Method and apparatus for detecting a state of imminent cardiac arrhythmia in response to a nerve signal from the autonomic nerve system to the heart, and for administrating anti-arrhythmia therapy in response thereto

• US 5,658,318 A
• Filed: 09/28/1995
• Issued: 08/19/1997
• Est. Priority Date: 06/24/1994
• Status: Expired due to Term

• Current Assignee: Pacesetter AB (Abbott Laboratories)
• Original Assignee: Pacesetter AB (Abbott Laboratories)
• Inventors: Stroetmann, Brigitte, Mund, Konrad, Kallert, Siegfried
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US08/534,933
• Time in Patent Office: 691 Days
• Field of Search: 128/642, 128/675, 128/700, 128/705, 607/17, 607/18, 607/23, 607/118, 607/6
• US Class Current: 607/6
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/388 Nerve conduction study, e.g. detecting action potential of peripheral nerves
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/362 Heart stimulators heart defibrillators A61N1/39
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A device for detecting a state of imminent cardiac arrhythmia, relative to a normal state for a heart, in response to activity in nerve signals conveying information from the autonomic nerve system to the heart, contains a sensor body for sensing neural activity, a comparator with a threshold value forming a condition for the presence of an arrhythmia, the comparator emitting an arrhythmia-indicating output signal depending on whether neural activity meets the condition, and the sensor body being placeable in an extracardiac position for at least one of the sympathetic and vagus nerves. The sensor body directly senses activity in the nerve at that location in direct contact with the nerve. An implanted blood pressure sensing cuff also can be provided which generates signals indicative of blood pressure which can be evaluated in combination with the nerve signals for identifying the state of imminent cardiac arrhythmia.

Claims

1. An apparatus for detecting a condition indicative of imminent cardiac arrhythmia of a heart of a subject and for administering anti-arrhythmia therapy in response thereto, comprising:

sensor means, placeable in an extracardiac position in said subject for directly sensing nerve signals conveying information from at least one member of the autonomic nerve system, of the group consisting of the sympathetic and vagus nerves of said subject, to said heart of said subject, said sensor means generating a single sensor signal corresponding to the sensed nerve signals;

a comparator supplied with said single sensor signal and having a threshold value defining a condition indicative of an arrhythmia and said comparator emitting an output signal indicating a state of imminent arrhythmia dependent on a relation between said single sensor signal and said threshold value; and

means for administering anti-arrhythmia therapy to said subject upon emission of said output signal indicating said state of imminent arrhythmia.

2. An apparatus as claimed in claim 1 wherein said sensor means comprise an electrode directly connectable with said member of the autonomic nervous system.

3. An apparatus as claimed in claim 1 wherein said member of the autonomic nervous system has a longitudinal extent, and wherein said sensor means comprise two electrodes directly connectable with said member of the autonomic nervous system and disposable a distance from each other along said longitudinal extent.

4. A method for detecting, a state of imminent cardiac arrhythmia of a heart of a subject and for administering anti-arrhythmia therapy to said subject in response thereto, comprising the steps of:

implanting a sensor in an extracardiac position in said subject and directly sensing nerve signals conveying information from at least one member of the autonomic nervous system, of the group consisting of the sympathetic and vagus nerves of said subject, to said heart of said subject, and generating a single sensor signal corresponding to the sensed nerve signals;

comparing said single sensor signal to a threshold value defining a condition indicative of an arrhythmia and emitting an output signal indicating a state of imminent arrhythmia dependent on a relationship of said single sensor signal relative to said threshold value; and

administering anti-arrhythmia therapy to said subject upon emission of said output signal.

5. A method as claimed in claim 4 wherein the step of implanting said sensor comprises implanting said sensor in direct contact with said member of the autonomic nervous system.

6. A method as claimed in claim 4 wherein said member of the autonomic nervous system has a longitudinal extent, and wherein the step of implanting said sensor comprises implanting two electrodes, forming said sensor, at a distance from each other in direct contact with said member of the autonomic nervous system along said longitudinal extent.

