WO2004084990A1 - Heart treatment device and heart treating method - Google Patents

Heart treatment device and heart treating method Download PDF

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Publication number
WO2004084990A1
WO2004084990A1 PCT/JP2004/003618 JP2004003618W WO2004084990A1 WO 2004084990 A1 WO2004084990 A1 WO 2004084990A1 JP 2004003618 W JP2004003618 W JP 2004003618W WO 2004084990 A1 WO2004084990 A1 WO 2004084990A1
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WO
WIPO (PCT)
Prior art keywords
heart
interval
stimulation
heart rate
unit
Prior art date
Application number
PCT/JP2004/003618
Other languages
French (fr)
Japanese (ja)
Inventor
Yoshihito Fukui
Original Assignee
Terumo Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to JP2003/89358 priority Critical
Priority to JP2003089358A priority patent/JP4252833B2/en
Application filed by Terumo Corporation filed Critical Terumo Corporation
Publication of WO2004084990A1 publication Critical patent/WO2004084990A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36114Cardiac control, e.g. by vagal stimulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362Heart stimulators
    • A61N1/365Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions

Abstract

A heart treatment device for preventing an abrupt change of heart rate caused by stimulation of a vagus nerve by controlling heart stimulation so that the change of heart rate may be in a predetermined range after the stimulation of the vagus nerve. The heart beat interval is monitored in response to heart stimulation and detection of heart systole. The vagus nerve stimulation is controlled according to the monitored heart beat interval, and the interval of heart stimulation is adjusted so that the heart beat interval extension after the vagus nerve stimulation is limited within a predetermined time interval. Thus, an abrupt drop of heart beat rate due to vagus nerve stimulation for suppressing sympathetic hypertonia and thereby mortal arrhythmia is prevented.

Description

Specification

Cardiac therapy device and cardiac treatment methods art

The present invention relates to cardiac therapy device and a cardiac therapy methods to slow the heart rate decreased due to the vagal nerve stimulation. BACKGROUND

Suddenly referred to as sudden cardiac death, particularly those due to heart disease in the death, the number amounts to about 5 million people in the country annually. Direct cause of sudden cardiac death is referred to as a lethal arrhythmia, is the occurrence of ventricular tachycardia Ya ventricular fibrillation causing the collapse of hemodynamic.

Ventricle ventricular tachycardia and paroxysmal unusually fast beating a state just trembling in small steps as a whole ventricle started individual muscle fibers randomly excited constituting the ventricle at the ventricular fibrillation. When fatal arrhythmia occurs, the heart's pumping function is reduced or lost, since it can not to begin feeding the necessary blood to the whole body, Kitaichi consciousness LOSS with decreasing cerebral blood flow immediately appropriate measures Ru mower may result in death if not subjected to.

To patients with Risk of Yo I Do sudden cardiac death, treatment is performed to embed the implantable defibrillator (ICD). ICD detects the occurrence of ventricular tachycardia Ya ventricular fibrillation, between this providing electrical shock to the heart, and performs defibrillation. However, ICD operates from occurring abnormality in the heart, so to speak supportive care treatment device, also large electrical shock for defibrillation may damage the tissue of the heart.

In time and, cardiac activity is subject to the control of the autonomic nervous system, the autonomic nervous system there is a sympathetic nervous system and the parasympathetic nervous system, the parasympathetic nervous system of the heart is the vagus nerve. Activity of the sympathetic nerve increases to (tension to) and Kokorokatsu dynamic (heart rate and cardiac output) is increased, cardiac activity (heart rate) If the activity of the vagus nerve increases is reduced. Activities in sympathetic 及 Pi vagus nerve, usually are antagonistic, heart appropriate resting heart rate is stably controlled in earthenware pots by maintaining approximately 70 beats Z min. That is, when the sympathetic nervous while acting excitatory manner relative to the heart, the vagus nerve acts suppressively against the tense heart.

Using the action Do you this Yo, recently, heart treatment equipment for treating particular good Ri ventricular arrhythmias performing electrical stimulation of the vagus nerve have been proposed (e.g., see Patent Document 1). The cardiac therapy device has a comparator with a threshold value for forming a condition for the presence of the sensor and arrhythmia for sensing neural activity to transmit information to the heart from the autonomic nervous system, the comparator, the arrhythmia nerve activity an output signal indicative of the outputs depending on whether your criteria. That is, immediately upon detecting a chronic fibrillation or other dangerous tachyarrhythmias from such changes in the activity of the autonomic nervous system, you activated 5 seconds lightly vagus nerve. And although the treatment and to detect the return to the normal state to the end, if you want to continuously detects an abnormal state for the heart is to continue treatment, star-shaped if it is advantageous to add to the sympathetic pro-click and it performs a few seconds in the ganglion.

Further, in order to prevent fatal arrhythmias, vagus nerve electrical stimulation pressurized El methods and apparatus have been proposed (e.g., see Patent Document 2). The apparatus for treating cardiac arrhythmias, through stimulation of the stimulation vagus nerve to the heart tissue, are intended to maintain the prevention or stopping of cardiac arrhythmias, the appropriate function of the heart. The cardiac therapy device, and tachycardia detection interval threshold value set in advance, not only to compare the beating of the patient, and complex changes in the ST segment of the electrocardiogram indicative of myocardial ischemia acute (voltage) other factors associated with ventricular tachycardia also scrutinized, which enables the inhibit this tachycardia by the child that is responsible for stimulation of the vagus nerve on this basis. The cardiac arrhythmia treatment apparatus, means for continuously measuring the electrocardiogram of the patient's heart, means for detect a characteristic indicative of a tachycardia of the electrocardiogram, the means for initializing the storage of a series of characteristics, one or more of It has an electrical stimulation hand stage supplying the patient's nervous system, a set of characteristics of the ECG following the supply of stimulation action from the means for Inisharai's.

[Patent Document 1] JP-A-8 - 5 2 1 2 1 No.

[Patent Document 2]

Disclosure of WO 93/2 1824 No. pamphlet Re' door (PCT / US 93/00051) invention

Although electrical stimulation to the vagus nerve results in a decrease in heart rate, a sudden drop in heart rate, at the same time give a sense of discomfort Ya discomfort to the patient, Shi Oko arrhythmias and unstable the refractory period of excitement there has been a problem that easy.

