Heart analysis using pressure-controlled intermittent coronary sinus occlusion

• US 4,969,470 A
• Filed: 10/04/1989
• Issued: 11/13/1990
• Est. Priority Date: 02/27/1984
• Status: Expired due to Term

• Current Assignee: Werner Mohl
• Original Assignee: Boston Scientific Corporation
• Inventors: Mohl, Werner, Tolkoff, Marc J.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US07/416,968
• Time in Patent Office: 405 Days
• Field of Search: 128/668, 128/672, 128/673, 128/674, 128/675, 128/691, 128/692, 600/16-18
• US Class Current: 600/486
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 2025/0003 having an additional lumen transmitting fluid pressure to the outside for measurement
• CPC Class Codes: A61M 2025/102 driven by a solenoid-activated pump
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3355 Controlling downstream pump pressure
• CPC Class Codes: A61M 25/10184 Means for controlling or monitoring inflation or deflation
• CPC Class Codes: A61M 60/143 inside the coronary sinus, e.g. for pressure-controlled intermittent coronary sinus occlusion
• CPC Class Codes: A61M 60/295 Balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/497 for balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/515 Regulation using real-time patient data
• CPC Class Codes: A61M 60/523 using blood flow data, e.g. from blood flow transducers
• CPC Class Codes: A61M 60/531 using blood pressure data, e.g. from blood pressure sensors
• CPC Class Codes: A61M 60/554 of blood pressure
• CPC Class Codes: A61M 60/585 User interfaces

Abstract

The coronary sinus is intermittently occluded by use of means for occluding the sinus, a pressure transducer for sensing the fluid pressure within the sinus and providing corresponding fluid pressure signals, and a controller responsive to the transducer and arranged to provide trigger signals to the occluding means to trigger an occlusion and to interrupt the occlusion, the system being characterized in that the controller is arranged to estimate a plateau level of the fluid pressure during each occlusion and for providing a trigger signal to interrupt each occlusion on the basis of the estimate. The duration of the interruption before the next occlusion is controlled in response to the volume flow in the sinus during the interruption. Pharmacological agents are injected into the sinus during the occlusion, for retroperfusion to the heart tissue. An analysis of heart function is obtained by analyzing the local pressure maxima in successive heartbeats during occlusion. Initiation of the next occlusion is timed based on fluid pressure signals taken from the sinus during occlusion. The degree of tissue at risk of infarction (or the amount of infarcted tissue) is estimated based on the fluid pressure signals.

Claims

1. A method for analyzing heart function comprising,

intermittently occluding the coronary sinus for a period of time spanning a plurality of successive heart beats,

measuring the fluid pressure in said sinus,

determining successive local pressure maxima which occur respectively in said successive heart beats during said occlusion, and

employing the successive local pressure maxima for analysis of heart function.