US5489293A
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Method and apparatus for treating cardiac tachyarrhythmia
Assignee: Pacesetter Inc
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Filing: 1994-03-31
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Granted: 1996-02-06
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Expires: 2014-03-31
Abstract
Abstract The present invention provides an apparatus and method for cardiac defibrillation which utilizes a lower voltage defibrillation output to depolarize the myocardial cells by providing a rapid sequence of defibrillation shocks synchronized with sensed sequential cardiac events or features during an arrhythmia. Each shock may be a conventional monophasic or biphasic pulse. Each of the shocks may be relatively short in duration, i.e. on the order of 0.5 to 3 milliseconds or may be relatively long, i.e. up to about 100 milliseconds. The amplifiers of the sensing circuitry are particularly adapted quickly recover to after each shock is delivered to allow synchronization of the next shock to the next cardiac feature. This is accomplished by using broad band amplifiers which have DC-baseline restoration capability in order to eliminate offsets caused by a preceding shock. A microprocessor in the pulse generator delivers a programmed number of pulses synchronized to the ECG. If a first sequence fails to terminate the arrhythmia, another sequence is delivered at a higher voltage and/or additional pulses are added to the sequence.
Inventors
- 👤 Benjamin D. Pless
- 👤 Rose A. Province
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-11-04 15:37
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/38; A61N1/39; A61N1/3956; A61N1/3906; A61N1/3912; A61N1/3987
Claims Analysis
Total Claims: 34
Claim 1
Independent Claim
97 words
A method for treating a cardiac tachyarrhythmia in a patient's heart comprising: (a) sensing an EGG signal from said patient's heart to provide a sensed ECG signal, said sensed ECG signal including a series of sensed cardiac features; (b) detecting tachyarrhythmia; and (c) delivering in sequence a plurality of electrical pulses to said patient's heart, wherein at least two of said pulses being delivered are synchronous with at least two of said sensed cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
Claim 2
Independent Claim
97 words
A method for treating a cardiac tachyarrhythmia in a patient's heart comprising: (a) sensing an EGG signal from said patient's heart to provide a sensed ECG signal, said sensed ECG signal including a series of sensed cardiac features; (b) detecting tachyarrhythmia; and (c) delivering in sequence a plurality of electrical pulses to said patient's heart, wherein at least two of said pulses being delivered are synchronous with at least two of said sensed cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
Claim 3
Dependent Claim
32 words
The method of claim 1 wherein said step of delivering includes delivering one of said plurality of electrical pulses for each one of a sequence of said series of sensed cardiac features.
Claim 4
Dependent Claim
26 words
The method of claim 1 and including the step of triggering the delivery of said electrical pulses based on an amplitude of said sensed ECG signal.
Claim 5
Dependent Claim
34 words
The method of claim 1 and including the step of triggering the delivery of said electrical pulses based on a rate of change of amplitude of said sensed ECG signal with respect to time.
Claim 6
Dependent Claim
55 words
The method of claim 1 and including the step of triggering the delivery of at least one of said electrical pulses based on an amplitude of said sensed ECG signal and at least one of said electrical pulses based on a rate of change of amplitude of said sensed ECG signal with respect to time.
Claim 7
Dependent Claim
26 words
The method of claim 1 wherein the delivery of one or more of said plurality of electrical pulses is delayed in time from a trigger signal.
Claim 8
Dependent Claim
42 words
The method of claim 1 wherein said step of delivering a plurality of electrical pulses includes delivering two or more synchronous pulses followed by one or more extra pulses spaced from a last one of said synchronous pulses by a predetermined interval.
Claim 9
Dependent Claim
44 words
The method of claim 1 wherein a first pulse of said plurality of pulses is delivered synchronous with a sensed cardiac feature having an amplitude greater than a threshold set as a function of the amplitude of a preceding series of sensed cardiac complexes.
