Esophageal stethoscope with carrier members for cardiac pacing and oximetry

• US 20030120167A1
• Filed: 02/06/2003
• Published: 06/26/2003
• Est. Priority Date: 01/21/2000
• Status: Active Grant

• Current Assignee: Eso -Technologies, Inc.
• Original Assignee: John L. Atlee III
• Inventors: Atlee, John L. III
• Granted Patent: US 6,855,116 B2
• Time in Patent Office: Days
• US Class Current: 600/528
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/285 Endotracheal, oesophageal or gastric probes
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 7/023 for introduction into the body, e.g. into the oesophagus oesophageal ECG probes A61B5/285
• CPC Class Codes: A61N 1/0517 Esophageal electrodes

Abstract

An esophageal stethoscope includes a tubular flexible body having an acoustic input region. A carrier member, which is separate from the tubular flexible body, is selectively engageable with the tubular flexible body either proximally or distally of the acoustic input region. The carrier member carries one or more devices for providing esophageal recording, monitoring or stimulation functions. For transesophageal cardiac pacing, electrodes are mounted to the carrier member such that engagement of the carrier member with the tubular flexible body functions to convert the esophageal stethoscope to a pacing stethoscope. To carry out a sensing, recording or monitoring function, such as esophageal oximetry, one or more oximetry probes are mounted to the carrier member such that engagement of the carrier member with the esophageal stethoscope converts the stethoscope for use in an oximetry sensing application. A “universal” stethoscope includes engagement structures at predetermined locations along the length of the tubular flexible body, for use in engaging a stimulation carrier and/or a recording/monitoring carrier with the esophageal stethoscope.

Claims

1. In an esophageal stethoscope including a tubular flexible body having a proximal end and a distal end and including an acoustic input region toward the distal end, the improvement comprising a carrier member separate from the tubular flexible body and engageable with the tubular flexible body, wherein the carrier member includes one or more devices for sensing and/or controlling a condition from or within the esophagus of a patient.

2. The improvement of claim 1, wherein the carrier member defines a passage within which a portion of the tubular flexible body is received for engaging the carrier member with the tubular flexible body.

3. The improvement of claim 2, wherein the carrier member comprises a channel-like member having wall structure defining the passage and terminating in a pair of spaced apart ends, wherein the space between the ends of the wall structure is in communication with the passage such that the tubular flexible body is passed through the space between the ends of the wall structure and into the passage for engaging the carrier member with the tubular flexible body.

4. The improvement of claim 3, wherein the carrier member wall structure is formed of a biocompatible resilient material, wherein the spaced apart ends of the wall structure are movable away from each other to enable the tubular flexible body to be received within the passage, and are movable toward each other into engagement with the tubular flexible body when the tubular flexible body is received within the passage.

5. The improvement of claim 3, further comprising retainer means interposed between the tubular flexible body and the carrier member for maintaining the carrier member in a predetermined axial position relative to the tubular flexible body.

6. The improvement of claim 5, wherein the retainer means comprises an opening in the tubular flexible body, and an engagement member associated with the carrier member and receivable within the opening when the tubular flexible body is received within the passage of the carrier member.

7. The improvement of claim 6, wherein the engagement member comprises a tab member extending inwardly from the carrier member wall structure and into the passage.

8. The improvement of claim 5, wherein the retainer means comprises one or more outward protrusion areas associated with the tubular flexible body and engageable with the carrier member.

9. The improvement of claim 8, wherein the one or more outward protrusion areas comprises one or more ring members associated with and extending outwardly from a wall defined by the tubular flexible body.

10. The improvement of claim 9, wherein the one or more ring members are formed integrally with the wall of the tubular flexible body.

11. The improvement of claim 9, wherein the one or more ring members are separate from and engageable with the wall of the tubular flexible body.

12. The improvement of claim 9, wherein the wall structure of the carrier member includes one or more grooves for receiving the one or more ring members.

