Apparatus for signal analysis of the electrical potential curve of heart excitation

• US 5,497,780 A
• Filed: 03/30/1994
• Issued: 03/12/1996
• Est. Priority Date: 03/31/1993
• Status: Expired due to Term

• Current Assignee: Biotronik Mess-Und Therapiegeraete GmbH & Company Ingenieurbuero Berlin (Biotronik SE & Company KG)
• Original Assignee: Manfred Zehender
• Inventors: Zehender, Manfred
• Primary Examiner(s): Manuel, George
• Assistant Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/220,082
• Time in Patent Office: 713 Days
• Field of Search: 128/696, 128/702-705, 128/709, 128/642, 607/4-6, 607/25, 607/26, 607/119, 607/120, 607/122, 607/129
• US Class Current: 600/374
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion

Abstract

An apparatus for signal analysis of the electrical potential curve of heart excitation, for example in the event of an insufficient blood supply at the heart and/or an abnormality in the cardiac rhythm, measures the potential curve by means of an arrangement of electrodes (2, 3, 4), whereby at least two of the three electrodes can be implanted in the heart (8), with a pole (7) of one electrode (3) being placed in the right ventricle and a pole (6) of another electrode (2) being placed in the right auricle or in the transition to the superior vena cava. A third electrode (4) with its pole (9) is implanted outside of the heart (8) in such a way that the connecting lines of the three poles form a triangle that encompasses a portion of the heart (8). The difference in potential between one of the electrodes and the two electrodes that have been connected together at a given time can be measured and the signal curve can be evaluated or sent to an evaluation device. The evaluation can be used to introduce appropriate therapeutic measures.

Claims

1. Apparatus for signal analysis in the event of an insufficient blood supply to a heart and/or a cardiac rhythm abnormality, comprising measuring electrode means for detection of electrical potential curves of heart excitation over time including at least three implantable electrodes, two of which, in their working positions, are adapted for implantation with their poles in the heart and the third of which is adapted for implantation with its pole lying outside of the heart, connecting lines for connecting the three poles to form a triangle that encompasses a portion of the heart, implantable evaluation and control means connected with said electrodes for measurement of an electrical potential between two electrodes connected together at a given time on one hand, and the third electrode on the other hand, whereby a difference in potential at the given time between one of the electrodes and the other two electrodes is measured and a signal representing an electrical potential curve is fed to the evaluation and control means, and memory means, located in the evaluation and control means, for acquisition and storing of the electrical potential curve of a normal heartbeat over time as a reference value, whereby later measurements can be compared with the stored reference value.

2. Apparatus in accordance with claim 1, wherein the evaluation and control means comprises a microprocessor and controls the memory means associated therewith for the storing of measurement data that serve as reference values.

3. Apparatus in accordance with claim 1, wherein at least the poles that are adapted to be implanted in the heart are electrically connected together by at least one of the connecting lines and the electrical potential is measured with respect to the pole adapted to be implanted outside of the heart.

4. Apparatus in accordance with claim 1, wherein the evaluation and control means includes multiplexers for selectably connecting together of two of the three electrodes.

5. Apparatus in accordance with claim 1, wherein the evaluation and control means comprises a microprocessor and multiplexers electrically connected to the microprocessor, wherein the poles are electrically connected to the multiplexers, and wherein the connection of the poles is changed by the microprocessor on a rotating basis by alternating the connection of any two poles after every one or more heartbeats.

6. Apparatus in accordance with claim 1, further comprising an implantable heart stimulator configured as a generator means connected to the control means for generating precise pulses of energy adapted to be delivered to the heart, and a fourth electrode connected to said generator means.

7. Apparatus in accordance with claim 6, wherein the evaluation and control means and the generator means are a unitary structure.

8. Apparatus in accordance with claim 1, wherein the evaluation and control means includes a generator unit and further including a line that connects the two electrodes which are adapted to be implanted inside the heart to the generator unit for the evaluation and control means wherein the pole that is adapted to be located outside of the heart is configured as a ring, which is secured to and surrounds the line that connects the two electrodes that are adapted to be implanted inside the heart.

9. Apparatus in accordance with claim 8, wherein the generator unit of the evaluation and control means includes a housing and wherein the pole of the electrode that is adapted to be implanted outside of the heart comprises at least a part of the housing for the generator unit.

10. Apparatus in accordance with claim 1 further comprising an acoustic signal transmitter connected to the control that is triggered by the measurement of an insufficient blood supply or a cardiac rhythm abnormality.

11. Apparatus in accordance with claim 1, further comprising a medication pump coupled with the evaluation and control means, wherein the pump is switched on in response to a measurement of an insufficient blood supply and/or an abnormality in the cardiac rhythm.

12. Apparatus in accordance with claim 1, further comprising a timer connected to the control means that triggers measurements at the electrodes in a specific, predetermined temporal rhythm.

13. Apparatus in accordance with claim 1, further comprising a heart stimulator coupled with said evaluation and control means in such a way that electrical pulses are fed to the electrode poles upon the occurrence of abnormalities in the cardiac rhythm.

14. Apparatus in accordance with claim 1, wherein the evaluation and control means includes multiplexers that are electrically connected with the electrodes, two summing amplifiers that are electrically connected with the multiplexers, an analog-digital converter electrically connected to the summing amplifiers, and a microprocessor that is electrically connected to the analog-digital converter, the multiplexers being adapted for switching each of the individual electrodes selectively to the two summing amplifiers whose outputs are connected to the analog-digital converter.

15. A method for signal analysis of electrical potential curves of heart excitation over time, particularly in the event of insufficient blood supply to a heart and/or a cardiac rhythm abnormality, comprising utilizing an electrode arrangement having at least three electrodes including the steps of implanting at least two of the three electrodes in the heart with a pole of one electrode implanted in the right heart chamber and a pole of the other electrode implanted in the right auricle or in the superior vena cava, implanting at least a third electrode with its pole outside the heart, forming connecting lines for the three poles in a triangle which encompasses a portion of the heart, measuring an electrical potential difference which exists between one of the electrodes and the other two electrodes at a given time, and evaluating a signal curve from the measurement of the potential difference.

16. The process according to claim 15, wherein the measuring step comprises connecting two of the three poles together and measuring the electrical potential between the two connected poles and the third pole.

17. The process according to claim 16, wherein at least the two poles implanted in the heart are connected together and the electrical potential is measured between these two poles and the pole implanted outside the heart.

18. The process according to claim 16, further comprising changing the two different poles which are connected together at a given time and measuring the electrical potential with respect to the remaining pole.

19. The process according to claim 16, further comprising switching the connection of the poles on a rotating basis by alternating the connection of any two poles after one or more heart beats.

20. The process according to claim 19, wherein the connecting together and switching connection of the electrodes and their poles is accomplished by an implanted, battery-driven control device (10) with a microprocessor (11).

21. The process according to claim 15, further comprising connecting the electrodes with one of an implanted defibrillator and an implanted heart pacemaker.

22. The process according to claim 21, further comprising the heart with at least one of the electrodes implanted in the heart.

23. The process according to claim 15, further comprising determining the electrical potential curve of a heartbeat over time for normal heartbeats, storing the electrical potential curve for normal heartbeats in a memory as a reference value, and comparing later measurements with the reference value stored in memory.

24. The process according to claim 23 further comprising recording deviations from the reference value and producing a signal in response to a measurement which deviates from the reference value.

25. The process according to claim 23 further comprising detecting deviations from the reference value and providing a control impulse to an applicator for a medicament.