Device and algorithm for a combined cardiomyostimulator and a cardiac pacer-carioverter-defibrillator

• US 5,607,385 A
• Filed: 08/17/1995
• Issued: 03/04/1997
• Est. Priority Date: 08/17/1995
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Peterson, David K., Gealow, Kendra K., Neisz, Johann J., Francischelli, David, Grandjean, Pierre A., Hammargren, John
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US08/516,081
• Time in Patent Office: 565 Days
• Field of Search: 607/4, 607/17, 607/25, 607/48, 600/17, 600/16, 128/702, 128/703, 128/705
• US Class Current: 600/17
• CPC Class Codes: A61N 1/36042 of grafted tissue, e.g. skeletal muscle
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A device and algorithm for a combined cardiomyostimulator and a cardiac pacer-cardioverter-defibrillator. In particular the present device operates, in a first embodiment, to deliver stimulation to a skeletal muscle grafted about a heart; sense depolarizations of a patient'"'"'s heart; measure the intervals separating successive depolarizations of the patient'"'"'s heart; define first and second interval ranges; determine the number of the measured intervals falling within the first and second interval ranges; inhibit the delivery of stimulation to a skeletal muscle grafted about a heart upon the sensing of a depolarization within the first or second interval range; detect the occurrence of a first type of arrhythmia when the number of the measured intervals falling within the first interval range equals a first predetermined value; detect the occurrence of a second type of an arrhythmia when the number of the intervals falling within the second interval range equals a second predetermined value; deliver a first type of arrhythmia therapy in response to the detection of the first arrhythmia; and deliver a second type of arrhythmia therapy in response to the detection of the second arrhythmia, the second type of arrhythmia therapy having a cardiac stimulation component and a skeletal muscle component.

Claims

1. An apparatus for stimulating a skeletal muscle grafted about a heart, detecting cardiac events and delivering therapeutic stimulation to the heart comprising:

means for delivering stimulation to a skeletal muscle grafted about a heart;

means for sensing depolarizations of a patient'"'"'s heart;

means for measuring the intervals separating successive depolarizations of the patient'"'"'s heart;

means for defining first and second interval ranges;

means for determining the number of the measured intervals falling within the first and second interval ranges;

means for inhibiting the means for delivering stimulation to a skeletal muscle grafted about a heart upon the sensing of a depolarization within the first or second interval range;

first means for detecting the occurrence of a first type of arrhythmia when the number of the measured intervals falling within the first interval range equals a first predetermined value;

second means for detecting the occurrence of a second type of an arrhythmia when the number of the intervals falling within the second interval range equals a second predetermined value;

means for delivering to the patient'"'"'s heart a first type of arrhythmia therapy in response to the detection of the first arrhythmia by the first detecting means; and

means for delivering to the patient'"'"'s heart and to the skeletal muscle grafted about the heart a second type of arrhythmia therapy in response to the detection of the second arrhythmia by the second detecting means, the second type of arrhythmia therapy having a cardiac stimulation component and a skeletal muscle component.

2. An apparatus according to claim 1 wherein the means for delivering first and second intervals comprise means for defining first and second intervals which are adjacent and non-overlapping.

3. An apparatus according to claim 1 wherein the means for delivering the second type of arrhythmia therapy comprises means for delivering a defibrillation pulse and means for delivering a defibrillation stimulation to the skeletal muscle grafted about the heart.

4. An apparatus according to claim 1 wherein the means for delivering a first type of arrhythmia therapy comprises means for delivering antitachycardia pacing pulses.

5. An apparatus according to claim 1 further comprising means for defining a third interval range, the third interval range encompassing intervals larger than the first interval range.

6. An apparatus according to claim 1 further comprising means for detecting a third type of arrhythmia and means for initiating a third type of arrhythmia therapy in response to the detection of the third type of arrhythmia.

7. An apparatus according to claim 6 wherein the third type of arrhythmia therapy comprises bradycardia pacing pulses.

8. An apparatus according to claim 1 wherein the means for delivering the second type of arrhythmia therapy further comprises:

means for temporarily storing energy;

means for charging the means for temporarily storing energy;

means for re-initiating delivering stimulation to a skeletal muscle grafted about a heart during the charging of the means for temporarily storing energy.