generally planar electrode body (102, 102A, 102B, 128, 132, 154, 156) of flexible, insulative material having a first surface and a second surface opposite said first surface, said electrodes exposed to said first surface, characterized in that said electrode body further comprises means (104, 164) for facilitating movement of said electrodes relative to one another within the plane generally defined by said planar electrode body.
Claim 2
Dependent Claim
85 words
An epicardial electrode arrangement of the type comprising a plurality of electrodes (100, 100A, 100B, 130, 152) mounted to a generally planar electrode body (102, 102A, 102B, 128, 132, 154, 156) of flexible, insulative material having a first surface and a second surface opposite said first surface, said electrodes exposed to said first surface, characterized in that said electrode body further comprises means (104, 164) for facilitating movement of said electrodes relative to one another within the plane generally defined by said planar electrode body.
Claim 3
Dependent Claim
24 words
An epidardial electrode arrangement according to claim 1 wherein said electrodes (100A) are also exposed to said second surface of said electrode body (102A).
Claim 4
Dependent Claim
66 words
An epicardial electrode arrangement according to claim 1 or 2 wherein said electrode body is a flexible sheet (102, 102A, 102B; 154, 156) provided with at least one perforation (104, 164) intermediate said electrodes (100, 100A, 100B, 152), extending from said first surface, to said second surface, of sufficient size to permit relative movement of said electrodes within the plane generally defined by said flexible sheet.
Claim 5
Dependent Claim
72 words
An epicardial electrode arrangement according to any one of claims 1 to 3 further comprising an elongated electrical conductor (106), having a proximal end and a distal end, the distal end of said electrical conductor coupled to said electrodes (100, 100A, 100B), an electrical connector (108) coupled to the proximal end of said elongated electrical conductor; and an insulative sheath, covering said electrical conductor, extending from said electrodes to said electrical connector.
Claim 6
Dependent Claim
92 words
An apex cup epicardial electrode arrangement, comprising: a flexible member (132) of insulative material; a plurality of elongated, flexible insulative sheets - (128), having a first end mounted to said member and a second end extending from said member; a plurality of electrodes (130), at least one electrode mounted to each of said plurality of flexible elongated insulative sheets; an elongated insulated electrical conductor (136) having a distal end coupled to each of said plurality of electrodes; and an electrical connector (138) coupled to the proximal end of said elongated insulative conductor.
Claim 7
Dependent Claim
92 words
An apex cup epicardial electrode arrangement, comprising: a flexible member (132) of insulative material; a plurality of elongated, flexible insulative sheets - (128), having a first end mounted to said member and a second end extending from said member; a plurality of electrodes (130), at least one electrode mounted to each of said plurality of flexible elongated insulative sheets; an elongated insulated electrical conductor (136) having a distal end coupled to each of said plurality of electrodes; and an electrical connector (138) coupled to the proximal end of said elongated insulative conductor.
Claim 8
Dependent Claim
101 words
An epicardial floating cup electrode consisting of: a first electrode means (152, 154) for attachment to the epicardium of the right ventricle of the human heart, for picking up electrical energy at a first location on the epicardium of a human heart; second electrode means (152, 156), for location at a second location on the epicardium of a human heart, for delivering electrical energy to the epicardium of the heart; and conductor means (162) coupled to said first electrode means and said second electrode means, for transferring electrical energy picked up at said first electrode means to said second electrode means.
Claim 9
Dependent Claim
101 words
An epicardial floating cup electrode consisting of: a first electrode means (152, 154) for attachment to the epicardium of the right ventricle of the human heart, for picking up electrical energy at a first location on the epicardium of a human heart; second electrode means (152, 156), for location at a second location on the epicardium of a human heart, for delivering electrical energy to the epicardium of the heart; and conductor means (162) coupled to said first electrode means and said second electrode means, for transferring electrical energy picked up at said first electrode means to said second electrode means.
