Implantable electrical nerve stimulator/pacemaker with ischemia for decreasing cardiac workload
First Claim
1. A system for influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse by stimulation of the patient'"'"'s nerve system, said system comprising:
- ischemia sensor means adapted to be located within the venous return system of a patient'"'"'s heart for sensing a constituent of the venous return blood draining from myocardial tissue and producing an electrical output signal substantially representing a chemical constituent of that blood;
signal transforming means for receiving the sensor means output signal and developing a stimulation trigger signal in response to an output signal indicative of a condition of ischemia; and
means responsive to said trigger signal for applying electric stimulation pulses to said nerve system.
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Accused Products
Abstract
A method and apparatus for stimulating the right and/or left carotid sinus nerves or the right stellate ganglion or the epidural space at about T2 with continuous and/or phasic electrical pulses in response to detected myocardial ischemia to decrease cardiac workload as a method to protect the myocardium. The automatic detection of the need for such stimulation is responsive to a change in ST segment variation different from a predetermined or programmed threshold suggesting acute myocardial ischemia and/or other criteria or indicators of myocardial ischemia, including changes if pH and/or oxygen saturation (SO2) detected from a sensor located in the heart, preferably the coronary sinus. The system is implemented with a dual chamber pacemaker with programming and telemetry capabilities for automatically recording in memory the aforementioned values for periods of time preceding and following each instance of stimulation for telemetry out on command and for programming "on" one or more of the sensors.
1391 Citations
32 Claims
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1. A system for influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse by stimulation of the patient'"'"'s nerve system, said system comprising:
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ischemia sensor means adapted to be located within the venous return system of a patient'"'"'s heart for sensing a constituent of the venous return blood draining from myocardial tissue and producing an electrical output signal substantially representing a chemical constituent of that blood; signal transforming means for receiving the sensor means output signal and developing a stimulation trigger signal in response to an output signal indicative of a condition of ischemia; and means responsive to said trigger signal for applying electric stimulation pulses to said nerve system. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A system for influencing the natural biological blood pressure regulatory system of a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse stimulation of the patient'"'"'s nerve system, said system comprising:
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electrode means coupled to said patient'"'"'s heart for detecting the patient'"'"'s electrocardiogram; means for receiving said patient'"'"'s electrocardiogram and developing a signal representative of the ST segment of that electrocardiogram; means for providing an ST segment variation threshold value; means for comparing the derived ST segment to said ST segment variation threshold level and providing an ST segment output signal when the measured ST segment variation varies from the ST segment variation threshold value in a predetermined manner; and means responsive to said ST segment output signal for applying electric stimulation pulses to said nerve system. - View Dependent Claims (10, 11)
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12. A method of influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse stimulation of the patient'"'"'s nerve system, comprising the steps of:
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sensing a constituent of the venous return blood draining from myocardial tissue and producing an output signal substantially representing a chemical constituent of that blood; comparing said output signal to a set point threshold value and developing a stimulation trigger signal in response to a magnitude indicative of a condition of ischemia; and applying electric stimulation pulses to said nerve system in response to said trigger signal. - View Dependent Claims (13, 14, 15, 16, 17)
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18. A method of influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse stimulation of the patient'"'"'s nerve system said method comprising the steps of:
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detecting said patient'"'"'s electrocardiogram and developing a signal representative of the ST segment variation of that electrocardiogram; comparing the derived ST segment variation to an ST segment variation threshold level and providing an ST segment output signal when the measured ST segment variation varies from the ST segment variation threshold in a predetermined manner; and applying electric stimulation pulses to said nerve system in response to said ST segment output signal. - View Dependent Claims (19, 20)
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21. A method of influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse stimulation of the patients'"'"'s nerve system, comprising the steps of:
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continuously measuring the electrogram of the patient'"'"'s heart; detecting certain characteristics of said electrogram indicative of an ischemia condition of the myocardium; initiating the storage of a sequence of said characteristics of said electrogram upon detection of an ischemic condition; delivering one or more electrical stimulation therapies to the patient'"'"'s nervous system for depressing the patient'"'"'s heart rate; and initiating the storage of a further sequence of said characteristics of said electrogram following delivery of said stimulation therapies. - View Dependent Claims (22)
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23. A system for influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse, stimulation of the patient'"'"'s nerve system, said system comprising:
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means for continuously measuring the electrogram of the patient'"'"'s heart; means for detecting certain characteristics of said electrogram indicative of an ischemic condition of the myocardriom; means for initiating the storage of a sequence of said characteristics of said electrogram upon detection of an ischemic condition; means for delivering one or more electrical stimulation therapies to the patient'"'"'s nervous system for depressing the patient'"'"'s heart rate; and means for initiating the storage of a further sequence of said characteristics of said electrogram following delivery of said stimulation therapies. - View Dependent Claims (24)
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25. A method of influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse stimulation of the patient'"'"'s nerve system, comprising the steps of:
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sensing a constituent of the venous return blood draining from myocardial tissue and producing an output signal substantially representing a chemical constituent of that blood; comparing said output signal to a set point threshold value and developing a stimulation trigger signal in response to a magnitude indicative of a condition of ischemia; and applying electric stimulation pulses to said nerve system and storing said output signal in response to said trigger signal. - View Dependent Claims (26, 27, 28)
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29. A system for influencing the natural biological blood pressure regulatory system in a patient, for reducing and controlling ischemia of myocardial tissue by electrical pulse, stimulation of the patient'"'"'s nerve system, said system comprising:
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ischemia sensor means adapted to be located within the venous return system of a patient'"'"'s heart for sensing a constituent of the venous return blood draining from myocardial tissue and producing an electrical output signal substantially representing chemical constituent of that blood; signal transforming means for receiving the electrical output signal and developing a stimulation trigger signal in respond to said electrical output signal indicative of a condition of ischemia; and means responsive to said trigger signal for applying electric stimulation pulses to said nerve system and storing said output signal. - View Dependent Claims (30, 31, 32)
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Specification