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WO1997040885A1 - Procede et dispositif pour la regulation electronique des battements d'un coeur - Google Patents

Procede et dispositif pour la regulation electronique des battements d'un coeur Download PDF

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Publication number
WO1997040885A1
WO1997040885A1 PCT/US1997/001907 US9701907W WO9740885A1 WO 1997040885 A1 WO1997040885 A1 WO 1997040885A1 US 9701907 W US9701907 W US 9701907W WO 9740885 A1 WO9740885 A1 WO 9740885A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrodes
heart
electro
stimulation device
catheter
Prior art date
Application number
PCT/US1997/001907
Other languages
English (en)
Inventor
Kenneth R. Jonkman
Michael R. S. Hill
Original Assignee
Medtronic, Inc.
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Medtronic, Inc. filed Critical Medtronic, Inc.
Priority to AU21183/97A priority Critical patent/AU2118397A/en
Publication of WO1997040885A1 publication Critical patent/WO1997040885A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/36017—External stimulators, e.g. with patch electrodes with leads or electrodes penetrating the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36114—Cardiac control, e.g. by vagal stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/385—Devices for inducing an abnormal cardiac function, e.g. fibrillation

Definitions

  • This invention relates to a method and device for controlling the operation of the human heart during a surgical procedure, and more particularly, to a device for electronically stopping and starting the heart.
  • a cardioplegia solution containing potassium is injected into the heart to stop its beating while the heart is cooled to minimize the physiological requirements of the heart tissue.
  • the blood is routed around the heart and lungs via a heart-lung machine.
  • An anti-clotting drug such as heparin, must be injected into the blood stream in a large enough quantity to avoid clotting of the blood when traveling through the heart-lung machine.
  • the injection of heparin into the blood stream during most heart surgery procedures is desired to a limited extent.
  • CABG coronary artery bypass grafting
  • the electro-stimulation device includes at least two electrodes for connection to at least one location in the body that affects or regulates the heartbeat.
  • At least one switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment the natural stimuli to the heart in order to control the beating of the heart, and preferably to stop the heart from beating.
  • the switch is a foot switch operable by a surgeon to free a surgeon's hands during surgery.
  • an electro-stimulation device for both electrically destimulating and stimulating the heart includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat.
  • a first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment the natural stimuli to the heart and thereby stop the heart from beating.
  • a second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate the heartbeat.
  • a method for arresting the beat of a heart in a living body includes the process of connecting a pair of electrodes to at least one location in the body that affects or regulates the heartbeat and supplying an electrical current to the electrodes of sufficient amplitude and duration to arrest the heartbeat.
  • the step of supplying an electrical current to the electrodes includes supplying an alternating current.
  • FIG. 1 is a perspective view of an electro-stimulation device according to the present invention
  • FIG. 2 is a perspective view of an electro-stimulation device according to a second embodiment of the present invention
  • FIG. 3 is a schematic diagram of a circuit for use with the electro- stimulation device of FIGS. 1 and 2;
  • FIG. 4 is a diagrammatical view of a pair of electrodes of the electro- stimulation device attached to a pair of points on the heart;
  • FIG. 5 is a diagrammatical view of a pair of electrodes of the electro- stimulation device attached to a single point on the heart;
  • FIG. 6 shows operation of a foot pedal by a surgeon during heart electro-stimulation
  • FIG. 7 is a cross sectional view of a catheter and a set of electrodes positioned circumferentially around the catheter according to the invention
  • FIG. 8 is a cross sectional view of a catheter and a set of electrodes positioned circumferentially around the catheter according to a second embodiment of the invention
  • FIG. 9 is a side elevational view of a catheter with electrodes positioned axially along the catheter according to a third embodiment of the invention
  • FIG. 10 is a side elevational view of a catheter with electrodes positioned axially along the catheter according to a fourth embodiment of the invention.
  • FIG. 11 is a top plan view of a catheter with electrodes positioned axially along the catheter according to a fifth embodiment of the invention.
