US5129394A
Expired / Lapsed
US
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Method and apparatus for controlling heart rate in proportion to left ventricular pressure
Assignee: Medtronic Inc
•
Filing: 1991-01-07
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Granted: 1992-07-14
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Expires: 2011-01-07
Abstract
Abstract A method and apparatus for sensing in vivo blood pressure proportional to the left ventricular pressure for detecting ventricular tachyarrhythmias or the cardiovascular status in congestive heart failure, and/or for adjusting the rate of a pacemaker. A lead with a pressure sensor near its distal end is placed transvenously through the coronary sinus and located in the coronary vein. When in place, a bulge or an inflatable balloon proximal to the pressure sensor may be used to acutely occlude the coronary vein until the sensor fibroses in. The balloon may be reinflated prior to pressure measurements. The pressure that is sensed in that location is proportional to the left ventricular pressure. Values representing the left ventricular pulse, systolic and diastolic pressures, as well as the differentiated rate of change (i.e., dP/dt), gross rate of change (ΔP/Δt) and mean or average of such pressure values are all or selectively developed by software algorithms and implemented in microprocessor based control circuitry. In one preferred embodiment, one or more of the values are utilized in software implemented algorithms to cause a pacemaker to pace the heart at a required rate to achieve a desired cardiac output. Alternatively, these left ventricular pressure related values may be employed to confirm the absence of mechanical pumping action of the heart which, in conjunction with other cardiac signals, confirm the existence of a tachyarrhythmia requiring anti-tachy pacing, cardioversion or defibrillation.
Inventors
- 👤 Rahul Mehra
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 06:53
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/36514; A61N1/36564; A61N1/3627
Claims Analysis
Total Claims: 44
Claim 1
Independent Claim
111 words
A method for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises: disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting a signal proportional to the left heart chamber blood pressure by said pressure transducer and providing a first signal in response to detection of normal heart pumping and a second signal in response to detection of abnormal heart pumping, characteristic of hemodynamic insufficiency; and supplying cardioversion energy to said heart in response to said second signal by application of stimulating pulses across said electrodes.
Claim 2
Independent Claim
111 words
A method for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises: disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting a signal proportional to the left heart chamber blood pressure by said pressure transducer and providing a first signal in response to detection of normal heart pumping and a second signal in response to detection of abnormal heart pumping, characteristic of hemodynamic insufficiency; and supplying cardioversion energy to said heart in response to said second signal by application of stimulating pulses across said electrodes.
Claim 3
Dependent Claim
40 words
The method of claim 1 wherein said step of disposing at least first and second electrodes further comprises the step of providing at least one of said electrodes in said coronary sinus region in specific relation with said pressure transducer.
Claim 4
Independent Claim
22 words
The method of claims 1 or 2 wherein said detecting step includes detecting a pressure proportional to left ventricular systolic blood pressure.
Claim 5
Independent Claim
21 words
The method of claims 1 or 2 wherein said detecting step includes detecting a pressure proportional to left ventricular pulse pressure.
Claim 6
Independent Claim
24 words
The method of claims 1 or 2 wherein said detecting step includes detecting a signal proportional to left ventricular peak to peak blood pressure.
Claim 7
Independent Claim
21 words
The method of claims 1 or 2 wherein said detecting step includes detecting differentiated time rate of change (dP/dt) pressure values.
Claim 8
Independent Claim
20 words
The method of claims 1 or 2 wherein said detecting step includes detecting time rate of change (ΔP/Δt) pressure values.
Claim 9
Dependent Claim
78 words
The method of claim 1 wherein said step of disposing a pressure transducer in the coronary sinus or coronary vein region further comprises: providing a pressure transducer in the distal portion of a lead body adapted to be inserted into the coronary sinus and from the coronary sinus into a coronary vein; and transvenously advancing said distal portion of said lead body through the superior vena cava, the right atrium, the coronary sinus, and into said coronary vein.
Claim 10
Dependent Claim
32 words
The method of claim 8 further comprising the step of: occluding the coronary vein proximal to the location of the pressure transducer when said pressure transducer is situated in the coronary vein.
Claim 11
Dependent Claim
30 words
The method of claim 9 wherein said step of occluding the coronary vein further comprises the step of: providing an occluding member on said lead proximal to said pressure transducer.
