# US 10,500,394 B1 · Pacemaker system equipped with a flexible intercostal generator > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,500,394 B1 - Document ID: US10500394B1 - Status: Granted - Kind: B1 - Application number: 15/691,924 - Filed: 2017-08-31 - Granted: 2019-12-10 - Earliest claimed: 2011-10-11 - Applicants: A-Hamid Hakki; A-Hadi Hakki - Inventors: A-Hamid Hakki; A-Hadi Hakki - Web page: https://patentgrep.com/patent/US10500394B1 ## CPC - A61N 1/057: {Anchoring means; Means for fixing the head inside the heart} - A61N 1/3756: {Casings with electrodes thereon, e.g. leadless stimulators} - A61N 1/0587: {Epicardial electrode systems; Endocardial electrodes piercing the pericardium} - A61N 1/362: Heart stimulators (heart defibrillators A61N1/39) - A61N 1/3956: {Implantable devices for applying electric shocks to the heart, e.g. for cardioversion} - A61N 7/00: Ultrasound therapy (lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 {; using ultrasound for introducing media into the body A61M37/0092}) - A61N 1/0504: {Subcutaneous electrodes} - A61N 1/36031: {using physiological parameters for adjustment} - A61N 1/3787: {from an external energy source} - A61N 1/39622: {Pacing therapy} - A61N 2007/0026: {Stimulation of nerve tissue} - A61N 2007/0052: {using the same transducer for therapy and imaging} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract A pacemaker system is configured to sense electrical and mechanical activity of the heart tissue within a mammalian body and to generate a corresponding signal responsive to the sensed cardiac activity. The system includes a flexible electrical generator that contains EKG (ECG) electrodes for measuring electrical activity and ECHO piezoelectric electrodes for measuring mechanical activity of the heart and Doppler blood flow. The generator is embedded in a flexible shield, and is contoured to conform to the anatomy of the intercostal space to be embedded between the ribs of a patient and in the position overlying the heart. The system provides for pacing as well as defibrillation, responsive to the readings of the heart activities. A microprocessor analyzes a cardiac situation, based on the sensor's readings, produces a diagnosis, and generates control signals, such as “pacing pulse” in a life-threatening situation, or “observe” in a non life-threatening situation. ## Claims ### Claim 1 A system implantable in the intercostal space in a patient body in closed proximity to and facing position relative to the heart of a patient for generating and sensing electrical and ultrasonic energy transmitted to and from a tissue of interest within a patient body, comprising: a flexible tube-like shield member having an elongated low-profile curvilinear contour and adapted to conform with an arcuated contour of an intercostal space envelope of a patient's body for being implanted in the intercostal space between a pair of adjacent ribs in substantial congruence with the intercostal space contour, said flexible shield member having thin walls defining an elongated receiving space therebetween; a flexible generator received within said receiving space in said flexible shield member and adapted for producing stimulation energy and for sensing electrical and ultrasonic energy associated with a tissue of interest; and a plurality of double-action electrodes operatively coupled with and embedded within said flexible generator, said plurality of double-action electrodes being configured to perform a double function, including (1) sensing of the electrical and mechanical heart activity of the heart of a patient and blood flow parameters, and (2) generating therapeutic stimulation pulses directed to the heart in response to a cardiac situation detected in correspondence to the heart activity and the blood flow parameters sensed by said double-action electrodes. ### Claim 2 (depends on 1) The system as recited in claim 1, wherein said plurality of double-action electrodes includes at least one piezoelectric crystal embedded within said shield member, said at least one piezoelectric crystal being configured to perform measurements of heart function by continuous and pulsed echocardiographic signals for diagnostic purposes, and to deliver high energy ultrasonic bursts for therapeutic of the heart tissue. ### Claim 3 (depends on 1) The system as recited in claim 1, wherein said flexible shield member is configured for insertion within a patient's intercostal space percutaneously or surgically. ### Claim 4 (depends on 1) The system as recited in claim 1, wherein said plurality of double-action electrodes include at least one electrically conductive electrode selected from the group consisting of high voltage pacing electrodes and low voltage pacing electrodes. ### Claim 5 (depends on 4) The system as recited in claim 4, wherein said generator embedded within said flexible shield is configured to detect electrical activity of the patient's heart based on the readings of said at least one electrically conductive electrode. ### Claim 6 (depends on 2) The system as recited in claim 2, wherein said generator embedded within said flexible shield is configured to detect mechanical activity of the patient's heart based on the reading of said at least one piezoelectric crystal. ### Claim 7 (depends on 4) The system as recited in claim 4, wherein said generator embedded within said flexible shield is configured to generate electrical energy directed through said high voltage pacing electrodes or said low voltage pacing electrodes to the patient's heart. ### Claim 8 (depends on 2) The system as recited in claim 2, wherein said generator includes an internal ultrasonic energy source operatively