Implantable cardiac function monitor and stimulator for diagnosis and therapy delivery
First Claim
1. Apparatus for applying therapy to a patient based upon a contractile state of the patient'"'"'s heart, the apparatus comprising:
- (a) intracardiac sensing means for sensing hemodynamic indicators of said contractile state in at least one ventricular chamber of the heart;
(b) signal means coupled to said sensing means for developing a control signal varying as a function of said hemodynamic indicators;
(c) patient therapy means having at least one stimulating electrode for applying stimulating pulses to tissue as a function of said control signal to increase the strength of contraction of the patient'"'"'s heart; and
(d) means for applying said control signal to said patient therapy means for changing said contractile state by increasing the strength of contraction of the heart.
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Accused Products
Abstract
An implantable monitor/stimulator is disclosed that monitors and assesses indices of cardiac function, including the strength and timing of cardiac contraction, then automatically executes a physician-selected mode of therapy. It accomplishes this by assessing impedance, electrocardiogram, and/or pressure measurements, then calculating various cardiac parameters. The results of these calculations may be stored within the device, telemetered to an external monitor or display and/or may be used by the physician to determine the mode of therapy to be chosen. If indicated, therapy is administered by the device itself or by telemetering control signals to various peripheral devices for the purpose of enhancing either contraction or relaxation of the heart. The cardiac parameters that are calculated all provide an assessment of level of cardiac function by monitoring changes in ventricular filling and ejection or by calculating isovolumic phase indices of heart contraction. Examples of such parameters are ejection fraction, cardiac output, stroke work, and/or various pressure-volume relationships. These parameters determine the mode of therapy that will be selected by a physician. Choices of therapy include several forms of pacing of cardiac or skeletal muscle, and telemetry to implanted or external units for drug infusion or for monitoring by a central data system.
426 Citations
18 Claims
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1. Apparatus for applying therapy to a patient based upon a contractile state of the patient'"'"'s heart, the apparatus comprising:
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(a) intracardiac sensing means for sensing hemodynamic indicators of said contractile state in at least one ventricular chamber of the heart; (b) signal means coupled to said sensing means for developing a control signal varying as a function of said hemodynamic indicators; (c) patient therapy means having at least one stimulating electrode for applying stimulating pulses to tissue as a function of said control signal to increase the strength of contraction of the patient'"'"'s heart; and (d) means for applying said control signal to said patient therapy means for changing said contractile state by increasing the strength of contraction of the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. Apparatus for applying therapy to a patient based upon a contractile state of the patient'"'"'s heart, the apparatus comprising:
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(a) intracardiac sensing means for sensing hemodynamic indicators of said contractile state in at least one ventricular chamber of the heart; (b) signal means coupled to said sensing means for developing a control signal varying as a function of said hemodynamic indicators; (c) a drug infusion system for administering a drug to the patient as a function of said control signal to increase the strength of contraction of the patient'"'"'s heart; and (d) means for applying said control signal to said drug infusion system for changing said contractile state by increasing the strength of contraction of the heart.
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18. A method of applying therapy to a patient, using an apparatus comprising:
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(a) intracardiac sensing means for sensing hemodynamic indicators of a contractile state of a patient'"'"'s heart; (b) signal means coupled to said sensing means for producing a control signal in response to the sensed hemodynamic indicators; and (c) patient therapy means comprising either (i) a stimulating electrode for applying stimulating pulses to tissue as a function of said control signal for increasing the strength of contraction of the patient'"'"'s heart, or (ii) a drug infusion system for administering a drug to the patient to increase the contractile strength of the patient'"'"'s heart; comprising the steps of; (i) sensing said hemodynamic indicators using said intracardiac sensing means; (ii) using said signal means to produce a control signal in response to the sensed hemodynamic indicators; and (iii) applying therapy to the patient using said therapy means by applying said stimulating pulses to said tissue, or using said drug infusion system to administer said drug to said patient, to increase the strength of contraction of the patient'"'"'s heart.
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Specification