Claim 12
Dependent Claim
120 words
Apparatus for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises: means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus or coronary vein of the heart adjacent to the left heart chambers; means for detecting a pressure proportional to left heart chamber blood pressure by said pressure transducer and providing a first signal in response to normal heart pumping and a second signal in response to abnormal heart pumping characteristic of hemodynamic insufficiency; and means for supplying cardioverting energy to said heart in response to said second signal by application of stimulating pulses by means of said first and second electrodes.
Claim 13
Dependent Claim
120 words
Apparatus for controlling cardiac tachyarrhythmias by passing an electrical current through the heart which comprises: means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus or coronary vein of the heart adjacent to the left heart chambers; means for detecting a pressure proportional to left heart chamber blood pressure by said pressure transducer and providing a first signal in response to normal heart pumping and a second signal in response to abnormal heart pumping characteristic of hemodynamic insufficiency; and means for supplying cardioverting energy to said heart in response to said second signal by application of stimulating pulses by means of said first and second electrodes.
Claim 14
Dependent Claim
39 words
The apparatus of claim 11 wherein said means for disposing at least first and second electrodes further comprises means for providing at least one of said electrodes in said coronary sinus region in specific relation with said pressure transducer.
Claim 15
Independent Claim
25 words
The method of claims 11 or 12 wherein said means for detecting pressure includes means for detecting pressure proportional to left ventricular systolic blood pressure.
Claim 16
Independent Claim
24 words
The method of claims 11 or 12 wherein said means for detecting pressure includes means for detecting pressure proportional to left ventricular pulse pressure.
Claim 17
Independent Claim
27 words
The method of claims 11 or 12 wherein said means for detecting pressure includes means for detecting pressure proportional to left ventricular peak to peak blood pressure.
Claim 18
Independent Claim
25 words
The method of claims 11 or 12 wherein said means for detecting pressure includes means for detecting differentiated time rate of change (dP/dt) pressure values.
Claim 19
Independent Claim
25 words
The method of claims 11 or 12 wherein said means for detecting pressure includes means for detecting gross time rate of change (ΔP/Δt) pressure values.
Claim 20
Dependent Claim
54 words
The apparatus of claim 11 wherein said means for disposing a pressure transducer in the coronary sinus or coronary vein region further comprises: means for providing a pressure transducer in the distal portion of a lead body adapted to be inserted into the coronary sinus and from the coronary sinus into a coronary vein.
Claim 21
Dependent Claim
31 words
The apparatus of claim 18 further comprising: means for occluding said coronary vein proximal to the location of the pressure transducer when said pressure transducer is situated in said coronary vein.
Claim 22
Dependent Claim
29 words
The apparatus of claim 19 wherein said means for occluding the coronary vein further comprises: means for providing an occluding member on said lead proximal to said pressure transducer.
Claim 23
Independent Claim
84 words
A method for regulating cardiac pacing rate in response to a patient's left heart blood pressure which comprises: disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting pressure signals by said pressure transducer; providing a pacing rate control signal derived from said pressure signals; and supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal.
Claim 24
Independent Claim
84 words
A method for regulating cardiac pacing rate in response to a patient's left heart blood pressure which comprises: disposing at least first and second electrodes in relation to the heart; disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; detecting pressure signals by said pressure transducer; providing a pacing rate control signal derived from said pressure signals; and supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal.
Claim 25
Dependent Claim
40 words
The method of claim 21 wherein said step of disposing at least first and second electrodes further comprises the step of providing at least one of said electrodes in said coronary sinus region in specific relation with said pressure transducer.
Claim 26
Dependent Claim
75 words
The method of claim 21 wherein said step of disposing a pressure transducer in the coronary sinus region further comprises: providing a pressure transducer in the distal portion of a lead body adapted to be inserted into the coronary sinus and from the coronary sinus into a coronary vein; and transvenously advancing a distal portion of said lead body through the superior vena cava, the right atrium, the coronary sinus, and into a coronary vein.
Claim 27
Dependent Claim
25 words
The method of claim 21 or 23 wherein said step of detecting pressure signals includes detecting pressure signals proportional to left ventricular systolic block pressure.
