Method and apparatus for chronically monitoring the hemodynamic state of a patient using doppler ultrasound
First Claim
1. A hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s heart to correspond to the patient'"'"'s metabolic needs, comprising:
- means for generating electrical stimulation pulses,ultrasonic means implanted within the patient'"'"'s cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system,means for determining cardiac performance based on said at least one monitored parameter, andmeans for adjusting said pulse generating means as a function of said cardiac performance,characterized in that said ultrasonic means is adapted to be implanted within the patient'"'"'s right heart and fixably positioned therein to ensonify the patient'"'"'s ascending aorta with ultrasonic energy such that said ultrasonic means detects returning ultrasonic energy predominantly reflected from blood cells within the ascending aorta and monitors said at least one volume of blood flow parameter.
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Accused Products
Abstract
A hemodynamic control apparatus and method for regulating blood flow within the cardiovascular system in a closed-loop control system using ultrasound measurement techniques to determine a hemodynamic status of the patient and to derive a control parameter for modulating the hemodynamics of the system using electrical or pharmaceutical therapy. This apparatus and method provides for the monitoring of heart contractility and blood flow output from the heart to control an implantable cardiac assist or therapy device to maintain cardiac output without invading the left heart or the arterial system of the patient.
455 Citations
22 Claims
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1. A hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s heart to correspond to the patient'"'"'s metabolic needs, comprising:
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means for generating electrical stimulation pulses, ultrasonic means implanted within the patient'"'"'s cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system, means for determining cardiac performance based on said at least one monitored parameter, and means for adjusting said pulse generating means as a function of said cardiac performance, characterized in that said ultrasonic means is adapted to be implanted within the patient'"'"'s right heart and fixably positioned therein to ensonify the patient'"'"'s ascending aorta with ultrasonic energy such that said ultrasonic means detects returning ultrasonic energy predominantly reflected from blood cells within the ascending aorta and monitors said at least one volume of blood flow parameter. - View Dependent Claims (2, 3)
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4. A hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s heart to correspond to the patient'"'"'s metabolic needs, comprising:
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means for generating electrical stimulation pulses, said generating means including means for generating ventricular pacing pulses, ultrasonic means implanted within the patient'"'"'s cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system, means for determining cardiac performance based on said at least one monitored parameter, said means for determining cardiac performance comprising a means for deriving a cardiac performance index, means for adjusting said pulse generating means as a function of said cardiac performance, means for sensing atrial heartbeats, means for determining a metabolic indicator rate as a function of blood flow per unit of time and independent of the rate of sensed natural atrial heartbeats, means for classifying whether the sensed natural atrial heart rate is physiological or pathological based on the sensed natural atrial heart rate, the metabolic indicator rate and the cardiac performance index, and control means operative when the sensed natural atrial heart rate is physiological for keying the operation of said ventricular pacing pulse generating means to the operation of said atrial heartbeat sensing means, and operative otherwise for keying the operation of said ventricular pacing pulse generating means to said metabolic indicator rate. - View Dependent Claims (5, 6, 7, 8, 9, 10)
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11. A hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s hearts to correspond to the patient'"'"'s metabolic needs, comprising:
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an implantable drug infusion pump, ultrasonic means implanted within the patient'"'"'s cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system, means for determining cardiac performance based on said at least one parameter, and means for adjusting the timing and dosage of a pharmaceutical administered by said implantable drug infusion pump as a function of said cardiac performance. - View Dependent Claims (12, 13, 14, 15)
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16. A method of operating a hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s heart to correspond to the patient'"'"'s metabolic needs, comprising the steps of:
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generating electrical stimulation pulses, ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the patient'"'"'s cardiovascular system, said ultrasonically monitoring step further comprising the substeps of implanting an ultrasonic transducer within the patient'"'"'s right heart, fixably positioning the ultrasonic transducer to direct its ultrasonic energy towards the patient'"'"'s ascending aorta, ensonifying the ascending aorta with ultrasonic energy, detecting the returning ultrasonic energy predominantly reflected from blood cells within the ascending aorta and deriving at least one blood flow volume parameter from said detected returning ultrasonic energy, determining cardiac performance based on said at least one monitored parameter, and adjusting said electrical stimulation pulses based on said cardiac performance. - View Dependent Claims (17, 18)
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19. A method of operating a hemodynamic control apparatus for determining a patient'"'"'s hemodynamic status and adjusting the hemodynamic output of the patient'"'"'s heart to correspond to the patient'"'"'s metabolic needs, comprising:
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interconnecting a source of cardiovascular-active pharmaceutical with a patient'"'"'s cardiovascular system, ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the patient'"'"'s cardiovascular system, determining cardiac performance based on said at least one monitored parameter, and adjusting the timing and dosage of the pharmaceutical introduced into the patient'"'"'s cardiovascular system based on said cardiac performance. - View Dependent Claims (20, 21, 22)
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Specification