CA1056462A - Arrhythmia prevention apparatus - Google Patents
Arrhythmia prevention apparatusInfo
- Publication number
- CA1056462A CA1056462A CA230,040A CA230040A CA1056462A CA 1056462 A CA1056462 A CA 1056462A CA 230040 A CA230040 A CA 230040A CA 1056462 A CA1056462 A CA 1056462A
- Authority
- CA
- Canada
- Prior art keywords
- stimulation
- heart
- electrode
- multivibrator
- signals
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
Abstract
ABSTRACT OF THE DISCLOSURE
A device for preventing arrhythmias such as fibrillation in which a plurality of electrodes are placed at selected points on a heart to sense depolarizations. An astable multivibrator receives the depolarization signals from the electrodes and provides an output signal to a device which in turn provides cardiac stimulation signals to all of the electrodes on the heart for the purpose of preventing the arrhythmia. The multivibrator is preferably synchronized to the QRS complex of the heart with its refract-ory period. In a second embodiment of the device, separate sensing and stimulation electrodes are used.
A device for preventing arrhythmias such as fibrillation in which a plurality of electrodes are placed at selected points on a heart to sense depolarizations. An astable multivibrator receives the depolarization signals from the electrodes and provides an output signal to a device which in turn provides cardiac stimulation signals to all of the electrodes on the heart for the purpose of preventing the arrhythmia. The multivibrator is preferably synchronized to the QRS complex of the heart with its refract-ory period. In a second embodiment of the device, separate sensing and stimulation electrodes are used.
Description
10564~;2 BACKGROUND OP T~E INVENTION
Arrhythmias of the heart, such as fib~illation, are well known to those familiar with the art. Localized or diffuse lesions of the myocardium, which may result from any one of various reasons, often lead to a pronounced dispersion of refractivity. As a result, under certain cir-cumstances the heart does not experience a total, simultaneous depolarization, but rather there results an unequal repolari-zation which has a dispersed vulnerable phase. A depolariza-tion excitation interspersed during this vulnerable phase fi-nally leads to electrical fragmentation, and a consequential inception of ventricular fibrillation.
It is known that the proper application of an electrical shock to the heart can change a fibrillating heart back to synchronous action of all myocardial fibers, that is, the heart can be defibrillated. Defibrillation by electrical impulses to the heart is due to a regular development of propagation of electrical excitation by means of simultaneous switching o all myocardial fibers that have gone out of step to cause the arrhythmia. Many defibrillation devices are known in the prior art for providing a defibrillation pulse after the arrhythmia has commenced.
However, it has become apparent that electrical de-fibrillation is not an ideal means of therapy for arrhythmia problems, First of all, it is not immediately available in most cases, and even where implantable defibrillation devices are used, they provide stimulation signals only after the dangerous condition of arrhythmia already exists. Further, though imp~antable defibrillators were developed to eliminate existing ventricular fibrillation as rapidly as possible,
Arrhythmias of the heart, such as fib~illation, are well known to those familiar with the art. Localized or diffuse lesions of the myocardium, which may result from any one of various reasons, often lead to a pronounced dispersion of refractivity. As a result, under certain cir-cumstances the heart does not experience a total, simultaneous depolarization, but rather there results an unequal repolari-zation which has a dispersed vulnerable phase. A depolariza-tion excitation interspersed during this vulnerable phase fi-nally leads to electrical fragmentation, and a consequential inception of ventricular fibrillation.
It is known that the proper application of an electrical shock to the heart can change a fibrillating heart back to synchronous action of all myocardial fibers, that is, the heart can be defibrillated. Defibrillation by electrical impulses to the heart is due to a regular development of propagation of electrical excitation by means of simultaneous switching o all myocardial fibers that have gone out of step to cause the arrhythmia. Many defibrillation devices are known in the prior art for providing a defibrillation pulse after the arrhythmia has commenced.
However, it has become apparent that electrical de-fibrillation is not an ideal means of therapy for arrhythmia problems, First of all, it is not immediately available in most cases, and even where implantable defibrillation devices are used, they provide stimulation signals only after the dangerous condition of arrhythmia already exists. Further, though imp~antable defibrillators were developed to eliminate existing ventricular fibrillation as rapidly as possible,
- 2 -~05646Z
they can do so only after detection of the actual state of fibrillation;
and because of the high power requirements of the electrical shocks required to defibrillate, the operating time of such implantable defibril-lators is highly limited Further, even after detecting the advent of fibrillation, such prior art defibrillators require a discrete period of charge time before providing a defibrillation shock.
To overcome the problems discussed above, the apparatus of this invention was designed to prevent defibrillation by sensing heart depolar-izations and providing cardiac stimulation level pulses to the heart to overcome electrical fragmentation before it causes defibrillation or other arrhythmias.
SUMMARY OF THE INVENTION
The apparatus of this invention provides a piurality of electrodes connected in 9paced relation to a heart. A depolarization occurring at any point on the heart is first sensed by any one of the electrodes and then transmitted to a stimulation device which receives the signal from the electrode to supply stimulation pulses to the entire plurality of electrodes connected to the heart. By means of this technique of stimula-tion, an anti-fragmentation is achieved which has a counter-effect on ventricular fibrillation. The stimulation signal generator may be, for example, a synchronous demand cardiac pacer, but in any case will be a device synchronized to a normal depolarization of the heart such as the QRS complex.
Thus, in accordance with the invention, there is provided cardiac arrhythmias prevention apparatus comprising: first means for sensing depolarization at any one of a plurality of areas on a heart; second means for providing cardiac stimulation signals to a plurality of areas on the heart in rapid response to any sensed depolarization by the first means; and means connecting the first means to the second means.
