JP2013523284A - 複合的心臓補助システム、方法および装置 - Google Patents
複合的心臓補助システム、方法および装置 Download PDFInfo
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Abstract
Description
Claims (38)
- 心臓補助システムであって、
(a)機械的心臓補助装置と、
(b)前記機械的心臓補助装置に動作的に結合されたコントローラであって、前記機械的心臓補助装置へ起動信号を送るように構成されたコントローラと、
(c)前記コントローラに動作的に結合された電気的治療装置であって、
(i)前記電気的治療装置に動作的に結合された少なくとも一つのセンサであって、心臓の特性を検出して前記心臓の特性に関する信号を前記電気的治療装置へ送るように構成されたセンサと、
(ii)前記電気的治療装置に動作的に結合された少なくとも一つのペーシング要素であって、前記心臓のペーシングを行うように構成されたペーシングリードと、を有する電気的治療装置と、を備える心臓補助システム。 - 前記センサがセンシングリードであり、前記センシングリードが前記心臓内または前記心臓の近傍に配置可能であるように構成される、請求項1の心臓補助システム。
- 前記センサが前記電気的治療装置と物理的に一体化されている、請求項1の心臓補助システム。
- 前記ペーシング要素がペーシングリードであり、前記ペーシングリードが前記心臓内または前記心臓の近傍に配置可能であるように構成される、請求項1の心臓補助システム。
- 前記ペーシング要素が前記電気的治療装置と物理的に一体化されている、請求項1の心臓補助システム。
- 前記コントローラが前記電気的治療装置と物理的に一体化されている、請求項1の心臓補助システム。
- 前記コントローラが前記機械的心臓補助装置と物理的に一体化されている、請求項1の心臓補助システム。
- 前記機械的心臓補助装置が拍動装置である、請求項1の心臓補助システム。
- 前記電気的治療装置が植込み型心臓再同期治療除細動器(“CRT−D”)である、請求項1の心臓補助システム。
- 前記電気的治療装置が植込み型除細動器(“ICD”)である、請求項1の心臓補助システム。
- 前記センサが、心室収縮の消失または低下を検知して前記電気的治療装置へ情報を送るように構成された電気的センシングリードであり、
前記電気的治療装置が、前記コントローラへ起動信号を送るように構成され、
前記心臓の細動が除去されるか正常な心律動が回復するまで循環支援を提供するよう動作するように、前記コントローラが前記機械的心臓装置へ起動信号を送るように構成される、請求項1の心臓補助システム。 - 前記センサが、心室収縮の消失または低下を検知して前記電気的治療装置へ情報を送るように構成された電気的センシングリードであり、
前記電気的治療装置が、前記コントローラへ起動信号を送るように構成されており、
前記電気的治療装置により前記心臓の細動が除去されるまで循環支援を提供するよう動作するように、前記コントローラが前記機械的心臓装置へ起動信号を送るように構成される、請求項1の心臓補助システム。 - 前記電気的治療装置が、前記少なくとも一つのペーシング要素を起動して、前記コントローラと同期して前記心臓の心室を電気的に刺激するように構成され、
前記コントローラが、前記機械的心臓補助装置を起動するように構成される、請求項1の心臓補助システム。 - 前記センサが、電気センサ、ECGセンサ、心臓振動センサ、心臓音響センサ、流量センサ、圧力センサ、インピーダンスセンサ、壁応力センサ、および光学反射センサで構成されるグループから選択され、
前記センサが、前記心臓もしくは前記心臓の大血管内、またはこれらの近傍に配置可能である、請求項1の心臓補助システム。 - 前記センサが音響センサであり、
前記音響センサが、前記心臓の大動脈弁の音を検出するように構成された大動脈弁音響センサである、請求項1の心臓補助システム。 - 心臓補助装置を制御する方法であって、
心臓の特性をセンサで検出する工程と、
前記心臓の特性に関する信号を前記センサを介して電気的治療装置へ送る工程と、
ペーシング要素へペーシング信号を送るために、前記心臓の特性の信号に少なくとも部分的に基づいて前記電気的治療装置を起動する工程と、
前記心臓の特性の信号に少なくとも部分的に基づき、コントローラへ信号を送る工程と、
前記コントローラへの前記信号に少なくとも部分的に基づき、前記コントローラからの起動信号で機械的心臓補助装置を起動する工程と、を含む方法。 - 前記コントローラへ前記信号を送る工程が、前記電気的治療装置と前記コントローラとに結合された接続リードを介して前記コントローラへ前記信号を送る工程をさらに含む、請求項16の方法。
- 前記センサがセンシングリードである、請求項16の方法。
- 前記ペーシング要素がペーシングリードである、請求項16の方法。
- 前記コントローラが前記電気的治療装置と物理的に一体化されている、請求項16の方法。
- 前記コントローラが前記機械的心臓補助装置と物理的に一体化されている、請求項16の方法。
- 前記機械的心臓補助装置が拍動装置である、請求項16の方法。
- 前記心臓の特性に関する情報に基づいて、前記心臓を補助する動作を同期的に行うように前記機械的心臓補助装置および前記電気的治療装置の両方を起動する工程をさらに含む、請求項16の方法。
- 前記心臓の特性が心室収縮の消失または低下を含み、