Those described in Patent Document 1 is intended to deal with this problem, when Kokorokatsu dynamic between this the activation current is supplied to the vagus nerve and sympathetic falls below a predetermined rate, the pacemaker block but it is intended to automatically start the stimulation to the heart, although it maintains the previous SL predetermined rate serving the lower limit of the heart rate, sudden heart in the process of reaching the predetermined record over preparative after vagus nerve stimulation can not and avoidance child lowering several failed and solve child the above problems.

Also, those described in Patent Document 2, as well as stimulating the vagus nerve in order to overcome the heart rate decreases due to the stimulation of the vagus nerve, the heart cormorants by heart rate of the patient is within the permissible range but is intended to stimulate against, but can maintain a lower limit value of the heart rate by a heart stimulation, similar to that described in Patent Document 1, child avoid number rapid heart rate drop leading to the heart rate limit value can not the patient's discomfort Ya discomfort, is to be et al has failed to reach to solve the problem that is easy to put the arrhythmia.

Accordingly, the present invention is, after vagus nerve stimulation, decreased heart rate controls the cardiac stimulation to the power sale by a within a predetermined range, and to prevent a sudden drop in heart rate due to stimulation of the vagus nerve.

Order to solve the above problems and achieve the object of the present invention, heart therapy device of the present invention, a nerve stimulator for stimulating the vagus nerve, and cardiac contraction detection means for detecting a self-contraction of the heart, related to self-shrinkage a heart rate measuring means for measuring a heartbeat from the detection result, and the heart stimulating means for stimulating the heart when the heart of a self-contraction is not detected within predetermined time period, heart rate was measured heartbeat and heart comparing means for comparing a predetermined cardiac threshold and the output, determines whether to perform the vagus nerve stimulation on the basis of the output of the heart rate comparing means, when performing vagus nerve stimulation, the predetermined time period is characterized in that the control cormorants by changing based on the cardiac output was measured.

Further, the heart treatment equipment according to the present invention, cardiac output measured is Ri der heartbeat interval, the control for changing the predetermined time period, in which adding a predetermined time increment in the measured heart beat interval It is with the features.

Et al is the preferred embodiment of the heart treatment equipment according to the present invention, either the advance constant meth time increment is the time interval is fixed, or the time interval corresponding to the heart rate drop the predetermined time increment is fixed it is characterized and this is.

Further, in other preferred correct form of the present invention, a function of heart rate interval in which the predetermined time 增 content measured and characterized in that this function has become a predetermined ratio of cardiac interval measured It is set to.

Furthermore,. The predetermined period in the cardiac therapy device of the present invention has a limit value, of predetermined period is in earthenware pots by being adjusted the limit value in earthenware pots by no exceed the absolute.

Also, cardiac therapy methods of the present invention includes a scan Tetsupu for detecting the self-contraction of the heart, the steps of measuring a heartbeat from the detection results for the self-contraction, autogenous shrinkage of the intracardiac the predetermined time period or a step of stimulating the heart if not detected, comparing the predetermined heart rate threshold and cardiac output detected a heartbeat, the vagus nerve stimulation on the basis of the result of the comparison step of this perform comprising the steps, which determines the whether, when performing vagus nerve stimulation in this decision step, characterized that you have the step of changing on the basis of the heart rate output measured a predetermined period there.

Then, in the preferred correct forms of cardiac therapy methods of the present invention, a measured heart rate output heartbeat interval, steps, previously constant because the beat-to-beat was measured to be changed based on the cardiac output measured the predetermined time period and wherein and this was is intended to add a time 增分.

Further, as a preferred form of the present invention is characterized in that it is a said pre-or-determined time increment is a fixed time interval, or fixed heart rate interval is equivalent to decrease.

Et al is, in a preferred correct forms of the present invention, a function of heart rate interval in which the predetermined time increments measured, characterized in that the function is a predetermined percentage of the heart rate interval measured there.

According to the present invention, the change in heart rate after vagus nerve stimulation to control the cardiac stimulation to the power sale by within a predetermined range, enabling the prevention child a sudden change in heart rate due to the vagus nerve stimulation Become. BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is a pro click view the configuration of the first embodiment shows the cardiac therapy device of the present invention. Figure 2 is a layout view of the heart electrode lead 及 Pi stimulus electrode for use in cardiac therapy device of the present invention.

Figure 3 is a flowchart for explaining the operation of the first embodiment of the heart treatment equipment according to the present invention shown in FIG.

Figure 4 is a pro click diagram a configuration example of the second embodiment shows a heart treatment equipment of the present invention.

Figure 5 is a flowchart for explaining the operation of the second embodiment of the heart treatment equipment according to the present invention shown in FIG.

6, first in the second embodiment, a tie Mi Ngucha preparative showing the relationship between the stimulus and ventricular stimulation intervals of the vagus nerve <7 of the present invention shown in FIG. 4, atrial shown in FIGS. 1 and 4 the first modification of the Z ventricular stimulation interval control means is a block diagram showing the.

Figure 8 is a block diagram showing a second modification of the atrial Z ventricular stimulation interval control means shown in FIGS. 1 and 4. BEST MODE FOR CARRYING OUT THE INVENTION

It will be described in detail with reference to preferred embodiments of the present invention in the accompanying drawings.

Incidentally, the embodiments described below, since Ru preferred embodiment der of the present invention, various technically preferable limitations are imposed, the scope of the present invention, particularly the present invention in the following description unless there are descriptions of limitation, the invention is not limited to these embodiments.

First, a first embodiment of a heart treatment equipment according to the present invention will be described with reference to flop-locking diagram of FIG.

In this specification, the term "event" of a heart, the atria or obtained by collectively and spontaneous contractions were detected in the ventricle, and shrinkage due to the child that is responsible for stimulating to atrial or ventricular is there.