.1 ~ ~ ~ -3-., ~
~056~6Z
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a block diagram of the first embodiment of the ~.
apparatus of this invention;
Figure 2 is a schematic diagram of portions of the diagram of Figure l; and -3a-BRIEF DESCRIPTION OF THE DRA~INGS
Figure 1 is a block diagram o the first embodiment of the apparat-us of this invention;
~ igure 2 is a schematic diagram of portions o the diagram of Figure l; and Figure 3 is a block diagram of a second embodiment of the apparatus of this invention.
DESCRIPTION OF THE INVENTION
In Figure 1, there is shown a first embodiment of the invention in which a plurality of terminals 10-14 are shown which are adapted to be con-nected to electrodes placed at various points on the heart ~not shown), which èlectrodes act both as sensing and stimulation electrodes.
Terminals 10, 11, 12, 13 and 14 are connected, respectively, to a plurality of input signal amplifiers 20, 21, 22, 23 and 24. Input amplif-iers 20-24 can be any one of a multiplicity of amplifiers well known to those skilled in the art, such as a single stage transistor amplifier.
The outputs of each amplifiers 20-24 are connected to the inputs of a five stage OR gate 25. The output of gate 25 is connected to timing circuitry 26. The output of timing circuitry 26 is connected to output pulse circuitry 27. The output of pulse circuitry 27 is connected to each of the inputs of a plurality of output amplifiers 30-34. The outputs of amplifiers 30, 31, 32, 33 and 34 are connected, respectively, to terminals 10, 11, 12, 13 and 14.
In operation, when a depolarization signal appears at any one of terminals 10-14, such a signal having been sensed at the related electrode attached to the heart, it will be amplified by the respect~Yeof amplifiers 20-24 and presented to gate 25. The signal will pass through gate 25 into timing circuitry 26. Circuitry 26 is more fully described in the discussion of Figure 2 below, however, to fully understand the operation of the circuit-ry of Figure 1, it must be recognized that circuitry 26 will operate in the manner of an astable multivibrator having a predetermined operating frequency and refraction period. If an input signal at any of terminals 10-14 reaches ~05646Z
circuitry 26 during the predetermined refractory period, thore will be no output from circuitry 26 to output pulse circuitry 27. Circuitry 26 is synchronized to the normal QRS waves rom the heart and will provide an out-put pulse when the QRS wave causes an input to circuitry 26. However, should a depolarization be sensed at any of the plurality of points on the heart at a time other than during the refractory period, this input to circuitry 26 will cause an output pulse to actuate output pulse circuitry 27.
Pulse circuitry 27, upon receiving an input signal, will provide an output stimulation pulse of predetermined width which will be amplified by each of amplifiers 30-34 to be felt on each of terminals 10-14, and thus s be provided to all of the electrodes on the heart for stimulation purposes.
Thus, an undesirable start of depolarization of an area of the myocardium will be sensed by any one or more of the electrodes and will result in a cardiac stimulation pulse to all of the electrodes. This cardiac stimulation will result in anti-fragmentation by capturing the entire heart comparatively quickly by bypassing the intraventricular interferences through the conduc-tions that are under voltage. Therefore, the input dispersion of refract-ivity is reduced, the vulnerable phase becomes narrower, and in this manner fibrillation is counter-effected in its nascent state.
Referring now to Figure 2, there are shown schematic diagrams of blocks 26 and 27 of Figure 1. Timing circuitry 26 is shown to the left of the vertical dashed liné of Figure 2, while output circuitry 27 is shown to the right of the dashed line.
In Figure 2 there is shown an input terminal 40 which is adapted to be connected to the output of gate 25 of Figure 1. Terminal 40 is con-nected through a capacitor 41 to the base of a transistor 42. The base of transistor 42 is also connected through a resistor 43 to a negative bus line 45. The emitter of transistor 42 is also connected to bus 45. The collector of transistor 42 is connected to the base of a transistor 46, and through a resistor 48 to a positive bus line 44. The emitter of transistor 46 is connected to negative bus 45, and the collector of transistor 46 is connected through a resistor 47 to bus 44. The collector of transistor 46 is also connected through a capacitor 49 to the base of a transistor 50, and through a resistor 51 to bus 44. The emitter of transistor 50 is connected to ~us 45. The collector of transistor 50 is connected through a resistor 52 to bus 44, through a capacitor 53 to the base of transistor 46, and through a capacitor 54 to the base of a transistor 55. The emitter of transistor 55 is connected to bus 44. The base of transistor 55 is connected through a resistor 56 to bus 44. The collector of transistor 55 is connected through a serial combination of a resistor 57 and a resistor 58 to bus 45. The base of transistor 55 is also connected through the serial combination of a resistor 61 and a capacitor 62 to the collector of a transistor 63. The base of transistor 63 is connected to a junction between resistors 57 and 58.
The collector of transistor 63 is also connected through a resistor 64 to bus 44. The emitter of transistor 63 is connected through a resistor 65 to bus 45, and is connected to an output terminal 66. Terminal 66 is adapted to bs connected to ampliiers 30-34 of Figure 3. Negative bus line 45 is connected to a negative power input terminal 67, and positive bus line 44 is connected to a positive voltage input terminal 68.
In operation, QRS signals and depolarization signals appearing at terminals 10-14 of Figure 1 will pass through amplifers 20-24 and gate 25 to appear at terminal 40 of Figure 2. This input signal will be felt on the base of transistor 42 to turn it on and switch transistor 46 to cut-off, Transistors 46 and 50, and their associated components, comprise an astable multivibrator. The output at the collector of transistor 50 is an asymmetrical square pulse, composed of, in the preferred embodiment, an 840 millisecond off or high portion, and a 160 millisecond on or low portion.
If a pulse ap~ears at the base of transistor 42, due to an input signal during the 840 millisecond off interval, transistor 46 will be switched to cut-off. As the collector of transistor 46 rises, transistor 50 will sat-urate due to the charge transferred to its base through capacitor 49. Thus, input pulses falling during the 840 millisecond off interval will shorten this off interval, and thereby increase the operation frequency of the astable multivibrator. The 160 millisecond on interval is referred to as the refractory period.
