Heart stimulator with stimulation control dependent on perfusion blood flow

• US 20060229684A1
• Filed: 06/09/2006
• Published: 10/12/2006
• Est. Priority Date: 05/31/2001
• Status: Abandoned Application

• Current Assignee: St. Jude Medical AB (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical AB (Abbott Laboratories Incorporated)
• Inventors: Strandberg, Hans
• Application Number:
  US11/450,632
• Publication Number:
  US 20060229684A1
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

A heart stimulator for multi-site stimulation of the heart of a patient has a pulse generator and a measuring device for measuring a physiological cardiac parameter and delivering a corresponding output signal to a control unit for controlling time intervals between pulses delivered to different stimulation sites in the heart dependent on the output signal according to a predetermined criterion. The measuring device has a ring-shaped electrode sized to fit within a blood vessel to measure perfusion blood flow of the patient'"'"'s heart, a counter-electrode adapted to contact the blood, and a measuring unit connected to the ring-shaped electrode and to the counter-electrode to measure voltage or current between those electrodes to determine the perfusion blood flow in the vessel, as the physiological parameter.

Claims

1-14. -14. (canceled)

15. A method for multi-site stimulation of a heart, comprising the steps of:

implanting an electrode system connected to a pulse generator in a patient for interacting with the heart of the patient to deliver said stimulation pulses to the heart at multiple, different stimulation sites;

implanting a ring-shaped electrode adapted to fit within a blood vessel of the patient to measure perfusion blood flow associated with the heart, and a counter-electrode in contact with blood of the patient, and measuring a quantity between said ring-shaped electrode and said counter-electrode selected from the group consisting of voltage and current, and electronically determining said perfusion blood flow from said quantity; and

controlling, dependent on said perfusion blood flow, time intervals between respective pulses generated by said pulse generator and delivered to said different, multiple stimulation sites.

16. A method as claimed in claim 15 comprising implanting said ring-shaped electrode to measure blood flow in a coronary sinus vein of the patient.

17. A method as claimed in claim 15 comprising measuring changes in said perfusion blood flow in response to changes of said time intervals.

18. A method as claimed in claim 15 comprising electronically storing a plurality of most recent measurements of said perfusion blood flow and the respective time intervals associated therewith.

19. A method as claimed in claim 18 comprising storing said perfusion flow values from at least two consecutive heart cycles with constant parameter settings from said control unit.

20. A method as claimed in claim 18 comprising comparing a current perfusion flow value with at least one of the stored perfusion flow values to obtain a comparison result and automatically adjusting said time intervals dependent on said comparison result.

21. A method as claimed in claim 15 comprising adjusting said time intervals one at a time.

22. A method as claimed in claim 15 comprising adjusting a plurality of said time intervals together.

23. A method as claimed in claim 15 comprising adjusting said time intervals in steps of varying sizes.

24. A method as claimed in claim 15 comprising controlling said time intervals dependent on said perfusion blood flow to cause a minimum blood flow during a cardiac cycle to be increased as much as possible.

25. A method as claimed in claim 15 comprising controlling said time intervals dependent on said perfusion blood flow to maximize an integral of said perfusion blood flow during a cardiac cycle for a predetermined heart rate.

26. A method as claimed in claim 15 comprising electronically determining said perfusion blood flow from said quantity in a determination unit disposed extracorporeally of said patient.

27. A method as claimed in claim 26 comprising telemetrically communicating a signal representing said quantity to said determination unit and communicating a signal representing said perfusion blood flow from said determination unit to an implanted control unit that is connected to, and controls, said pulse generator.