WO2004105869A2 - Defibrillator with two operating modes - Google Patents

Defibrillator with two operating modes Download PDF

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Publication number
WO2004105869A2
WO2004105869A2 PCT/FR2004/001244 FR2004001244W WO2004105869A2 WO 2004105869 A2 WO2004105869 A2 WO 2004105869A2 FR 2004001244 W FR2004001244 W FR 2004001244W WO 2004105869 A2 WO2004105869 A2 WO 2004105869A2
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WO
Grant status
Application
Patent type
Prior art keywords
characterized
apparatus according
patient
mode
automatic
Prior art date
Application number
PCT/FR2004/001244
Other languages
French (fr)
Other versions
WO2004105869A3 (en )
Inventor
Alfred E. Schiller
Albert Cansell
Original Assignee
Schiller Medical
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

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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
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators

Abstract

The invention relates to an external cardiac defibrillator, comprising a fibrillation and ventricular tachycardia detection device, connected to a patient by means of defibrillation electrodes for recording a cardiac signal for the patient and for the application of a defibrillating electric shock to a patient, characterised by two operating modes, one of an emergency defibrillator used by third parties if the apparatus detects a fibrillation or ventricular tachycardia signal, or as an automatic defibrillator carried by the patient, which permanently monitors the rhythm of said patient and, if necessary, automatically delivers one or several defibrillation shocks to the patient. The invention is of interest to cardiac defibrillator producers.

Description

Defibrillator two operating modes

The present invention provides an external defibrillator in two modes.

The scope of the invention is that the emergency cardiac resuscitation consecutive to a cardiac arrest due to ventricular fibrillation or ventricular tachycardia.

Cardiac defibrillation emergency has in recent years a boom and a considerable development.

Cardiac defibrillation is the only way to reduce heart access due to fibrillation or ventricular tachycardia which irretrievably lead to death if not treated by a defibrillation shock within a few minutes. Originally, until about ten years, the use of a defibrillator was limited to emergency doctors, who were then only entitled to use such devices and were thus also only ones to have. This situation is largely insufficient given the small chance that an emergency doctor can be at the scene of the incident in a short enough time to save the topic, it was set up, initially, use defibrillators by rescuers such as professional firefighters, who are more numerous and have a much wider coverage than emergency physicians. The devices present widely used by staff are type-Automatic External Defibrillator called DSA. The principle of this type of device is that it automatically detects arrhythmia requiring defibrillation and recommends the rescuer applying a shock.

Secondly these semi-automatic defibrillators have begun to be extended to a population of users much broader still up to the public. These DSAs are then commonly called PAD, that is to say defibrillators can be used by members of the public who have received minimal first aid training.

These types of devices: DSA or CSA course still assume the presence of a third party must be present close to the victim of cardiac arrest and having such a device.

This condition is not acceptable in the case of patients known to be prone to fibrillation access sometimes common, but can occur at any time, we proceed to the implantation of an automatic implantable defibrillator that applies the shock if necessary. The operation of implantation of such a device is however cumbersome and invasive for the patient, it was developed an alternative for such patients prone to recurrent fibrillation and possibly awaiting implantation of an implantable defibrillator which consists of an automatic external device worn by the patient.

Such a device is described for example in EP 1 064 963. The device worn by the patient continuously monitors the heart rate of the subject, and in case of ventricular fibrillation automatically triggers a defibrillation shock via electrodes applied on the chest.

Both types of external devices: first version DSA / CSA to be implemented by a third party and the other automatic defibrillator release carried by the patient, however, did not satisfy optimally and in all terms of real application needs of patients known to be at permanent risk of fibrillation.

