Physiologically responsive blood pump for ischemia detection and treatment

Patent metadata

Field	Value
Publication number	US-2017112985-A1
Application number	US-201615298569-A
Country	US
Kind code	A1
Filing date	Oct 20, 2016
Priority date	Oct 23, 2015
Publication date	Apr 27, 2017
Grant date	—

Abstract

A ventricular assist device incorporating a rotary pump configured to be in fluid communication with a heart and systemic circulation of a subject to assist blood flow from the heart to the systemic circulation. The device includes a pump drive circuit for applying power to the pump, one or more sensors for sensing one or more electrogram signals (such as subcutaneous pre-cordial electrode signals) in the patient, and a signal processing circuit to determine the presence or absence of a reduction in cardiac blood flow, ischemic condition or myocardial infarction condition based on subcutaneous pre-cordial electrode signals, to control power supplied to the pump from the pump drive circuit, and to operate the pump in either a normal sinus rhythm mode in the absence of an ischemic condition or myocardial infarction condition, or a modified mode of operation in the presence of an ischemic condition or myocardial infarction condition.

First claim

1 . A ventricular assist device comprising:
a rotary pump configured to be implantable in fluid communication with a heart and systemic circulation of a subject to assist blood flow from the heart to the systemic circulation; a pump drive circuit for applying power to the pump; a pump drive circuit to control the speed of the pump; one or more sensors for sensing one or more electrogram signals in a patient; and a signal processing circuit in communication with the sensors and the pump drive circuit, the signal processing circuit being operative to receive the subcutaneous ECG signals, wherein the signal processing circuit is operative to determine the presence or absence of a reduction in cardiac blood flow or an ischemic condition or myocardial infarction condition based on subcutaneous pre-cordial electrode signals, and to control power supplied to the pump from the pump drive circuit so as to control the speed of the pump and operate the pump in a normal sinus rhythm mode in the absence of an ischemic condition or myocardial infarction condition, and to operate the pump in at least one modified mode of operation in the presence of an ischemic condition or myocardial infarction condition.

2 . A ventricular assist device as claimed in claim 1 , wherein the pump is a rotary impeller pump.

3 . A ventricular assist device as claimed in claim 1 , wherein the signal processing circuit is operative to adjust the varying speed responsive to a condition of the subject.

4 . A ventricular assist device as claimed in claim 3 , wherein the signal processing circuit adjusts the varying speed in accordance with electrophysiological signals received by the circuit from the sensors.

5 . A ventricular assist device as claimed in claim 1 , in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the P-wave of the subject's cardiac cycle.

6 . A ventricular assist device as claimed in claim 1 , in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the R-wave of the subject's cardiac cycle.

7 . A ventricular assist device as claimed in claim 1 , wherein the electrophysiological signals include subcutaneous ECG waveforms.

8 . A ventricular assist device as claimed in claim 7 , wherein the subcutaneous ECG waveforms include at least one unipolar signal.

9 . A ventricular assist device as claimed in claim 7 , wherein the subcutaneous ECG waveforms include at least one bipolar signal from a pair of electrodes.

10 . A ventricular assist device as claimed in claim 1 , wherein the circuit is operable to detect an ischemic condition and the at least one modified mode of operation includes at least one ischemia mode different from the normal sinus rhythm mode.

11 . A ventricular assist device as claimed in claim 10 , wherein the at least one ischemia mode includes a non-pulsatile mode wherein the pump runs in a non-pulsatile manner.

12 . A ventricular assist device as claimed in claim 10 , wherein the at least one ischemia mode includes a pulsatile mode different from the normal sinus rhythm mode.

13 . A ventricular assist device as claimed in claim 12 , wherein the at least one pulsatile mode includes an increase in pump speed for increased cardiac output.

14 . A ventricular assist device as claimed in claim 10 , wherein the at least one ischemia mode includes a pulsatile mode wherein the pump runs in a pulsatile manner unsynchronized with the cardiac cycle of the subject.

15 . A ventricular assist device as claimed in claim 1 , wherein the circuit is operable to detect a myocardial infarction condition and the at least one modified mode of operation includes at least one myocardial infarction mode different from the normal sinus rhythm mode.

16 . A ventricular assist device as claimed in claim 15 , wherein the at least one myocardial infarction mode includes a non-pulsatile mode wherein the pump runs in a non-pulsatile manner.

17 . A ventricular assist device as claimed in claim 15 , wherein the at least one myocardial infarction mode includes a pulsatile mode different from the normal sinus rhythm mode.

18 . A ventricular assist device as claimed in claim 15 , wherein the at least one myocardial infarction mode includes a pulsatile mode wherein the pump runs in a pulsatile manner unsynchronized with the cardiac cycle of the subject.

19 . A ventricular assist device as claimed in claim 18 , wherein the at least one pulsatile mode includes an increase in pump speed for increased cardiac output.

20 . A ventricular assist device as claimed in claim 1 , wherein the at least one modified mode includes a non-pulsatile mode and wherein the signal processing circuit is operative via the motor driver to control power supplied to the pump so as to vary the speed of the pump in the non-pulsatile mode based on a condition of the subject.

21 . A ventricular assist device as claimed in claim 1 , wherein at least one modified mode includes a ventricular tachy-arrhythmia mode in response to a detected tachy-arrhythmia condition.

22 . A ventricular assist device as claimed in claim 6 , wherein the substantially fixed phase relationship of the varying speed with the R-wave of the subject's cardiac cycle depends on a moving average cycle time over a number of cardiac cycles.

Assignees

• Heartware Inc

Inventors

• Yomtov Barry M

Classifications

• A61M2230/04

  Heartbeat characteristics, e.g. ECG, blood pressure modulation · CPC title

• A61M2205/3303

  Using a biosensor · CPC title

• A61M2205/3365

  Rotational speed · CPC title

• A61M2205/50

  with microprocessors or computers · CPC title

• A61B5/29

  for permanent or long-term implantation · CPC title