Diastolic coronary perfusion detection for timed delivery of therapeutic and/or diagnostic agents

• US 20050043616A1
• Filed: 08/07/2003
• Published: 02/24/2005
• Est. Priority Date: 08/07/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Chinchoy, Edward
• Granted Patent: US 7,951,129 B2
• Time in Patent Office: Days
• US Class Current: 600/431
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00

Abstract

During diastolic coronary perfusion, blood perfuses through the heart via the coronary arteries. Delivery of a therapeutic and/or diagnostic agent to the heart during diastolic coronary perfusion allows the therapeutic and/or diagnostic agent to efficiently perfuse through the heart. A medical device according to the invention detects closure of the aortic valve of a heart, and initiates delivery of a therapeutic and/or diagnostic agent upon detection of aortic valve closure. The medical device detects aortic valve closure by processing a signal. Exemplary signals used by the medical device to detect aortic valve closure include left or right ventricular accelerometer signals, left or right ventricular flow signals, left or right ventricular pressure signals, aortic pressure signals, pulse pressure signals, systemic arterial pressure signals, electrogram signals, and phonocardiogram signals

Claims

1. A method comprising:

receiving a signal that reflects activity of a heart;

processing the signal to detect closure of an aortic valve of the heart; and

initiating delivery of a therapeutic and/or diagnostic agent to the heart upon detection of closure of the aortic valve.

2. The method of claim 1, wherein processing a signal comprises processing at least one of a ventricular accelerometer signal, a ventricular flow signal, a ventricular pressure signal, a pulse pressure signal, an aortic pressure signal, a systemic arterial pressure signal, an electrogram signal, and a phonocardiogram signal.

3. The method of claim 1, wherein processing the signal comprises digitally processing the signal.

4. The method of claim 3, wherein digitally processing the signal comprises digitally processing a pressure signal to detect a dichrotic notch within the signal.

5. The method of claim 1, wherein initiating delivery of a therapeutic and/or diagnostic agent comprises delivering the therapeutic and/or diagnostic agent to an aorta of the heart.

6. The method of claim 1, wherein initiating delivery of a therapeutic and/or diagnostic agent comprises controlling a pump to deliver the therapeutic and/or diagnostic agent to the heart via a catheter.

7. The method of claim 6, wherein the pump is implanted within a patient.

8. The method of claim 1, wherein the therapeutic and/or diagnostic agent includes at least one of a biological agent, a genetic agent and a pharmaceutical agent.

9. A medical device comprising:

a pump to deliver a therapeutic and/or diagnostic agent to a heart via a catheter; and

a processor means for receiving a signal that reflects activity of the heart, for processing the signal to detect closure of an aortic valve of the heart, and for controlling the pump to deliver the therapeutic and/or diagnostic agent to the heart upon detection of closure of the aortic valve.

10. The medical device of claim 9, further comprising a sensor to generate the signal.

11. The medical device of claim 10, wherein the sensor is fluidly coupled to a one of a left ventricle or a right ventricle of the heart.

12. The medical device of claim 10, wherein the sensor comprises one of a microphone, a flow sensor, an accelerometer, a pressure sensor, a vibration sensor, an electrode, an oximeter.

13. The medical device of claim 9, wherein the signal includes at least one of a ventricular accelerometer signal, a ventricular flow signal, a ventricular pressure signal, an aortic pressure signal, a systemic arterial pressure signal, an electrogram signal, a phonocardiogram signal.

14. The medical device of claim 9, wherein the processor digitally processes the signal.

15. The medical device of claim 14, wherein the signal comprises a pressure signal, and the processor digitally processes the pressure signal to detect a dichrotic notch within the pressure signal.

16. The medical device of claim 9, wherein the pump delivers the therapeutic and/or diagnostic agent to the aorta via the catheter.

17. The medical device of claim 9, wherein the therapeutic and/or diagnostic agent includes at least one of a biological agent, a genetic agent, a pharmaceutical agent.

