摘要:
Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
摘要:
A method for preventing early recurrence of atrial fibrillation by pacing a heart in AAI mode at a rate faster than the intrinsic rate for a selected period of time immediately after delivering therapy to terminate the fibrillation. Ventricular backup pacing in VVI mode may also be provided during the atrial pacing.
摘要:
Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver a pharmacologic agent, particularly a NO-donor drug, to the heart are disclosed. A proximal connector of an infusion catheter is coupled to an infusion pump, and a distal catheter segment having a distal infusion catheter lumen end opening is disposed in the pericardial space. The implantable infusion pump is operable in conjunction with an implantable ischemia monitor to monitor the ischemic state and trigger delivery or regulate the periodic delivery of the pharmacologic agent to optimally treat ischemia. The patient may operate a patient activator that the patient when feeling ischemia symptoms to transmit a signal that is received by the implantable infusion pump and triggers delivery of a bolus and/or continuous infusion.
摘要:
A patient-controlled system for temporarily disabling an electrical cardioverting therapy in order to prepare the patient psychologically and physiologically for the pain associated with electrical cardioversion therapy. In an example embodiment, the system includes a capacitive circuit capable of charging and discharging in order to apply the electrical therapy. The implanted medical device automatically causes the capacitive circuit to charge and discharge at least once within a selected period. The system includes a patient activator device that communicates with the implanted device. A disabling circuit is also included within the implanted medical device that temporarily disables the electrical therapy application in response to the patient activator device. The system further includes an alerting arrangement that alerts the patient activator device in response to the disabling circuit. An override circuit overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.
摘要:
A method and system is provided for responding, from internally within a patient, to an atrial arrhythmia in a heart including measuring from within the patient at least one electrocardiogram characteristic indicative of the atrial arrhythmia, and controlling from within the patient drug therapy delivery to the patient responsive to measuring the at least one electrocardiogram characteristic. Drug therapy is initiated to the patient responsive to measuring the at least one electrocardiogram characteristic. According to one aspect of the present invention, the drug therapy is staged within the patient prior to measuring the at least one electrocardiogram characteristic. According to another example embodiment, the heart is paced from within the patient at a predefined rate responsive to measuring the at least one electrocardiogram characteristic, pacing occurring alone, or in combination with drug therapy.
摘要:
Control of defibrillation therapy delivered by implantable medical devices (IMDs) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.
摘要:
A method of performing a medical procedure, such as surgery, is provided. A nerve is stimulated in order to adjust the beating of the heart to a first condition, such as a stopped or slowed condition. The medical procedure is performed on the heart or another organ. The stimulation of the nerve is stopped in order to adjust the beating of the heart to a second condition, such as a beating condition. The heart itself may also be stimulated to a beating condition, such as by pacing. The stimulation of the nerve may be continued in order to allow the medical procedure to be continued. Systems and devices for performing the medical procedure are also provided.
摘要:
Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
摘要:
Control of defibrillation therapy delivered by implantable medical devices (IMDs) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.