Method and apparatus to control conduction through the heart to treat cardiac conditions

• US 20070027394A1
• Filed: 07/29/2005
• Published: 02/01/2007
• Est. Priority Date: 07/29/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sigg, Daniel, Ujhelyi, Michael
• Granted Patent: US 8,892,197 B2
• Time in Patent Office: Days
• US Class Current: 600/508
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61M 2005/1726 the body parameters being measured at, or proximate to, the infusion site
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/63 Motion, e.g. physical activity
• 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
• CPC Class Codes: A61N 1/0575 with drug delivery
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

Control of conduction through a heart is described. A lead with a proximal end and a distal end is provided. The distal end of the lead is inserted into a target area. An agent is delivered through the lead to the target area. Delivery of the agent is monitored via a closed loop feedback system.

Claims

1. A computer implemented method comprising:

delivering an agent to a target area of a heart;

monitoring an electrical response by the heart to the agent via a closed loop system;

adjusting a quantity of the agent through the closed loop system; and

maintaining the heart'"'"'s ventricular rate at a level to treat cardiac dysfunction to normalize heart rate.

2. The computer implemented method of claim 1 further comprising:

determining an acceptable agent amount through the closed loop system based upon the electrical response of the heart.

3. The computer implemented method of claim 1 wherein monitoring the electrical response relates to one of ventricular rate, activity of a patient, and artrioventricular (AV) conduction time.

4. The computer implemented method of claim 3 wherein the quantity of the agent is adjusted from a first dose to a second dose for a high ventricular rate.

5. The computer implemented method of claim 3 wherein the quantity of the agent is adjusted from a first dose to a third dose for a low ventricular rate.

6. The computer implemented method of claim 1 wherein the agent is one of a drug and a biological agent.

7. The computer implemented method of claim 1 wherein the drug or biological agents modulate cardiac conduction.

8. The computer implemented method of claim 1 wherein the agents are one of calcium channel antagonists, beta-adrenergic antagonists, digitalis-derived drugs, purinergic agents, parasympathetic agents, local anesthetics, and adrenergic agonists.

9. The computer implemented method of claim 8 wherein the purinergic compound includes adenosine compound.

10. The computer implemented method of claim 8 wherein the parasympathetic compound includes acetylcholine-like compounds.

11. The computer implemented method of claim 1 wherein the target area is an AV node.

12. The computer implemented method of claim 11 wherein the target area is a triangle of Koch.

13. The computer implemented method of claim 11 further comprising:

adjusting the quantity of agent dosage based upon the patient activity.

14. The computer implemented method of claim 1 further comprising:

notifying automatically one of a physician and the patient when a maximum dosage level is attained but a cardiac condition still exists.

15. A method comprising:

delivering an agent to a target area of a heart;

monitoring an electrical response by the heart to the agent via an IMD;

determining an acceptable agent amount through the IMD based upon the electrical response of the heart;

adjusting a quantity of the agent through the IMD based on the determined acceptable agent amount; and

maintaining the heart'"'"'s ventricular rate at a level to treat one of supraventricular arrhythmias (SVA) and chronic heart block.

16. A method comprising:

delivering a catheter to an AVN region using a cardiac navigation system; and

fixating the catheter using a fixation element.

17. The method of claim 16 further comprising:

monitoring heart related data;

determining whether a cardiac condition is present in a patient; and

delivering an agent via the catheter to the AVN region.

18. The method of claim 17 further comprising:

adjusting a quantity of agent to deliver to the AVN region based upon physical activity of a patient.

19. A computer system comprising:

a processor coupled to a memory, the memory having stored therein instructions which when executed by a processor cause the processor to generate data and to perform a method comprising;

(a) delivering an agent to a target area of a heart;

(b) monitoring an electrical response by the heart to the agent via a closed loop system;

(c) adjusting a quantity of the agent through the closed loop system; and

(d) maintaining the heart'"'"'s ventricular rate at an optimal level to treat cardiac dysfunction to normalize heart rate; and

an interconnect coupled to the processor and the memory to allow the data to be transferred between the memory and the processor.

20. An apparatus comprising:

storage media including instructions stored thereon which when executed cause a computer system to perform a method including;

(a) delivering an agent to a target area of a heart;

(b) monitoring an electrical response by the heart to the agent via a closed loop system;

(c) adjusting a quantity of the agent through the closed loop system; and

(d) maintaining the heart'"'"'s ventricular rate at an optimal level to treat cardiac dysfunction to normalize heart rate.

21. A system of agent delivery and titration to the heart comprising:

an agent delivery device adapted to deliver an agent to a target tissue of the heart;

a medical device for monitoring cardiac activity in data and electrical communication with the delivery device; and

an interface between the medical device and the delivery device to enable delivery and titration of the agent based on a rate monitored by the medical device.