Cardiac pacemaker compression harness

A therapeutic device for providing cold treatments to cardiac pacemaker implantation patients is comprised of a bilobed chest pad having an elastic chest strap connected thereto. The chest strap is fixed at one end to the lower lobe of the chest pad and is wrapped around the torso of the patient under tension and temporarily is coupled to the opposing portion of the lower lobe of the chest pad. The cold compress, which is placed behind the chest pad over the incision site, is thereby firmly kept in contact with the incision site. A shoulder strap is slidingly coupled at one end to the chest strap and is positioned on the back of the patient and wrapped under tension behind the back and over the shoulder of the patient, which shoulder is adjacent to the incision site. The end of the shoulder strap is then temporarily coupled to the upper lobe of the chest pad. The shoulder strap, substantially adds to the compression on the cold compact and retains the chest pad and shoulder strap in place notwithstanding normal activity of the patient. As a result, the patient is able to move about and engage in normal activities very soon after cardiac implantation and yet continue to receive the benefits of thermal therapy to minimize the trauma normally associated with a subcutaneous cardiac pacemaker implantation.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
The invention relates to a medical apparatus, and more specifically to 
treatment apparatus used in connection with pacemaker implantations. 
2. Description of the Prior Art 
Subcutaneous pacemaker implants are common throughout the world and many 
thousands occur each year in the United States alone. The procedure has 
been simplified such that in many instances the operation is carried out 
in the physician's office. Under current practice, after the pacemaker is 
implanted subcutaneously through an incision against the chest wall, the 
incision is then sutured and a gauze bandage is taped over the implant 
site to protect and keep the incision site sterile during the healing 
process. Typically, any swelling or hematoma, which is caused by the 
trauma of implantation, is left untreated and healing is left to normal 
body processes. However, in some patients, this trauma is pronounced and 
very uncomfortable. In extreme cases, the trauma can lead to 
complications. 
Trauma and swelling of the cardiac pacemaker incision site can be 
substantially reduced and pain alleviated, if in the hours immediately 
after implantation, a cold compress is applied and maintained on the site. 
Conventional cold compresses are often used for this purpose and are 
effective. 
However, to obtain the benefit of the cold compress, the compress must be 
maintained on the site for several hours, typically up to four hours, 
which is also typically the time of effective cooling of presently 
available compresses. Also just as typical, the patient desires to be or 
is mobile and participates in normal ambulatory activity. While it is 
always possible to tape the compress to the patient's chest, the removal 
of the tape may be painful and in almost all cases, causes some irritation 
and in some patients, severe allergic reaction. 
A typical cold compress as is currently available, is sold by Health Corps 
of Cambridge, Mass. under the brand name Omni Pack. The Omni Pack is 
simply a strip of woven stretch material with Velcro in fasteners on which 
a terry cloth pouch has been stitched in the center. The terry cloth pouch 
provides a rectangular space to hold cold or hot packs while the linear 
strap of the Omni Pack is wrapped around an arm or leg. The Omni Pack is 
particularly difficult to apply to a patient and to a cardiac implanation 
site, which is typically on the front chest wall a few inches above the 
pectoral muscle. The bandage-type attachment on the Omni Pack, even if 
extended to encircle the chest, simply slips from position. 
Other devices used to hold cold packs includes those such as shown by 
Meistrell, "Adjustable Wrappable, Stretchable Wrap Sheet," U.S. Pat. No. 
4,805,620 (1989), which is a wrapping to hold multiple hot or cold packs 
adjacent to the chest and arm of the body. Meistrell's device 
substantially covers the entire neck and shoulder area on one side and 
wraps across the chest with two chest straps as well as anchoring on the 
upper arm adjacent the covered shoulder. While this device would be 
effective for holding a compress in the general area of the implant, it is 
a severely encumbering device, restricting the comfort and motion of the 
patient. 
Lebold, "Hot and Cold Pack," U.S. Pat. No. 3,889,684 (1975) is more typical 
of the prior art cold packs. It is comprised simply of a terry cloth pouch 
into which a cold pack is inserted. The terry cloth pouch has a plurality 
of Velcro straps and fasteners on its periphery which allow it to be 
strapped around the user's ankle, neck or limbs. The device, however, is 
particularly ill adapted for fitting to a large irregular body section, 
the upper chest-shoulder region, which is required for pacer implant 
treatment. 
Bonner, Jr., "Cold Compress," U.S. Pat. No. 4,556,055 (1985) is another 
typical prior art example of a device for practicing cryotherapy. Bonner, 
like Lebold, includes a pocket for insertion of the cold pack and a 
longitudinal panel connected by Velcro fasteners for wrapping the cold 
pack around a cylindrically shaped body section or limb. Draping the cold 
pack in the form of Bonner, like a bandolier, across the shoulder and 
chest of a patient having a pacemaker implant, is neither comfortable, 
practical nor effective to securely retain the cold pack over the incision 
site. 
What is needed then is some type of device wherein cryotherapy can be 
practically and comfortably practiced in connection with cardiac pacemaker 
implants. 
BRIEF SUMMARY OF THE INVENTION 
The invention is an apparatus for therapeutic cryotherapy as applied to 
cardiac pacemaker implantation using a cold compress on a patient 
comprising a chest pad. An elastic chest strap is arranged and configured 
for connection to the chest pad. An elastic shoulder strap is arranged and 
configured for connection to the chest strap and to the chest pad. The 
chest pad holds the cold compress in proximity to a cardiac pacemaker 
implantation site on the patient. As a result, trauma resulting from 
cardiac pacemaker implantation is substantially reduced while mobility and 
comfort of the patient is substantially enhanced. 
The shoulder strap is slidingly coupled to the chest strap. The chest strap 
has a longitudinal length. The shoulder strap is capable of being 
arbitrarily positioned along the longitudinal length of the chest strap. 
The shoulder strap is slidingly coupled to the chest strap by a closed 
sewn loop defined within the shoulder strap. The chest strap is disposed 
through the closed loop of the shoulder strap. 
The chest strap has two ends. One of the ends is fixed to the chest pad at 
one side of the chest pad and an opposing one of the two ends is 
temporarily coupled to at least an opposing side of the chest pad. The 
chest pad is comprised of an upper lobe and a lower lobe. The chest strap 
is coupled to the chest pad on the lower lobe of the chest pad. The 
shoulder strap has two ends. One end is slidingly coupled to the chest 
strap and an opposing one of the two ends is capable of being temporarily 
coupled to the chest pad. The shoulder strap is temporarily coupled to the 
chest pad on the upper lobe of the chest pad. 
The cardiac pacemaker implantation is made at an incision site and the 
chest pad is placed over the incision site. The cold pack is disposed 
between the chest pad and the incision site. The chest strap is wrapped 
under tension around the upper torso of the patient and is coupled at both 
of its ends to the chest pad. The chest strap is placed underneath the 
arms of the patient. The shoulder strap is adjusted under tension over a 
selected one of the shoulders of the patient, is slidingly coupled at one 
end to the chest strap, and is coupled at an opposing end of the shoulder 
strap to the chest pad to maintain the chest pad over the cardiac 
pacemaker implantation site notwithstanding normal patient activity, to 
retain the cold compress in position, and to increase compressive force on 
the cold compress. 
The invention can alternatively be described as an apparatus for providing 
thermal therapy to cardiac pacemaker incision site on the upper torso of a 
patient comprising a cold compress component for maintaining a cold 
compress in firm contact over the cardiac pacemaker implantation site, and 
a stabilizing component for retaining the cold compress in position over 
the cardiac pacemaker implantation site regardless of normal patient 
activity. As a result, thermal therapy is provided to the patient 
following cardiac pacemaker implantation without substantial restriction 
on normal activity of the patient. 
The cold compress component comprises a first element for contacting a cold 
compress and a second element for applying a downward compressive force on 
the first element to maintain the cold compress in intimate contact with 
the cardiac pacemaker incision site. 
The stabilizing component comprises an element for preventing the cold 
compress element from sliding from the cardiac pacemaker incision site. 
The stabilizing component is arranged and configured to retain the cold 
compress element in position regardless of whether the cold compress 
element is positioned on left or right side of the patient. 
