EP0988088A1 - Einrichtung und verfahren zur ventrikulären defibrillation - Google Patents

Einrichtung und verfahren zur ventrikulären defibrillation

Info

Publication number
EP0988088A1
EP0988088A1 EP98923795A EP98923795A EP0988088A1 EP 0988088 A1 EP0988088 A1 EP 0988088A1 EP 98923795 A EP98923795 A EP 98923795A EP 98923795 A EP98923795 A EP 98923795A EP 0988088 A1 EP0988088 A1 EP 0988088A1
Authority
EP
European Patent Office
Prior art keywords
ventricular fibrillation
ventricular
defibrillation
pacing pulses
coarse
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98923795A
Other languages
English (en)
French (fr)
Inventor
William Hsu
Yayun Lin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cardiac Pacemakers Inc
Original Assignee
Cardiac Pacemakers Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiac Pacemakers Inc filed Critical Cardiac Pacemakers Inc
Publication of EP0988088A1 publication Critical patent/EP0988088A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • H—ELECTRICITY
    • H03—ELECTRONIC CIRCUITRY
    • H03C—MODULATION
    • H03C5/00—Amplitude modulation and angle modulation produced simultaneously or at will by the same modulating signal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • A61N1/39622—Pacing therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3987—Heart defibrillators characterised by the timing or triggering of the shock

Definitions

  • plurality of electrical pacing pulses are delivered to the heart.
  • the electrical pulses are high energy pacing pulses delivered between the ventricle pacing electrode and the first defibrillation electrode.
  • the electrical pulses are high energy pacing pulses delivered between the first and the second defibrillation electrodes.
  • These electrical pacing pulses serve to precondition the cardiac tissue surrounding the first defibrillation electrode so that a subsequent defibrillation pulse delivered between the first and second defibrillation electrodes at a predetermined time after a final electrical pulse will have a higher probability of converting a ventricular arrhythmia.
  • FIG. 3 there is shown the electrocardiogram of the ventricular fibrillation prior to defibrillation treatment by a defibriUator system.
  • the electrocardiogram shows an asynchronous defibrillation shock being delivered at 82 to the heart 18 .
  • the total amount of current delivered to the heart is important for defibrillation. However, how that current is distributed throughout the heart can be even a more important factor for defibrillation. Different amounts of current flow through different parts of the heart during a shock.
  • shocks delivered from intracardiac electrodes the distribution of potential gradients is highly uneven. High potential gradients occur near the defibrillation electrodes (known as "high field” areas), and low potential gradients occur in those cardiac regions distant from the defibrillation electrodes (known as "low field” areas).
  • the defibriUator system 10 terminates the ventricular arrhythmia at 124 by delivering a cardioversion/defibrillation pulse of electrical energy through the ventricular defibrillation electrode and across the ventricular region of the heart 18 at a predetermined time after the final electrical pulse.
  • Figure 5 indicates that as a result of preconditioning the heart 18 with the high energy pacing pulses, the potential for aberrant ventricular contractions in the "high field" area surrounding the first defibrillation electrode 36 is reduced as a quiescent interval of time is created at 126.
  • the sensed cardiac signals are then analyzed by the electronic control circuitry 24 of the defibriUator system 10 at 132 to determine if the heart is experiencing a ventricular arrhythmia.
  • a ventricular arrhythmia can include ventricular tachyarrythmia and ventricular fibrillation.
  • the electronic control circuitry 24 of the defibriUator system 10 determines the occurrence and/or presence of a ventricular arrhythmias by analyzing the morphology of the R- waves detected by the defibriUator system 10 and the rate relation of the ventricular R- waves to preprogrammed ventricular rate and rate acceleration parameters.
  • the term "affected”, as used in conjunction with the state of coarse ventricular fibrillation complex signals, means to produce a material influence upon or alteration in the cardiac electrogram signals that are sensed during a ventricular fibrillation.
  • the plurality of electrical pacing pulses are used to affect the state of coarse ventricular fibrillation complex signals by creating coarse ventricular fibrillation complex signals.
  • Subsequent pacing pulses delivered after the creation of a coarse ventricular fibrillation complex signal can then be coordinated to up-slope portions of the detected coarse ventricular fibrillation signals to further coarsen the ventricular signal.
  • a programmable time duration interval is started at step 210.
  • the system then begins to compute a Standard Amplitude of Morphology (SAM) at 212 over the programmable time duration interval for the sensed ventricular morphology signals from a first signal appearing across the electrodes of the ventricular catheter (e.g., the first defibrillation electrode and the second defibrillation electrode).
  • SAM Standard Amplitude of Morphology
  • the SAM value is calculated by averaging a predetermined number of the largest peak-to-peak morphology signal values detected over a predetermined time interval.
  • the predetermined time interval can be programmed within a range of 1- 10 seconds.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)
EP98923795A 1997-05-27 1998-05-27 Einrichtung und verfahren zur ventrikulären defibrillation Withdrawn EP0988088A1 (de)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US86377397A 1997-05-27 1997-05-27
US863773 1997-05-27
PCT/US1998/010741 WO1998053879A1 (en) 1997-05-27 1998-05-27 System and method for ventricular defibrillation

