Source: http://www.google.com/patents/US6001091?dq=5,598,374
Timestamp: 2014-07-23 08:21:07
Document Index: 566558480

Matched Legal Cases: ['art.\n6', 'art.\n7', 'art.\n18', 'art.\n28', 'art.\n29', 'art.\n38', 'art.\n39', 'application No. 08', 'Application No. 4']

Patent US6001091 - Revascularization with heart pacing - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign in<nobr>Advanced Patent Search</nobr>PatentsAn apparatus for treating a heart by stimulating revascularization of the heart or creating channels in the heart, the apparatus comprising an artificial energy source for causing a first created heartbeat and a revascularization device for creating a first revascularization event in the heart, the revascularization...http://www.google.com/patents/US6001091?utm_source=gb-gplus-sharePatent US6001091 - Revascularization with heart pacingAdvanced Patent SearchPublication numberUS6001091 APublication typeGrantApplication numberUS 08/793,000Publication dateDec 14, 1999Filing dateFeb 3, 1997Priority dateFeb 3, 1997Fee statusLapsedPublication number08793000, 793000, US 6001091 A, US 6001091A, US-A-6001091, US6001091 A, US6001091AInventorsDouglas R. Murphy-Chutorian, Richard L. MuellerOriginal AssigneeEclipse Surgical Technologies, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (17), Non-Patent Citations (93), Referenced by (12), Classifications (10), Legal Events (5) External Links: USPTO, USPTO Assignment, EspacenetRevascularization with heart pacingUS 6001091 AAbstract An apparatus for treating a heart by stimulating revascularization of the heart or creating channels in the heart, the apparatus comprising an artificial energy source for causing a first created heartbeat and a revascularization device for creating a first revascularization event in the heart, the revascularization device being controllable to provide a first revascularization event to occur at a selected time in relation to the first created heartbeat.
What is claimed is: 1. An apparatus for treating a heart, the apparatus comprising:a revascularization device for creating a first revascularization event in the heart; and a control circuit, coupled to the revascularization device, that causes the revascularization device to cause a first created heartbeat and the revascularization device to create the first revascularization event in the heart at a selected time in relation to the first created heartbeat. 2. The apparatus of claim 1, wherein the selected time is fixed.
3. The apparatus of claim 1, wherein the selected time is variable.
4. The apparatus of claim 1, wherein the first revascularization event is substantially simultaneous with a creation of the first created heartbeat.
5. The apparatus of claim 1, wherein the selected time is fixed to cause the first revascularization event to occur after a depolarization of the heart and before a repolarization of the heart.
6. The apparatus of claim 1, wherein the selected time is fixed to cause the first revascularization event to occur after an R wave produced by the heart and before a T wave produced by the heart.
7. The apparatus of claim 1, wherein the selected time is fixed to cause the first revascularization event to occur after the revascularization device has delivered energy to the heart to cause the first created heartbeat and before the first heartbeat.
8. The apparatus of claim 1 wherein the control circuit is configured to cause created heartbeats at a pace faster than a normal heartbeat.
9. The apparatus of claim 1, wherein the control circuit is configured to be coupled to a device for sensing heart function.
10. The apparatus of claim 9, wherein the control circuit is configured to cause created heartbeats at a pace faster than a normal heartbeat.
11. The apparatus of claim 9, wherein the device for sensing is a flow measurement device.
12. The apparatus of claim 9, wherein the device for sensing is a pressure measurement device.
13. The apparatus of claim 9, wherein the device for sensing is an electrocardiogram device.
14. The apparatus of claim 1, wherein the first revascularization event has a fixed duration.
15. The apparatus of claim 1, wherein the first revascularization event has a variable duration.
16. The apparatus of claim 1, wherein control circuit is configured to cause the revascularization device to cause multiple heartbeats at a selected rate.
17. The apparatus of claim 16, wherein the control circuit is configured to cause the revascularization device to cause multiple revascularization events in the heart.