The invention is also characterized as a method of applying a cold compress 
to a cardiac pacemaker incision site comprising the steps of disposing a 
cold pack on the incision site and placing a chest pad over the cold pack. 
An elastic chest strap is wrapped under tension around the upper torso of 
the patient and under the arms of the patient. The chest strap is 
connected at its ends to the chest pad to apply a compressive force 
through the chest pad on the cold pack to maintain the cold pack in 
contact with the cardiac pacemaker incision site. A shoulder strap is 
wrapped under tension over the shoulder of the patient. The shoulder strap 
is attached at opposing ends to the chest strap and to the chest pad to 
retain the chest pad and cold pack in position over the cardiac pacemaker 
implantation incision site. 
The step of wrapping the shoulder strap under tension over the shoulder of 
the patient comprises the step of adjusting the shoulder strap under 
tension at the end coupled to the chest strap so that the length of the 
shoulder strap between the chest strap and the chest pad is minimized. 
The step of wrapping the chest strap under tension around the torso of the 
patient comprises the step of temporarily coupling one end of the chest 
strap to the chest pad. The ends of the chest strap are coupled to the 
chest pad on a lower lobe of the chest pad. 
The step of wrapping the shoulder strap under tension over the shoulder of 
the patient comprises the step of temporarily coupling one end of the 
shoulder strap to the chest pad. The opposing end of the shoulder strap is 
slidingly coupled to the chest strap and is disposed under tension around 
the back of the patient. 
The step of wrapping the shoulder strap over the shoulder of the patient 
comprises the step of temporarily coupling one end of the shoulder strap 
to the chest pad. The opposing end of the shoulder strap is slidingly 
coupled to the chest strap and disposed under tension around the back of 
the patient. 
The invention may be better visualized by turning to the following drawings 
.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
The invention is a harness for holding a cold pack on the upper torso of a 
patient who has received a cardiac pacemaker implant. The implants are 
normally subcutaneously disposed in the upper chest portion of the 
patient. A therapeutic device for providing cold treatments to cardiac 
pacemaker implantation patients is comprised of a bilobed chest pad having 
an elastic chest strap connected thereto. The chest strap is fixed at one 
end to the lower lobe of the chest pad and is wrapped around the torso of 
the patient under tension and temporarily is coupled to the opposing 
portion of the lower lobe of the chest pad. The cold compress, which is 
placed behind the chest pad over the incision site, is thereby firmly kept 
in contact with the incision site. A shoulder strap is slidingly coupled 
at one end to the chest strap and is positioned on the back of the patient 
and wrapped under tension behind the back and over the shoulder of the 
patient, which shoulder is adjacent to the incision site. The end of the 
shoulder strap is then temporarily coupled to the upper lobe of the chest 
pad. The shoulder strap, substantially adds to the compression on the cold 
compact and retains the chest pad and shoulder strap in place 
notwithstanding normal activity of the patient. As a result, the patient 
is able to move about and engage in normal activities very soon after 
cardiac implantation and yet continue to receive the benefits of thermal 
therapy to minimize the trauma normally associated with a subcutaneous 
cardiac pacemaker implantation. 
Turning first to FIG. 1, which depicts a perspective view of the invention 
shown in a detached configuration, the illustrated embodiment is shown as 
being comprised of a chest pad 10 under which a cold compress (not shown) 
is placed. Chest pad 10 holds the cold compress on the incision site on 
the patient's chest. Chest pad 10 may also include a stitched rear pocket 
(not shown) for holding the compress, although after final adjustment, the 
temporary holding function of such a pocket may become superfluous. In the 
illustrated embodiment chest pad 10 has two lobes, a lower enlarged 
portion or lobe 10a adapted to provide a broad surface for applying a 
compressive force to the compress, and an upper smaller portion or lobe 
10b adapted for connection to an elastic shoulder strap 20 for positioning 
and retention of position. An elastic chest strap 12 has one end 14 sewn 
to chest pad 10. Opposing end 16 of chest strap 12 has a Velcro fastener 
18. Slidingly coupled to chest strap 12 is a shoulder strap 20. Shoulder 
strap 20 is slidingly coupled to chest strap 12 by means of a sewn loop 22 
best depicted in cross-section in FIG. 3. Sewn loop 22 encircles chest 
strap 12 and permits chest strap 12 to be adjusted at any point along the 
longitudinal length of chest strap 12. Loop 22 is sewn to itself so that 
chest strap 20 may be translated in either direction along chest strap 12 
as diagrammatically depicted by arrow 24 in FIG. 1. Opposing end 26 of 
chest strap 20 has a Velcro fastener 28 stitched or adhered thereto. 
