Method and apparatus for reduction of pain from electric shock therapies
First Claim
1. A therapeutic method, comprising the steps of applying a patient-perceptible preceding stimulus to a patient'"'"'s body and subsequently applying a painful therapeutic stimulus to the patient'"'"'s body, wherein said preceding stimulus comprises electrical stimulation initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus and having an amplitude of at least 10 volts, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level.
1 Assignment
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Accused Products
Abstract
A method and apparatus for pretreating a patient prior to a therapeutic painful stimulus, comprising the application of pain inhibiting stimuli to a patient prior to an application of the therapeutic painful stimulus. Applying pain inhibiting stimuli comprises the steps of sensing a need for the therapeutic painful stimulus, preparing to deliver the pain inhibiting stimuli to the patient prior to applying the therapeutic painful stimulus, and delivering the pain inhibiting stimuli to the patient prior to applying the therapeutic painful stimulus. The method and apparatus are embodied in modem, fully automatic, fully implantable, single or dual chamber atrial or ventricular cardioverter-defibrillators. The pain inhibiting prepulse method is intended primarily for use in conscious patients but may also be used in sleeping patients.
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Citations
91 Claims
- 1. A therapeutic method, comprising the steps of applying a patient-perceptible preceding stimulus to a patient'"'"'s body and subsequently applying a painful therapeutic stimulus to the patient'"'"'s body, wherein said preceding stimulus comprises electrical stimulation initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus and having an amplitude of at least 10 volts, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level.
- 12. A therapeutic method, comprising the steps of applying a patient-perceptible preceding stimulus to a patient'"'"'s body and subsequently applying a painful therapeutic stimulus to the patient'"'"'s body, wherein said preceding stimulus includes an auditory stimulus initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level.
- 16. A therapeutic method, comprising the steps of applying a patient-perceptible preceding stimulus to a patient'"'"'s body and subsequently applying a painful therapeutic stimulus to the patient'"'"'s body, wherein said preceding stimulus includes a vibro-tactile stimulus initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level.
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34. A medical therapeutic apparatus, comprising:
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(a) at least one transmission element adapted for connection to a patent'"'"'s body; (b) a pulse generator coupled to said at least one transmission element; and (c) a controller coupled to said pulse generator and to said at least one transmission element for applying, via said at least one transmission element, a patient-perceptible preceding stimulus to the patient'"'"'s body and for applying, via said at least one transmission element, a painful therapeutic stimulus to the patient'"'"'s body after application of said preceding stimulus, wherein said preceding stimulus includes electrical stimulation initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus and having an amplitude of at least 10 volts, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67)
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45. A medical therapeutic apparatus for pretreating a patient prior to a painful therapeutic electrical shock delivered from an implantable cardioverter-defibrillator to treat an arrhythmia, comprising:
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(a) at least one first electrode adapted for location in a portion of the patient'"'"'s body selected from the group of portions consisting of the right atrium, superior vena cava, and coronary sinus; (b) a second electrode adapted for location in the right ventricle of the patient'"'"'s heart; (c) a pulse generator coupled to said first and second electrodes; and (d) a controller coupled to said pulse generator and to said first and second electrodes for applying, via said first and second electrodes, preceding patient-perceptible electrical stimulation and a painful therapeutic electrical shock to the patient'"'"'s body after application of said preceding electrical stimulation, wherein said preceding electrical stimulation is initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic shock and has an amplitude of at least 10 volts, whereby the patient perceives pain associated with said painful therapeutic electrical shock as being reduced and/or the patient physiologically responds to said painful therapeutic electrical at a reduced level.
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46. An implantable cardioverter-defibrillator apparatus for pretreating a patient prior to a painful therapeutic electrical shock delivered to treat an arrhythmia, which reduces the patient'"'"'s perception of and/or response to the therapeutic electrical shock, comprising:
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(a) at least one first electrode adapted for location in a portion of the patient'"'"'s body selected from the group of portions consisting of the right atrium, superior vena cava, and coronary sinus; (b) at least one second electrode adapted for location in a portion of the patient'"'"'s body selected from the group of portions consisting of the right atrium, superior vena cava, and coronary sinus, but not in said body part in which said at least one first electrode is located; (c) a third electrode adapted for location in the right ventricle of the patient'"'"'s heart; (d) a pulse generator coupled to said first, second and third electrodes; and (e) a controller coupled to said pulse generator and to said first, second and third electrodes for applying, via said first, second and third electrodes, patient-perceptible preceding electrical stimulation of at least 10 volts for a time period between 0.1 and 25 milliseconds to the patient'"'"'s body, wherein said preceding electrical stimulation is initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic shock.
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47. A medical therapeutic apparatus, comprising:
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(a) at least one transmission element adapted for connection to a patent'"'"'s body; (b) a pulse generator coupled to said at least one transmission element; and (c) a controller coupled to said pulse generator and to said at least one transmission element for applying, via said at least one transmission element, a patient-perceptible preceding stimulus to the patient'"'"'s body and for applying, via said at least one transmission element, a painful therapeutic stimulus to the patient'"'"'s after application of said preceding stimulus, wherein said preceding stimulus includes an auditory stimulus initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus and said at least one transmission element includes a speaker device whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level. - View Dependent Claims (48, 49, 50)
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51. A medical therapeutic apparatus, comprising:
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(a) at least one transmission element adapted for connection to a patent'"'"'s body; (b) a pulse generator coupled to said at least one transmission element; and (c) a controller coupled to said pulse generator and to said at least one transmission element for applying, via said at least one transmission element, a patient-perceptible preceding stimulus to the patient'"'"'s body and for applying via said at least one transmission element, a painful therapeutic stimulus to the patient'"'"'s after application of said preceding stimulus, wherein said preceding stimulus includes a vibro-tactile stimulus initiated within a predetermined time period of 20-500 milliseconds prior to the painful therapeutic stimulus and said at least one transmission element includes a vibrator device, whereby the patient perceives pain associated with said painful therapeutic stimulus as being reduced and/or the patient physiologically responds to said painful therapeutic stimulus at a reduced level. - View Dependent Claims (68)
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69. A method of cardioverting or defibrillating a patient'"'"'s heart, comprising:
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applying a set of cardioversion electrodes to the patient'"'"'s body; initiating application of a patient-perceptible stimulus to a portion of the patient'"'"'s body other than the patient'"'"'s heart, employing means other than the set of cardio-version electrodes; and within 20 to 500 milliseconds following initiation of the patient perceptible stimulus, delivering a high voltage shock to the patient'"'"'s heart by means of electrodes within the set of cardioversion electrodes. - View Dependent Claims (70, 71, 72, 73, 74, 75, 76, 77, 78, 79)
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80. A method of delivering a painful treatment to a portion of a patient'"'"'s body comprising:
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applying means for delivery of the painful therapy to a first portion of the patient'"'"'s body; initiating application of a patient perceptible stimulus to a second portion of the patient'"'"'s body other than the first portion, employing means other than the means for delivery of the painful therapy; and within 20 to 500 milliseconds following initiation of the patient-perceptible stimulus, delivering the painful therapy. - View Dependent Claims (81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91)
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Specification