Catherter for measuring an intraventricular pressure and method of using same

• US 20070016084A1
• Filed: 08/30/2004
• Published: 01/18/2007
• Est. Priority Date: 08/28/2003
• Status: Abandoned Application

• Current Assignee: Institut De Cardiologie De Montrã©Al
• Original Assignee: Institut De Cardiologie De Montrã©Al
• Inventors: Denault, Andre
• Application Number:
  US10/569,508
• Publication Number:
  US 20070016084A1
• Time in Patent Office: Days
• US Class Current: 600/485
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis

Abstract

A method for diagnosing a right ventricular dysfunction of a subject. The method includes measuring a right intraventricular pressure waveform in the subject over at least one cardiac cycle, extracting a ventricular parameter indicative of a right ventricular function from the measured right intraventricular pressure waveform, and establishing a diagnosis at least in part on a basis of the ventricular parameter.

Claims

1. A pressure monitoring device for monitoring a right intraventricular pressure in a heart having a right ventricle, the right ventricle having electrically excitable tissues and electrically non-excitable tissues, the right ventricle being in fluid communication with a pulmonary artery, said device comprising:

a. a pressure measuring portion for measuring the right intraventricular pressure, said pressure measuring portion being insertable within the right ventricle; and

b. a stabilizer connected to said pressure measuring portion for stabilising said pressure monitoring device such that when said pressure measuring portion is positioned within the right ventricle for measuring the intraventricular pressure therein, said pressure monitoring device is spaced from the electrically excitable tissues of the right ventricle.

2. A pressure monitoring device as defined in claim 1, wherein said stabilizer includes a substantially elongated and deformable stabilising body defining a stabilising body proximal end and a longitudinally opposed stabilising body distal end.

3. A pressure monitoring device as defined in claim 2, wherein said stabilising body is configured and sized such as to be located at least in part within a pulmonary artery when said pressure measuring portion is positioned for measuring the intraventricular pressure.

4. A pressure monitoring device as defined in claim 3, wherein said stabilising body distal end is configured and sized such as to be located within a pulmonary artery when said pressure measuring portion is positioned for measuring the intraventricular pressure.

5. A pressure monitoring device as defined in claim 4, wherein said stabilizer includes:

a. an inflatable balloon connected to said stabilising body and located in proximity to said stabilising body distal end; and

b. an inflation system fluidly coupled to said balloon for controllably inflating and deflating said balloon.

6. A pressure monitoring device as defined in claim 2, wherein said pressure measuring portion includes:

a. a substantially elongated and deformable pressure measurement body defining a pressure measurement body proximal end and a longitudinally opposed pressure measurement body distal end, said pressure measurement body distal end being connected to said proximal stabilising body end, said pressure measurement body having a substantially longitudinally extending lumen, said pressure measurement body also having a lateral opening in fluid communication with said lumen and extending substantially radially therefrom in a substantially proximal relationship to said pressure measurement body distal end; and

b. a pressure sensor for sensing a pressure of a fluid within said the right ventricle.

7. A pressure monitoring device as defined in claim 6, wherein said pressure sensor is located in a substantially proximal relationship to said pressure measurement body proximal end so as to be located outside of the subject when said pressure measurement portion is positioned for measuring the intraventricular pressure.

8. A pressure monitoring device as defined in claim 7, wherein said opening is substantially rectangular.

9. A pressure monitoring device as defined in claim 8, wherein said opening is oriented substantially longitudinally in said pressure measurement body.

10. A pressure monitoring device as defined in claim 9, wherein said lateral opening is located at about 25-40 cm from said stabilising body distal end.

11. A pressure monitoring device as defined in claim 10, wherein said lateral opening is located at about 30 cm from said stabilising body distal end.

12. A method for diagnosing a right ventricular dysfunction of a subject, said method comprising the steps of:

a. measuring a right intraventricular pressure waveform in the subject over at least one cardiac cycle;

b. extracting a ventricular parameter indicative of a right ventricular function from the measured right intraventricular pressure waveform; and

c. establishing a diagnosis at least in part on a basis of the ventricular parameter.

13. A method as defined in claim 12, wherein the ventricular parameter is an increase in right intraventricular pressure during a diastole of the right ventricle.

14. A method as defined in claim 13, wherein the diagnosis is a right ventricular diastolic dysfunction indicated by an increase in right intraventricular pressure during the diastole of at least a first predetermined amount.