Claim 10
Dependent Claim
27 words
A floating cup electrode according to claim 6 wherein said first location is the right ventricular wall, in the region of the apex of the human heart.
Claim 11
Dependent Claim
21 words
A floating cup electrode according to claim 6 or 7 wherein said second location is the wall of the left ventricle.
Claim 12
Dependent Claim
153 words
An endocardial lead, comprising: a connector assembly (20, 48, 80), including at least one electrical connector (22, 24, 50, 82, 84); an elongated J-shaped lead body (10, 40, 60, 70) having a proximal end and a distal end, said proximal end of said lead body mounted to said connector assembly, said lead body including a first segment having a generally straight configuration extending from said connector assembly to a first point, and a second, curved portion (12, 42, 62, 72) extending distal to said first point, said lead body including a first elongated electrode (14, 44, 64, 74, 213, 256), exposed to the exterior surface of said lead body at least adjacent said first point, and wherein said lead body also includes an elongated insulative sheath extending from said first electrode to said connector assembly; and a conductor extending from said first electrode to said connector assembly, mounted within said elongated insulative sheath.
Claim 13
Dependent Claim
153 words
An endocardial lead, comprising: a connector assembly (20, 48, 80), including at least one electrical connector (22, 24, 50, 82, 84); an elongated J-shaped lead body (10, 40, 60, 70) having a proximal end and a distal end, said proximal end of said lead body mounted to said connector assembly, said lead body including a first segment having a generally straight configuration extending from said connector assembly to a first point, and a second, curved portion (12, 42, 62, 72) extending distal to said first point, said lead body including a first elongated electrode (14, 44, 64, 74, 213, 256), exposed to the exterior surface of said lead body at least adjacent said first point, and wherein said lead body also includes an elongated insulative sheath extending from said first electrode to said connector assembly; and a conductor extending from said first electrode to said connector assembly, mounted within said elongated insulative sheath.
Claim 14
Dependent Claim
35 words
An endocardial lead according to claim 9 wherein said elongated lead body (10, 40) is provided with a third, generally straight segment (16, 44, 215, 258), distal to said second, curved segment (12, 42, 211).
Claim 15
Dependent Claim
45 words
An endocardial lead according to claim 9 or claim 10 where,, in said first electrode (44, 64, 291) is exposed to the exterior of said lead body - (40, 60) at least from said first point to the distal end of said elongated lead body.
Claim 16
Dependent Claim
83 words
An endocardial lead according to claim 10 wherein said first elongated electrode (14, 213, 256) extends from said first point to a second point proximal to said first point, further comprising: a second elongated electrode (16, 215, 258), exposed to the surface of said elongated lead body distal to said second, curved segment (12, 211) and coupled to said conductor; and a second insulative sheath (211) extending over said second, curved segment of said lead body intermediate said first and second elongated electrodes.
Claim 17
Dependent Claim
56 words
An endocardial lead according to any one of claims 9 to 12, further comprising: a third electrode (18) mounted to the distal end of said elongated lead body (10); a second electrical conductor, coupled to said third electrode, mounted within said first and second insulative sheaths, extending from said third electrode, to said connector assembly (20).
Claim 18
Dependent Claim
28 words
An endocardial lead according to claim 9 wherein said first elongated electrode (64, 291) is limited to said second, curved segment (62) of said elongated lead body (60).
Claim 19
Dependent Claim
38 words
An endocardial lead according to any one of claims 9 to 14, further comprising: active fixation means (76, 78) for penetrating heart tissue and anchoring said endocardial lead within the heart, mounted to said elongated lead body -
Claim 20
Dependent Claim
7 words
(70), distal to said first electrode (74).
Claim 21
Dependent Claim
7 words
(70), distal to said first electrode (74).
