Control of a defibrillator and/or pacemaker

• US 20080058884A1
• Filed: 08/28/2007
• Published: 03/06/2008
• Est. Priority Date: 08/29/2006
• Status: Active Grant

• Current Assignee: Jeffrey Matos
• Original Assignee: Jeffrey Matos
• Inventors: Matos, Jeffrey
• Granted Patent: US 8,214,043 B2
• Time in Patent Office: Days
• US Class Current: 607/30
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/3904 External heart defibrillators [EHD]
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A cardiac monitoring and treatment apparatus allows a victim of a medical emergency access to a medical professional (MP) who can monitor, diagnose and treat the victim from a remote site. The apparatus includes a cardiac monitoring and treatment device (CMTD) coupled to an electronic adaptor designed to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the MP. The CMPD comprises a cardiac treatment circuit for effecting cardiac pacing and/or defibrillation and a cardiac signal circuit for receiving cardiac signals. The cardiac signals are (1) transmitted from the signal circuit to the second T/R device for evaluation by the MP, (2) the MP may transmit a control signal to the treatment circuit, and (3), in response thereto, the treatment circuit may generate one or more electrical pulses for treatment of the victim.

Claims

1. A cardiac monitoring and treatment apparatus which allows a victim of a medical emergency immediate access to a medical professional who can remotely monitor, diagnose and treat the victim from a remote site, said apparatus comprising, in combination:

(a) an electronic adaptor device adapted to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by said medical professional, said adaptor device including;

(1) at least one T/R input port for receiving electronic signals from said first T/R device; and

(2) at least one T/R output port for transmitting electronic signals to said first T/R device; and

(3) a first data translation device connected to said input port; and

(4) a second data translation device connected to said output port; and

(b) a cardiac monitoring and treatment device comprising;

(1) a cardiac treatment circuit for effecting at least one of cardiac pacing and defibrillation, said treatment circuit having a control input coupled to said first data translation device for receiving at least one remote control signal from said second T/R device and a treatment output adapted to be connected to at least one cardiac treatment electrode; and

(2) a cardiac signal circuit for receiving and amplifying electrical cardiac signals from the victim, said cardiac signal circuit comprising;

(i) a cardiac sensing electrode input adapted to be connected to at least one cardiac sensing electrode; and

(ii) a cardiac signal circuit output coupled to said second data translation device;

whereby

(1) said cardiac signals are transmitted from said cardiac signal circuit to said second T/R device for evaluation by said medical professional, (2) said at least one control signal may be transmitted from said second T/R device to said control input of said cardiac treatment circuit, and (3) in response thereto, said cardiac treatment circuit may generate one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said victim.

2. The apparatus defined in claim 1, wherein said communication between said interface unit and said first T/R device is effected by communication means selected from the group consisting of:

(i) a hard-wired, electrical signal connection,

(ii) radiofrequency signal transmission,

(iii) infrared signal transmission,

(iv) Bluetooth signal transmission,

(v) a Wi-Fi signal connection, and

(vi) an Internet connection.

3. The apparatus defined in claim 1, wherein:

said coupling (b)(1) between said control input and said first data translation device, and said coupling (b)(2) between said cardiac signal circuit output and said second data translation device is effected by communication means selected from the group consisting of;

(i) a hard-wired electrical signal connection,

(ii) radiofrequency signal transmission,

(iii) infrared signal transmission,

(iv) Bluetooth signal transmission,

(v) a Wi-Fi signal transmission, and

(vi) an Internet connection.

4. The apparatus defined in claim 1, further comprising said first T/R device and a communication housing, said housing containing said adapter device and said first T/R device.

5. The apparatus defined in claim 1, further comprising a cardiac monitoring and treatment device housing, said housing containing said adapter device and said cardiac monitoring and treatment device.

6. The apparatus defined in claim 1, wherein at least one of said first and second data translation device consists of circuitry with functionality consisting of at least one of:

(i) signal encoding,

(ii) signal decoding, and

(iii) signal conditioning.