Claim 10
Dependent Claim
34 words
The method of claim 1 and further including the step of monitoring a fibrillation interval and delivering a first pulse of said plurality of pulses based on a monitored regularity of said fibrillation interval.
Claim 11
Dependent Claim
36 words
The method of claim 1 wherein said step of detecting includes identifying cardiac complexes within said sensed ECG signal and measuring a plurality of intervals between a sequence of said cardiac complexes to characterize said tachyarrhythmia.
Claim 12
Dependent Claim
24 words
The method of claim 10 wherein said step of detecting further includes the step of averaging said plurality of intervals to characterize said tachyarrhythmia.
Claim 13
Dependent Claim
31 words
The method of claim 1 wherein said step of delivering includes delivering each of said electrical pulses as a waveform selected from the group consisting of monophasic, biphasic and multiphasic waveforms.
Claim 14
Dependent Claim
39 words
The method of claim 1 and further including the step of charging a capacitor prior to delivery of each of said electrical pulses and electrically coupling said capacitor to said patient's heart to deliver each of said electrical pulses.
Claim 15
Dependent Claim
41 words
The method of claim 1 wherein each of said electrical pulses has an amplitude, said method further including the step of modifying the amplitude of each subsequent pulse in said plurality of pulses relative to the amplitude of the preceding pulse.
Claim 16
Dependent Claim
41 words
The method of claim 1 wherein each of said electrical pulses has a duration, said method further including the step of modifying the duration of each subsequent pulse in said plurality of pulses relative to the duration of the preceding pulse.
Claim 17
Dependent Claim
48 words
The method of claim 1 wherein each of said electrical pulses has a duration and an amplitude, said method further including the step of modifying the amplitude and duration of each subsequent pulse in said plurality of pulses relative to the amplitude and duration of the preceding pulse.
Claim 18
Dependent Claim
21 words
The method of claim 1 wherein said step of delivering includes delivering each of said electrical pulses for a predetermined duration.
Claim 19
Dependent Claim
24 words
The method of claim 1 and further including the step of delivering one or more additional sequences of electrical pulses to said patient's heart.
Claim 20
Dependent Claim
61 words
The method of claim 18 and including the step of detecting the continued presence of an arrhythmia following delivery of a first or subsequent sequence of electrical pulses and delivering said one or more additional sequences of electrical pulses with an amplitude changed from the amplitude of a preceding sequence if said first or subsequent sequence fails to terminate said arrhythmia.
Claim 21
Dependent Claim
34 words
The method of claim 18 wherein the number of electrical pulses in one or more of said additional sequences is changed from the preceding sequence if a preceding sequence fails to terminate said arrhythmia.
Claim 22
Dependent Claim
88 words
A medical device for electrically stimulating a patient's heart comprising: a sensing lead for sensing ECG signals of said patient's heart, said ECG signals including a series of cardiac features; an ECG signal analyzer for detecting a tachyarrhythmia; and pulse delivery circuitry coupled to said signal analyzer and for delivering a plurality of electrical pulses to said patient's heart such that at least two of said electrical pulses are delivered synchronous with at least two of said cardiac features before a reduction is made of a possible tachyarrhythmia.
Claim 23
Dependent Claim
88 words
A medical device for electrically stimulating a patient's heart comprising: a sensing lead for sensing ECG signals of said patient's heart, said ECG signals including a series of cardiac features; an ECG signal analyzer for detecting a tachyarrhythmia; and pulse delivery circuitry coupled to said signal analyzer and for delivering a plurality of electrical pulses to said patient's heart such that at least two of said electrical pulses are delivered synchronous with at least two of said cardiac features before a reduction is made of a possible tachyarrhythmia.
Claim 24
Dependent Claim
15 words
A medical device according to claim 21 wherein said ECG signal analyzer includes a microprocessor.
Claim 25
Dependent Claim
33 words
A medical device according to claim 21 wherein said pulse delivery circuitry includes a battery, a power supply circuit coupled to said battery and an output stage coupled to said power supply circuit.
