Method and system for sensing cardiac contractions during vagal stimulation-induced cardiopalegia

• US 6,628,987 B1
• Filed: 09/26/2000
• Issued: 09/30/2003
• Est. Priority Date: 09/26/2000
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Keogh, James R., Jahns, Scott E., Hill, Michael R. S.
• Primary Examiner(s): Schaetzle, Kennedy
• Assistant Examiner(s): DROESCH, KRISTEN L
• Application Number:
  US09/669,355
• Time in Patent Office: 1,099 Days
• Field of Search: 128/897-898, 600/508-510, 600/519, 607/1-3, 607/9, 607/10, 607/42, 607/62
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/385 Devices for inducing an abnormal cardiac function, e.g. fibrillation

Abstract

A system of performing a medical procedure, such as surgery, is provided. The system comprises a sensor to sense a state of cardiac tissue, such as an impending contraction and an indicator to indicate the state of the cardiac tissue. Methods and devices for performing the medical procedure are also provided.

Claims

1. A method for performing a medical procedure, comprising:

stimulating a nerve to inhibit beating of a heart;

performing the medical procedure while stimulating the nerve;

sensing an imminent escape beat while stimulating the nerve; and

adjusting stimulation of the nerve when an imminent escape beat is sensed.

2. The method of claim 1 wherein the step of sensing the imminent escape beat entails detecting at least one signal indicative of a cardiac contraction.

3. The method of claim 1 further comprising:

signaling when the imminent escape beat is sensed.

4. The method of claim 3 wherein the step of signaling when the imminent escape beat is sensed entails a visual signal.

5. The method of claim 4 wherein the visual signal is a flashing light.

6. The method of claim 3 wherein the step of signaling when the imminent escape beat is sensed entails an audible signal.

7. The method of claim 6 wherein the audible signal is a beeping tone.

8. The method of claim 1 wherein nerve stimulation is increased.

9. The method of claim 1 wherein nerve stimulation is decreased.

10. The method of claim 1 further comprising:

stopping breathing while inhibiting beating of the heart.

11. The method of claim 1 further comprising:

delivering at least one drug during the medical procedure.

12. The method of claim 11 wherein the drug is selected from the group consisting of:

a beta-blocker, a cholinergic agent, a cholinesterase inhibitor, a calcium channel blocker, a sodium channel blocker, a potassium channel agent, adenosine, an adenosine receptor agonist, an adenosine deaminase inhibitor, dipyridamole, a monoamine oxidase inhibitor, digoxin, digitalis, lignocaine, a bradykinin agent, a serotoninergic agonist, an antiarrythmic agent, a cardiac glycoside, a local anesthetic, atropine, a calcium solution, an agent that promotes heart rate, an agent that promotes heart contractions, dopamine, a catecholamine, an inotrope glucagon, a hormone, forskolin, epinephrine, norepinephrine, thyroid hormone, a phosphodiesterase inhibitor, prostacyclin, prostaglandin and a methylxanthine.

13. The method of claim 1 wherein the nerve is selected from the group consisting of:

a vagal nerve, a parasympathetic nerve, a carotid sinus nerve, a fat pad.

14. The method of claim 1 wherein the medical procedure is selected from the group consisting of:

a surgical procedure, a non-surgical procedure, a fluoroscopic procedure, a cardiac procedure, a vascular procedure, a neurosurgical procedure, an electrophysiology procedure, a diagnostic procedure, a therapeutic procedure, an ablation procedure, an endovascular procedure, a liver procedure, a spleen procedure, a pulmonary procedure, an aneurysm repair, an imaging procedure, a CAT scan procedure, a MRI procedure, a pharmacological therapy, a drug delivery procedure, a biological delivery procedure, a genetic therapy, a cellular therapy, a cancer therapy, a radiation therapy, a transplantation procedure, a coronary angioplasty procedure, a stent delivery procedure, an atherectomy procedure, a procedure that requires precise control of cardiac motion, a procedure that requires precise control of bleeding, a non-invasive procedure, a minimally invasive procedure, an invasive procedure, a port-access procedure, an endoscopic procedure, a sternotomy procedure, a thoracotomy procedure and a robotic procedure.

15. A method for performing a medical procedure, comprising:

stimulating a nerve to inhibit beating of a heart;

performing the medical procedure;

sensing a state of cardiac tissue while beating of the heart is inhibited; and

stopping stimulation of the nerve when the state of cardiac tissue indicates an imminent contraction.

16. The method of claim 15 further comprising:

delivering at least one drug during the medical procedure.

17. The method of claim 15 further comprising:

stopping breathing while stimulating the nerve to inhibit beating of the heart.

18. The method of claim 15, further comprising:

stimulating beating of the heart while stopping stimulation of the nerve to inhibit beating of the heart.

19. A method for performing a medical procedure, comprising:

stimulating a nerve to inhibit beating of a heart;

performing the medical procedure;

sensing a state of cardiac tissue while beating of the heart is inhibited; and

allowing beating of the heart to occur when the state of cardiac tissue indicates an imminent contraction.

20. The method of claim 19 further comprising:

delivering at least one drug during the medical procedure.

21. The method of claim 19 further comprising:

stopping breathing while inhibiting beating of the heart.

22. The method of claim 19 further comprising:

stimulating beating of the heart while allowing beating of the heart to occur.

23. A method for performing a medical procedure, comprising:

stimulating a nerve to inhibit beating of a heart;

performing the medical procedure while stimulating the nerve;

detecting at least one indicator of an imminent cardiac contraction while stimulating the nerve;

signaling when an imminent cardiac contraction is detected; and

allowing the heart to beat when the imminent cardiac contraction is detected.

24. The method of claim 23 further comprising:

stopping stimulation of the nerve when the imminent cardiac contraction is detected.

25. The method of claim 23 further comprising:

adjusting stimulation of the nerve when the imminent cardiac contraction is sensed.

26. The method of claim 25 wherein nerve stimulation is increased.

27. The method of claim 25 wherein nerve stimulation is decreased.