The trailing edge of the pulse appearing at the collector of transistor 50 will be felt through capacitor 54 on the base of transistor 55. Transistors 55 and 63 comprise a well-known monostable multivibrator, in conjunction with their associated components, which operates in a manner well known to those skilled in the art, to provide an output at terminal 66 for a predetermined pulse duration. Terminal 66 is connected to the inputs of amplifiers 30-34 of Figure 1, and thus the trailing edge of the pulse appearing at the collector of transistor 50 will cause stimulation pulses to appear through all of the terminals 10-14 to all of the electrodes con-nected in spaced relation on the heart.
Timing circuitry 26 can be likened to an R-wave synchronize~ pulse generator. That is, it has a predetermined operating frequency with a pre- `~
determined reractory period. Pulses falling outside the refractory period will shorten the operation frequency o the circuitry, and result in an output stimulation pulse. Pulses falling during the refractory period will ~ `
not result in stlmulation pulses to the heart. By synchronizing the output pulses to the QRS complex, through proper selection of the operation frequency and refractory period, undesirable side effects of rhythmical stimulations are avoided. The 1 Hz operation frequency chosen for the above described embodiment is only an example, but is preferred because, with a 160 millisecond refractory period, it allows synchronization to a maximum rate o 315 pulses per minute.
Referring now to Figure 3, there is shown a second embodiment of the apparatus of this invention in which separate leads are used for sensing heart depolarizations and for stimulating the heart. Again in Figure 3, the ~ell known electrodes are not shown but terminals adapted to be connected to the electrodes are depicted.
A plurality of terminals 70-74 are shown and are adapted to be connected to a plurality of sensing electrodes placed in space relation on the heart. ~erminals 70, 71, 72, 73 and 74 are connected, respectively, to amplifiers 20-24. Amplifiers 20-24 are again connected through gate 25 to circuitry 26, which is in turn connected to circuitry 27. The output of circuitry 27 is connected to the inputs o amplifiars 30-34. In Figure 3 the outputs of amplifers 30-34 are connected to, respectively, terminals 80, 81, 82, 83 and 84. In the embodiment of ~igure 3, terminals 80-84 are adapted to be connected to a second plurality of electrodes connected in spaced relation on the heart for purposes of providing stimulation signals to the heart.
The operation of the apparatus of Figure 3 is exactly the same as that described above for Figures 1, and 2, with the single exception that the stimulation signals are provided to separate electrodes from the electrodes which perform the sensing function.
From the above description of the apparatus of this invention, it will be apparent that there may be other embodiments other than the pre-erred embodiments shown which are capable of performing the ibrillation p~evention function o this invention, but which will still be within the scope of this invention. It should also be noted that the fibrillation prevention apparatus of this invention has been tested clinically on animals and has been shown to be an effective means of preventing the arrhythmia.
they can do so only after detection of the actual state of fibrillation;
and because of the high power requirements of the electrical shocks required to defibrillate, the operating time of such implantable defibril-lators is highly limited Further, even after detecting the advent of fibrillation, such prior art defibrillators require a discrete period of charge time before providing a defibrillation shock.
To overcome the problems discussed above, the apparatus of this invention was designed to prevent defibrillation by sensing heart depolar-izations and providing cardiac stimulation level pulses to the heart to overcome electrical fragmentation before it causes defibrillation or other arrhythmias.
SUMMARY OF THE INVENTION
The apparatus of this invention provides a piurality of electrodes connected in 9paced relation to a heart. A depolarization occurring at any point on the heart is first sensed by any one of the electrodes and then transmitted to a stimulation device which receives the signal from the electrode to supply stimulation pulses to the entire plurality of electrodes connected to the heart. By means of this technique of stimula-tion, an anti-fragmentation is achieved which has a counter-effect on ventricular fibrillation. The stimulation signal generator may be, for example, a synchronous demand cardiac pacer, but in any case will be a device synchronized to a normal depolarization of the heart such as the QRS complex.
Thus, in accordance with the invention, there is provided cardiac arrhythmias prevention apparatus comprising: first means for sensing depolarization at any one of a plurality of areas on a heart; second means for providing cardiac stimulation signals to a plurality of areas on the heart in rapid response to any sensed depolarization by the first means; and means connecting the first means to the second means.
.1 ~ ~ ~ -3-., ~
~056~6Z
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a block diagram of the first embodiment of the ~.
apparatus of this invention;
Figure 2 is a schematic diagram of portions of the diagram of Figure l; and -3a-BRIEF DESCRIPTION OF THE DRA~INGS
Figure 1 is a block diagram o the first embodiment of the apparat-us of this invention;
~ igure 2 is a schematic diagram of portions o the diagram of Figure l; and Figure 3 is a block diagram of a second embodiment of the apparatus of this invention.
DESCRIPTION OF THE INVENTION
In Figure 1, there is shown a first embodiment of the invention in which a plurality of terminals 10-14 are shown which are adapted to be con-nected to electrodes placed at various points on the heart ~not shown), which èlectrodes act both as sensing and stimulation electrodes.
Terminals 10, 11, 12, 13 and 14 are connected, respectively, to a plurality of input signal amplifiers 20, 21, 22, 23 and 24. Input amplif-iers 20-24 can be any one of a multiplicity of amplifiers well known to those skilled in the art, such as a single stage transistor amplifier.
The outputs of each amplifiers 20-24 are connected to the inputs of a five stage OR gate 25. The output of gate 25 is connected to timing circuitry 26. The output of timing circuitry 26 is connected to output pulse circuitry 27. The output of pulse circuitry 27 is connected to each of the inputs of a plurality of output amplifiers 30-34. The outputs of amplifiers 30, 31, 32, 33 and 34 are connected, respectively, to terminals 10, 11, 12, 13 and 14.
