JP2013128792A - Artificial heart control device and artificial heart system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an artificial heart control device, an artificial heart system and a method for controlling an artificial heart, capable of optimum load control for recovery of functions of a user's own heart.SOLUTION: The artificial heart control device 60 for controlling a blood pump for assisting the flow of blood of the heart includes: a timing detection part 80 for detecting reference timing in a cardiac cycle of the heart, and a blood pump control part 62 for controlling the rotational frequency of the blood pump. The blood pump control part 62 controls the rotational frequency of the blood pump to be a rotational frequency corresponding to a given control pattern based on the reference timing detected by the timing detection part 80.

Description

  The present invention relates to an artificial heart control device, an artificial heart system, and an artificial heart control method.

  Recent advances in medical technology are increasing the number of cases that can treat heart diseases that have been considered serious. On the other hand, when the heart disease becomes severe, there are cases in which only heart transplantation is currently available, and the patient waiting for transplantation has to wait for a suitable donor. As a result, heart transplantation cannot be performed quickly, which may cause a serious obstacle to the maintenance of life.

  In such a situation, recently, an artificial heart is implanted in a patient waiting for transplantation for the purpose of BTT (Bridge To Transplant) and blood circulation is assisted, so that a patient waiting for transplantation becomes a donor who can be adapted for a long period of time. You can wait. Moreover, at present, the use of artificial heart for the purpose of BTR (Bridge To Recovery) aiming at recovery of the function of the self-heart has been attracting attention by improving the stability and reliability of the artificial heart. Many cases have been reported in which the function of the self-heart is restored by implanting an artificial heart.

  Although the technique for promoting the recovery of the function of the self-cardiac by using the artificial heart for the purpose of using the BTR has not been established yet, the control of the artificial heart necessary for the recovery of the function of the self-cardiac is not yet established. Several techniques are disclosed.

  For example, Patent Document 1 discloses an artificial heart that adjusts a load on a ventricle by providing a post-load adjustment chamber for temporarily storing ejected blood from the ventricle. For example, Patent Document 2 discloses an artificial heart that adjusts the rotation speed of a blood pump in response to a rapid change that deviates from the normal operating range of a steady flow blood pump. Further, for example, in Patent Document 3, the ventricle is paced by a cardiac pacing function in accordance with whether or not the blood removal cannula is sucked, and the heart rate of a certain number of self-hearts is maintained even when an artificial heart is worn. Thus, an artificial heart is disclosed that prevents the blood removal cannula from sucking, the thrombus and the bradycardia from occurring. Furthermore, for example, Patent Literature 4 discloses a cardiac function evaluation device that evaluates cardiac function by measuring the blood flow rate of a blood pump. Further, for example, Patent Document 5 discloses an artificial heart that reduces the rotation speed of a blood pump in order to suppress thrombus formation around the aortic valve. Further, for example, Non-Patent Document 1 discloses a technique related to a computer simulation that models the behavior when the rotational speed of a steady flow blood pump is changed.

WO99 / 51285 pamphlet JP 2005-66013 A JP 2000-126282 A JP 2002-224066 A US Patent Application Publication No. 2005/0071001

Vandenverghe S. et. Al., “Unloading Effect of a Rotary Blood Pump Assessed by Mathematical Modeling”, Artificial Organs, 27 (12), pp.1094-1101, 2003

  However, in the techniques disclosed in Patent Literature 1 to Patent Literature 5 and Non-Patent Literature 1, the rotation speed of the blood pump is changed on the assumption of a constant cardiac cycle regardless of the length of the cardiac cycle of the own heart. However, there is a problem that an excessive or insufficient load is applied to the self-heart, and the recovery of the function of the self-heart is inhibited or the blood cannot be circulated sufficiently.

  The present invention has been made in view of the technical problems as described above, and an object of the present invention is to provide an artificial heart control device, an artificial heart system, and an artificial heart system capable of optimal load control for restoring the function of the own heart. It is to provide a method for controlling an artificial heart.

  In order to solve the above-described problems, the present invention provides an artificial heart control device for controlling a blood pump that assists the blood flow of the heart, comprising a timing detection unit that detects a reference timing within the cardiac cycle of the heart; A blood pump control unit that controls the number of rotations of the blood pump, and the number of rotations corresponding to a given control pattern based on the reference timing detected by the timing detection unit. It is related with the artificial heart control apparatus which controls the rotation speed of the said blood pump so that it may become.

  According to the present invention, the reference timing within the cardiac cycle of the heart is detected, and the rotation speed of the blood pump is controlled so that the rotation speed corresponds to a given control pattern based on the reference timing. Therefore, the load on the ventricle can be reduced in accordance with the cardiac cycle of the heart, and the recovery of the function of the heart can be promoted.

  In the artificial heart control device according to the present invention, the reference timing may be a start timing of a systole within the cardiac cycle.

  According to the present invention, it becomes possible to detect the reference timing with high accuracy and easily using a detection signal from an easily usable means such as a general electrocardiogram measuring instrument. In addition, the load on the ventricle can be easily reduced in accordance with the cardiac cycle of the heart, and the recovery of the function of the heart can be further promoted.

  In the artificial heart control device according to the present invention, the reference timing may be a start timing of a diastole within the cardiac cycle.

  According to the present invention, for example, the reference timing can be detected with high accuracy and easily by using a detection signal from an easily usable means such as a blood pressure measuring instrument. The load on the ventricle can be controlled in accordance with the cardiac cycle of the heart, and the recovery of the function of the heart can be further promoted.

  Further, in the artificial heart control device according to the present invention, the blood pump control unit can control the rotation speed of the blood pump so that the blood flow in the ventricle of the heart changes based on the reference timing. .

  According to the present invention, the retention of blood in the heart's ventricle can be suppressed, and thrombus formation can be easily prevented.

  In the artificial heart control device according to the present invention, the blood pump control unit changes the rotation speed of the blood pump according to a given periodic function within one or a plurality of cardiac cycles of the heart with reference to the reference timing. Can be controlled.

  According to the present invention, the rotation speed of the blood pump is changed according to a given periodic function within one or a plurality of cardiac cycles of the heart with reference to the reference timing. Thus, the load on the ventricle can be reduced in accordance with the cardiac cycle of the heart, and the functional recovery of the heart can be promoted.

  Further, in the artificial heart control device according to the present invention, the blood pump control unit reduces the rotation speed of the blood pump in the diastole of the heart based on the reference timing, and the blood pump in the systole of the heart. The rotation speed of the blood pump can be controlled to increase the rotation speed of the blood pump.

  According to the present invention, while assisting the myocardium in the systole within the cardiac cycle, it is not necessary to disturb the movement of the myocardium during the diastole within the cardiac cycle, and optimal assistance is provided for each systole and diastole. By doing this, it becomes possible to promote the recovery of the function of the heart.

  Further, in the artificial heart control device according to the present invention, the blood pump control unit sets the output flow rate of the blood pump to 0 in the systole of the heart based on the reference timing, and the blood in the diastole of the heart. The rotation speed of the blood pump can be controlled so that the reverse flow rate of the pump becomes zero.

  According to the present invention, even when the blood pump is a continuous flow type, a so-called off-pump test, which could not be easily realized so far, can be easily realized, and the risk for the patient can be reduced.

