EP0310026A2
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EP
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Cardiac and pulmonary physiological analysis via intracardiac measurements with a single sensor
Assignee: Individual
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Filing: 1988-09-28
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Granted: —
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Expires: 2008-09-28
Abstract
Abstract Physiological activity of a patient is detected and analyzed by means of a single sensor (7) situated in the vascular system of the patient. Pulmonary activity is derived from analysis of changes in cardiac activity, such as sensed from blood flow, pressure or volume changes, measured in a preferred embodiment as impedance change within the right heart. Pulmonary activity is separated from cardiac activity implicit in such changes by filtering lower (19) and higher (20) frequency components. The separated signals are processed to derive control signals for stimulating the heartbeat in a pacemaker system, preferably by a single sensor-stimulator electrode (6) implanted within the right heart. Thus, a single functional parameter, namely intra-cardiac impedance, varying both with the intrathoracic pressure fluctuations following respiration and with cardiac contraction is representative of the pulmonary activity and of the cardiac activity. Resulting derived sub-signals then provide information regarding cardiac and pulmonary activity and are used to monitor the patient's condition and control variably the rate of a cardiac pacemaker.
Inventors
- 👤 Eckhard Dr. Alt
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-25 19:03
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36514; A61N1/36521; A61N1/36571
Claims Analysis
Total Claims: 41
Claim 1
Independent Claim
79 words
Electronic medical instrumentation for determining a plurality of physiological parameters related to a patient's condition, comprising in combination: a single sensor located within the heart with corresponding means producing at said sensor a single variable signal representative of a plurality of physiological parameters of the patient, and physiological activity detection means for processing said single variable signal to separate the signal into subsignals respectively representative of a plurality of the patient's physiological parameters presented in said single variable signal.
Claim 2
Dependent Claim
79 words
Electronic medical instrumentation for determining a plurality of physiological parameters related to a patient's condition, comprising in combination: a single sensor located within the heart with corresponding means producing at said sensor a single variable signal representative of a plurality of physiological parameters of the patient, and physiological activity detection means for processing said single variable signal to separate the signal into subsignals respectively representative of a plurality of the patient's physiological parameters presented in said single variable signal.
Claim 3
Dependent Claim
24 words
The instrumentation of Claim 1 further comprising in said detection means, pulmonary and cardiac activity analyzing means responsive to respective ones of said subsignals.
Claim 4
Dependent Claim
56 words
The instrumentation of Claim 1 further comprising: a heart pacemaker having means for generating heart pacing pulses at said single sensor, and control means for producing heart pacing pulses responsive to changes derived as a function of a plurality of physiological parameters representative of the patient's cardiac and pulmonary activity derived from said single variable signal.
Claim 5
Dependent Claim
75 words
The instrumentation of Claim 3 further comprising: means for generating a periodic electrical interrogation signal at said single sensor of low enough energy that the heart is not paced thereby, which interrogation signal responds to and varies with cardiac and pulmonary activity, and means for processing in said physiological activity detection means the variations of the interrogation signal with cardiac and pulmonary activity to derive signals representative of pulmonary and cardiac activity of the patient.
Claim 6
Dependent Claim
30 words
The instrumentation of Claim 1 wherein the corresponding means producing the single variable signal representative of cardiac and pulmonary activity responds to changes of pressure in the patient's vascular system.
Claim 7
Dependent Claim
25 words
The instrumentation of Claim 5 wherein the single variable signal responds to the changes in the volume of the patient's blood in the cardiovascular system.
Claim 8
Dependent Claim
16 words
The instrumentation of Claim 5 wherein the single sensor is located in the patient's right heart.
Claim 9
Dependent Claim
31 words
The instrumentation of Claim 1 wherein the corresponding means producing the single variable signal representative of heart activity responds to changes in the flow of blood in the patient's cardiovascular system.
Claim 10
Dependent Claim
118 words
Electronic medical instrumentation for determining a plurality of physiological parameters related to a patient's heart activity, comprising in combination, detection means for processing a single variable electrical signal derived from a measuring element located to sense one or more physiological parameters within the patient's heart varying with both the intrathoracic pressure fluctuations acting externally on the heart from the patient's breathing and the internal heart activity as a function of dynamic cardiac activity changes detected by said measuring element as a detected single variable electrical signal, and separate signal processing channels for deriving from said single variable electrical signal two sub-signals respectively representative of the patient's breathing and internal heart activity for use in monitoring the patient's condition.
