Method of and system for monitoring and treating a malfunctioning heart

• US 5,014,698 A
• Filed: 10/02/1989
• Issued: 05/14/1991
• Est. Priority Date: 10/06/1987
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Leonard Bloom
• Inventors: Cohen, Todd J.
• Primary Examiner(s): Jaworski, Francis
• Assistant Examiner(s): MANUEL, GEORGE C
• Application Number:
  US07/416,024
• Time in Patent Office: 589 Days
• Field of Search: 128/419 D, 128/419 PG, 128/419 P, 128/696
• US Class Current: 607/4
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A system for treating the malfunctioning heart of a patient includes means which derive at least one electrical signal from the patient'"'"'s heart and means which derive at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit with a RAM and a ROM, receives and responds to the at least one electrical signal and to the at least one physiologic signal. Output means controlled by the central processing unit provides corrective measure(s) to the patient. A method of treating the malfunctioning heart of a patient, includes deriving at least one electrical signal from the patient'"'"'s heart, deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, processing the at least one electrical signal and the at least physiologic signal, and providing a corrective measure or measures to the patient whenever a malfunction is identified.

Claims

1. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit, and output means, including defibrillating means, controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, whereby malfunctions of the heart may be corrected.

2. The combination of claim 1, wherein the output means includes antiachycardia pacing means controlled by the central processing unit.

3. The combination of claim 1, wherein the output means includes antibradycardia pacing means controlled by the central processing unit.

4. The combination of claim 1, wherein the output means includes cardioverting means controlled by the central processing unit.

5. The combination of claim 1, wherein the output means includes drug delivery means controlled by the central processing unit.

6. The combination of claim 1, wherein the output means includes a heart-assist device controlled by the central processing unit.

7. The combination of claim 1, further including monitoring means and/or recording means coupled to the central processing unit for monitoring and/or recording input and output signals to and from the central processing unit.

8. The combination of claim 1, wherein the output means further includes drug delivery means, antiachycardia pacing means, antibradycardia pacing means and cardioverting means controlled by the central processing unit.

9. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying stable SVT.

10. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying unstable SVT.

11. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying stable VT.

12. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying unstable VT.

16. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying asystole.

17. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying stable bradycardia.

18. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying unstable bradycardia.

19. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying ischemia.

20. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying early infarction.

21. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying heart failure alone.

22. The combination of claim 1, including means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying stable SVT, unstable SVT, stable VT, unstable VT, stable atrial fibrillation, unstable atrial fibrillation, ventricular fibrillation, asystole, stable bradycardia, unstable bradycardia, ischemia, early infarction and heart failure alone.

13. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one electrical signal from the patient'"'"'s heart comprise means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying stable atrial fibrillation, whereby malfunctions of the heart may be connected.

14. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one electrical signal from the patient'"'"'s heart comprise means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying unstable atrial fibrillation, whereby malfunctions of the heart may be corrected.

15. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one electrical signal from the patient'"'"'s heart comprise means for monitoring heart rhythm to develop the at least one electrical signal, and means responsive to the at least one electrical signal and to the at least one physiologic signal for identifying ventricular fibrillation, whereby malfunctions of the heart may be corrected.

23. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one electrical signal from the patient'"'"'s heart, means for deriving, at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit, and output means, includes defibrillating means, controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from a plurality of heart-malfunction-corrective inputs, whereby malfunctions of the heart may be corrected.

24. The system according to claim 23, wherein said output means includes cardioverting means controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

25. The system according to claim 23, wherein said output means includes antitachycardia pacing means controlled by the central processing unit for providing at least one heart-malfunction-corrective antitachycardia pacing input to the patient.

26. The system according to claim 23, wherein said output means includes at least one heart-assist device controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

27. The system according to claim 23, wherein said output means includes antibradycardia pacing means controlled by the central processing input for providing a heart-malfunction-corrective pacing input to the patient.

28. The system according to claim 23, wherein said output means includes at least one drug delivery device controlled by the central processing unit for providing at least one heart-malfunction-corrective drug input to the patient.

29. In a system for treating the malfunctioning heart of a patient, the combination of means for monitoring heart rhythm to develop at least one electrical signal from the patient'"'"'s heart, means for deriving at, least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including stable atrial fibrillation, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit as a basis for identifying malfunctions of the heart including stable atrial fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including stable atrial fibrillation may be corrected.

30. The system according to claim 29, wherein said output means includes cardioverting means controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

31. The system according to claim 29, wherein said output means includes antiachycardia pacing means controlled by the central processing unit for providing at least one heart-malfunction-corrective antitachycardia pacing input to the patient.