7. An apparatus for detecting a condition indicative of imminent cardiac arrhythmia of a heart of a subject and for administering anti-arrhythmia therapy in response thereto, comprising:

nerve sensor means, placeable in an extracardiac position in said subject for directly sensing nerve signals conveying information from at least one member of the autonomic nerve system, of the group consisting of the sympathetic and vagus nerves of said subject, to said heart of said subject, said nerve sensor means generating a nerve sensor signal corresponding to the sensed nerve signals;

a comparator supplied with said nerve sensor signal and having a threshold value defining an autonomic nervous system condition indicative of an arrhythmia, said comparator emitting a comparator output signal dependent on a relationship of said nerve sensor signal relative to said threshold value;

hemodynamic sensor means, placeable relative to a blood vessel in said subject, for monitoring blood pressure in said blood vessel, said hemodynamic sensor means generating a hemodynamic sensor signal corresponding to the blood pressure;

hemodynamic signal monitoring means supplied with said hemodynamic sensor signal for analyzing said hemodynamic sensor signal relative to hemodynamic conditions indicative of an arrhythmia, said hemodynamic signal monitor emitting a hemodynamic output signal dependent on a relationship of said hemodynamic sensor signal to said hemodynamic condition;

control means, supplied with said comparator output signal and said hemodynamic output signal, for generating a control output signal indicating a state of imminent arrhythmia dependent on said comparator output signal and said hemodynamic output signal; and

means for administering anti-arrhythmia therapy to said subject upon emission of said control output signal.

8. An apparatus as claimed in claim 7 wherein said sensor means comprise an electrode directly connectable with said member of the autonomic nervous system.

9. An apparatus as claimed in claim 7 wherein said member of the autonomic nervous system has a longitudinal extent, and wherein said sensor means comprise two electrodes directly connectable with said member of the autonomic nervous system and disposable a distance from each other along said longitudinal extent.

10. An apparatus as claimed in claim 7 wherein said hemodynamic sensor means comprise an annular holder part adapted for surrounding said blood vessel, and a sensor part disposed inside of said holder part.

11. An apparatus as claimed in claim 10 wherein said sensor part comprises a blood pressure-sensitive cuff.

12. A method for detecting a condition indicative of imminent cardiac arrhythmia of a heart of a subject and for administering anti-arrhythmia therapy in response thereto, comprising the steps of:

implanting a sensor in an extracardiac position in said subject and directly sensing nerve signals conveying information from at least one member of the autonomic nervous system, of the group consisting of the sympathetic and vagus nerves of said subject, to said heart of said subject, and generating a sensor signal corresponding to the sensed nerve signals;

comparing said nerve sensor signal to a threshold value defining an autonomic nervous system condition indicative of an arrhythmia, and emitting a comparator output signal dependent on a relationship of said nerve sensor signal relative to said threshold value;

implanting a hemodynamic sensor relative to a blood vessel in said subject, and monitoring blood pressure in said blood vessel, and generating a hemodynamic sensor signal corresponding to the blood pressure;

analyzing said hemodynamic sensor signal relative to hemodynamic conditions indicative of an arrhythmia, and emitting a hemodynamic output signal dependent on a relationship of said hemodynamic sensor signal to said hemodynamic condition;

generating a control output signal indicating a state of imminent arrhythmia dependent on said comparator output signal and said hemodynamic output signal; and

administering anti-arrhythmia therapy to said subject upon emission of said control output signal.

13. A method as claimed in claim 12 wherein the step of implanting said sensor comprises implanting said sensor in direct contact with said member of the autonomic nervous system.

14. A method as claimed in claim 12 wherein said member of the autonomic nervous system has a longitudinal extent, and wherein the step of implanting said sensor comprises implanting two electrodes, forming said sensor, at a distance from each other in direct contact with said member of the autonomic nervous system along said longitudinal extent.