Method and apparatus for treatment of cardiac tachyarrhythmias

• US 20070191890A1
• Filed: 07/26/2006
• Published: 08/16/2007
• Est. Priority Date: 11/19/2002
• Status: Active Grant

• Current Assignee: Massachusetts Institute of Technology
• Original Assignee: Massachusetts Institute of Technology
• Inventors: Cohen, Richard, Armoundas, Antonis
• Granted Patent: US 8,249,704 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy

Abstract

Method and apparatus for preventing heart rhythm disturbances by recording cardiac electrical activity, measuring beat-to-beat variability in the morphology of electrocardiographic waveforms, and using the measured beat-to-beat variability to control the delivery of electrical impulses to the heart during the absolute refractory period.

Claims

1. Method of preventing a heart rhythm disturbance comprising:

detecting cardiac electrical activity;

analyzing the cardiac electrical activity to measure beat-to-beat variability in the morphology of electrocardiographic waveforms; and

delivering electrical impulses during a time interval after the R-wave and prior to the end of repolarization.

2. The method of claim 1 wherein the beat-to-beat variability is repolarization alternans.

3. The method of claim 1 wherein the electrical impulses are delivered during absolute refractory period.

4. The method of claim 1 further comprising the step of using one or more threshold values in the analyzing step to determine when to initiate the delivering step.

5. The method of claim 1 further comprising the step of detecting and analyzing beat-to-beat variability in arterial blood pressure.

6. The method of claim 1 further comprising the step of detecting and analyzing beat-to-beat variability in instantaneous lung volume.

7. The method of claim 1, wherein the heart rhythm disturbance is a tachyarrhythmia.

8. The method of claim 1, wherein the heart rhythm disturbance is a bradyarrhythmia.

9. The method of claim 1, wherein the detecting step utilizes at least one passive electrode inside the body in the vicinity of the heart.

10. The method of claim 1, wherein the detecting step utilizes at least one passive electrode within the heart.

11. The method of claim 1 further comprising the use of an implanted device in the detecting, analyzing and/or delivering steps.

12. The method of claim 11, wherein the implanted device serves as a cardiac pacemaker or a cardiac cardioverter/defibrillator.

13. The method of claim 11, wherein the implanted device has means for generating electrical stimulating pulses of specified energies and applying the pulses to body tissue at specified times.

14. The method of claim 11, wherein the implanted device has means for generating electrical stimulating pulses of specified amplitudes and durations and applying the pulses to body tissue at specified times.

15. The apparatus of claim 1, wherein the delivered electrical impulses reduce repolarization alternans

16. The method of claim 1, wherein the electrical impulses are delivered during absolute refractory period on alternate beats

17. The method of claim 1, wherein the electrical impulses are delivered during absolute refractory period of each beat.

18. The method of claim 1, wherein the delivered electrical impulses alternate in polarity in successive beats.

19. System for preventing a heart rhythm disturbance comprising:

electrode means for detecting cardiac electrical activity;

means for analyzing the cardiac electrical activity to measure beat-to-beat variability in the morphology of electrocardiographic waveforms; and

means for delivering electrical impulses during a time interval after the R-wave and prior to the end of repolarization.

20. The system of claim 19, wherein the beat-to-beat variability is repolarization alternans.

21. The system of claim 19, wherein the electrical impulses are delivered during absolute refractory period.

22. The system of claim 19 further comprising using one or more threshold values in the means for analyzing to determine when to initiate delivery of electrical impulses.

23. The system of claim 19 further including means for detecting and analyzing beat-to-beat variability in arterial blood pressure.

24. The system of claim 19 further comprising means for detecting and analyzing beat-to-beat variability in instantaneous lung volume.

25. The system of claim 19, wherein the heart rhythm disturbance is a tachyarrhythmia.

26. The system of claim 19, wherein the heart rhythm disturbance is a bradyarrhythmia.

27. The system of claim 19, wherein the means for detecting utilizes at least one passive electrode, inside the body, in the vicinity of the heart.

28. The system of claim 19, wherein the means for detecting utilizes at least one passive electrode within the heart.

29. The system of claim 19 further comprising the use of an implanted device in the means for detecting, analyzing and/or delivering.

30. The system of claim 29, wherein the implanted device serves as a cardiac pacemaker, or a cardiac cardioverter/defibrillator.

31. The system of claim 29, wherein the implanted device includes means for generating electrical stimulating pulses of specified energies, and applying the pulses to body tissue at specified times.

32. The system of claim 29, wherein the implanted device has means for generating electrical and stimulating pulses of specified amplitudes and durations and applying the pulses to the body tissue at specified times.

33. The system of claim 19, wherein the delivered electrical impulses reduce repolarization alternans.

34. The system of claim 19, wherein the electrical impulses are delivered during absolute refractory period on alternate beats.

35. The system of claim 19, wherein the electrical impulses are delivered during absolute refractory period of each beat.

36. The system of claim 19, wherein the delivered electrical impulses alternate in polarity in successive beats.