Claim 22
Independent Claim
155 words
A system for applying electrical energy to a human heart, comprising: at least first, second and third electrodes designed for being mounted around said human heart, spaced from one another, at the level of the ventricles of said human heart, such that said first electrode is adjacent said second electrode and said second electrode is adjacent said third electrode; and pulse application means for applying a first electrical pulse to said at least first, second and third electrodes such that said first and second electrodes are at a first polarity during said electrical pulse, while said third electrode is at a second polarity during said electrical pulse; and for subsequently applying a second electrical pulse to at least said first, second and third electrodes such that said second and third electrodes are at said first polarity during said second electrical pulse and said first electrode is at said second polarity during said second electrical pulse.
Claim 23
Independent Claim
155 words
A system for applying electrical energy to a human heart, comprising: at least first, second and third electrodes designed for being mounted around said human heart, spaced from one another, at the level of the ventricles of said human heart, such that said first electrode is adjacent said second electrode and said second electrode is adjacent said third electrode; and pulse application means for applying a first electrical pulse to said at least first, second and third electrodes such that said first and second electrodes are at a first polarity during said electrical pulse, while said third electrode is at a second polarity during said electrical pulse; and for subsequently applying a second electrical pulse to at least said first, second and third electrodes such that said second and third electrodes are at said first polarity during said second electrical pulse and said first electrode is at said second polarity during said second electrical pulse.
Claim 24
Dependent Claim
126 words
A system for applying electrical energy according to claim 16 comprising a fourth electrode adapted to be mounted in spaced relationship to and adjacent said first and third electrodes wherein said pulse application means is designed for applying said first electrical pulse to said first, second, third and fourth electrodes such that said first and second electrodes are at a first polarity and said third and fourth electrodes are at a second polarity during said first electrical pulse, and for applying said second electrical pulse across said first, second, third and fourth electrodes such that said first and fourth electrodes are at said first polarity during said second electrical pulse and said second and third electrodes are at said second polarity during said second electrical pulse.
Claim 25
Dependent Claim
56 words
A system for applying electrical energy according to claim 16 wherein said pulse application means is designed for applying a third electrical pulse to said first, second and third electrodes such that said first and third electrodes are at said first polarity and said second electrode is at said second polarity during said third defibrillation pulse.
Claim 26
Dependent Claim
98 words
A system according to claim 17 wherein said pulse application means is designed for applying a third electrical pulse to said first, second, third and fourth electrodes such that said first and second electrodes are at said second polarity and said third and fourth electrodes are at said first polarity during said third electrical pulse, and for applying a fourth electrical pulse to said first, second, third and fourth electrodes such that said first and fourth electrodes are at said second polarity and said second and third electrodes are at said first polarity during said fourth electrical pulse.
Claim 27
Independent Claim
126 words
A system for applying electrical energy to a human heart, comprising: first and second electrodes designed for being mounted opposite one another across the left ventricular cavity of said human heart, and third and fourth electrodes designed for being mounted opposite one another across the left ventricular cavity of said human heart such that a line joining said first and second electrodes is roughly orthogonal to a line joining said third and fourth electrodes across said heart; and pulse application means for applying an electrical pulse to said first, second, third and fourth electrodes such that said first and second electrodes are at a first polarity during said electrical pulse and that said third and fourth electrodes are at a second polarity during said electrical pulse.
Claim 28
Independent Claim
126 words
A system for applying electrical energy to a human heart, comprising: first and second electrodes designed for being mounted opposite one another across the left ventricular cavity of said human heart, and third and fourth electrodes designed for being mounted opposite one another across the left ventricular cavity of said human heart such that a line joining said first and second electrodes is roughly orthogonal to a line joining said third and fourth electrodes across said heart; and pulse application means for applying an electrical pulse to said first, second, third and fourth electrodes such that said first and second electrodes are at a first polarity during said electrical pulse and that said third and fourth electrodes are at a second polarity during said electrical pulse.
