DE1962743A1 - Pacemaker - Google Patents

Description

2 Hamburg 52

QleaestraBe β P.O. Box 320 58Ο Call 89 28 O3

New registration December 12, 1969

Applicant: United States Atomic Energy Commission

my file: 6IO / 69

UNITED STATES ATOMIC ENERGY COMMISSION Germantown, Maryland, U.S.A.

Pacemaker

Priority: United States of America from 12/24/1968 File number: 786,559

In recent years, great strides have been made in the development of cardiac assisting or replacing machines that are used when the human heart is weak and / or injured. The Hers, however, is more than a mere pump for the blood; rather, its activity has to be in accordance with numerous physiological conditions which are constantly changing. _e Diss has the consequence that up to now ζ .Llrfr-i -.- ho Pr-cfclsa; ® «solved ^ BTüsn nuts,

UU - 8; £ -4 f

1 9627 A3

before a completely adequate artificial heart or such a pacemaker device to work perfectly can be brought. For example, such devices must meet the highest demands in terms of reliability suffice, they must have the ability to meet the changing blood demands, and they must be able to generate such a pulsating flow as the human body apparently requires or at least as it is considered important.

As already indicated, devices of the type in question are generally assigned to artificial hearts, which are pumps that replace cardiac activity, or pacemakers, ie pumps that support the activity of the heart. Artificial herds have the advantage _s that allow a heart that is no longer capable of another activity that can completely replace; However, they have the disadvantage that they require very high energy * require a versatile monitoring system and complications arise * if the pump fails. On the other hand, the pacemaker devices require less energy, and you can also rely on the E-3PZ for the control function, which is also used when it is heavily used

Ö3S828 / ¹ M 7 p

or prevent the worst if the pump fails. The major disadvantage of such pacemaker devices consists, however, in the fact that the synchronization of its puncture with that of the natural one Poses a problem to the heart

The invention is based on the object of eliminating the last-mentioned disadvantages and a cardiac pacemaker device to create that can be used together with the heart and has the ability to choose from among a multitude of different expected cardiac activity conditions automatically synchronized with the natural heart to be able to work.

This task is solved by means of a single-acting, feedback pacemaker connected in series between the ejection of the left ventricle and the aorta and which contains an inlet and an outlet chamber, the inlet and outlet of which is regulated by control valves, and which also has a control valve for regulating the flow of air from the inlet chamber to the outlet chamber. There is also a hydraulically operated control system which senses the pressure in the inlet chamber and controls the movement of a piston in the partition between the two chambers, which regulates the pumping action of the device.

009828/1179

The pacemaker according to the invention is accordingly connected in series with the left ventricle of the heart and with the aorta / it supports the function of the left ventricle, thus enabling it to work at a reduced pressure level. How to know The left ventricle is used to supply the body's circulatory system, which requires the greatest amount of fluid, and thus the greatest pumping demand is placed on the Heart set · By a single-acting pacemaker coupled with it, as it is described as a preferred embodiment of the invention, the heart has the possibility of under not difficult conditions with regard to To work flow rate and amount and to reproduce the physiologically required conditions of flow rate and pressure when expelling. When the invention The device uses a hydraulic fluid from a controlled pressure source to keep the fluid flowing through the system Pulsing blood at the same time that the left ventricle is pulsing. The flow of blood from the device into the arteries is adapted to the inflow into the device from the left ventricle, so that the pressure and flow conditions in the blood circulation correspond to the physiological conditions.

The pacemaker according to the invention has the advantage that it is both artistic and functional

009828/1179

the previously known devices is improved. Other merits and advantages of the invention are from the following Description of a preferred embodiment of the invention based on the accompanying drawings.

In the drawing, a preferred embodiment of the invention is shown in section, partially schematized.

As illustrated in the drawing, the single-acting feedback cardiac pacemaker device 10 has a tubular inlet 12 which opens into the main container 14 from which the tubular outlet 16 extends. There is also a control device 18. The inlet and outlet tubes 12 and 16, as well as the main container 14, are constructed of a suitable inert flexible or foldable material such as polyurethane. The inlet pipe 12 can by known surgical techniques to the outlet of the left ventricle (not shown) are connected, while the outlet tube (not shown) in a similar fashion to the aorta 16 _s is connected to the flow direction of the blood running in the direction DER arrows A and B, and it can be seen that the device 10 is arranged in series dan * .it with respect to the heart within the river 1st »£ ' ^! 9 rule ei rw.l - ^^. V'-r "* ^{n <} int Wyy: f-'ni I ^ I ^ su-Q, ύϊβτ