Publications (1)

Publication Number Publication Date
EP0988088A1 true EP0988088A1 (de) 2000-03-29

Family

ID=25341753

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98923795A Withdrawn EP0988088A1 (de) 1997-05-27 1998-05-27 Einrichtung und verfahren zur ventrikulären defibrillation

Country Status (3)

Country Link
EP (1) EP0988088A1 (de)
CA (1) CA2291039A1 (de)
WO (1) WO1998053879A1 (de)

Families Citing this family (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6275732B1 (en) 1998-06-17 2001-08-14 Cardiac Pacemakers, Inc. Multiple stage morphology-based system detecting ventricular tachycardia and supraventricular tachycardia
US6266554B1 (en) 1999-02-12 2001-07-24 Cardiac Pacemakers, Inc. System and method for classifying cardiac complexes
US6308095B1 (en) 1999-02-12 2001-10-23 Cardiac Pacemakers, Inc. System and method for arrhythmia discrimination
US7139608B2 (en) 2002-07-31 2006-11-21 Uab Research Foundation Pacing methods and devices using feedback controlled timing
US8560063B2 (en) * 2002-09-10 2013-10-15 Uab Research Foundation Post-defibrillation pacing methods and devices
US7228176B2 (en) 2004-07-22 2007-06-05 Cardiac Pacemakers, Inc. Systems, devices, and methods for tachyarrhythmia discrimination or therapy decisions
US7212849B2 (en) 2004-10-28 2007-05-01 Cardiac Pacemakers, Inc. Methods and apparatuses for arrhythmia detection and classification using wireless ECG
US9314210B2 (en) 2005-06-13 2016-04-19 Cardiac Pacemakers, Inc. Method and apparatus for rate-dependent morphology-based cardiac arrhythmia classification
US9427564B2 (en) * 2010-12-16 2016-08-30 Zoll Medical Corporation Water resistant wearable medical device
US10449361B2 (en) 2014-01-10 2019-10-22 Cardiac Pacemakers, Inc. Systems and methods for treating cardiac arrhythmias
WO2015106015A1 (en) 2014-01-10 2015-07-16 Cardiac Pacemakers, Inc. Systems and methods for detecting cardiac arrhythmias
US10463866B2 (en) 2014-07-11 2019-11-05 Cardiac Pacemakers, Inc. Systems and methods for treating cardiac arrhythmias
EP3253450B1 (de) 2015-02-06 2021-03-24 Cardiac Pacemakers, Inc. System zur behandlung von herzrhythmusstörungen
US10758737B2 (en) 2016-09-21 2020-09-01 Cardiac Pacemakers, Inc. Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4559946A (en) * 1982-06-18 1985-12-24 Mieczyslaw Mirowski Method and apparatus for correcting abnormal cardiac activity by low energy shocks
SE9202662D0 (sv) * 1992-09-16 1992-09-16 Siemens Elema Ab Anordning foer att alstra av stimulationspulser och defibrilleringschocker bildade hjaertdefibrilleringssekvenser
US5489293A (en) * 1993-08-31 1996-02-06 Ventritex, Inc. Method and apparatus for treating cardiac tachyarrhythmia
US5713924A (en) * 1995-06-27 1998-02-03 Medtronic, Inc. Defibrillation threshold reduction system
US5632766A (en) * 1995-08-11 1997-05-27 Cardiac Pacemakers, Inc. Ventricular defibrillation by coordination of shocks with sensed coarse VF complexes

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9853879A1 *

Also Published As

Publication number Publication date
WO1998053879A1 (en) 1998-12-03
CA2291039A1 (en) 1998-12-03

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