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WO1994000192B1 - Method and apparatus for treatment of angina - Google Patents

Method and apparatus for treatment of angina

Info

Publication number
WO1994000192B1
WO1994000192B1 PCT/US1993/005496 US9305496W WO9400192B1 WO 1994000192 B1 WO1994000192 B1 WO 1994000192B1 US 9305496 W US9305496 W US 9305496W WO 9400192 B1 WO9400192 B1 WO 9400192B1
Authority
WO
WIPO (PCT)
Prior art keywords
rate
human heart
sensing
heart
stimulator according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1993/005496
Other languages
French (fr)
Other versions
WO1994000192A1 (en
Filing date
Publication date
Application filed filed Critical
Priority to EP93914443A priority Critical patent/EP0647151B1/en
Priority to AU44103/93A priority patent/AU661179B2/en
Priority to DE69307510T priority patent/DE69307510T2/en
Priority to JP6502391A priority patent/JPH07504597A/en
Publication of WO1994000192A1 publication Critical patent/WO1994000192A1/en
Publication of WO1994000192B1 publication Critical patent/WO1994000192B1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Abstract

A stimulator for providing stimulus pulses to the SA nodal fat pad, in response to heart rate exceeding a predetermined level, in order to reduce the ventricular rate. The device is also provided with a cardiac pacemaker to pace the ventricle in the event that the stimulus pulses reduce the heart rate below a predetermined value. The device is also provided with a feedback regulation mechanism for controlling the parameters of the stimulation pulses applied to the AV nodal fat pad, as a result of their determined effect on heart rate.

Claims

AMENDED CLAIMS[received by the International Bureau on 29 December 1993 (29.12.93); original claims 16-22 cancelled; original claims 3, 5-7, 12, 13 and 15 amended; remaining claims unchanged (4 pages)]In conjunction with the above disclosure, I claim:
1. An electrical medical stimulator, comprising: electrode means for delivery of electrical stimulation to the fat pad associated with the sinus node of a human heart; pulse generator means for generating stimulus pulses and for providing said stimulus pulses to said electrode means; means for sensing the rate at which said human heart is beating; means for defining a first heart rate; and initiating means responsive to said sensing means for initiating the operation of said pulse generator means in response to the rate of said human heart exceeding said first heart rate.
2. A stimulator according to claim 1 wherein said means for sensing the rate of said human heart comprises means for sensing atrial depolarizations of said human heart and wherein said pulse generator means is further responsive to said sensing means and delivers said stimulating pulses synchronized to said sensed atrial depolarizations.
3. An electrical medical stimulator according to claim 1 or claim 2; wherein said means for sensing the rate at which said human heart is beating comprises means for sensing atrial depolarizations of said human heart; and wherein said pulse generator means is responsive to said means for sensing atrial depolarizations and delivers said depolarizations and comprises means for delivering said stimulus pulses during the refractory period of the atrium of said human heart.
4. A stimulator according to claim 1 or claim 2 or claim 3 further comprising means for defining a second heart rate and means for pacing said human heart when the rate of said human heart falls below said second heart rate.
5. An electrical medical stimulator according to claim 4, wherein said pacing means comprises means for pacing the atrium of said human heart.
6. An electrical medical stimulator according to claim 6, further comprising: means for defining a third heart rate above said second rate and below said first rate, such that said pulse generator means provides said stimulus pulses to said electrode means only when the rate of said human heart is above said third rate.
7. An electrical medical stimulator according to claim 1 or claim 2 or claim 3 or claim 4 or claim 5 or claim 6, further comprising: means responsive to said sensing means and to said pulse generator mans for determining the effect of said stimulus pulses on the rate of said human heart and means for adjusting the amplitude of said stimulus pulses as a function of the determined effect of said stimulus pulses.
8. A stimulator according to claim 7 wherein said determining means comprises means for comparing the rate of which said human heart following delivery of said stimulus pulses to a predetermined upper rate, and wherein said adjusting means is responsive to the failure of delivered stimulus pulses to reduce the rate of said human heart below said upper rate and in response thereto increments the amplitude of said stimulus pulses.
9. A stimulator according to claim 8 wherein said determining means compares the rate of said human heart following delivery of said stimulus pulses to an intermediate heart rate less than said upper rate and, in response to delivery of said stimulus pulses resulting in a reduction of the rate of said human heart below said intermediate rate decrements the amplitude of said stimulus pulses.
10. A stimulator according to claim 9 further comprising means for pacing said human heart when the rate of said human heart falls below a predetermined pacing rate, below said intermediate rate.
1 1. A stimulator according to claim 1 or claim 7 or claim 8 or claim 9 or claim 10 wherein said sensing means comprises means for sensing the depolarizations of the atrium of said human heart.
12. A stimulator according to claim 1 or claim 2 or claim 3 or claim 4 or claim 5 or claim 6 or claim 7 or claim 8 or claim 9 or claim 10 or claim 11 further comprising deactivating means responsive to said sensing means for terminating the operation of said pulse generator means in response to the rate of said human heart persistently falling below a defined rate below said first heart rate.
13. An electrical medical stimulator according to claim 1 or claim 2 or claim 3 or claim 4 or claim 5 or claim 6 or claim 7 or claim 8 or claim 9 or claim 10 or claim 1 1 or claim 12, further comprising: sensor means for sensing a physiologic parameter other than heart rate; means for defining a first sensor threshold; and wherein said initiating means is responsive to an output of said sensor means exceeding or falling below said first sensor threshold for initiating the operation of said pulse generator means.
14. A stimulator according to claim 13 further comprising means for defining a second sensor threshold different from said first sensor threshold; and deactivating means responsive to an output of said sensor means exceeding or falling below said second sensor threshold for terminating the operation of said pulse generator means.
15. An electrical medical stimulator according to claim 1 or claim 2 or claim 3 or claim 4 or claim 5 or claim 6 or claim 7 or claim 8 or claim 9 or claim 10 or claim 11 or claim 12, further comprising: sensor means for sensing a physiologic parameter other than heart rate; and means responsive to said sensor means for controlling the operation of said pulse generator means.
PCT/US1993/005496 1992-06-30 1993-06-09 Method and apparatus for treatment of angina Ceased WO1994000192A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP93914443A EP0647151B1 (en) 1992-06-30 1993-06-09 Apparatus for treatment of angina
AU44103/93A AU661179B2 (en) 1992-06-30 1993-06-09 Method and apparatus for treatment of angina
DE69307510T DE69307510T2 (en) 1992-06-30 1993-06-09 DEVICE FOR TREATING ANGINA PECTORIS
JP6502391A JPH07504597A (en) 1992-06-30 1993-06-09 Electrical medical stimulators and electrical stimulation methods

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US90695992A 1992-06-30 1992-06-30
US07/906,959 1992-06-30

Publications (2)

Publication Number Publication Date
WO1994000192A1 WO1994000192A1 (en) 1994-01-06
WO1994000192B1 true WO1994000192B1 (en) 1994-02-03

Family

ID=25423302

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1993/005496 Ceased WO1994000192A1 (en) 1992-06-30 1993-06-09 Method and apparatus for treatment of angina

Country Status (7)

Country Link
US (1) US5334221A (en)
EP (1) EP0647151B1 (en)
JP (1) JPH07504597A (en)
AU (1) AU661179B2 (en)
CA (1) CA2138043A1 (en)
DE (1) DE69307510T2 (en)
WO (1) WO1994000192A1 (en)

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