Patent US3293074A successfully refreshed from Google Patents.
EP0474957A2
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EP
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Ultrasonic doppler synchronized cardiac electrotherapy device
Assignee: Individual
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Filing: 1991-03-22
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Granted: —
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Expires: 2011-03-22
Abstract
Abstract A cardiac electrotherapy device comprises a Doppler measurement cardiac pacing lead within at least one Doppler measurement ultrasonic piezoelectric transducer means (55/57/58, 56/62/63) being arranged and mounted onto the said cardiac lead at the circumference thereof in a manner as to be able of generating an essential narrow directivity characteristic adjacent to the catheter body (50) in such a way as to prevent an intersection of the ultrasonic beam of said transducer means with said plastic body (50) in straight position of this body. <IMAGE>
Inventors
- 👤 Bozidar Ferek-Petric
- 👤 Branco Dr. Breyer
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 16:00
CPC Classifications
A; A61; A61B; A61B8/00; A61B8/06; A61B8/12; A61B8/44; A61B8/4444; A61B8/445; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36514; A61N1/36528; A61N1/36571
Claims Analysis
Total Claims: 22
Claim 1
Independent Claim
164 words
A cardiac electrotherapy device comprising a Doppler measurement cardiac pacing lead, electronic circuitry for cardiac electrotherapy and electronic circuitry for Doppler blood flow velocity measurement, timing and processing of the velocity data, wherein said Doppler measurement cardiac pacing lead comprises a plastic catheter body (10, 20, 30, 50, 80, 100, 120, 280, 301), lead conductors (31/37, 52/60/65, 87/90/93, 281/289, 327/303/326 and 302) and a pacing electrode (11, 21, 51, 101, 124), at least one Doppler measurement ultrasonic piezoelectric transducer means (12, 22/23, 33, 55/56, 81/82, 283, 305/306, 405/506), comprising transducer electrodes (34/35, 57/58, 62/63, 83/84, 85/86, 284/285, 310 to 313, 410, 512), said transducer means being arranged and mounted onto the said cardiac lead at the circumference thereof in a manner as to be able of generating an essential narrow directivity characteristic adjacent to the catheter body in such a way as to prevent an intersection of the ultrasonic beam of said transducer means with said plastic body in straight position of this body.
Claim 2
Dependent Claim
60 words
Device according to claim 1 wherein said transducer means has a shape of a hollow cylinder (12, 22, 23, 33, 55, 56), hollow cone, perforated disk (283) or foil, with said electrodes (34/35, 57/58, 62/63, 284/285) arranged at the ends thereof and is coaxially mounted onto the cardiac lead, and poled so as to generate a hollow conical directivity characteristic.
Claim 3
Dependent Claim
57 words
Device according to claim 1, wherein said transducer means has a shape of a hollow cylinder (81, 82) or hollow cone or folded piezoelectric plastic foil with said electrodes (83/84, 85/86) arranged along the inner and outer circumferential surfaces thereof and is coaxially mounted onto the cardiac lead so as to generate a hollow conical directivity characteristic.
Claim 4
Dependent Claim
34 words
Device according to claim 2 or 3, wherein two transducer means (22/23, 55/56, 81/82) are arranged, spaced apart from each other, whereby the directivity characteristics cross each other to form a sensitivity volume (106).
Claim 5
Dependent Claim
64 words
Device according to claim 1 wherein said transducer means (305, 306, 405, 506) comprises at least one pair of plate-like transducers (305/405), each having arranged said electrodes (310, 311, 410) on both sides, and that the paired transducers (305/405 and 306/506) are tilted towards each other so as to obtain a sensitivity area by an overlapping region (600 and 603) of their directivity characteristics.
Claim 6
Dependent Claim
65 words
Device according to any of claims 1 to 5, wherein said transducer means of said lead comprises a reflective or absorbing member (14, 26, 27, 40, 69, 70, 97, 98, 104, 105, 294, 304) mounted fixedly at one side of the transducer means in order to prevent the ultrasonic radiation in direction to the side of the transducer means where said reflective member is mounted.
Claim 7
Dependent Claim
64 words
Device according to any of claims 1 to 6, wherein said transducer means comprises an ultrasonic lens (13, 24, 25, 39, 67, 68, 95, 96, 102, 103, 293) mounted fixedly at one side of said transducer means (12, 22, 23, 33, 55, 56, 81, 82, 283) whereby the ultrasonic radiation is directed to the side of said transducer means where said lens is mounted.
Claim 8
Dependent Claim
33 words
Device according to claim 7, wherein said lens has a shape of a top-cut hollow cone which is coaxial with the lead axis, the lens being essentially of a tapered conical ring form.
