Method and device for treating cardiac arrhythmias

Patent metadata

Field	Value
Publication number	US-11052261-B2
Application number	US-201715826498-A
Country	US
Kind code	B2
Filing date	Nov 29, 2017
Priority date	Sep 3, 2009
Publication date	Jul 6, 2021
Grant date	Jul 6, 2021

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, wherein the electrodes are configured for external positioning on the patient;
a housing configured to be positioned external to the patient and
a waveform generator configured to generate an alternating current (AC) and an electrical shock which are applied to the electrodes, the waveform generator being disposed in the housing;
wherein the electrical shock is at least 400 volts (V), and
wherein the AC has a frequency in a range between 50 Hz to 20 kHz, has a duration, and includes a ramped amplitude waveform 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 device is configured to administer the AC after a delay from onset of cardiac excitation.

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

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

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

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

8. The device of claim 1 , wherein the electrical shock is applied by the waveform generator immediately after the end of the AC.

9. The device of claim 1 , wherein the peak-to-peak amplitude of the AC increases until the application of the electrical shock.

10. The device of claim 1 , wherein the peak-to-peak amplitude of the AC increases throughout the duration of the AC.

11. The device of claim 1 , wherein the ramped amplitude waveform is a gradually increasing sine wave.

12. The device of claim 1 , wherein the ramped amplitude waveform is a gradually increasing triangular wave.

13. The device of claim 1 , wherein the ramped amplitude waveform is a gradually increasing square wave.

14. The device of claim 1 , wherein the electrical shock is administered after offset of the AC.

15. The device of claim 1 , wherein the electrical shock is administered after onset of the AC and no later than offset of the AC.

16. The device of claim 1 , wherein the duration in a range of 0.25 to 5 seconds.

17. The device of claim 1 , wherein the duration in a range of 0.1 to 2.0 seconds.

18. The device of claim 1 , wherein the gradually increasing peak-to-peak amplitude increases for at least seventy percent of a duration of the AC.

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

20. A device for treating arrhythmia comprising:
at least one electrode configured to be applied externally to a torso of a patient;
a waveform generator configured to generate an alternating current (AC) and an electrical shock which are applied to the at least one electrode; and
a computer, logic circuit, or microprocessor configured to command the waveform generator to generate or deliver alternating current (AC) and the electrical shock to the at least one electrode;
wherein the waveform generator is configured to generate the alternating current (AC) to have a frequency between 50 Hz and 20 kHz and a duration;
wherein during at least sixty percent of the duration, the AC is defined by a ramped amplitude waveform having a gradually increasing peak-to-peak amplitude of the AC, and
wherein the electrical shock is at least 400 volts (V).

21. The device of claim 20 , wherein the waveform generator is configured to generate an alternating current (AC) having a frequency between 50 Hz and 500 Hz.

22. The device of claim 20 , wherein the waveform generator is configured to generate an alternating current (AC) having a frequency between 500 Hz and 1 kHz.

23. The device of claim 20 , wherein the waveform generator is configured to generate an alternating current (AC) having a frequency between 250 Hz and 500 Hz.

24. The device of claim 20 , wherein the device is configured to generate and administer a biphasic electrical shock following application of AC.

25. The device of claim 20 , wherein the device is configured to generate and administer a biphasic electrical shock following application of AC.

26. The device of claim 20 , wherein the electrical shock is administered after offset of the AC, or after onset of the AC and before offset of the AC.

27. The device of claim 20 , wherein the duration is in a range of 0.025 to 5 seconds.

28. The device of claim 20 , wherein the duration is at least 0.050 seconds and the ramped waveform rises for at least seventy percent of the duration.

29. The device of claim 20 , wherein the duration is at least 0.100 seconds and the ramped waveform rises for at least eighty percent of the duration.

30. A device for treating arrhythmia comprising:
a plurality of electrodes configured to be applied to a patient;
a housing configured to be positioned internal or external to the patient and a waveform generator configured to generate an alternating current (AC) and an electrical shock which is applied to the electrodes, the waveform generator being disposed in the housing;
wherein the electrical shock is at least 400 volts (V), and
wherein the AC has a frequency in a range between 50 Hz to 20 kHz, has a duration, and includes a ramped amplitude waveform defined by a gradually increasing peak-to-peak amplitude of the AC during at least sixty percent of the duration.

31. The device of claim 30 , wherein the waveform generator is configured to generate AC having a frequency between about 50 Hz to 300 Hz.

32. The device of claim 30 , wherein the electrodes are configured for intravascular or intracardiac positioning in the patient.

33. The device of claim 30 , wherein the electrodes are configured for extravascular or external positioning on the patient.

34. The device of claim 30 , wherein the device further comprises a sensing circuit for determining the presence of arrhythmia.

35. The device of claim 34 , wherein the device automatically generates the AC when arrhythmia is detected.

36. The device of claim 30 , wherein the device is implantable.

37. The device of claim 34 , wherein the device further comprises a programmable logic circuit, such that the device is configured to administer AC after a delay from onset of cardiac excitation.

38. The device of claim 30 , wherein the electrical shock is a biphasic electrical shock following application of AC.

39. The device of claim 30 , wherein the waveform generator is configured to produce an alternating current (AC) having a frequency between 50 Hz and 500 Hz.

40. The device of claim 30 , wherein the waveform generator is configured to produce alternating current (AC) having a frequency between 500 Hz and 1 kHz.

41. The device of claim 30 , wherein the waveform generator is configured to produce an alternating current (AC) having a frequency between 250 Hz and 500 Hz.

Assignees

• Univ Johns Hopkins

Inventors

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

Classifications

• A61N1/3906 Primary

  characterised by the form of the shockwave · CPC title

• A61N1/36514

  controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585) · CPC title

• A61N1/395

  for treating atrial fibrillation · CPC title

• A61N1/3962 Primary

  in combination with another heart therapy · CPC title

• A61N1/3625

  External stimulators · CPC title