  • FIG. 12 is a top plan view of a catheter with electrodes positioned axially and circumferentially along the catheter according to a sixth embodiment of the invention.
  • FIG. 13 is a cross sectional view similar to FIG. 8 showing the current density distribution between two of the electrodes
  • FIG. 14 is a cross sectional view similar to FIG. 7 showing the current density distribution between two of the electrodes.
  • FIG. 15 is a top view of a catheter with electrodes positioned axially and circumferentially along the catheter and showing the current density distribution between two of the electrodes.
  • a first embodiment of an electro-stimulation device 10 includes a housing 12 and a control panel 14 located on an upper surface of the housing 12.
  • the control panel 14 is divided into a heart stimulation control area 15 and a heart destimulation control area 17.
  • the stimulation control area 15 includes a rotary dial 16 and scale 16A for setting the amount of current that is passed to the heart, and a rotary dial 18 and scale 18A for setting the duration or frequency of cycles that the current is passed to the heart to start the heart beating.
  • the destimulation control area 17 includes a rotary dial 20 and scale 20A for setting the amount of current that is passed to the heart, and a rotary dial 22 and scale 22 A for setting the duration that the current is passed to the heart to stop the heart from beating.
  • a normally open stimulation switch 24 can be pressed to initiate heart stimulation while a normally open destimulation switch 26 can be pressed to initiate the heart destimulation.
  • An on/off switch 28 can be used to turn the entire device off when not in use.
  • a foot pedal assembly 30 has a normally open heart stimulation foot switch 32 and a heart destimulation foot switch 34 that can be used as an alternative to switches 24, 26. The provision of a foot pedal assembly permits the surgeon to control when the heart stimulation and destimulation occurs while leaving the hands free to perform other procedures. This also permits the surgeon's hands to remain sterile since contact with the housing 12 or switches 26, 28 is avoided.
  • the foot pedal assembly 30 is connected via cable 36 to an electronic control device 50 (FIG. 3) within the housing 12.
  • foot switches 32, 34 An alternative to providing two different foot switches 32, 34 would be to provide a single foot switch which intermittently switches between stimulation and destimulation each time the switch is actuated. It is also contemplated that automatic stimulation could be provided after a preset time period or only if the device detects that the heart did not automatically restart.
  • a pair of electrodes 37, 38 are connected via a pair of leads 39A, 39B, respectively, to the electronic control device 50 for supplying electrical current to the heart during stimulation and destimulation.
  • a second pair of electrodes 43 A, 45 A can also be connected via a pair of leads 43, 45, respectively, to the electronic control device 50 for supplying electrical current to the phrenic nerve to control breathing during heart stimulation and destimulation.
  • a lead 48 having a connector 49 may be provided in addition to or alternatively of the phrenic nerve electrodes 43A, 43B. The connector 49 interfaces with a respirator (not shown) and, upon stimulation or destimulation of the heart, sends a logic signal to activate or deactivate the respirator.
  • the electro- stimulation device 40 is microprocessor based and includes a housing 41 having a display 42, a plurality of numeric keys 44, a heart stimulation switch 46, and a heart destimulation switch 48.
  • One of the keys 44 may be an on/off switch for supplying electrical power to the device 40.
  • the device 40 prompts a user to enter the patient's age, height, weight, body temperature, etc., via the keys 44 to calculate die proper amount of electrical current and its duration necessary for proper heart stimulation and destimulation.
  • the amount of current and duration to stop the heart will typically be different tiian me amount of current and duration to start the heart, and will vary from one person to another depending on factors such as height, weight, body temperature, etc.
  • the current may be of the alternating, direct, or waveform type.
  • the electronic control device 50 for use with the electro-stimulator of FIGS. 1 and 2 includes a regulated power source 52, such as a battery and regulator, a stimulation timer circuit 54, a destimulation timer circuit 55, a stimulation power amplifier 56, and a destimulation power amplifier 57.
