Cardiac therapy system

• US 5,318,592 A
• Filed: 09/14/1992
• Issued: 06/07/1994
• Est. Priority Date: 09/12/1991
• Status: Expired due to Term

• Current Assignee: Biotronik Mess-Und Therapiegeraete GmbH & Company Ingenieurbuero Berlin (Biotronik SE & Company KG)
• Original Assignee: Biotronik Mess-Und Therapiegeraete GmbH & Company Ingenieurbuero Berlin (Biotronik SE & Company KG)
• Inventors: Schaldach, Max
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Getzow, Scott M.
• Application Number:
  US07/943,249
• Time in Patent Office: 631 Days
• Field of Search: 128/419 PG, 128/419 D, 600/16, 600/17, 600/18
• US Class Current: 607/5
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371

Abstract

A cardiac therapy system for use with a conventional cardiac pacemaker ciit is controlled by activity signals of the autonomous nervous system (ANS) in a patient'"'"'s body which constitute a measure for the patient'"'"'s cardiovascular output requirement. The system includes pickup circuitry for detecting at least the autonomous nervous system activity signals in the patient'"'"'s body, a control circuit for generating control signals as a function of time and/or intensity of the autonomous nervous system signals picked up in the patient'"'"'s body, a neurostimulator for changing vascular resistance by nerve stimulation of the patient in adaptation to the patient'"'"'s intracardial output requirement, in response to control signals from the control circuit, an arrythmia suppressor for generating anti-arrhythmia stimulation pulses to the patient'"'"'s heart which are controlled by control signals from the control circuit, and a pump assist for assisting the pumping of the patient'"'"'s heart in response to control signals from the control circuit.

Claims

1. A cardiac therapy system controlled by activity signals of the autonomous nervous system in a patient'"'"'s body which constitute a measure for the patient'"'"'s cardiovascular output requirement, for use with a conventional cardiac pacemaker circuit, the system comprising:

pickup means for detecting at least the autonomous nervous system activity signals in the patient'"'"'s body;

control means for generating control signals as a function of time and/or intensity of the autonomous nervous system signals picked up in the patient'"'"'s body by the pickup means;

neurostimulator means for changing vascular resistance by nerve stimulation of the patient in adaptation to the patient'"'"'s intracardial output requirement, in response to control signals from the control means;

arrythmia suppressor means for generating anti-arrhythmia stimulation pulses to the patient'"'"'s heart which are controlled by control signals from the control means;

and

pump assist means for assisting the pumping of the patient'"'"'s heart in response to control signals from the control means.

2. A therapy system according to claim 1, wherein the pickup means detects further signals in the patient'"'"'s body which constitute a measure of external physical stress on the patient or the stress on body organs and wherein the control means generates the control signals in response to the detected further signals.

3. A therapy system according to claim 2, wherein the control means generates the control signals as a function of event patterns that are predetermined wherein the event patterns comprises:

the occurrence of the autonomous nervous system signals within predetermined time windows,

the frequency and/or intensity of the autonomous nervous system signals,

the frequency and/or intensity of the further signals,

external programming signals, and

previously generated control signals generated earlier in this way.

4. A cardiac therapy system according to claim 1, wherein the activity signals of the autonomous nervous system include a regionally operative increase in the intracardial impedance in the region of the right ventricle of the patient'"'"'s heart.

5. A cardiac therapy system according to claim 4, wherein the control means includes determination means for determining values of the activity signals of the autonomous nervous system in a range of maximum changes that are a function of the patient'"'"'s activity.

6. A cardiac therapy system according to claim 1, wherein the autonomous nervous system activity is influenced by nociceptive stimuli and by the nerve stimulation by the neurostimulator means and/or the anti-arrhythmia signals from the arrythmia suppressor means.

7. A cardiac therapy system for a patient having a heart, comprising:

pickup means for detecting signals representative of the patient'"'"'s cardiovascular function, the signals detected including at least autonomous nervous system signals;

arrythmia suppressor means for producing anti-arrythmia signals;

pump assist means for assisting the pumping activity of the patient'"'"'s heart;

neurostimulator means for producing nerve stimulation signals; and

control means for receiving the signals representative of the patient'"'"'s cardiovascular function from the pickup means, and for generating control signals for controlling the arrythmia suppressor means, the pump assist means, and the neurostimulator means.

8. A cardiac therapy system according to claim 7, further comprising a pacemaker, wherein the control means further produces pacemaker control signals.

9. A cardiac therapy system according to claim 7, wherein the pickup means comprises:

an intracardial impedance determining circuit, connected to a circuit for determining a regionally operative increase of the intracardial impedance in the region of the patient'"'"'s heart'"'"'s right ventricle, which is in turn connected to an activity value determining circuit, for producing the autonomous nervous system signals, wherein the autonomous nervous system signals represent information of activity values of the autonomous nervous system relating to intensity and time position during a cardiac time interval;

and wherein the control means comprises;

logic means for receiving and logically linking the autonomous nervous system signals from the pickup means, and memory means for generating the control signals for controlling the arrythmia suppressor means, the pump assist means, and the neurostimulator means.

10. A cardiac therapy system according to claim 9, wherein the pickup means further comprises pickups for detecting signals within the patient'"'"'s body which are a measure of external physical stress, including stress on individual organs of the patient which are dependent on the external physical stress, and for outputting stress signals to the control means.

11. A cardiac therapy system according to claim 9, wherein the logic means comprises programmable means for receiving external programming signals which influence the operation of the logic means.

12. A cardiac therapy system according to claim 9, wherein the memory means receives as address input previously generated control signals.

13. A cardiac therapy system according to claim 7, wherein nerve stimulation signals from the neurostimulator means are applied to the patient for changing vascular resistance of the patient by nerve stimulation of the patient in adaptation to the patient'"'"'s intracardial output requirement.

14. A cardiac therapy system controlled by activity signals of the autonomous nervous system in a patient'"'"'s body which constitute a measure for the patient'"'"'s cardiovascular output requirement, the system comprising:

pickup means for detecting at least the autonomous nervous system activity signals in the patient'"'"'s body; and

control means for generating control signals as a function of time and/or intensity of the autonomous nervous system signals picked up in the patient'"'"'s body by the pickup means;

wherein the system further comprises at least one of;

neurostimulator means for changing vascular resistance by nerve stimulation of the patient in adaptation to the patient'"'"'s intracardial output requirement, in response to control signals from the control means;

arrythmia suppressor means for generating anti-arrhythmia stimulation pulses to the patient'"'"'s heart which are controlled by control signals from the control means; and

pump assist means for assisting the pumping of the patient'"'"'s heart in response to control signals from the control means.