Indeed, if we take the case of such a patient presenting such a danger and living in his family, the opportunities that are currently available to it are as follows. In a first alternative, the family acquires a DSA / CSA type device capable of being operated by another family member. But in this case, there is a risk that at some point the patient lying alone can not be saved. Moreover, it is virtually impossible for the patient to move alone. And finally, at night, during sleep, the occurrence of arrhythmia with cardiac arrest will not be noticed by family members. The alternative is that the family acquired a portable defibrillator in which case the patient should at any time and in any place wearing the device, which is extremely restrictive. The present invention aims to overcome these obvious disadvantages by providing an external cardiac defibrillator comprising a fibrillation detection device and ventricular tachycardia and being connectable to a patient by means of defibrillation electrodes intended for the sampling of the patient's cardiac signal and application of an electrical defibrillation shock from stored electrical energy and a control circuit characterized in that it comprises two operating modes, firstly a mode operation of defibrillator external aid used by third parties to bring relief and apply one or more defibrillation shocks to the patient if the unit detects a signal fibrillation or ventricular tachycardia, and also an operation mode defibrillator worn by the patient which continuously monitors the heart rate of the latter and, if it detects a fibrillation signal or ventricular tachycardia, issue one or more defibrillation shocks automatically.

To better understand the value and utility of the invention, hereafter consider the case of a patient with recurrent fibrillation occurring unpredictably and lives at his home in his family who has a defibrillator the invention. One or more members have been trained in the use of this device. There are three cases for this patient.

During the day the patient is constantly surrounded by his family. He does not wear the device on him. Once an arrhythmia leading to cardiac arrest occurs, a family member witness, immediately apply the defibrillation electrodes on the chest of his relative in fibrillation, check that the unit is in DSA or switches in this mode, and applies to the patient saving shock after fibrillation was confirmed by the device.

Also during the day, the patient is taken to be alone or, for example at home, either by moving one, for example for walking. In this case, the device is switched to monitoring mode and ready to give an automatic shock. The patient wears the device on him, with the defibrillation electrodes applied to the chest and connected to the device, itself carried by example to the belt, in the same way a mobile device permanently monitoring 1 electrocardiogram said Holter ECG.

At night, the camera will also be in this mode by monitoring and automatic triggering shock and will also be connected to the patient in case of the occurrence during sleep of an arrhythmia resulting in cardiac arrest and need so a shock.

For the above reasons, the defibrillator 1 according to the invention can be called personal defibrillator. However to avoid any risk of limitation, this term is used only rarely in this description.

The invention will be better understood by reference to the following description made with reference to the single accompanying figure which is a block schematic diagram showing the major functional decomposition sets of one embodiment of dual mode defibrillator according to invention.

In general, there is a defibrillator apparatus with the essential functions of both a semi-automatic defibrillator AED used by a third party and an automatic defibrillator worn by the patient. The functions common to both modes of operation are: at least two electrodes applied to the patient's chest, which can serve both the pick signal and applying one or more defibrillation shocks, a General power supply operation of the apparatus, a fibrillation detection circuit with temporary storage means for electrical energy, for example one or more capacitor (s) and a circuit for delivery of one or more defibrillation pulses. In addition to these functions common to both operating modes, the device includes more functions specific to each of the two operating modes: semiautomatic through the use of a third party, and automatic worn by the patient. The additional functions specific to the mode of semi-automatic operation through the use of a third person consist, for example, functions of messages and instructions to the operator indicating the different maneuvers he has to do, including including, for example messages or instructions: "applying the electrodes - request an analysis - recommended shock - shock delivery - you spread" etc. The additional specific functions for the automatic mode of operation when one device is worn by the patient, consisting of a monitoring circuit, which continuously monitors the patient's electrocardiogram to detect the occurrence of a potential ventricular fibrillation, so that applying a decision function of a shock or more bumps and automatic delivery circuits of this or these shocks.

This device is complemented by suitable means to use its autonomous and focused namely a power supply battery, a housing, a holding means in or on the patient's body, a guide wire and other means and matching accessories.

The apparatus also comprises at least means for switching between a first mode of semi-automatic operation and a DSA operation mode carried fully automatic ATM. This switching means is controlled by a mechanical element, optical, electronic or software. It can be operated manually or automatically when a condition is met for instance automatically switch to automatic mode when a sensor can detect reliably that one appliance is worn by the patient. This means is coupled to an operating mode indicator indicating to the operator the selected mode of operation that is to say one in which the appliance is located.

This indicator can be either visual or sound. According to an improved variant, it is visual and acoustic.

The apparatus includes naturally also all usual accessories and devices well known for an apparatus having this kind of applications, including on the one hand a storage of signals and events occurring during monitoring or treatment, and secondly transmission devices at a distance from these signals or events.