Cardiac therapy device 1 of the present invention, a ventricular stimulation unit 2 for generating a stimulus signal to the right ventricle 2 2 heart 2 1, ventricular contraction detecting unit 3 for detecting the contraction of the right ventricle 2 2, heart 2 1 an atrial stimulation unit 4 for generating a stimulus signal to the right atrium 2 3, the atrium contraction detecting unit 5 for detecting the contraction of the right atrium 2 3, nerve stimulation unit which generates a neural stimulation signal to stimulate the vagus nerve 2 6 6, a control unit 7 for controlling the neural stimulation and atrial stimulation interval, the oR circuit 8 to which a signal is supplied to preparative re gar the detected signals and atrial stimulation atrial contraction, the output of the oR circuit 8 is supplied a row cormorant heartbeat measuring section 9 measures the heart beat intervals, as in the atrium stimulation interval timer 1 0 to ϋ start output is supplied reset by the time measurement of the OR circuit 8, the clocked time of the atrium stimulation interval timer 1 0 a comparison unit 1 1 for comparing the atrial stimulus interval that is set in the control unit 7 A heartbeat threshold storage unit 1 2 for storing the heart rate interval threshold for controlling the setting of the stimulation and cardiac tufts stimulation interval to the vagus nerve 2 6, beat-to-beat measurements measured by the heart rate measurement unit 9 and heart threshold storage unit a heart rate comparator unit 1 3 for comparing the heart rate interval threshold value stored in 1 2, the atrioventricular delay timer 1 4 to scan top-output of and a star bets at the output of the OR circuit 8 ventricle contraction detecting unit 3 , atrioventricular delay comparison with atrioventricular delay set-value memory unit 1 5 that stores the atrioventricular delay time predetermined, the output of the atrioventricular delay timer 1 4 and the output of the atrioventricular delay set-value memory unit 1 5 a comparator unit 1 6.

Ventricular stimulation unit 2 及 Pi ventricle contraction detecting unit 3 is connected to the ventricular stimulation Ζ detecting electrode 1 8 Ri by the common ventricular electrode lead 1 7, the atrium stimulation unit 4 及 Pi atrium contraction detecting unit 5 is similarly atrial It is connected to the atrial stimulation detection electrodes 2 0 through the electrode rie de 1 9. Ventricular stimulation detection electrode 1 8 and atrial stimulation Ζ detecting electrode 2 0 are respectively disposed in the right ventricle 2 2 and the right atrium 2 3 of the heart 2 1.

In general, in an electrode for a heart, the heart muscle, myocardial electrodes embedded in the so-called the myocardium via the vena cava is a catheter electrode to insert the electrode to the heart. Those shown in FIG. 2 is an example of a catheter electrode, Re ventricular electrode lead 1 7 and atrial electrode lead 1 9 noise initially derived from the vena cava to the heart 2 1 of the right atrium 2 3. Atrial electrode lead 1 9 from vena cava was 揷入 the right atrium 2 3, earthenware pots by hooking into the bag-like right auricle which protrudes the bending was tip from the right atrium 2 3 walls in J-shape and 揷入 to, atrial stimulation / sensing electrodes 2 0 are placed in earthenware pots by contacting the right auricle wall. Also, the ventricular electrode lead 1 7 which is 揷入 similarly from the vena cava in the right atrium 2 3 enters the right ventricle 2 2 through the atrioventricular valve, provided at the distal end portion of the ventricular electrode lead 1 7 ventricle stimulating / detecting electrode 1 8 Ru placed so contacts the bottom of the right ventricle 2 2.

State Although not shown in FIG. 2, nerve stimulation unit 6 is connected via the nerve electrode lead 2 4 to the nerve stimulation electrodes 2 5, neural stimulation electrodes 2 5 wearing plated on vagal 2 6 in is fixed. Is a nerve stimulation electrodes 2 5 and wind-put area, right center position of the cervical region or outside the carotid artery is preferred. Furthermore, neural stimulation electrodes 2 5 and by the child indwelling catheter electrode in the blood vessel, it is possible also by Uni arrangement child to stimulate the vagus nerve 2 6 adjacent to the vessel wall. In that case, in an arrangement region, it is preferable subclavian vein.

Control unit 7 for controlling the atrial stimulation interval and nerve stimulation, nerve stimulation signal control unit 2 7 for controlling the neural stimulation unit 6 divides rather large, the atrium stimulation interval control unit 2 8 for controlling the stimulation interval of atrial It consists of. Their to, atrial stimulation interval control unit 2 8, the limit value storage unit 2-9 stores the limit value of the upper limit of a predetermined atrial stimulation intervals, fixed time of a predetermined heart tufts stimulation interval the increment value storage unit 3 0 stores incremental, an adder 3 1 for adding a time increment which is stored in the increment value storage unit 3 to 0 heartbeat interval measured value output from the heart rate measuring means 9, the adding section 3 comparing the limit Sakaichi of prestored atrial stimulation interval 1 and the output of the limit value storage unit 2 9, a limit Sakaichi limiting unit 3 2 for limiting the upper limit of the output of the adder 3 1 the limit value , the limit value storage unit 2 9, the output of the limit value limiting unit 3 2 及 Pi heart rate comparator unit 1 3 is supplied, on the basis of the output of the heart rate comparator unit 1 3, the limit value storage unit 2 9 and the limit value limiting section and a finally selected cardiac tufts stimulation interval and set to the atrium stimulation interval setting unit 3 3 which from 3 2 output.

Hereinafter, a description of the operation of the first embodiment of the heart treatment equipment according to the present invention shown in FIG.

First, the atrium contraction detecting unit 5, the contraction of the right atrium 2 3 is detected, the atrium contraction detecting unit 5, along with supplies its output to the OR circuit 8, the control unit 7 of the neural stimulation signal control unit 2 supplied to the 7. The output of the OR circuit 8, the cormorants I already described, is supplied to the heart rate measurement unit 9, the atrium stimulation interval timer 1 0 及Piboshitsu delay timer 1 4, the heart rate measuring unit 9, the atrium stimulation interval timer 1 0 and tufts timing of the chamber delay timer 1 4 (measurement time in total) make-start.

That is, the heart rate measuring unit 9 measures the atrial event heartbeat interval atrial from (atrial contraction detection or atrial stimulation) to next atrial event (atrial contraction detection or atrial stimulation) (event interval). Then, the heart rate comparator unit 1 3, the heartbeat interval threshold heartbeat interval measured by the heart rate measurement unit 9 is stored in the heart rate threshold storage section 1 2 (e.g., heart rate interval 750ms corresponding to the heart rate 8 0) Comparison is, when the heart beat interval measured is below this threshold, the other words heart rate exceeds 8 0, the output from the heartbeat ratio 較部 1 3 is obtained, the neural stimulation signal control unit 2 7 and atrial stimulation control unit 7 It is supplied to the atrial stimulation interval setting unit 3 3 intervals controller 2 8.