7. The apparatus defined in claim 1, wherein said cardiac monitoring and treatment device further comprises a display device, coupled to said cardiac signal circuit output, for displaying said cardiac signals to a local medical professional, and at least one of (i) a local pacing control device and (ii) a local defibrillation control device, coupled to said cardiac treatment circuit control input, for generating one or more local control signals for application to said control input.

whereby

(a) in a first operating mode, (1) said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said second T/R device for evaluation by said remote medical professional, (2) said at least one remote control signal may be transmitted from said second T/R device to said control input of said cardiac treatment circuit, (3) in response thereto, said cardiac treatment circuit may generate one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said victim;

and

(b) in a second operating mode, (1) said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said display device, for analysis by said local medical professional;

(2) said cardiac treatment circuit is responsive to said at least one local control signal generated by said at least one local control device; and

(3) in response thereto, said cardiac treatment circuit may generate one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said victim;

thereby allowing said local medical professional to control said cardiac monitoring and treatment device.

8. The apparatus defined in claim 7, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for generating a local control signal that prevents said at least one remote control signal from controlling said cardiac treatment circuit.

9. The apparatus defined in claim 7, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for receiving a remote control signal that prevents said one or more local control signals from controlling said cardiac treatment circuit.

10. The apparatus defined in claim 1, further comprising a logic device coupled to said cardiac signal circuit output and to said cardiac treatment circuit, for automatically generating at least one local control signal, in response to the receipt of electrical cardiac signals, for automatic local control of said cardiac treatment circuit;

whereby

(a) in a first operating mode, (1) said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said second T/R device for evaluation by said remote medical professional, (2) said at least one remote control signal may be transmitted from said second T/R device to said control input of said cardiac treatment circuit, (3) in response thereto, said cardiac treatment circuit may generate one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said victim; and

(b) in a second operating mode, (1) said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said logic device for evaluation by said logic device;

(2) said cardiac treatment circuit is responsive to said at least one local control signal generated by said logic device; and

(3) in response thereto, said cardiac treatment circuit may generate one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said victim;

thereby allowing said logic device to control said cardiac monitoring and treatment device.

11. The apparatus defined in claim 10, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for generating a local control signal that prevents said at least one remote control signal from controlling said cardiac treatment circuit.

12. The apparatus defined in claim 10, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for receiving a remote control signal that prevents said one or more local control signals from controlling said cardiac treatment circuit.

13. The apparatus defined in claim 7, wherein said at least one local control device and said cardiac treatment circuit are operative to control at least one of:

(α

) pacing pulse rate;

(β

) pacing pulse voltage;

(γ

) pacing pulse current;

(δ

) pacing pulse width;

(ε

) pacing pulse shape;

(ζ

) pacing mode;

(η

) pacing sensitivity;

(θ

) defibrillation pulse energy;

(τ

) defibrillation pulse synchronization;

(κ

) defibrillation pulse voltage;

(λ

) defibrillation pulse width; and

(μ

) defibrillation pulse shape.

14. The apparatus defined in claim 1, wherein said cardiac treatment circuit is operative, in response to said at least one remote control signal, to control at least one of:

(α

) pacing pulse rate;

(β

) pacing pulse voltage;

(γ

) pacing pulse current;

(δ

) pacing pulse width;

(ε

) pacing pulse shape;

(ζ

) pacing mode;

(η

) pacing sensitivity;

(θ

) defibrillation pulse energy;

(τ

) defibrillation pulse synchronization;

(κ

) defibrillation pulse voltage;

(λ

) defibrillation pulse width; and

(μ

) defibrillation pulse shape.

