Medium voltage therapy applied as a test of a physiologic state
First Claim
1. An electrotherapy device for treating arrhythmia in a patient, the device comprising:
- a patient interface including;
a plurality of electrodes adapted to be placed in electrical contact with the patient; and
at least one hemodynamic sensor;
electrotherapy circuitry operatively coupled to the patient interface and including a medium voltage therapy (MVT) pulse generator adapted to supply the MVT via the patient interface as a configurable waveform having a set of adjustable waveform parameters, wherein the waveform is defined by series of pulse trains having an adjustable train repetition rate, the pulse trains being composed of pulses having an adjustable pulse width, an adjustable pulse period, and an adjustable pulse amplitude, the MVT being of an energy level insufficient to shock the heart into a reset state;
patient monitoring circuitry including;
arrhythmia monitoring circuitry operatively coupled to at least a pair of the plurality of electrodes; and
cardiac output monitoring circuitry operatively coupled to the at least one hemodynamic sensor;
a controller operatively coupled to the patient monitoring circuitry and the electrotherapy circuitry, and configured to;
cause the electrotherapy circuitry to initiate application of the MVT to the musculature of the patient via the plurality of electrodes to target a selected muscle group, wherein the selected muscle group is repeatedly (a) forced into a contracted state, (b) maintained in the contracted state, and (c) thereafter allowed to relax, thereby achieving a forced hemodynamic output in the patient;
based on an output of the patient monitoring circuitry, and in response to application of the MVT, ascertain an initial hemodynamic state of the patient;
adjust the waveform parameters to establish a test hemodynamic condition in the patient as a response to the applied MVT, the test hemodynamic condition being associated with an expected hemodynamic state; and
ascertain a difference between the expected hemodynamic state and an actual physiologic state in the patient responsive to the hemodynamic condition, the difference being indicative of an ascertained patient condition.
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Accused Products
Abstract
Aspects of the invention are directed to advanced monitoring and control of medium voltage therapy (MVT) in implantable and external devices. Apparatus and methods are disclosed that facilitate dynamic adjustment of MVT parameter values in response to new and changing circumstances such as the patient'"'"'s condition before, during, and after administration of MVT. Administration of MVT is automatically and dynamically adjusted to achieve specific treatment or life-support objectives, such as prolongation of the body'"'"'s ability to endure and respond to MVT, specifically addressing the type of arrhythmia or other pathologic state of the patient with targeted treatment, a tiered-intensity MVT treatment strategy, and supporting patients in non life-critical conditions where the heart may nevertheless benefit from a certain level of assistance.
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Citations
24 Claims
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1. An electrotherapy device for treating arrhythmia in a patient, the device comprising:
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a patient interface including; a plurality of electrodes adapted to be placed in electrical contact with the patient; and at least one hemodynamic sensor; electrotherapy circuitry operatively coupled to the patient interface and including a medium voltage therapy (MVT) pulse generator adapted to supply the MVT via the patient interface as a configurable waveform having a set of adjustable waveform parameters, wherein the waveform is defined by series of pulse trains having an adjustable train repetition rate, the pulse trains being composed of pulses having an adjustable pulse width, an adjustable pulse period, and an adjustable pulse amplitude, the MVT being of an energy level insufficient to shock the heart into a reset state; patient monitoring circuitry including; arrhythmia monitoring circuitry operatively coupled to at least a pair of the plurality of electrodes; and cardiac output monitoring circuitry operatively coupled to the at least one hemodynamic sensor; a controller operatively coupled to the patient monitoring circuitry and the electrotherapy circuitry, and configured to; cause the electrotherapy circuitry to initiate application of the MVT to the musculature of the patient via the plurality of electrodes to target a selected muscle group, wherein the selected muscle group is repeatedly (a) forced into a contracted state, (b) maintained in the contracted state, and (c) thereafter allowed to relax, thereby achieving a forced hemodynamic output in the patient; based on an output of the patient monitoring circuitry, and in response to application of the MVT, ascertain an initial hemodynamic state of the patient; adjust the waveform parameters to establish a test hemodynamic condition in the patient as a response to the applied MVT, the test hemodynamic condition being associated with an expected hemodynamic state; and ascertain a difference between the expected hemodynamic state and an actual physiologic state in the patient responsive to the hemodynamic condition, the difference being indicative of an ascertained patient condition. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A method for treating arrhythmia in a patient using an electrotherapy device, the method comprising:
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providing a patient interface, including a plurality of electrodes and at least one hemodynamic sensor, placed in electrical contact with the patient; generating medium voltage therapy (MVT) via the patient interface as a configurable waveform having a set of adjustable waveform parameters, wherein the waveform is defined by series of pulse trains having an adjustable train repetition rate, the pulse trains being composed of pulses having an adjustable pulse width, an adjustable pulse period, and an adjustable pulse amplitude, the MVT being of an energy level insufficient to shock the heart into a reset state; monitoring the patient via the patient interface for an occurrence of an arrhythmia; in response to a detected occurrence of an arrhythmia, initiating application of the MVT to the musculature of the patient via the patient interface to target a selected muscle group, wherein the selected muscle group is repeatedly (a) forced into a contracted state, (b) maintained in the contracted state, and (c) thereafter allowed to relax, thereby achieving a forced hemodynamic output in the patient; monitoring a hemodynamic condition of the patient via the patient interface; computationally ascertaining an initial hemodynamic state of the patient based on the arrhythmia monitoring and the hemodynamic condition monitoring; automatically adjusting the waveform parameters to establish a test hemodynamic condition in the patient as a response to the applied MVT, the test hemodynamic condition being associated with an expected hemodynamic state; and computationally ascertaining a difference between the expected hemodynamic state and an actual physiologic state in the patient responsive to the hemodynamic condition, the difference being indicative of an ascertained patient condition. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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Specification