In operation, when a depolarization signal appears at any one of terminals 10-14, such a signal having been sensed at the related electrode attached to the heart, it will be amplified by the respect~Yeof amplifiers 20-24 and presented to gate 25. The signal will pass through gate 25 into timing circuitry 26. Circuitry 26 is more fully described in the discussion of Figure 2 below, however, to fully understand the operation of the circuit-ry of Figure 1, it must be recognized that circuitry 26 will operate in the manner of an astable multivibrator having a predetermined operating frequency and refraction period. If an input signal at any of terminals 10-14 reaches ~05646Z
circuitry 26 during the predetermined refractory period, thore will be no output from circuitry 26 to output pulse circuitry 27. Circuitry 26 is synchronized to the normal QRS waves rom the heart and will provide an out-put pulse when the QRS wave causes an input to circuitry 26. However, should a depolarization be sensed at any of the plurality of points on the heart at a time other than during the refractory period, this input to circuitry 26 will cause an output pulse to actuate output pulse circuitry 27.
Pulse circuitry 27, upon receiving an input signal, will provide an output stimulation pulse of predetermined width which will be amplified by each of amplifiers 30-34 to be felt on each of terminals 10-14, and thus s be provided to all of the electrodes on the heart for stimulation purposes.
Thus, an undesirable start of depolarization of an area of the myocardium will be sensed by any one or more of the electrodes and will result in a cardiac stimulation pulse to all of the electrodes. This cardiac stimulation will result in anti-fragmentation by capturing the entire heart comparatively quickly by bypassing the intraventricular interferences through the conduc-tions that are under voltage. Therefore, the input dispersion of refract-ivity is reduced, the vulnerable phase becomes narrower, and in this manner fibrillation is counter-effected in its nascent state.
Referring now to Figure 2, there are shown schematic diagrams of blocks 26 and 27 of Figure 1. Timing circuitry 26 is shown to the left of the vertical dashed liné of Figure 2, while output circuitry 27 is shown to the right of the dashed line.
In Figure 2 there is shown an input terminal 40 which is adapted to be connected to the output of gate 25 of Figure 1. Terminal 40 is con-nected through a capacitor 41 to the base of a transistor 42. The base of transistor 42 is also connected through a resistor 43 to a negative bus line 45. The emitter of transistor 42 is also connected to bus 45. The collector of transistor 42 is connected to the base of a transistor 46, and through a resistor 48 to a positive bus line 44. The emitter of transistor 46 is connected to negative bus 45, and the collector of transistor 46 is connected through a resistor 47 to bus 44. The collector of transistor 46 is also connected through a capacitor 49 to the base of a transistor 50, and through a resistor 51 to bus 44. The emitter of transistor 50 is connected to ~us 45. The collector of transistor 50 is connected through a resistor 52 to bus 44, through a capacitor 53 to the base of transistor 46, and through a capacitor 54 to the base of a transistor 55. The emitter of transistor 55 is connected to bus 44. The base of transistor 55 is connected through a resistor 56 to bus 44. The collector of transistor 55 is connected through a serial combination of a resistor 57 and a resistor 58 to bus 45. The base of transistor 55 is also connected through the serial combination of a resistor 61 and a capacitor 62 to the collector of a transistor 63. The base of transistor 63 is connected to a junction between resistors 57 and 58.
The collector of transistor 63 is also connected through a resistor 64 to bus 44. The emitter of transistor 63 is connected through a resistor 65 to bus 45, and is connected to an output terminal 66. Terminal 66 is adapted to bs connected to ampliiers 30-34 of Figure 3. Negative bus line 45 is connected to a negative power input terminal 67, and positive bus line 44 is connected to a positive voltage input terminal 68.
In operation, QRS signals and depolarization signals appearing at terminals 10-14 of Figure 1 will pass through amplifers 20-24 and gate 25 to appear at terminal 40 of Figure 2. This input signal will be felt on the base of transistor 42 to turn it on and switch transistor 46 to cut-off, Transistors 46 and 50, and their associated components, comprise an astable multivibrator. The output at the collector of transistor 50 is an asymmetrical square pulse, composed of, in the preferred embodiment, an 840 millisecond off or high portion, and a 160 millisecond on or low portion.
If a pulse ap~ears at the base of transistor 42, due to an input signal during the 840 millisecond off interval, transistor 46 will be switched to cut-off. As the collector of transistor 46 rises, transistor 50 will sat-urate due to the charge transferred to its base through capacitor 49. Thus, input pulses falling during the 840 millisecond off interval will shorten this off interval, and thereby increase the operation frequency of the astable multivibrator. The 160 millisecond on interval is referred to as the refractory period.
The trailing edge of the pulse appearing at the collector of transistor 50 will be felt through capacitor 54 on the base of transistor 55. Transistors 55 and 63 comprise a well-known monostable multivibrator, in conjunction with their associated components, which operates in a manner well known to those skilled in the art, to provide an output at terminal 66 for a predetermined pulse duration. Terminal 66 is connected to the inputs of amplifiers 30-34 of Figure 1, and thus the trailing edge of the pulse appearing at the collector of transistor 50 will cause stimulation pulses to appear through all of the terminals 10-14 to all of the electrodes con-nected in spaced relation on the heart.
Timing circuitry 26 can be likened to an R-wave synchronize~ pulse generator. That is, it has a predetermined operating frequency with a pre- `~
determined reractory period. Pulses falling outside the refractory period will shorten the operation frequency o the circuitry, and result in an output stimulation pulse. Pulses falling during the refractory period will ~ `
not result in stlmulation pulses to the heart. By synchronizing the output pulses to the QRS complex, through proper selection of the operation frequency and refractory period, undesirable side effects of rhythmical stimulations are avoided. The 1 Hz operation frequency chosen for the above described embodiment is only an example, but is preferred because, with a 160 millisecond refractory period, it allows synchronization to a maximum rate o 315 pulses per minute.
Referring now to Figure 3, there is shown a second embodiment of the apparatus of this invention in which separate leads are used for sensing heart depolarizations and for stimulating the heart. Again in Figure 3, the ~ell known electrodes are not shown but terminals adapted to be connected to the electrodes are depicted.
