METHOD AND SYSTEM FOR MONITORING VENTRICULAR FUNCTION OF A HEART

• US 20090024042A1
• Filed: 07/02/2008
• Published: 01/22/2009
• Est. Priority Date: 07/03/2007
• Status: Abandoned Application

• Current Assignee: Endotronix, Inc.
• Original Assignee: Endotronix, Inc.
• Inventors: Nunez, Anthony I., Rowland, Harry D.
• Application Number:
  US12/167,001
• Publication Number:
  US 20090024042A1
• Time in Patent Office: Days
• US Class Current: 600/486
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis

Abstract

A method for monitoring a right atrial pressure (RAP) and a left atrial pressure (LAP) for diagnosis of a heart condition includes positioning a transseptal device with respect to a pulmonary artery to monitor at least one flow characteristic of blood through the pulmonary artery. The transseptal device is configured to generate one or more signals representative of the at least one flow characteristic. A right ventricular end diastolic pressure (RVEDP) and a left ventricular end diastolic pressure (LVEDP) are detected to facilitate monitoring the heart condition.

Claims

1. A method for monitoring a right atrial pressure (RAP) and a left atrial pressure (LAP) for diagnosis of a heart condition, the method comprising:

positioning a transseptal device with respect to a pulmonary artery to monitor at least one flow characteristic of blood through the pulmonary artery, the transseptal device configured to generate one or more signals representative of the at least one flow characteristic; and

detecting a right ventricular end diastolic pressure (RVEDP) and a left ventricular end diastolic pressure (LVEDP) to facilitate monitoring the heart condition.

2. A method in accordance with claim 1 wherein positioning a transseptal device with respect to a pulmonary artery facilitates monitoring at least one of a pulmonary artery pressure, a measurement of a pulmonary artery systolic pressure, and pulmonary artery diastolic pressure.

3. A method in accordance with claim 1 wherein positioning a transseptal device with respect to a pulmonary artery to monitor at least one flow characteristic of blood through the pulmonary artery monitoring a pulmonary artery systolic pressure as a composite of a right ventricular systolic pressure and a resistance across a pulmonary vascular bed.

4. A method in accordance with claim 1 wherein the pulmonary artery diastolic pressure is representative of a left ventricular end diastolic pressure when a mitral valve is open.

5. A method in accordance with claim 1 further comprising determining whether a systolic pressure and a diastolic pressure are within a normal range and the RAP and the LAP are within a normal range.

6. A method in accordance with claim 5 further comprising querying a ‘

v’

wave analysis if the systolic pressure and the diastolic pressure are within a normal range and the RAP and the LAP are within a normal range.

7. A method in accordance with claim 5 further comprising considering tricuspid valve regurgitation if the ‘

v’

wave is determined to be greater than 15 mmHg.

8. A method in accordance with claim 5 wherein, if the RAP is within a normal range and the LAP is high, the method further comprising querying a ‘

c’

wave form and a ‘

v’

wave form and averaging a sum of a ‘

c’

wave and a ‘

v’

wave.

9. A method in accordance with claim 8 further comprising querying a severe mitral regurgitation if the sum value of the ‘

c’

wave and the ‘

v’

wave is greater than 15 mmHg.

10. A method in accordance with claim 5 further comprising determining whether the systolic pressure and the diastolic pressure is greater than or equal to a high normal, as calculated by averaging every 60^th systolic peak value and every 60^th diastolic trough value for 24 hours.

11. A method in accordance with claim 10 wherein, if the systolic pressure and the diastolic pressure is greater than or equal to a high normal, the method further comprising considering uncontrolled hypertension, drug effect, and exercise.

12. A method in accordance with claim 11 wherein, if and the RAP is low and the LAP is low, the method further comprising considering an increased peripheral vascular resistance and a drug effect.

13. A method in accordance with claim 11 wherein, if one of the RAP and the LAP is high, the method further comprising considering severe volume overload.