15. The apparatus defined in claim 10, wherein said logic device and said cardiac treatment circuit are operative to control at least one of:

(α

) pacing pulse rate;

(β

) pacing pulse voltage;

(γ

) pacing pulse current;

(δ

) pacing pulse width;

(ε

) pacing pulse shape;

(ζ

) pacing mode;

(η

) pacing sensitivity;

(θ

) defibrillation pulse energy;

(τ

) defibrillation pulse synchronization;

(κ

) defibrillation pulse voltage;

(λ

) defibrillation pulse width; and

(μ

) defibrillation pulse shape.

16. The apparatus defined in claim 7, wherein said cardiac monitoring and treatment device further comprises communication confirmation means for determining whether communication between said second T/R device and said cardiac monitoring and treatment device is proper, and wherein, in the absence of proper communication between said second T/R device and said cardiac monitoring and treatment device, said communication confirmation means switches said cardiac treatment circuit to said second operating mode.

17. The apparatus defined in claim 16, further comprising:

(c) said second T/R device, said second T/R device including means for generating a test signal, and wherein said communication confirmation means comprises means for detecting said test signal, thereby to confirm that communication is proper.

18. The apparatus defined in claim 16, wherein said communication confirmation means is further coupled to said display device and causes said display device to display a message in the absence of proper communication.

19. The apparatus defined in claim 17, wherein said cardiac monitoring and treatment device includes means for generating a handshake signal in response to the receipt of said test signal and transmitting said handshake signal to said second T/R device.

20. The apparatus defined in claim 19, wherein said second T/R device includes means for indicating the absence of proper communication with said cardiac monitoring and treatment device.

21. The apparatus defined in claim 19, wherein said means for generating said test signal is responsive to the receipt of said handshake signal to generate at least one additional test signal, whereby the presence of said proper communication

(i) is determined at said cardiac monitoring and treatment device by the ongoing receipt of said test signals;

and

(ii) is determined at said second T/R device by the ongoing receipt of said handshake signals.

22. The apparatus defined in claim 10, wherein said cardiac monitoring and treatment device further comprises communication confirmation means for determining whether communication between said second T/R device and said cardiac monitoring and treatment device is proper, and wherein, in the absence of proper communication between said second T/R device and said cardiac monitoring and treatment device, said communication confirmation means switches said cardiac treatment circuit to said second operating mode.

23. The apparatus defined in claim 22, further comprising:

(c) said second T/R device, said second T/R device including means for generating a test signal, and wherein said communication confirmation means comprises means for detecting said test signal, thereby to confirm that communication is proper.

24. The apparatus defined in claim 22, wherein said communication confirmation means further comprises means for indicating the absence of proper communication with said second T/R device, said indicating means comprising at least one of:

(i) a visual display; and

(ii) sound generating means for producing at least one audible indication;

wherein, in the absence of proper communication, said indicating means is operative to indicate said absence.

25. The apparatus defined in claim 23, wherein said cardiac monitoring and treatment device includes means for generating a handshake signal in response to the receipt of said test signal and transmitting said handshake signal to said second T/R device.

26. The apparatus defined in claim 25, wherein said second T/R device includes means for indicating the absence of proper communication with said cardiac monitoring and treatment device.

27. The apparatus defined in claim 25, wherein said means for generating said test signal is responsive to the receipt of said handshake signal to generate at least one additional test signal, whereby the presence of said proper communication

(i) is determined at said cardiac monitoring and treatment device by the ongoing receipt of said test signals;

and

(ii) is determined at said second T/R device by the ongoing receipt of said handshake signals.

28. The apparatus defined in claim 7, wherein said adapter and said cardiac monitoring and treatment device are external to a body of said victim.

29. The apparatus defined in claim 28, further comprising said first T/R device;

and

wherein said communication between said adapter and said first T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

30. The apparatus defined in claim 29, further comprising said second T/R device;

and wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

31. The apparatus defined in claim 7, further comprising said first T/R device, disposed outside the body of the victim;

and

wherein said adapter and said cardiac monitoring and treatment device are inside a body of said victim, and wherein said display device, said local pacing control device and said local defibrillation control device are outside said body and wherein each of;

(i) said coupling between said display device and said cardiac signal circuit;

(ii) said coupling between said at least one local control device and said treatment circuit control input; and

(iii) said communication between said adapter and said first T/R device;

are by communication means selected from the group consisting of;

(a) radiofrequency signal transmission

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission.

