Methods, systems and computer program products to inhibit ventricular fibrillation during cardiopulmonary resuscitation

• US 8,843,195 B2
• Filed: 04/23/2010
• Issued: 09/23/2014
• Est. Priority Date: 12/02/2003
• Status: Active Grant

• Current Assignee: UAB Research Foundation (University of Alabama System)
• Original Assignee: UAB Research Foundation (University of Alabama System)
• Inventors: Ideker, Raymond E., Walcott, Gregory P.
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US12/766,290
• Publication Number:
  US 20100204623A1
• Time in Patent Office: 1,614 Days
• Field of Search: 607/3, 607 5- 7
• US Class Current: 607/5
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5043 Displays
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5058 Sensors or detectors
• CPC Class Codes: A61H 2203/03 especially adapted for animals
• CPC Class Codes: A61H 2230/04 Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
• CPC Class Codes: A61H 31/00 Artificial respiration or heart stimulation, e.g. heart massage artificial respiration by treatment with gas or air, e.g. mouth-to-mouth respiration A61M16/00; applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers A61N1/36 ; teaching or training models, demonstration models for medical purposes G09B23/288
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61H 31/007 Manual driven
• CPC Class Codes: A61N 1/39044 in combination with cardiopulmonary resuscitation [CPR] therapy

Abstract

Methods, systems and computer program products determine and identify a favorable time to deliver cardiac compression to a subject to avoid a vulnerable period of a spontaneous intrinsic cardiac cycle.

Claims

1. A method for performing chest compression during cardiopulmonary resuscitation (CPR), comprising;

electrically stimulating a subject'"'"'s heart during cardiopulmonary resuscitation; and

compressing the heart at a selected time proximate to the delivery of the electrical stimulation that avoids compressing the heart during a vulnerable T-wave portion of the intrinsic cardiac cycle, wherein the selected time that avoids compressing the heart during the vulnerable T-wave portion of the intrinsic cardiac cycle is selected responsive to an electrically stimulated cardiac cycle and/or a sensed measure of spontaneous cardiac activity that includes a T-wave portion.

2. A method according to claim 1, wherein the compressing step is initiated in advance of the electrical stimulation.

3. A method according to claim 1, wherein the compressing step is initiated during the electrical stimulation.

4. A method according to claim 3, wherein the compressing step is initiated after the electrical stimulation at a time that does not overlap with the T wave portion of a spontaneous intrinsic cardiac cycle.

5. A method according to claim 1, wherein the electrical stimulation comprises applying a shock with an external defibrillator.

6. A method according to claim 5, wherein electrical stimulation comprises applying a shock to the heart with an implantable defibrillator.

7. A method according to claim 1, wherein compressing the heart comprises manually compressing the heart.

8. A method according to claim 7, further comprising automatically generating an audible alert when compression is to be initiated to direct a person to initiate manual compression.

9. A method according to claim 8, wherein the manual compression is a closed chest manual compression.

10. A method according to claim 8, wherein the manual compression is an internal chest compression.

11. A method according to claim 8, wherein the manual compression is an open chest compression.

12. A method according to claim 1, wherein the compressing the heart comprises mechanically compressing the heart using a compression device.

13. A method according to claim 12, further comprising automatically controlling the device to apply the mechanical compression based on the timing of the electrical stimulation.

14. A method according to claim 13, wherein the device is an external device residing on a closed chest of the subject.

15. A method according to claim 13, wherein the device comprises an internal portion that automatically inflates and deflates to provide a minimally invasive direct cardiac massage.

16. A method according to claim 14, wherein the external device comprises an inflatable vest configured to compress the chest.

17. A system for performing chest compression during cardiopulmonary resuscitation (CPR), comprising;

means for electrically stimulating a subject'"'"'s heart during cardiopulmonary resuscitation; and

means for compressing the heart at a selected time proximate to the delivery of the electrical stimulation that avoids compressing the heart during a vulnerable T-wave portion of the intrinsic cardiac cycle, wherein the selected time that avoids compressing the heart during the vulnerable T-wave portion of the intrinsic cardiac cycle is selected responsive to an electrically stimulated cardiac cycle and/or a sensed measure of spontaneous cardiac activity that includes a T-wave portion.

18. A system according to claim 17, wherein the means for compressing the heart comprises a mechanically operated device.

19. A system according to claim 18, further comprising means for automatically controlling the mechanically operated device to apply a mechanical compression responsive to the timing of the electrical stimulation.

20. A system according to claim 19, wherein the device is an external device configured to reside about a closed chest of the subject.

21. A system according to claim 19, wherein the device comprises an internal portion that is configured to automatically inflate and deflate to provide a minimally invasive direct cardiac massage.

22. A system according to claim 19, wherein the means for stimulating comprises electrodes configured to engage a chest of the subject undergoing CPR.

23. A system according to claim 22, wherein the means for stimulating comprises implantable electrodes positioned in the subject.

24. A system according to claim 17, further comprising an audible indicator signal alerting as to when timing for compressing the heart is favorable.