18. The apparatus of claim 1, wherein the control circuit is configured to cause multiple events between heartbeats.
19. The apparatus of claim 1, wherein the revascularization device is configured for transmyocardial revascularization.
20. The apparatus of claim 1, wherein the revascularization device is an ultrasound energy delivery device.
21. The apparatus of claim 1, wherein the revascularization device is a mechanical cutter.
22. The apparatus of claim 1, wherein the revascularization device is a laser energy delivery device.
23. The apparatus of claim 1, further comprising a catheter coupled to the revascularization device for percutaneous use.
24. The apparatus of claim 1, wherein the revascularization device is configured for surgical use.
25. The apparatus of claim 1, wherein the revascularization device is configured for minimally invasive surgery (MIS) use.
26. An apparatus for treating a heart, the apparatus comprising:a device for causing a first created heartbeat, wherein the device for causing the first created heartbeat comprises at least one of a laser energy delivery device, an ultrasound energy delivery device, a mechanical cutter, or a piercer; and wherein the device for causing the first created heartbeat is configured for creating a first revascularization event in the heart, the device being controllable to provide a first revascularization event to occur at a selected time in relation to the first created heartbeat. 27. The apparatus of claim 26, wherein the selected time is fixed to cause the first revascularization event to occur after a depolarization of the heart and before a repolarization of the heart.
28. The apparatus of claim 26, wherein the selected time is fixed to cause the first revascularization event to occur after an R wave produced by the heart and before a T wave produced by the heart.
29. The apparatus of claim 26 wherein the device for causing the first created heartbeat is configured to cause the heart to beat at pace faster than a normal heartbeat.
30. The apparatus of claim 26, wherein the device for causing the first heartbeat is configured to be coupled to a device for sensing heart function.
31. The apparatus of claim 26, wherein device for causing the first created heartbeat comprises a laser energy delivery device.
32. The apparatus of claim 26, wherein the device for causing the first created heartbeat comprises an ultrasound energy delivery device.
33. The apparatus of claim 26, wherein the revascularization device comprises a mechanical cutter.
34. The apparatus of claim 26, wherein the device for causing the first created heartbeat comprises a piercer.
35. The apparatus of claim 26, further comprising a catheter coupled to the device for causing the first created heartbeat for percutaneous use.
36. An apparatus for treating a heart by stimulating revascularization of the heart or creating channels in the heart, the apparatus comprising:a laser; and a control circuit, coupled to the laser, adapted to cause the laser to cause a first created heartbeat and to cause the laser to create a first revascularization event in the heart at a selected time in relation to the first created heartbeat. 37. The apparatus of claim 36, wherein the selected time is fixed to cause the first revascularization event to occur after a depolarization of the heart and before a repolarization of the heart.
38. The apparatus of claim 36, wherein the selected time is fixed to cause the first revascularization event to occur after an R wave produced by the heart and before a T wave produced by the heart.
39. The apparatus of claim 36, wherein the control circuit is configured to cause the laser to cause created heartbeats at a rate faster than a normal heartbeat.
40. The apparatus of claim 36, wherein the control circuit is configured to be coupled to a device for sensing heart function.
41. The apparatus of claim 36, further comprising a catheter coupled to the revascularization device for percutaneous use.
CROSS-REFERENCE TO RELATED APPLICATIONS The following applications are hereby incorporated herein by reference: U.S. Patent Application Entitled METHOD AND APPARATUS FOR CREATION OF DRUG DELIVERY AND/OR STIMULATION POCKETS IN THE MYOCARDIUM, application No. 08/773,788, Filed on Dec. 23, 1996, inventor(s): Mueller; U.S. Patent Application Entitled METHOD AND APPARATUS FOR MECHANICAL TRANSMYOCARDIAL REVASCULARIZATION OF THE HEART, application Ser. No. 08/713531, Filed on Sep. 13, 1996, inventor(s): Mueller and now U.S. Pat. No. 5,871,495; U.S. Patent Application Entitled METHOD FOR NON-SYNCHRONOUS LASER ASSISTED TRANSMYOCARDIAL REVASCULARIZATION, application Ser. No. 08/729325, filed on Oct. 15, 1996, inventor(s): Murphy-Chutorian and now U.S. Pat. No. 5,785,702; and U.S. Patent Application Entitled MINIMALLY INVASIVE METHOD FOR FORMING REVASCULARIZATION CHANNELS, application Ser. No. 08/794,733, inventor(s) Daniel et. al.