Claim 29
Dependent Claim
42 words
A system according to claim 20 wherein said first, second and third electrodes are epicardial electrodes adapted to be attached to the left ventricular epicardium, and said fourth electrode is carried by an endocardial lead adapted for insertion into the right ventricle.
Claim 30
Dependent Claim
26 words
A system according to claim 21 wherein said fourth electrode is designed for implantation within said human heart, spaced from the apex of said right ventricle.
Claim 31
Independent Claim
109 words
A system for applying electrical energy to a human heart, comprising: first and second epicardial electrodes designed for application to the left ventricle of said human heart in closely spaced relationship from one another; a third electrode adapted to be applied to the right ventricle of said human heart, across said left ventricular cavity from and roughly equidistant from said first and second electrodes; and pulse application means for applying an electrical pulse across said first, second and third electrodes such that said first and second electrodes are of a first polarity during said electrical pulse and said third electrode is of a second polarity during said electrical pulse.
Claim 32
Independent Claim
109 words
A system for applying electrical energy to a human heart, comprising: first and second epicardial electrodes designed for application to the left ventricle of said human heart in closely spaced relationship from one another; a third electrode adapted to be applied to the right ventricle of said human heart, across said left ventricular cavity from and roughly equidistant from said first and second electrodes; and pulse application means for applying an electrical pulse across said first, second and third electrodes such that said first and second electrodes are of a first polarity during said electrical pulse and said third electrode is of a second polarity during said electrical pulse.
Claim 33
Dependent Claim
28 words
A system according to claim 23 wherein said third electrode has a surface area equal to the sum of the surface areas of said first and second electrodes.
Claim 34
Dependent Claim
25 words
A system according to claim 23 wherein said third electrode is an endocardial lead designed for insertion into the right ventricle of said human heart.
Claim 35
Dependent Claim
54 words
A system according to claim 25 comprising an endocardial, J-shaped lead including a first generally straight portion, a second, curved portion distal to said first portion, and a third generally straight portion distal to said curved portion wherein said third electrode includes electrode surfaces on said first and third portions of said endocardial lead.
Claim 36
Independent Claim
126 words
A system for applying electrical energy to a human heart, comprising: first and second epicardial electrodes designed for application to the left ventricle of said human heart, spaced from one another and roughly equidistant from the septum of said human heart; third and fourth electrodes designed for application to said human heart, across the left ventricular cavity of said human heart from said first and second electrodes, and roughly equidistant from the septum of said human heart; and pulse application means for applying a defibrillation pulse across said first, second, third and fourth electrodes such that said first and second electrodes are of a first polari ty during said defibrillation pulse and said third and fourth electrodes are of a second polarity during said defibrillation pulse.
Claim 37
Independent Claim
126 words
A system for applying electrical energy to a human heart, comprising: first and second epicardial electrodes designed for application to the left ventricle of said human heart, spaced from one another and roughly equidistant from the septum of said human heart; third and fourth electrodes designed for application to said human heart, across the left ventricular cavity of said human heart from said first and second electrodes, and roughly equidistant from the septum of said human heart; and pulse application means for applying a defibrillation pulse across said first, second, third and fourth electrodes such that said first and second electrodes are of a first polari ty during said defibrillation pulse and said third and fourth electrodes are of a second polarity during said defibrillation pulse.
Claim 38
Dependent Claim
75 words
A system according to claim 27 comprising an endocardial, J-shaped defibrillation lead designed for insertion into the right ventricle of said heart and having a generally J-shaped configuration including a first, generally straight portion, a second, curved portion distal to said first portion and a third, generally straight portion distal to said second portion wherein said third and fourth electrodes are electrode surfaces mounted to said first and third portions of said endocardial lead, respectively.
Claim 39
Dependent Claim
33 words
A system according to claim 27 wherein third and fourth electrodes are epicardial electrodes designed for being mounted to the epicardium of the right ventricle of said human heart, spaced from one another.