Claim 11
Dependent Claim
118 words
Electronic medical instrumentation for determining a plurality of physiological parameters related to a patient's heart activity, comprising in combination, detection means for processing a single variable electrical signal derived from a measuring element located to sense one or more physiological parameters within the patient's heart varying with both the intrathoracic pressure fluctuations acting externally on the heart from the patient's breathing and the internal heart activity as a function of dynamic cardiac activity changes detected by said measuring element as a detected single variable electrical signal, and separate signal processing channels for deriving from said single variable electrical signal two sub-signals respectively representative of the patient's breathing and internal heart activity for use in monitoring the patient's condition.
Claim 12
Dependent Claim
76 words
The instrumentation defined in Claim 9 further comprising: said measuring element comprising a single sensor electrode implanted in the right heart of the patient, a heart pacer for producing stimulation signals at said single sensor electrode, and further including means responsive to control by signals detected at said single sensor electrode for stimulating the heartbeat rate with impulses to said single sensor electrode for both stimulating the heartbeat rate and sensing physiological activity within the heart.
Claim 13
Dependent Claim
34 words
The instrumentation defined in Claim 10 wherein said detection means further comprises impedance measuring means responsive primarily to impedance changes at said single electrode resulting from pulmonary activity and cardiac activity of the patient.
Claim 14
Dependent Claim
58 words
The instrumentation defined in Claim 9 further comprising, means for dividing the signal into said two sub-signals respectively processed by the two processing channels comprising a low frequency filter passing signals corresponding to intrathoric pressure fluctuations at the patient's breathing rate and a high frequency filter passing periodic signals of cardiac activity corresponding to the patient's cardiac activity.
Claim 15
Dependent Claim
113 words
In a cardiac heartbeat pacing system, the improvement comprising in combination, electronic heartbeat stimulating means for inducing a signal in an electrode implanted within the heart to stimulate a heartbeat, measuring means for measuring a variable within the heart representative of at least one physiological factor of the patient from said electrode in response to a periodic pulmonary activity signal of a frequency and amplitude that represents breathing rate and tidal volume and which does not interfere with signals at the bipolar electrode for stimulating the heartbeat of the patient, and means for modulating the signal from the heartbeat stimulating means as a function of the pulmonary activity measured by the measuring means.
Claim 16
Dependent Claim
113 words
In a cardiac heartbeat pacing system, the improvement comprising in combination, electronic heartbeat stimulating means for inducing a signal in an electrode implanted within the heart to stimulate a heartbeat, measuring means for measuring a variable within the heart representative of at least one physiological factor of the patient from said electrode in response to a periodic pulmonary activity signal of a frequency and amplitude that represents breathing rate and tidal volume and which does not interfere with signals at the bipolar electrode for stimulating the heartbeat of the patient, and means for modulating the signal from the heartbeat stimulating means as a function of the pulmonary activity measured by the measuring means.
Claim 17
Dependent Claim
67 words
A system as defined in Claim 13 wherein said measuring means includes impedance sensing means for distinguishing two said physiological factors from periodically recurring impedance changes relating to cardiac and pulmonary activity, and means for isolating the respective periodically recurring changes into two differing frequency ranges by passing the respective two signals through band pass filters thereby to derive separate non-interfering signals for cardiac and pulmonary activity.
Claim 18
Dependent Claim
77 words
In a cardiac pacing method for stimulating a heartbeat with an electronic stimulation signal induced in an electrode implanted in the heart of a patient, the improvement comprising in combination the steps of, deriving a ventilatory signal from a parameter measurement from said electrode that does not interfere with the stimulation signal, establishing a control signal from said ventilatory signal for the patient being monitored, and controlling the stimulation signal as a function of the control signal.
Claim 19
Dependent Claim
77 words
In a cardiac pacing method for stimulating a heartbeat with an electronic stimulation signal induced in an electrode implanted in the heart of a patient, the improvement comprising in combination the steps of, deriving a ventilatory signal from a parameter measurement from said electrode that does not interfere with the stimulation signal, establishing a control signal from said ventilatory signal for the patient being monitored, and controlling the stimulation signal as a function of the control signal.
