Method and system for the treatment of hyperkinetic atrial arrhythmia

• US 6,416,493 B1
• Filed: 06/27/1997
• Issued: 07/09/2002
• Est. Priority Date: 06/27/1996
• Status: Expired due to Term

• Current Assignee: Mauro Del Giglio
• Original Assignee: Mauro Del Giglio
• Inventors: Del Giglio, Mauro
• Primary Examiner(s): STRIGHT, RONALD K
• Application Number:
  US08/884,567
• Time in Patent Office: 1,838 Days
• Field of Search: 604/19, 604/20, 604/65, 604/66, 604/67, 604/96, 604/247, 604/246, 604/96.01, 604/97.01, 604/98.01, 604/99.01, 604/99.02, 604/99.03, 604/99.04, 604/101.01, 604/101.03, 604/101.05, 600/18, 600/377, 600/381
• US Class Current: 604/96.01
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters
• CPC Class Codes: A61N 1/30 Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis

Abstract

A method and device for the pharmacological cardioversion of fibrillation or atrial flutter is disclosed. The device is implantable in the human body and provides equipment for drug infusion using an electrocatheter positioned in the right atrium, the right ventricle, or the coronary sinus. The electrocatheter is provided with sensors which monitor the electromechanical activity of the heart and which intervene to activate the infusion in the presence of fibrillation or flutter. The catheter may be provided with at least one balloon which can be inflated and deflated to create a chamber which permits perfusion of the drug directly into the vein of Marshall.

Claims

1. A medical device adapted for implantation in a patient'"'"'s body for treatment of atrial arrythmia, comprising:

a catheter having a distal end and a proximal end, the catheter having at least one expandable balloon positioned near its distal end, a drug delivery outlet and first and second lumens, the first lumen being connected to the drug delivery outlet, and the second lumen being connected to the expandable balloon, the catheter further having at least one sensing electrode and at least one stimulation electrode, each sensing and stimulation electrode being connected to a separate conductor;

a housing connected to the proximal end of the catheter;

first and second pumps contained within the housing;

first and second reservoirs contained within the housing, the first reservoir being connected to the first lumen and configured to contain a drug, the second reservoir being connected to the second lumen and configured to contain an inflation medium including one of a liquid and a gas, the first pump being connected such that the drug is pumped from the first reservoir through the first lumen and out the drug delivery outlet when the first pump is activated, the second pump being connected such that the inflation medium is pumped from the second reservoir through the second lumen into the balloon when the second pump is activated;

a first circuit connected to the at least one sensing electrode through a respective conductor, the first circuit being configured for sensing electrical activity of the patient'"'"'s heart including atrial fibrillation and at least one of cardiac rate, QRS duration, PQ distance, QTc length, onset of A-V block, and cardiac muscle contractility, the first circuit configured to generate at least one output signal indicative of the sensed electrical activity; and

a second circuit connected to receive the at least one output signal from the first circuit and configured to generate a first activation signal when atrial fibrillation is sensed, the second circuit being connected to provide the first activation signal to the first pump to activate the first pump, such that the drug is delivered through the drug delivery outlet when the first activation signal is provided to the first pump, the second circuit being configured to terminate the first activation signal upon sensing at least one of an increase in cardiac rate above a predetermined high rate threshold, a decrease in cardiac rate below a predetermined low rate threshold, an increase in QRS duration above a predetermined QRS threshold, an increase in PQ distance above a predetermined threshold PQ distance, an increase in QTc length above a predetermined threshold QTc length, the onset of A-V block and a reduction in cardiac muscle contractility below a predetermined threshold cardiac muscle contractility.

2. The medical device of claim 1 further comprising a two-way telemetry circuit connected so that the first circuit and the second circuit are externally programmable.

3. The medical device of claim 2 wherein the telemetry circuit further comprises a microcontroller.

4. The medical device of claim 3 wherein the microcontroller is capable of stopping drug infusion upon detection of predetermined thresholds.

5. The medical device of claim 1 wherein the second circuit is configured to generate a second activation signal when atrial fibrillation is sensed, the second circuit being connected to provide the second activation signal to the second pump such that the inflation medium is pumped into the at least one balloon when the second activation signal is provided to the second pump.

6. The medical device of claim 1 wherein the first activation signal comprises a first programmed infusion cycle having programmable parameters including at least one of drug dosage and time of drug administration.

7. The medical device of claim 1 wherein the first reservoir further comprises a port for filling the first reservoir.

8. The medical device of claim 1 wherein the first pump is a mechanical pump.

9. The medical device of claim 1 wherein the drug delivery outlet comprises a one-way valve.

10. The medical device of claim 1 wherein the drug delivery outlet comprises a porous segment through which the drug may be released.