  Further, the artificial heart control device according to the present invention includes an abnormality detection unit that detects an abnormal state during control of the blood pump, and when the abnormal state is detected by the abnormality detection unit, the blood pump control unit, It is possible to control the rotation speed of the blood pump so as to be a constant command rotation speed.

  According to the present invention, on the condition that an abnormal state is detected, the rotation speed of the blood pump is controlled so as to be a constant indicated rotation speed, so that the load on the ventricle is matched to the cardiac cycle of the patient's heart. As a result, the recovery of the function of the self-heart can be promoted and the reliability can be improved.

  The artificial heart control device according to the present invention further includes a control pattern determination unit that determines the control pattern based on a detection signal from a sensor that detects a state of the human body in which the blood pump is operating, and the blood pump control A control unit configured to control the number of rotations of the blood pump so that the number of rotations corresponds to the control pattern determined by the control pattern determination unit based on the reference timing detected by the timing detection unit; it can.

  According to the present invention, the control pattern is determined based on the detection signal from the sensor that detects the state of the human body in which the blood pump is operating, and the rotation speed corresponding to the control pattern is set based on the reference timing. Since the rotation speed of the blood pump is controlled, it is possible to dynamically control the reduction of the ventricular load according to the cardiac cycle of the patient's heart so that the recovery of the function of the heart can be further promoted. become.

  The present invention also provides a blood pump for assisting a blood flow in the heart, a sensor for detecting a state of a human body in which the blood pump is operating, and the blood pump based on a detection signal from the sensor. The artificial heart system including the artificial heart control device according to any one of the above.

  ADVANTAGE OF THE INVENTION According to this invention, the artificial heart system which enables optimal load control for the function recovery | restoration of the own heart can be provided now.

  In the artificial heart system according to the present invention, the blood pump has a cannula tip inserted into the left ventricle of the heart, and can send blood in the left ventricle to the aorta.

  According to the present invention, it is possible to provide an artificial heart system having a blood pump that functions as a left ventricular assist device capable of optimal load control for restoring the function of the own heart.

  The present invention is also a method for controlling an artificial heart for controlling a blood pump for assisting a blood flow in the heart, the timing detecting step for detecting a reference timing in the cardiac cycle of the heart, and the timing detecting step And a blood pump control step for controlling the rotation speed of the blood pump so that the rotation speed corresponds to a given control pattern on the basis of the reference timing detected in step 1.

  In the artificial heart control method according to the present invention, the reference timing may be a start timing of a systole within the cardiac cycle.

  In the artificial heart control method according to the present invention, the reference timing may be a start timing of a diastole within the cardiac cycle.

  In the artificial heart control method according to the present invention, the blood pump control step may control the rotation speed of the blood pump so that the blood flow in the ventricle of the heart changes based on the reference timing. it can.

  Further, in the artificial heart control method according to the present invention, the blood pump control step sets the rotation speed of the blood pump according to a given periodic function within one or a plurality of cardiac cycles of the heart with reference to the reference timing. Control to change can be performed.

  Further, in the artificial heart control method according to the present invention, the blood pump control step reduces the rotation speed of the blood pump in the diastole of the heart and the blood in the systole of the heart based on the reference timing. The rotation speed of the blood pump can be controlled to increase the rotation speed of the pump.

  In the artificial heart control method according to the present invention, the blood pump control step may be configured such that the blood pump output flow rate is 0 in the systole of the heart and the diastole of the heart is based on the reference timing. The rotation speed of the blood pump can be controlled so that the reverse flow rate of the blood pump becomes zero.

  The artificial heart control method according to the present invention further includes an abnormality detection step of detecting an abnormal state during control of the blood pump, wherein the blood pump control step is performed when the abnormal state is detected in the abnormality detection step. The rotation speed of the blood pump can be controlled so as to be a constant indicated rotation speed.

  The artificial heart control method according to the present invention further includes a control pattern determination step for determining the control pattern based on a detection signal from a sensor that detects a state of the human body in which the blood pump is operating, the blood pump Controlling the rotation speed of the blood pump so that the control step has a rotation speed corresponding to the control pattern determined in the control pattern determination step based on the reference timing detected in the timing detection step. Can do.

  According to any one of the above-described inventions, it is possible to provide a method for controlling an artificial heart that enables optimal load control for restoring the function of the own heart.

The figure which shows the structural example of the artificial heart system in embodiment which concerns on this invention. Explanatory drawing of the blood pump in this embodiment. The figure which shows an example of sectional drawing of the blood pump in this embodiment. Explanatory drawing of the sensor in this embodiment. The block diagram of the structural example of the artificial heart control apparatus in this embodiment. FIG. 6 is a block diagram of a configuration example of a timing detection unit in FIG. 5. The block diagram of the structural example of the control pattern determination part of FIG. The block diagram of the hardware structural example of the artificial heart control apparatus in this embodiment. FIG. 9 is a flowchart of a processing example of the artificial heart control device in FIG. 8. FIG. 10 is a flowchart of a detailed processing example of step S18 in FIG. 9. FIG. 9 is a flowchart of another processing example of the artificial heart control device of FIG. 8 in the present embodiment. The figure which shows typically the general relationship between the electrocardiogram and cardiac cycle in this embodiment. Fig.13 (a)-FIG.13 (e) are the figures which show the example of the control pattern in this embodiment. FIG. 14A and FIG. 14B are diagrams illustrating a processing example when an abnormality is detected in the artificial heart control device according to the present embodiment. The figure which shows typically the self-heart and blood pump in this embodiment.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The embodiments described below do not unduly limit the contents of the present invention described in the claims. Also, not all of the configurations described below are essential constituent requirements of the present invention.

  FIG. 1 shows a configuration example of an artificial heart system according to an embodiment of the present invention.

  An artificial heart system (pump system, motor system in a broad sense) 100 according to an embodiment of the present invention includes a blood pump (pump, motor, artificial heart pump) 10, a control unit 20, and a sensor 30. 10 and the control unit 20 are connected via a cable 40. The sensor 30 detects the state of the patient (human body) in which the blood pump 10 is operating, and is embedded in the patient's body or attached to the surface of the patient's body or organ. A detection signal corresponding to 30 detection results is transmitted to the control unit 20 via a wired or wireless transmission medium.

  Blood pump 10 functions as a left ventricular assist device (LVAD) that assists the function of the left ventricle of self-heart 200. The blood pump 10 is a continuous flow type blood pump in which a circulating blood flow is continuous.

  The control unit 20 includes a power supply device 50 and an artificial heart control device 60, and is provided outside the body. The power supply device 50 supplies a power supply voltage from any one of an AC power supply, a built-in battery, and an emergency battery to the artificial heart control device 60 via the power supply line VL. The artificial heart control device 60 generates a drive current (drive signal in a broad sense) for driving the blood pump 10 using the detection signal from the sensor 30 in a state where the power supply voltage is applied from the power supply device 50. More specifically, the artificial heart control device 60 controls the rotation speed of the blood pump 10 by using a drive current generated using a detection signal from the sensor 30. The cable 40 has a signal line through which a drive current supplied from the control unit 20 to the blood pump 10 is transmitted.

  FIG. 2 is an explanatory diagram of the blood pump 10 in the present embodiment. In FIG. 2, the self-heart 200 and the circulatory system in the body are schematically shown.