  • the timer circuits and power amplifiers can be chosen from any of several well-known timers and amplifiers that can incorporate the dials 16, 18, 20, and 22. These dials may be of the variable resistive, capacitive, or pulse type to vary me timer frequency and power dissipation.
  • input from the keys 44 stored in a microprocessor 60 shown in dashed line) in the FIG.
  • the stimulation switch 24 and stimulation foot switch 32 on pedal assembly 30 are connected in parallel such that actuation of one or the other switch begins heart stimulation.
  • the destimulation switch 26 and stimulation foot switch 34 on pedal assembly 30 are connected in parallel such mat the actuation of one or the other switch begins heart destimulation.
  • the switches are of the single- shot type that permit current to flow through die circuit for the amount of time set by the timers 54, 56, even when the switches are released.
  • the switches may be of the type requiring manual positioning between me open and closed positions.
  • the timers 54, 56 may provide an audible signal to indicate when the appropriate duration of electrical current application has been reached.
  • the timers 54, 56 may also be eliminated. In tiiis instance, the appropriate switch is manually closed until the surgeon visually observes that the heart has been properly stimulated or destimulated.
  • the electrode 37 is connected to the sinoatrial region 72 of heart 70 while the electrode 38 is connected to the atrioventricular region 74 in a unipolar arrangement, while the electrodes 43A, 43B are connected to the phrenic nerve (not shown) or to other regions of the body or heart.
  • the separate connection regions on the heart serve to alternatively stimulate and destimulate the heart.
  • the electrode terminations may be of the type used in pacemakers, such as corkscrews, clips, pads, tines or barbs, needles, etc.
  • the electrodes 37, 38 may both be connected to the ventricular wall as shown in FIG. 5 in a bipolar arrangement or at any position that a pacemaker is commonly connected to.
  • the electrodes 43 A, 43B may be connected in a bipolar arrangement to the vagus nerve or one of its cardiac branches.
  • the electrodes 37, 38 are placed near each other at a particular region for stimulating the heart while the electrodes 43A, 45A are placed near each other at a second region for destimulating the heart.
  • the tissue between each pair of serves to close the circuit such that electrical current from the power source and amplifier passes through the tissue to cause stimulation or destimulation of the heart.
  • a series of current pulses is passed long enough through the tissue to augment any recurring natural heartbeat stimuli to stop the heart from beating.
  • a continuous pulse train for 10-30 seconds using a constant current of 10- 100mA in conjunction with a constant pulse width of 0.02-0.05 msec, and a frequency between 6 Hz and 50 Hz applied to the epicardial parasympathetic nerves is sufficient to augment me recurring natural heartbeat stimuli to stop the heart.
  • a burst pulse width of current be applied instead of a continuous pulse train.
  • a burst pulse width having the same current amplitude and frequency as in the constant pulse width is applied during the QT interval or repolarization phase.
  • the burst pulse time will be less that me continuous pulse train to stop the heart.
  • the burst pulse is programmable for different burst times, current amplitudes, and frequency.
  • the natural heart beat stimuli will typically occur again automatically a short time thereafter.
  • the separate heart stimulation leads therefore, provide an added safety feature in the event tiiat the heart does not automatically restart.
  • a series of current pulses are passed through the tissue to initiate the natural heartbeat stimuli. These current pulses are similar to those used in pacemakers.
  • the electrodes 37, 38 are secured at an appropriate position on the patient 80 (FIG. 6).
  • one of the foot switches 32, 34 is pressed to initiate or stop the heartbeat as required.
  • the surgeon may wish to stop the heartbeat while making one or a plurality of stitches where movement of the heart would normally be a hindrance.
  • the heart may then be stimulated either naturally or artificially through the present device to beat for a predetermined time to permit blood flow throughout the body and then be destimulated or stopped again to continue stitching.
  • the electrodes 43 A, 45A may be connected to the phrenic nerve and/or the connector 49 may be attached to a respirator to still the lungs during the surgical procedure. When the electrodes are attached to the phrenic nerve, a continuous pulse train having the range of values as discussed previously is sufficient for controlling lung movement.