15. A method as defined in claim 14, wherein the first predetermined amount is about 4 mmHg.

16. A method as defined in claim 14, wherein the first predetermined amount is about 5 mmHg.

17. A method as defined in claim 12, wherein the ventricular parameter is a slope of an increase in right intraventricular pressure during a diastole of the right ventricle.

18. A method as defined in claim 17, wherein the diagnosis is a right ventricular diastolic dysfunction indicated by a slope of an increase in right intraventricular pressure during the diastole larger than a first predetermined amount.

19. A method as defined in claim 18, wherein the first predetermined amount is about 10 mmHg/s.

20. A method as defined in claim 12, further comprising the steps of:

a. measuring a pulmonary artery pressure waveform in the subject over at least one cardiac cycle;

b. extracting a pulmonary artery parameter indicative of a pulmonary artery function from the measured pulmonary artery pressure waveform; and

c. establishing a diagnosis at least in part on a basis of the pulmonary artery parameter and at least in part on a basis of the intraventricular parameter.

21. A method as defined in claim 20, wherein:

a. the ventricular parameter is a maximal right intraventricular systolic pressure; and

b. the pulmonary artery parameter is a maximal pulmonary artery systolic pressure.

22. A method as defined in claim 21, wherein a diagnosis of pulmonary artery obstruction is established when the maximal pulmonary artery systolic pressure is substantially smaller than the maximal right intraventricular systolic pressure.

23. A method as defined in claim 22, wherein a diagnosis of pulmonary artery obstruction is established when the maximal pulmonary artery systolic pressure is smaller than the maximal right intraventricular systolic pressure by at least a first predetermined amount.

24. A method as defined in claim 23, wherein the first predetermined amount is about 5 mmHg.

25. A method as defined in claim 22, wherein a diagnosis of mild pulmonary artery obstruction is established when the maximal pulmonary artery systolic pressure is smaller than the maximal right intraventricular systolic pressure by at least a second predetermined amount and at most a third predetermined amount.

26. A method as defined in claim 25, wherein a diagnosis of severe pulmonary artery obstruction is established when the maximal pulmonary artery systolic pressure is smaller than the maximal right intraventricular systolic pressure by at least the third predetermined amount.

27. A method as defined in claims 25, wherein the second predetermined amount is about 5 mmHg.

28. A method as defined in claims 25, wherein the third predetermined amount is about 10 mmHg.

30. A method as defined in claim 20, wherein:

a. the right ventricle has electrically excitable tissues and electrically non-excitable tissues;

b. the right intraventricular pressure waveform is measured with a pressure monitoring device and the pressure monitoring device includes a pressure measuring portion for measuring the right intraventricular pressure, the measuring portion being insertable within the right ventricle, and a stabilizer connected to the pressure measuring portion for stabilising the pressure monitoring device such that when the pressure measuring portion is positioned for measuring the intraventricular pressure, the pressure monitoring device is spaced from the electrically excitable tissues of the right ventricle.

35. A method as defined in claims 26, wherein the second predetermined amount is about 5 mmHg.

36. A method as defined in claims 26, wherein the third predetermined amount is about 10 mmHg.

29. A method for monitoring a right ventricular function of a subject having a right ventricle, said method comprising the steps of:

a. inserting a pressure monitoring device in the right ventricle of the subject;

b. measuring a right intraventricular pressure waveform in the subject over a plurality of cardiac cycles; and

c. extracting a ventricular parameter indicative of a right ventricular function from the measured waveform for at least some cardiac cycles from the plurality of cardiac cycles.

31. A method for classifying a subject as being likely to experience complications during a surgery, said method comprising the steps of:

a. measuring a right intraventricular pressure waveform in the subject over at least one cardiac cycle prior to the surgery;

b. extracting a ventricular parameter indicative of a right ventricular function from the measured waveform; and

c. establishing a likelihood of occurrence of complications during the surgery at least in part on a basis of the ventricular parameter.

32. A method as defined in claim 31, wherein the ventricular parameter is an increase in right intraventricular pressure during a diastole of the right ventricle.

33. A method as defined in claim 32, wherein the likelihood of occurrence of complications during the surgery is established as being high upon the measurement of an increase in right intraventricular pressure during the diastole of at least a first predetermined amount.

34. A method as defined in claim 33, wherein the first predetermined amount is about 5 mmHg.