Pacing Management During Cardiopulmonary Resuscitation

• US 20100211124A1
• Filed: 04/28/2010
• Published: 08/19/2010
• Est. Priority Date: 08/23/2005
• Status: Active Grant

• Current Assignee: Quan Ni, Yanting Dong
• Original Assignee: Quan Ni, Yanting Dong
• Inventors: Dong, Yanting, Ni, Quan
• Granted Patent: US 8,517,013 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• 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 implemented using an implantable cardioverter-defibrillator (ICD), comprising:

detecting a cardiac tachyarrhythmia of a patient using the ICD;

delivering a defibrillation therapy to treat the tachyarrhythmia using the ICD;

if the defibrillation therapy fails to terminate the tachyarrhythmia, temporarily disabling the ICD from delivering defibrillation therapy at least for a time during which cardiopulmonary resuscitation (CPR) is administered to the patient; and

enabling the ICD to deliver defibrillation therapy in response to termination of CPR.

2. The method of claim 1, comprising detecting CPR compressions by the ICD, and temporarily disabling the ICD from delivering defibrillation therapy in response to the detecting the CPR compressions.

3. The method of claim 1, comprising detecting CPR compressions by the ICD, wherein if the defibrillation therapy fails to terminate the cardiac arrhythmia and in response to the ICD detecting CPR compressions, temporarily disabling the ICD from delivering defibrillation therapy.

4. The method of claim 1, comprising delivering, using the ICD, pacing pulses to the patient'"'"'s heart at least during a time when defibrillation therapy is temporarily disabled.

5. The method of claim 1, comprising detecting CPR compressions by the ICD and delivering, using the ICD, pacing pulses to the patient'"'"'s heart in timed relation to the detected CPR compressions at least during a time when defibrillation therapy is temporarily disabled.

6. The method of claim 1, comprising detecting CPR compressions by the ICD, wherein enabling the ICD comprises enabling the ICD to deliver defibrillation therapy in response to the ICD detecting termination of CPR compressions.

7. The method of claim 1, comprising generating audible prompts for prompting for a series of CPR compressions.

8. The method of claim 1, comprising:

prompting for CPR compressions; and

delivering, using the ICD, pacing pulses to a heart chamber in coordination with the compression prompting.

9. The method of claim 1, comprising:

detecting the patient'"'"'s transthoracic impedance using the ICD; and

delivering, using the ICD, pacing pulses in coordination with changes in the detected transthoracic impedance.

10. A medical device, comprising:

an implantable cardioverter-defibrillator (ICD) comprising a compression detector configured to detect cardiopulmonary resuscitation (CPR) compressions; and

a controller of the ICD configured to detect a cardiac tachyarrhythmia of a patient and deliver defibrillation therapy to treat the tachyarrhythmia, the controller, in response to the defibrillation therapy failing to terminate the tachyarrhythmia, configured to temporarily disable the ICD from delivering defibrillation therapy at least for a time during which CPR is administered to the patient, the controller configured to enable the ICD to deliver defibrillation therapy in response to termination of CPR.

11. The device of claim 10, wherein the controller is configured to temporarily disable the ICD from delivering defibrillation therapy in response to the compression detector detecting the CPR compressions.

12. The device of claim 10, wherein the controller is configured to temporarily disable the ICD from delivering defibrillation therapy in response to the defibrillation therapy failing to terminate the tachyarrhythmia and the compression detector detecting the CPR compressions.

13. The device of claim 10, wherein the ICD comprises a pacemaker, the controller configured to coordinate delivery of pacing pulses to the patient'"'"'s heart by the pacemaker at least during a time when defibrillation therapy is temporarily disabled.

14. The device of claim 10, wherein the ICD comprises a pacemaker, the controller configured to coordinate delivery of pacing pulses to the patient'"'"'s heart by the pacemaker in timed relation to the detected CPR compressions at least during a time when defibrillation therapy is temporarily disabled.

15. The device of claim 10, wherein the controller is configured to enable the ICD to deliver defibrillation therapy in response to the compression detector detecting termination of CPR compressions.

16. The device of claim 10, wherein the ICD comprises an audio signal generator, and the controller is configured to cooperate with the audio signal generator to generate audible prompts for prompting for a series of CPR compressions.

17. The device of claim 10, wherein the ICD comprises an audio signal generator and a pacemaker, the controller configured to cooperate with the audio signal generator and the pacemaker to generate audible prompts for prompting for a series of CPR compressions and deliver a pacing pulse to a heart chamber in coordination with the compression prompting.

18. The device of claim 10, wherein the compression detector comprises a transthoracic impedance sensor and the ICD comprises a pacemaker, the controller configured to control delivery of pacing pulses in coordination with changes in a sensed transthoracic impedance signal produced by the impedance sensor indicative of CPR compressions.

19. The device of claim 10, wherein the compression detector comprises an accelerometer and the ICD comprises a pacemaker, the controller configured to control delivery of pacing pulses in coordination with changes in an accelerometer output signal produced by the accelerometer indicative of CPR compressions.

20. The device of claim 10, wherein the controller is configured to store data pertaining to coordination between electrical cardiac stimulation and CPR compression, and transfer the stored data to an external device.