Medtronic, Inc.

Vincent J Schouten

Koen J Weijand

Alexis C Renirie

There is provided an implanted system and method for delivering subsonic mechanical waves to one or more selected patient areas, said areas including the patient's heart and/or lungs. The mechanical waves are delivered for the purpose of treating fibrillation or like arrhythmias, for enhancing lung gas exchange, enhancing cardiac muscle fiber relaxation, and enhancing coronary perfusion. Mechanical waves are generated in a frequency range of about 1,100,000 Hz, and preferably 1-50,000 Hz. The waves may be delivered continuously for short or long time periods, or may be controlled in timing either with respect to detected portions of a patient's heartbeat signal or in response to a detected event such as fibrillation. In one preferred embodiment, the implantable system includes a defibrillation shock generator and control for responding to a defibrillation event by first delivering a sequence of mechanical waves and then delivering an electrical defibrillation shock. In another embodiment, the system and method treat incipient fibrillation or arrhythmia by delivering mechanical waves of predetermined timing to the patient's heart and/or lungs. In a specific embodiment, mechanical waves are delivered through an array of transducers to the patient's atrial wall, to treat atrial fibrillation.

System for delivering mechanical waves

System and a corresponding method for treating defibrillation in a heart

A system and method of providing for cardiac pacing which incorporates modulation of the pacing rate in order to minimize variations in ventricular power output, e.g., variation related to patient respiratory phases. In a preferred embodiment, pacing rate is increased during inspiration relative to expiration, to restore a measure of the normal rate modulation which occurs in a normal person. Patient respiration is monitored and a respiration signal is processed to determine the timing of rate modulation. Parameters representative of respiratory changes, such as right ventricular volume and right ventricular blood pressure are also monitored and, together with respiration amplitudes changes, are used to determine an incremental rate signal for controlling the extent of rate variation. Heart rate and patient activity are also sensed, to provide further control of rate modulation, with maximum modulation being provided when the patient is sleeping, and minimal or no modulation being provided when the patient is active. The system of this invention is applicable in combination with conventional pacing systems, or can be adapted to special clinical applications.

System and method for respiration-modulated pacing

There is provided an implanted system and method for delivering subsonic mechanical waves to one or more selected patient areas, the areas including the patient's heart and/or lungs. The mechanical waves are delivered for the purpose of treating fibrillation or like arrhythmias, for enhancing lung gas exchange, enhancing cardiac muscle fiber relaxation, and enhancing coronary perfusion. Mechanical waves are generated in a frequency range of about 1-100,000 Hz, and preferably 1-50,000 Hz. The waves may be delivered continuously for short or long time periods, or may be controlled in timing either with respect to detected portions of a patient's heartbeat signal or in response to a detected event such as fibrillation. In one preferred embodiment, the implantable system includes a defibrillation shock generator and control for responding to a defibrillation event by first delivering a sequence of mechanical waves and then delivering an electrical defibrillation shock. In another embodiment, the system and method treat incipient fibrillation or arrhythmia by delivering mechanical waves of predetermined timing to the patient's heart and/or lungs. In a specific embodiment, mechanical waves are delivered through an array of transducers to the patient's atrial wall, to treat atrial fibrillation.

System and method of mechanical treatment of cardiac fibrillation

Apparatus and method are provided for obtaining a measure of blood flow, and more specifically cardiac output, by analyzing blood temperature variations in the arterial tract. In a first embodiment, a lead carrying two closely spaced temperature sensors is positioned so that the sensors are in the atrial tract and produce temperature signals representative of small cyclical temperature variations of the blood outputted from the heart. The two signals have substantially similar patterns for each cardiac cycle, but the signals are separated by a short time (.increment.T) representative of the distance between the two sensors. The patterns are correlated to find .increment.T, from which cardiac output is calculated. In an alternate embodiment, a single blood temperature sensor is employed along with a sensor for determining cardiac contractions, and a measure of cardiac output is obtained by comparing the time difference between a feature of the blood temperature signal with the time of cardiac contraction.

Cardiac flow sensor

There is provided a system and method for high rate pacing of patients for training, or revalidation of heart muscle. The system and method of this invention provide a therapy particularly directed for patients with CHF, to enable effective exercise of the cardiac muscle without requiring the patient to exercise. In another embodiment, an alternate high rate routine, or algorithm is provided for assisting a patient to exercise during at least some part of the high rate pacing routine. The high rate pacing therapy may be initiated either automatically, based upon the patient's circadian rhythm; automatically by patient data sensed by a system of sensors; or may be initiated directly by the patient by use of a simple external programmer device. The pacemaker of the invention suitably stores a plurality of algorithms which can be selected, or which can be modified or replaced by an external programmer. Whether used by a CHF patient or a patient who does not have CHF but who is in danger of developing it, the exercise algorithms suitably provide for high rate pacing in the range of about 90-160 bpm. For a CHF patient, the high rate pacing is carried out for a duration in the area of about 20 minutes, preferably twice a day. The duration and frequency of therapy can be programmed to match patient needs, and may vary from only several minutes to much greater than 20 minutes, carried out 1, 2 or more times daily, or automatically based upon patient data.

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Cadier en Keer, Netherlands

Vincent J Schouten