Claim 20
Dependent Claim
29 words
The method described in Claim 15 further comprising the step of deriving the ventilatory signal by measurement of the impedance characteristics of the electrode in response to intracardiac impedance.
Claim 21
Independent Claim
76 words
The method of control of a heartbeat pacing system having an electrode implanted in a patient's heart and means for producing periodic electronic stimulation signals thereto to induce heartbeats, comprising the steps of: measuring the impedance within the heart by means of the implanted electrode to produce a variable impedance signal indicative of dynamic instantaneous physiological functioning of the lungs and heart, and modulating the periodic stimulation signals as a function of the variable impedance signal.
Claim 22
Independent Claim
76 words
The method of control of a heartbeat pacing system having an electrode implanted in a patient's heart and means for producing periodic electronic stimulation signals thereto to induce heartbeats, comprising the steps of: measuring the impedance within the heart by means of the implanted electrode to produce a variable impedance signal indicative of dynamic instantaneous physiological functioning of the lungs and heart, and modulating the periodic stimulation signals as a function of the variable impedance signal.
Claim 23
Independent Claim
99 words
The method of monitoring physiological functioning of the lungs and the heart during variations of workload exercise in a patient, comprising the steps of: developing a single variable signal having two periodic signal components respectively signifying the cardiac activity and the pulmonary activity of the patient, and separating the two periodic signal components into processing channels responsive respectively to a lower frequency pulmonary activity and a higher frequency cardiac activity with said channels having a bandwidth sufficient to identify modulations of rate and amplitude of the respective lower and higher frequency signals for monitoring respectively pulmonary and cardiac activity.
Claim 24
Independent Claim
99 words
The method of monitoring physiological functioning of the lungs and the heart during variations of workload exercise in a patient, comprising the steps of: developing a single variable signal having two periodic signal components respectively signifying the cardiac activity and the pulmonary activity of the patient, and separating the two periodic signal components into processing channels responsive respectively to a lower frequency pulmonary activity and a higher frequency cardiac activity with said channels having a bandwidth sufficient to identify modulations of rate and amplitude of the respective lower and higher frequency signals for monitoring respectively pulmonary and cardiac activity.
Claim 25
Independent Claim
74 words
The method of monitoring a patient's cardiac activity from a set of only two separated positions within the heart of a patient by means of a single variable impedance signal carrying separable signal components of two differing periodic frequency ranges respectively in a higher heartbeat rate range and a lower respiratory rate range which respective signal components carry information pertaining to pulmonary and cardiac activity as frequency and amplitude variations of the impedance signal.
Claim 26
Independent Claim
74 words
The method of monitoring a patient's cardiac activity from a set of only two separated positions within the heart of a patient by means of a single variable impedance signal carrying separable signal components of two differing periodic frequency ranges respectively in a higher heartbeat rate range and a lower respiratory rate range which respective signal components carry information pertaining to pulmonary and cardiac activity as frequency and amplitude variations of the impedance signal.
Claim 27
Independent Claim
76 words
The method of pacing a heart at an impulse rate derived in part from a set of cardiac and pulmonary activity signals derived from a common electronic detection device located in a blood flow path indicating flow of blood in the vicinity of the heart for detection of physiological changes of both cardiac and pulmonary activity derived from a single measurable physiological parameter detectable from the flow of blood within the cardiovascular system of the patient.
Claim 28
Independent Claim
76 words
The method of pacing a heart at an impulse rate derived in part from a set of cardiac and pulmonary activity signals derived from a common electronic detection device located in a blood flow path indicating flow of blood in the vicinity of the heart for detection of physiological changes of both cardiac and pulmonary activity derived from a single measurable physiological parameter detectable from the flow of blood within the cardiovascular system of the patient.
Claim 29
Independent Claim
42 words
The method of detecting ventilatory parameters of a patient from an analysis of the influence of periodic intrathoracic pressure fluctuations produced by a detector electrode implanted within the heart in a frequency range including the pulmonary rate and excluding the heartbeat rate.
Claim 30
Independent Claim
42 words
The method of detecting ventilatory parameters of a patient from an analysis of the influence of periodic intrathoracic pressure fluctuations produced by a detector electrode implanted within the heart in a frequency range including the pulmonary rate and excluding the heartbeat rate.
