Methods and apparatus for detecting medical conditions of the heart

• US 6,243,603 B1
• Filed: 09/15/1998
• Issued: 06/05/2001
• Est. Priority Date: 09/15/1998
• Status: Expired due to Term

• Current Assignee: UAB Research Foundation (University of Alabama System)
• Original Assignee: UAB Research Foundation (University of Alabama System)
• Inventors: KenKnight, Bruce H., Ideker, Raymond E.
• Primary Examiner(s): Evanisko, George R.
• Application Number:
  US09/153,407
• Time in Patent Office: 994 Days
• Field of Search: 607/4, 607/5, 607/9, 607/14
• US Class Current: 607/5
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration

Abstract

An implantable system for detecting electrical activity from a patient'"'"'s heart comprises a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of the heart for sensing electrical activity from the heart, and a detector operatively associated with the first sensing electrode for determining (e.g., diagnosing or prognosing) a medical condition of the heart with the sensed electrical activity. Typically the system further comprises a second sensing electrode configured for positioning in the right ventricle of the heart, where the detector is operatively associated with both the first sensing electrode and the second sensing electrode. The second sensing electrode may be positioned in other locations as well, such as also within a vein on the left surface of the left ventricle of the heart (although spaced apart from the first sensing electrode), in the right atrium, in the superior vena cava, etc. Finally, a third sensing electrode may also be included, with the third electrode positioned in any of the foregoing locations (again, spaced apart from the first and second electrodes), with the detector operatively associated with all of the first, second, and third sensing electrodes. Determination of a medical condition may be carried out by any suitable means, such as by detecting premature beats in the heart. The method is particularly useful for identifying the chamber of premature beat origin.

Claims

1. An implantable system for detecting electrical activity from a patient'"'"'s heart, comprising:

a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of said heart for sensing electrical activity from said heart;

a second sensing electrode configured for positioning in the right ventricle of said heart for sensing electrical activity from said heart; and

detector means operatively associated with said both first sensing electrode and said second sensing electrode for diagnosing or prognosing a medical condition of said heart with both said sensed electrical activity;

wherein said detector means detects premature beats in said heart for said diagnosis or prognosis of said medical condition of said heart with both said sensed electrical activity.

2. An implantable system according to claim 1, further comprising a third sensing electrode configured for positioning in the right atrium or superior vena cava of said heart;

wherein said detector means is operatively associated with all of said first, second, and third sensing electrodes;

and wherein said detector means is configured to diagnose or prognose a medical condition of said heart by relating information obtained from said first, second, and third electrodes.

3. An implantable system according to claim 1, wherein said detector means identifies the heart chamber of premature beat origin in said heart.

4. An implantable system according to claim 1, wherein said detector means detects the presence of sinus rhythm with syntactic relationships among electrogram features for said diagnosis or prognosis of said medical condition of said heart with said sensed electrical activity.

5. An implantable system according to claim 1, wherein said detector means predicts cardiac arrhythmia in said patient prior to the onset of said cardiac arrhythmia for said diagnosis or prognosis of said medical condition of said heart with said sensed electrical activity.

6. An implantable system according to claim 1, wherein said detector means discriminates the location of origin of premature beats in said heart for for said diagnosis or prognosis of said medical condition of said heart with said sensed electrical activity.

7. An implantable system according to claim 6, wherein said detector means predicts future onset of cardiac arrhythmia from said sensed electrical activity;

said system further comprising;

a plurality of primary electrodes configured for delivering a therapeutic pulse to said heart;

a power supply; and

control circuit means operatively associated with said power supply, said primary electrodes and said detector means for delivering a therapeutic pulse through said primary electrodes upon the prediction of future onset of cardiac arrhythmia in said patient by said detector means.

8. An implantable system according to claim 7, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.

9. An implantable system according to claim 1, wherein said detector means includes a determining circuit configured to determine the presence of cardiac arrhythmia a in said patient.

10. An implantable system according to claim 9, further comprising:

a plurality of primary electrodes configured for delivering a therapeutic pulse to said heart;

a power supply; and

a control circuit operatively associated with said power supply, said primary electrodes and said determining circuit, said control circuit configured for delivering a therapeutic pulse through said primary electrodes upon the determination of the presence of cardiac arrhythmia in said patient.

