JP5196786B2 - 同期制御システム - Google Patents
同期制御システム Download PDFInfo
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- JP5196786B2 JP5196786B2 JP2006537000A JP2006537000A JP5196786B2 JP 5196786 B2 JP5196786 B2 JP 5196786B2 JP 2006537000 A JP2006537000 A JP 2006537000A JP 2006537000 A JP2006537000 A JP 2006537000A JP 5196786 B2 JP5196786 B2 JP 5196786B2
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- heart
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- cardiac assist
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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
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36578—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0004—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by the type of physiological signal transmitted
- A61B5/0006—ECG or EEG signals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
- A61B7/02—Stethoscopes
- A61B7/04—Electric stethoscopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/161—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel mechanically acting upon the outside of the patient's blood vessel structure, e.g. compressive structures placed around a vessel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/165—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart
- A61M60/178—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart drawing blood from a ventricle and returning the blood to the arterial system via a cannula external to the ventricle, e.g. left or right ventricular assist devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/165—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart
- A61M60/191—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart mechanically acting upon the outside of the patient's native heart, e.g. compressive structures placed around the heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/20—Type thereof
- A61M60/247—Positive displacement blood pumps
- A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
- A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
- A61M60/274—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/20—Type thereof
- A61M60/289—Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/40—Details relating to driving
- A61M60/465—Details relating to driving for devices for mechanical circulatory actuation
- A61M60/468—Details relating to driving for devices for mechanical circulatory actuation the force acting on the actuation means being hydraulic or pneumatic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/515—Regulation using real-time patient data
- A61M60/531—Regulation using real-time patient data using blood pressure data, e.g. from blood pressure sensors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/50—Details relating to control
- A61M60/508—Electronic control means, e.g. for feedback regulation
- A61M60/562—Electronic control means, e.g. for feedback regulation for making blood flow pulsatile in blood pumps that do not intrinsically create pulsatile flow
- A61M60/569—Electronic control means, e.g. for feedback regulation for making blood flow pulsatile in blood pumps that do not intrinsically create pulsatile flow synchronous with the native heart beat
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/871—Energy supply devices; Converters therefor
- A61M60/873—Energy supply devices; Converters therefor specially adapted for wireless or transcutaneous energy transfer [TET], e.g. inductive charging
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/871—Energy supply devices; Converters therefor
- A61M60/88—Percutaneous cables
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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
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
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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
- A61N1/37—Monitoring; Protecting
- A61N1/3702—Physiological parameters
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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
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36528—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure the parameter being measured by means of ultrasound
Description
