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Medium voltage therapy applied as a test of a physiologic state

  • US 9,144,684 B2
  • Filed: 07/22/2014
  • Issued: 09/29/2015
  • Est. Priority Date: 07/02/2009
  • Status: Active Grant
First Claim
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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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