Claim 26
Dependent Claim
85 words
A medical device for electrically stimulating a patient's heart comprising: a sensor for sensing electrical signals of said patient's heart, said sensed signals including a sequence of sensed cardiac features; a pulse generator adapted to generate a sequence of pulses wherein at least two of said pulses are synchronous with at least two of said cardiac features; and delivery means coupled to said pulse generator for delivering said pulses to said patient's heart after a first sensed tachyarrhythmia and prior to a next sensed tachyarrhythmia.
Claim 27
Dependent Claim
85 words
A medical device for electrically stimulating a patient's heart comprising: a sensor for sensing electrical signals of said patient's heart, said sensed signals including a sequence of sensed cardiac features; a pulse generator adapted to generate a sequence of pulses wherein at least two of said pulses are synchronous with at least two of said cardiac features; and delivery means coupled to said pulse generator for delivering said pulses to said patient's heart after a first sensed tachyarrhythmia and prior to a next sensed tachyarrhythmia.
Claim 28
Dependent Claim
28 words
The medical device of claim 24 wherein said delivery means includes a pulse output stage and at least first and second electrodes coupled to said pulse output stage.
Claim 29
Dependent Claim
39 words
The medical device of claim 25 wherein said pulse generator includes circuitry for developing a synchronization trigger signal and a microprocessor coupled to said pulse output stage to control the delivery of said pulses upon receiving said trigger signal.
Claim 30
Dependent Claim
96 words
An implantable medical device for the electrical termination of tachyarrhythmia comprising: sensing means responsive to cardiac depolarizations for producing a sense signal indicative of naturally occurring cardiac activity; detection means responsive to said sensing means for detecting cardiac tachyarrhythmia and for producing a tachyarrhythmia signal indicative of such tachyarrhythmia; trigger signal generating means responsive to said detection means for generating a trigger signal concurrent with each of said cardiac depolarizations; and pulse generator means responsive to said trigger signals for delivering a sequence of synchronous electrical pulses to cardiac tissue in response to said trigger signals.
Claim 31
Dependent Claim
96 words
An implantable medical device for the electrical termination of tachyarrhythmia comprising: sensing means responsive to cardiac depolarizations for producing a sense signal indicative of naturally occurring cardiac activity; detection means responsive to said sensing means for detecting cardiac tachyarrhythmia and for producing a tachyarrhythmia signal indicative of such tachyarrhythmia; trigger signal generating means responsive to said detection means for generating a trigger signal concurrent with each of said cardiac depolarizations; and pulse generator means responsive to said trigger signals for delivering a sequence of synchronous electrical pulses to cardiac tissue in response to said trigger signals.
Claim 32
Dependent Claim
30 words
The medical device of claim 27 wherein said pulse generator means includes a battery, at least one capacitor and a power supply circuit for charging said capacitor from said battery.
Claim 33
Independent Claim
87 words
A method for treating a cardiac tachyarrhythmia in a patient's heart comprising: (a) sensing an ECG signal from said patient's heart, said ECG signal including a series of cardiac features; (b) detecting a tachyarrhythmia; and (c) delivering in sequence three or more electrical pulses to said patient's heart, at least two of said pulses being delivered synchronous with at least two of said cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
Claim 34
Independent Claim
87 words
A method for treating a cardiac tachyarrhythmia in a patient's heart comprising: (a) sensing an ECG signal from said patient's heart, said ECG signal including a series of cardiac features; (b) detecting a tachyarrhythmia; and (c) delivering in sequence three or more electrical pulses to said patient's heart, at least two of said pulses being delivered synchronous with at least two of said cardiac features and wherein said sequence of electrical pulses is delivered before a determination is made as to whether said tachyarrhythmia has been terminated.
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USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1999-02-05 | 1999-08-07 | 2000-02-06 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2003-02-05 | 2003-08-07 | 2004-02-06 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2007-02-05 | 2007-08-07 | 2008-02-06 | $7700.00 | Window Closed / Lapsed |