Arrhythmia prediction and prevention for implanted devices

• US 5,042,497 A
• Filed: 01/30/1990
• Issued: 08/27/1991
• Est. Priority Date: 01/30/1990
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated 4100 Hamline AVE North St Paul MN
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Shapland, J. Edward
• Primary Examiner(s): Jaworski, Francis
• Assistant Examiner(s): Manuel, George
• Application Number:
  US07/472,162
• Time in Patent Office: 574 Days
• Field of Search: 128/671, 128/419 PT, 128/419 PG, 128/419 P, 128/419 D, 128/696, 128/702
• US Class Current: 600/509
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A system for predicting and preventing cardiac arrhythmias for use in combination with an implanted arrhythmia treatment device comprising means for sensing the neural activity of a patient and triggering the implanted arrhythmia treatment device to take preventative and curative actions for an impending arrhythmia upon an elevation of the neural activity. The preventative actions include overdrive pacing of the heart, charging a defibrillator capacitor, activating an alternative cardiac sensing scheme, and applying an anti-arrhythmia drug to the heart of a patient.

Claims

1. A system for predicting and preventing cardiac arrhythmias for use in combination with an implantable arrhythmia treatment device, said system comprising:

means for monitoring the neural activity of a patient to predict an impending arrhythmia;

means for taking actions in said implantable arrhythmia treatment device prior to an initial irregular beat of said impending arrhythmia to prevent the initial irregular beat or prepare for said arrhythmia upon said means for monitoring detecting a predetermined change in said neural activity.

2. The system of claim 1, wherein the neural activity being monitored is sympathetic or parasympathetic neural activity.

3. The system of claim 1, wherein said means for monitoring comprises means for determining the heart rate variability based upon the interval between consecutive heart beats.

4. The system of claim 1, wherein said means for monitoring comprises means for determining the respiration rate variability based upon the interval between consecutive breaths.

5. The system of claim 1, wherein said means for monitoring comprises means for measuring the systolic time interval of the heart.

6. The system of claim 1, wherein said means for taking actions comprises means for overdrive pacing the heart.

7. The system of claim 1, wherein said means for taking actions charges a defibrillation capacitor in said implanted device in preparation for delivering a defibrillation pulse to the patient.

8. The system of claim 1, wherein said means for taking actions comprises means for adjusting a particular mode of therapy.

9. The system of claim 1, wherein said means for taking actions comprises means for activating a cardiac sensing scheme in said implanted arrhythmia treatment device.

10. The system of claim 1, wherein said means for taking actions comprises means for alerting a patient in which the implantable arrhythmia treatment device is implanted of said impending arrhythmia by said alarm.

11. The system of claim 1, wherein said means for taking actions comprises means for applying a cardiovascular drug to the heat of the patient.

12. The system of claim 1, wherein said means for taking actions comprises means for storing data relating to heart function for later review by a physician.

13. A system for predicting and preventing cardiac arrhythmias for use in combination with an implantable arrhythmia treatment device, said system comprising:

means for monitoring the sympathetic neural activity of a patient to predict an impending arrhythmia;

means for monitoring the ECG of the heart of the patient;

means for detecting the concurrence of both a change in the sympathetic neural activity and an abnormal characteristic of said ECG, and generating a concurrence output signal;

means for taking actions in said implantable arrhythmia treatment device prior to an initial irregular beat of said impending arrhythmia to prevent the initial irregular beat or prepare for said arrhythmia upon the generation of said concurrence output signal.

14. The system of claim 13, wherein said means for monitoring the autonomic neural activity comprises means for determining the heart rate variability based upon the interval between consecutive heart beats.

15. The system of claim 13, wherein said means for monitoring the autonomic neural activity comprises means for determining the respiration rate variability based upon the interval between consecutive breaths.

16. The system of claim 13, wherein said means for monitoring the autonomic neural activity comprises means for measuring the systolic time interval of the heart.

17. The system of claim 13, wherein said means for taking actions comprises means for overdrive pacing the heart.

18. The system of claim 13, wherein said means for taking actions charges a defibrillation capacitor in said implanted device in preparation for delivering a defibrillation pulse to the patient.

19. The system of claim 13, wherein said means for taking actions comprises means for choosing a particular mode of therapy for preventing the onset of the arrhythmia.

20. The system of claim 13, wherein said means for taking actions comprises means for activating a cardiac sensing scheme in said implanted arrhythmia treatment device.

21. A method for predicting and preventing cardiac arrhythmias comprising the steps of:

sensing the neural activity of the heart of a patient to predict an impending arrhythmia;

triggering an implantable arrhythmia treatment device prior to an initial irregular beat of said impending arrhythmia to take actions to prevent the initial irregular beat or prepare for said arrhythmia upon an elevation of the sympathetic neural or reduction in parasympathetic activity.

22. The method of claim 21, wherein said step of sensing senses the sympathetic neural activity of the heart of the patient.

23. The method of claim 21, wherein said step of triggering an implanted arrhythmia treatment device comprises overdrive pacing of the heart.

24. The method of claim 21, wherein said step of triggering an implanted arrhythmia treatment device comprises charging a defibrillation capacitor in preparation for delivering a defibrillation pulse.

25. The method of claim 21, wherein said step of triggering an implanted arrhythmia treatment device comprises activating an alternative cardiac sensing scheme.

26. The method of claim 21, wherein said step of triggering an implanted arrhythmia device comprises the application of a cardiovascular drug.

27. The method of claim 26, wherein said step of triggering an implanted arrhythmia treatment device comprises the application of an anti-arrhythmia drug to the heart of the patient.

29. The method of claim 26, wherein said step of sensing senses the autonomic neural activity of the heart of the patient.

28. A method for predicting and preventing cardiac arrhythmias comprising the steps of:

sensing the neural activity of the heart of a patient to predict an impending arrhythmia;

sensing the ECG of the heart of the patient;

triggering an implantable arrhythmia treatment device prior to an initial irregular beat of said impending arrhythmia to take actions to prevent the initial irregular beat or prepare for said arrhythmia upon the concurrence of a change in the neural activity and an abnormal condition of the ECG.