1.ECGは心室収縮の開始を効果的に表示するが、収縮期の終了は表示しない。さらにT波が心室の再分極を表示しているあいだ、T波は広範囲に渡るので調整を目的とする場合にはあまり正確ではない。
2.全身の動脈血圧は大動脈弁の閉鎖時を明確にするには非常に有効であるが、経皮動脈経路を介する一時的な場合にのみ有益であって長期間の使用には適さない。
3.大動脈圧波は結合しているが遅延している。さらに大動脈圧は大動脈弁から末梢にかけて測定され、大動脈弁の閉鎖時を正確に表示しないこともある。
4.心拍数が変化するにつれて(特に患者が突然、運動したり、心配したり、調律が心房性細動のものであったり心筋が収縮状態のときのものであったりするとき)、ECGのR波の後の大動脈弁の開放時および閉鎖時は大きく変化することもある。このように比較的、安定して収縮期の開始を調整することが可能な(およびバルーン膨張の開始が可能な)間は、心臓拡張期を開始するタイミングはECGのみでは正確に表示できない。
Claims (8)
- 患者の心臓の脈動と時間的に関連させて血管の圧縮および前記血管の圧縮の停止を交互に行い、患者が装備した心臓補助装置の脈動を制御する装置であって、
前記心臓補助装置が、流体圧を発生させるポンプと、血管内の血液に圧力を加える膨張可能なカフと、流体圧を発生させる前記ポンプと血管内の血液に圧力を加える前記カフとの間で圧力を送るための流体と、を備え、
前記流体内にマイクロフォンを備え、前記マイクロフォンが、前記流体を介して前記マイクロフォンに伝えられる前記血管の心音を検出することを特徴とする装置。 - 前記マイクロフォンによって検出される前記心音が、前記心臓補助装置の動作を制御するために使用されることを特徴とする請求項1に記載の装置。
- 前記流体がガスであることを特徴とする請求項2に記載の装置。
- 前記マイクロフォンが、前記ポンプ内または前記ポンプに近接した場所で前記流体内に配置されることを特徴とする請求項1に記載の装置。
- 前記圧力が前記カフに加えられ、前記カフが前記血管の外側へと同様に圧力を加えることを特徴とする請求項4に記載の装置。
- 前記圧力が前記血管の外部へと直接的に加えられることを特徴とする請求項1に記載の装置。
- 前記圧力が大動脈の外部へと加えられることを特徴とする、請求項6に記載の装置。
- 前記心臓補助装置が、患者の心臓の調律のR波を電気的に検出したことに応じて前記心臓補助装置の脈動状態を変化させ、
前記患者の大動脈弁の閉鎖により生成された心音を前記マイクロフォンが検出したことに応じて、先行するR波以前の脈動状態に前記心臓補助装置を戻すことを特徴とする請求項1に記載の装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2003906070 | 2003-10-31 | ||
AU2003906070A AU2003906070A0 (en) | 2003-10-31 | Synchronisation Control System | |
PCT/AU2004/001486 WO2005042089A1 (en) | 2003-10-31 | 2004-10-28 | Synchronisation control system |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2007509653A JP2007509653A (ja) | 2007-04-19 |
JP5196786B2 true JP5196786B2 (ja) | 2013-05-15 |
Family
ID=34528666
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2006537000A Expired - Fee Related JP5196786B2 (ja) | 2003-10-31 | 2004-10-28 | 同期制御システム |
Country Status (8)
Country | Link |
---|---|
US (4) | US7765003B2 (ja) |
EP (2) | EP1677872B1 (ja) |
JP (1) | JP5196786B2 (ja) |
CN (1) | CN1874821B (ja) |
AU (1) | AU2004284842B2 (ja) |
DK (1) | DK1677872T3 (ja) |
ES (1) | ES2561354T3 (ja) |
WO (1) | WO2005042089A1 (ja) |
Families Citing this family (119)
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AUPQ090499A0 (en) | 1999-06-10 | 1999-07-01 | Peters, William S | Heart assist device and system |
AUPR669001A0 (en) * | 2001-07-30 | 2001-08-23 | Sunshine Heart Company Pty Ltd | A fluid pressure generating means |
AU2002952691A0 (en) * | 2002-11-15 | 2002-11-28 | Sunshine Heart Company Pty Ltd | Heart assist device utilising aortic deformation |
WO2005041783A1 (en) | 2003-10-30 | 2005-05-12 | Sunshine Heart Company Pty Ltd | A wrap |
US7887478B2 (en) * | 2003-10-31 | 2011-02-15 | Sunshine Heart Company Pty Ltd | Percutaneous gas-line |
JP5196786B2 (ja) | 2003-10-31 | 2013-05-15 | サンシャイン・ハート・カンパニー・ピーティーワイ・リミテッド | 同期制御システム |
US7955248B2 (en) * | 2003-11-11 | 2011-06-07 | Sunshine Heart Company Pty Ltd | Actuator for a heart assist device |
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US11621583B2 (en) | 2012-05-21 | 2023-04-04 | University Of Washington | Distributed control adaptive wireless power transfer system |
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AU2015204701B2 (en) | 2014-01-10 | 2018-03-15 | Cardiac Pacemakers, Inc. | Systems and methods for detecting cardiac arrhythmias |
WO2015106007A1 (en) | 2014-01-10 | 2015-07-16 | Cardiac Pacemakers, Inc. | Methods and systems for improved communication between medical devices |
US20150364861A1 (en) * | 2014-06-17 | 2015-12-17 | Minnetronix, Inc. | Implantable connection mechanisms for continuous high power delivery |
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ES2561354T3 (es) | 2016-02-25 |
JP2007509653A (ja) | 2007-04-19 |
US20150328466A1 (en) | 2015-11-19 |
US20070060787A1 (en) | 2007-03-15 |
WO2005042089A1 (en) | 2005-05-12 |
EP1677872B1 (en) | 2015-12-02 |
AU2004284842B2 (en) | 2010-03-04 |
CN1874821A (zh) | 2006-12-06 |
EP3028739A1 (en) | 2016-06-08 |
US7765003B2 (en) | 2010-07-27 |
US20140051909A1 (en) | 2014-02-20 |
CN1874821B (zh) | 2011-06-01 |
US8571658B2 (en) | 2013-10-29 |
DK1677872T3 (en) | 2016-02-15 |
AU2004284842A1 (en) | 2005-05-12 |
US9119908B2 (en) | 2015-09-01 |
EP1677872A4 (en) | 2008-04-09 |
US20100324354A1 (en) | 2010-12-23 |
US9561375B2 (en) | 2017-02-07 |
EP1677872A1 (en) | 2006-07-12 |
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