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 either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure, means responsive to an output from the determining means for providing a signal whenever a relationship between either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure reaches at least a predetermined value indicative of hemodynamic compromise, and means responsive to the signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon the relationship reaching at least the predetermined value.
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Accused Products
Abstract
A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure in the right side of a patient'"'"'s circulatory system being sensed. A first signal is developed representative of mean right atrial pressure (MRAP) and a second signal is developed representing right ventricular systolic pressure (RVSP). When the difference (or ratio) between MRAP and RVSP reaches at least a predetermined value, the combination being an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In these cases, a heart rate criterion, for example a rate over 150 bpm, may also have to be met before cardioverting/defibrillation is initiated. Fixed or variable baselines against which the predetermined value is to be measured may be provided. Other hemodynamic parameters, such as RVDP, RVSP, MRVP and/or MAP could be used as one or another of the hemodynamic parameters.
74 Citations
43 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 either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure, means responsive to an output from the determining means for providing a signal whenever a relationship between either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure reaches at least a predetermined value indicative of hemodynamic compromise, and means responsive to the signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon the relationship reaching at least the predetermined value.
- 17. 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 a first hemodynamic parameter and a second hemodynamic parameter, means responsive to an output from the determining means for providing a signal whenever a relationship between the first and second hemodynamic parameters reaches at least a predetermined value indicative of hemodynamic compromise, and means responsive to the signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means as at least one cardioverting pulse upon the relationship reaching at least the predetermined value.
- 28. A method of treating a malfunctioning heart comprising monitoring either right atrial pressure or central venous pressure, monitoring right ventricular pressure, determining if a relationship between either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure reaches at least predetermined value indicative of hemodynamic compromise, and delivering cardioverting/defibrillating electrical energy to the heart upon determining that the relationship between either right atrial pressure and right ventricular pressure or central venous pressure and right ventricular pressure has reached at least the predetermined value.
- 36. A method of treating a malfunctioning heart comprising monitoring a first hemodynamic parameter, monitoring a second hemodynamic parameter, determining if a relationship between the first hemodynamic parameter and the second hemodynamic parameter reaches at least predetermined value, and delivering at least one pulse of cardioverting/defibrillating electrical energy to the heart upon determining that the relationship between the first hemodynamic parameter and the second hemodynamic parameter indicative of hemodynamic compromise has reached at least the predetermined value.
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42. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy and electrode means for electrically coupling the storage means to the heart, an improvement comprising determining means for determining a first hemodynamic parameter and a second hemodynamic parameter in a circulatory system, and means for enabling discharge of the electrical energy stored by the storage means across the electrode means as at least one pulse of cardioverting/defibrillating energy upon output from the determining means indicating that a relationship between the first hemodynamic parameter and the second hemodynamic parameter has reached at least a predetermined value indicative of hemodynamic compromise.
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43. A method of treating a malfunctioning heart comprising monitoring at least two hemodynamic parameters in a circulatory system, determining if a relationship between the first hemodynamic parameter and the second hemodynamic parameter reach at least a predetermined value indicative of hemodynamic compromise, and delivering cardioverting/defibrillating electrical energy to the heart upon determining that the relationship between the hemodynamic parameters has reached at least the predetermined value.
Specification