  The self-heart 200 is divided into a left atrium, a left ventricle, a right atrium, and a right ventricle. The right atrium and the right ventricle have a function of circulating blood in the pulmonary circulatory system, and the left atrium and the left ventricle are in the systemic circulatory system. Has the function of circulating blood. That is, blood returned from the systemic circulation through the upper and lower vena cava is stored in the right atrium and then sent to the right ventricle. The blood fed into the right ventricle circulates in the pulmonary circulatory system through the pulmonary artery due to the pulsation of the right ventricle and becomes oxygenated. The blood returned from the pulmonary circulation system through the pulmonary veins is stored in the left atrium and then sent to the left ventricle. The blood fed into the left ventricle circulates through the systemic circulation through the aorta by the pulsation of the left ventricle. In order to assist the function of the left ventricle, the blood pump 10 in the present embodiment sucks blood sent into the left ventricle and sends it out to the aorta.

  In FIG. 3, an example of sectional drawing of the blood pump 10 in this embodiment is shown. FIG. 3 shows an example of a cross-sectional configuration of the blood pump 10, but the present embodiment is not limited to the blood pump having the configuration of FIG.

  The blood pump 10 has a drive unit 11 having a cylindrical motor and a pump unit 12 connected to the drive unit 11. The pump unit 12 includes an impeller 13 that is driven via a rotating shaft of a motor, and a pump casing 14 that is connected to the drive unit 11 so as to cover the impeller 13. When the blood in the left ventricle of the own heart flows into the pump casing 14 through the blood vessel (artificial blood vessel) and the inflow port 15, the flow energy is given by the impeller 13 and then the outflow port provided on the side surface of the pump casing 14. 16 and the blood vessel (artificial blood vessel) to flow into the aorta.

  In the blood pump 10, a mechanical seal portion 17 is provided between the drive portion 11 and the pump portion 12. For this reason, the pump part 12 and the drive part 11 are slidably and satisfactorily sealed, and the leakage of blood from the pump part 12 to the drive part 11 is suppressed as much as possible. As a result, the formation of thrombus is suppressed, and the stoppage of the pump operation and the change in the operation state thereof are suppressed.

  The pump unit 12 is a centrifugal pump that can be expected to have a larger blood flow than in the case of an axial pump, and a DC motor can be used as a motor that drives the impeller 13.

  When the blood pump 10 has the configuration of FIG. 3, the control unit 20 of FIG. 1 further has means for circulating a cool seal liquid that suppresses coagulation of blood in the mechanical seal part and heat generation of the drive part 11 and the pump part 12. . In this case, a circulation path of the cool seal liquid is formed via the cable 40.

  The blood pump 10 having the above configuration is controlled in rotation speed in accordance with the cardiac cycle of the patient's own heart. Therefore, the artificial heart control device 60 can control the number of rotations of the blood pump 10 according to the cardiac cycle of the patient's own heart based on the detection signal from the sensor 30.

  FIG. 4 is an explanatory diagram of the sensor 30 in the present embodiment. In FIG. 4, the same parts as those in FIG. FIG. 4 schematically shows an example of attaching the sensor 30 to the patient's body, and the sensor 30 according to the present invention is not limited to that shown in FIG.

  The sensor 30 in the present embodiment is attached to the patient's body, blood pump 10 or the like according to the detection target. For example, the electrocardiogram, blood flow, blood pressure, operating state of the blood pump 10, and other cardiac cycles of the self-heart 200 It is desirable to detect at least one of the measured values with high correlation.

  For example, as shown in FIG. 4, an electrocardiogram lead and a special cannula are attached as a sensor 30 to a fixed part of a cannula inserted into the left ventricle of the self-heart 200 or a position P1 around the fixed part. By providing an electrocardiographic amplifier in 60 and amplifying the detection signal from the sensor 30, the artificial heart control device 60 can acquire a detection signal corresponding to the electrocardiogram of the own heart 200.

  Alternatively, for example, an electrocardiographic lead and a special cannula are attached as the sensor 30 at the position P2 which is the body surface close to the patient's own heart 200, and an electrocardiographic amplifier is provided in the artificial heart control device 60 of the control unit 20 to By amplifying the detection signal, the artificial heart control device 60 can acquire the detection signal corresponding to the body surface electrocardiogram of the own heart 200.

  Since the electrocardiogram or the body surface electrocardiogram measured in the body or body surface of the patient in this way changes depending on the pulsation of the self-heart 200, the cardiac cycle of the self-heart 200 can be detected based on the electrocardiogram or the body surface electrocardiogram. It becomes.

  For example, as shown in FIG. 4, an ultrasonic / electromagnetic flow meter is attached as a sensor 30 to a position P3 of a cannula for delivering blood removed from the self-heart 200 to the aorta using the blood pump 10, and By providing a flow meter amplifier in the heart control device 60 and amplifying the detection signal from the sensor 30, the detection signal corresponding to the discharge amount of the blood pump 10 can be acquired in the artificial heart control device 60.

  Alternatively, for example, an ultrasonic / electromagnetic flow meter is attached as the sensor 30 to the position P4 of the aorta of the own heart 200, and a flow meter amplifier is provided in the artificial heart control device 60 of the control unit 20 to amplify the detection signal from the sensor 30. Thus, the artificial heart control device 60 can acquire a detection signal corresponding to the blood flow volume of the aorta of the own heart 200.

  The discharge amount of the blood pump 10 changes according to the systole and diastole within the cardiac cycle of the self-heart 200, and the blood flow rate of the aorta also changes according to the systole and diastole within the cardiac cycle of the self-heart 200. Therefore, the cardiac cycle of the self-heart 200 can be detected based on the blood flow volume of the blood pump 10 or the blood flow volume of the aorta. Note that the blood flow volume of the pulmonary artery may be detected, and the cardiac cycle of the self-heart 200 may be detected based on the detection signal.

  Further, for example, as shown in FIG. 4, a rotation speed measuring device or a current sensor is attached as a sensor 30 to a predetermined position P5 in the blood pump 10 or the control unit 20, so that the artificial heart control device 60 can actually measure the rotation of the blood pump 10. The detection signal corresponding to the number, the detection signal corresponding to the power consumption of the blood pump 10 or the detection signal corresponding to the estimated flow rate of the blood pump 10 can be acquired.

  The actual rotation speed of the blood pump 10, the power consumption of the blood pump 10, or the estimated flow rate of the blood pump 10 changes according to the systole or diastole in the cardiac cycle of the self-heart 200. It becomes possible to detect the cardiac cycle of the self-heart 200 based on the power consumption of the pump 10 or the estimated flow rate of the blood pump 10.

  For example, as shown in FIG. 4, a pressure transducer is attached as a sensor 30 to a position P6 of the aorta of the own heart 200, and a pressure transducer amplifier is provided in the artificial heart control device 60 of the control unit 20 to detect a detection signal from the sensor 30. , The detection signal corresponding to the aortic pressure can be acquired in the artificial heart control device 60.

  Alternatively, for example, a pressure transducer is attached as a sensor 30 to the position P7 on the patient's body surface, and a pressure transducer amplifier is provided in the artificial heart control device 60 of the control unit 20 to amplify the detection signal from the sensor 30. The artificial heart control device 60 can acquire a detection signal corresponding to the arterial pressure.

  Since the aortic pressure and the arterial pressure change according to the systole and the diastole within the cardiac cycle of the self-heart 200, the cardiac cycle of the self-heart 200 can be detected based on the aortic pressure or the arterial pressure. Note that the ventricular pressure may be detected, and the cardiac cycle of the own heart 200 may be detected based on the detection signal.