The neural stimulation signal control unit 2 7, in addition to the output of the heart rate comparator unit 1 3, the output from the atrium contraction detecting unit 5 also supplied, receives the output of the heart rate comparator unit 1 3 heartbeat interval is shortened and in conjunction with the detection of atrial contraction to activate the neural stimulation signal control unit 2 7 supplies a signal which becomes because of trigger to stimulate the vagus nerve 2 6 nerve stimulation unit 6. The nerve stimulation unit 6 performs receiving this signal, the nerve electrode lead 2 4, Ri by the nerve stimulation electrodes 2 5, the stimulation of the vagus nerve 2 6.

When vagal 2 6 is stimulated, so the heart rate suddenly decreases, there is a possibility to increase the occurrence of fatal arrhythmia reversed. That is, when the heart rate decreases, cardiac interval measured by the heart rate measurement unit 9 is increased. Ie, Ri due to a decrease in heart rate, the measured value of the heart rate measurement unit 9 is long Ri by threshold heart rate threshold storage section 1 2, no output is obtained from the heart rate comparator unit 1 3. Therefore, signals for stimulating the vagus nerve 2 6 from the heartbeat comparing section 1 3 to the nerve stimulation signal control unit 2 7 is not supplied, stimulation of the vagus nerve 2 6 is not performed.

Also, cardiac output measurement unit 9 is supplied to the adder 3 1 atrial stimulation interval control unit 2 8, wherein the pre-stored in the heart rate interval and increment the storage unit 3 0 measured by the heart rate measurement unit 9 has been fixed time increment has is the summing. Then, the addition time interval is sent to the limit value limiting unit 3 2 and compared with limit Sakaichi atrial stimulation interval stored in the limit value storing unit 2 9. And this time 增分 In recent and new arithmetic value obtained by adding even small Ri by limit value stored in the limit value storing unit 2 9, supply a new calculated value in the atrium stimulation interval setting unit 3 3 It is. The atrial stimulation interval setting unit 3 3 other are signals supplied from the limit value and heart comparator unit 1 3 stored in the limit value storing unit 2 9 of this new calculated value, the heart rate comparator unit 1 when there is an output from the 3, that is, when not exceeding the heart rate interval threshold heartbeat interval measured by the heart rate measurement unit 9 is stored in the heart rate threshold storage section 1 2 (e.g., heart rate 8 nonzero ' above), the new calculated value, as a threshold for the atrial stimulation interval timer 1 0, supplied from the atrium stimulation interval setting unit 3 3 to the comparing unit 1 1. Conversely, when there is no output from the heartbeat comparator unit 1 3, i.e. when exceeding the heart rate interval threshold heartbeat interval measured by the heart rate measuring unit 9 is stored in the heart rate threshold storage section 1 2 (heart rate 8 0 or less), the new was Do calculated value is not selected, the limit Sakaichi stored in the limit value storing unit 2 9, as a threshold for the atrial stimulation interval timer 1 0, the atrium stimulation interval setting unit 3 3 output to the supplied to the comparing unit 1 1.

The output of the atrium contraction detecting unit 5 is sent to the atrioventricular delay timer 1 4 via the OR circuit 8, the atrioventricular delay timer 1 4 makes a star and. Counting value in atrioventricular delay timer 1 4 this exceeds a predetermined set value stored in the atrioventricular delay set-value memory unit 1 5, the output is obtained from the atrioventricular delay ratio 較部 1 6, ventricular stimulation Ri by the ventricular stimulation unit 2 is performed. On the other hand, the timing value of the atrioventricular delay timer 1 4, the ventricular contraction is detected by the ventricle contraction detecting unit 3 before reaching the set value stored in the atrioventricular delay set value SL 憶部 1 5, atrioventricular timing of the delay timer 1 4 be sampled Ppushi, ventricular stimulation is not performed.

Figure 3 is a flow diagram for explaining the operation of the first embodiment of the present invention.

Hereinafter, with reference to the flow diagram of FIG. 3, the operation of this embodiment in detail. First, to set the limit value to be stored in the limit value storing unit 2 9 atrial stimulation interval control unit 2 8, the heartbeat interval 1000ms corresponding to, for example, heart rate 6 0. In this stage of the initialization, rather than the output from the heart rate comparator unit 1 3 is supplied to the comparator 1 1 1000ms set the limit value storage unit 2 9 is the output of the atrial stimulation interval setting unit 3 3 ( step S l).

Then, an atrial stimulation interval timer 1 0 is a star bets (step S 2), followed by the atrium contraction detecting unit 5, whether or not the atrium contraction is detected is determined (Step S 3). If the atrium contraction in judging step S 3 is detected, the measurement of the heartbeat intervals in heart rate measuring unit 9, one or is, and the monitor (step S 4) measurement of atrial events interval is started, the atrium stimulation It is interval timer 1 0 Ghali set (Step-up S 5). Next, compared with the heart rate comparator unit 1 3, atrial events interval measured by the heart rate measurement unit 9, pre-stored threshold heart rate threshold storage section 1 2, the heart rate interval 750ms corresponding to the heart rate 8 0 if e Example greater than or is small how determined (step S 6). The atrial event interval, for example, 625 ms, (when ie, the heart rate exceeds 8 0) is determined to be smaller Ri by threshold 750 ms, the output is obtained from the heartbeat comparing section 1 3, the output is sent to the neural stimulation signal control unit 2 7 stimulation of the vagus nerve 2 6 is performed (step S 7).

Also, cardiac atrial event interval measured by the measuring unit 9 is supplied to the adder 3 1 atrial stimulation interval control unit 2 8, wherein the atrial Iben preparative 增分 value storage unit 3 0 of the measured value of the distance fixed time incremental of stored, for example, 100ms is added to (step S 8). Subsequently, the limit value limiting section 3 2, whether calculated value 725ms, which is added in step S 8 (625ms + 100ms) is also large Ri by the limit value 1000ms previously stored in the limit value storing unit 2 9 is determined (step S 9). Ni will Yo in the case of this, in decision S 9, small Ri by the limit value 1000ms which are subject to time by the adding unit 3 1 increments the calculated value 725ms is stored in the limit value storing unit 2 9 previously set case, the new arithmetic value is sent from the limit value limiting unit 3 2 the atrium stimulation interval setting unit 3 3, the atrium stimulation interval setting unit 3 3, heart rate comparing section 1 3 of the output generated in step S 6 the obtained (atrial event interval 625ms is Ri small by the threshold value 750 ms), a new calculated value as a threshold for the atrial stimulation interval timer 1 0 supplied to the comparator 1 1 (step S 1 0).

