Apparatus for determining the AV transmission time

• US 6,208,901 B1
• Filed: 03/03/1998
• Issued: 03/27/2001
• Est. Priority Date: 03/03/1997
• 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: Hartung, Wolfgang
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US09/033,853
• Time in Patent Office: 1,120 Days
• Field of Search: 607/23, 607/24, 607/18, 607/119, 607/122
• US Class Current: 607/23
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

In an apparatus for determining the AV transmission time or AV delay in the heart, the apparatus having a signal-sensor arrangement that is disposed in the heart and detects a natural cardiac action, further having at least one signal output and a processing unit that has at least one signal input that is connected to the signal output of the signal-sensor arrangement for calculating the natural AV transmission time based on the detected cardiac action, the signal-receiver arrangement includes a pressure-sensor arrangement that is disposed in the vicinity of the tricuspid valve in the right atrium and/or in the right ventricle for detecting intracardial pressure changes associated with the opening of the tricuspid valve.

Claims

1. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement-sensor arrangement detecting movements of the tricuspid valve, wherein the pressure-sensor arrangement includes a plurality of pressure sensors for being disposed at different positions relative to the tricuspid valve, each having a signal output;

at least one electrode for being provided in the heart for sensing a cardiac-action potential, said at least one electrode having at least one signal output; and

a processing unit having a plurality of signal inputs, the plurality of signal inputs including a number of signal inputs corresponding to the number of the plurality of pressure sensors, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the at least one signal output of said at least one electrode, the processing unit calculating at least one of the natural AV transmission time and the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on said cardiac-action potential detected using said at least one electrode, said processing unit including;

means for determining a time interval between a signal sensed by the electrode and representing said cardiac-action potential and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for evaluating signals received from the signal outputs of the plurality of pressure sensors at said signal inputs, said means for evaluating taking into consideration respective time delays of the signals.

2. The apparatus according to claim 1, wherein at least one of said plurality of pressure sensors is for being disposed in the atrium and at least one is for being disposed in the ventricle.

3. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement-sensor arrangement detecting movements of the tricuspid valve;

at least one electrode for being provided in the heart for sensing a cardiac-action potential, said at least one electrode having at least one signal output;

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the at least one signal output of said at least one electrode, the processing unit calculating at least one of the natural AV transmission time and the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on said cardiac-action potential detected using said at least one electrode, said processing unit including;

means for determining a time interval between a signal sensed by the electrode and representing said cardiac-action potential and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

timing means and switching means, which timing means and switching means serve to effect blocking of the at least one signal input that is connected to the at least one signal output of the signal-sensor arrangement, for presetting a time window for detecting signals generated by the signal-sensor arrangement; and

sensing means having a signal output connected to the processing unit for detecting a spontaneous or induced atrial signal, the signal output being connected to a corresponding signal input of the processing unit.

4. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement-sensor arrangement detecting movements of the tricuspid valve, the signal-sensor arrangement further including;

a sensor that detects movement or deformity of a pressure-sensor surface on an electrical path;

a cardiac catheter; and

a plurality of pressure-sensor surfaces disposed on the cardiac catheter, the catheter having jacket-surface segments that are separated from one another, said pressure-sensor surfaces being formed on or connected to the catheter by said jacket-surface segments;

at least one electrode for being provided in the heart for sensing a cardiac-action potential, said at least one electrode having at least one signal output; and

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the at least one signal output of said at least one electrode, the processing unit calculating at least one of the natural AV transmission time and the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on said cardiac-action potential detected using said at least one electrode, said processing unit including;

means for determining a time interval between a signal sensed by the electrode and representing said cardiac-action potential and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay.

5. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement-sensor arrangement detecting movements of the tricuspid valve wherein the movement-sensor arrangement includes a plurality of movement sensors that are disposed at different positions relative to the tricuspid valve, each having a signal output;

at least one electrode for being provided in the heart for sensing a cardiac-action potential, said at least one electrode having at least one signal output; and

a processing unit having a plurality of signal inputs, the plurality of signal inputs including a number of signal inputs corresponding to the number of the plurality of movement sensors, at least one of said signal inputs being connected to at least one of the signal outputs of the signal-sensor arrangement, and at least one of said signal inputs being connected to the at least one signal output of said at least one electrode, the processing unit calculating at least one of the natural AV transmission time and the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on said cardiac-action potential detected using said at least one electrode, said processing unit including;

means for determining a time interval between a signal sensed by the electrode and representing said cardiac-action potential and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for evaluating signals received from the signal outputs of the plurality of movement sensors at the signal inputs, said means for evaluating taking into consideration any relative time delays of the signals.

6. The apparatus according to claim 5, wherein at least one of said plurality of movement sensors is for being disposed in the atrium and at least one is for being disposed in the ventricle.

7. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement-sensor arrangement detecting movements of the tricuspid valve;

at least one electrode for being provided in the heart for sensing a cardiac-action potential, said at least one electrode having at least one signal output; and

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the at least one signal output of said at least one electrode, the processing unit calculating at least one of the natural AV transmission time and the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on said cardiac-action potential detected using said at least one electrode, said processing unit including;

means for determining a time interval between a signal sensed by the electrode and representing said cardiac-action potential and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for discriminating movement and pressure components in the signals of the pressure- or movement-sensor arrangement, including at least one low-frequency bandpass filter.

8. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement sensor arrangement detecting movements of the tricuspid valve, the pressure-sensor arrangement including a plurality of pressure sensors for being disposed at different positions relative to the tricuspid valve, each having a signal output;

a device for generating a stimulation pulse and transmitting the stimulation pulse to the atrium of the heart, the device having a signal output; and

a processing unit having a plurality of signal inputs, the plurality of signal inputs including a number of signal inputs corresponding to the number of the plurality of pressure sensors, at least one of said signal inputs being connected to at least one of the signal outputs of the signal-sensor arrangement, and at least one of said signal inputs being connected to the signal output of said device for generating a stimulation pulse, the processing unit the natural AV transmission time or the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on a stimulation pulse generated by said device for generating a stimulation pulse, said processing unit including;

means for determining a time interval between a stimulation pulse generated by said device for generating a stimulation pulse and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for evaluating signals received from the signal outputs of the plurality of pressure sensors at said signal inputs, said means for evaluating taking into consideration respective time delays of the signals.

9. The apparatus according to claim 8, wherein at least one of said plurality of pressure sensors is for being disposed in the atrium and at least one is for being disposed in the ventricle.

10. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement sensor arrangement detecting movements of the tricuspid valve;

a device for generating a stimulation pulse and transmitting the stimulation pulse to the atrium of the heart, the device having a signal output;

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the signal output of said device for generating a stimulation pulse, the processing unit the natural AV transmission time or the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on a stimulation pulse generated by said device for generating a stimulation pulse, said processing unit including;

means for determining a time interval between a stimulation pulse generated by said device for generating a stimulation pulse and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

timing means and switching means, which timing means and switching means serve to effect blocking of the at least one signal input that is connected to the at least one signal output of the signal-sensor arrangement, for presetting a time window for detecting signals generated by the signal-sensor arrangement; and

sensing means having a signal output connected to the processing unit for detecting a spontaneous or induced atrial signal, the signal output being connected to a corresponding signal input of the processing unit.

11. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement sensor arrangement detecting movements of the tricuspid valve;

a device for generating a stimulation pulse and transmitting the stimulation pulse to the atrium of the heart, the device having a signal output; and

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the signal output of said device for generating a stimulation pulse, the processing unit the natural AV transmission time or the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on a stimulation pulse generated by said device for generating a stimulation pulse, said processing unit including;

means for determining a time interval between a stimulation pulse generated by said device for generating a stimulation pulse and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for discriminating movement and pressure components in the signals of the pressure- or movement-sensor arrangement, including at least one low-frequency bandpass filter.

12. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement sensor arrangement detecting movements of the tricuspid valve, the signal-sensor arrangement further comprising;

a sensor that detects movement or deformity of a pressure-sensor surface on an electrical path;

a cardiac catheter; and

a plurality of pressure-sensor surfaces disposed on the cardiac catheter, the catheter having jacket-surface segments that are separated from one another, said pressure-sensor surfaces being formed on or connected to the catheter by said jacket-surface segments;

a device for generating a stimulation pulse and transmitting the stimulation pulse to the atrium of the heart, the device having a signal output; and

a processing unit having at least two signal inputs, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the signal output of said device for generating a stimulation pulse, the processing unit the natural AV transmission time or the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on a stimulation pulse generated by said device for generating a stimulation pulse, said processing unit including;

means for determining a time interval between a stimulation pulse generated by said device for generating a stimulation pulse and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay.

13. An apparatus for determining a natural AV transmission time or a natural AV delay in a heart, comprising:

a signal-sensor arrangement for being disposed in the heart and to detect a natural cardiac action, said signal-sensor arrangement having at least one signal output and having a pressure- or movement-sensor arrangement for being disposed near the tricuspid valve in at least one of the right atrium and the right ventricle, said pressure- or movement sensor arrangement detecting movements of the tricuspid valve, the movement-sensor arrangement including a plurality of movement sensors that are disposed at different positions relative to the tricuspid valve, each having a signal output;

a device for generating a stimulation pulse and transmitting the stimulation pulse to the atrium of the heart, the device having a signal output; and

a processing unit having a plurality of signal inputs, the plurality of signal inputs including a number of signal inputs corresponding to the number of said plurality of movement sensors, at least one of said signal inputs being connected to the at least one signal output of the signal-sensor arrangement and at least one of said signal inputs being connected to the signal output of said device for generating a stimulation pulse, the processing unit the natural AV transmission time or the natural AV delay based on cardiac action detected using the signal-sensor arrangement and on a stimulation pulse generated by said device for generating a stimulation pulse, said processing unit including;

means for determining a time interval between a stimulation pulse generated by said device for generating a stimulation pulse and a signal supplied by the at least one of a pressure-sensor arrangement and a movement-sensor arrangement, said time interval being used for the computation of the natural AV transmission time or the natural AV delay; and

means for evaluating signals received from the signal outputs of the plurality of movement sensors at the signal inputs, said means for evaluating taking into consideration any relative time delays of the signals.

14. The apparatus according to claim 13, wherein at least one of said plurality of movement sensors is for being disposed in the atrium and at least one is for being disposed in the ventricle.