32. The apparatus defined in claim 7, further comprising said first T/R device, disposed inside the body of the victim;

and

wherein said adapter and said cardiac monitoring and treatment device are inside a body of said victim, and wherein said display device, said local pacing control device and said local defibrillation control device are outside said body; and

wherein each of;

(i) said coupling between said display device and said cardiac signal circuit; and

(ii) said coupling between said at least one local control device and said treatment circuit control input;

are by communication means selected from the group consisting of;

(a) radiofrequency signal transmission

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission;

and wherein said communication between said adapter and said first T/R device are by communication means selected from the group consisting of;

(a) a wired connection; and

(b) a wireless connection.

33. The apparatus defined in claim 31, further comprising said second T/R device;

and wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

34. The apparatus defined in claim 32, further comprising said second T/R device;

and

wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(a) radiofrequency signal transmission

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission.

35. The apparatus defined in claim 7, wherein said cardiac monitoring and treatment device is inside a body of said victim, and wherein said adapter, said display device, said local pacing control device and said local defibrillation control device are outside said body and wherein each of:

(i) said coupling between said display device and said cardiac signal circuit;

(ii) said coupling between said at least one local control device and said treatment circuit control input; and

(iii) said communication between said cardiac monitoring and treatment device and said adapter;

are by communication means selected from the group consisting of;

(a) radiofrequency signal transmission

(b) a WiFi signal transmission;

(c) an wireless Internet connection;

(d) Bluetooth signal transmission.

36. The apparatus defined in claim 35, further comprising said first T/R device, disposed outside the body of the victim, wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of:

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

37. The apparatus defined in claim 36A, further comprising said second T/R device, wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of:

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

38. The apparatus defined in claim 10, wherein said adapter and said cardiac monitoring and treatment device are external to a body of said victim.

39. The apparatus defined in claim 38, further comprising said first T/R device;

and

wherein said communication between said adapter and said first T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

40. The apparatus defined in claim 39, further comprising said second T/R device;

and wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

41. The apparatus defined in claim 10, further comprising:

said first T/R device, disposed outside the body of the victim; and

wherein said adapter and said cardiac monitoring and treatment device and said logic device are implanted inside a body of said victim, and wherein said first T/R device is outside said body, and wherein said first T/R device and said adapter communicate by means selected from the group consisting of;

(a) radiofrequency signal transmission;

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission.

42. The apparatus defined in claim 10, further comprising:

said first T/R device, disposed inside the body of the victim; and

wherein said adapter and said cardiac monitoring and treatment device and said logic device are implanted inside a body of said victim, and wherein said first T/R device is outside said body, and wherein said first T/R device and said adapter communicate by means selected from the group consisting of;

(a) a wired connection; and

(b) a wireless connection.

43. The apparatus defined in claim 41, further comprising said second T/R device;

and

wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

44. The apparatus defined in claim 42, further comprising said second T/R device;

and

wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of;

(a) radiofrequency signal transmission

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission.

45. The apparatus defined in claim 10, wherein said cardiac monitoring and treatment device and said logic device are implanted inside a body of said victim, wherein said adapter is outside said body, and wherein said cardiac monitoring and treatment device and said adapter communicate by means selected from the group consisting of:

(a) radiofrequency signal transmission;

(b) a WiFi signal transmission;

(c) an wireless Internet connection; and

(d) Bluetooth signal transmission.

46. The apparatus defined in claim 45, further comprising said first T/R device, wherein said communication between said adapter and said first T/R device are by communication means selected from the group consisting of:

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

47. The apparatus defined in claim 46, further comprising said second T/R device, wherein said communication between said first T/R device and said second T/R device are by communication means selected from the group consisting of:

(1) a hard-wired, electrical signal connection,

(2) radiofrequency signal transmission,

(3) an Internet connection.

