Method and device for treating cardiac arrhythmias

Patent metadata

Field	Value
Publication number	US-10532216-B2
Application number	US-201514604457-A
Country	US
Kind code	B2
Filing date	Jan 23, 2015
Priority date	Sep 3, 2009
Publication date	Jan 14, 2020
Grant date	Jan 14, 2020

Abstract

The present invention provides both methods and devices for termination of arrhythmias, such as ventricular or atrial tachyarrhythmias. The device and method involves application of alternating current (AC) for clinically significant durations at selected therapeutic frequencies through the cardiac tissue to a subject experiencing arrhythmia. Methods are also provided to minimize or eliminate pain during defibrillation.

First claim

What is claimed is:

1. A device comprising:
a plurality of electrodes configured to be applied to a patient; and
a waveform generator configured to generate an alternating current (AC) and an electrical shock which are applied to the electrodes,
wherein the electrical shock is at least 400 volts (V),
wherein the AC has a frequency in a range between 50 Hz to 20 kHz and is defined by a ramped amplitude waveform having a duration, and
wherein the ramped amplitude waveform is defined by a gradually increasing peak-to-peak amplitude of the AC during at least sixty percent of the duration.

2. The device of claim 1 , wherein the AC has a frequency between about 50 Hz to 300 Hz.

3. The device of claim 1 , wherein the electrodes are configured for extravascular or external positioning on the patient.

4. The device of claim 1 , wherein the device is implantable.

5. The device of claim 1 , wherein the device further comprises a programmable logic circuit, such that the device is configured to administer the AC after a delay from onset of cardiac excitation.

6. The device of claim 1 , wherein the electrical shock is a biphasic electrical shock following application of the AC.

7. The device of claim 1 , wherein the AC has a frequency between 50 Hz and 500 Hz.

8. The device of claim 1 , wherein the AC has a frequency between 500 Hz and 1 kHz.

9. The device of claim 1 , wherein the AC has a frequency between 250 Hz and 500 Hz.

10. The device of claim 1 , wherein the electrical shock is administered after offset of the AC, or after onset of the AC and before offset of the AC.

11. The device of claim 1 , wherein the AC is administered for a duration between about 0.025 to 5 seconds.

12. The device of claim 11 , wherein the AC is administered for a duration of at least 0.050 seconds and the ramped waveform rises for at least seventy percent of the duration.

13. The device of claim 12 , wherein the AC is administered for a duration of at least 0.100 seconds and the ramped waveform rises for at least eighty percent of the duration.

14. The device of claim 1 , wherein the electrodes are configured to be implanted in or about a cardiac chamber of a user.

15. A device comprising:
electrodes configured to be applied to a patient; and
a waveform generator configured to generate an alternating current (AC) and an electrical shock which are applied to the electrodes,
wherein the electrical shock is at least 400 volts (V),
wherein the AC has a frequency in a range of 50 Hz to 20 kHz; and
wherein the AC has a gradually increasing peak-to-peak amplitude.

16. The device of claim 15 , wherein the electrical shock is applied by the waveform generator immediately after the end of the AC.

17. The device of claim 16 , wherein the peak-to-peak amplitude of the AC increases until the application of the electrical shock.

18. The device of claim 17 , wherein the peak-to-peak amplitude of the AC increases through application of the AC.

19. The device of claim 15 , wherein the gradually increasing peak-to-peak amplitude of the AC forms a ramped waveform.

20. The device of claim 15 , wherein the AC is a sine wave.

21. The device of claim 15 , wherein the AC is a triangular wave.

22. The device of claim 15 , wherein the AC is a square wave.

23. The device of claim 15 , wherein the device is an implantable device.

24. The device of claim 15 , wherein the electrical shock is administered after offset of the AC.

25. The device of claim 15 , wherein the electrical shock is administered after onset of the AC and no later than offset of the AC.

26. The device of claim 15 , wherein the AC is administered for a duration in a range of 0.25 to 5 seconds.

27. The device of claim 15 , wherein the AC is administered for a duration in a range of 0.1 to 2.0 seconds.

28. The device of claim 15 , wherein the gradually increasing peak-to-peak amplitude increases for at least seventy percent of a duration of the AC.

29. The device of claim 15 , wherein the electrical shock is a biphasic electrical shock following application of the AC.

30. The device of claim 15 , wherein the electrodes are configured to be implanted in or about a cardiac chamber of a user.

31. The device of claim 15 , wherein the electrodes are configured to be applied externally on a subject.

32. The device of claim 15 , wherein the device is implantable and the device includes a housing having an outer surface forming one of the electrodes.

33. The device of claim 15 , wherein at least one of the electrodes is implantable under the skin outside of a thoracic cavity of the user.

34. The device of claim 15 , wherein at least one of the electrodes is implantable within a blood vessel of the user.

Assignees

• Univ Johns Hopkins

Inventors

• Tandri Harikrishna
• Berger Ronald David
• Weinberg Seth
• Tung Leslie
• Halperin Henry
• Hunter David

Classifications

• A61N1/3956

  Implantable devices for applying electric shocks to the heart, e.g. for cardioversion · CPC title

• A61N1/3621

  for treating or preventing abnormally high heart rate · CPC title

• A61N1/3906 Primary

  characterised by the form of the shockwave · CPC title

• A61N1/3987

  characterised by the timing or triggering of the shock · CPC title

• A61N1/06

  for high-frequency therapy · CPC title