Hemodynamically responsive system for and method of treating a malfunctioning heart
First Claim
1. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy, electrode means for electrically coupling the storage means to the heart, determining means for determining at least one hemodynamic parameter, means for providing a first signal representative of baseline level for the parameter, means responsive to output from the determining means for developing a second signal representing current level of the parameter over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon change in the current level of the parameter of at least a predetermined amount from the representative baseline level for the parameter.
1 Assignment
0 Petitions
Accused Products
Abstract
A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient'"'"'s circulatory system being sensed. A signal is developed representative of short term mean arterial pressure (MAP), mean right atrial pressure (MRAP), mean right ventricle pressure (MRVP), mean left atrial pressure (MLAP), mean left ventricle pressure (MLVP), mean central venous pressure (MCVP), mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP), mean pulmonary capillary wedge pressure (MPCWP), right ventricular systolic pressure (RVSP), right ventricular end diastolic pressure (RVEDP), or right ventricular pulse presure (RVPP). A signal representative of fixed or varying baseline pressure is provided and if the short term current pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying baseline pressure and current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/-defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.
114 Citations
48 Claims
- 1. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy, electrode means for electrically coupling the storage means to the heart, determining means for determining at least one hemodynamic parameter, means for providing a first signal representative of baseline level for the parameter, means responsive to output from the determining means for developing a second signal representing current level of the parameter over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon change in the current level of the parameter of at least a predetermined amount from the representative baseline level for the parameter.
- 24. A method of treating a malfunctioning heart comprising providing a representation of baseline for a hemodynamic parameter, determining current level of the parameter over a period of given duration, and delivering cardioverting/defibrillating electrical energy to the heart in response to change of at least a predetermined magnitude in the current parameter from the baseline for the parameter.
- 43. In a system for treating a malfunctioning heart of the type which includes means using electrical energy, determining means for determining at least one hemodynamic parameter, means for providing a first signal representative of baseline level for the parameter, means responsive to output from the determining means for developing a second signal representing current level of the parameter over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for providing malfunction-correcting electrical energy to the heart upon change in the current level of the parameter of at least a predetermined amount from the representative baseline level for the parameter.
- 46. In a system for treating a malfunctioning heart undergoing tachycardia/fibrillation, the system being of the type which includes means using electrical energy, determining means for determining at least one hemodynamic parameter, means for providing a first signal representative of baseline level for the at least one parameter, means responsive to output from the determining means for developing a second signal representing current level of the at least one parameter over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for providing malfunction-correcting electrical energy to the heart undergoing tachycardia/fibrillation upon change in the current level of the at least one parameter of at least a predetermined amount from the representative baseline level for the parameter in an effort to overcome the tachycardia/fibrillation.
Specification