JP4262596B2 - 埋め込み可能医療デバイスにおいて高電圧および抗頻脈ペーシング治療の送出を制御する方法および装置 - Google Patents
埋め込み可能医療デバイスにおいて高電圧および抗頻脈ペーシング治療の送出を制御する方法および装置 Download PDFInfo
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- JP4262596B2 JP4262596B2 JP2003516621A JP2003516621A JP4262596B2 JP 4262596 B2 JP4262596 B2 JP 4262596B2 JP 2003516621 A JP2003516621 A JP 2003516621A JP 2003516621 A JP2003516621 A JP 2003516621A JP 4262596 B2 JP4262596 B2 JP 4262596B2
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- 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
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
-
- 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
- A61N1/3925—Monitoring; Protecting
-
- 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
-
- 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
-
- 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
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3688—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions configured for switching the pacing mode, e.g. from AAI to DDD
Description
[発明の背景]
埋め込み可能カーディオバータ−ディフィブリレータ(ICD)の技術は、長い間、心室頻脈性不整脈をレートおよびタイプによって識別してきた。心室頻脈(VT)は一般に、150〜250bpmのレートを有する不整脈である。これらの調律はさらに、そのECG形状によって、単形性または多形性であると区別することができる。VTの最高範囲を超え、最高約350bpmのレートを有する不整脈は、粗動波と呼ばれることが多い。350bpmより高いレートの無秩序(chaotic)波形は心室細動(VF)として分類される。
[発明の概要]
本発明は、現行のATP送出デバイスに伴う、前述の問題および他の問題に対処する新規のシステムおよび方法を提案する。本発明は、ATP治療の送出と、ショック送出に備えた高電圧コンデンサの充電との間の時間を制御する。この制御は所定の基準セットに基づいて行われる。一実施形態において、本発明のシステムは、コンデンサ充電中にATP(ATP−DCC)モードで動作することができる。このモードにおいて、全てまたは実質上全てのATP治療は、高電圧コンデンサの充電中に送出される。システムは、全てまたは実質上全てのATP治療が高電圧コンデンサの充電前に送出される、さらに別のコンデンサ充電前ATP(ATP−BCC)モードに切り換えてよい。この切り換えは、所定の基準のセットに基づいて起こる。
Claims (9)
- 心臓に送出される電気治療を制御するのに用いるシステムであって、
充電されて、高電圧電気刺激を心臓に送出するようにする第1回路と、
抗頻脈ペーシング(ATP)治療を心臓に送出する第2回路と、
前記第1および第2回路に結合されて、所定の基準に基づいて、ATP治療を送出する時刻に対して前記第1回路の充電時間を調整する制御回路と、
ATP−DCCモードで動作して、前記ATP治療の送出の間に前記第1回路の充電を始動する手段と、
ATP−BCCモードで動作して、前記ATP治療の送出後に前記第1回路の充電を始動する手段と、
以前に送出した前記ATP治療の有効性に関する所定の基準に基づいて、前記ATP−BCCモードと前記ATP−DCCモードの間で移行する手段と、
を備え、
前記制御回路は、ATP−BCCモードで動作している間に、失敗したATP治療送出試行の数を示す第1パラメータに基づいて、前記ATP−BCCモードから前記ATP−DCCモードへ移行する手段を含み、
前記制御回路は、ATP−DCCモードで動作している間に、成功したATP治療送出試行の数を示す第2パラメータに基づいて、前記ATP−DCCモードから前記ATP−BCCモードへ移行する手段を含み、
前記ATP−DCCモードは、高電圧ショック用のコンデンサの充電中の、低電圧抗頻脈ペーシング治療であり、
前記ATP−BCCモードは、高電圧ショック用のコンデンサの充電前の、低電圧抗頻脈ペーシング治療である、
電気治療を制御するのに用いるためのシステム。 - 前記制御回路に結合されて、前記第1および第2パラメータを格納する格納デバイスをさらに含み、
前記第1および第2パラメータの少なくとも1つはプログラム可能である、
請求項1に記載の電気治療を制御するのに用いるシステム。 - 前記第2パラメータは、送出されたATP治療試行の総数のうちの成功したATP試行の数として測定される請求項1に記載の電気治療を制御するのに用いるシステム。
- 前記制御回路に結合されて、心調律を検知するようにする少なくとも1つの電極と、前記制御回路に結合されて、前記心調律のタイプを解析するようにする処理回路とをさらに含み、
前記所定の基準は、心臓内で発生する前記心調律のタイプを考慮する、
請求項1に記載の電気治療を制御するのに用いるシステム。 - 前記制御回路は、前記第1および第2パラメータに対して異なる値を利用する手段を含み、
