System and process for monitoring myocardial integrity
First Claim
1. A process for the on-line monitoring of the viability of myocardial tissue of a patient during and after a surgical procedure comprising the steps of:
- implanting multiple electrodes in said tissue prior to said surgical procedure;
sensing the instantaneous unipolar electrical potentials of said electrodes prior to said surgical procedure;
registering the peak-to-peak voltage values of said instantaneous unipolar electrical potentials for a period of time occurring prior to said surgical procedure for each of said electrodes which have a negative slope exceeding a predetermined valueperforming said surgical procedure;
sensing the instantaneous unipolar electrical potentials which have a negative slope exceeding said predetermined value of each of said electrodes during and after said surgical procedure;
comparing said registered values for each of said electrodes with said sensed potentials during and after surgery for each of said electrodes; and
providing an output indication of injured tissue when said registered values exceed said sensed potentials during and after surgery by a predetermined amount for at least one of said electrodes.
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Accused Products
Abstract
A process and apparatus for providing an electrophysiologic indicator of reversible myocardial ischemic injury as well as a procedure and apparatus for providing a method of assessing the status of myocardial preservation during elective cardioplegic arrest in order to assure complete electromechanical arrest from the onset of the application of the standard cardioplegic techniques. The procedure for establishing an indication of reversible myocardial ischemic injury involves implanting multiple electrodes in the myocardial tissue and sensing the instantaneous unipolar electrical potentials of the electrodes and comparing those sensed potentials with a series of registered potentials for healthy tissue. The procedure and apparatus for assessing the status of myocardial preservation involves the use of the same implanted multiple electrodes which are placed in the ventricle and the apparatus provides for a sensing and documenting of ventricular electrical activity in the visually arrested heart at a time when a peripheral EKG would be quiescent in order to detect persistent activity originating in the lower atrial septum and conducted through the AV node to the ventricles at what was previously considered to be safe myocardial temperatures.
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Citations
10 Claims
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1. A process for the on-line monitoring of the viability of myocardial tissue of a patient during and after a surgical procedure comprising the steps of:
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implanting multiple electrodes in said tissue prior to said surgical procedure; sensing the instantaneous unipolar electrical potentials of said electrodes prior to said surgical procedure; registering the peak-to-peak voltage values of said instantaneous unipolar electrical potentials for a period of time occurring prior to said surgical procedure for each of said electrodes which have a negative slope exceeding a predetermined value performing said surgical procedure; sensing the instantaneous unipolar electrical potentials which have a negative slope exceeding said predetermined value of each of said electrodes during and after said surgical procedure; comparing said registered values for each of said electrodes with said sensed potentials during and after surgery for each of said electrodes; and providing an output indication of injured tissue when said registered values exceed said sensed potentials during and after surgery by a predetermined amount for at least one of said electrodes. - View Dependent Claims (2, 3)
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4. An apparatus for the on-line monitoring of and displaying of the viability of myocardial tissue comprising:
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a plurality of electrodes suitable for implantation in said myocardial tissue; means for sensing the instantaneous electrical potentials of each of said electrodes including a gain control means and a slope detector means wherein said sensing means outputs an amplitude measurement signal when the slope of said instantaneous sensed potential of said electrodes exceeds a predetermined negative value; means for storing the peak-to-peak amplitude of said signals output from said sensing means for each of said electrodes during a controlled period when said plurality of electrodes are implanted in said myocardial tissue and said myocardial tissue is determined to be healthy tissue; means for comparing the peak-to-peak amplitude of said signals output from said sensing means with said stored amplitudes wherein said comparator means outputs an indication signal indicating injured tissue when the output of said sensing means is less than a predetermined fraction of said stored values for at least one of said electrodes. - View Dependent Claims (5, 6, 7, 8, 9)
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10. A process for accessing the status of myocardial preservation during cardioplegic arrest in order to assure complete electromechanical arrest from the onset of the application of standard cardioplegic techniques, comprising the steps of:
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implanting multiple electrodes in the ventricle of the heart of a patient prior to the initiation of standard cardioplegic techniques; sensing and recording the output of said multiple electrodes prior to the application of standard cardioplegic techniques; applying standard cardioplegic techniques to said patient; sensing and recording the output of said multiple electrodes during the application of said cardioplegic techniques; and providing an output indication of the persistent ventricular activity when signals are sensed during the application of said cardioplegic techniques.
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Specification