Hemodynamically responsive system for and method of treating a malfunctioning heart
First Claim
1. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy, electrode means for electrically coupling the storage means to the heart, pressure responsive sensing means for sensing pressure within at least one vessel between the heart and at least one lung, means for providing a first signal representative of baseline pressure, means responsive to output from the sensing means for developing a second signal representing mean current pressure over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon change in the mean current pressure of at least a predetermined amount from the representative baseline pressure.
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Abstract
A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient'"'"'s circulatory system being sensed. A signal is developed representative of short term mean arterial pressure (MAP), mean right atrial pressure (MRAP), mean right ventrical pressure (MRVP), mean left atrial pressure (MLAP), mean left ventricle pressure (MLVP), mean central venous pressure (MCVP), mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP) or mean pulmonary capillary wedge pressure (MPCWP). A signal representative of fixed baseline pressure is provided and if the short term current mean pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying the baseline pressure and mean current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodient, the rate and pressure criteria both must exist at the same time, before cardioverting/-defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.
89 Citations
37 Claims
- 1. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy, electrode means for electrically coupling the storage means to the heart, pressure responsive sensing means for sensing pressure within at least one vessel between the heart and at least one lung, means for providing a first signal representative of baseline pressure, means responsive to output from the sensing means for developing a second signal representing mean current pressure over a period of given duration, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon change in the mean current pressure of at least a predetermined amount from the representative baseline pressure.
- 16. A method of treating a malfunctioning heart comprising sensing pressure within a vessel between the heart and at least one lung, providing a representation of baseline pressure, determining mean current pressure from the sensed pressure at the site over a period of given duration, and delivering cardioverting/defibrillating electrical energy to the heart in response to change of at least a predetermined magnitude in the mean current pressure from the baseline pressure.
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27. In a system for treating a malfunctioning heart of the type which includes storage means for storing electrical energy, electrode means for electrically coupling the storage means to the heart, pressure responsive sensing means for sensing pressure within at least one vessel between the heart and at least one lung, means for providing a first signal representative of baseline pressure, means responsive to output from the sensing means for developing a second signal representing mean current pressure, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for charging and enabling discharge of the electrical energy stored by the storage means across the electrode means upon change in the mean current pressure of at least a predetermined amount from the representative baseline pressure.
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28. A method of treating a malfunctioning heart comprising sensing pressure within a vessel between the heart and at least one lung, providing a representation of baseline pressure, determining means current pressure from the sensed pressure, and delivering cardioverting/defibrillating electrical energy to the heart in response to change of at least a predetermined magnitude in the mean current pressure from the baseline pressure.
- 29. A system for treating a malfunctioning heart comprising pressure responsive sensing means for sensing pressure within at least one vessel between the heart and at least one lung, means for providing a first signal representative of baseline pressure, means responsive to output from the sensing means for developing a second signal representing current pressure, and means responsive to output from the means for providing the first signal and output from the means for developing the second signal for enabling electrical means for correcting the malfunction upon change in the current pressure of at least a predetermined amount from the representative baseline pressure.
Specification