13. The improvement of claim 9, wherein the carrier member defines a proximal end and a distal end, and wherein the ring members are located on the tubular flexible body such that a first one of the ring members is located adjacent the proximal end of the carrier member and a second one of the ring members is located adjacent the distal end of the carrier member.

14. The improvement of claim 2, wherein the one or more devices comprise a series of pacing electrodes for transesophageal cardiac stimulation.

15. The improvement of claim 14, wherein each pacing electrode is interconnected with an electrical lead wire, and wherein the carrier member defines passage structure for receiving the electrical lead wires and wherein the passage structure is oriented such that the electrical lead wires extend from a proximal end defined by the carrier member.

16. The improvement of claim 14, wherein the carrier member is engageable with the tubular flexible body between the acoustic input region and the distal end of the tubular flexible body.

17. The improvement of claim 2, wherein the one or more devices comprise one or more oximetry transceivers.

18. The improvement of claim 17, wherein the one or more oximetry transceivers are interconnected with one or more electrical lead wires, and wherein the carrier member defines passage structure for receiving the electrical lead wires and wherein the passage structure is oriented such that the electrical lead wires extend from a proximal end defined by the carrier member.

19. The improvement of claim 2, wherein the carrier member includes an outwardly movable area to which the one or more devices are mounted.

20. The improvement of claim 19, wherein the outwardly movable area comprises a deformable membrane located over a recess formed in the carrier member, wherein the one or more devices are mounted to the deformable membrane, and further comprising an inflatable member located within the recess, wherein inflation of the inflatable member functions to deform the membrane outwardly to move the one or more devices outwardly relative to the carrier member.

21. The improvement of claim 20, wherein the inflatable member is interconnected with an inflation tube, and wherein the carrier member defines a passage for receiving the inflation tube and oriented such that the inflation tube extends from the recess to a proximal end defined by the carrier member.

22. The improvement of claim 20, wherein the one or more devices comprise a pair of spaced apart oximetry transceivers, and wherein the carrier member includes a pair of spaced apart recesses and a deformable membrane located over each recess, wherein an inflatable member is located within each recess and wherein an oximetry transceivers is mounted to each deformable membrane, wherein the oximetry transceivers are oriented on the deformable membranes such that inflation of the inflatable members is operable to position the oximetry transceivers so as to face each other.

23. The improvement of claim 1, further comprising a second carrier member separate from the tubular flexible body and engageable with the tubular flexible body toward the distal end, wherein a distal first one of the carrier members carries a series of pacing electrodes for transesophageal cardiac stimulation, and wherein a proximal second one of the carrier members carries one or more oximetry sensors.

24. The improvement of claim 23, wherein the first carrier member is engageable with the tubular flexible body distally of the acoustic input region and wherein the second carrier member is engageable with the tubular flexible body proximally of the acoustic input region.

25. The improvement of claim 24, wherein each carrier member defines a passage within which a portion of the tubular flexible body is received for engaging the carrier member with the tubular flexible body.

26. The improvement of claim 25, wherein each carrier member comprises a channel-like member having wall structure defining a passage terminating in a pair of spaced apart ends, wherein the space between the ends of the wall structure is in communication with the passage such that the tubular flexible body is passed through the space between the ends of the wall structure and into the passage for engaging the carrier member with the tubular flexible body.

27. The improvement of claim 25, further comprising retainer structure interposed between each carrier member and the tubular flexible body for maintaining each carrier member in a predetermined axial position relative to the tubular flexible body.

28. The improvement of claim 27, wherein the retainer structure comprises one or more openings formed in a wall defined by the tubular flexible body at a predetermined location on the tubular flexible body, and one or more engagement members formed on each carrier member and adapted to be received within the one or more openings in the wall of the tubular flexible body.

29. An esophageal stethoscope assembly, comprising:

a tubular flexible body having a proximal end and a distal end, and including an acoustic input region defined on the tubular flexible body toward the distal end; and

a carrier member separate from the tubular flexible body and engageable with the tubular flexible body, wherein the carrier member includes one or more devices for sensing and/or controlling a condition from or within the esophagus of a patient.

