Method and apparatus for delivering pre-shock defibrillation therapy

• US 7,089,055 B2
• Filed: 06/28/2002
• Issued: 08/08/2006
• Est. Priority Date: 06/28/2002
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lovett, Eric G., Lang, Douglas J., Cates, Adam W.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Assistant Examiner(s): Alexander, John D
• Application Number:
  US10/184,019
• Publication Number:
  US 20040002739A1
• Time in Patent Office: 1,502 Days
• Field of Search: 607 2- 5, 607/9, 607/14, 607/46, 607/119, 607/120, 607/122
• US Class Current: 607/4
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

An apparatus and method is presented for improving cardiac function after successful termination of a tachyarrhythmia such as ventricular fibrillation. A series of electrical stimulation pulses are delivered prior to a defibrillation shock if one or more specific criteria are met.

Claims

1. A cardiac rhythm management device, comprising:

a sensing channel for generating electrograms reflecting cardiac electrical activity;

a defibrillation shocking channel for delivering a defibrillation shock pulse to the heart;

a stimulation channel for delivering stimulation pulses to improve post-shock cardiac function;

a controller for causing the defibrillation shocking channel to deliver a first defibrillation shock with no preceding stimulation pulses upon detection of a tachyarrhythmia from the sensed electrogram;

wherein the controller is programmed to deliver subsequent defibrillation shocks with increasing energy until the tachyarrhythmia is terminated or a specified maximum energy is reached; and

,

wherein the controller is programmed to cause the delivery of a series of stimulation pulses to the heart prior to delivery of a subsequent defibrillation shock if the energy of the subsequent defibrillation shock is above a specified threshold and if the tachyarrhythmia has been present for a minimum specified time.

2. The device of claim 1 wherein the stimulation channel is additionally utilized as a pacing channel by the controller.

3. The device of claim 1 wherein the defibrillation shocking channel includes a pair of shock electrodes and further wherein the stimulation channel utilizes the shock electrodes for delivering stimulation pulses.

4. The device of claim 1 wherein the stimulation pulses are in a frequency range approximately between 10 and 100 Hz.

5. The device of claim 1 wherein the series of stimulation pulses delivered to the heart prior to delivery of a subsequent defibrillation shock is a pulse train of a duration on the order of 100 milliseconds to 2 seconds.

6. The device of claim 1 wherein the stimulation pulses are of a magnitude on the order of 15 to 200 volts.

7. The device of claim 1 wherein the controller is programmed to increase the energy of a subsequent defibrillation shock if a specified number of previous defibrillation shocks were unsuccessful in terminating the tachyarrhythmia.

8. A method for operating a cardiac rhythm management device, comprising:

generating electrograms reflecting cardiac electrical activity;

delivering a first defibrillation shock upon detection of a tachyarrhythmia from a sensed electrogram;

delivering subsequent defibrillation shocks with increasing energy until the tachyarrhythmia is terminated or a specified maximum energy is reached; and

,

delivering of a series of stimulation pulses to the heart prior to delivery of a subsequent defibrillation shock if the energy of the subsequent defibrillation shock is above a specified threshold and if the tachyarrhythmia has been present for a minimum specified time.

9. The method of claim 8 wherein the stimulation pulses are in a frequency range approximately between 10 and100 Hz.

10. The method of claim 8 wherein the series of stimulation pulses delivered prior to delivery of a subsequent defibrillation shock is a pulse train having a duration between 10 and 100 milliseconds.

11. The method of claim 8 wherein the stimulation pulses have an amplitude between 15 and 200 volts.

12. The method of claim 8 further comprising increasing the energy of subsequent defibrillation shocks if a specified number of previous defibrillation shocks were unsuccessful in terminating the tachyarrhythmia.