The main container 14 is divided into an upper chamber 24 and a lower chamber 26 by two walls 28 and 32. As illustrated, a driven piston 34 is arranged between the walls 28 and 32, on which a push rod 36 is seated, which is guided through the outer wall of the main container 14 and extends into the control device 18. In the inlet pipe 12, in the outlet pipe 16 and between the two chambers 24 and 26, check valves © 38 _s 42 and 44 are arranged, the non-return movement of which is limited by stops 38a, 42a and 442. From the above description it can be seen that when the piston ~ $ K upwards wxu. below reciprocates, fluid from the chambers 24 and is pumped through the valve 44 26, wherein the upper chamber 24 is replenished through the check valve 38 is emptied ₅ while the lower chamber 26 through the valve 42 *

The control device l8 consists of a housing 46 in which a cylinder 48 is formed. In the cylinder 48 is slidably disposed a regulating piston 52 supported by a spring 5 ^ is biased upwards »The piston 52 is on the Pushrod 36 attached, which extends through the piston, and it's going through the top of the piston ' a shaft pin 56 is present.

In the housing 46, a hydraulic double-piston "spool valve 58 is slidably mounted within a cylinder 62 009828/1179

arranges, with an inlet 64, an outlet 66 and a into the one formed in the cylinder 48 above the piston 52 Chamber leading supply line 68 is in communication. The inlet 64 is connected continuously via an inflow manifold 73 a sufficiently high pressure maintaining hydraulic fluid is supplied. The spool valve 58 is seated Bolt 72, which has a guide pin? 4 at its end and operates as described below. The movement of the spool valve 58 causes the hydraulic fluid from the inlet 64 to pressurize the space above the piston 52 and can through this Valve the liquid withdrawn from the aforementioned space and displaced through the Aus a8 66, as this in itself is known.

A receiver spring bellows 76 seated in the control device 18 is connected via the already mentioned hose line 22 to a sensing spring bellows 78 which is installed in the upper chamber 24 of the main container 14. Suitable fluid is located within the suspension bellows 76 and 78 as well as in the hose line 22, so that when the suspension bellows 78 is compressed by an increase in pressure in the upper chamber 24, the suspension bellows 76 in the regulating device 18 expands by a decrease in pressure in the chamber 24 the opposite effect occurs. On the suspension bellows 76 there is a bolt 82 with one on it

009828/1170

attached pin 84. The push rod 36 and the bolts 72 and 82 are connected to one another by a connecting piece 86 which compensates for the movements and which can be rotated the pin 84 is articulated, and in which the guide pin 7 ^ and the shaft bolt in recesses made therein 56 intervene.

When the pacemaker device IO is put into operation should, as already mentioned *, the inlet pipe 12 with the outlet of the left ventricle and the outlet tube be connected to the aorta · You can either connect the device 10 externally, for example if it is only about short periods of time, for example during an operation or in acute danger, should be used, or it can be used as part of it of a fully implanted system. The flow divider 73 is fed to any separate source connected, from which a suitable hydraulic pressure fluid can be fed. This can either implanted or placed outside the body. The Auelaß 66 is connected to a line (not shown), by which the hydraulic fluid with reduced Pressure is returned to the source where it is pressurized again, as is known per se is.

009828/1179

In the drawing, the device 10 is illustrated in the position it assumes before a left ventricle beat occurs. When the left ventricle beats, blood flows through inlet 12 and check valve 38, which opens, into chamber 24. Sensing bellows 78 is compressed somewhat as a result of the increase in pressure and thereby recipient bellows 76 expands. In- a result of this expansion, the connection piece 86 is operated · and rotates about the shaft pin 56, whereby the spool valve 58 is raised _s with the result that in the space above the piston 52 in the introduced through the inlet 64 medium pressure trains "As the pressure increases, a counterforce arises, and this causes the piston 52 and, accordingly, the piston 3 ^ to begin to move downwards. To the extent that the blood continues to flow into the upper chamber 24, the Federungsbalg 78 outputs i? Conductor signal to the effect that the valve 58 remains in the open position t. As a result, the piston 52 can continue to move at a speed that is directly dependent on the supply of blood from the left ventricle.

When the pistons 52 and 3 begin their downward movement, pressure is exerted on the blood that is already in the lower part of the cheese, - \ ^ f. "^ v: ^" -: -lr: l dar ^ p ^ FT ^ Tiil 44 in &'. biaxial · ν; *!>.:, ■ -i-öh;, · "' r.en *" ^: ^:., · "';? .- v : ^,; i? £ fc <«? £ v-'L

