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Method and system for the prediction of cardiac arrhythmias

a cardiac arrhythmia and system technology, applied in the field of methods and systems for the prediction of cardiac arrhythmias, can solve the problem of little time to protect the individual from death, and achieve the effect of increasing the likelihood of the occurrence of cardiac arrhythmias

Inactive Publication Date: 2006-01-05
CEDARS SINAI MEDICAL CENT
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0007] Methods and systems are provided for determining an increased likelihood of the occurrence of a cardiac arrhythmia in a patient. The methods and systems disclosed herein generally comprise monitoring the sympathetic neural discharges of a patient from the left stellate ganglion, the thoracic ganglia, and/or any other...

Problems solved by technology

Sudden cardiac death (SCD) is a major public health problem that accounts for more than half of all cardiovascular deaths.
VF, if not terminated, results in death.
This leaves very little time to protect the individual from death resulting from SCD.

Method used

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  • Method and system for the prediction of cardiac arrhythmias
  • Method and system for the prediction of cardiac arrhythmias
  • Method and system for the prediction of cardiac arrhythmias

Examples

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Effect test

example 1

Rabbit Renal Sympathetic Nerve Recordings

[0050] A standard wire electrode and a nanoelectrode array was implanted on the renal sympathetic nerve of a New Zealand white rabbit. Simultaneous recordings of the ECG and renal sympathetic neural discharges were obtained. The renal sympathetic neural discharges was recorded with both a standard wire electrode and a nanoelectrode array and amplifier. The signals were digitized with a band pass filter of 30 to 500 Hz and a digitization rate of 1 K / sec.

[0051]FIG. 3 shows the ECG and renal sympathetic neural discharge recordings obtained from the rabbit. The nanoelectrode recordings provided a lower baseline noise than the wire electrode and therefore a higher signal-to-noise ratio. FIG. 3A shows bursts of renal sympathetic neural discharges, which did not correlate with changes in the heart rate. FIG. 3B shows the suppression of renal sympathetic neural discharges by intravenous bolus dose of xylazine and ketamine.

example 2

Sympathetic Neural Discharges of the Left Stellate Ganglion and Heart Rate Control

[0052] The relationship between the sympathetic neural discharges of the left stellate ganglion and the heart rate was investigated in a normal canine subject. A normal canine subject was anesthetized with isoflurane and the chest was opened at the third intercostal space. The left stellate ganglion was identified and a nanoelectrode was implanted under the fibrous capsule. The fibrous capsule was then closed with a 4-0 silk suture and additional sutures were placed on the wire to secure the nanoelectrodes. The nanoelectrodes were then connected to a DSI transmitter (DSI TL 10M3-D70-EEE, Data Sciences, International) with a band pass filter of 0.05 to 100 Hz and a digitization rate of 1 K / sec. An additional bipolar pair of the DSI transmitter was used for ECG recordings between the right and left chest. All recordings shared a common ground.

[0053]FIG. 4 shows the relationship between the sympathetic ...

example 3

Effects of Anti-Convulsants on SNA

[0058] Anti-convulsant drugs may exert an anti-arrhythmic effect by suppressing the high frequency sympathetic nerve discharges from the left stellate ganglion. Phenyloin (Dilantin®) is one of the most commonly used anti-convulsants and has been shown to suppress the sympathetic neural discharges in ambulatory dogs within the therapeutic range of 10-20 mg / L.

[0059] After confirming the successful recording of sympathetic neural discharges from the canine subject, 400 mg (approximately 18 mg / kg) of phenyloin was administered intravenously to the canine subject. FIG. 9 shows the continuous tracings of heart rate and sympathetic neural discharges over a 24 hour period for a canine subject. Phenyloin was injected at 9:45 a.m. and the tracings following that time show the effects of phenyloin injection on the heart rate and the sympathetic neural discharges of the canine subject.

[0060] The serum concentration of the canine subject two hours after the i...

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Abstract

Methods and systems are provided for determining an increased likelihood of the occurrence of a cardiac arrhythmia in a patient. The methods and systems comprise monitoring the sympathetic neural discharges of a patient from the left stellate ganglion, the thoracic ganglia, or both, and detecting increases in the sympathetic neural discharges. The methods and systems may further comprise delivering anti-arrhythmic therapy to the patient in response to a detected increase in the sympathetic neural discharge, such as delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, cardioversion or defibrillation shocks. Pharmacologic agents which may be used in connection with the delivery of anti-arrhythmic therapy include those which are known to exert anti-arrhythmic effect and anti-convulsant agents, such as phenyloin, carbamazepine, valproate, and phenobarbitone.

Description

GOVERNMENT INTEREST [0001] This invention was made in part with government support under Grant R01 HL66389, awarded by the National Institutes of Health. The government has certain rights to this invention.FIELD OF THE INVENTION [0002] The invention generally relates to a methods and systems for the prediction of cardiac arrhythmias of the type that can result in sudden cardiac death. BACKGROUND OF THE INVENTION [0003] Sudden cardiac death (SCD) is a major public health problem that accounts for more than half of all cardiovascular deaths. SCD takes the lives of approximately 450,000 people in the United States each year, more than lung cancer, breast cancer, stroke, and AIDS combined. Most cases of SCD are due to ventricular arrhythmias and there is often an element of underlying ischemic heart disease. Ventricular tachycardia (VT) and ventricular fibrillation (VF) are different types of ventricular arrhythmias. VT is an abnormally fast ventricular heart rhythm which is, by itself,...

Claims

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Application Information

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IPC IPC(8): A61N1/362A61B5/0402
CPCA61B5/04001A61N1/362A61N1/36A61N1/36585A61N1/37258A61N1/3962A61N1/39622A61B5/24A61B5/388
Inventor CHEN, PENG-SHENG
Owner CEDARS SINAI MEDICAL CENT
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