32. The system according to claim 29, wherein said output means includes at least one heart-assist device controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

33. The system according to claim 29, wherein said output means includes antibradycardia pacing means controlled by the central processing unit for providing a heart-malfunction-corrective pacing input to the patient.

34. The system according to claim 29, wherein said output means includes at least one drug delivery device controlled by the central processing unit for providing at least one heart-malfunction-corrective drug input to the patient.

35. In a system for treating the malfunctioning heart of a patient, the combination of means for monitoring heart rhythm to develop at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including unstable atrial fibrillation, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit as a basis for identifying malfunctions of the heart including unstable atrial fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including unstable atrial fibrillation may be corrected.

36. The system according to claim 35, wherein said output means includes cardioverting means controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

37. The system according to claim 35, wherein said output means includes antitachycardia pacing means controlled by the central processing unit for providing at least one heart-malfunctioned-corrective antitachycardia pacing input to the patient.

38. The system according to claim 35, wherein said output means includes at least one heart-assist device controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

39. The system according to claim 35, wherein said output means includes antibradycardia pacing means controlled by the central processing unit for providing a heart-malfunction-corrective pacing input to the patient.

40. The system according to claim 35, wherein said output means includes at least one drug delivery device controlled by the central processing unit for providing at least one heart-malfunction-corrective drug input to the patient.

41. In a system for treating the malfunctioning heart of a patient, the combination of means for monitoring heart rhythm to develop at least one electrical signal from the patient'"'"'s heart, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including ventricular fibrillation, means for inputting the at least one electrical signal and the at least one physiologic signal to the central processing unit as a basis for identifying heart malfunctions including ventricular fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including ventricular fibrillation may be corrected.

42. The system according to claim 41, wherein said output means includes cardioverting means controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

43. The system according to claim 41, wherein said output means includes antitachycardia pacing means controlled by the central processing unit for providing at least one heart-malfunction-corrective antitachycardia pacing input to the patient.

44. The system according to claim 41, wherein said output means includes at least one heart-assist device controlled by the central processing unit for providing another heart-malfunction-corrective input to the patient.

45. The system according to claim 41, wherein said output means includes antibradycardia pacing means controlled by the central processing unit for providing a heart-malfunction-corrective pacing input to the patient.

46. The system according to claim 44, wherein said output means includes at least one drug delivery device controlled by the central processing unit for providing at least one heart-malfunction-corrective drug input to the patient.

47. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit, and output means, including defibrillating means, controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, whereby malfunctions of the heart may be corrected.

48. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one EKG signal from the patient comprise means for monitoring heart rhythm to develop the at least one EKG signal, and means responsive to the at least one EKG signal and to the at least one physiologic signal for identifying stable atrial fibrillation, whereby malfunctions of the heart may be corrected.

49. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one EKG signal from the patient comprise means for monitoring heart rhythm to develop the at least one EKG signal, and means responsive to the at least one EKG signal and to the at least one physiologic signal for identifying unstable atrial fibrillation, whereby malfunctions of the heart may be corrected.

50. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit for controlling delivery of selected heart-malfunction-corrective inputs to the patient, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit, output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from among a plurality of the heart-malfunction-corrective inputs, wherein said means for deriving at least one EKG signal from the patient comprise means for monitoring heart rhythm to develop the at least one EKG signal, and means responsive to the at least one EKG signal and to the at least one physiologic signal for identifying ventricular fibrillation, whereby malfunctions of the heart may be corrected.

51. In a system for treating the malfunctioning heart of a patient, the combination of means for deriving at least one EKG signal from the patient, means for deriving at, least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit, and output means including defibrillating means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient from a plurality of heart-malfunction-corrective inputs, whereby malfunctions of the heart including fibrillation may be corrected.

52. In a system for treating the malfunctioning heart of a patient, the combination of means for monitoring heart rhythm to develop at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including stable atrial fibrillation, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit as a basis for identifying malfunctioning of the heart including stable atrial fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including stable atrial fibrillation may be corrected.

53. In a system for treating the malfunctioning heart of a patient, the combination of means for monitoring heart rhythm to develop at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including unstable atrial fibrillation, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit as a basis for identifying malfunctions of the heart including unstable atrial fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including unstable atrial fibrillation may be corrected.

54. In a system for treating the malfunctioning heat of a patient, the combination of means for monitoring heart rhythm to develop at least one EKG signal from the patient, means for deriving at least one physiologic signal from or related to the patient'"'"'s circulatory system, a central processing unit including means for identifying malfunctions of the heart including ventricular fibrillation, means for inputting the at least one EKG signal and the at least one physiologic signal to the central processing unit as a basis for identifying heart malfunctions including ventricular fibrillation, and output means controlled by the central processing unit for providing at least one heart-malfunction-corrective input to the patient, whereby malfunctions of the heart including ventricular fibrillation may be corrected.