  Further, for example, as shown in FIG. 4, a conductance catheter for measuring the volume in the ventricle of the own heart 200 is attached as the sensor 30, and the conductance catheter device is provided in the artificial heart control device 60 of the control unit 20. The control device 60 can acquire a detection signal corresponding to the volume of the ventricle.

  Since the volume of the ventricle changes according to the systole or diastole within the cardiac cycle of the self-heart 200, it is possible to detect the cardiac cycle of the self-heart 200 based on the volume of the ventricle. In addition, for example, a photoelectric pulse wave may be detected, and the cardiac cycle of the own heart 200 may be detected based on the detection signal.

  The detection signal from the sensor 30 attached to the body or body surface of the patient as described above is output to the artificial heart control device 60 of the control unit 20, and the artificial heart control device 60 specifies the cardiac cycle. A reference timing is detected.

FIG. 5 shows a block diagram of a configuration example of the artificial heart control device 60 in the present embodiment.
FIG. 6 shows a block diagram of a configuration example of the timing detection unit 80 of FIG. In FIG. 6, the same parts as those in FIG.
FIG. 7 shows a block diagram of a configuration example of the control pattern determination unit 68 of FIG. 7, the same parts as those in FIG. 5 are denoted by the same reference numerals, and description thereof will be omitted as appropriate.

  As shown in FIG. 5, the artificial heart control device 60 includes a timing detection unit 80, a blood pump control unit 62, a control pattern storage unit 64, a blood pump drive control unit 66, a control pattern determination unit 68, an abnormality And a detection unit 70.

  The timing detection unit 80 acquires a detection signal from at least one of the sensors attached to the attachment position shown in FIG. 4, and detects a reference timing within the cardiac cycle of the own heart 200 based on the detection signal. . By determining one reference timing within one cardiac cycle, the cardiac cycle of the self-heart 200 can be specified.

  The reference timing within the cardiac cycle is preferably selected as appropriate within the cardiac cycle according to the detection target of the sensor 30. For example, when the sensor 30 can easily detect the start timing of the cardiac cycle, it is desirable to employ the start timing of the cardiac cycle as the reference timing. Since the cardiac cycle has a so-called systole and diastole, for example, when the sensor 30 can easily detect the start timing of the systole within the cardiac cycle, When the systolic start timing is employed, for example, when the sensor 30 can easily detect the start timing of the diastole within the cardiac cycle, it is desirable to employ the start timing of the diastole within the cardiac cycle as the reference timing. .

  In the present embodiment, as shown in FIG. 6, the timing detection unit 80 includes first to fifth reference timing detection units 81 to 85 and a selection processing unit 86, and is a reference timing detected by a plurality of types of detection methods. One reference timing within the cardiac cycle is selected from the above, and the cardiac cycle is specified using the reference timing.

  The first reference timing detection unit 81 receives a first detection signal DET1 (for example, an electrocardiogram measurement signal), and the first reference timing detection unit 81 detects the self-heart 200 based on the first detection signal DET1. The reference timing within the cardiac cycle is detected. A second detection signal DET2 (for example, a blood flow measurement signal) is input to the second reference timing detection unit 82, and the second reference timing detection unit 82 receives the self-heart 200 based on the second detection signal DET2. The reference timing within the cardiac cycle is detected. The third reference timing detector 83 receives a third detection signal DET3 (for example, a blood pressure pump power consumption measurement signal), and the third reference timing detector 83 is based on the third detection signal DET3. A reference timing within the cardiac cycle of the self-heart 200 is detected. A fourth detection signal DET4 (for example, a blood pressure measurement signal) is input to the fourth reference timing detection unit 84, and the fourth reference timing detection unit 84 detects the self-heart 200 based on the fourth detection signal DET4. The reference timing within the cardiac cycle is detected. A fifth detection signal DET5 (for example, a ventricular volume measurement signal) is input to the fifth reference timing detection unit 85, and the fifth reference timing detection unit 85 is based on the fifth detection signal DET5. The reference timing within the cardiac cycle is detected. As the detection signal, a ventricular pressure measurement signal from a sensor that detects the intraventricular pressure may be used.

  The selection processing unit 86 selects one reference timing from the reference timings detected by the reference timing detection units of the first to fifth reference timing detection units 81 to 85 based on a selection control signal (not shown). . As the selection control signal, the reference timing detection unit having the highest priority according to the priority order of the first to fifth reference timing detection units 81 to 85, for example, based on the ease of timing detection and the accuracy of timing detection as described above. The selection of the reference timing detected by may be instructed.

  In FIG. 6, the description has been made assuming that one reference timing is selected from the reference timings detected by the five types of reference timing detection units. However, the detection is performed by two to four types or six or more types of reference timing detection units. One reference timing may be selected from the reference timing. Further, the timing detection unit 80 may include only one reference timing detection unit, and the reference timing detected by the reference timing detection unit may be adopted as the output of the timing detection unit 80.

  In FIG. 5, the blood pump control unit 62 controls the number of rotations of the blood pump 10 so that the number of rotations corresponds to a given control pattern with reference to the reference timing detected by the timing detection unit 80. More specifically, blood pump drive control unit 66 generates a drive current corresponding to the instruction content from blood pump control unit 62, and the rotational speed of blood pump 10 is controlled using the drive current. The blood pump control unit 62 may incorporate such a function of the blood pump drive control unit 66.

  The control pattern referred to by the blood pump control unit 62 is stored in the control pattern storage unit 64. For example, the control pattern may be a pattern in which control information for specifying the number of rotations of the blood pump 10 is set for each of a plurality of periods divided within the cardiac cycle. Such a control pattern may be directly set in the control pattern storage unit 64 as setting information based on the clinical doctor's findings, or may be determined by the control pattern determination unit 68.

  As shown in FIG. 7, the control pattern determination unit 68 includes a control pattern calculation unit 90, and a detection signal from at least one of the sensors attached to the attachment position shown in FIG. Setting information based on the findings is acquired, a control pattern is determined according to a given pattern determination function (pattern determination algorithm) based on the detection signal or the setting information, and the control pattern is stored in the control pattern storage unit 64 .

  The control pattern calculation unit 90 controls the rotation speed of the blood pump 10 within one or a plurality of cardiac cycles based on detection values (measurement values) specified by the first to fifth detection signals DET1 to DET5. The control pattern is calculated. For example, the control pattern calculation unit 90 specifies the maximum value, the minimum value, the period, the phase shift until the control start timing of the rotational speed based on the reference timing, and how to change the rotational speed of the blood pump 10. A control pattern is calculated that specifies the waveform, the frequency at which the rotation speed of the blood pump 10 is changed Y (Y is a natural number less than or equal to X) times in X (X is a natural number of 1 or more) beats, and the like. The control pattern calculated in this way is stored in the control pattern storage unit 64.

  In FIG. 7, the control pattern is calculated from five types of detection signals. However, the control pattern may be calculated from two to four types or six or more types of detection signals. Further, the control pattern calculation unit 90 may calculate the above-described control pattern based on only one detection signal.