11. An implantable system according to claim 9, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.

12. An implantable system for detecting electrical activity from a patient'"'"'s heart, comprising:

a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of said heart for sensing electrical activity from said heart;

a second sensing electrode configured for positioning in the right ventricle of said heart for sensing electrical activity from said heart; and

detector means operatively associated with said both first sensing electrode and said second sensing electrode for diagnosing or prognosing a medical condition of said heart with both said sensed electrical activity;

wherein said detector means predicts cardiac arrhythmia in said patient prior to the onset of said cardiac arrhythmia for said diagnosis or prognosis of said medical condition of said heart with both said sensed electrical activity.

13. An implantable system according to claim 12, further comprising a third sensing electrode configured for positioning in the right atrium or superior vena cava of said heart;

wherein said detector means is operatively associated with all of said first, second, and third sensing electrodes;

and wherein said detector means is configured to diagnose or prognose a medical condition of said heart by relating information obtained from said first, second, and third electrodes.

14. An implantable system according to claim 12, wherein said detector means detects the presence of sinus rhythm with syntactic relationships among electrogram features for said diagnosis or prognosis of said medical condition of said heart with said sensed electrical activity.

15. An implantable system according to claim 12, wherein said detector means predicts future onset of cardiac arrhythmia from said sensed electrical activity;

said system further comprising;

a plurality of primary electrodes configured for delivering a th erapeutic pulse to said heart;

a power supply; and

control circuit means operatively associated with said power supply, said primary electrodes and said detector means for delivering a therapeutic pulse through said primary electrodes upon the prediction of future onset of cardiac arrhythmia in said patient by said detector means.

16. An implantable system according to claim 15, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.

17. An implantable system according to claim 12, wherein said detector means includes a determining circuit configured to determine the presence of cardiac arrhythmia in said patient.

18. An implantable system according to claim 17, further comprising:

a plurality of primary electrodes configured for delivering a therapeutic pulse to said heart;

a power supply; and

a control circuit operatively associated with said power supply, said primary electrodes and said determining circuit, said control circuit configured for delivering a therapeutic pulse through said primary electrodes upon the determination of the presence of cardiac arrhythmia in said patient.

19. An implantable system according to claim 18, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.

20. An implantable system for detecting electrical activity from a patient'"'"'s heart, comprising:

a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of said heart for sensing electrical activity from said heart;

a second sensing electrode configured for positioning in the right ventricle of said heart for sensing electrical activity from said heart; and

detector means operatively associated with said both first sensing electrode and said second sensing electrode for diagnosing or prognosing a medical condition of said heart with both said sensed electrical activity;

wherein said detector means discriminates the location of origin of premature beats in said heart for said diagnosis or prognosis of said medical condition of said heart with both said sensed electrical activity.

21. An implantable system according to claim 20, further comprising a third sensing electrode configured for positioning in the right atrium or superior vena cava of said heart;

wherein said detector means is operatively associated with all of said first, second, and third sensing electrodes;

and wherein said detector means is configured to diagnose or prognose a medical condition of said heart by relating information obtained from said first, second, and third electrodes.

22. An implantable system according to claim 20, wherein said detector means detects the presence of sinus rhythm with syntactic relationships among electrogram features for said diagnosis or prognosis of said medical condition of said heart with said sensed electrical activity.

23. An implantable system according to claim 20, wherein said detector means descrimenates an atrial location of origin from a ventricular location of origin of premature beats in said heart.

24. An implantable system according to claim 20, wherein said detector means predicts future onset of cardiac arrhythmia from said sensed electrical activity;

said system further comprising;

a plurality of primary electrodes configured for delivering a therapeutic pulse to said heart;

a power supply; and

control circuit means operatively associated with said power supply, said primary electrodes and said detector means for delivering a therapeutic pulse through said primary electrodes upon the prediction of future onset of cardiac arrhythmia in said patient by said detector means.

25. An implantable system according to claim 24, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.

26. An implantable system according to claim 20, wherein said detector means includes a determining circuit configured to determine the presence of cardiac arrhythmia in said patient.

27. An implantable system according to claim 26, further comprising:

a plurality of primary electrodes configured for delivering a therapeutic pulse to said heart;

a power supply; and

a control circuit operatively associated with said power supply, said prinary electrodes and said determining circuit, said control circuit configured for delivering a therapeuticpulse through said primary electrodesupon the determination of the presence of cardiac arrhythmia in said patient.

28. An implantable system according to claim 26, wherein a first one of said primary electrodes is configured for positioning through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart.