Wearable cardiac defibrillator system with anti-bradyarrhythmia pacing and methods

• US 8,838,236 B2
• Filed: 09/17/2013
• Issued: 09/16/2014
• Est. Priority Date: 09/21/2012
• Status: Active Grant

• Current Assignee: West Affum Holdings DAC
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Debardi, Gary, Banville, Isabelle, Stickney, Ronald Eugene
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/029,589
• Publication Number:
  US 20140088660A1
• Time in Patent Office: 364 Days
• Field of Search: 607/7, 607/10, 607/27
• US Class Current: 607/7
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock
• CPC Class Codes: A61N 1/3993 User interfaces for automatic external defibrillators

Abstract

In one embodiment, a wearable defibrillation system may sense whether its wearer meets an unconscious bradyarrhythmia condition that can be associated with becoming unconscious. Even though such a condition might not be helped with a defibrillation pulse, the wearable defibrillation system may still administer pacing pulses to prevent the bradycardia from becoming worse, such as a sudden cardiac arrest. In some embodiments, the pacing pulses are administered at a frequency too slow for the patient to regain consciousness. An advantage is that, because the patient remains unconscious, he does not experience the sometimes severe discomfort due to the pacing pulses.

Claims

1. A wearable defibrillation system comprising:

a support structure configured to be worn by a patient;

a charge storage module coupled to the support structure and configured to store charge;

electrodes configured to detect an ECG of the patient;

a monitoring device other than the electrodes configured to sense a physiological parameter of the patient other than the ECG; and

a processor configured to determine at least in part from the physiological parameter whether the patient meets an unconscious bradyarrhythmia condition, and

in which portions of the charge are delivered to the patient as pacing pulses if it is determined that the patient meets the unconscious bradyarrhythmia condition.

2. The system of claim 1, in which

the monitoring device includes one of a perfusion sensor, a pulse oximeter, a Doppler device for detecting blood flow, a cuff for detecting blood pressure, an optical sensor, an illumination detector, a source for detecting color change in tissue, a motion sensor, a device that can detect artery wall movement, a device that can detect heart wall movement, a sound sensor, a device with a microphone, and an SpO2 sensor.

3. The system of claim 1, in which

the unconscious bradyarrhythmia condition is determined to be met if the physiological parameter indicates that the patient'"'"'s heart rate is less than 45 bpm.

4. The system of claim 1, further comprising:

an output device configured to issue a query to the patient; and

an input device configured to receive an input in response to the query, and

in which the unconscious bradyarrhythmia condition is confirmed to be met if the input device does not receive the input.

5. The system of claim 1, further comprising:

an output device configured to transmit a warning to bystanders if the patient is determined to meet the unconscious bradyarrhythmia condition.

6. The system of claim 1, further comprising:

a communication module configured to transmit an alert message to a remotely located third party if the patient is determined to meet the unconscious bradyarrhythmia condition.

7. The system of claim 1, in which

at least two successive pacing pulses occur at a pacing interval that corresponds to a frequency a less than 50 bpm.

8. The system of claim 1, in which

the processor is configured to detect perfusion pulses occurring naturally in the patient, and

after the last detected naturally occurring perfusion pulse, a subsequent pacing pulse is delivered at least after a pacing interval that corresponds to a frequency of 50 bpm has elapsed.

9. The system of claim 1, in which

the pacing pulses are initially delivered at a first frequency, and

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a second frequency that is smaller than the first frequency.

10. The system of claim 1, in which

the pacing pulses are initially delivered at a first frequency,

the pacing pulses are then delivered at a second frequency that is larger than the first frequency, but

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a third frequency that is smaller than the second frequency.

11. A wearable defibrillation system comprising:

a support structure configured to be worn by a patient;

a charge storage module coupled to the support structure and configured to store charge;

electrodes configured to sense an ECG of the patient; and

a processor configured to determine at least in part from the ECG whether the patient meets an unconscious bradyarrhythmia condition, and

in which portions of the charge are delivered to the patient as pacing pulses if it is determined that the patient meets the unconscious bradyarrythmia condition, the pacing pulses being delivered at a frequency of less than 45 bpm.