  In FIG. 5, the abnormality detection unit 70 detects an abnormal state during the control of the blood pump 10. As such an abnormal state, for example, there is a state where the value range of the detection signal from the sensor 30 is out of the normal value range, or a state where the fluctuation of the value of the detection signal from the sensor 30 exceeds a threshold value. Then, when an abnormal state is detected by the abnormality detection unit 70, the blood pump control unit 62 controls the rotation speed of the blood pump 10 so as to become the indicated rotation speed. Here, it is desirable that the designated rotational speed is a constant rotational speed. Thus, when an abnormal state is detected while controlling the rotation speed of the blood pump 10 within the cardiac cycle based on the detection signal from the sensor 30, a constant command rotation is performed regardless of the detected reference timing. By continuing the control of the blood pump 10 by the number, the function of assisting the blood flow of the self-heart 200 by the blood pump 10 can be continued and the patient can be prevented from falling into a dangerous state.

  In the present embodiment, the artificial heart control device 60 may have a configuration in which one or more blocks of the blocks in FIG. 5 are omitted. For example, the artificial heart control device 60 may have a configuration in which the control pattern determination unit 68 is omitted from the configuration in FIG.

  Next, the operation of the artificial heart control device 60 having the above configuration will be described. The function of the artificial heart control device 60 in the present embodiment may be realized by hardware or may be realized by software. In the following, it is assumed that the function of the artificial heart control device 60 in the present embodiment is realized by software processing.

  FIG. 8 shows a block diagram of a hardware configuration example of the artificial heart control device 60 in the present embodiment.

  The artificial heart control device 60 includes a CPU 300, an I / F circuit 302, a read only memory (ROM) 304, a random access memory (RAM) 306, and a bus 308. The CPU 300, the I / F circuit 302, the ROM 304, and the RAM 306 are electrically connected.

  For example, the ROM 304 or the RAM 306 stores a program that realizes the function of the artificial heart control device 60. The CPU 300 reads out a program stored in the ROM 304 or the RAM 306 and executes processing corresponding to the program, thereby realizing the functions of each unit constituting the artificial heart control device 60 by software processing. That is, the following processing is realized by the CPU 300 that reads a program stored in the ROM 304 or the RAM 306 and performs processing corresponding to the program. Note that the RAM 306 is used as a work area for processing by the CPU 300 or as a buffer area for the I / F circuit 302 or the ROM 304. As shown in FIG. 4, the I / F circuit 302 performs input / output interface processing with one or a plurality of sensors attached to the patient's body or body surface.

FIG. 9 shows a flowchart of a processing example of the artificial heart control device 60 of FIG.
FIG. 10 shows a flowchart of a detailed processing example of step S18 of FIG.

  For example, the ROM 304 or RAM 306 in FIG. 8 stores a program for realizing the processing shown in FIGS. 9 and 10, and the CPU 300 reads the program stored in the ROM 304 or RAM 306 and performs processing corresponding to the program. By executing, the processing shown in FIGS. 9 and 10 can be realized by software processing.

  First, as shown in FIG. 4, the artificial heart control device 60 acquires detection signals from one or more sensors attached to the patient's body or body surface (step S10). Here, as the abnormality detection step, the artificial heart control device 60 determines whether the value of the detection signal from the sensor, for example, is within the range of normal values determined according to the type of the detection signal in the abnormality detection unit 70. Is detected, abnormality detection processing is performed (step S12).

  When an abnormal state is not detected in step S12 (step S12: N), the artificial heart control device 60 performs the intracardiac cycle based on the detection signal acquired in step S10 in the timing detection unit 80 as a timing detection step. A reference timing detection process for detecting the reference timing is performed (step S14).

  When the reference timing in the cardiac cycle is detected in step S14 (step S16: Y), the artificial heart control device 60 uses the control pattern determination unit 68 as the control pattern determination step to state the human body in which the blood pump is operating. The control pattern is determined based on the detection signal from the sensor that detects the error, and the control pattern is stored in the control pattern storage unit 64 (step S18).

  Subsequently, as a blood pump control step, the artificial heart control device 60 reads the control pattern stored in the control pattern storage unit 64 in the blood pump control unit 62 and rotates the blood pump 10 in accordance with the control pattern. The number is controlled (step S20), and the process returns to step S10 (return).

  In step S20, as shown in FIG. 10, the artificial heart control device 60 detects the cardiac cycle of the self-heart 200 based on the reference timing in the cardiac cycle detected in step S14 in the blood pump control unit 62. Then, the start timing of the cardiac cycle is specified (step S30). Subsequently, in the blood pump control unit 62, based on the cardiac cycle detected in step S30 and the control pattern determined in step S18, the current rotation speed of the blood pump 10 is set so as to be a target rotation speed. Determination is made (step S32), and control is performed to generate the drive current of the blood pump 10 so as to achieve the rotation speed (end). That is, the blood pump control unit 62 controls the rotation speed of the blood pump so that the rotation speed corresponds to the control pattern determined in the control pattern determination step with reference to the reference timing detected in the timing detection step.

  On the other hand, when the reference timing in the cardiac cycle is not detected in step S14 (step S16: N), the artificial heart control device 60 returns to step S10 as it is without controlling the rotation speed of the blood pump 10 (return). .

  When an abnormal state is detected in step S12 (step S12: Y), the artificial heart control device 60 performs a blood pump control step so that the blood pump control unit 62 has a constant indicated rotational speed as a blood pump control step. Is controlled (step S22), and the process returns to step S10 (return).

  In FIG. 9, the control pattern is determined on the condition that the reference timing has been detected. However, the present embodiment is not limited to this. For example, after the detection signal from the sensor is acquired in step S10, the artificial heart control device 60 uses a control pattern determination unit 68 as a control pattern determination step from a sensor that detects the state of the human body in which the blood pump is operating. It is also possible to determine a control pattern based on the detected signal and store the control pattern in the control pattern storage unit 64.

  9 and 10, the control pattern is determined using the detection signal from the sensor, but the present embodiment is not limited to this. For example, one or more types of control patterns are prepared in advance corresponding to clinical doctor findings and various detection signal values, and based on clinical doctor findings and various detection signal values. One control pattern may be selected.

  FIG. 11 shows a flowchart of another processing example of the artificial heart control device 60 of FIG. 8 in the present embodiment. In FIG. 11, the same steps as those in FIG. 9 are denoted by the same reference numerals, and description thereof will be omitted as appropriate.

  In this case, for example, the ROM 304 or RAM 306 in FIG. 8 stores a program for realizing the processing shown in FIGS. 10 and 11, and the CPU 300 reads out the program stored in the ROM 304 or RAM 306 and corresponds to the program. By executing the above processing, the processing shown in FIGS. 10 and 11 can be realized by software processing.

  The processing flow shown in FIG. 11 is different from the processing flow shown in FIG. 9 in that step S18 is omitted. That is, when the reference timing in the cardiac cycle is detected in step S14 (step S16: Y), the artificial heart control device 60 detects the blood pump control unit 62 in the control pattern storage unit 64 as a blood pump control step. A control pattern stored in advance corresponding to the signal is read out, the number of rotations of the blood pump 10 is controlled corresponding to the control pattern (step S20), and the process returns to step S10 (return).

  By the way, a case where a patient whose blood flow of the self-heart is assisted by an artificial heart system including this type of artificial heart control device rarely has been reported to sufficiently recover its function. For this reason, it has become important to promote recovery of the function of the patient's own heart using an artificial heart system.

