Heart treatment equipment and heart treatment method

• US 20070100380A1
• Filed: 05/26/2004
• Published: 05/03/2007
• Est. Priority Date: 05/30/2003
• Status: Abandoned Application

• Current Assignee: Terumo Kabushiki Kaisha
• Original Assignee: Terumo Corporation
• Inventors: Fukui, Yoshihito
• Application Number:
  US10/558,421
• Publication Number:
  US 20070100380A1
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/395 for treating atrial fibrillation
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

There is disclosed heart treatment equipment in which it is possible to carry out controlling of a preventive treatment after an anti-tachyarrhthmia treatment in order to execute prevention and treatment of a fatal arrhythmia and the anti-tachyarrhythmia treatment is carried out by controlling tachyarrhythmia prevention means and tachyarrhythmia treatment means (tachyarrhythmia termination means) according to the result of detecting occurrence of tachyarrhythmia. In the anti-tachyarrhythmia treatment, there is provided with a structure for reducing or stopping the activation current with respect to the vagus nerve or a repression current with respect to the sympathetic nerve after a supply of an electroshock to the heart such as cardioversion, defibrillation or the like, so that it is possible to prevent deterioration of hemodynamics, recurrence of fatal arrhythmia and supraventicular arrhythmia such as atrial fibrillation or the like.

Claims

1. Heart treatment equipment comprising:

tachyarrhythmia prevention means for preventing occurrence of tachyarrhythmia;

tachyarrhythmia detection means for detecting said occurrence of tachyarrhythmia;

tachyarrhythmia termination means supplying anti-tachyarrhythmia treatment for terminating said tachyarrhythmia in response to said tachyarrhythmia detection means; and

control means for connecting said tachyarrhythmia prevention means and said tachyarrhythmia detection means,

wherein said control means includes means for deactivating said tachyarrhythmia prevention means in its operation in response to said tachyarrhythmia detection means.

3. Heart treatment equipment according to claim 1, wherein said tachyarrhythmia prevention means includes nerve stimulation means.

4. Heart treatment equipment according to claim 3, wherein said nerve stimulation means is means for stimulating a parasympathetic nerve.

5. Heart treatment equipment according to claim 4, wherein said parasympathetic nerve stimulation is a stimulation for activating excitement of the parasympathetic nerve.

6. Heart treatment equipment according to claim 4, wherein said parasympathetic nerve is a vagus nerve.

7. Heart treatment equipment according to claim 3, wherein said nerve stimulation means is means for stimulating a sympathetic nerve.

8. Heart treatment equipment according to claim 7, wherein said sympathetic nerve stimulation is a stimulation having a level which does not increase heart rate or blood pressure.

9. Heart treatment equipment according to claim 7, wherein said sympathetic nerve stimulation is a stimulation for blocking transmission of the sympathetic nerve excitement.

10. Heart treatment equipment according to claim 7, wherein said sympathetic nerve is a ganglion stellatum.

11. Heart treatment equipment according to claim 1, wherein said anti-tachyarrhythmia treatment which said tachyarrhythmia termination means supplies includes at least one of anti-tachyarrhythmia pacing, cardioversion and defibrillation.

12. Heart treatment equipment according to claim 1 further comprising bradycardia detection means for detecting occurrence of bradycardia;

and bradycardia treatment means for generating a heart stimulation pulse in response to said bradycardia detection means.

13. Heart treatment equipment according to claim 1, wherein said control means further includes means for activating said tachyarrhythmia prevention means subsequent to the deactivation of said tachyarrhythmia prevention means.

14. Heart treatment equipment according to claim 13 further comprising timing means for clocking a predetermined time, wherein said activation means activates said tachyarrhythmia prevention means in response to said timing means.

15. Heart treatment equipment according to claim 14, wherein said timing means sets a clocking time in conformity with said anti-tachyarrhythmia treatment in response to the supply of said anti-tachyarrhythmia treatment of said tachyarrhythmia termination means.

16. Heart treatment equipment according to claim 13 further comprising heart rate measuring means for measuring heartbeats, wherein said activation means activates said tachyarrhythmia prevention means in response to said heart rate measuring means.

17. Heart treatment equipment according to claim 16, wherein said activation means activates said tachyarrhythmia prevention means in a case when the heart rate which said heart rate measuring means measured exceeds a predetermined threshold.

18. Heart treatment equipment according to claim 14 further comprising tachyarrhythmia termination confirmation means for confirming whether or not said tachyarrhythmia was terminated by said tachyarrhythmia termination means, wherein said timing means starts clocking of said predetermined time in response to said tachyarrhythmia termination confirmation means.

19. Heart treatment equipment according to claim 16 further comprising tachyarrhythmia termination confirmation means for confirming whether or not said tachyarrhythmia was terminated by said tachyarrhythmia termination means, wherein said activation according to said heart rate measuring means is carried out in response to said tachyarrhythmia termination confirmation means.

2. Heart treatment equipment comprising:

tachyarrhythmia prevention means for preventing occurrence of tachyarrhythmia;

tachyarrhythmia detection means for detecting said occurrence of tachyarrhythmia;

tachyarrhythmia confirmation means for confirming that said tachyarrhythmia continues in response to said tachyarrhythmia detection means;

tachyarrhythmia termination means supplying anti-tachyarrhythmia treatment for terminating said tachyarrhythmia in response to said tachyarrhythmia confirmation means; and

control means for connecting said tachyarrhythmia prevention means and said tachyarrhythmia confirmation means,

wherein said control means includes means for deactivating said tachyarrhythmia prevention means in its operation in response to said tachyarrhythmia confirmation means.

20. Heart treatment equipment comprising:

tachyarrhythmia prevention means for preventing occurrence of tachyarrhythmia by a nerve stimulation;

tachyarrhythmia detection means for detecting said occurrence of tachyarrhythmia;

tachyarrhythmia termination means supplying anti-tachyarrhythmia treatment for terminating said tachyarrhythmia in response to said tachyarrhythmia detection means; and

control means for connecting said tachyarrhythmia prevention means and said tachyarrhythmia detection means,

wherein said nerve stimulation by said tachyarrhythmia prevention means operates at least in a first operation mode and a second operation mode, nerve stimulation energy of said second operation mode is set to be lower than nerve stimulation energy of said first operation mode and said control means includes first control means for operating said tachyarrhythmia prevention means in said second operation mode in response to said tachyarrhythmia detection means.

22. Heart treatment equipment according to claim 20, wherein said nerve stimulation means is means for stimulating a parasympathetic nerve.

23. Heart treatment equipment according to claim 22, wherein said parasympathetic nerve stimulation is a stimulation for activating excitement of the parasympathetic nerve.

24. Heart treatment equipment according to claim 22, wherein said parasympathetic nerve is a vagus nerve.

25. Heart treatment equipment according to claim 20, wherein said nerve stimulation means is means for stimulating a sympathetic nerve.

26. Heart treatment equipment according to claim 25, wherein said sympathetic nerve stimulation is a stimulation having a level which does not increase heart rate or blood pressure.

27. Heart treatment equipment according to claim 25, wherein said sympathetic nerve stimulation is a stimulation for blocking transmission of the sympathetic nerve excitement.

28. Heart treatment equipment according to claim 25, wherein said sympathetic nerve is a ganglion stellatum.

29. Heart treatment equipment according to claim 20, wherein said anti-tachyarrhythmia treatment which said tachyarrhythmia termination means supplies includes at least one of anti-tachyarrhythmia pacing, cardioversion and defibrillation.

30. Heart treatment equipment according to claim 20 further comprising bradycardia detection means for detecting occurrence of bradycardia;

and bradycardia treatment means for generating a heart stimulation pulse in response to said bradycardia detection means.

31. Heart treatment equipment according to claim 20, wherein said nerve stimulation energy setting is carried out by adjusting a nerve stimulation signal parameter of said nerve stimulation.

32. Heart treatment equipment according to claim 31, wherein said nerve stimulation signal parameter is at least one of stimulation frequency, pulse width, a number of pulses, pulse current, pulse voltage, delay time, rest time and repetition times or a combination of a plurality of ones selected from these.

33. Heart treatment equipment according to claim 20, wherein said control means further includes second control means for operating said tachyarrhythmia prevention means in said first operation mode subsequently to the operation in said second operation mode.

34. Heart treatment equipment according to claim 33 further comprising timing means for clocking a predetermined time, wherein said second control means operates in response to said timing means.

35. Heart treatment equipment according to claim 34, wherein said timing means sets a clocking time in conformity with said anti-tachyarrhythmia treatment in response to the supply of said anti-tachyarrhythmia treatment of said tachyarrhythmia termination means.

36. Heart treatment equipment according to claim 33 further comprising heart rate measuring means for measuring heartbeats, wherein said second control means operates in response to said heart rate measuring means.

37. Heart treatment equipment according to claim 36, wherein said second control means operates in a case when the heart rate which said heart rate measuring means measured exceeds a predetermined threshold.