12. The system of claim 11, in which

the unconscious bradyarrhythmia condition is determined to be met if the ECG indicates that the patient'"'"'s heart rate is less than 45 bpm.

13. The system of claim 11, further comprising:

an output device configured to issue a query to the patient; and

an input device configured to receive an input in response to the query, and

in which the unconscious bradyarrhythmia condition is confirmed to be met if the input device does not receive the input.

14. The system of claim 11, further comprising:

an output device configured to transmit a warning to bystanders if the patient is determined to meet the unconscious bradyarrhythmia condition.

15. The system of claim 11, further comprising:

a communication module configured to transmit an alert message to a remotely located third party if the patient is determined to meet the unconscious bradyarrhythmia condition.

16. The system of claim 11, in which

the processor is configured to detect perfusion pulses occurring naturally in the patient, and

after the last detected naturally occurring perfusion pulse, a subsequent pacing pulse is delivered at least after a pacing interval that corresponds to a frequency of 45 bpm has elapsed.

17. The system of claim 11, in which

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a subsequent frequency that is smaller than 45 bpm.

18. The system of claim 11, in which

the pacing pulses are then delivered at a second frequency that is larger than 45 bpm, but

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a third frequency that is smaller than the second frequency.

19. A non-transitory computer-readable storage medium storing one or more programs which, when executed by a wearable defibrillation system worn by a patient, they result in:

causing to be sensed a physiological parameter of the patient other than the patient'"'"'s ECG;

causing to be determined at least in part from the physiological parameter whether the patient meets an unconscious bradyarrhythmia condition; and

if so, causing to be delivered pacing pulses to the patient.

20. A non-transitory computer-readable storage medium storing one or more programs which, when executed by a wearable defibrillation system worn by a patient, they result in:

causing the patient'"'"'s ECG to be sensed;

causing to be determined at least in part from the ECG whether the patient meets an unconscious bradyarrhythmia condition; and

if so, causing pacing pulses to be delivered to the patient at a frequency of less than 45 bpm.

21. A method for a wearable defibrillation system worn by a patient, comprising:

sensing is physiological parameter of the patient other than the patient'"'"'s ECG;

determining at least in part from the physiological parameter whether the patient meets an unconscious bradyarrhythmia condition; and

if so, delivering pacing pulses to the patient.

22. The method of claim 21, in which

the unconscious bradyarrhythmia condition is determined to be met if the physiological parameter indicates that the patients heart rate is less than 40 bpm.

23. The method of claim 21, further comprising:

issuing a query to the patient;

then waiting for an input in response to the query, and

in which the unconscious bradyarrhythmia condition is determined to be met if no input is received.

24. The method of claim 21, further comprising:

transmitting a warning to bystanders if the patient is determined to meet the unconscious bradyarrhythmia condition.

25. The method of claim 21, further comprising:

transmitting an alert message to a remotely located third party if the patient is determined to meet the unconscious bradyarrhythmia condition.

26. The method of claim 21, in which

at least two successive pacing pulses occur at a pacing interval that corresponds to a frequency of less than 50 bpm.

27. The method of claim 21, further comprising:

detecting perfusion pulses occurring naturally in the patient, and

after the last detected naturally occurring perfusion pulse, a subsequent pacing pulse is delivered at least after a pacing interval that corresponds to a frequency of 50 bpm has elapsed.

28. The method of claim 21, in which

the pacing pulses are initially delivered at a first frequency, and

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a second frequency that is smaller than the first frequency.

29. The method of claim 21, in which

the pacing pulses are initially delivered at a first frequency,

the pacing pulses are then delivered at a second frequency that is larger than the first frequency, but

if it is later determined that the patient no longer meets the unconscious bradyarrhythmia condition, the pacing pulses are then delivered at a third frequency that is smaller than the second frequency.

30. A method for a wearable defibrillation system worn by a patient, comprising:

sensing the patient'"'"'s ECG;

determining at least in part from the ECG whether the patient meets an unconscious bradyarrhythmia condition; and

if so, delivering pacing pulses to the patient at a frequency of less than 45 bpm.