Method and apparatus for electrically forcing cardiac output in an arrhythmia patient
First Claim
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1. A method for forcing cardiac output during tachyarrhythmia in a patient, comprising the steps of:
- (a) attaching a plurality of electrodes to external portions of a patient'"'"'s body proximate the patient'"'"'s thoracic region so that the electrodes may deliver electrical pulses which will be transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of tachyarrhythmia in the patient;
(c) detecting the presence of tachyarrhythmia in the patient; and
(d) delivering electrical current pulses through the patient'"'"'s body, via said electrodes after detecting tachyarrhythmia, at a rate between about 60 and 200 pulses per minute, said electrical current pulses having a voltage less than a normal defibrillation voltage level, to force contraction in the patient'"'"'s heart and facilitate a minimum level of cardiac output until cessation of the tachyarrhythmia or until other medical intervention is provided.
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Abstract
An electrical method and apparatus for stimulating cardiac cells causing contraction to force hemodynamic output during fibrillation, hemodynamically compromising tachycardia, or asystole. Forcing fields are applied to the heart to give cardiac output on an emergency basis until the arrhythmia ceases or other intervention takes place. The device is used as a stand alone external or internal device, or as a backup to an ICD, atrial defibrillator, or an anti-tachycardia pacemaker. The method and apparatus maintain some cardiac output and not necessarily defibrillation.
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Citations
46 Claims
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1. A method for forcing cardiac output during tachyarrhythmia in a patient, comprising the steps of:
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(a) attaching a plurality of electrodes to external portions of a patient'"'"'s body proximate the patient'"'"'s thoracic region so that the electrodes may deliver electrical pulses which will be transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of tachyarrhythmia in the patient;
(c) detecting the presence of tachyarrhythmia in the patient; and
(d) delivering electrical current pulses through the patient'"'"'s body, via said electrodes after detecting tachyarrhythmia, at a rate between about 60 and 200 pulses per minute, said electrical current pulses having a voltage less than a normal defibrillation voltage level, to force contraction in the patient'"'"'s heart and facilitate a minimum level of cardiac output until cessation of the tachyarrhythmia or until other medical intervention is provided. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method for producing minimal cardiac output on an emergency basis in a patient experiencing arrhythmia, comprising the steps of:
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(a) attaching a plurality of electrodes to external portions of a patient'"'"'s chest so that the electrodes may deliver electrical pulses which will be transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of arrhythmia in the patient;
(c) detecting the presence of arrhythmia in the patient; and
(d) delivering electrical current pulses through the patient'"'"'s body, via said electrodes immediately after detecting arrhythmia, at a rate between about 60 and 200 pulses per minute, said electrical current pulses having a voltage greater than that which would only pace the heart and less than that which would defibrillate the patient'"'"'s heart, so as to force some contraction in the patient'"'"'s heart, whereby a minimum level of cardiac output is maintained until cessation of the arrhythmia or until other medical intervention is provided. - View Dependent Claims (11, 12, 13, 14)
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15. A device, for external attachment to a human body, for maintaining some cardiac output of a patient'"'"'s heart during arrhythmia using electrical forcing fields, comprising:
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(a) power supply means;
(b) arrhythmia detection means connected to said power supply means;
(c) pulse delivery means connected to said power supply means for delivering multiple electrical current pulses through portions of the patient'"'"'s upper body; and
(d) output control means connected to said arrhythmia detection means, said power supply means, and said pulse delivery means for controlling the delivery of multiple electrical current pulses to the patient'"'"'s upper body after the detection of arrhythmia, said electrical current pulses having a voltage greater than about 25 volts and less than the voltage necessary to defibrillate the patient, said output control means providing pulses suitable for only producing contraction in the patient'"'"'s heart sufficient to maintain a level of cardiac output which is a fraction of the normal maximum cardiac output until cessation of the arrhythmia or until other medical intervention is provided. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A device, for external attachment to a human body, for maintaining some cardiac output of a patient'"'"'s heart during dysrhythmia using electrical forcing fields, comprising:
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(a) power supply means for providing power to pulse delivery means, arrythmia detection means, and output control means;
(b) arrhythmia detection means operatively connected to said power supply means;
(c) pulse delivery means operatively connected to said power supply means for delivering multiple electrical current pulses through portions of the patient'"'"'s upper body, said multiple electrical pulses comprising cardiac therapy responsive to the particular patient'"'"'s cardiac rhythm; and
(d) output control means operatively connected to said arrhythmia detection means, said power supply means, and said pulse delivery means for controlling the delivery of multiple electrical current pulses to the human heart after the detection of arrhythmia;
said electrical current pulses having an amplitude suitable for delivery through the patient'"'"'s upper body and for contributing to the mechanical and electrical mechanisms adequate to produce contractions in the patient'"'"'s heart and to cause only a fraction of the normal maximum cardiac output but enough cardiac output to maintain cardiac viability until cessation of the dysrhythmia or until other medical intervention is provided.- View Dependent Claims (34, 35, 36)
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37. A method for providing hemodynamic output of a heart during arrythmia, comprising the steps of:
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(a) attaching a plurality of electrodes to external portions of a patient'"'"'s body proximate the patient'"'"'s chest so that the electrodes may deliver or receive electrical pulses transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of arrhythmia in the patient;
(c) detecting the presence of arrhythmia in the patient;
(d) delivering a first series of electrical current pulses for a first period of time, through the patient'"'"'s body, via said electrodes after detecting arrhythmia, at a rate between about 60 and 200 pulses per minute;
said electrical current pulses having a voltage less than a normal defibrillation voltage level, and having a current of greater than about 140 mA, to force hemodynamic activity by contraction of the patient'"'"'s heart and to facilitate a minimum level of cardiac output; and
(e) determining the output status of the heart. - View Dependent Claims (38, 39, 40, 41, 42)
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43. A method for providing hemodynamic output of a heart during arrythmia, comprising the steps of:
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(a) attaching a plurality of electrodes to external portions of a patient'"'"'s body proximate the patient'"'"'s chest so that the electrodes may deliver or receive electrical pulses transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of arrhythmia in the patient;
(c) detecting the presence of arrhythmia or low cardiac output in the patient;
(d) delivering a first series of electrical current pulses for a first period of time, through a portion of the patient'"'"'s body, via said electrodes after detecting arrhythmia, at a rate between about 60 and 200 pulses per minute;
said electrical current pulses having a voltage less than a normal defibrillation voltage level, and having a pulse width of less than about 100 ms, to force hemodynamic activity by contraction of the patient'"'"'s heart and facilitate a minimum level of cardiac output; and
(e) determining the output status of the heart. - View Dependent Claims (44, 45)
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46. A method for conducting emergency electrical cardiopulmonary resuscitation in a human, comprising the steps of:
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(a) attaching a plurality of electrodes to external portions of a patient'"'"'s body proximate the patient'"'"'s thoracic region so that the electrodes may deliver electrical pulses which will be transmitted through portions of the patient'"'"'s upper body;
(b) providing means for detecting the presence of arrhythmia in the patient;
(c) detecting the presence of arrhythmia in the patient; and
(d) delivering electrical current pulses through the patient'"'"'s body to the patient'"'"'s heart, via said electrodes after detecting arrhythmia, at a rate between about 60 and 200 pulses per minute and at a voltage of less than a normal defibrillation voltage level, to force contraction in the patient'"'"'s heart and to facilitate a minimum level of cardiac output until cessation of the arrhythmia or until other medical intervention is provided.
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Specification