38. Heart treatment equipment according to claim 34 further comprising tachyarrhythmia termination confirmation means for confirming whether or not said tachyarrhythmia is terminated by said tachyarrhythmia termination means, wherein said timing means starts clocking of said predetermined time in response to said tachyarrhythmia termination confirmation means.

39. Heart treatment equipment according to claim 36 further comprising tachyarrhythmia termination confirmation means for confirming whether or not said tachyarrhythmia is terminated by said tachyarrhythmia termination means, wherein the operation of said second control means according to said heart rate measuring means is carried out in response to said tachyarrhythmia termination confirmation means.

21. Heart treatment equipment comprising:

tachyarrhythmia prevention means for preventing occurrence of tachyarrhythmia by a nerve stimulation;

tachyarrhythmia detection means for detecting said occurrence of tachyarrhythmia;

tachyarrhythmia confirmation means for confirming that said tachyarrhythmia continues in response to said tachyarrhythmia detection means;

tachyarrhythmia termination means supplying anti-tachyarrhythmia treatment for terminating said tachyarrhythmia in response to tachyarrhythmia confirmation means; and

control means for connecting said tachyarrhythmia prevention means and said tachyarrhythmia confirmation means,

wherein said nerve stimulation by said tachyarrhythmia prevention means operates at least in a first operation mode and a second operation mode, nerve stimulation energy of said second operation mode is set to be lower than nerve stimulation energy of said first operation mode and said control means includes first control means for operating said tachyarrhythmia prevention means in said second operation mode in response to said tachyarrhythmia confirmation means.

40. A heart treatment method comprising:

an activation step for observing heart activity and for activating a tachyarrhythmia prevention program which carries out a nerve stimulation if necessary;

a tachyarrhythmia observation step for observing said occurrence of tachyarrhythmia; and

a step for carrying out anti-tachyarrhythmia treatment for terminating said tachyarrhythmia according to said tachyarrhythmia detection by said tachyarrhythmia observation step and at the same time for deactivating said tachyarrhythmia prevention program.

42. Heart treatment method according to claim 40, wherein said nerve stimulation means is means for stimulating a parasympathetic nerve.

43. Heart treatment method according to claim 42, wherein said parasympathetic nerve stimulation is stimulation for activating excitement of the parasympathetic nerve.

44. Heart treatment method according to claim 42, wherein said parasympathetic nerve is a vagus nerve.

45. Heart treatment method according to claim 40, wherein said nerve stimulation means is means for stimulating a sympathetic nerve.

46. Heart treatment method according to claim 45, wherein said sympathetic nerve stimulation is a stimulation having a level which does not increase heart rate or blood pressure.

47. Heart treatment method according to claim 45, wherein said sympathetic nerve stimulation is a stimulation for blocking transmission of the sympathetic nerve excitement.

48. Heart treatment method according to claim 45, wherein said sympathetic nerve is a ganglion stellatum.

49. Heart treatment method according to claim 40, wherein said anti-tachyarrhythmia treatment includes at least one of anti-tachyarrhythmia pacing, cardioversion and defibrillation.

50. Heart treatment method according to claim 40 further comprising bradycardia detection step for detecting occurrence of bradycardia and for generating a heart stimulation pulse in response to the bradycardia detection.

51. Heart treatment method according to claim 40 further comprising a re-activation step for again activating said tachyarrhythmia prevention program deactivated by a step for deactivating the tachyarrhythmia prevention program.

52. Heart treatment method according to claim 51, wherein the re-activation of said tachyarrhythmia prevention program is carried out after a predetermined time elapsed after said tachyarrhythmia prevention program deactivated.

53. Heart treatment method according to claim 52, wherein said predetermined time is set to a time in conformity with said anti-tachyarrhythmia treatment.

54. Heart treatment method according to claim 51, wherein the re-activation of said tachyarrhythmia prevention program is carried out according to heartbeats measurement.

55. Heart treatment method according to claim 54, wherein the re-activation of said tachyarrhythmia prevention program is carried out in a case when the heart rate obtained by said measurement exceeds a predetermined threshold.

56. Heart treatment method according to claim 52, wherein said predetermined time clocking starts after said tachyarrhythmia was confirmed to be terminated by said anti-tachyarrhythmia treatment.

57. Heart treatment method according to claim 54, wherein said heartbeats measurement starts after said tachyarrhythmia was confirmed to be terminated by said anti-tachyarrhythmia treatment.