前記電気的治療装置を起動する工程が、前記心臓の特性に関する情報に基づいて前記心臓へ心室リードを介して除細動放電を送るために前記電気的治療装置を起動する工程をさらに含み、
前記機械的心臓補助装置を起動する工程が、前記心臓の細動が除去されるか正常な心律動が回復するまで循環支援を提供するように前記機械的心臓補助装置を起動する工程をさらに含む、請求項16の方法。 - 前記心臓の特性が心室収縮の消失または低下を含み、
前記電気的治療装置を起動する工程が、前記心臓の特性に関する情報に基づいて前記心臓へ心室リードを介して除細動放電を送るために前記電気的治療装置を起動する工程をさらに含み、
前記機械的心臓補助装置を起動する工程が、前記電気的治療装置が前記心臓へ除細動放電を送るまで循環支援を提供するように前記機械的心臓補助装置を起動する工程をさらに含む、請求項16の方法。 - 前記電気的治療装置がICDである、請求項16の方法。
- 前記電気的治療装置がCRT−Dである、請求項16の方法。
- 前記電気的治療装置を起動する工程および前記機械的心臓補助装置を起動する工程が、前記心臓へ前記ペーシング要素を介して前記ペーシング信号を送るように前記電気的治療装置を起動する一方で、大動脈圧迫構造を作動させて上行大動脈を圧迫するように前記機械的心臓補助装置を同期的に起動する工程をさらに含み、
前記機械的心臓補助装置と前記電気的治療装置とが協働して前記心臓を補助する、請求項16の方法。 - 前記心臓の特性が、心臓振動、心音、流量、圧力、インピーダンス、壁応力、および光学反射で構成されるグループから選択される、請求項16の方法。
- 心臓の補助および強化方法であって、
心臓の特性をセンシングリードで検出する工程と、
電気的心臓治療装置へ前記センシングリードを介して前記心臓の特性に関する情報を送る工程と、
前記心臓の特性に関する前記情報に少なくとも部分的に基づいて前記電気的心臓治療装置を起動する工程と、
前記電気的心臓治療装置およびコントローラに結合された接続リードを介して前記心臓の特性に関する前記情報を前記コントローラへ送る工程と、
前記心臓の特性に関する前記情報に少なくとも部分的に基づき、前記コントローラからの起動信号で植込み型の機械的心臓補助装置を起動する工程と、
所定量の収縮抵抗が前記心臓で生じるように、前記機械的心臓補助装置および前記電気的心臓治療装置の起動を周期的にタイミング調整する工程と、を含む方法。 - 前記電気心臓治療装置がICDである、請求項30の方法。
- 前記電気心臓治療装置がCRT−Dである、請求項30の方法。
- 前記機械的心臓補助装置および前記電気的心臓治療装置の起動を周期的にタイミング調整する工程が、毎日、所定治療期間にわたって前記所定量の収縮抵抗が前記心臓で生じるように前記装置の起動をタイミング調整する工程をさらに含む、請求項30の方法。
- 前記心臓の強化の際に前記所定治療期間を増減する工程をさらに含む、請求項33の方法。
- 所定の時間経過後に前記所定治療期間を増減する工程をさらに含む、請求項33の方法。
- 心臓補助装置の制御方法であって、
心臓の特性をセンサで検出する工程と、
電気的治療装置へ前記センサを介して前記心臓の特性に関する信号を送る工程と、
前記心臓の特性の信号に少なくとも部分的に基づいてリードへ信号を送るように前記電気的治療装置を起動する工程と、
前記心臓の特性の信号に少なくとも部分的に基づいてコントローラへ信号を送る工程と、
前記コントローラへの前記信号に少なくとも部分的に基づいて前記コントローラからの起動信号で機械的心臓補助装置を起動する工程と、を含む方法。 - 前記信号がペーシング信号である、請求項36の方法。
- 前記信号が除細動信号である、請求項36の方法。
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- 2011-04-01 CN CN201180027436.4A patent/CN102939117B/zh not_active Expired - Fee Related
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- 2011-04-01 WO PCT/US2011/030954 patent/WO2011123789A1/en active Application Filing
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AU2011235908A1 (en) | 2012-10-18 |
AU2011235908B2 (en) | 2015-02-19 |
WO2011123789A1 (en) | 2011-10-06 |
US20140148639A1 (en) | 2014-05-29 |
EP2552509A1 (en) | 2013-02-06 |
EP2552509B1 (en) | 2020-11-04 |
US9042979B2 (en) | 2015-05-26 |
CA2795251A1 (en) | 2011-10-06 |
CN102939117A (zh) | 2013-02-20 |
CN102939117B (zh) | 2015-12-02 |
JP5918213B2 (ja) | 2016-05-18 |
US20110270331A1 (en) | 2011-11-03 |
MX2012011161A (es) | 2012-12-05 |
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