Post-heart surgery cardioverting system and method

Abstract

A post-surgical cardioverting system and method applies cardioverting electrical energy to the atria of the heart of a post-surgical heart patient. The system includes a first lead including a first elongated electrode having a proximal end and a distal end, a second lead including a second elongated electrode having a proximal end and a distal end, and sutures for releasably anchoring the distal ends of the first and second electrodes to the pericardium and disposing the first and second electrodes along the pericardium overlying the right and left atria respectively. A non-implantable cardiovertor is coupled to the first and second leads for applying the cardioverting electrical energy to the first and second electrodes. When cardioversion is no longer required, the first and second leads may be pulled out of the patient's chest.

What is claimed is: 
     
       1. A post-surgical cardioverting system for applying cardioverting electrical energy to the heart of a post-surgical heart patient, said system comprising: a first lead including a first elongated electrode, said first electrode having a proximal end and a distal end;   a second lead including a second elongated electrode, said second electrode having a proximal end and a distal end;   first anchor means for releasably anchoring the distal ends of said first and second electrodes to body tissue external to but in close proximity to the heart beneath the skin of the patient to dispose said first and second electrodes in electrical contact with the heart; and   non-implantable cardioverting means coupled to said first and second leads for applying said cardioverting electrical energy to said first and second electrodes.   
     
     
       2. A system as defined in claim 1 wherein said first anchor means comprises suture means for releasably suturing the distal ends of said first and second electrodes to said body tissue external to but in close proximity to the heart. 
     
     
       3. A system as defined in claim 1 further including second anchor means for releasably anchoring the proximal ends of said first and second electrodes to body tissue external to but in close proximity to the heart beneath the skin of the patient. 
     
     
       4. A system as defined in claim 3 wherein said second anchor means comprises suture means for releasably suturing the proximal ends of said first and second electrodes to said body tissue external to but in close proximity to the heart. 
     
     
       5. A system as defined in claim 1 further including sensing means for sensing R waves of the heart, and wherein said cardioverting means is coupled to said sensing means and responsive to R waves sensed by said sensing means for applying said cardioverting electrical energy to said first and second electrodes in timed relation to a sensed R wave. 
     
     
       6. A system as defined in claim 5 wherein said cardioverting means is further responsive to said sensed R waves for applying said cardioverting electrical energy to said first and second electrodes when the time between immediately successive R waves is greater than a preselected minimum time interval. 
     
     
       7. A system as defined in claim 5 wherein said sensing means comprises third and fourth electrodes and attachment means for releasably attaching said third and fourth electrodes to a ventricle of the heart. 
     
     
       8. A system as defined in claim 7 wherein said cardioverting means further includes pacing means coupled to said third and fourth electrodes for applying pacing electrical energy pulses to said third and fourth electrodes. 
     
     
       9. A system as defined in claim 1 wherein said first and second elongated electrodes each have a length dimension for extending across a substantial portion of a respective chamber of the heart. 
     
     
       10. A system as defined in claim 1 wherein said first and second elongated electrodes each have a length dimension for extending across a substantial portion of the right and left atria respectively. 
     
     
       11. A system as defined in claim 1 wherein said first and second elongated electrodes each have a length dimension of approximately six centimeters. 
     
     
       12. A system as defined in claim 1 wherein said first and second leads each have an impedance of one ohm or less. 
     
     
       13. A method of cardioverting the heart of a heart surgery patient subsequent to a heart surgery procedure, said method comprising the steps of: providing a first lead having a first elongated electrode, said first electrode having a distal end and a proximal end;   providing a second lead having a second elongated electrode, said second electrode having a distal end and a proximal end;   following said heart surgery procedure and before closing the chest of the patient, releasably anchoring said distal ends of said first and second electrodes to body tissue external to but in close proximity to the heart beneath the skin of the patient to dispose said first and second electrodes in electrical contact with the heart;   providing a non-implanted cardioverting means for providing cardioverting electrical energy;   coupling said non-implanted cardioverting means to said first and second electrodes; and   causing said cardioverting means to apply said cardioverting electrical energy to said first and second electrodes when the heart of the patient is in need of cardioversion.   
     
     
       14. A method as defined in claim 13 wherein said anchoring step includes releasably suturing said distal ends of said first and second electrodes to body tissue external to but in close proximity to the heart beneath the skin of the patient. 
     
     
       15. A method as defined in claim 13 wherein said anchoring step includes releasably anchoring said distal ends of said first and second electrodes to the pericardium. 
     
