Method and apparatus for treating hemodynamic disfunction

Abstract

A method of treating hemodynamic disfunction by simultaneously pacing both ventricles of a heart. At least one ECG amplifier is arranged to separately detect contraction of each ventricle and a stimulator is then activated for issuing stimulating pulses to both ventricles in a manner to assure simultaneous contraction of both ventricles, thereby to assure hemodynamic efficiency. A first ventricle is stimulated simultaneously with contraction of a second ventricle when the first fails to properly contract. Further, both ventricles are stimulated after lapse of a predetermined A-V escape interval. One of a pair of electrodes, connected in series, in placed through the superior vena cava into the right ventricle and a second is placed in the coronary sinus about the left ventricle. Each electrode performs both pacing and sensing functions. The pacer is particularly suitable for treating bundle branch blocks or slow conduction in a portion of the ventricles.

Description

CROSS REFERENCE TO RELATED APPLICATIONS[0001]This is a continuation of Reissue application No. 08 / 547,691, filed Oct. 19, 1995 now U.S. Pat. No. RE 38,119 E, which is a continuation of Reissue application No. 07 / 890,280, filed May 29, 1992 now abandoned, which is a reissue of U.S. Pat. No. 4,928,688, all of which are incorporated herein by reference.BACKGROUND OF THE INVENTION[0002]I. Field of the Invention[0003]This invention pertains to medical devices, but more specifically, to a method for increasing the cardiac output of a patient suffering from congestive heart failure by stimulating the heart of the patient at multiple sites simultaneously.[0004]II. Discussion of the Prior Art[0005]Normally, impulses from the SA node affect contraction of the atria and then propagate to the AV node. The AV node, in turn, emits a second nerve impulse which affects contraction of the ventricles. These nerve impulses affect contraction, i.e., depolarization of the tissue of the heart, in a coord...

AI Technical Summary

Benefits of technology

[0022]The advantages of the present invention include a more precise and coordinated simultaneous ventricular depolarization of both the right and left ventricular to thereby increase hemodynamic efficiency of a patient experiencing congestive heart failure or weak contractions.

Problems solved by technology

Of many cardiac deficiencies which have in the past been diagnosed and treated, conduction difficulties have presented significant problems for which a pacer has been used for treatment.

When a bundle block occurs, these nerve impulses are not properly transmitted from the SA node to the AV node and ventricles.

This uncoordinated movement increases depolarization time and results in more inefficient pumping rather than a more coordinated and simultaneous ventricular depolarization.

In essence, such conduction deficiencies result in asynchrony between the left and right ventricle.

Additionally, arrhythmias of the heart produce uncoordinated ventricular contraction that affects the hemodynamic efficiency of the heart.

Moreover, it was found that hearts with impaired functions show profound reductions in pumping ability due to incoordinate contraction of the ventricles.

Although Funke does teach the concept of simultaneous stimulation of a plurality of spaced electrodes, he does not disclose its specific use as a method of improving the cardiac output of patients suffering from congestive heart failure, nor does he discuss the specfic placement of the electrodes about the heart.

In addition, the electrodes perform either stimulating or sensing, not both, therefore a large number of electrodes is required in this system.

However, this pulsing scheme and configuration is disclosed for use in a ventricular defibrillation device and not for cardiac pacing to improve cardiac output wherein a more precise synchronization of stimulation signals with the Q-R-S complex is required.

However, there is no specific technique disclose of providing stimulating signals to the electrodes to perform a pacemaking function.

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