A plurality of terminals 70-74 are shown and are adapted to be connected to a plurality of sensing electrodes placed in space relation on the heart. ~erminals 70, 71, 72, 73 and 74 are connected, respectively, to amplifiers 20-24. Amplifiers 20-24 are again connected through gate 25 to circuitry 26, which is in turn connected to circuitry 27. The output of circuitry 27 is connected to the inputs o amplifiars 30-34. In Figure 3 the outputs of amplifers 30-34 are connected to, respectively, terminals 80, 81, 82, 83 and 84. In the embodiment of ~igure 3, terminals 80-84 are adapted to be connected to a second plurality of electrodes connected in spaced relation on the heart for purposes of providing stimulation signals to the heart.
The operation of the apparatus of Figure 3 is exactly the same as that described above for Figures 1, and 2, with the single exception that the stimulation signals are provided to separate electrodes from the electrodes which perform the sensing function.
From the above description of the apparatus of this invention, it will be apparent that there may be other embodiments other than the pre-erred embodiments shown which are capable of performing the ibrillation p~evention function o this invention, but which will still be within the scope of this invention. It should also be noted that the fibrillation prevention apparatus of this invention has been tested clinically on animals and has been shown to be an effective means of preventing the arrhythmia.
Claims (12)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. Cardiac arrhythmia prevention apparatus comprising: first means for sensing depolarization at any one of a plurality of areas on a heart;
second means for providing cardiac stimulation signals to a plurality of areas on the heart in rapid response to any sensed depolarization by the first means; and means connecting the first means to the second means.
second means for providing cardiac stimulation signals to a plurality of areas on the heart in rapid response to any sensed depolarization by the first means; and means connecting the first means to the second means.
2. The apparatus of claim 1 in which: the first means includes multivibrator means having a predetermined refractory period; and the second means includes means for limiting stimulation pulses to a duration shorter than said refractory period and occurring during said refractory period.
3. The apparatus of claim 2 in which the multivibrator means include means for setting said refractory period at a time value which allows syn-chronization of the stimulation signals with cardiac QRS signals.
4. The apparatus of claim 1 in which: the first means includes a plurality of electrode means adapted to be connected in spaced relation on the heart; and the second means includes means for responding rapidly to a signal from any one of the electrode means to provide cardiac stimulation signals to all the electrode means.
5. The apparatus of claim 4 in which: the means for responding includes means for synchronizing the stimulation signals to the cardiac QRS
signals.
signals.
6. The apparatus of claim 1 in which: the first means includes a plurality of sensing electrode means adapted to be connected in spaced relation on the heart; and the second means includes a plurality of stimulation electrode means adapted to be connected in spaced relation on the heart and means for responding to a heart depolarization sensed from any one of the sensing electrode means to rapidly provide stimulation signals on all of the stimulation electrodes.
7. The apparatus of claim 6 in which: the means for responding includes means for synchronizing the stimulation signals to the cardiac QRS
signals.
signals.
8. The apparatus of claim 6 in which: the plurality of sensing and stimulation electrode means comprise the same set of electrode means in spaced relation on the heart; the first means includes input means connected to the electrode means including means for responding to depolar-izations on any of the electrode means to provide a signal; and the second means includes output means connected to the electrode means; multivibrator means having a preset refractory period and an operation frequency which is variable in response to signals from the input means; means connecting the multivibrator means between the input means and the output means; and the output means including means for responding to the multivibrator means to provide heart stimulation signals to all the electrode means.
9. The apparatus of claim 6 in which: the first means includes input means connected to the sensing electrode means; the input means including means for responding to depolarizations on any of the sensing electrode means to provide a signal; and the second means includes output means connected to the stimulation electrode means; multivibrator means having a preset refractory period and an operation frequency variable in response to signals from the input means; means connecting the multivibrator means between the input means and the output means; means in the multi-vibrator means responsive to the input means signal to provide another signal; and the output means including means for responding to the multi-vibrator means signal to provide heart stimulation signals to all the stimulation electrode means.
10. The apparatus of claim 8 in which: the input means includes input amplifier means connected to the electrodes and the multivibrator means; and the second means includes output amplifier means connected to the multivibrator means and the electrodes, and responsive to an output signal of the multivibrator means to provide heart stimulation signals simultaneously to all the electrodes.
11. The apparatus of claim 10 in which: the multivibrator means has a refractory period longer than the duration of the stimulation signals.
