Extravascular implantable electrical lead having undulating configuration

Patent metadata

Field	Value
Publication number	US-10675478-B2
Application number	US-201514963303-A
Country	US
Kind code	B2
Filing date	Dec 9, 2015
Priority date	Dec 9, 2014
Publication date	Jun 9, 2020
Grant date	Jun 9, 2020

Abstract

This disclosure describes an implantable medical electrical lead and an ICD system utilizing the lead. The lead includes a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration. The lead includes a defibrillation electrode that includes a plurality of defibrillation electrode segments disposed along the undulating configuration spaced apart from one another by a distance. The lead also includes at least one electrode disposed between adjacent sections of the plurality of defibrillation sections. The at least one electrode is configured to deliver a pacing pulse to the heart and/or sense cardiac electrical activity of the heart.

First claim

The invention claimed is:

1. An implantable medical electrical lead comprising:
a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration;
a defibrillation electrode that includes a plurality of defibrillation electrode segments disposed along the undulating configuration, wherein each defibrillation electrode segment of the plurality of defibrillation electrode segments is spaced apart from each adjacent defibrillation electrode segment of the plurality of defibrillation electrode segments by a respective distance, and wherein the plurality of defibrillation electrode segments are disposed to cover at least 80% of the undulating configuration; and
at least one electrode disposed between adjacent segments of the plurality of defibrillation electrode segments, the at least one electrode configured to perform at least one of:
deliver a pacing pulse to a heart; or
sense cardiac electrical activity of the heart.

2. The lead of claim 1 , wherein the plurality of defibrillation electrode segments are disposed to cover at least 90% of the undulating configuration.

3. The lead of claim 1 , wherein the undulating configuration includes a plurality of peaks, a first portion of the plurality of peaks extending in a first direction away from a major longitudinal axis of the lead and a second portion of the plurality of peaks extending in a second, opposite direction away from the major longitudinal axis of the lead, wherein the plurality of defibrillation electrode segments are disposed along the first portion of the plurality of peaks and the at least one electrode is disposed on the second portion of the plurality of peaks.

4. The lead of claim 3 , wherein the plurality of peaks of the undulating configuration are within a common plane.

5. The lead of claim 3 , wherein at least one of the plurality of peaks of the undulating configuration is not in a common plane with the other ones of the plurality of peaks of the undulating configuration.

6. The lead of claim 1 , wherein the undulating configuration includes a plurality of peaks, a first portion of the plurality of peaks extending in a first direction away from a major longitudinal axis of the lead and a second portion of the plurality of peaks extending in a second, opposite direction away from the major longitudinal axis of the lead, wherein the plurality of defibrillation electrode segments are disposed to cover at least a portion of the plurality of peaks and the at least one electrode is disposed along a portion of the undulating portion between peaks.

7. The lead of claim 1 , further including a conductor disposed within the lead body, wherein the plurality of defibrillation electrode segments are electrically coupled to the conductor.

8. The lead of claim 7 , further including a connector disposed at the proximal end of the lead body, the connector being configured to electrically couple with an electrical energy generator, and wherein the conductor is coupled to the connector.

9. The lead of claim 1 , wherein the plurality of defibrillation electrode segments includes a first defibrillation electrode segment and a second defibrillation electrode segment, the lead further comprising:
a first conductor disposed within the lead body and electrically connected to the first defibrillation electrode segment; and
a second conductor disposed within the lead body and electrically connected to the second defibrillation electrode segment.

10. The lead of claim 1 , wherein the at least one electrode comprises at least two electrodes, wherein the at least two electrodes are disposed along a major longitudinal axis of the lead.

11. The lead of claim 1 , wherein the undulating configuration defines a substantially sinusoidal configuration.

12. The lead of claim 1 , wherein the at least one electrode is configured to conduct electrical pulses between an adjacent one of the plurality of defibrillation electrode segments.

13. The lead of claim 1 , further comprising at least one additional electrode that is disposed at least one of:
proximal to a most proximal one of the defibrillation electrode segments; or
distal to a most distal one of the defibrillation electrode segments, the at least one additional electrode configured to perform at least one of:
deliver a pacing pulse to the heart; or
sense cardiac electrical activity of the heart.

14. The lead of claim 13 , wherein the at least one additional electrode is not disposed along the undulating configuration.

15. An extravascular implantable cardioverter-defibrillator (ICD) system comprising:
an extravascular electrical stimulation lead that includes:
a lead body defining a proximal end and a distal portion, wherein at least a part of the distal portion of the lead body defines an undulating configuration;
a defibrillation electrode that includes at least a first defibrillation electrode segment and a second defibrillation electrode segment disposed along the undulating configuration spaced apart from one another by a distance, wherein the first defibrillation electrode segment and the second defibrillation electrode segment are disposed to cover at least 80% of the undulating configuration; and
at least one electrode disposed between the first and second defibrillation electrode segments, the at least one electrode configured to perform at least one of:
deliver a pacing pulse to a heart; or
sense cardiac electrical activity of the heart; and

an implantable cardioverter defibrillator (ICD) coupled to the extravascular electrical stimulation lead, the ICD including:
a therapy module configured to generate and deliver electrical stimulation therapy; and
a switch module configured to selectively couple the therapy module to an electrode vector in which both the first and second defibrillation electrode segments simultaneously function at a common polarity to deliver defibrillation therapy.

16. The extravascular ICD system of claim 15 , wherein the undulating configuration includes a plurality of peaks, a first portion of the plurality of peaks extending in a first direction away from a major longitudinal axis of the lead and a second portion of the plurality of peaks extending in a second, opposite direction away from the major longitudinal axis of the lead, wherein the first and second defibrillation electrode segments are disposed along respective ones of the first portion of the plurality of peaks and the at least one electrode is disposed on the second portion of the plurality of peaks.

17. The extravascular ICD system of claim 15 , wherein the undulating configuration includes a plurality of peaks, a first portion of the plurality of peaks extending in a first direction away from a major longitudinal axis of the lead and a second portion of the plurality of peaks extending in a second, opposite direction away from the major longitudinal axis of the lead, wherein the first defibrillation electrode segment is disposed along one of the first portion of peaks extending in the first direction, the second defibrillation electrode segment is disposed along one of the second portion of peaks extending in the second direction, and the at least one electrode is disposed along a segment of the undulating portion between two adjacent peaks.

18. The extravascular ICD system of claim 15 , wherein the electrode vector is a first electrode vector, and wherein the switch module couples the therapy module to a second electrode vector that includes at least one of the first

Assignees

• Medtronic Inc

Inventors

• Marshall Mark T
• Martinez Gonzalo
• Nikolski Vladimir P
• Olson Nathan L
• Seifert Kevin R
• Whitman Teresa A

Classifications

• A61B5/6882

  Anchoring means · CPC title

• A61N1/3962 Primary

  in combination with another heart therapy · CPC title

• A61B5/686

  Permanently implanted devices, e.g. pacemakers, other stimulators, biochips (A61B5/6861 takes precedence) · CPC title

• A61N1/0504 Primary

  Subcutaneous electrodes · CPC title

• A61N1/057

  Anchoring means; Means for fixing the head inside the heart · CPC title