14. A method in accordance with claim 10 wherein, if the systolic pressure and the diastolic pressure is less than a high normal and the diastolic pressure is a low normal, the method further comprising considering severe aortic regurgitation, high peripheral vascular resistance and hypovolumia.

15. A method in accordance with claim 14 wherein, if the systolic pressure and diastolic pressure are less than or equal to a low normal, as calculated by an averaging of every 60^th systolic peak value and every 60^th diastolic trough value for 24 hours, the method further comprising considering severe anemia, hypovolumia, drug effect, severe infection, and chronic heart failure (CHF).

16. A method in accordance with claim 15 wherein, if CHF is considered and a value of the RAP is above 12, the method further comprising querying the LAP and, if a value of the LAP is above 15, considering severe CHF.

17. A method in accordance with claim 15 wherein, if CHF is considered and a value of the RAP is above 12, the method comprising obtaining the LVEDP instead of the LAP and determining whether the LVEDP value is greater than 15.

18. A method in accordance with claim 17 wherein, if the LVEDP value is greater than 15 but not greater than 25, the method further comprising considering moderate CHF and if the LVEDP value is greater than 25, then considering severe CHF.

19. A method in accordance with claim 10 wherein, if the systolic pressure and the diastolic pressure is less than a high normal, the method further comprising considering whether the RAP is low and at least one of the LAP and the LVEDF are high.

20. A method in accordance with claim 19 wherein, if the RAP is low and at least one of the LAP and the LVEDP is high, the method further comprising considering moderate to severe mitral regurgitation with one of low volume and anemia.

21. A method in accordance with claim 19 wherein, if the RAP is low and at least one of the LAP and the LVEDP is low, the method further comprising considering hypovolumia and severe anemia.

22. A method in accordance with claim 1 further comprising averaging the one or more signals generated by the transseptal device and representative of the at least one flow characteristic across a time cycle, wherein a rate of rise of a value is representative of a change in pressure divided by a change in time value that reflects a change in a function of the heart.

23. A method in accordance with claim 22 wherein, if a rate of rise for at least one of the RAP and the LAP is greater than 5 mmHg in a 24 hour cycle, the method further comprising considering an early CHF.

24. A method in accordance with claim 22 wherein, if a rate of rise for at least one of the RAP and the LAP is greater than 10 mmHg in a 7 day cycle, the method further comprising considering an early CHF.

25. A method in accordance with claim 22 wherein, if a rate of rise for at least one of the RAP and the LAP is greater than 15 mmHg in a 30 day cycle, the method further comprising considering an early CHF.

26. A method in accordance with claim 22 further comprising inferring an atrial rate

27. A system for diagnosing a heart condition, the system comprising:

a transseptal device positioned with respect to a pulmonary artery to monitor at least one flow characteristic of blood through the pulmonary artery, the transseptal device configured to generate at least one signal representative of the at least one flow characteristic to facilitate monitoring a right atrial pressure (RAP) and a left atrial pressure (LAP); and

an external reader operatively coupled to the transseptal device, the external reader configured to;

receive the at least one generated signal from the transseptal device representative of the at least one flow characteristic;

process the at least one received signals; and

generate an appropriate output representative of the at least one flow characteristic of blood through the pulmonary artery.

28. A system in accordance with claim 27 wherein the transseptal device comprises at least one sensor configured to sense one of at least one of a physical, chemical and physiological parameter within a respective heart chamber to facilitate obtaining data for at least one of cardiac blood pressure analysis, temperature analysis, blood chemical analysis, blood osmolar analysis, and cellular count analysis.

29. A system in accordance with claim 28 wherein the transseptal device is configured to transmit measurement data wirelessly to the external reader.

30. A system in accordance with claim 28 wherein the external reader comprises an RF filter operatively coupled to a plurality of sensors.

31. A system in accordance with claim 27 wherein the external reader comprises a processor, a memory, a plurality of input channels, and a plurality of output channels and a computer.

32. A system in accordance with claim 27 wherein the external reader receives data from a user, and is further configured to run an algorithm to facilitate diagnosing a heart condition and display data.