coupled to and implanted in the patient's body along with said generator and said at least one piezoelectric crystal, wherein said at least one piezoelectric crystal, being powered by said internal ultrasonic energy source, produces pulsed and continuous ultrasound signals to detect mechanical heart function or the lack thereof. ### Claim 9 (depends on 8) The system as recited in claim 8, wherein said plurality of double-action electrodes includes an echo electrode, and wherein said internal ultrasonic energy source in said generator includes an ultrasound Doppler source positioned in proximity to and in operative coupling with said echo electrode for pacing. ### Claim 10 (depends on 9) The system as recited in claim 9, wherein said generator embedded within said flexible shield is configured to produce electric shock pulse responsive to combined acquired readings on the electrical and mechanical activity of the patient's heart when a life threatening heart rhythm has been diagnosed. ### Claim 11 (depends on 1) The system as recited in claim 1, further including an external power source and a transmitting antenna operatively coupled to said external power source, wherein said generator embedded within said flexible shield includes a receiver and a receiving antenna operatively coupled to said receiver for wireless power transfer between said external power source and a battery in said generator. ### Claim 12 (depends on 1) The system as recited in claim 1, further including an external ultrasonic generator and a transmitting antenna operatively coupled to said external ultrasonic generator, wherein said generator embedded within said flexible shield includes an internal ultrasonic source, a receiver and a receiving antenna operatively coupled to said receiver for wireless power transfer between said external ultrasonic generator and said internal ultrasonic source implanted along with said generator in the patient's body. ### Claim 13 (depends on 10) The system as recited in claim 10, further including a microprocessor operatively coupled to said generator, wherein said plurality of double-action electrodes transmit data to the microprocessor to determine presence of electromechanical dissociation based on electrical and mechanical signals from the heart or to diagnose a life-threatening heart rhythm, or to confirm the presence of the non life-threatening heart rhythm based on electrical and mechanical signals from the heart to avoid inappropriate shocks. ### Claim 14 (depends on 1) The system as recited in claim 1, wherein said flexible shield is formed of a biocompatible electrically-conductive composition. ### Claim 15 (depends on 1) The system as recited in claim 1, wherein said flexible shield is contoured to assume a contour of the intercostal space. ### Claim 16 A method for sensing energy transmitted from and generating energy transmitted to the heart of a patient, comprising the steps of: forming a flexible generator, embedding said flexible generator in a flexible tube-like shield having an elongated low-profile curvilinear contour and adapted to conform to an arcuated contour of an intercostal space envelope of a patient, and attaching at least one double-action electrode to said flexible generator embedded in said flexible shield, said at least one double-action electrode being configured to sense at least one parameter associated in the heart activity and to produce a pacing signal responsive to said sensed at least one parameter; implanting said flexible generator embedded in said flexible shield in the intercostal space of the patient between a pair of adjacent ribs in substantial congruence with the intercostal space contour with said at least one parameter sensing electrode in proximity to and in facing positional relationship with the heart of the patient; operatively coupling a microprocessor to said flexible generator; sensing said at least one parameter of the heart activity with said at least one parameter sensing electrode; transmitting said sensed at least one parameter to said microprocessor for processing thereat; and generating, at said microprocessor, a control signal responsive to said sensed at least one parameter and transmitting said control signal to said flexible generator to produce a pacing signal if said sensed at least one parameter is indicative of a life-threatening heart condition. ### Claim 17 (depends on 16) The method of claim 16, further comprising: embedding piezoelectric crystals in said flexible generator, and measuring the mechanical heart activity by said piezoelectric crystals. ### Claim 18 (depends on 16) The method of claim 16, further comprising: embedding electrically conductive electrodes in said flexible generator, and measuring the electrical heart activity. ### Claim 19 (depends on 16) The method of claim 16, further comprising: embedding a Doppler sensor in said flexible generator, and measuring blood flow of the heart. ### Claim 20 (depends on 16) The method of claim 16, further comprising: embedding a receiving antenna in said flexible generator, embedding a battery with said flexible generator, embedding an internal ultrasonic energy source with said flexible generator, positioning a source of energy external to the patient's body, wherein said external source of energy includes a source selected from a group including an electrical power source and ultrasonic power source, coupling a transmitting antenna to said external source of energy, and wirelessly transmitting energy from said external source of energy through said transmitting and receiving antennas to said battery and said internal ultrasonic energy source, respectively, embedded in said generator.