Method and apparatus for controlling heart rate in proportion to left ventricular pressure
First Claim
1. A method for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises:
- disposing at least first and second electrodes in relation to the heart;
disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers;
detecting a signal proportional to the left heart chamber blood pressure by said pressure transducer and providing a first signal in response to detection of normal heart pumping and a second signal in response to detection of abnormal heart pumping, characteristic of hemodynamic insufficiency; and
supplying cardioversion energy to said heart in response to said second signal by application of stimulating pulses across said electrodes.
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Accused Products
Abstract
A method and apparatus for sensing in vivo blood pressure proportional to the left ventricular pressure for detecting ventricular tachyarrhythmias or the cardiovascular status in congestive heart failure, and/or for adjusting the rate of a pacemaker. A lead with a pressure sensor near its distal end is placed transvenously through the coronary sinus and located in the coronary vein. When in place, a bulge or an inflatable balloon proximal to the pressure sensor may be used to acutely occlude the coronary vein until the sensor fibroses in. The balloon may be reinflated prior to pressure measurements. The pressure that is sensed in that location is proportional to the left ventricular pressure. Values representing the left ventricular pulse, systolic and diastolic pressures, as well as the differentiated rate of change (i.e., dP/dt), gross rate of change (ΔP/Δt) and mean or average of such pressure values are all or selectively developed by software algorithms and implemented in microprocessor based control circuitry. In one preferred embodiment, one or more of the values are utilized in software implemented algorithms to cause a pacemaker to pace the heart at a required rate to achieve a desired cardiac output. Alternatively, these left ventricular pressure related values may be employed to confirm the absence of mechanical pumping action of the heart which, in conjunction with other cardiac signals, confirm the existence of a tachyarrhythmia requiring anti-tachy pacing, cardioversion or defibrillation.
339 Citations
40 Claims
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1. A method for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises:
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disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting a signal proportional to the left heart chamber blood pressure by said pressure transducer and providing a first signal in response to detection of normal heart pumping and a second signal in response to detection of abnormal heart pumping, characteristic of hemodynamic insufficiency; and supplying cardioversion energy to said heart in response to said second signal by application of stimulating pulses across said electrodes. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. Apparatus for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises:
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means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus or coronary vein of the heart adjacent to the left heart chambers; means for detecting a pressure proportional to left heart chamber blood pressure by said pressure transducer and providing a first signal in response to normal heart pumping and a second signal in response to abnormal heart pumping characteristic of hemodynamic insufficiency; and means for supplying cardioverting energy to said heart in response to said second signal by application of stimulating pulses by means of said first and second electrodes. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method for regulating cardiac pacing rate in response to a patient'"'"'s left heart blood pressure which comprises:
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disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting pressure signals by said pressure transducer; providing a pacing rate control signal derived from said pressure signals; and supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. Apparatus for regulating cardiac pacing rate in response to a patient'"'"'s left heart blood pressure which comprises:
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means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; means for detecting pressure signals by said pressure transducer and providing a pacing rate control signal derived from the pressure signal; and means for supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40)
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Specification