18. The medical device of claim 9, wherein the processor comprises a monitor module to process the signal and detect closure of the aortic valve.

19. The medical device of claim 9, wherein the medical device is implanted within a patient.

20. A system comprising:

a catheter;

a pump to deliver a therapeutic and/or diagnostic agent to a heart via the catheter;

a sensor to generate a signal that reflects activity of the heart; and

a processor to receive the signal, process the signal to detect closure of an aortic valve of the heart, and control the pump to deliver the therapeutic and/or diagnostic agent to the heart upon detection of closure of the aortic valve.

21. The system of claim 20, wherein the sensor comprises one of a microphone, a flow sensor, an accelerometer, a pressure sensor, a vibration sensor, an electrode and an oximeter, and the signal includes at least one of a ventricular accelerometer signal, a ventricular flow signal, a ventricular pressure signal, an aortic pressure signal, a systemic arterial pressure signal, an electrogram signal, a phonocardiogram signal.

22. The system of claim 21, wherein the sensor is located within one of the left and right ventricles of the heart.

23. The system of claim 20, wherein the processor digitally processes the signal.

24. The system of claim 23, wherein the signal comprises a pressure signal, and the processor digitally processes the pressure signal to detect a dichrotic notch within the pressure signal.

25. The system of claim 20, wherein the pump delivers the therapeutic and/or diagnostic agent to the aorta via the catheter.

26. The system of claim 20, wherein the therapeutic and/or diagnostic agent includes at least one of a biological agent, a genetic agent, and a pharmaceutical agent.

27. The system of claim 20, wherein at least one of the catheter, the pump, the sensor, and the processor are implanted within a patient.

28. A computer-readable medium comprising instructions that cause a programmable processor to:

receive a signal that reflects activity of a heart;

process the signal to detect closure of an aortic valve of the heart; and

control a pump to deliver a therapeutic and/or diagnostic agent to the heart upon detection of closure of the aortic valve.

29. The computer-readable medium of claim 28, wherein the instructions that cause a programmable processor to process the signal further comprise instructions that cause a programmable processor to process at least one of a ventricular accelerometer signal, a ventricular flow signal, a ventricular pressure signal, an aortic pressure signal, a systemic arterial pressure signal, an electrogram signal, a phonocardiogram signal.

30. The computer-readable medium of claim 28, wherein the instructions that cause a programmable processor to process the signal further comprise instructions that cause a programmable processor to digitally process the signal.

31. The computer-readable medium of claim 30, wherein the instructions that cause a programmable processor to digitally process the signal further comprise instructions that cause a programmable processor to digitally process a pressure signal to detect a dichrotic notch within the signal.

32. A system comprising:

means for detecting activity within a heart and generating a signal as a function of the activity;

means for delivering a therapeutic and/or diagnostic agent to the heart; and

means for processing the signal to detect closure of an aortic valve of the heart, and controlling the delivery means to deliver the therapeutic and/or diagnostic agent upon detection of closure of the aortic valve.

33. The system of claim 32, wherein the means for generating the signal includes means for generating at least one of a ventricular accelerometer signal, a ventricular flow signal, a ventricular pressure signal, an aortic pressure signal, a systemic arterial pressure signal, an electrogram signal, a phonocardiogram signal.

34. The system of claim 32, wherein the means for processing the signal comprises means for digitally processing the signal.

35. The system of claim 34, wherein the means for generating the signal comprises means for generating a pressure signal, and the means for digitally processing the signal comprises means for digitally processing the pressure signal to detect a dichrotic notch within the signal.

36. The system of claim 32, wherein the means delivering the therapeutic and/or diagnostic agent comprises means for delivering the therapeutic and/or diagnostic agent to an aorta of the heart.

37. The system of claim 32, wherein the therapeutic and/or diagnostic agent includes at least one of a biological agent, a genetic agent and a pharmaceutical agent.

38. The system of claim 32, wherein at least one of the means for detecting and generating, means for delivering, and means for processing and controlling are implanted within a patient.