30. The esophageal stethoscope assembly of claim 29, wherein the tubular flexible body extends along a longitudinal axis, and wherein the carrier member defines an axial passage and includes wall structure defining a pair of spaced ends, wherein the space between the spaced ends of the wall structure is in communication with the axial passage, and wherein the carrier member is engageable with the tubular flexible body by application of a push-on force transverse to the longitudinal axis of the tubular flexible body such that the tubular flexible body passes through the space between the wall structure ends and into the axial passage of the carrier member.

31. The esophageal stethoscope assembly of claim 30, wherein the carrier member wall structure is formed of a resilient material such that the wall structure is separable to enlarge the space between the wall structure ends to allow the tubular flexible body to pass therethrough into the axial passage of the carrier member, and wherein the resiliency of the wall structure is operable to thereafter engage the wall structure with the tubular flexible body.

32. The esophageal stethoscope assembly of claim 31, further comprising retainer structure interposed between the carrier member and the tubular flexible body for maintaining the carrier member in a predetermined axial position relative to the tubular flexible body.

33. The esophageal stethoscope assembly of claim 30, wherein the carrier member is engageable with the tubular flexible body distally of the acoustic input region and wherein the one or more devices comprise a series of pacing electrodes carried by the carrier member.

34. The esophageal stethoscope assembly of claim 30, wherein the carrier member is engageable with the tubular flexible body proximally of the acoustic input region and wherein the one or more devices comprise one or more oximetry sensors carried by the carrier member.

35. The esophageal stethoscope assembly of claim 30, wherein the carrier member is engageable with the tubular flexible body distally of the acoustic input region and wherein the one or more devices comprise a series of pacing electrodes, and further comprising a second carrier member separate from the tubular flexible body and engageable with the tubular flexible body proximally of the acoustic input region, wherein the proximal second carrier member carries one or more oximetry sensors.

36. A method of mounting one or more sensing and/or controlling devices to an esophageal stethoscope for use in sensing and/or controlling a condition of a patient from or within the esophagus, wherein the stethoscope includes a tubular flexible body having a proximal end and a distal end, comprising engaging a carrier member, separate from the tubular flexible body, with the tubular flexible body, wherein the one or more devices are mounted to the carrier member.

37. An esophageal stethoscope, comprising a tubular flexible body having a proximal end and a distal end and including an acoustic input region toward the distal end, wherein the tubular flexible body includes first engagement structure located distally of the acoustic input region and second engagement structure located proximally of the acoustic input region, wherein the first engagement structure is adapted to engage a first carrier member separate from the tubular flexible body and including one or more stimulation devices for use in transesophageal cardiac pacing, and wherein the second engagement structure is adapted to engage a second carrier member separate from the tubular flexible body and including one or more oximetry sensors for use in esophageal oximetry.

38. The esophageal stethoscope of claim 37, wherein each of the first and second engagement structures comprises one or more openings in wall structure defined by the tubular flexible body at a predetermined axial location relative to the acoustic input region.

39. The esophageal stethoscope of claim 38, wherein each carrier member defines an internal passage for receiving the tubular flexible body, and one or more engagement members extending into the internal passage and engageable with the one or more openings.

40. The esophageal stethoscope of claim 37, wherein at least one of the first and second engagement structures comprises an outward protrusion on wall structure defined by the tubular flexible body at a predetermined axial location relative to the acoustic input region.

41. The esophageal stethoscope of claim 40, wherein at least one of the carrier members defines a recessed area for receiving the outward protrusion.

42. The esophageal stethoscope of claim 41, wherein the outward protrusion comprises a ring member and wherein the recessed area comprises a groove formed in an internal wall associated with the carrier member.

43. The esophageal stethoscope of claim 41, wherein the outward protrusion comprises at least one tab member interconnected with the tubular flexible body and receivable with at least one opening formed in the carrier member.