Claim 40
Independent Claim
196 words
A system for applying electrical energy to a human heart, comprising: an endocardial defibrillation lead of the type including a first electrode at its distal tip and a second electrode proximal to said first electrode, said first and second electrodes being positioned on said endocardial lead such that upon insertion of said endocardial lead said first electrode is located in the apex of the right ventricle of said human heart and said second electrode is spaced from said first electrode, outside of the right ventricle of said human heart; a floating cup electrode of the type including a first electrode, a second electrode, and a conductor coupling said first electrode to said second electrode, said floating cup electrode being designed for application to the epicardium of said human heart such that said first electrode is mounted to the epicardium of the right ventricle so as to overlap said distal electrode of said endocardial pa cing lead, and such that said second electrode is mounted to the epicardium of said human heart, spaced from said first electrode; and pulse application means for applying a defibrillation pulse across said proximal and distal electrodes of said endocardial defibrillation lead.
Claim 41
Independent Claim
196 words
A system for applying electrical energy to a human heart, comprising: an endocardial defibrillation lead of the type including a first electrode at its distal tip and a second electrode proximal to said first electrode, said first and second electrodes being positioned on said endocardial lead such that upon insertion of said endocardial lead said first electrode is located in the apex of the right ventricle of said human heart and said second electrode is spaced from said first electrode, outside of the right ventricle of said human heart; a floating cup electrode of the type including a first electrode, a second electrode, and a conductor coupling said first electrode to said second electrode, said floating cup electrode being designed for application to the epicardium of said human heart such that said first electrode is mounted to the epicardium of the right ventricle so as to overlap said distal electrode of said endocardial pa cing lead, and such that said second electrode is mounted to the epicardium of said human heart, spaced from said first electrode; and pulse application means for applying a defibrillation pulse across said proximal and distal electrodes of said endocardial defibrillation lead.
Claim 42
Dependent Claim
48 words
A system according to claim 30 wherein said floating cup electrode is designed such that said second electrode of said floating cup is adapted to be applied to the epicardium of the left ventricle of said human heart, in the region of the apex of said human heart.
Claim 43
Independent Claim
142 words
A system for applying electrical pulses to a human heart, comprising: first, second and third epicardial electrodes designed for mounting said first electrode to the left ventricle of said human heart opposite the septum of said human heart, and said second and third epicardial electrodes to the (eft ventricle roughly equidistant from said first electrode; an endocardial, J-shaped lead including a first generally straight portion, a second, curved portion distal to said first portion, and a third generally straight portion distal to said curved portion, said lead having electrode surfaces on said first and third portions; and pulse application means for applying a defibrillation pulse across said electrodes such that said first, second and third electrodes are of a first polarity during said defibrillation pulse and said electrodes on said endocardial J-shaped lead are of a second polarity during said electrical pulse.
Claim 44
Independent Claim
142 words
A system for applying electrical pulses to a human heart, comprising: first, second and third epicardial electrodes designed for mounting said first electrode to the left ventricle of said human heart opposite the septum of said human heart, and said second and third epicardial electrodes to the (eft ventricle roughly equidistant from said first electrode; an endocardial, J-shaped lead including a first generally straight portion, a second, curved portion distal to said first portion, and a third generally straight portion distal to said curved portion, said lead having electrode surfaces on said first and third portions; and pulse application means for applying a defibrillation pulse across said electrodes such that said first, second and third electrodes are of a first polarity during said defibrillation pulse and said electrodes on said endocardial J-shaped lead are of a second polarity during said electrical pulse.
Claim 45
Dependent Claim
86 words
A system according to claim 23 wherein said third electrode comprises a pair of epicardial electrodes designed for being mounted to the right ventricle of said human heart in closely spaced relationship to one another and roughly equidistant from said first and second electrodes, and wherein said pulse application means is designed for applying a pulse such that said first and second electrodes are of a first polarity during said electrical pulse and said pair of electrodes is at a second polarity during said electrical pulse.
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