In decision step S 6, the atrial I base down bets interval measured by the heart rate measurement unit 9, for more than the heartbeat interval threshold 750ms stored in the heart rate threshold storage section 1 2 (heart rate 8 0 or less), 及 Pi , not less than the limit value 1000ms the calculation value time increment by an adder 3 1 is added at decision step S 9 are stored in the limit value storing unit 2 9 (heartbeat interval 900ms or more, i.e. heart rate 6 6 or less ) will continue to limit 1000ms supplied to the comparison unit 1 1 as a threshold for the atrial stimulation interval timer 1 0, the process proceeds to the next step (step S 1 1).

In decision S 3, if the atrium contraction is not detected, the atrium stimulation interval timer 1 0 whether or not timeout is judged (Step S 1 2). If atrial stimulation interval timer 1 0 is Taimua © preparative, i.e., if the between time counting of the atrial stimulation interval timer 1 0 exceeds a limit value of the set atrial stimulation interval at step S 1 the (1000 ms) (heartbeat 6 0 - below), atrial stimulation is performed outputted to the atrium stimulation unit 4 is emitted from the comparator unit 1 1 (step S 1 3). Also, at the same time, the output of the comparator unit 1 1 is supplied to the heart rate measuring unit 9 via the OR circuit 8, and the monitor is measuring atrial event interval is started (Step S 1 4), atrial stimulation sent to the interval timer 1 0, which re set Tosuru (step S 1 5).

Then, similarly to the decision step S 6, heart tufts event interval measured by the heart rate measurement unit 9, whether the heartbeat threshold. Value storage section 1 2 small Ri by cardiac interval threshold 750ms set in is determined (step S 1 6). The atrial event interval measuring value is stored in the heart rate threshold storage section 1 2 Re, Ru heartbeat interval threshold 750ms by Ri small les, when Ru is determined (heart rate 8 0 greater), the process proceeds to step S 8 hereinafter, the processes in and after step S 9 is performed real. In decision step S 1 6, atrial Iben preparative interval measurement value measured by the heart rate measurement unit 9, in the case of more heart beat interval threshold 750ms stored in the heart rate threshold storage section 1 2, the atrium stimulation interval set first and it was left limits 1000ms stored in the limit value storing unit 2 9 (scan Tetsupu S 1 7), the process proceeds to the next step.

Or atrial contraction is detected in the atrium contraction detecting unit 5, the output from the comparison means 1 1 is emitted atrial stimulation is performed, the detection signal or stimulus signal via the OR circuit 8, atrioventricular delay timer 1 4 sent to, and starts counting the atrioventricular delay timer 1 4 (step S 1 8). Then, whether the next ventricular contraction by ventricular contraction detecting unit 3 is detected is determined (Step S 1 9). In decision step S 1 9, the ventricular contraction is detected, atrioventricular delay timer 1 4 stops counting (scan Tetsupu S 2 0), the flow returns to decision step S 3. On the other hand, decision step S 1 9 i.e. whether the force when the ventricle contraction is not detected, the atrioventricular delay timer 1 4 is Thailand Muau bets, the atrioventricular delay total time period of the timer 1 4 atrioventricular delay set value storage unit the setting value stored in the first 5 ultrasonic Etaka whether or not (step S 2 1). When atrioventricular delay timer 1 4 at decision Sutetsu flop S 2 1 is when it is determined not to have Taimuau bets, returns to decision step S 1 9, which is atrioventricular delay timer 1 4 backlash Imuau TMG, emitted is output from the atrioventricular delay comparison unit 1 6 to the ventricle stimulation unit 2 ventricular stimulation is performed (step S 2 2).

Then, based on the block diagram of FIG. 4, illustrating a second embodiment of a heart treatment equipment of the present invention. A first embodiment the same parts of the invention shown in FIG. 1 are denoted by the same reference numerals. In the first embodiment, monitor and by controlling the stimulation of the vagus nerve 2 6 based on the detection of atrial contractions, but controls the atrial stimulation interval, a second embodiment the detection of ventricular contraction measures the heart beat intervals by, it is intended to'll control the stimulation and ventricular stimulation interval vagal 2 6.

That is, the second embodiment of the present invention is the first embodiment and configuration on a different place, 'the output of the comparator unit 1 1 is supplied to the ventricular stimulation unit 2, the output OR circuit ventricular contraction detecting unit 3 8 and nerve stimulation signal control unit 2 7 that is supplied to, and the first embodiment of the ventricular stimulation interval control unit 2 8 a and ventricular instead of atrial stimulation interval control unit 2 8 and the atrial stimulation interval setting unit 3 3 in that the stimulation interval setting unit 3 3 A is provided. As a result, in the first embodiment of the present invention shown in FIG. 1, the atrium stimulation unit 4, the atrium contraction detecting unit 5, atrioventricular delay timer 1 4, AV delay setting value storage unit 1 5, atrioventricular delay comparison unit 1 6 is removed from the second embodiment.

The operation of the second embodiment of the heart treatment equipment according to the present invention, by Ri is described in the flow diagram shown in FIG.

First, it sets the limit value to be stored in the limit value storing unit 2 9 ventricular stimulation interval control unit 2 8 A, the heart rate interval 1000ms corresponding to, for example, heart rate 6 0. In this stage of the initialization, the output from the heart rate comparator unit 1 3 rather than, 1000 ms set the limit value storage unit 2 9 is supplied to the output to comparison unit 1 1 of the ventricular stimulation interval setting unit 3 3 A that (step S 3 1). In the following, the ventricular stimulation interval timer 1 0 A is a star bets (Step S 3 2), followed by the ventricle contraction detecting unit 3, whether the ventricular contraction is detected is determined (Step S 3 3 ). If ventricular contractions in judging step S 3 3 is detected, the measurement of the heartbeat intervals in heart rate measuring unit 9, that is, a monitor (Sutetsu flop S 3 4) the measurement of the ventricular event interval is started, the ventricular stimulation interval timer 1 0 A is reset (Sutetsu flop S 3 5).

