The Uab Research Foundation

Duke University

Other

Cardiac Pacemakers, Inc.

Gregory P Walcott

Raymond E Ideker

Steven D Girouard

Michael E Benser

Xiangsheng Zheng

Bruce H KenKnight

Fred William Chapman

Jeffrey A Hall

Stephen John Hahn

Wade A Bowe

Jeffrey J Giba

G Neal Kay

Donald A Richardson

Jay A Warren

Milton M Morris

Tyson G Taylor

David S Wood

Mudit Jain

Randolph A Cooper

Dual sequential defibrillation (DSD) systems and methods include the use of a timing device. The timing device can assist a user with DSD administration by providing notifications spaced apart by the inter-shock timing. The user can use these notifications to trigger the administration of defibrillation in a sequential manner. The timing device can also be coupled to two defibrillation devices and can output a signal to each of the defibrillation devices to cause the defibrillation device to administer a defibrillation. The output of the signals by the timing device can be spaced apart by the inter-shock timing. Additionally, the signals can be QRS-like in nature to cause the defibrillation devices to administer a defibrillation when in a sync mode.

Dual sequential defibrillation systems and methods

Methods, systems and computer program products are provided for reducing a risk of pulseless electrical activity (PEA) include detecting a first post-defibrillation blood flow of a subject and detecting a second post-defibrillation blood flow of the subject after the first post-defibrillation blood flow. If the first post-defibrillation blood flow of the subject is above a first threshold value and the second post-defibrillation blood flow is below a second threshold value, a plurality of electrical pulses that reduces a risk of PEA is delivered.

Method and system for reducing cardiac low pressure states

Methods, systems and computer program products determine and identify a favorable time to deliver cardiac compression to a subject to avoid a vulnerable period of a spontaneous intrinsic cardiac cycle.

Methods, systems and computer program products to inhibit ventricular fibrillation during cardiopulmonary resuscitation

An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein. An additional electrode configured for positioning in the superior vena cava, right atrium (including the right atrial appendage, or the right ventricle may also be included, and the pulse generator may be configured or programmed for concurrently delivering a first defibrillation pulse through the additional electrode and the atrial septum electrode, and a second defibrillation pulse through the atrial septum electrode and the second electrode. Electrode assemblies and methods useful for carrying out the invention are also disclosed.

Inter-atrial septum or superior vena cava electrodes for atrial defibrillation

Methods, systems and computer program products for cardiac pacing are provided. A defibrillation shock is applied to a heart of the patient and a pacing stimulation signal is automatically applied to the heart of the patient subsequent to termination of the delivery of the defibrillation shock. The pacing stimulation may be applied to the heart of the patient within about two seconds of termination of the defibrillation shock. The pacing stimulation signal may be applied to the heart of the patient subsequent to termination of the defibrillation shock irrespective of a characterization of electrical activity detected in the heart. The pacing stimulation may be single and/or paired pacing stimulation.

Post-defibrillation pacing methods and devices

An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned to stimulate Bachmann's bundle, or positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein. An additional electrode configured for positioning in the superior vena cava, right atrium (including the right atrial appendage, or the right ventricle may also be included, and the pulse generator may be configured or programmed for concurrently delivering a first defibrillation pulse through the additional electrode and the atrial septum electrode, and a second defibrillation pulse through the atrial septum electrode and the second electrode. Electrode assemblies and methods useful for carrying out the invention are also disclosed.

Bachmann's bundle electrode for atrial defibrillation

Methods, systems and computer program products for combining atrial defibrillation treatment techniques include techniques for reducing the discomfort associated with defibrillation and/or reducing the defibrillation threshold. Techniques include timing the defibrillation shock to reduce discomfort based on a sensed signal, giving the shock relatively early during atrial fibrillation, therapeutic drugs, administering more than one shock in succession, pacing the heart before, after, or during the defibrillation shock or shocks, and placing the shock electrodes in locations that may reduce discomfort.

Methods and systems for reducing discomfort from cardiac defibrillation shocks

The present invention provides systems, methods and computer program products for detecting the presence of cardiac activity in a patient. The present invention includes a detector circuit that is configured to detect the influence of a first defibrillation shock on the patient immediately subsequent to termination of a first defibrillation shock.

Devices for detecting the presence of cardiac activity following administration of defibrillation therapy

Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function. Additionally, a cardiac timing interval, such as the A-V timing interval, may be adjusted by applying stimulation to a heart of the patient utilizing a cardiac timing interval, detecting a change in cardiac function by sensing cardiac function associated with application of the stimulation using the cardiac timing interval and adjusting the cardiac timing interval directly from the detected change in cardiac function.

Pacing methods and devices using feedback controlled timing

A cardiac ablation apparatus for producing a circumferential ablation that electrically isolates a heart chamber wall portion from vessel such as a pulmonary vein extending into said wall portion comprises (a) an elongate centering catheter having a distal end portion; (b) an expandable centering element connected to said centering catheter distal end portion and configured for positioning within said vessel when in a retracted configuration, and for securing said elongate centering catheter in a substantially axially aligned position with respect to said vessel when said centering element is in an expanded configuration; (c) an ablation catheter slidably connected to said centering catheter said ablation element having a distal end portion, and (d) an expandable ablation element connected to said ablation catheter distal end portion. The ablation element is configured to form a circumferential ablation on the wall around the elongate centering catheter when the centering catheter is axially aligned with respect to the vessel. In a further embodiment, a non-expandable, compliant centering element is employed, such as an elastic finger. Systems incorporating such an apparatus and methods of use thereof are also disclosed.

Ablation catheter, system, and method of use thereof

A method of reducing the likelihood of pulseless electrical activity (PEA) after defibrillation in a subject comprises administering to a subject afflicted with fibrillation a first treatment waveform, the first treatment waveform insufficient to defibrillate the heart; and then administering to the subject a second treatment waveform that defibrillates the heart and restores organized electrical activity in the heart. The first treatment waveform reduces the likelihood of onset of PEA following the second treatment waveform, as compared to that likelihood which would be present in the absence of the first treatment waveform.

Method for improving cardiac function following delivery of a defibrillation shock

An ablation catheter stores a platelet inhibitor substance within a plurality of pockets or recesses of its shaft. The substance is adapted to elute upon contact with biological fluid. In the pocket configuration, the platelet inhibitor substance is in a capsule positioned within the pocket. In the recess configuration, the platelet inhibitor substance is in a hydrogel or silicone-based porous/semi-porous matrix positioned within the recess. Elution of the platelet inhibitor substance prevents or at least substantially minimizes the adhesion of blood platelets on the catheter surface during ablation. In another configuration, the catheter includes an internal lumen network having apertures terminating at the surface of the shaft. The lumen communicates with a source of platelet inhibitor fluid that is forced through the lumen by a variable pump.

Growing community of inventors

Durham, NC, United States of America

Gregory P Walcott