Claim 9
Dependent Claim
108 words
Device according to any of claims 1 to 8, wherein said Doppler measurement cardiac pacing lead (120) comprises a connector assembly at its proximal end wherein said lead conductors electrically connect pacing electrodes with corresponding pins (170, 171) of said connector assembly and transducer electrodes with corresponding pins (171, 172) of said connector assembly in such a way as to enable the electrical connection of said pacing electrodes with cardiac pacing electronic circuitry cited in claim 1 as well as the electrical connection of said transducer electrodes with Doppler electronic circuitry cited in claim 1 without interference between said transducers high frequency signal and said pacing electrodes signals.
Claim 10
Dependent Claim
60 words
Device according to any of claims 1 to 9, comprising means for a ventricular pacing synchronous with atrial contractions with the use of a single said lead (120) and means for a rate responsive pacing (166), wherein said means are controlled by means of processing (160, 168, 169) of the Doppler waveform of blood flow through a cardiac valve (125).
Claim 11
Dependent Claim
85 words
Device according to any of claims 1 to 10, comprising means for measurement of the blood velocity during determined time interval (DMI) synchronized with the ventricular electrical activity, said interval occurring with a determined delay (DRP) after ventricular activity (QRS), said circuitry detecting and range gating characteristic pulsed wave Doppler waveform (151, 153, 154) produced by the blood flow through the tricuspid cardiac valve (125) or, if the lead form claim 4 has two transducers, detecting characteristic continuous wave Doppler waveform in the same area.
Claim 12
Dependent Claim
42 words
Device according to claim 11, comprising means for discrimination between early diastolic filling wave (151) and atrial filling wave (153), as well as means for measurement of peak velocities (E, A) of both waves and calculation of time integrals of both waves.
Claim 13
Dependent Claim
30 words
Device according to claim 12, comprising means for ventricular pacing (I) synchronous with atrial filling wave (154) detected by said circuitry, whereby ventricular pacing maintains the physiologic atrio-ventricular delay (155).
Claim 14
Dependent Claim
39 words
Device according to claim 12 or 13, comprising means (160 to 163, 168, 169) for calculation of ratio of the peak velocities (E/A) of said filling wave and calculation of ratio of the time integrals of said filling waves.
Claim 15
Dependent Claim
66 words
Device according to claim 14, comprising means (160, 161) for beat to beat comparison of said ratios, and means for detection of consecutive decrease of said ratios indicating the high rate induced ischemia, as well as means (160, 161) for successive decrease of ventricular pacing rate in the case of high rate ischemia in such a way as to prevent the high rate induced cardiac ischemia.
Claim 16
Dependent Claim
66 words
Device according to any of claims 10 to 15 comprising means (160, 161, 167) for detection of atrial fibrillation i.e. the disappearance of said atrial filling wave as well as means (160, 161, 166) to maintain the rate responsive ventricular pacing while the atrial fibrillation is sustained, and means (160, 161, 166) to revert to synchronous ventricular pacing upon the occurrence of said atrial filling wave.
Claim 17
Dependent Claim
59 words
Device according to any of claims 12 to 16, comprising means (counter "RR" in 160) for measurement of the time interval between the ventricular pacing impulse and the said early diastolic wave, said interval QE being the sensor for rate-responsive pacing in such a way that the pacing rate increases whenever the said interval QE decreases and vice versa.
Claim 18
Dependent Claim
48 words
Device according to any of claims 12 to 17, comprising means for detection of missing ventricular contractions i.e. the disappearance of said early diastolic waves (151), and means to discriminate if the missing contractions are caused by the loss of capture or by the ventricular fibrillation or tachycardia.
Claim 19
Dependent Claim
45 words
Device according to any of claims 12 to 18, comprising means for detection of sudden decrease of said measured peak velocity (E) of the said early diastolic wave (151) in single beat, said sudden decrease indicating that said single beat is the ventricular premature beat.
Claim 20
Dependent Claim
47 words
Device according to any of claims 12 to 16, comprising means for rate responsive pacing in such a way as to monitor the peak velocity (E) of the early ventricular filling wave (151) and to increase the pacing rate whenever the velocity (E) increases and vice versa.
Claim 21
Dependent Claim
47 words
Device according to any of claims 12 to 16, comprising means for rate responsive pacing in such a way as to measure the diastolic filling period as well as the rapid filling period and to increase the pacing rate whenever the said periods decrease and vice versa.
Claim 22
Dependent Claim
42 words
Device according to any of claims 12 to 16, comprising means for rate responsive pacing in such a way as to measure and calculate the rapid filling fraction and to increase the pacing frequency whenever the said fraction decreases and vice versa.
References Cited (Backward Citations)
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