Next, the ventricular event interval measured by the heart rate measuring unit 9 (heartbeat interval), whether or not reached the heartbeat interval threshold 750ms set in the heart rate threshold storage unit 1 2 is determined (Step S 3 6). When the ventricular event interval is Ru is determined to be smaller Ri by the threshold value 750 ms (heart rate is 8 0 or higher), the output from the heartbeat comparator unit 1 3 is obtained, the output neural stimulation signal control unit 2 7 stimulation of the vagus nerve 2 6 is made to sent by (Sutetsu flop S 3 7).

Also, the ventricular event interval measured by the heart rate measurement unit 9 is supplied to the adder 3 1 of the ventricular stimulation interval control unit 2 8 A, the increment value storage unit 3 0 on the measurement values ​​of the ventricle event interval fixed time 增 min 100ms stored is added (step S 3 8). Then, the limit value limiting section 3 2, whether calculated value which is added in Step S 3 8 is smaller Ri by the limit value 1000ms previously stored in the limit value storing unit 2 9 W

There is determined (Step S 3 9). In decision S 3 9, if the calculated value time adding section 3 1 增分 is added is determined to be smaller Ri by the limit value 1000ms stored in the limit value storing unit 2 9 the previously set , the new calculated value is sent from the limit value limiting unit 3 2 to ventricular stimulation interval setting unit 3 3 a, generated by the ventricular stimulation interval setting unit 3 3 a stearyl-up S 3 6 heartbeat of the comparison unit 1 3 to obtain an output (ventricular Iben preparative interval is smaller Ri by heartbeat interval threshold), the new calculated value as a threshold for ventricular stimulation interval timer 1 OA is supplied to the comparator 1 1 (Step-up S 4 0) . '

In decision S 3 6, ventricular I venting interval measured by the heart rate measurement unit 9 is greater Ri by beat-to-beat 隔闘 value 750ms stored in the heart rate threshold storage section 1 2 (heart rate 8 0 or less),及 Pi, determined Sutetsu flop S 3 9 the addition section 3 1 a time increment when the calculated value of the addition is larger Ri by the limit value 1000ms stored in limited Sakaichi storage unit 2 9 (heartbeat interval 900ms or more, that heart rate 6 6 below), pulls the connection can limit 1000ms supplied to the comparison unit 1 1 as a threshold for ventricular stimulation interval timer 1 0 a, the process proceeds to the next step (step S 4 1).

In decision S 3 3, if the ventricle contraction is not detected, ventricular stimulation interval timer 1 0 A is whether or not Taimuau bets is determined (Step S 4 2). If you are ventricular stimulation interval timer 1 0 A backlash Imuau preparative, i.e., if the time measured by the ventricular stimulation interval timer 1 0 A has exceeded the limit value 1000ms settings ventricular stimulation interval Step S 3 1 is ventricular stimulation is made outputted to the comparing unit 1 1 power et ventricular stimulation unit 2 are sera originating (step S 4 3). At the same time, the output of the comparator unit 1 1 is supplied to the heart rate measuring unit 9 via the OR circuit 8, and the monitor is measuring ventricular event interval is started (Step S 4 4), a ventricular stimulation It is sent to the interval timer 1 OA, which reset Tosuru (step S 4 5). Then, similarly to judgment step S 3 6, ventricular Iben bets interval measured by the heart rate measurement unit 9, whether the heart rate threshold storage section 1 2 small Ri by beat-to-beat 隔閾 value 750ms set to is determined ( step S 4 6). And, when the ventricular event interval measured is determined to be less Ri by cardiac interval threshold 750ms stored in the heart rate threshold storage section 1 2 proceeds to stearyl-up S 3 8, hereinafter, Step S 3 9 subsequent processes Ru is carried out. In decision step S 4 6, the atrial Iben bets interval measured by the heart rate measurement unit 9 is determined to be larger Ri by cardiac interval threshold 750ms stored in the heart rate threshold storage section 1 2, ventricular stimulation interval initially set the limit value storage unit 2 9 limit value stored in the left (1000 ms) is supplied to the comparator 1 1 (step S 4 7), the flow returns to step S 3 3.

6, in the second embodiment of the present invention shown in FIG. 4, a tie Mi Ngucha preparative showing the relationship between the stimulus and ventricular stimulation intervals of the vagus nerve ventricular stimulation interval limit 1000 ms, the heart rate interval threshold 750 ms, the time if set to increment 100ms illustrates an example of controlling the ventricular stimulation and vagus nerve stimulation (the atrial stimulation instead of ventricular stimulation, can be applied to the first embodiment of the present invention shown in FIG. 1 not to say.

In Thailand Mi Nguchiya Ichito in FIG. 6, the time VI, V2, V3, V4, V5 represents the point at which ventricular stimulation is performed, the time Rl, R2 represents a time when the ventricle contraction is detected.

That is, at time VI, and ventricular stimulation from ventricular stimulation unit 2 and the monitor, a star preparative cause the ventricular stimulation interval timer 1 0 A. During limits 1000ms ventricular stimulation interval, since the ventricular contraction is not detected, it is determined that the ventricular stimulation interval timer 1 0 A is timeout (limit value 1000ms), indicate that the ventricular stimulation is performed at the time V2 ing. Subsequently, at time R1 after 850ms from ventricular stimulation is performed at the time V2, ventricular contraction is detected, resulting ventricular stimulation interval timer 1 0 A is reset. At this time the ventricular event interval measured by the heart rate measuring unit 9 is 850Ms, rather the size Ri by cardiac interval threshold 750 ms, the heart rate comparator unit 1 3 good Ri neural stimulation signal control unit 2 7 is Ino output such emitted, stimulation of the vagus nerve 2 6 is not performed. Further, the adding section 3 1 is supplied a value of 850ras from the heartbeat measurement unit 9, the value and the fixed time increment 100ms increment memory unit 3 0 is added. The summed calculated value 950ms is sent to the limit value limiting section 3 2, where it is compared with a limit value 1000ms stored in the limit value storing unit 2 9. Since the calculated value 950ms the limit value 1000 ms' goodness Ri small Rere, limit value limiting unit 3 2 forces we calculated value 950 ms is supplied to the chamber stimulating interval setting unit 3 3 A. On the other hand, the ventricular stimulation interval setting unit 3 3 A, the output from the heart rate comparator unit 1 3 is being supplied, the ventricular event interval measured by the heart rate measurement unit 9 is 750ms heartbeat interval threshold 850ms for Ri large, no output is obtained from the heart rate comparator unit 1 3. In state there is no output from the heartbeat comparator unit 1 3, 3 3 A ventricular stimulation interval setting unit selects the limit value 1000ms limit value storage unit 2 9, the comparator 1 and the value is a threshold value of ventricular stimulation intervals It is sent to the 1.