.L

Chamber 26 has risen to a value just above that pressure in the system downstream of the shut-off valve 42, then this shut-off valve 42 opens and blood flows out of the lower chamber 26 through the shut-off valve 42. As a result, the lower chamber 26 is emptied at a corresponding plowing speed j at which the upper chamber 24 fills *. Since the pistons 34 and 52 must move against any increase in resistance in the system, a steady static counterforce is maintained by a corresponding increase in pressure within the tree above the piston 52, which is achieved by increasing the opening of the spool valve 58. This higher pressure, which thereby comes to the effective area of the piston 52 to act ^ corresponds to the force which results from the pressure difference in the chambers 24 and 26 minus the bias of the spring 54 ^ which, on the effective area of the piston J4 who is in contact with it comes into play »

When the flow into upper chamber 24 stops, that is on the point in time when the left ventricle has completely thermoset-filled a blood surge and the exact volume of the delivered blood Has accommodated blood, the movement of the piston is also stopped, and so does the pressure in chambers 24 and 26 If, however, the shut-off valves 38 and also close The Äbtast bellows 78 expands, and as a result

the suspension bellows 76 is compressed. As a result, the hydraulic spool valve 58 moves downwards, the opening above the piston 52 is closed off from the inlet 64, and the outlet 66 opens. The energy accumulated in the spring 54 during the movement of the piston 52 now acts as an unbalanced force component. This forces the pistons 52 and 34 to move upward, forcing the blood from the upper chamber 24 through the check valve 44 into the lower chamber. After this transfer has been completed, the device 10 is in the state suitable for receiving the next pulse of the left ventricle.

It can be seen that the pacemaker device described above Not only does the left ventricle of the heart do a good part of the work, but also does it at all times works synchronously with the heartbeat of the left ventricle and different ones expelled from the heart Able to accommodate volumes. It is also evident that as a result of synchronization with the heart in the system can be worked exactly according to the physiological conditions · Another significant factor of the present The invention consists in the fact that the pressure level at which the left ventricle is working is simply adjusted can be that the pressure with which the hydraulic Liquid is fed in, changes, and you can do this

009828/1179

also adapt or change by changing the 5 © » load characteristics of the suspension bellows 76 and 78 accordingly adjusted. If, regardless of the position in which it is mounted, the device 10 should fail, then can the heart is still correct with normal circulatory loads function, which is an important factor in all cardiac pacemaker devices.

From the above it follows that according to the invention a Pacemaker has been created, which can either be implanted or attached externally « While it is only a preferred embodiment of the invention has been explained in more detail, but it goes without saying that im Within the scope of the present application: according to the potential Any changes are possible according to the knowledge of the person skilled in the art.

The present invention has been made under and under Contract made with the United States Atomic Energy Commission.

009828/1179

Claims (5)

Claims TlJ pacemaker, characterized by a) a main container (14) which has a flexible wall material and which is divided by a movable wall (28, 32) is in an upper chamber (24) and a lower chamber (26) and a shut-off valve (44), which contains the flow from the chamber (24) into the chamber (26) allowed, b) an inlet shut-off valve (38) which regulates the flow into the upper chamber (24), o) an outlet shut-off valve (42) which regulates the outflow from the lower chamber (26), and d) a control device (18) that comes into action the flow of liquid into the upper chamber (24), through which the movable wall (28,32) is moved so that the upper Chamber (24) expands and the lower chamber (26) is compressed, the check valve (44) closes and the liquid is pumped from the lower chamber (26) through the outlet check valve (42), and ultimately that the interruption of the inflow into the upper chamber (24) and thus the movement of the movable wall (28,32) in the Direction of an expansion of the lower chamber (26) and a compression of the upper chamber (24), whereby the blood flows from the upper chamber (24) through the check valve (44) into the lower chamber (26). First 2. Cardiac pacemaker according to claim 1, characterized in that the control device (18) has an in the movable Wall mounted (28,32) powered piston (34), which is exposed on both sides to the pressures within the chambers (24 and 26), and a push rod (36) between the piston (34) and a cylinder (48) with a hydraulic device having a piston (52) with which the push rod (36) can be actuated in accordance with the change in pressure within the upper chamber (24) is. 3. Cardiac pacemaker according to claim 2, characterized in that a scanning spring bellows arranged in the upper chamber (24) (78), a receiver spring bellows (76) arranged in the control device (18) and a hydraulic one controlled spool valve (58) for controlled supply and discharge of liquid are present and the cylinder (48), in which the regulating piston (52) is slidable * under a There is a preload that acts in the opposite direction to the fluid pressure acting on it, and that between the scanning suspension bellows (78) and the receiver suspension bellows (76) a connecting hose (22) is available" 4 _a pacemaker according to claim 3, characterized in that the sensing spring bellows (78) and the receiver spring bellows (76) form a closed fluid system 009828/1179 are arranged connected to one another, and that the collapse of one of the suspension bellows the expansion of the causes other suspension bellows. Characterized 5. A pacemaker according to Claim J or 4, that the regulating piston (52) is brought by a spring under tension. 009828/1179 Blank page