Claim 28
Independent Claim
24 words
The method of claims 21 or 23 wherein said step of detecting pressure signals includes detecting pressure signals proportional to left ventricular pulse pressure.
Claim 29
Independent Claim
27 words
The method of claims 21 or 23 wherein said step of detecting pressure signals includes detecting left pressure signals proportional to ventricular peak to peak blood pressure.
Claim 30
Independent Claim
24 words
The method of claims 21 or 23 wherein said step of detecting pressure signals includes detecting differentiated time rate of change (dP/dt) pressure values.
Claim 31
Independent Claim
23 words
The method of claims 21 or 23 wherein said step of detecting pressure signals includes detecting time rate of change (ΔP/Δt) pressure values.
Claim 32
Dependent Claim
32 words
The method of claim 21 further comprising the step of: occluding said coronary vein proximal to the location of said pressure transducer when said pressure transducer is situated in said coronary vein.
Claim 33
Dependent Claim
30 words
The method of claim 29 wherein said step of occluding said coronary vein further comprises the step of: providing an occluding member on said lead proximal to said pressure transducer.
Claim 34
Dependent Claim
92 words
Apparatus for regulating cardiac pacing rate in response to a patient's left heart blood pressure which comprises: means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; means for detecting pressure signals by said pressure transducer and providing a pacing rate control signal derived from the pressure signal; and means for supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal.
Claim 35
Dependent Claim
92 words
Apparatus for regulating cardiac pacing rate in response to a patient's left heart blood pressure which comprises: means for disposing at least first and second electrodes in relation to the heart; means for disposing a pressure transducer within the coronary sinus region of the heart adjacent to the left heart chambers; means for detecting pressure signals by said pressure transducer and providing a pacing rate control signal derived from the pressure signal; and means for supplying pacing energy stimulation pulses to said electrodes at a rate established by said rate control signal.
Claim 36
Dependent Claim
39 words
The apparatus of claim 31 wherein said means for disposing at least first and second electrodes further comprises means for providing at least one of said electrodes in said coronary sinus region in specific relation with said pressure transducer.
Claim 37
Dependent Claim
51 words
The apparatus of claim 32 wherein the means for disposing a pressure transducer in the coronary sinus region further comprises: means for providing a pressure transducer in the distal portion of a lead body adapted to be inserted into the coronary sinus and from the coronary sinus into a coronary vein.
Claim 38
Independent Claim
26 words
The apparatus of claims 31 or 33 wherein said means for detecting pressure signals includes means for detecting signals proportional to left ventricular systolic blood pressure.
Claim 39
Independent Claim
25 words
The apparatus of claims 31 or 33 wherein said means for detecting pressure signals includes means for detecting signals proportional to left ventricular pulse pressure.
Claim 40
Independent Claim
28 words
The apparatus of claims 31 or 33 wherein said means for detecting pressure signals includes means for detecting signals proportional to left ventricular peak to peak blood pressure.
Claim 41
Independent Claim
26 words
The apparatus of claims 31 or 33 wherein said means for detecting pressure signals includes means for detecting differentiated time rate of change (dP/dt) pressure values.
Claim 42
Independent Claim
26 words
The apparatus of claims 31 or 33 wherein said means for detecting pressure signals includes means for detecting gross time rate of change (ΔP/Δt) pressure values.
Claim 43
Dependent Claim
30 words
The apparatus of claim 31 further comprising: means for occluding said coronary vein proximal to location of said pressure transducer when said pressure transducer is situated in said coronary vein.
Claim 44
Dependent Claim
29 words
The apparatus of claim 39 wherein said means for occluding said coronary vein further comprises: means for providing an occluding member on said lead proximal to the pressure transducer.
References Cited (Backward Citations)
US3358690A
Cited
USRE27757E
Cited
US3857399A
Cited
US4407296A
Cited
US4485813A
Cited
US4566456A
Cited
WO1987001947A1
Cited
US4774950A
Cited
US4899752A
Cited
US4899751A
Cited
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1995-07-14 | 1996-01-13 | 1996-07-14 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1999-07-14 | 2000-01-13 | 2000-07-14 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2003-07-14 | 2004-01-13 | 2004-07-14 | $7700.00 | Window Closed / Lapsed |