     
       16. A method as defined in claim 15 wherein said anchoring step includes disposing said first and second electrodes along the inside of the pericardium. 
     
     
       17. A method as defined in claim 15 wherein said anchoring step includes disposing said first and second electrodes along the outside of the pericardium. 
     
     
       18. A method as defined in claim 15 wherein said anchoring step includes releasably anchoring said proximal ends of said first and second electrodes to the pericardium. 
     
     
       19. A method as defined in claim 18 wherein said anchoring step includes releasably suturing said distal ends and said proximal ends of said first and second electrodes to the pericardium. 
     
     
       20. A method as defined in claim 13 wherein said method is for applying cardioverting electrical energy to the atria of the heart and wherein said anchoring step includes disposing said first electrode to overlie the right atrium and disposing said second electrode to overlie the left atrium. 
     
     
       21. A method as defined in claim 20 wherein said anchoring step includes releasably anchoring said distal ends of said first and second electrodes to the pericardium, disposing said first electrode along the pericardium to overlie the right atrium, and disposing said second electrode along the pericardium to overlie the left atrium. 
     
     
       22. A method as defined in claim 21 wherein said anchoring step includes disposing said first and second electrodes along the inside of the pericardium. 
     
     
       23. A method as defined in claim 21 wherein said anchoring step includes disposing said first and second electrodes along the outside of the pericardium. 
     
     
       24. A method as defined in claim 21 wherein said anchoring step includes releasably anchoring said proximal ends of said first and second electrodes to the pericardium. 
     
     
       25. A method as defined in claim 24 wherein said anchoring step includes releasably suturing said distal ends and said proximal ends of said first and second electrodes to the pericardium. 
     
     
       26. A method as defined in claim 13 including the further steps of; providing sensing means for sensing R waves of the heart,   sensing R waves of the heart with said sensing means; and   causing said cardioverting means to apply said cardioverting electrical energy to said first and second electrodes in timed relation to a sensed R wave.   
     
     
       27. A method as defined in claim 26 wherein said last recited causing step includes causing said cardioverting means to apply said cardioverting electrical energy to said first and second electrodes when the time between immediately successive sensed R waves is greater than a preselected minimum time period. 
     
     
       28. A method as defined in claim 26 wherein said step of providing said sensing means includes providing third and fourth electrodes, releasably attaching said third and fourth electrodes to a ventricle of the heart, and coupling said third and fourth electrodes to said cardioverting means. 
     
     
       29. A method as defined in claim 28 including the further steps of providing said cardioverting means with pacing means for providing pacing electrical energy pulses, coupling said pacing means to said third and fourth electrodes, and causing said pacing means to apply said pacing electrical energy pulses to said third and fourth electrodes. 
     
     
       30. A method of cardioverting the atria of the heart of a heart surgery patient subsequent to an opened chest heart surgery procedure, said method comprising the steps of: providing a first lead having a first elongated electrode, said first electrode having a distal end and a proximal end;   providing a second lead having a second elongated electrode, said second electrode having a distal end and a proximal end;   following said heart surgery procedure and prior to closing the chest of the patient, releasably anchoring said distal ends of said first and second electrodes to the pericardium;   disposing said first electrode along the pericardium adjacent to the right atrium of the heart;   disposing said second electrode along the pericardium adjacent to the left atrium of the heart;   providing a non-implanted cardioverting means for providing cardioverting electrical energy;   coupling said cardioverting means to said first and second electrodes through said first and second leads; and   applying said cardioverting electrical energy with said cardioverting means to said first and second electrodes when the atria are in need of cardioversion.   
     
     
       31. A post-surgical defibrillating system for applying defibrillating electrical energy to the heart of a post-surgical heart patient, said system comprising: a first lead including a first elongated electrode, said first electrode having a proximal end and a distal end;   a second lead including a second elongated electrode, said second electrode having a proximal end and a distal end;   first anchor means for releasably anchoring the distal ends of said first and second electrodes to body tissue external to but in close proximity to the heart beneath the skin of the patient to dispose said first and second electrodes in electrical contact with the heart; and   non-implantable defibrillator coupled to said first and second leads for applying said defibrillating electrical energy to said first and second electrodes. .Iadd.   
     
