Hemodynamically responsive system for treating a malfunctioning heart
First Claim
1. A system for treating a malfunctioning heart comprising first means for deriving at least one electrical signal representing electrical activity of the heart;
- second means for deriving at least one signal representing at least one hemodynamic parameter;
signal processing means responsive to outputs from said first means and said second means for developing at least three control signals and a signal representative of occurrences of an R-wave;
controllable antitachycardia pacemaking means for supplying pacing signals to the heart;
controllable antibradycardia pacemaking means for supplying pacing signals to the heart; and
controllable cardioverting/defibrillating means, said cardioverting/defibrillating means, said antibradycardia pacemaking means and said antitachycardia pacemaking means being coupled to said signal processing means and responsive to the control signals therefrom for selectively treating heart rhythm malfunctions.
2 Assignments
0 Petitions
Accused Products
Abstract
A system for 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 pressure (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 includes antitachycardia and antibradycardia pacemakers.
-
Citations
28 Claims
-
1. A system for treating a malfunctioning heart comprising first means for deriving at least one electrical signal representing electrical activity of the heart;
- second means for deriving at least one signal representing at least one hemodynamic parameter;
signal processing means responsive to outputs from said first means and said second means for developing at least three control signals and a signal representative of occurrences of an R-wave;
controllable antitachycardia pacemaking means for supplying pacing signals to the heart;
controllable antibradycardia pacemaking means for supplying pacing signals to the heart; and
controllable cardioverting/defibrillating means, said cardioverting/defibrillating means, said antibradycardia pacemaking means and said antitachycardia pacemaking means being coupled to said signal processing means and responsive to the control signals therefrom for selectively treating heart rhythm malfunctions. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
- second means for deriving at least one signal representing at least one hemodynamic parameter;
-
9. An implantable system for treating a malfunctioning heart which includes an implantable, controllable cardioverter/defibrillator, first means for deriving at least one electrical signal representing electrical activity of the heart;
- second means for deriving at least one signal representing at least one hemodynamic parameter;
signal processing means responsive to outputs from said first means and said second means for developing at least three control signals and a signal representative of occurrences of an R-wave;
controllable antitachycardia pacemaking means for supplying pacing signals to the heart; and
controllable antibradycardia pacemaking means for supply pacing signals to the heart, said implantable cardioverter/defibrillator, said antibradycardia pacemaking means and said antitachycardia pacemaking means being coupled to said signal processing means and responsive to the control signals therefrom for selectively treating heart rhythm malfunctions. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16)
- second means for deriving at least one signal representing at least one hemodynamic parameter;
-
17. A system for treating a malfunctioning heart, the system comprising a cardioverter/defibrillator, first means for deriving from at least one electrocardiographic signal resulting from electrical activity of the heart at least one signal representing at least an approximation of the probability density function of the electrocardiographic signal;
- second means for deriving at least one signal representing at least one hemodynamic parameter; and
signal processing means for developing at least one control signal, said cardioverter/defibrillator being coupled to said signal processing means and responsive to output therefrom. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
- second means for deriving at least one signal representing at least one hemodynamic parameter; and
Specification