(4) a cellular telephone;

(5) a cordless telephone;

(6) a satellite telephone;

(7) a wired telephone connected to the public telephone network; and

(8) a digital wired telephone connected to the Internet.

48. The apparatus defined in claim 7, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one cardiac treatment electrode connected to said treatment output;

(ii) said at least one local control device is operative to control at least one of;

(a) pacing electrode selection; and

(b) defibrillation electrode selection; and

(iii) said cardiac treatment circuit is operative, in response to said at least one control signal, to control at least one of;

(a) pacing electrode selection; and

(b) defibrillation electrode selection.

49. The apparatus defined in claim 1, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one cardiac treatment electrode connected to said treatment output;

(ii) said cardiac treatment circuit is operative, in response to said at least one remote control signal, to control at least one of;

(a) pacing electrode selection; and

(b) defibrillation electrode selection.

50. The apparatus defined in claim 10, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one electrode connected to said treatment output;

(ii) said logic device is operative to generate local control signals for the control of at least one of;

(a) pacing electrode selection; and

(b) defibrillation electrode selection; and

(iii) said cardiac treatment circuit is operative, in response to said at least one control signal, to control at least one of;

(a) pacing electrode selection; and

(b) defibrillation electrode selection.

51. The apparatus defined in claim 7, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one cardiac sensing electrode connected to said cardiac sensing electrode input;

(ii) said at least one local control device is operative to control cardiac sensing electrode selection; and

(iii) said cardiac signal circuit is operative, in response to said at least one control signal, to control cardiac sensing electrode selection.

52. The apparatus defined in claim 1, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one cardiac sensing electrode connected to said cardiac sensing electrode input; and

(ii) said cardiac signal circuit is operative, in response to said at least one remote control signal, to control sensing electrode selection.

53. The apparatus defined in claim 10, wherein:

(i) said cardiac monitoring and treatment device further comprises at least one cardiac sensing electrode connected to said cardiac sensing electrode input;

(ii) said logic device is operative to generate local control signals for the control of cardiac sensing; and

(iii) said cardiac signal circuit is operative, in response to said at least one control signal, to control cardiac sensing electrode selection.

54. The apparatus defined in claim 1, further comprising:

(c) said second T/R device, said second T/R device including a transmitter/receiver system selected from the group consisting of;

(1) a cellular telephone;

(2) a cordless telephone;

(3) a satellite telephone;

(4) a wired telephone connected to the public telephone network;

(5) a digital wired telephone connected to the Internet; and

(6) a radiofrequency transmitter/receiver system.

55. The apparatus defined in claim 54, further comprising a computer coupled to said second T/R device, said computer comprising a processor, a display and a memory.

56. The apparatus defined in claim 55, wherein said coupling between said computer and said second T/R device is effected by communication means selected from the group consisting of:

(i) a hard-wired, electrical signal connection,

(ii) radiofrequency signal transmission,

(iii) infrared signal transmission,

(iv) Bluetooth signal transmission,

(v) a Wi-Fi signal connection, and

(vi) an Internet connection.

57. The apparatus defined in claim 1, wherein said data translation device has stored therein a unique identification number and wherein said first data translation device is responsive to electronic signals received from said input port for comparing an incoming identification number represented by said signals with said unique identification number and for preventing communication with said cardiac monitoring and treatment device if said unique and said incoming identification numbers are not the same.

58. The apparatus defined in claim 57, wherein said data translation device has stored therein a private password and wherein said data translation device is further responsive to electronic signals for comparing an incoming password represented by said signals with said private password and for preventing communication with said cardiac monitoring and treatment device if said private and incoming passwords are not the same.

59. The apparatus defined in claim 57, wherein said first data translation device is coupled to said second data translation device and is operative to produce information signals for transmission by said second data translation device to said output port, said information signals representing whether or not the unique identification number is the same as the incoming identification number.