EP0503839A2
Expired / Lapsed
EP
⏱️ 0.0 years remaining
Method and apparatus for chronically monitoring the hemodynamic state of a patient using doppler ultrasound
Assignee: Telectronics NV
•
Filing: 1992-03-05
•
Granted: —
•
Expires: 2012-03-05
Abstract
Abstract A hemodynamic control apparatus and method for regulating blood flow within the cardiovascular system in a closed-loop control system using ultrasound measurement techniques to determine a hemodynamic status of the patient and to derive a control parameter for modulating the hemodynamics of the system using electrical or pharmaceutical therapy. This apparatus and method provides for the monitoring ot heart contractility and blood flow output from the heart to control an implantable cardiac assist or therapy device(5A) to maintain cardiac output without invading the left heart or the arterial system of the patient. <IMAGE>
Inventors
- 👤 Tibor A. Nappholz
- 👤 Harry L. Valenta, Jr.
- 👤 Steven M. Maas
- 👤 Ken Koestner
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-11-05 06:04
CPC Classifications
A; A61; A61B; A61B8/00; A61B8/06; A61B8/065; A61B8/44; A61B8/4444; A61B8/445; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36514; A61N1/36528; A61B8/08; A61B8/12; A61B8/48; A61B8/488; A61N1/36571; Y; Y10; Y10S; Y10S128/00; Y10S128/13
Claims Analysis
Total Claims: 24
Claim 1
Independent Claim
90 words
A hemodynamic control apparatus for determining a patient's hemodynamic status and adjusting the hemodynamic output of the patient's heart to correspond to the patient's metabolic needs, comprising: means for generating electrical stimulation pulses, ultrasonic means implanted within the patient's cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system, means for determining cardiac performance based on said at least one monitored parameter, and means for adjusting said pulse generating means as a function of said cardiac performance.
Claim 2
Dependent Claim
44 words
A hemodynamic control apparatus in accordance with claim 1, wherein said ultrasonic means is adapted to be implanted within the patient's right heart for ensonifying the patient's ascending aorta with ultra-sonic energy and detecting returning ultrasonic energyreflected from blood cells within the ascending aorta.
Claim 3
Dependent Claim
55 words
A hemodynamic control apparatus in accordance with claim 1, wherein said means for adjusting said pulse generating means adjusts at least one of the pulse generation parameters from,the group of pulse generation parameters comprising electrical stimulation pulse timing, electrical stimulation pulse duration, electrical stimulation pulse amplitude, electrical stimulation pulse polarity, pacing mode and pacing rate.
Claim 4
Dependent Claim
38 words
A hemodynamic control apparatus in accordance with claim 1, wherein said ultrasonic means includes ultrasonic transmitting means utilizing timed bursts of ultrasonic pulses, and ultrasonic receiving means employing Doppler measurement techniques, for monitoring said at least one parameter.
Claim 5
Dependent Claim
157 words
A hemodynamic control apparatus in accordance with claim 1, wherein said generating means includes means for generating ventricular pacing pulses, wherein said means for determining cardiac performance comprises a means for deriving a cardiac performance index, and wherein said apparatus further comprises: means for sensing atrial heartbeats, means for determining a metabolic indicator rate as a function of blood flow per unit of time and independent of the rate of sensed natural atrial heart-beats, means for classifying whether the sensed natural atrial heart rate is physiological or pathological based on the sensed natural atrial heart rate, the metabolic indicator rate and the cardiac performance index, and control means operative when the sensed natural atrial heart rate is physiological for keying the operation of said ventricular pacing pulse generating means to the operation of said atrial heartbeat sensing means, and operative otherwise for keying the operation of said ventricular pacing pulse generating means to said metabolic indicator rate.
Claim 6
Dependent Claim
75 words
A hemodynamic control apparatus in accordance with claim 5, wherein said ultrasonic means comprises: means for determining the rate of change of the blood flow volume in response to a heartbeat, and means for deriving a cardiac contractility parameter from the rate of change of the blood flow volume, and wherein said means for determining said cardiac performance index and said means for determining said metabolic indicator rate are based on said cardiac contractility parameter.
Claim 7
Dependent Claim
52 words
A hemodynamic control apparatus in accordance with claim 5, wherein said ultrasonic means comprises: means for integrating the blood flow velocity over time to determine cardiac output; and wherein said means for determining said cardiac performance index and said means for determining said metabolic indicator rate are based on said cardiac output.
Claim 8
Dependent Claim
57 words
A hemodynamic control apparatus in accordance with claim 5, wherein said ultrasonic means comprises: means for integrating the blood flow velocity over at least one cardiac cycle to determine the stroke volume, and wherein said means for determining said cardiac performance index and said means for determining said metabolic indicator rate are based on said stroke volume.
Claim 9
Dependent Claim
59 words
A hemodynamic control apparatus in accordance with claim 5, wherein said classifying means defines an atrial tracking rate which is proportional to said metabolic indicator rate, and wherein said classifying means classifies the sinus heart rate as pathological when the sensed natural atrial heart rate is faster than said atrial tracking rate and the cardiac performance index is decreasing.
Claim 10
Dependent Claim
38 words
A hemodynamic control apparatus in accordance with claim 5, wherein said ultrasonic means includes ultrasonic transmitting means utilizing timed bursts of ultrasonic pulses, and ultrasonic receiving means employing Doppler measurement techniques, for monitoring said at least one parameter.