Thus, when the patient is accompanied by at least one person, that person uses during a cardiac arrest the defibrillator as a semi-automatic external defibrillator. When the patient is alone, the defibrillator is worn by the patient and operates independently in the manner of an automatic external defibrillator.

To complete the description above, we now describe the general block diagram schematic of the single figure showing the composition in major functional blocks of the dual-mode defibrillator according to the invention.

It is broken down generally into two branches joined together by an interface module and leading to a discharge circuit module referenced controlled by one or the other branch for discharging the defibrillation capacitor through the defibrillation electrodes referenced ELECTRODES . The discharge circuit shape the defibrillation pulse as defined by the device. This pulse can be changed in shape, energy, or in any or all of its features according to the needs and effectiveness. One of the branches, the one shown on the right in the diagram, is specific to the operation in semi-automatic mode called DSA with its own circuits MODE SEMI-AUTOMATIC FUNCTION DEFIBRILLATOR and DSA DSA. The other branch is that of fully automatic ATM with its general functions FULLY AUTOMATIC MODE ATM and CIRCUIT DECISION-Module as to trigger the defibrillation shock by DISCHARGE CIRCUIT CIRCUIT DECISION-to-order.

The circuitry is powered by a power BATTERY named because it is used also for the majority of its energy to the load or capacitor (s) defibrillation through a charging circuit referenced LOAD CAPACITOR (S).

The shock is applied to the patient's body through the electrodes by which the pulse or defibrillation pulses traverse (s) the patient's chest. These electrodes are used simultaneously to sample the electrocardiogram signal ECG of the patient, signal that is monitored and analyzed by the unit MONITORING CIRCUIT AND ANALYSIS OF SIGNAL to detect ventricular fibrillation. This module is connected both to CIRCUIT DECISION-module of the fully automatic mode at branch ATM and FUNCTION module DEFIBRILLATOR AED branch in MODE SEMI-AUTOMATIC DSA.

INTERFACE The module has an operating mode indicator referenced MODE INDICATOR informing the user about the operating mode in use is the semi-automatic mode DSA is the fully automatic mode ATM. INTERFACE module receives the different switching commands between the two modes from different sources. It may be a control type software switch or electronic control, a control SWITCHING MODE MANUAL or a switching control from one state or information from sensors or detectors . These sensors or detectors provide information by their condition or emit values ​​for concluding a condition or function is performed, for example, 1 'defibrillation apparatus is worn by the patient, the electrodes are in place or any other indication necessary for safety on the proper functioning of the defibrillator 1 and efficacy of defibrillation.

As can be seen, the apparatus of the invention provides a significant improvement in a patient's life and that of his entourage and security interest on the trigger defibrillation and time of occurrence thereof.

It may be surprising to leave circuits decision defibrillation, but it can be considered sufficiently secure and frees the patient and his entourage many constraints.

Anyway, living comfort material gain is remarkable and is in line with all current requests from both the patient and his entourage.

