Catheter, cardiac pacemaker and method of pacing
First Claim
1. An electrode system for a cardiac pacer comprising a catheter in the form of a single nondiverging filament for insertion into a heart through the vascular system and including in combination:
- first stimulating electrode means at the distal end of said catheter for positioning the apex of the right ventricle;
second sensing electrode means on said catheter and spaced from said stimulating electrode means for positioning adjacent the wall of the heart atrium and producing signals varying as a function of the cardiac P wave and including at least first and second electrodes mounted in the wall of said catheter equidistant from said distal end and insulated from each other and providing a bipolar signal to said cardiac pacer; and
electrical conductor means for connecting said sensing electrode means to a cardiac pacer providing said signals as input and for connecting the output of a pulse generating unit of the cardiac pacer to said stimulating electrode means.
1 Assignment
0 Petitions
Accused Products
Abstract
A cardiac pacemaker with a single catheter for insertion into a heart through the vascular system. An electrode system for the catheter including a stimulating electrode at the distal end of the catheter for positioning at the apex of the right ventricle, with the stimulating electrode connected to the pulse generating unit of the pacemaker, and sensing electrodes on the catheter spaced from the stimulating electrode for positioning adjacent to the wall of the right atrium for sensing signals generated by the atrial excitation or P-wave, with the P-wave signals connected as input to the pacemaker for determining the timing of the ventricular stimulating pulses.
The sensing electrodes are circumferentially equidistant from the stimulating electrode and provide one or more bipolar signals for the pulse generating unit.
In alternative configurations, the stimulating electrode and the sensing electrodes are positioned in various locations within the heart to provide other methods of cardiac control.
360 Citations
42 Claims
-
1. An electrode system for a cardiac pacer comprising a catheter in the form of a single nondiverging filament for insertion into a heart through the vascular system and including in combination:
-
first stimulating electrode means at the distal end of said catheter for positioning the apex of the right ventricle; second sensing electrode means on said catheter and spaced from said stimulating electrode means for positioning adjacent the wall of the heart atrium and producing signals varying as a function of the cardiac P wave and including at least first and second electrodes mounted in the wall of said catheter equidistant from said distal end and insulated from each other and providing a bipolar signal to said cardiac pacer; and electrical conductor means for connecting said sensing electrode means to a cardiac pacer providing said signals as input and for connecting the output of a pulse generating unit of the cardiac pacer to said stimulating electrode means. - View Dependent Claims (2, 3, 4)
-
-
5. In a cardiac pacer the improvement including in combination:
-
a catheter in the form of a single nondiverging filament for insertion into a heart through the vascular system; first stimulating electrode means at the distal end of said catheter for positioning in the apex of a heart ventricle; second sensing electrode means on said catheter and spaced from said stimulating electrode means for positioning adjacent the wall of the heart atrium and producing signals varying as a function of the cardiac P wave and including at least first and second electrodes mounted in the wall of said catheter equidistant from said distal end and circumferentially positioned around the catheter and insulated from each other and providing a bipolar signal; means for generating a stimulating pulse in response to an input signal; means for connecting said stimulating pulse to said first stimulating electrode means; and means for connecting said bipolar signal as an input signal to said generating means. - View Dependent Claims (6)
-
-
7. In a cardiac pacer having means for receiving a P wave signal as an input and providing a stimulating pulse for a stimulating electrode as an output, the improvement including in combination:
-
a single catheter in the form of a single nondiverging filament for insertion into a heart through the vascular system; first stimulating electrode means at the distal end of said catheter for positioning in the apex of a heart ventricle; second sensing electrode means on said catheter and spaced from said stimulating electrode means for positioning adjacent the wall of the heart atrium and producing signals varying as a function of the cardiac P wave and including first and second pairs of electrodes mounted in the wall of said catheter equidistant from said distal end and circumferentially positioned about said catheter with the electrodes of said first pair forming a first set and with the electrodes of said second pair forming a second set, with the first and second sets sensing orthogonal components of the cardiac P wave and providing bipolar signals; and circuit means having said bipolar signals as inputs for providing a P wave signal as an output varying as a function of the combination of said bipolar signals. - View Dependent Claims (8, 9)
-
-
10. A process for stimulating the heart action as a function of body requirements, including the steps of:
-
sensing a cardiac P wave at a pair of electrodes closely adjacent each other in a catheter in the form of a single nondiverging filament, with the electrodes located adjacent the atrium wall equidistant and spaced from a stimulation electrode and producing a bipolar electrical signal varying as a function of the sensed P wave; generating electrical pulses and varying the pulse rate as a function of said electrical signal; and introducing said pulses into the ventricle of the heart by the stimulation electrode. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
-
-
19. An electrode system for a cardiac pacer comprising a catheter in the form of a single nondiverging filament for inserting into a heart through the vascular system and including in combination;
-
first stimulating electrode means adjacent the distal end of said catheter for positioning within the heart; second sensing electrode means on said catheter and spaced from said distal end for positioning within and adjacent the wall of the heart and producing signals varying as a function of cardiac electrical output and including at least first and second electrodes mounted in the wall of said catheter equidistant from said distal end and insulated from each other and providing a bipolar signal to said cardiac pacer; and electrical conductor means for connecting said sensing electrode means to a cardiac pacer providing said signals as input and for connecting the output of a pulse generating unit of the cardiac pacer to said stimulating electrode means. - View Dependent Claims (20, 21, 22)
-
-
23. In a cardiac pacer the improvement including in combination:
-
a catheter in the form of a single nondiverging filament for inserting into a heart through the vascular system; first stimulating electrode means adjacent the distal end of said catheter for positioning within the heart; second sensing electrode means on said catheter and spaced from said distal end for positioning within and adjacent the wall of the heart and producing signals varying as a function of cardiac electrical output, and including first and second pairs of electrodes mounted in the wall of said catheter equidistant from said distal end, with the electrodes of said first pair forming a first set and with the electrodes of said second pair forming a second set, with the first and second sets sensing orthogonal components of cardiac electrical output and providing two bipolar signals; and circuit means having said bipolar signals as inputs for providing a heart function signal as an output varying as a function of the combination of said bipolar signals. - View Dependent Claims (24, 25)
-
-
26. A process for stimulating the heart action as a function of body requirements, including the steps of:
-
sensing a cardiac electrical output at a pair of electrodes closely adjacent each other in a catheter in the form of a single nondiverging filament, with the electrodes located within and adjacent the wall of the heart and equidistant and spaced from a stimulation electrode in the catheter and producing a bipolar electrical signal varying as a function of the sensed heart electrical output; generating electrical pulses and varying the pulse rate as a function of said electrical signal; and introducing said pulses into the heart by the stimulation electrode. - View Dependent Claims (27, 28, 29)
-
-
30. A process for stimulating the heart action as a function of body requirements, including the steps of:
-
at predetermined time intervals sensing a cardiac QRS complex at a pair of electrodes closely adjacent each other in a catheter in the form of a single nondiverging filament, with the electrodes located in the heart adjacent the ventricle wall and equidistant and spaced from a stimulation electrode and producing a bipolar electrical signal indicating occurrence of the sensed QRS complex; in the absence of the electrical signal at the predetermined time intervals generating an electrical pulse; and introducing said pulse into the ventricle of the heart by the stimulation electrode. - View Dependent Claims (31, 32, 33, 34)
-
-
35. A process for stimulating the heart action as a function of body requirements, including the steps of:
-
sensing a cardiac P wave at a pair of electrodes closely adjacent each other in a catheter in the form of a single nondiverging filament, with the electrodes located in the high lateral right atrium equidistant and spaced from a stimulation electrode in the catheter and producing a bipolar electrical signal indicating occurrence of the sensed P wave; generating electrical pulses; inhibiting an electrical pulse when a P wave has been sensed; introducing said pulses into the right atrial appendage of the heart by the stimulation electrode. - View Dependent Claims (36, 37, 38)
-
-
39. A process for stimulating the heart action as a function of body requirements, including the steps of:
-
sensing a cardiac P wave at a pair of electrodes closely adjacent each other in a catheter in the form of a single nondiverging filament, with the electrodes located in the high lateral right atrium equidistant and spaced from a stimulation electrode in the catheter and producing a bipolar electrical signal indicating an occurrence of the sensed P wave; generating electrical pulses; inhibiting an electrical pulse when a P wave has been sensed; and introducing said pulses into the heart at the coronary sinus by the stimulation electrode. - View Dependent Claims (40, 41, 42)
-
Specification