Implantable extravascular electrical stimulation lead having improved sensing and pacing capability

Abstract

Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted are described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first segment and a second segment proximal to the first segment by a distance, a first electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment and the second segment of the defibrillation electrode, and at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode.

1 . An implantable medical electrical lead comprising:
 an elongated lead body having a distal portion and a proximal end;   a connector at the proximal end of the lead body;   a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first segment and a second segment proximal to the first segment by a distance;   a first electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment and the second segment of the defibrillation electrode; and   at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode.   
     
     
         2 . The lead of  claim 1 , wherein the at least one pace/sense electrode comprises a first pace/sense electrode and a second pace/sense electrode located between the first segment and the second segment, the implantable medical electrical lead further comprising:
 a second electrical conductor extending from the connector at the proximal end of the lead body and electrically coupling to the first pace/sense electrode; and   a third electrical conductor extending from the connector at the proximal end of the lead body and electrically coupling to the second pace/sense electrode.   
     
     
         3 . The lead of  claim 2 , wherein the first and second pace/sense electrodes located between the first segment and the second segment comprise one of or a combination of ring electrodes, hemispherical electrodes, coil electrodes, partial-ring electrodes, partial-hemispherical electrodes, partial-coil electrodes. 
     
     
         4 . The lead of  claim 1 , further comprising at least one pace/sense electrode located distal to the first segment of the defibrillation electrode. 
     
     
         5 . The lead of  claim 1 , further comprising at least one pace/sense electrode located proximal to the second segment of the defibrillation electrode. 
     
     
         6 . The lead of  claim 1 , wherein the at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode comprises a coil electrode or partial-coil electrode. 
     
     
         7 . The lead of  claim 1 , wherein the distance between the first segment and the second segment is between approximately 1-3 centimeters (cm). 
     
     
         8 . The lead of  claim 1 , wherein the distal portion of the lead is arranged such that when the lead is implanted the at least one pace/sense electrode and the defibrillation electrode are both substantially centered over a ventricle of a heart of the patient. 
     
     
         9 . An implantable medical electrical lead comprising:
 an elongated lead body having a distal portion and a proximal end;   a connector at the proximal end of the lead body;   a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first segment and a second segment proximal to the first segment by approximately 1-3 centimeters (cm); and   at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode.   
     
     
         10 . The lead of  claim 9 , further comprising an electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment and the second segment of the defibrillation electrode. 
     
     
         11 . The lead of  claim 9 , further comprising:
 a first electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment of the defibrillation electrode; and   a second electrical conductor extending from the proximal end of the lead body and electrically coupling to the second segment of the defibrillation electrode.   
     
     
         12 . The lead of  claim 9 , wherein the at least one pace/sense electrode comprises at least two pace/sense electrodes located between the first segment and the second segment. 
     
     
         13 . The lead of  claim 9 , wherein the at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode comprises a coil electrode. 
     
     
         14 . The lead of  claim 9 , further comprising at least one of a pace/sense electrode located distal to the first segment of the defibrillation electrode and a pace/sense electrode located proximal to the second segment of the defibrillation electrode. 
     
     
         15 . The lead of  claim 9 , wherein the distal portion of the lead is configured such that when the lead is implanted the at least one pace/sense electrode and the defibrillation electrode are both substantially centered over a ventricle of a heart of the patient. 
     
     
         16 . An implantable cardioverter-defibrillator system comprising:
 an implantable cardioverter-device (ICD) that includes a therapy module configured to generate and deliver electrical stimulation therapy; and   an implantable medical electrical lead electrically coupled to the therapy module, wherein the lead comprises:
 an elongated lead body having a distal portion and a proximal end; 
 a connector at the proximal end of the lead body; 
 a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first segment and a second segment proximal to the first segment by a distance; and 
 at least one pace/sense electrode located between the first segment and the second segment of the defibrillation electrode. 
   
     
     
         17 . The system of  claim 16 , wherein the lead further comprises an electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment and the second segment of the defibrillation electrode. 
     
     
         18 . The system of  claim 16 , wherein
 the lead further comprises:
 a first electrical conductor extending from the proximal end of the lead body and electrically coupling to the first segment of the defibrillation electrode; and 
 a second electrical conductor extending from the proximal end of the lead body and electrically coupling to the second segment of the defibrillation electrode, and 
   the ICD further comprises a switching array configured to selectively couple the therapy module to any one of just the first segment of the defibrillation electrode, just the second segment of the defibrillation electrode, and both the first and second segments of the defibrillation electrode simultaneously.   
     
     
         19 . The system of  claim 16 , wherein the distance between the first segment and the second segment is between approximately 1-3 centimeters (cm). 
     
     
         20 . The system of  claim 16 , wherein the distal portion of the lead is arranged such that when the lead is implanted the at least one pace/sense electrode and the defibrillation electrode are both substantially centered over a ventricle of a heart of the patient.