The opposing side of chest pad 10 has a plurality of complementary Velcro 
fastening sections 30 sewn or attached to the outside of chest pad 10, as 
best depicted in FIG. 1. The portion of chest strap 12 nearest end 16 of 
chest pad 10 is placed beneath the adjacent arm of the patient, stretched 
behind his back and thence under the opposite arm and stretched across the 
chest as shown in FIG. 2 and attaches to a Velcro fastening pad 32. 
Similarly, fastener 28 of shoulder strap 20 is placed and stretched over 
either the left or right shoulder of the patient and similarly attached to 
one of Velcro fasteners 34. In the illustrated embodiment, fastening pads 
30 and 32 are hook fasteners, while fastening pads 18 and 28, are the eye 
or felt portions of the Velcro connectors. 
Therefore, the pad through the adjustability of shoulder strap 20, both in 
terms of the length of its attachment as well as its position along chest 
strap 12, allows chest pad 10 to be snugly placed over the appropriate 
incision site on the patient regardless of a wide variety of patient sizes 
and shapes. The elasticity of stretched chest strap 12 provide enough 
compressive force to insure good thermal contact between the cold compress 
placed behind the rear surface of chest pad 10 and the incision site. The 
elasticity of stretched shoulder strap 20 keeps the cold compress, which 
is by far the most massive element in the assembly, pulled up over the 
incision site, which is usually high on the upper chest and substantially 
increases the compressive force on the cold compress. In addition, 
shoulder strap 20 pulls upper lobe 10b of chest pad 10 in against the 
chest thereby tending to make an enclosure over the cold compress. This 
enclosure also creates a downward force on the cold compress which tends 
to neutralize the upward force on the cold compress created by the 
compression of chest strap 12 against lower lobe 10a, which latter 
compressive force might otherwise tend to squeeze the compress up and out 
from underneath chest pad 10. 
Chest strap 12 can be snugly wrapped around the patient's chest underneath 
the patient's arms and can provide enough compression to keep the cold 
compress against the incision site even though chest plate 10 need not 
have any retaining pocket in to which the cold compress is placed or any 
other means for fixing the cold compress to the rear surface of chest 
plate 10. The retention of the cold compress is facilitated by both the 
snugness of the fit which can be adjusted by chest strap 12 along with the 
connection of the ends of chest strap 12 to a lower half or lobe of chest 
plate 10. However, in order to prevent chest plate 10 from sliding down 
during movement and to further ensure the secure retention and pressure of 
the cold compress against the incision site, shoulder strap 20 is adjusted 
so that it is disposed comfortably and snugly over the patient's shoulder 
and connected to Velcro fasteners 30 on top half portion of chest pad 10. 
Therefore, normal movement and flexing of the patient is generally 
insufficient to cause chest strap 12 and chest pad 10 from working down 
over the generally inwardly tapering torso of the patient. 
It is expressly understood that many other embodiments and modifications 
are contemplated as included within the device although not specifically 
illustrated. For example, it is expressly contemplated that Velcro 
fasteners may be placed in different positions or switched, namely a felt 
fastener exchange for hook fastener and visa versa. Similarly, although 
Velcro is preferred attachment means, any other attachment means, 
including low bonded pressure adhesives, now known or later devised, may 
also be equivalently substituted. Still further, although it is expressly 
contemplated that no pocket, strap, tape or other means is necessary to 
secure the cold compress to chest pad 10, the inclusion of such elements 
in the invention are to be included and are contemplated. Complementary 
Velcro fasteners can also be provided on the outside ends of chest strap 
12 so that chest strap 12 can be stretched and overlapped at its opposing 
ends on chest pad 10 and thus connected together.