12. The apparatus of claim 7 in which: the synchronizing means comprises an R-wave synchronous pulse generator having input means and output means; the generator input means connected to the sensing electrode means and the generator output means connected to the stimulation electrode means; and the generator including means for providing cardiac stimulation pulses to all the stimulation electrode means in response to a signal from at least one of the sense electrodes.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US05/487,241 US3937226A (en) | 1974-07-10 | 1974-07-10 | Arrhythmia prevention apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1056462A true CA1056462A (en) | 1979-06-12 |
Family
ID=23934936
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA230,040A Expired CA1056462A (en) | 1974-07-10 | 1975-06-24 | Arrhythmia prevention apparatus |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US3937226A (en) |
| JP (2) | JPS5131088A (en) |
| CA (1) | CA1056462A (en) |
| DE (1) | DE2528817C2 (en) |
| FR (1) | FR2277573A1 (en) |
| GB (1) | GB1503174A (en) |
| NL (1) | NL182779C (en) |
| SE (1) | SE412166B (en) |
Families Citing this family (89)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4088140A (en) * | 1976-06-18 | 1978-05-09 | Medtronic, Inc. | Demand anti-arrhythmia pacemaker |
| US4354497A (en) * | 1977-05-23 | 1982-10-19 | Medtronic, Inc. | Cardiac depolarization detection apparatus |
| US4181133A (en) * | 1978-05-22 | 1980-01-01 | Arco Medical Products Company | Programmable tachycardia pacer |
| US4365639A (en) * | 1980-02-07 | 1982-12-28 | Applied Cardiac Electrophysiology | Catheter, cardiac pacemaker and method of pacing |
| US4630611A (en) * | 1981-02-02 | 1986-12-23 | Medtronic, Inc. | Orthogonally-sensing lead |
| DE3115124A1 (en) * | 1981-04-10 | 1982-11-04 | Biotronik Meß- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin, 1000 Berlin | "HEART PACEMAKER" |
| US4750494A (en) * | 1981-05-12 | 1988-06-14 | Medtronic, Inc. | Automatic implantable fibrillation preventer |
| US4754753A (en) * | 1981-05-12 | 1988-07-05 | Medtronic, Inc. | System for sensing electrical depolarization wave signals and their direction |
| DE3127597A1 (en) * | 1981-07-13 | 1983-02-17 | Siemens AG, 1000 Berlin und 8000 München | METHOD AND PACEMAKER FOR BIFOCAL STIMULATION OF THE HEART |
| SE8107269L (en) * | 1981-12-04 | 1983-06-05 | Siemens Elema Ab | DEVICE FOR ENDING A TAKYCARDI |
| US4708145A (en) * | 1982-06-01 | 1987-11-24 | Medtronic, Inc. | Sequential-pulse, multiple pathway defibrillation method |
| US4548203A (en) * | 1982-06-01 | 1985-10-22 | Purdue Research Foundation | Sequential-pulse, multiple pathway defibrillation method |
| US4554922A (en) * | 1982-09-30 | 1985-11-26 | Prystowsky Eric N | Method of inhibiting cardiac arrhythmias |
| DE3523226A1 (en) * | 1985-06-28 | 1987-01-08 | Osypka Peter | DEFIBRILLATION ELECTRODE |
| US4928688A (en) * | 1989-01-23 | 1990-05-29 | Mieczyslaw Mirowski | Method and apparatus for treating hemodynamic disfunction |
| USRE38119E1 (en) | 1989-01-23 | 2003-05-20 | Mirowski Family Ventures, LLC | Method and apparatus for treating hemodynamic disfunction |
| US4969463A (en) * | 1989-06-06 | 1990-11-13 | Cardiac Pacemakers, Inc. | Defibrillation electrode and method for employing gatling discharge defibrillation |
| US5281219A (en) * | 1990-11-23 | 1994-01-25 | Medtronic, Inc. | Multiple stimulation electrodes |
| US5107834A (en) * | 1991-01-30 | 1992-04-28 | Cardiac Pacemakers, Inc. | Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration |
| US5158079A (en) * | 1991-02-25 | 1992-10-27 | Incontrol, Inc. | Implantable device for preventing tachyarrhythmias |
| US5209229A (en) * | 1991-05-20 | 1993-05-11 | Telectronics Pacing Systems, Inc. | Apparatus and method employing plural electrode configurations for cardioversion of atrial fibrillation in an arrhythmia control system |
| AU1736392A (en) * | 1991-06-11 | 1992-12-17 | Raymond E. Ideker | Reduced current cardiac pacing apparatus |
| US5243978A (en) * | 1991-10-07 | 1993-09-14 | Medtronic, Inc. | Method and apparatus for wide area antitachycardia pacing |
| US5366486A (en) * | 1992-06-25 | 1994-11-22 | Indiana University Foundation | Automatic fibrillation detector and defibrillator apparatus and method |
| US5782890A (en) * | 1992-07-01 | 1998-07-21 | Medtronic, Inc. | Method for heart transplant monitoring and analog telemetry calibration |
| US5403356A (en) * | 1993-04-28 | 1995-04-04 | Medtronic, Inc. | Method and apparatus for prevention of atrial tachy arrhythmias |
| US5411531A (en) * | 1993-09-23 | 1995-05-02 | Medtronic, Inc. | Method and apparatus for control of A-V interval |
| US5447519A (en) * | 1994-03-19 | 1995-09-05 | Medtronic, Inc. | Method and apparatus for discrimination of monomorphic and polymorphic arrhythmias and for treatment thereof |
| US5476503A (en) * | 1994-03-28 | 1995-12-19 | Pacesetter, Inc. | Sense array intelligent patch lead for an implantable defibrillator and method |
| JP3212611B2 (en) * | 1994-04-21 | 2001-09-25 | メドトロニック・インコーポレーテッド | Implantable medical device for eliminating atrial fibrillation |
| US5562708A (en) * | 1994-04-21 | 1996-10-08 | Medtronic, Inc. | Method and apparatus for treatment of atrial fibrillation |
| US5713924A (en) * | 1995-06-27 | 1998-02-03 | Medtronic, Inc. | Defibrillation threshold reduction system |
