PHYSIOLOGICALLY RESPONSIVE VAD

• US 20110178361A1
• Filed: 01/18/2011
• Published: 07/21/2011
• Est. Priority Date: 01/19/2010
• Status: Active Grant

• Current Assignee: Heartware,Inc. (Medtronic Plc)
• Original Assignee: Heartware,Inc. (Medtronic Plc)
• Inventors: Yomtov, Barry
• Granted Patent: US 8,864,644 B2
• Time in Patent Office: Days
• US Class Current: 600/16
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3515 using magnetic means
• CPC Class Codes: A61M 2205/3538 using electrical conduction through the body of the patient
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/8243 by induction
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/178 drawing blood from a ventricle and returning the blood to the arterial system via a cannula external to the ventricle, e.g. left or right ventricular assist devices
• CPC Class Codes: A61M 60/216 including a rotating member acting on the blood, e.g. impeller
• CPC Class Codes: A61M 60/414 transmitted by a rotating cable, e.g. for blood pumps mounted on a catheter
• CPC Class Codes: A61M 60/422 the force acting on the blood contacting member being electromagnetic, e.g. using canned motor pumps
• CPC Class Codes: A61M 60/515 Regulation using real-time patient data
• CPC Class Codes: A61M 60/569 synchronous with the native heart beat
• CPC Class Codes: A61M 60/876 Implantable batteries
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy

Abstract

A ventricular assist device incorporating a rotary pump such as a rotary impeller pump implantable in fluid communication with a ventricle and an artery to assist blood flow from the ventricle to the artery. The device includes a pump drive circuit supplying power to the pump, one or more sensors for sensing one or more electrophysiological signals such as electrogram signals in and a signal processing circuit connected to the sensors and to the pump drive circuit. The signal processing circuit is operative to detect the sensor signals and control power supplied to the pump from the pump drive circuit so that the pump runs in a pulsatile mode, with a varying speed synchronized with the cardiac cycle. When an arrhythmia is detected, the pump drive circuit may also run the pump in an atrial arrhythmia mode or a ventricular arrhythmia mode different from the normal pulsatile mode.

Claims

1. A ventricular assist device comprising:

a rotary pump implantable in fluid communication with a ventricle and an artery of a subject to assist blood flow from the ventricle to the artery;

a pump drive circuit;

one or more sensors for sensing one or more electrophysiological signals in a patient and providing sensor signals representing the electrophysiological signals;

a signal processing circuit in communication with the sensors and the pump drive circuit, the signal processing circuit being operative to detect the sensor signals, and control power supplied to the pump from the pump drive circuit so that the pump runs in a normal pulsatile mode with a varying speed synchronized with the cardiac cycle of the subject.

2. A ventricular assist device as claimed in claim 1 wherein the pump is a rotary impeller pump.

3. A ventricular assist device as claimed in claim 1, wherein the signal processing circuit is operative to adjust the varying speed responsive to a condition of the subject.

4. A ventricular assist device as claimed in claim 3, wherein the signal processing circuit adjusts the varying speed in accordance with electrophysiological signals received by the circuit from the sensors.

5. A ventricular assist device as claimed in claim 1, in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the P-wave of the subject'"'"'s cardiac cycle.

6. A ventricular assist device as claimed in claim 1, in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the R-wave of the subject'"'"'s cardiac cycle.

7. A ventricular assist device as claimed in claim 1, wherein the device further comprises a pacemaker operative to synchronize the left ventricle and right ventricle of a patient'"'"'s heart.

8. A ventricular assist device as claimed in claim 7, wherein the pacemaker is further operative to synchronize the left ventricle, right ventricle and the fixed phase relationship of the pump with the portion of the cardiac cycle.

9. A ventricular assist device as claimed in claim 1, wherein the electrophysiological signals include LV and RV waveforms.

10. A ventricular assist device as claimed in claim 1, wherein the LV and RV waveforms include at least one bipolar signal.

11. A ventricular assist device as claimed in claim 1 wherein the signal processing circuit is operative to determine the presence or absence of an arrhythmia based on the sensor signals and to control power supplied to the pump from the pump drive circuit so as to operate the pump in the normal pulsatile mode in the absence of an arrhythmia and to operate the pump in at least one modified mode of operation in the presence of an arrhythmia.

12. The ventricular assist device of claim 11, wherein the circuit is operable to detect an atrial arrhythmia and the at least one modified mode of operation includes at least one atrial arrhythmia mode different from the normal pulsatile mode.

13. The ventricular assist device of claim 12 wherein the at least one atrial arrhythmia mode includes a non-pulsatile mode wherein the pump runs in a non-pulsatile manner.

14. The ventricular assist device of claim 12 wherein the at least one atrial arrhythmia mode includes an atrial arrhythmia pulsatile mode different from the normal pulsatile mode.

15. The ventricular assist device of claim 11, wherein the circuit is operable to detect a ventricular arrhythmia and the at least one modified mode of operation includes at least ventricular arrhythmia mode different from the normal pulsatile mode.

16. A ventricular assist device as claimed in claim 15 wherein the at least one ventricular arrhythmia mode includes a non-pulsatile mode wherein the pump runs in a non-pulsatile manner.

17. A ventricular assist device as claimed in claim 15 wherein the at least one ventricular arrhythmia mode includes a pulsatile mode wherein the pump runs in a pulsatile manner unsynchronized with the cardiac cycle of the subject.

18. A ventricular assist device as claimed in claim 11 wherein the at least one modified mode includes a non-pulsatile mode and wherein the signal processing circuit is operative to control power supplied to the pump so as to vary the speed of the pump in the non-pulsatile mode based on a condition of the subject.

19. A ventricular assist device as claimed in claim 6 wherein the substantially fixed phase relationship of the varying speed with the R-wave of the subjects cardiac cycle depends on a moving average cycle time over a number of cardiac cycles.