Claim 11
Dependent Claim
95 words
A hemodynamic control apparatus in accordance with claim 5, further including: means for determining a cardiac performance index minimum value characterizing the threshold level of hemodynamic output resulting from generated ventricular pacing pulses which successfully stimulate the heart, means for comparing subsequent cardiac performance indices resulting from ventricular pacing pulses to said,cardiac performance index minimum value, and control means responsive to said comparing means for adjusting the energy level of said generated ventricular pacing pulses to safely stimulate the heart so that the cardiac performance indices will consistently exceed the cardiac performance index minimal value.
Claim 12
Dependent Claim
98 words
A hemodynamic control apparatus for determining a patient's hemodynamic status and adjusting the hemodynamic output of the patient's hearts to correspond to the patient's metabolic needs, comprising: an implantable drug infusion pump, ultrasonic means implanted within the patient's cardiovascular system for monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the cardiovascular system, means for determining cardiac performance based on said at least one parameter, and means for adjusting the timing and dosage of a pharmaceutical administered by said implantable drug infusion pump as a function of said cardiac performance.
Claim 13
Dependent Claim
92 words
A hemodynamic control apparatus in accordance with claim 12, wherein said means for determining cardiac performance comprises a means for deriving a cardiac performance index, and wherein said adjusting means further includes: means for determining a cardiac performance index minimum value characterizing the threshold level of hemodynamic output resulting from at least one heartbeat, means for comparing subsequent cardiac performance indices, during a predetermined time period, to said cardiac performance index minimum value, and control means responsive to said comparing means for activating and controlling the output of said drug infusion pump.
Claim 14
Dependent Claim
45 words
A hemodynamic control apparatus in accordance with claim 12, wherein said ultrasonic means is adapted to be implanted within the patient's right heart for ensonifying the patient's ascending aorta with ultrasonic energy and detecting returning ultrasonic energy reflected from blood cells within the ascending aorta.
Claim 15
Dependent Claim
90 words
A hemodynamic control apparatus in accordance with claim 12, wherein said cardiac performance index is based on the contractility of the heart, and wherein said adjusting means further includes: means for determining a cardiac performance index minimum value characterizing the threshold level ot hemodynamic output for supporting the needs of the body, means for comparing subsequent cardiac performance indices, during a predetermined time period, to said cardiac performance index minimum value, and control means responsive to said comparing means for activating and controlling the output of said drug infusion pump.
Claim 16
Dependent Claim
37 words
A hemodynamic control apparatus in accordance with claim 12, wherein said ultrasonic means includes ultrasonic transmitting means utilizing timed bursts of ultrasonic pulses, and,ultrasonic receiving means employing Doppler measurement techniques, for monitoring said at least one parameter.
Claim 17
Independent Claim
82 words
A method of operating a hemodynamic control apparatus for determining a patient's hemodynamic status and adjusting the hemodynamic output of the patient's heart to correspond to the patient's metabolic needs, comprising the steps of: generating electrical stimulation pulses, ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the patient's cardiovascular system, determining cardiac performance based on said at least one monitored parameter, and adjusting said electrical stimulation pulses based on said cardiac performance.
Claim 18
Dependent Claim
55 words
A method of operating a hemodynamic control apparatus in accordance with claim 17, wherein said adjusting step adjusts at least one of the pulse generation parameters from the group of pulse generation parameters comprising electrical stimulation pulse timing, electrical stimulation pulse duration, electrical stimulation pulse amplitude, electrical stimulation pulse polarity, pacing mode and pacing rate.
Claim 19
Dependent Claim
64 words
A method of operating a hemodynamic control apparatus in accordance with claim 17, wherein said step of ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per uni: of time within the patient's cardiovascular system includes the steps of ensonifying the ascending aorta with ultrasonic energy and detecting the returning ultrasonic energy reflected from blood cells within the ascending aorta.
Claim 20
Dependent Claim
30 words
A method of operating a hemodynamic control apparatus in accordance with claim 17, wherein said step of determining cardiac performance includes the step of measuring the contractility of the heart.
Claim 21
Independent Claim
95 words
A method of operating a hemodynamic control apparatus for determining a patient's hemodynamic status and adjusting the hemodynamic output of the patient's heart to correspond to the patient's metabolic needs, comprising: interconnecting a source of cardiovascular-active pharmaceutical with a patient's cardiovascular system, ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the patient's cardiovascular system, determining cardiac performance based on said at least one monitored parameter, and adjusting the timing and dosage of the pharmaceutical introduced into the patient's cardiovascular system based on said cardiac performance.
Claim 22
Dependent Claim
101 words
A method of operating a hemodynamic control apparatus in accordance with claim 21, wherein said step of determining cardiac performance comprises a step of deriving a cardiac performance index, and wherein said adjusting step further includes the sub-steps of: determining a cardiac performance index minimum value characterizing the threshold level of hemodynamic output resulting from at least one heart beat, comparing subsequent cardiac performance indices, during a predetermined time period, to said cardiac performance index minimum value, and adjusting the timing and dosage of the pharmaceutical introduced into the patient's cardiovascular system in response to the results of said comparing step.
Claim 23
Dependent Claim
65 words
A method of operating a hemodynamic control apparatus in accordance with claim 22, wherein said step of ultrasonically monitoring at least one parameter corresponding to the volume of blood flow per unit of time within the patient's cardiovascular system includes the the steps of ensonifying the ascending aorta with ultrasonic energy and detecting the returning ultrasonic energy reflected from blood cells within the ascending aorta.
Claim 24
Dependent Claim
32 words
A method of operating a hemodynamic control apparatus in accordance with claim 21, wherein said step of deriving a cardiac performance index includes the step of measuring the contractility of the heart.
References Cited (Backward Citations)
No citation records indexed.
USPTO Annuity & Maintenance Windows
Maintenance schedule is calculated for granted US utility patents.