| US6904318B2 (en) * | 2000-09-26 | 2005-06-07 | Medtronic, Inc. | Method and system for monitoring and controlling systemic and pulmonary circulation during a medical procedure |
| US5683429A (en) * | 1996-04-30 | 1997-11-04 | Medtronic, Inc. | Method and apparatus for cardiac pacing to prevent atrial fibrillation |
| US6449507B1 (en) * | 1996-04-30 | 2002-09-10 | Medtronic, Inc. | Method and system for nerve stimulation prior to and during a medical procedure |
| US7269457B2 (en) * | 1996-04-30 | 2007-09-11 | Medtronic, Inc. | Method and system for vagal nerve stimulation with multi-site cardiac pacing |
| US6628987B1 (en) * | 2000-09-26 | 2003-09-30 | Medtronic, Inc. | Method and system for sensing cardiac contractions during vagal stimulation-induced cardiopalegia |
| US8036741B2 (en) * | 1996-04-30 | 2011-10-11 | Medtronic, Inc. | Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure |
| US20040199209A1 (en) * | 2003-04-07 | 2004-10-07 | Hill Michael R.S. | Method and system for delivery of vasoactive drugs to the heart prior to and during a medical procedure |
| US5720768A (en) * | 1996-05-22 | 1998-02-24 | Sulzer Intermedics Inc. | Dual chamber pacing with interchamber delay |
| US5873896A (en) * | 1997-05-27 | 1999-02-23 | Uab Research Foundation | Cardiac device for reducing arrhythmia |
| US5871508A (en) * | 1997-08-06 | 1999-02-16 | Medtronic, Inc. | Apparatus for cardiac pacing in transplant |
| US6479523B1 (en) * | 1997-08-26 | 2002-11-12 | Emory University | Pharmacologic drug combination in vagal-induced asystole |
| US6556862B2 (en) | 1998-03-19 | 2003-04-29 | Cardiac Pacemakers, Inc. | Method and apparatus for treating supraventricular tachyarrhythmias |
| US6246906B1 (en) | 1998-03-19 | 2001-06-12 | Cardiac Pacemakers, Inc. | System and method for treating atrial arrhythmias |
| US6122545A (en) * | 1998-04-28 | 2000-09-19 | Medtronic, Inc. | Multiple channel sequential cardiac pacing method |
| US6463334B1 (en) | 1998-11-02 | 2002-10-08 | Cardiac Pacemakers, Inc. | Extendable and retractable lead |
| US6501990B1 (en) * | 1999-12-23 | 2002-12-31 | Cardiac Pacemakers, Inc. | Extendable and retractable lead having a snap-fit terminal connector |
| DE69925493T2 (en) | 1998-08-17 | 2006-01-26 | Medtronic, Inc., Minneapolis | DEVICE FOR PREVENTING FOREST STYRIUM ARRHYTHMS |
| WO2000009206A1 (en) | 1998-08-17 | 2000-02-24 | Medtronic, Inc. | Method and apparatus for prevention of atrial tachyarrhythmias |
| US6466820B1 (en) | 1998-12-29 | 2002-10-15 | Medtronic, Inc. | Multi-site cardiac pacing system having trigger pace window |
| US6456878B1 (en) | 1998-12-29 | 2002-09-24 | Medtronic, Inc. | Cardiac pacing system delivering multi-site pacing in a predetermined sequence triggered by a sense event |
| US6496730B1 (en) | 1998-12-29 | 2002-12-17 | Medtronic, Inc. | Multi-site cardiac pacing system having conditional refractory period |
| US6477415B1 (en) | 1998-12-29 | 2002-11-05 | Medtronic, Inc. | AV synchronous cardiac pacing system delivering multi-site ventricular pacing triggered by a ventricular sense event during the AV delay |
| US6078837A (en) | 1999-01-27 | 2000-06-20 | Medtronic, Inc. | Method and apparatus for treatment of fibrillation |
| US6868287B1 (en) | 1999-02-12 | 2005-03-15 | The Trustees Of Columbia University In The City Of New York | Cardiac remodeling |
| US7840278B1 (en) * | 1999-06-25 | 2010-11-23 | Puskas John D | Devices and methods for vagus nerve stimulation |
| US6324425B1 (en) | 1999-07-28 | 2001-11-27 | Medtronic, Inc., | Recharge circuitry for multi-site stimulation of body tissue |
| US6363288B1 (en) | 1999-08-20 | 2002-03-26 | Pacesetter, Inc. | CS lead with single site sensing and dual site pacing |
| US6421564B1 (en) | 1999-11-12 | 2002-07-16 | Medtronic, Inc. | Bi-chamber cardiac pacing system employing unipolar left heart chamber lead in combination with bipolar right chamber lead |
| US6847842B1 (en) | 2000-05-15 | 2005-01-25 | Cardiac Pacemakers, Inc. | Method and apparatus for reducing early recurrence of atrial fibrillation with defibrillation shock therapy |
| US6487446B1 (en) * | 2000-09-26 | 2002-11-26 | Medtronic, Inc. | Method and system for spinal cord stimulation prior to and during a medical procedure |
| US6609028B2 (en) | 2001-04-26 | 2003-08-19 | Medtronic, Inc. | PVC response-triggered blanking in a cardiac pacing system |
| US6804555B2 (en) | 2001-06-29 | 2004-10-12 | Medtronic, Inc. | Multi-site ventricular pacing system measuring QRS duration |
| US6668194B2 (en) | 2001-07-16 | 2003-12-23 | Medtronic, Inc. | Method and apparatus for monitoring conduction times in a bi-chamber pacing system |
| US6871096B2 (en) * | 2001-10-26 | 2005-03-22 | Medtronic, Inc. | System and method for bi-ventricular fusion pacing |
| US20050027323A1 (en) * | 2001-10-30 | 2005-02-03 | Medtronic, Inc. | Implantable medical device for monitoring cardiac blood pressure and chamber dimension |
| US6795732B2 (en) * | 2001-10-30 | 2004-09-21 | Medtronic, Inc. | Implantable medical device employing sonomicrometer output signals for detection and measurement of cardiac mechanical function |
| US6959214B2 (en) | 2001-11-28 | 2005-10-25 | Medtronic, Inc. | Implantable medical device for measuring mechanical heart function |
| US7146214B2 (en) * | 2002-04-22 | 2006-12-05 | Medtronic, Inc. | Anti-tachycardia pacing based on multi-site electrograms |