Claims

1. External device defibrillation, cardiac monitoring and detection of the fibrillation or ventricular tachycardia comprising a fibrillation detection device and ventricular tachycardia and being connectable to a patient by means of defibrillation electrodes intended for the removal of the patient signal and application of an electrical defibrillation shock from stored electrical energy, characterized in that it comprises a control circuit having two modes of operation, first a mode of operation as external backup defibrillator used by at least a third person to rescue and apply one or more defibrillation shocks to the patient if the unit detects a signal fibrillation or ventricular tachycardia and recommends at least one impact and secondly a mode operating as autonomous and automatic defibrillator worn by the patient, who Surveill e permanently heart rate of the latter and, in the case where it detects a fibrillation signal or ventricular tachycardia, deliver to a patient or more defibrillation shocks automatically.
2. Apparatus according to claim 1 characterized in that it comprises at least one switching means for switching in one of one or the other of two modes of operation provided.
3. Apparatus according to claim 2 characterized in that the switching means of the operating modes is manual.
4. Apparatus according to claim 2 characterized in that the switching means of the operating modes is mechanical.
5. Apparatus according to claim 2 characterized in that the switching means of the operating modes is controlled electronically.
6. Apparatus according to claim 2 characterized in that the switching means of the operating modes is controlled by software.
7. An apparatus according to claim 2 characterized in that the switching means of the operating modes is automatic.
8. Apparatus according to the preceding claim characterized in that the automatic switching means of the operating modes is controlled by the state or indicating one or more sensor (s) or detector (s).
9. Apparatus according to the preceding claim characterized in that the means of automatic switching of operation modes is controlled when a condition or function is completed.
10. Apparatus according to the preceding claim characterized in that the condition or function performed for the transition to automatic mode is port 1 of the device by the patient
11. Apparatus according to claims 1 or 2 characterized in that the apparatus comprises a control intended to confirm and remind the operation mode in operation that is to say one in which it is after this switching.
12. Apparatus according to the preceding claim characterized in that the visual indicator is.
13. Apparatus according to claim 11 characterized in that the lamp is sound.
14. Apparatus according to claim 11 characterized in that the indicator is visual and audible.
15. Apparatus according to claim 1 characterized in that it comprises two branches each comprising specific functional blocks each mode connected firstly to an interface and secondly the discharge circuit of the defibrillation capacitor and receiving information monitoring circuits and analyzing the signal from the electrodes.
16. Apparatus according to claim 15 characterized in that the part of the ATM automatic mode comprises decision circuits connected to the discharge circuit and the circuits for monitoring and analyzing the signal from the electrodes.
17. Apparatus according to claim 15 characterized in that the part of the semi-automatic mode DSA includes a manual trigger block shock.
18. Apparatus according to claim 15 characterized in that one interface comprises a mode indicator and is connected to one or more detector (s) or sensor (s), to a manual switching modes and an electronic or software switch modes.
PCT/FR2004/001244 2003-05-22 2004-05-19 Defibrillator with two operating modes WO2004105869A3 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR03/06193 2003-05-22
FR0306193A FR2855059B1 (en) 2003-05-22 2003-05-22 external defibrillator has two modes of operation.

Publications (2)

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WO2004105869A2 true true WO2004105869A2 (en) 2004-12-09
WO2004105869A3 true WO2004105869A3 (en) 2005-02-24

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5078134A (en) * 1988-04-25 1992-01-07 Lifecor, Inc. Portable device for sensing cardiac function and automatically delivering electrical therapy
US5474574A (en) * 1992-06-24 1995-12-12 Cardiac Science, Inc. Automatic external cardioverter/defibrillator
US6289243B1 (en) * 1999-12-01 2001-09-11 Cardiac Science, Inc. Automatic external cardioverter/defibrillator with tachyarrhythmia detector using a modulation (amplitude and frequency) domain function
WO2001095977A1 (en) * 2000-06-12 2001-12-20 Cardiac Science, Inc. A public access defibrillator
US20020156503A1 (en) * 1999-10-14 2002-10-24 Daniel J. Powers Method and apparatus for providing on-screen incident review in an aed

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4576170A (en) * 1980-07-09 1986-03-18 Micro-Circuits Company Heart monitor and defibrillator device
US6280461B1 (en) * 1996-05-23 2001-08-28 Lifecor, Inc. Patient-worn energy delivery apparatus
US6148233A (en) * 1997-03-07 2000-11-14 Cardiac Science, Inc. Defibrillation system having segmented electrodes
US20030069510A1 (en) * 2001-10-04 2003-04-10 Semler Herbert J. Disposable vital signs monitor

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5078134A (en) * 1988-04-25 1992-01-07 Lifecor, Inc. Portable device for sensing cardiac function and automatically delivering electrical therapy
US5474574A (en) * 1992-06-24 1995-12-12 Cardiac Science, Inc. Automatic external cardioverter/defibrillator
US20020156503A1 (en) * 1999-10-14 2002-10-24 Daniel J. Powers Method and apparatus for providing on-screen incident review in an aed
US6289243B1 (en) * 1999-12-01 2001-09-11 Cardiac Science, Inc. Automatic external cardioverter/defibrillator with tachyarrhythmia detector using a modulation (amplitude and frequency) domain function
WO2001095977A1 (en) * 2000-06-12 2001-12-20 Cardiac Science, Inc. A public access defibrillator

Also Published As

Publication number Publication date Type
WO2004105869A3 (en) 2005-02-24 application
FR2855059B1 (en) 2006-03-17 grant
FR2855059A1 (en) 2004-11-26 application

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