This invention relates generally to a method and apparatus for revascularization of a heart, and more particularly to a method and apparatus for revascularization using heart pacing.
Another object of the invention is to help cause a stabilized beat to occur after laser firing to steer the heart back quickly to a regular pattern, interrupting a memory effect possible by continuing fibrillations.
These and other objects are achieved in an apparatus for treating a heart by stimulating revascularization of the heart. The apparatus includes an artificial energy source for causing a created heartbeat and a revascularization device for creating a revascularization event in the heart. The revascularization device is controllable to cause the revascularization event to occur at a selected time in relation to the created heartbeat.
In various embodiments, the selected time is fixed to cause the revascularization event to occur after depolarization and before repolarization of the heart, the selected time is fixed to cause the revascularization event to occur substantially simultaneously with the created heartbeat, or the selected time is variable. In another embodiment of the invention, the revascularization device is configured to cause multiple revascularization events in the heart.
The revascularization device may be a laser energy delivery device, a mechanical cutter, an ultrasound energy delivery device, or other device to make channels or to stimulate the heart. The artificial energy source for causing a created heartbeat may be a pacemaker or other device for causing heartbeats. In another embodiment of the invention, the artificial energy source for causing a created heartbeat is the revascularization device.
In one embodiment of the invention an apparatus is provided for controlling a revascularization device with a control circuit coupled to a revascularization device. The control circuit is configured to cause the revascularization device to create a revascularization event in the heart at a selected time relative to a created heartbeat. The created heartbeat is created by an artificial energy source.
In another embodiment of the invention a method is provided for treating a heart by stimulating revascularization of the heart or creating channels in the heart. A device is provided for introducing energy to the heart. Energy delivered from the device for introducing energy to the heart causes a created heartbeat. A revascularization event is created in the heart at a selected time in relation to the created heartbeat.
The apparatus and method of the present invention provide revascularization events to the heart at a specific time in the heartbeat cycle. The heart is paced. A pace signal starts a heartbeat cycle. A revascularization event is provided to the heart relative to the pace signal. By timing the revascularization event with respect to the pace signal, the revascularization event is provided at a selected time within the created heartbeat cycle.
Pulse generator 38 provides the pacing signal to the patient's heart or to another location on the patient's body in order to pace the patient's heart via pacing leads 24. Pulse generator 38 may be a heart pacemaker such a modified model 540 External Pulse Generator, SeaMED Corp., Redmond, Wash. The pacemaker is modified such that it generates a pulse to the pacing leads when it receives an external logic signal. Alternatively, pulse generator 38 is any artificial energy source capable of causing the heart to beat.
In a preferred embodiment laser 28 is a holmium laser available as an Eclipse 4000� holmium laser from Eclipse Surgical Technologies, Inc., Sunnyvale, Calif. Other types of medical lasers may also be used, for example, an excimer laser, a CO2 laser, an Argon laser, a Nd-yag laser, an erbium laser, or a diode laser. A single laser may be used, or multiple lasers or multiple fibers from a single laser can be used in order to cause more revascularization to occur at one time. For a discussion of tuning of a laser for revascularization, see U.S. Pat. No. 5,785,702 entitled Method for Non-Synchronous Laser Assisted Transmyocardial Revascularization, which is incorporated herein by reference. As an alternative to a laser revascularization device, another revascularization device such as a mechanical cutter or an ultrasound energy delivery device may be used in order to create channels in the heart or to revascularize the heart. The revascularization device can be coupled to a catheter for percutaneous and minimally invasive surgery (MIS) approaches. Alternatively, the revascularization device can be used directly in open heart surgery. If the revascularization device is coupled to a catheter, it can be introduced percutaneously and moved into the heart through the vasculature.
FIG. 3a includes pace signal 46a, footswitch signal 50a, and a laser burst signal 54a. Signal 55a occurs after pace signal 46a is active at 47a. Thus, a revascularization occurs after the heart is paced. As shown, laser burst 55a and 55a' occur only when foot switch signal 50a is active. Laser burst signals 55a and 55a' occur after pace signal 47a but before pace signal 47a'. Laser burst signals 55a" and 55a'" occur after the pace signal 47a'.