     
       32.  A post-surgical cardioverting system for applying cardioverting electrical energy to the heart of a post-surgical heart patient, said system comprising: a first lead including a first elongated electrode, said first electrode having a proximal end and a distal end;   a second lead including a second elongated electrode, said second electrode having a proximal end and a distal end;   said first and second electrodes adapted to be in electrical contact with the heart;   at least one anchor at the distal end of said first and second electrodes releasably connected beneath the skin of the patient; and   a non-implantable cardioverter electrically coupled for cardioversion by said first and second leads to the heart..Iaddend..Iadd.33. A system as defined in claim 32 in which said anchor is adapted to be connected to body tissue external to but in close proximity to the heart beneath the skin of the patient..Iaddend..Iadd.34. A system as defined in claim 32 in which said anchor is adapted to be attached to the pericardium of the heart..Iaddend..Iadd.35. A system as described in claim 32 in which said   
     
     
        anchor is a suture..Iaddend..Iadd.36.  A system as defined in claim 32 in which said anchor is a suture adapted to be attached to the pericardium of the heart..Iaddend..Iadd.37. A post-surgical cardioverting system for applying cardioverting electrical energy to the heart of a post-surgical heart patient, said system comprising: a first lead including a first elongated electrode;   a second lead including a second elongated electrode;   anchor means for releasably anchoring the first and second electrodes to body tissue beneath the skin of the patient to dispose said first and second electrodes in electrical contact with the heart; and   non-implantable cardioverting means coupled to said first and second leads for applying said cardioverting electrical energy to said first and second   
     
     
        electrodes for cardioversion of the heart..Iaddend..Iadd.38.  A system as defined in claim 37 in which said anchor means is adapted to be connected to body tissue external to but in close proximity to the heart beneath the skin of the patient..Iaddend..Iadd.39. A system as defined in claim 37 in which said anchor means is adapted to be attached to the pericardium of the heart..Iaddend..Iadd.40. A system as described in claim 37 in which 
     
     
        said anchor means is a suture..Iaddend..Iadd.41.  A system as described in claim 37 in which said anchor means is a suture adapted to be attached to the pericardium of the heart..Iaddend..Iadd.42. A method of cardioverting the heart of a heart surgery patient subsequent to a heart surgery procedure, said method comprising the steps of: providing a first lead having a first elongated electrode, said first electrode having a distal end and a proximal end;   providing a second lead having a second elongated electrode, said second electrode having a distal end and a proximal end;   placing said first and second electrodes in electrical contact with the heart;   following said heart surgery procedure, releasable anchoring said distal ends of said first and second electrodes to body tissue beneath the skin of the patient;   providing a non-implanted cardiovertor for providing cardioverting electrical energy;   coupling said non-implantable cardioverting means to said first and second electrodes; and   causing said cardioverting means to apply said cardioverting electrical energy to said first and second electrodes for cardioversion of the   
     
     
        heart..Iaddend..Iadd.43.  A method as defined in claim 42 wherein said anchoring step includes anchoring said first and second electrodes to body tissue external to but in close proximity to the heart..Iaddend..Iadd.44. A method as defined in claim 42 wherein said anchoring step includes anchoring said first and second electrodes to the pericardium of the heart..Iaddend..Iadd.45. A method as defined in claim 42 wherein said anchoring step includes suturing..Iaddend..Iadd.46. A method as defined in claim 42 wherein said anchoring step includes suturing the first and 
     
     
        second electrodes to the pericardium of the heart..Iaddend..Iadd.47.  A method of cardioverting the heart of a heart surgery patient subsequent to a heart surgery procedure, said method comprising the steps of: providing a first lead having a first elongated electrode;   providing a second lead having a second elongated electrode;   following said heart surgery procedure releasably disposing said first and second electrodes in electrical contact with the heart;   providing a non-implanted cardioverting means for providing cardioverting electrical energy;   coupling said non-implanted cardiovertor to said first and second electrodes; and   causing said cardioverting means to apply said cardioverting electrical energy to said first and second electrodes for cardioversion of the heart..Iaddend..Iadd.48. A method as defined in claim 47 wherein said disposing step includes releasably anchoring said first and second electrodes to body tissue external to but in close proximity to the heart..Iaddend..Iadd.49. A method as defined in claim 47 wherein said disposing step includes releasably anchoring said first and second electrodes to the pericardium of the heart..Iaddend..Iadd.50. A method as defined in claim 47 wherein said disposing step includes suturing..Iaddend..Iadd.51. A method as defined in claim 47 wherein said anchoring step includes releasably suturing the first and second electrodes to the pericardium of the heart..Iaddend.