Claim 31
Dependent Claim
38 words
The method defined in Claim 21 of detecting the thoracic pressure changes during ventilation of a patient from said detector electrode implanted within the right ventricle producing a signal varying with the blood suction effect of pulmonary activity.
Claim 32
Dependent Claim
52 words
The method of Claim 22 for commonly processing a common signal representative of both the instantaneous dynamic pulmonary and cardiac activity of a patient having the characteristic of insignificant reduction of the pulmonary signal component with changes in cardiac activity obtained from monitoring a single cardiac responsive parameter obtained from said electrode.
Claim 33
Independent Claim
43 words
The method of operating a stimulus electrode implanted in the heart for controlling a heartbeat pulse rate in a concurrent mode as a detector of the impedance within the heart, and controlling stimulus to the electrode as a function of the detected impedance.
Claim 34
Independent Claim
43 words
The method of operating a stimulus electrode implanted in the heart for controlling a heartbeat pulse rate in a concurrent mode as a detector of the impedance within the heart, and controlling stimulus to the electrode as a function of the detected impedance.
Claim 35
Dependent Claim
88 words
A heart pacemaker comprising in combination, pulse generator means for generating heart pacing pulses, a single sensor and means coupled thereto for deriving from a patient a single signal modulated with a multiplicity of physiological functional parameters related to a patient's condition, detection means responsive to said single signal to provide sub-signal components representative of said physiological parameters for respectively pulmonary activity and cardiac activity, and control means for changing the rate of the heart pacing pulses in response to the detected pulmonary and cardiac activity sub-signal components.
Claim 36
Dependent Claim
88 words
A heart pacemaker comprising in combination, pulse generator means for generating heart pacing pulses, a single sensor and means coupled thereto for deriving from a patient a single signal modulated with a multiplicity of physiological functional parameters related to a patient's condition, detection means responsive to said single signal to provide sub-signal components representative of said physiological parameters for respectively pulmonary activity and cardiac activity, and control means for changing the rate of the heart pacing pulses in response to the detected pulmonary and cardiac activity sub-signal components.
Claim 37
Dependent Claim
107 words
A heart pacemaker as defined in Claim 25, wherein said single sensor and means for deriving the single signal comprises: a stimulating electrode situated in a patient's right heart, means for for generating an electrical measurement signal of low energy unable to pace the heart to derive said single signal, means for transmitting the measurement signal and pacing signal to the stimulating electrode over a common communication channel, means coupled to said channel for receiving, detecting, and analyzing the single signal to derive signals representative of dynamic changes in pulmonary and cardiac activity, and means for varying the pacing signal rate in response to said dynamic changes.
Claim 38
Dependent Claim
60 words
A heart pacemaker as defined in Claim 25 having a pacing electrode positioned in a patient's right heart, wherein said means for deriving a single signal comprises: pressure sensing means situated in the cardiovascular system of a patient for producing said single signal, and means for detecting said physiological parameters from monitoring the pressure sensed by said pressure sensing means.
Claim 39
Dependent Claim
55 words
A heart pacemaker as defined in Claim 25 having a pacing electrode positioned in a patient's right heart, wherein said means for deriving a single signal comprises: blood flow sensing means situated in a patient's cardiovascular system, and means for detecting said physiological parameters from monitoring blood flow sensed by said blood flow sensing means.
Claim 40
Dependent Claim
85 words
A heart pacemaker system including pulse generator means for generating heart pacing pulses, comprising in combination, blood flow sensing means coupled with means for deriving from a patient therefrom a single signal modulated with a multiplicity of physiological functional parameters relating to the patient's condition, detection means responsive to said single signal to provide sub-signal components representative of said physiological parameters for respectively cardiovascular activity, and control means for changing the rate of the pacing pulses in response to the detected cardiocascular activity sub-signal components.
Claim 41
Dependent Claim
85 words
A heart pacemaker system including pulse generator means for generating heart pacing pulses, comprising in combination, blood flow sensing means coupled with means for deriving from a patient therefrom a single signal modulated with a multiplicity of physiological functional parameters relating to the patient's condition, detection means responsive to said single signal to provide sub-signal components representative of said physiological parameters for respectively cardiovascular activity, and control means for changing the rate of the pacing pulses in response to the detected cardiocascular activity sub-signal components.
References Cited (Backward Citations)
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