As shown in FIG. 3b, the time delay between the pace signal 47b and laser burst signal 55b is set so that the laser burst signal 55b occurs between the R wave 57b and the T wave 57b'. The electrocardiogram signal 57b is shown for illustrative purposes and is not used to control the time at which the laser burst occurs. The heart is paced at a rate faster than the unpaced heartbeat rate. As shown on signal 56b, the time between heartbeats is greater prior to signal 47b than after signal 47b. The rate of the paced heart is faster than the rate of the unpaced heart in order to allow the pace signal 46b to control the heart. The signal from an electrocardiogram or other sensor can be used to calculate a pace rate faster than the normal unpaced heart rate and provide the pace signal 46b at this pace rate. If the heart during revascularization goes into a fast or chaotic rhythm the operator may change the rate of pacing in order to attempt to regulate the heart rate and return the heart rate to a rate closer to the normal heart rate.
FIG. 3f illustrates revascularization with heart pacing including multiple laser pulses per heartbeat cycle. FIG. 3f includes electrocardiogram signal 56f, pace signal 46f, and laser burst signal 54f. Electrocardiogram signal 56f or signal from another type of sensor (e.g. pressure sensor) can be used to observe whether the heart is beating efficiently and to disable the laser if the heart is not beating. Laser bursts 55f and 55f' occur after pace signal 47f and after R wave 57f and before T wave 57f'. Multiple laser bursts 55f and 55f' are provided in order to allow for possibly greater depth of revascularization per heartbeat cycle or to create stimulation zones with or without connecting channels. The rate at which the heart is paced is faster than the unpaced rate of the heart. As seen in FIG. 3f, the time between heartbeat signals on the electrocardiogram signal 56f is greater before first pace signal 47f than the time between heartbeat signals after pace signal 47f. It may be desirable to cause a revascularization event to occur after a depolarization of the heart and before a repolarization of the heart.
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TobinickApparatus and method employing a single laser for removal of hair, veins and capillariesUS6592576May 29, 2001Jul 15, 2003Plc Medical Systems, Inc.Myocardial revascularizationUS6660001Jan 19, 2001Dec 9, 2003Providence Health System-OregonMyocardial revascularization-optical reflectance catheter and methodUS6740040Jan 30, 2001May 25, 2004Advanced Cardiovascular Systems, Inc.Ultrasound energy driven intraventricular catheter to treat ischemiaUS6863653Oct 9, 1998Mar 8, 2005Eclipse Surgical Technologies, Inc.Ultrasound device for axial rangingUS7001336Apr 1, 2004Feb 21, 2006Advanced Cardiovascular Systems, Inc.Method for treating ischemiaUS7110811Dec 30, 2002Sep 19, 2006Cardiac Pacemakers, Inc.Method and apparatus for atrial tachyarrhythmia cardioversionUS7901359Dec 6, 2005Mar 8, 2011Advanced Cardiovascular Systems, Inc.Ultrasound energy driven intraventricular catheter to treat ischemia* Cited by examinerClassifications U.S. Classification606/1, 607/9, 606/12International ClassificationA61B18/24, A61B17/00Cooperative ClassificationA61B2017/00247, A61B2017/00973, A61B2018/00392, A61B18/24European ClassificationA61B18/24Legal EventsDateCodeEventDescriptionFeb 5, 2008FPExpired due to failure to pay maintenance feeEffective date: 20071214Dec 14, 2007LAPSLapse for failure to pay maintenance feesJun 27, 2007REMIMaintenance fee reminder mailedJun 16, 2003FPAYFee paymentYear of fee payment: 4Aug 18, 1997ASAssignmentOwner name: ECLIPSE SURGICAL TECHNOLOGIES, INC., CALIFORNIAFree format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MURPHY-CHUTORIAN, DOUGLAS R.;MUELLER, RICHARD L.;REEL/FRAME:008663/0803Effective date: 19970407RotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services©2012 Google