| AU2003239474A1 (en) | 2002-05-17 | 2003-12-02 | Stan F. Obino | Device and method for the treatment of cardiac disorders |
| US20040088014A1 (en) * | 2002-10-31 | 2004-05-06 | Burnes John E. | Multi-site anti-tachycardia pacing with programmable delay period |
| US7321794B2 (en) * | 2002-11-15 | 2008-01-22 | Advanced Bionics Corporation | Method and system for treating atrial fibrillation |
| US6889083B2 (en) * | 2003-04-21 | 2005-05-03 | Medtronic, Inc. | Atrial tracking recovery to restore cardiac resynchronization therapy in dual chamber tracking modes |
| US7231249B2 (en) * | 2003-07-24 | 2007-06-12 | Mirowski Family Ventures, L.L.C. | Methods, apparatus, and systems for multiple stimulation from a single stimulator |
| US7027866B2 (en) | 2003-07-29 | 2006-04-11 | Medtronic, Inc. | Mechanically-based interval optimization for a biventricular pacing engine |
| US20050055057A1 (en) * | 2003-09-05 | 2005-03-10 | Mirowski Famliy Ventures, L.L.C. | Method and apparatus for providing ipselateral therapy |
| US20050055058A1 (en) * | 2003-09-08 | 2005-03-10 | Mower Morton M. | Method and apparatus for intrachamber resynchronization |
| US7203540B2 (en) * | 2003-12-22 | 2007-04-10 | Cardiac Pacemakers, Inc. | Method and system for setting cardiac resynchronization therapy parameters |
| US7123960B2 (en) | 2003-12-22 | 2006-10-17 | Cardiac Pacemakers, Inc. | Method and system for delivering cardiac resynchronization therapy with variable atrio-ventricular delay |
| US8112149B2 (en) * | 2006-02-27 | 2012-02-07 | Monitoring Information Technologies, Inc. | System and method for heart and activity monitoring |
| US8620425B2 (en) | 2010-04-29 | 2013-12-31 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
| US8639327B2 (en) | 2010-04-29 | 2014-01-28 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
| US8888699B2 (en) | 2010-04-29 | 2014-11-18 | Medtronic, Inc. | Therapy using perturbation and effect of physiological systems |
| US8718763B2 (en) | 2011-01-19 | 2014-05-06 | Medtronic, Inc. | Vagal stimulation |
| US8781583B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
| US8725259B2 (en) | 2011-01-19 | 2014-05-13 | Medtronic, Inc. | Vagal stimulation |
| US8706223B2 (en) | 2011-01-19 | 2014-04-22 | Medtronic, Inc. | Preventative vagal stimulation |
| US8781582B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
Family Cites Families (16)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3108597A (en) * | 1958-09-12 | 1963-10-29 | Relaxacizor Inc | Generator for electronic muscle stimulator |
| US3144019A (en) * | 1960-08-08 | 1964-08-11 | Haber Edgar | Cardiac monitoring device |
| US3138151A (en) * | 1962-06-11 | 1964-06-23 | Robert L Chapman | Detector and alarm ventricular impulses |
| US3244174A (en) * | 1964-01-31 | 1966-04-05 | Gen Electric | Body implantable conductor |
| US3345990A (en) * | 1964-06-19 | 1967-10-10 | American Optical Corp | Heart-beat pacing apparatus |
| US3478746A (en) * | 1965-05-12 | 1969-11-18 | Medtronic Inc | Cardiac implantable demand pacemaker |
| US3433228A (en) * | 1966-05-06 | 1969-03-18 | Cordis Corp | Multimode cardiac pacer |
| US3667477A (en) * | 1966-11-25 | 1972-06-06 | Canadian Patents Dev | Implantable vesical stimulator |
| DE1919246C3 (en) * | 1968-07-27 | 1981-07-30 | Harmjanz, Dietrich, Prof. Dr.Med., 3101 Gross Hehlen | Electrode arrangement for electrical stimulation of the right ventricle |
| GB1227186A (en) * | 1968-09-18 | 1971-04-07 | ||
| US3747604A (en) * | 1969-12-15 | 1973-07-24 | American Optical Corp | Atrial and ventricular demand pacer with separate atrial and ventricular beat detectors |
| CA1000366A (en) * | 1971-03-15 | 1976-11-23 | Mieczyslaw Mirowski | Cardioverter having single intravascular catheter electrode system |
| US3814104A (en) * | 1971-07-05 | 1974-06-04 | W Irnich | Pacemaker-electrode |
| US3815611A (en) * | 1971-11-26 | 1974-06-11 | Medtronic Inc | Muscle stimulation and/or contraction detection device |
| US3805795A (en) * | 1972-03-17 | 1974-04-23 | Medtronic Inc | Automatic cardioverting circuit |
| JPS5212733B2 (en) * | 1972-05-04 | 1977-04-09 |
-
1974
- 1974-07-10 US US05/487,241 patent/US3937226A/en not_active Expired - Lifetime
-
1975
- 1975-06-24 CA CA230,040A patent/CA1056462A/en not_active Expired
- 1975-06-26 GB GB27115/75A patent/GB1503174A/en not_active Expired
- 1975-06-27 DE DE2528817A patent/DE2528817C2/en not_active Expired
- 1975-07-03 FR FR7520894A patent/FR2277573A1/en active Granted
- 1975-07-03 NL NLAANVRAGE7507925,A patent/NL182779C/en not_active IP Right Cessation
- 1975-07-09 JP JP50084904A patent/JPS5131088A/ja active Pending
- 1975-07-09 SE SE7507851A patent/SE412166B/en not_active IP Right Cessation
-
1983
- 1983-10-31 JP JP1983169984U patent/JPS5985242U/en active Pending
Also Published As
| Publication number | Publication date |
|---|---|
| NL182779C (en) | 1988-05-16 |
| FR2277573B1 (en) | 1982-03-26 |
| SE7507851L (en) | 1976-01-12 |
| DE2528817C2 (en) | 1985-06-20 |
| DE2528817A1 (en) | 1976-01-29 |
| US3937226A (en) | 1976-02-10 |
| NL7507925A (en) | 1976-01-13 |
| FR2277573A1 (en) | 1976-02-06 |
| SE412166B (en) | 1980-02-25 |
| JPS5985242U (en) | 1984-06-08 |
| NL182779B (en) | 1987-12-16 |
| AU8205475A (en) | 1976-12-16 |
| JPS5131088A (en) | 1976-03-16 |
| GB1503174A (en) | 1978-03-08 |
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