  However, in this type of artificial heart control device, the blood pump is always operated at a constant command speed, or the speed of the blood pump is changed regardless of the cardiac cycle. In the period, excessive or insufficient ventricular load reduction was performed, and on the contrary, recovery of the function of the self-heart was hindered.

  Therefore, in the present embodiment, as described above, the reference timing in the cardiac cycle is detected, and the blood pump 10 corresponding to the control pattern is controlled based on the reference timing, so that the cardiac cycle of the patient's own heart Accordingly, the load on the ventricle can be reduced and the recovery of the function of the own heart can be promoted.

  Below, the specific example of operation | movement of the artificial heart control apparatus 60 in this embodiment is demonstrated. For convenience of explanation, the sensor 30 is only one of the electrocardiogram measuring devices, and the timing detection unit 80 detects the reference timing based only on the detection signal from the electrocardiogram measuring device.

  FIG. 12 schematically shows a general relationship between the electrocardiogram and the cardiac cycle in the present embodiment.

  One heartbeat of the self-heart 200 can be specified by measuring how an electrical signal generated in the sinus node is transmitted. For example, an electrical signal generated in the sinus node is transmitted to the atrial muscle and contracts the atrium to generate the P wave of FIG. As a result, the atrium is contracted to increase the internal pressure, and a QRS wave is generated in accordance with the contraction period of the ventricle. Thereafter, a T wave is generated when the ventricle expands.

  Here, the period from R to the end of the T wave is called a systole in the cardiac cycle, and the period from the end of the systole to the next heartbeat R is called a diastole in the cardiac cycle. The systole is an isovolumetric systole, a period in which the heart muscle is under tension with the arterial valve and the valve between the atrium and the ventricle closed, and then the valve between the atrium and the ventricle is closed. And ejection period, which is a period in which the arterial valve is open and blood is being pumped from the ventricle. In addition, the diastole is an isovolumetric relaxation period in which the ventricle is relaxed with the arterial valve and the valve between the atrium and the ventricle closed, and a period between the atrium and the ventricle with the arterial valve closed. And a full period, which is a period in which the valve is opened and blood is stored in the ventricle.

  As is apparent from FIG. 12, when an electrocardiogram measuring instrument is employed as the sensor 30, it is easy to detect R in FIG. Therefore, in this case, it is easy to detect the start timing of the systole (isovolumetric systole) within the cardiac cycle as the reference timing, and the detection can be performed with high accuracy.

  Note that the reference timing in the present embodiment is not limited to the start timing of the systole. For example, the start timing of the diastole within the cardiac cycle may be detected as the reference timing. In this case, by detecting the reference timing based on the blood pressure such as the aortic pressure or the arterial pressure, it becomes easy to detect the start timing of the diastole, and the detection can be performed with high accuracy. As described above, it is desirable that the timing to be detected as the reference timing in the cardiac cycle is appropriately selected according to the type of the sensor 30.

  FIG. 13A to FIG. 13E show examples of control patterns in the present embodiment. In each of FIGS. 13A to 13E, the horizontal axis represents the time axis, and the vertical axis represents the electrocardiogram waveform and the control pattern indicating the rotation speed of the blood pump 10. The control pattern for performing the control shown in FIGS. 13A to 13E is directly stored in the control pattern storage unit 64 as setting information based on the clinical doctor's findings, or in the control pattern determination unit 68. Can be determined.

  In the present embodiment, the blood pump control unit 62 of the artificial heart control device 60, as shown in FIGS. 13 (a) to 13 (e), 1 of the heart based on the reference timing within the cardiac cycle of the own heart. Or the control which changes the rotation speed of the blood pump 10 according to a given periodic function within a some cardiac cycle is performed. Therefore, it is desirable that the control pattern for controlling the blood pump control unit 62 is to instruct a change in the rotation speed of the blood pump 10 as follows.

  FIG. 13A is an example of a control pattern in which the rotation speed of the blood pump 10 is changed during each period of systole and diastole in the cardiac cycle. More specifically, when the cardiac cycle is specified based on the detection signal from the electrocardiogram measuring instrument, the rotation speed of the blood pump 10 becomes R1 (R1 is a positive number) during the systole within the cardiac cycle, This is an example of a control pattern for instructing the rotation speed of the blood pump 10 to be R2 (R1> R2> 0, R2 is a positive number) during the diastole within the cardiac cycle. That is, FIG. 13A shows a control pattern for instructing control to decrease the rotation speed of the diastolic blood pump in the cardiac cycle.

  As described above, based on the reference timing, the rotation speed of the blood pump 10 is controlled so as to decrease the rotation speed of the blood pump 10 in the diastole of the heart and to increase the rotation speed of the blood pump 10 in the systole of the heart. Thus, while assisting the myocardium in the systole, it is not necessary to disturb the movement of the myocardium in the diastole, and the recovery of the function of the self heart can be promoted without applying an excessive load on the self heart.

  FIG. 13B is an example of a control pattern in which the rotation speed of the blood pump 10 is changed during the systole and diastole periods in the cardiac cycle, and the change timing is shifted. More specifically, when the cardiac cycle is specified based on the detection signal from the electrocardiogram measuring instrument, the rotation speed of the blood pump 10 is delayed by a predetermined period from the start timing of the systole within the cardiac cycle by R3 (R3 Is a positive number), and the blood pump 10 is instructed to be R4 (R3> R4> 0, R4 is a positive number) after a predetermined period from the start timing of the diastole within the cardiac cycle. It is an example of a control pattern.

  In this way, while changing the load according to the cardiac cycle of the self heart, by shifting the timing, it is possible to achieve both appropriate load control and promotion of functional recovery according to the current function of the self heart. Will be able to.

  FIG. 13C shows an example of a control pattern in which the rotation speed of the blood pump 10 is changed during each systole and diastole period in the cardiac cycle, and the change range of the rotation speed is larger than that in FIG. is there. More specifically, when the cardiac cycle is specified based on the detection signal from the electrocardiogram measuring instrument, the rotation speed of the blood pump 10 is R5 (R5> R1, R5 is a positive number during the systole within the cardiac cycle) This is an example of a control pattern instructing the rotational speed of the blood pump 10 to be R6 (R2> R6, R5> R6> 0, R6 is a positive number) during the diastole within the cardiac cycle.

  As described above, it is desirable to control the rotation speed of the blood pump 10 by changing the change range of the rotation speed of the blood pump 10 in accordance with the current function of the self-heart.

  FIG. 13D is an example of a control pattern in which the rotation speed of the blood pump 10 is changed by 1 (= Y) times every 2 (= X) heartbeats. More specifically, when the cardiac cycle is specified based on the detection signal from the electrocardiogram measuring instrument, the rotation speed of the blood pump 10 is R7 (R7, R7) during the systole in the first cardiac cycle of the two cardiac cycles. Is a positive number), and the rotational speed of the blood pump 10 is R8 (R7> R8> 0, R8 is a positive number) during the diastole and the systole and diastole of the next cardiac cycle. FIG.

  Thus, the control pattern in this embodiment does not have to control the rotation speed of the blood pump 10 for each cardiac cycle, and the rotation of the blood pump 10 depends on the degree of recovery of the function of the patient's own heart 200. The number of control periods may be shortened.