Next, the fast heart rate Natsute, at time R2 after 625ms since made the detection of ventricular time R 1, re Pi ventricular contraction is detected. Ri by the detection of the ventricle at this time R2, ventricular stimulation interval timer 1 0 A is reset. In this case, since the ventricular event interval measured is below the heart rate interval threshold 750ms at 625 ms, the signal to the heart rate comparator unit 1 3 good Ri neural stimulation signal control unit 2 7 is sent, the vagus nerve by nerve stimulation unit 6 2 6 of stimulation is performed. At the same time the addition section 3 1, is the ventricular event interval time increment 100ms stored in incremental value storage section 3 0 to 625ms is added from the heartbeat measuring unit 9, the calculated value of this 725ms is a limit value limiting section 3 are sent to the 2. In the limit value limiting section 3 2, is compared with a limit value 1000ms stored in the limit value storing unit 2 9, the limit value limiting unit 3 2 ventricular this calculated value 725ms follows since operation values ​​is less smaller by limit as the candidate of the stimulation interval and sends the ventricular stimulation interval setting unit 3 3 a. At this time, since the ventricular event interval is smaller Ri by cardiac interval threshold 750ms stored in 625ms der Ri heartbeat threshold storage unit 1 2, the heart rate comparator unit 1 3 output from the ventricular stimulation interval setting unit 3 3 A It has been added. Accordingly, the ventricular stimulation interval setting unit 3 3 A, the calculated value 725ms is output is selected and sent to the comparison unit 1 1 and the threshold of a new ventricular stimulation intervals.

Next, when the new during the threshold 725ms Configuration ventricular stimulation interval ventricular contraction is not detected, ventricular stimulation interval timer 1 0 A is determined to have Taimua © bets, at the time V3 after 725ms from the time R2 and a monitor ventricular stimulation is performed, the ventricular stimulation interval timer 1 0 a is Ru reset. This and can, than the ventricular event interval measured is below the heart rate interval threshold 750ms stored in the heart rate threshold SL 憶部 1 2 725Ms, nerves output from the heartbeat comparator unit 1 tristimulus signal controller 2 has been supplied to 7, fry shrinkage such detected ventricular in the ventricle contraction detecting unit 3, the products should not be stimulation of the vagus nerve 2 6. Measurements 725ms of heart rate measuring unit 9 is supplied to the adder 3 1, the addition section 3 1, and the time 增分 100ms stored in the increment value storage unit 3 0 is added, is summed calculated value 825ms as the candidate of ventricular stimulation intervals via the limit value limiting unit 3 2 it is sent to the ventricular stimulation interval setting unit 3 3 a. At this time, the output of the ventricular stimulus interval setting unit 3 3 Since the A output of the heart rate comparator unit 1 3 is added ventricular stimulation interval setting unit 3 3 A is calculated value 825ms, and the number of values ​​a new ventricular stimulation as the threshold value of the distance Ru is supplied to the comparison means 1 1.

When the ventricular contraction during a new ventricular stimulation intervals 825ms not detected, the ventricular stimulation interval timer 1 0 A is determined to have timed out, the ventricle stimulation is performed at the time V4 after 825ms from the time V3 also, the ventricular stimulation interval timer 1 0 a is reset and. Since this time the heart rate measuring unit 9 with the ventricular event interval 825ms measured is also rather large Ri by cardiac interval threshold 750 ms, the stimulation of the vagus nerve 2 6 rather than the output from the heart rate comparator unit 1 3 is not performed. In addition section 3 1, time increment 100ms fixed with the heart chamber Iben preparative interval 825ms is added, but the new calculated value 925ms is sent from the limit value limiting unit 3 2 to ventricular stimulation interval setting unit 3 3 A, ventricular ventricular stimulation interval setting unit 3 3 a the output is not supplied from the heartbeat comparator unit 1 3 is the stimulation interval setting unit 3 3 a selects the limit value 1000ms stored in the limit value storing unit 2 9, send to the comparison unit 1 1. That is, the threshold of the ventricular stimulation interval will and this returning to limit 1000 ms. Between 1000ms, from time V4 to time V5, when there is no detection of ventricular contraction, ventricular stimulation interval timer 1 0 A is monitor ventricular stimulation is performed with when Taimuau bets.

7, the first preferred embodiment and the first modification of the first in the second embodiment, the atrial stimulation interval control unit 2 8 and ventricular stimulation interval control unit 2 8 A of the present invention shown in FIGS. 1 and 4 it is a block diagram showing. This variation illustrates atrial Z ventricular stimulation interval control unit (2 8, 2 8 A) when the increment is a predetermined percentage of the cardiac interval time.

In this modification, instead of the increment value storage unit 3 0 of FIG. 1 and FIG. 4, incremental ratio storage unit 3 4 and the increment value calculator 35 is provided.

Hereinafter, the operation of the atrial ventricular stimulation interval control unit of the first modification shown in FIG. 7 (2 8, 2 8 A). The 增分 ratio storage unit 3 4, for example, the incremental ratio of 2 0% and is set, for example, event intervals atrial or ventricular measured by the heart rate measuring unit 9 is assumed to be 600 ms, increment value calculator in 35, the time increment that 120ms multiplied by 2 0% to a value of 600ms from the heartbeat measurement unit 9 is calculated. And this value is added the value of the 120ms from the value and increment calculation unit 35 that 600ms from the heartbeat measurement unit 9 in addition section 3 1, a value of 720ms is output to the limit value limiting unit 3 2. Limit value controller 3 2 compares the fixed value 1000ms which is previously stored in the value and the limit value storing unit 2 9 that this 720 ms. In this case, the new calculated value 720ms and Rere U value because the limit value 1000ms by Ri small, the new calculated value is outputted from the limit value controller 3 2, atrial ventricular stimulation interval setting unit 3 3, 3 3 It is sent to the A. In this case because there is output from the heart rate comparator unit 1 3, atrial / ventricular stimulation interval control unit 3 3, 3 3 A selects this new calculated value 720 ms, which a new threshold of atrial or ventricular stimulation interval and to supply the comparator unit 1 1.

