Pacing management during cardiopulmonary resuscitation

• US 20070049976A1
• Filed: 08/23/2005
• Published: 03/01/2007
• Est. Priority Date: 08/23/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Dong, Yanting, Ni, Quan
• Granted Patent: US 7,720,535 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G09B 23/288 for artificial respiration or heart massage

Abstract

Systems and methods provide for coordinated cardiac pacing with delivery of cardiopulmonary resuscitation (CPR) to a patient. Managing cardiac pacing in a patient during a cardiac arrhythmia involves detecting a cardiac arrhythmia using a patient implantable medical device, prompting a cardiopulmonary resuscitation compression, and delivering, using the patient implantable medical device, a pacing pulse to a heart chamber in coordination with the compression prompt.

Claims

1. A method of managing cardiac pacing in a patient during a cardiac arrhythmia using a patient implantable medical device, comprising:

detecting a cardiac arrhythmia using the patient implantable medical device;

prompting a cardiopulmonary resuscitation compression; and

delivering, using the patient implantable medical device, a pacing pulse to a heart chamber in coordination with the compression prompt.

2. The method of claim 1, wherein delivering the pacing pulse to the heart chamber comprises:

detecting an onset of the cardiopulmonary resuscitation compression; and

delivering the pacing pulse in response to the detected compression onset.

3. The method of claim 1, wherein delivering the pacing pulse to the heart chamber comprises:

detecting an acceleration of the patient implantable medical device; and

delivering the pacing pulse in response to the detected acceleration.

4. The method of claim 1, wherein:

delivering the pacing pulse to the heart chamber comprises delivering the pacing pulse at a predetermined rate; and

prompting the cardiopulmonary resuscitation compression comprises providing a patient-externally audible prompt.

5. The method of claim 1, wherein delivering the pacing pulse to the heart chamber comprises:

detecting a patient'"'"'s transthoracic impedance using the patient implantable medical device; and

delivering the pacing pulse in response to a change in the detected transthoracic impedance.

6. The method of claim 1, wherein prompting the cardiopulmonary resuscitation compression comprises providing a patient-externally audible prompt.

7. The method of claim 1, wherein prompting the cardiopulmonary resuscitation compression comprises providing a patient-externally audible prompt at a predetermined rate.

8. The method of claim 1, wherein prompting the cardiopulmonary resuscitation compression comprises prompting a cardiopulmonary resuscitation breath by provision of a patient-externally audible prompt distinct from that associated with prompting the cardiopulmonary resuscitation.

9. The method of claim 1, comprising prompting a first predetermined number of cardiopulmonary resuscitation breaths following provision of a second predetermined number of prompts for cardiopulmonary resuscitation compressions.

10. The method of claim 1, comprising adjusting or terminating the prompting in response to detecting cessation of the cardiac arrhythmia.

11. A patient-implantable medical device, comprising:

a pacing circuit configured to deliver pacing pulses to a heart chamber;

a sensing circuit configured to sense cardiac signals;

a prompting circuit configured for prompting a cardiopulmonary resuscitation compression; and

a processor coupled to the pacing circuit, the sensing circuit, and the prompting circuit, the processor configured to detect a cardiac arrhythmia using the sensing circuit, prompt a cardiopulmonary resuscitation compression, and coordinate delivery of the pacing pulses to the heart chamber in coordination with the compression prompt.

12. The device of claim 11, comprising an impedance sensing circuit coupled to the processor and configured to sense an impedance signal indicative of a cardiopulmonary resuscitation compression, wherein the processor is configured to coordinate delivery of the pacing pulses to the heart chamber in response to detecting the compression.

13. The device of claim 11, comprising an accelerometer coupled to the processor and configured to sense an acceleration signal indicative of a cardiopulmonary resuscitation compression, wherein the processor is configured to coordinate delivery of the pacing pulses to the heart chamber in response to detecting the compression.

14. The device of claim 11, wherein the prompting circuit is configured for prompting a cardiopulmonary resuscitation breath.

15. The device of claim 11, wherein the processor is configured to prompt a cardiopulmonary resuscitation breath at a predetermined rate following a predetermined number of prompts for cardiopulmonary resuscitation compressions.

16. The device of claim 11, wherein the processor is configured to adjust or terminate the prompting in response to detecting cessation of the cardiac arrhythmia.

17. A patient-implantable medical device for managing cardiac pacing in a patient during a cardiac arrhythmia, comprising:

means for detecting a cardiac arrhythmia;

means for prompting a cardiopulmonary resuscitation compression; and

means for delivering a pacing pulse to a heart chamber in coordination with the compression prompt.

18. The device of claim 17, comprising means for detecting an onset of the cardiopulmonary resuscitation compression, wherein the pacing pulse delivery means is configured to deliver the pacing pulse in coordination with the compression onset detecting means.

19. The device of claim 17, comprising means for detecting an acceleration of the patient implantable medical device.

20. The device of claim 17, comprising means for detecting electro-mechanical association of the cardiac response to the pacing pulse.