  FIG. 13E is an example of a control pattern that changes the rotation speed of the blood pump 10 in a sine wave shape. More specifically, when the cardiac cycle is specified based on the detection signal from the electrocardiogram measuring instrument, the rotational speed of the blood pump 10 is gradually increased in a sinusoidal shape during the systole of the cardiac cycle, and R9 (R9, R9 Is a positive number), and during the diastole within the cardiac cycle, the rotational speed of the blood pump 10 is gradually reduced to a sine wave to indicate R10 (R9> R10> 0, R10 is a positive number). It is an example of a pattern. In FIG. 13 (e), the rotation speed of the blood pump 10 is changed to a sine wave shape, but is not limited to this waveform, as shown in FIGS. 13 (a) to 13 (d). It is not always necessary to change the rotational speed to a rectangular shape.

  As described above, in this embodiment, the control for changing the rotation speed of the blood pump 10 according to a given periodic function within one or more cardiac cycles of the heart is performed based on the reference timing. It is possible to reduce the ventricular load according to the cardiac cycle of the self-heart and promote the functional recovery of the self-heart.

  In the present embodiment, if there is a possibility that the rotation speed of the blood pump 10 may become uncontrollable due to a failure of the sensor 30 or an abnormality in the control algorithm, the abnormality detection unit 70 detects the abnormality and keeps constant. Has a mechanism for forcibly changing the blood pump 10 to the normal operation state in which the blood pump 10 is operated at the indicated rotational speed.

  FIG. 14A and FIG. 14B show a processing example when an abnormality is detected in the artificial heart control device 60 in the present embodiment. 14A and 14B, the horizontal axis represents the time axis, and the vertical axis represents the electrocardiogram waveform and the control pattern for instructing the rotation speed of the blood pump 10.

  In FIG. 14A, for example, the start timing of the systole within the cardiac cycle is detected as the reference timing, and the rotation speed of the blood pump 10 during the systole of the cardiac cycle is increased to R11 (R11 is a positive integer). When an abnormal state is detected at time T1 in a control operation state in which the rotation speed of the blood pump 10 in the diastolic period is controlled to be reduced to R12 (R11> R12> 0, R12 is a positive integer), The rotation speed of blood pump 10 is controlled in the normal operation state from the time when the timing is detected. In this normal operation state, for example, the rotation speed of the blood pump 10 is controlled to be constant at R13 (R11> R13> R12). R13 may be larger than R11 or smaller than R12.

  In FIG. 14B, for example, the start timing of the systole in the cardiac cycle is detected as a reference timing, and the rotation speed of the blood pump 10 in the systole of the cardiac cycle is increased to R14 (R14 is a positive integer) When an abnormal state is detected at time T2 in a control operation state in which the rotation speed of the blood pump 10 in the diastole of the cardiac cycle is controlled to be reduced to R15 (R14> R15> 0, R15 is a positive integer), The rotation speed of blood pump 10 is controlled in the normal operation state from the time when the state is detected. In this normal operation state, for example, the rotation speed of the blood pump 10 is controlled to be constant at R16 (R14> R16> R15). R16 may be larger than R14 or smaller than R15.

  As described above, in the present embodiment, on the condition that an abnormal state is detected, it is forcibly changed to a normal operation state in which the blood pump 10 is controlled to have an indicated rotational speed (for example, the rotational speed is constant). As a result, the reliability of the artificial heart system can be improved and the load on the ventricle can be reduced in accordance with the cardiac cycle of the patient's own heart, thereby promoting the functional recovery of the own heart.

  Further, according to the present embodiment having the above-described configuration, the blood pump control unit 62 uses the rotation speed designation method based on the control pattern so that the blood flow in the ventricle of the heart changes based on the reference timing. The rotation speed of the pump 10 can be controlled. By doing so, the following effects can be obtained.

  FIG. 15 schematically shows the self-heart 200 and the blood pump 10 in the present embodiment. In FIG. 15, the same parts as those in FIG.

  As shown in FIG. 15, the cannula tip portion 402 of the blood pump 10 is inserted into the left ventricle 202 of the own heart 200 through a cannula graft portion 400 as an artificial blood vessel. Blood returned to the left atrium 206 via the pulmonary vein 204 is pumped into the left ventricle 202 when the mitral valve is opened. Thereafter, the aortic valve 208 is opened and blood is sent out to the aorta 210. The blood returned from the aorta 210 via the systemic circulation system via the superior vena cava 212 and the inferior vena cava 214 is stored in the right atrium 216 and is sent to the right ventricle 218 when the tricuspid valve is opened. Thereafter, the pulmonary valve 220 is opened and blood is sent to the pulmonary artery 222.

  Here, paying attention to the flow of blood sent from the left atrium 206 to the left ventricle 202, when the rotation speed of the blood pump 10 is high, the cannula tip as it is from the left atrium 206 as in the flow F1 shown in FIG. The blood flowing in the part 402 becomes dominant. However, when the rotation speed of the blood pump 10 is low, blood tends to flow along the wall of the left ventricle 202 as in the flow F2 shown in FIG. Therefore, in the vicinity of the insertion of the cannula tip 402, blood tends to stay, and the possibility that the blood clots and a thrombus is formed increases.

  Therefore, as described above, the blood pump control unit 62 controls the rotation speed of the blood pump 10 so that the blood flow in the ventricle of the heart changes based on the reference timing. It becomes possible to suppress the retention of blood in the vicinity PL, and to prevent thrombus formation.

  Further, in a general artificial heart system, an off-pump test is required in which the blood pump is appropriately stopped in order to confirm the degree of recovery of the patient's own heart. However, it is said that the off-pump test can be easily realized only by opening and closing a valve in the case of a pulsating blood pump, but is difficult to realize in the case of a continuous flow (steady flow) blood pump. Yes.

  However, according to the present embodiment having the above-described configuration, the blood pump control unit 62 determines that the output flow rate of the blood pump 10 is 0 in the systole of the heart based on the reference timing by the method of specifying the number of rotations based on the control pattern. In addition, the rotation speed of the blood pump 10 can be controlled so that the reverse flow rate of the blood pump 10 becomes 0 in the diastole of the heart.

  For example, an ultrasonic / electromagnetic flow meter or a blood pump rotation speed measuring device is used as the sensor 30 to detect the output flow rate and the reverse flow rate of the blood pump 10, and the control pattern determination unit 68 is based on the detection result. Then, based on the reference timing, the rotation speed of the blood pump 10 is controlled so that the output flow rate of the blood pump 10 becomes 0 in the systole of the heart and the reverse flow rate of the blood pump 10 becomes 0 in the diastole of the heart. What is necessary is just to determine a control pattern. And based on this control pattern, the blood pump control part 62 controls the rotation speed of the blood pump 10. As a result, even if the blood pump 10 used in the artificial heart system is a continuous flow blood pump, an off-pump test that could not be easily realized can be easily realized, thereby reducing the risk to the patient. become able to.

  As described above, the artificial heart control device, the artificial heart system, and the artificial heart control method according to the present invention have been described based on the above embodiment. However, the present invention is not limited to the above embodiment, and the gist thereof is as follows. The present invention can be implemented in various modes without departing from the scope, and for example, the following modifications are possible.

  (1) In the above embodiment, the blood pump is described as a continuous flow type. However, the present invention is not limited to this, and the blood pump gives a predetermined cycle to the blood flow to be circulated. It may be a pulsatile blood pump. In this case, it is not necessary to implement an off-pump test using the control pattern.