41. A heart treatment method comprising:

an activation step for observing heart activity and for activating a tachyarrhythmia prevention program which carries out a nerve stimulation if necessary;

a tachyarrhythmia observation step for observing said occurrence of tachyarrhythmia;

a tachyarrhythmia confirmation step for confirming that said tachyarrhythmia continues in response to said tachyarrhythmia detection by said tachyarrhythmia observation step; and

a step for carrying out anti-tachyarrhythmia treatment for terminating said tachyarrhythmia according to the confirmation of said tachyarrhythmia continuation and at the same time for deactivating said tachyarrhythmia prevention program.

58. A heart treatment method comprising:

an activation step for observing heart activity and for activating a tachyarrhythmia prevention program which carries out a nerve stimulation in a first operation mode if necessary;

a tachyarrhythmia observation step for observing said occurrence of tachyarrhythmia; and

a step for carrying out anti-tachyarrhythmia treatment for terminating said tachyarrhythmia according to said tachyarrhythmia detection by said tachyarrhythmia observation step and at the same time for changing said tachyarrhythmia prevention program so as to carry out a nerve stimulation in a second operation mode which has smaller nerve stimulation energy than nerve stimulation energy of the first operation mode.

60. Heart treatment method according to claim 58, wherein said nerve stimulation means is means for stimulating a parasympathetic nerve.

61. Heart treatment method according to claim 60, wherein said parasympathetic nerve stimulation is stimulation for activating excitement of the parasympathetic nerve.

62. Heart treatment method according to claim 60, wherein said parasympathetic nerve is a vagus nerve.

63. Heart treatment method according to claim 58, wherein said nerve stimulation means is means for stimulating a sympathetic nerve.

64. Heart treatment method according to claim 63, wherein said sympathetic nerve stimulation is a stimulation having a level which does not increase heart rate or blood pressure.

65. Heart treatment method according to claim 63, wherein said sympathetic nerve stimulation is a stimulation for blocking transmission of the sympathetic nerve excitement.

66. Heart treatment method according to claim 63, wherein said sympathetic nerve is a ganglion stellatum.

67. Heart treatment method according to claim 58, wherein said anti-tachyarrhythmia treatment includes at least one of anti-tachyarrhythmia pacing, cardioversion and defibrillation.

68. Heart treatment method according to claim 58 further comprising bradycardia detection step for detecting occurrence of bradycardia and for generating a heart stimulation pulse in response to the bradycardia detection.

69. Heart treatment method according to claim 58, wherein said nerve stimulation energy setting is carried out by adjusting a nerve stimulation signal parameter of said nerve stimulation.

70. Heart treatment method according to claim 69, wherein said nerve stimulation signal parameter is at least one of stimulation frequency, pulse width, a number of pulses, pulse current, pulse voltage, delay time, rest time and repetition times or a combination of a plurality of ones selected from these.

71. Heart treatment method according to claim 58 wherein said nerve stimulation operated in said second operation mode is changed-over to said first operation mode.

72. Heart treatment method according to claim 71, wherein the change-over to said first operation mode is carried out after operating in said second operation mode for a predetermined time.

73. Heart treatment method according to claim 72, wherein said predetermined time is set to a time in conformity with said anti-tachyarrhythmia treatment.

74. Heart treatment method according to claim 71, wherein the change-over to said first operation mode is carried out according to heartbeats measurement.

75. Heart treatment method according to claim 74, wherein the change-over to said first operation mode is carried out in a case when said measured heart rate exceeds a predetermined threshold.

76. Heart treatment method according to claim 72, wherein said predetermined time clocking starts after said tachyarrhythmia was confirmed to be terminated by said anti-tachyarrhythmia treatment.

77. Heart treatment method according to claim 74, wherein said heartbeat measurement starts after said tachyarrhythmia was confirmed to be terminated by said anti-tachyarrhythmia treatment.

59. A heart treatment method comprising:

an activation step for observing heart activity and for activating a tachyarrhythmia prevention program which carries out a nerve stimulation in a first operation mode if necessary;

a tachyarrhythmia observation step for observing said occurrence of tachyarrhythmia;

tachyarrhythmia confirmation step for confirming that said tachyarrhythmia continues in response to said tachyarrhythmia detection by said tachyarrhythmia observation step; and

a step for carrying out anti-tachyarrhythmia treatment for terminating said tachyarrhythmia according to the confirmation of said tachyarrhythmia continuation and at the same time for changing said tachyarrhythmia prevention program so as to carry out a nerve stimulation in a second operation mode which has smaller nerve stimulation energy than nerve stimulation energy of the first operation mode.