Source: http://www.google.com/patents/US6205357?dq=6,578,054
Timestamp: 2017-05-24 10:58:58
Document Index: 598580149

Matched Legal Cases: ['art. 4', 'art. 5', 'art. 6', 'art. 9', 'art. 12', 'art. 14', 'art. 20', 'art. 21', 'art. 22', 'art. 25', 'art. 28', 'art. 30']

Patent US6205357 - Methods and apparatus for detecting and treating medical conditions of the heart - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsAn implantable system for detecting electrical activity from a patient's heart comprises a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of the heart for sensing electrical activity from the heart, and...http://www.google.com/patents/US6205357?utm_source=gb-gplus-sharePatent US6205357 - Methods and apparatus for detecting and treating medical conditions of the heartAdvanced Patent SearchTry the new Google Patents, with machine-classified Google Scholar results, and Japanese and South Korean patents.Publication numberUS6205357 B1Publication typeGrantApplication numberUS 09/206,022Publication dateMar 20, 2001Filing dateDec 4, 1998Priority dateDec 4, 1998Fee statusPaidAlso published asCA2353601A1, DE69924404D1, DE69924404T2, EP1135189A1, EP1135189B1, WO2000033914A1Publication number09206022, 206022, US 6205357 B1, US 6205357B1, US-B1-6205357, US6205357 B1, US6205357B1InventorsRaymond E. Ideker, Jay A. Warren, Bruce H. KenknightOriginal AssigneeUab Research FoundationExport CitationBiBTeX, EndNote, RefManPatent Citations (27), Non-Patent Citations (2), Referenced by (74), Classifications (9), Legal Events (6) External Links: USPTO, USPTO Assignment, EspacenetMethods and apparatus for detecting and treating medical conditions of the heart
US 6205357 B1Abstract
That which is claimed is: 1. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; monitoring the effectiveness of said second therapeutic electrical pulse in treating said cardiac arrhythmia; and then delivering a third therapeutic electrical pulse to the heart of said patient if said second therapeutic electrical pulse is not effective in treating said arrhythmia, said third therapeutic electrical pulse being a higher energy pulse than said second therapeutic electrical pulse. 2. A method according to claim 1, wherein said first and second therapeutic pulses are ventricular therapeutic pulses.
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 4. A method according to claim 1, wherein said step of delivering a second therapeutic electrical pulse is carried out with a plurality of primary electrodes;
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 5. A method according to claim 1, wherein said step of delivering a third therapeutic electrical pulse is carried out with a plurality of primary electrodes;
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 6. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system, said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said step of delivering a second therapeutic electrical pulse is carried out during the first three beats of cardiac arrhythmia. 7. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said step of delivering a second therapeutic electrical pulse is carried out within the first three seconds of cardiac arrhythmia. 8. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system, said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said step of detecting electrical activity from the heart is carried out with at least a first sensing electrode positioned within a vein on the left surface of the left ventricle of said heart. 9. A method according to claim 8, wherein said step of detecting electrical activity from the heart is further carried out with a second sensing electrode positioned within the right ventricle of said heart.
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said detecting step is carried out by detecting premature beats in said heart; and wherein said detecting step further comprises the step of identifying the heart chamber of premature beat origin in said heart. 12. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system, said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said detecting step comprises detecting the presence of sinus rhythm with syntactic relationships among electrogram features. 13. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system, said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said detecting step further comprises the step of discriminating the location of origin of premature beats in said heart. 14. A method according to claim 13, wherein said discriminating step comprises discriminating an atrial location of origin from a ventricular location of origin of premature beats in said heart.
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; and selecting an atrial or ventricular therapeutic electrical pulse as said first therapeutic electrical pulse based on said detected electrical activity. 16. A method of selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia by an implantable system, said method comprising:
detecting electrical activity from the heart of said patient; predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; delivering a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; then monitoring the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; and delivering a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said first and second therapeutic pulses are atrial therapeutic pulses. 17. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; wherein said discrimination circuit is further configured to monitor the effectiveness of said second therapeutic electrical pulse in treating said cardiac arrhythmia; and wherein said therapy circuit is configured to deliver a third therapeutic electrical pulse to the heart of said patient if said second therapeutic electrical pulse is not effective in treating said arrhythmia, said third therapeutic electrical pulse being a higher energy pulse than said second therapeutic electrical pulse. 18. A system according to claim 17, wherein said therapy circuit is configured to deliver ventricular therapy pulses as said first and second therapeutic pulses.
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 20. A system according to claim 17, further comprising a plurality of primary electrodes operatively associated with said therapy circuit for delivering said second therapeutic electrical pulse;
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 21. A system according to claim 17, further comprising a plurality of primary electrodes operatively associated with said therapy circuit for delivering said third therapeutic electrical pulse;
a first one of said primary electrodes positioned through the coronary sinus ostium and within a vein on the surface of the left ventricle of said heart. 22. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective and during the first three beats of cardiac arrhythmia. 23. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective within the first three seconds of cardiac arrhythmia. 24. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; said system further comprising at least a first sensing electrode configured for positioning within a vein on the left surface of the left ventricle of said heart operatively associated with said detector for detecting electrical activity from the heart. 25. A system according to claim 24, further comprising a second sensing electrode configured for positioning within the right ventricle of said heart and operatively associated with said detector for detecting electrical activity from the heart.
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; said discrimination circuit configured to detect detecting premature beats in said heart and to identify the heart chamber of premature beat origin in said heart. 28. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; said discrimination circuit configured to detect the presence of sinus rhythm with syntactic relationships among electrogram features. 29. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; and a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; said discrimination circuit further configured to discriminate the location of origin of premature beats in said heart. 30. A system according to claim 29, said discrimination circuit further configured to discriminate an atrial location of origin from a ventricular location of origin of premature beats in said heart.
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective; said discrimination circuit further configured to select an atrial or ventricular therapeutic electrical pulse as said first therapeutic electrical pulse based on said detected electrical activity. 32. An implantable system for selecting a cardiac therapy to be delivered to a patient's heart for the prevention or treatment of cardiac arrhythmia, said system comprising:
a detector for detecting electrical activity from the heart of said patient; a discrimination circuit for predicting the future onset of a cardiac arrhythmia in said patient from said detected electrical activity; a therapy circuit configured to deliver a first therapeutic electrical pulse to the heart of said patient prior to the onset of cardiac arrhythmia; said discrimination circuit further configured to monitor the effectiveness of said first therapeutic electrical pulse in preventing cardiac arrhythmia from said detected electrical activity; said therapy circuit further configured to deliver a second therapeutic electrical pulse to the heart of said patient at the onset of cardiac arrhythmia if said first therapeutic electrical pulse is not effective and to deliver atrial therapeutic pulses as said first and second therapeutic pulses.
Therapy pulse
RA−>RV
RA−>CS
PA−>OS
RA−>OS
OS−>CS
CS−>PA
PA−>RA
PA−>LV
RA−>LV
PA−>RV
RV−>LV
Pulse segment
RV−>RA
LV−>PA
LV−>RA
RV−>PA
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