  (2) The blood pump in the above embodiment is realized by an AC motor driven by a three-phase drive signal, a motor driven by a drive signal other than three phases, or a DC motor.

  (3) In the artificial heart system 100 of the above embodiment, a monitor device may be provided as necessary. This monitor device includes the power supply voltage of the control unit 20, the operating state of the blood pump 10 (the driving current of the blood pump 10, the target rotational speed, the actual rotational speed, etc.), the value of the detection signal from the sensor 30, the self-heart It is desirable that information such as 200 cardiac cycles that can be confirmed by the doctor or the patient himself / herself is displayed.

  (4) In the above embodiment, the present invention has been described as an artificial heart control device, an artificial heart system, and an artificial heart control method, but the present invention is not limited to this. For example, it may be a program in which the processing procedure of the artificial heart control method according to the present invention is described, or a recording medium on which the program is recorded.

DESCRIPTION OF SYMBOLS 10 ... Blood pump, 11 ... Drive part, 12 ... Pump part, 13 ... Impeller,
14 ... pump casing, 15 ... inlet, 16 ... outlet,
17 ... Mechanical seal part, 20 ... Control unit, 30 ... Sensor,
40 ... cable, 50 ... power supply, 60 ... artificial heart control device,
62 ... Blood pump control unit, 64 ... Control pattern storage unit,
66 ... Blood pump drive control unit, 68 ... Control pattern determination unit, 70 ... Abnormality detection unit,
80 ... timing detection unit, 81 ... first reference timing detection unit,
82: second reference timing detector, 83: third reference timing detector,
84: Fourth reference timing detection unit, 85: Fifth reference timing detection unit,
86 ... Selection processing unit, 90 ... Control pattern calculation unit, 100 ... Artificial heart system,
200 ... Self heart, 202 ... Left ventricle, 204 ... Pulmonary vein, 206 ... Left atrium,
208 ... aortic valve, 210 ... aorta, 212 ... superior vena cava, 214 ... inferior vena cava,
216 ... right atrium, 218 ... right ventricle, 220 ... pulmonary valve, 222 ... pulmonary artery,
300 ... CPU, 302 ... I / F circuit, 304 ... ROM, 306 ... RAM,
308 ... Bath, 400 ... Cannula graft, 402 ... Cannula tip,
DET1 to DET5 ... first to fifth detection signals, F1, F2 ... blood flow,
PL ... Near the tip of the cannula

Claims (20)

An artificial heart control device for controlling a blood pump that assists the blood flow of the heart,
A timing detector for detecting a reference timing in the cardiac cycle of the heart;
A blood pump control unit for controlling the number of rotations of the blood pump,
The blood pump control unit,
An artificial heart control device that controls the number of rotations of the blood pump so that the number of rotations corresponds to a given control pattern based on the reference timing detected by the timing detection unit. In claim 1,
The reference timing is
An artificial heart control device characterized by the start timing of a systole in the cardiac cycle. In claim 1,
The reference timing is
An artificial heart control device characterized by the start timing of a diastole within the cardiac cycle. In any one of Claims 1 thru | or 3,
The blood pump control unit,
An artificial heart control device characterized by controlling the rotation speed of the blood pump so that the blood flow in the ventricle of the heart changes based on the reference timing. In any one of Claims 1 thru | or 4,
The blood pump control unit,
An artificial heart control device that performs control to change the rotation speed of the blood pump in accordance with a given periodic function within one or a plurality of cardiac cycles of the heart with reference to the reference timing. In any one of Claims 1 thru | or 5,
The blood pump control unit,
Controlling the rotation speed of the blood pump so as to decrease the rotation speed of the blood pump in the diastole of the heart and to increase the rotation speed of the blood pump in the systole of the heart based on the reference timing. An artificial heart control device. In any one of Claims 1 thru | or 3,
The blood pump control unit,
Based on the reference timing, the rotation speed of the blood pump is controlled so that the output flow rate of the blood pump is 0 in the systole of the heart and the reverse flow rate of the blood pump is 0 in the diastole of the heart. An artificial heart control device. In any one of Claims 1 thru | or 7,
Including an abnormality detection unit for detecting an abnormal state during control of the blood pump;
The blood pump control unit,
When the abnormal state is detected by the abnormality detection unit, the artificial heart control device controls the rotation speed of the blood pump so that a constant indicated rotation speed is obtained. In any one of Claims 1 thru | or 8.
A control pattern determining unit that determines the control pattern based on a detection signal from a sensor that detects a state of a human body in which the blood pump is operating
The blood pump control unit,
The number of rotations of the blood pump is controlled so that the number of rotations corresponds to the control pattern determined by the control pattern determination unit based on the reference timing detected by the timing detection unit. Artificial heart control device. A blood pump that assists in the flow of blood in the heart,
A sensor for detecting a state of a human body in which the blood pump is operating;
An artificial heart system comprising: the artificial heart control device according to any one of claims 1 to 9, which controls the blood pump based on a detection signal from the sensor. In claim 10,
The blood pump is
Having a cannula tip inserted into the left ventricle of the heart;
An artificial heart system characterized in that blood in the left ventricle is sent to the aorta. A method of controlling an artificial heart for controlling a blood pump that assists in the blood flow of the heart,
A timing detection step for detecting a reference timing within the cardiac cycle of the heart;
And a blood pump control step of controlling the rotation speed of the blood pump so that the rotation speed corresponds to a given control pattern based on the reference timing detected in the timing detection step. Artificial heart control method. In claim 12,
The reference timing is
A method for controlling an artificial heart, which is a start timing of a systole in the cardiac cycle. In claim 12,
The reference timing is
A method for controlling an artificial heart, wherein the timing is a start timing of a diastole within the cardiac cycle. In any of claims 12 to 14,
The blood pump control step comprises:
A method for controlling an artificial heart, wherein the number of rotations of the blood pump is controlled so that a blood flow in a heart chamber of the heart changes based on the reference timing. In any of claims 12 to 15,
The blood pump control step comprises:
A control method for an artificial heart, characterized in that control is performed to change the rotation speed of the blood pump in accordance with a given periodic function within one or more cardiac cycles of the heart with reference to the reference timing. In any of claims 12 to 16,
The blood pump control step comprises:
Controlling the rotation speed of the blood pump so as to decrease the rotation speed of the blood pump in the diastole of the heart and to increase the rotation speed of the blood pump in the systole of the heart based on the reference timing. A method for controlling an artificial heart. In any one of claims 12 to 14,
The blood pump control step comprises:
Based on the reference timing, the rotation speed of the blood pump is controlled so that the output flow rate of the blood pump is 0 in the systole of the heart and the reverse flow rate of the blood pump is 0 in the diastole of the heart. And a method for controlling an artificial heart. In any of claims 12 to 18,
Including an abnormality detection step of detecting an abnormal state during control of the blood pump;
The blood pump control step comprises:
A method for controlling an artificial heart, comprising: controlling the rotation speed of the blood pump so that a constant indicated rotation speed is obtained when the abnormal state is detected in the abnormality detection step. In any of claims 12 to 19,
A control pattern determining step for determining the control pattern based on a detection signal from a sensor for detecting a state of a human body in which the blood pump is operating;
The blood pump control step comprises:
The number of rotations of the blood pump is controlled so that the number of rotations corresponds to the control pattern determined in the control pattern determination step on the basis of the reference timing detected in the timing detection step. Artificial heart control method.

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