前記値のそれぞれは、前記ATP治療の送出中に発生する心調律のタイプと関連している、
請求項4に記載の電気治療を制御するのに用いるシステム。 - 前記制御回路は、1つまたは複数の前記心調律の発生の頻度に基づいて、ATP治療を送出する時刻に対して前記第1回路の充電時間を調整する手段をさらに含む請求項4に記載の電気治療を制御するのに用いるシステム。
- 前記制御回路は、VT発症の検出に基づいて前記ATP−DCCモードから前記ATP−BCCモードへ移行する手段を含み、
所定数のVT調律が、所定期間の間に検出される、
請求項6に記載の電気治療を制御するのに用いるシステム。 - 前記所定の基準は、前記ATP治療の送出以前に発生した心調律のタイプの変化に関連する基準を含む請求項4に記載の電気治療を制御するのに用いるシステム。
- 前記制御回路は、前記ATP治療の送出中に発生する心調律のタイプの変化に関連する前記基準に基づいて前記ATP−BCCモードから前記ATP−DCCモードへ移行する手段を含む請求項8に記載の電気治療を制御するのに用いるためのシステム。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/918,224 US6718204B2 (en) | 2001-07-30 | 2001-07-30 | Method and apparatus to control delivery of high-voltage and anti-tachy pacing therapy in an implantable medical device |
PCT/US2002/023779 WO2003011391A2 (en) | 2001-07-30 | 2002-07-25 | Method and apparatus to control delivery of high-voltage and anti-tachy pacing therapy in an implantable medical device |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2004536678A JP2004536678A (ja) | 2004-12-09 |
JP2004536678A5 JP2004536678A5 (ja) | 2005-09-15 |
JP4262596B2 true JP4262596B2 (ja) | 2009-05-13 |
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Application Number | Title | Priority Date | Filing Date |
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JP2003516621A Expired - Fee Related JP4262596B2 (ja) | 2001-07-30 | 2002-07-25 | 埋め込み可能医療デバイスにおいて高電圧および抗頻脈ペーシング治療の送出を制御する方法および装置 |
Country Status (5)
Country | Link |
---|---|
US (3) | US6718204B2 (ja) |
EP (1) | EP1418982B1 (ja) |
JP (1) | JP4262596B2 (ja) |
CA (1) | CA2454235A1 (ja) |
WO (1) | WO2003011391A2 (ja) |
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-
2001
- 2001-07-30 US US09/918,224 patent/US6718204B2/en not_active Expired - Lifetime
-
2002
- 2002-07-25 CA CA002454235A patent/CA2454235A1/en not_active Abandoned
- 2002-07-25 WO PCT/US2002/023779 patent/WO2003011391A2/en active Application Filing
- 2002-07-25 EP EP02763358A patent/EP1418982B1/en not_active Expired - Lifetime
- 2002-07-25 JP JP2003516621A patent/JP4262596B2/ja not_active Expired - Fee Related
-
2004
- 2004-03-26 US US10/810,449 patent/US20040181259A1/en not_active Abandoned
-
2007
- 2007-03-16 US US11/687,282 patent/US8170663B2/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
US20030023273A1 (en) | 2003-01-30 |
US20040181259A1 (en) | 2004-09-16 |
CA2454235A1 (en) | 2003-02-13 |
WO2003011391A3 (en) | 2003-10-16 |
EP1418982A2 (en) | 2004-05-19 |
US6718204B2 (en) | 2004-04-06 |
JP2004536678A (ja) | 2004-12-09 |
US20070156189A1 (en) | 2007-07-05 |
EP1418982B1 (en) | 2012-12-19 |
US8170663B2 (en) | 2012-05-01 |
WO2003011391B1 (en) | 2003-12-18 |
WO2003011391A2 (en) | 2003-02-13 |
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