Figure 8 is similar to FIG. 7, in the first implementation embodiment and the second embodiment of the present invention shown in FIGS. 1 and 4, the atrium stimulation interval control unit 2 8 及 beauty ventricular stimulation interval control unit 2 8 a pro-click configuration diagram showing a second modification of the a. This variation illustrates atrial Z ventricular stimulation interval control unit (2 8, 2 8 A) when the time interval you corresponds to the time the heart rate drop increments is fixed.

According to this modification, the heart rate converter 3 6 heartbeat interval from the heart rate measuring unit 9 (atrial Iben preparative interval or ventricular event intervals) is supplied, for example, the heart rate reduction of 2 0 beats per minute heart rate decreased amount storage unit 3 7 to be set, a subtraction unit 3 8 for subtracting the heart rate decreased amount storage unit 3 7 setpoint 2 0 beats from the output of the heart rate conversion unit 3 6, the subtracting unit 3 8 heartbeat interval converter 3 9 which converts the output to cardiac interval is provided.

Hereinafter, the operation of the atrial / ventricular stimulation interval control unit (2 8, 2 8 A) shown in FIG. Heart rate decreased amount storage unit 3 7, decreased heart rate per minute 2 0 beats is set. When Iben preparative distance meter measuring atrial or ventricular by the heart rate measuring unit 9 you to have been 600 ms, this value is supplied to the heart rate conversion unit 3 6, per minute heart rate 1 0 0 (60 s / 600ms) is converted to. Thereafter, Ri by the subtraction unit 3 8, heart rate decreased amount 2 0 stored in the heart rate 1 0 0 heart rate decreased amount storage unit 3 to 7 which is the output of the heart rate converting portion 3 6 is subtracted, value of the heart rate 8 0 is supplied from the subtraction portion 3 8 in the heartbeat intervals converter 3 9. Heartbeat interval converter 3 9 converts the heart rate 8 0 with the heartbeat interval 750 ms, and supplies this value to the limit value limiting unit 3 2.

Then, the limit value limiting section 3 2, a value of the heart rate is an interval output of the transformation unit 3 9 750 ms is compared with a limit value 1000ms stored in the limit value storing unit 2 9. Since this new calculated value 750ms small Ri by limit 1000ms limit value storage unit 2 9, the limit value limiting unit 3 2 sends the new calculated value 750ms atrial Z ventricular stimulation interval setting unit 3 3, 3 3 A . At this time, the atrial / ventricular stimulation interval setting unit 3 3, 3 3 A, because there is an output from the heartbeat comparing section 1 3, the comparing unit with a new calculated value 750ms and the threshold of a new atrial or ventricular stimulation interval supplied to 1 1, has been described first and second embodiments of the present invention and its modification, the present invention is not a Rawareru this and the above-mentioned embodiment, description of the scope of patent claims it is possible with this to take a wide embodiments without departing from the.

The cormorants I described above, according to the present invention, since the stimulation interval heart cormorants by heart rate changes after vagus nerve stimulation falls within a predetermined range can and adjusted child, Monau and the vagus nerve stimulation can and child to suppress the occurrence of heart rate and a monitor rapid changes can and child prevention, that due to the rapid changes in the by Ri heart rate to this fatal arrhythmia.

Claims

The scope of the claims
1. And nerve stimulation means for stimulating the vagus nerve,
And heart contraction detection means for detecting a self-contraction of the heart,
A heart rate measuring means for measuring a heartbeat from the detection result related to the self-contraction,
A cardiac stimulation device for stimulating the heart when the self contraction of the heart is not detected within predetermined time period,
And heart comparator Ru compared to 'a predetermined heart rate threshold and cardiac output were measured pulsation of the heart,
On the basis of the output of the heart rate comparator means determines whether or not to vagal nerve stimulation, when performing vagus nerve stimulation, control earthenware pots by changing the basis of the period in which the predetermined the cardiac output obtained by the measurement cardiac therapy device comprising a call.
2. Heart treatment equipment according to paragraph 1 range 請 nucleophilic, wherein said measuring the cardiac output is the heartbeat interval.
3. The predetermined control for changing the period, heart treatment equipment according to claim 2 in which adding a predetermined time increment to said measured heart rate interval.
4. Heart treatment equipment according to the range 囲第 3 of claims is a predetermined time interval which increment is fixed.
5. Cardiac therapy device as claimed in claim 3 is between the interval when said predetermined time increment corresponds to a fixed heart rate decreased.
6. Heart treatment equipment according to claim 3 wherein said predetermined time increment and said function der Rukoto of the measured heart beat intervals.
7. The function is cardiac therapy device according to claim 6 which is a predetermined percentage of the measured heart beat intervals.
8. The have a predetermined duration limit value, heart treatment equipment according to claim 1, wherein the period of said predetermined is adjusting the limit value to the power sale by no exceed the absolute.
9. Detecting the self-contraction of the heart,
A scan Tetsupu for measuring a heartbeat from the detection result related to the self-contraction,
A method to stimulate the heart if the self contraction of the heart is not detected within predetermined time period,
Comparing the predetermined heart rate threshold and cardiac output obtained by detecting the beating of the heart,
Comprising the steps, of determining whether to perform the vagus nerve stimulation on the basis of the comparison step in the results,
When performing vagus nerve stimulation in the determining step, cardiac therapy wherein that you have a stearyl-up to change based on the period in which the predetermined said measured heart rate output.
1 0. Heart Osamu. 療方 method according to claim 9, wherein the measured cardiac output is characterized that it is a heart beat interval.
1 1. The predetermined steps to change based period cardiac output was the measurement, the heart according to the first 0 wherein the claims is intended to apply a predetermined time increment in cardiac interval measured Method of treatment.
1 2. The cardiac treatment methods according to the first 1 wherein according in advance the time interval time increment has fixed set.
1 3. The cardiac treatment methods according to the first 1 wherein according a time interval predetermined time 增分 corresponds to heart rate reduction fixed.
1 4. The cardiac treatment method according to the first 1 wherein according a function of a predetermined time increment is the measured heart beat intervals.
1 5. Cardiac therapy method according to the first item 4 claims wherein the function is a predetermined ratio of the measured heart beat intervals.
1 6. The have a predetermined duration limit, cardiac therapy method according to paragraph claims that period in which the predetermined is adjusted to cormorants by no exceed the absolute the limit value,
PCT/JP2004/003618 2003-03-27 2004-03-18 Heart treatment device and heart treating method WO2004084990A1 (en)

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