  • a set of four electrodes 102, 104, 106, and 108 are equally circumferentially spaced around a catheter 100.
  • Each electrode 102-108 is embedded in and extends from an inner wall 110 to an outer wall 112 of the catheter 100.
  • a separate insulated lead 102a, 104a, 106a, and 108a are each soldered or otherwise electrically connected to their respective electrode.
  • the insulated leads extend through the catheter 100 and into the electronic control device 50. Any pair of electrodes can be accessed through extra switches in the control device 50 for supplying electrical current to the heart during stimulation and destimulation.
  • a set of three electrodes 122, 124 and 126 are equally circumferentially spaced around a catheter 120.
  • Each electrode 122-126 is embedded in and extends from an inner wall 130 to an outer wall 132 of the catheter 120.
  • 124a and 126a are each soldered or otherwise electrically connected to their respective electrode.
  • the insulated leads extend through the catheter 100 and into the electronic control device 50. Any pair of electrodes can be accessed through extra switches in the control device 50 for supplying electrical current to the heart during stimulation and destimulation.
  • each electrode 142, 144 may be spaced axially on a catheter 140.
  • the longitudinal centerline of each electrode 142, 144 extends perpendicularly to the axis of the catheter 140.
  • two electrodes 152, 154 are spaced axially and circumferentially from each other on the catheter 150. Their longitudinal centerlines extend parallel to the axis of the catheter. Two additional electrodes
  • 156, 158 may be provided on an opposite side of the catheter
  • Each of the electrodes 162-166 extends approximately 120° around the circumference of the catheter 160.
  • the catheters 100-160 as shown in FIGS. 7-12 are preferably of a small size to fit easily into the internal jugular vein, superior vena cava or other appropriate vessel adjacent to the desired nerve bundle.
  • the internal jugular vein is next to the vagal nerve bundle, and thus presents an ideal path for the catheter when attempting to stimulate the vagal nerve.
  • the human internal jugular vein is about 2 to 6 mm in diameter and tapers over an estimated length of about 15 cm. Hence, the use of a 7F or smaller size catheter is contemplated.
  • the electrodes are placed on the catheter in such a way that the amplitude required to stimulate the nerve fibers would have the correct field distribution.
  • the spacing between the electrodes would need to be about 1 - 2cm to achieve nerve stimulation. This spacing may vary depending on the size of the internal jugular vein and vagal nerve bundle, as well as the amount of applied current.
  • electrodes 104, 106 of the catheter 100 are in contact with a nerve (not shown) and have been selected to apply a current thereto.
  • FIG. 14 shows a similar occurrence for the three-electrode embodiment of FIG. 8. Since the electrodes in this embodiment are spaced a greater distance than the electrodes from in the FIG. 7 embodiment, the current distribution is not as concentrated, and therefore produces a different neural stimulation.
  • An axial current distribution may be required in addition to or in place of the circumferential distribution, as shown in FIG. 15, depending on the particular nerve stimulation desired.
  • the axial current distribution is obtained by accessing a pair of axially spaced electrodes (FIG. 9) or a pair of axially and circumferentially spaced electrodes (FIGS. 10-12).
  • the preferred use of the electro-stimulation device would be a transvenous implementation through standard transvenous implantation techniques such as those used to implant pace/ sense leads into the heart.
  • transvenous vagal stimulation in laproscopic/endoscopic/minithorascopic surgical coronary artery bypass graft (CABG) procedures, the use of vagal nerve stimulation provides a reversible, quick acting (like an on/off switch) method for slowing the heart rate.
  • CABG coronary artery bypass graft
  • the electro-stimulation device could be provided with two or more electrode-wielding catheters for use in multiple transvenous regions for the stimulation of different nerves.
  • a pair of catheters could be inserted into the internal jugular vein for stimulation of the right and left vagal nerve bundles.
  • the right bundle could be used to elicit more specific heart effects and reduce heart rate and increase AV delay for antiarrhythrnic and hemodynamic benefits; whereas the left bundle could be used to effect afferent vagal information and potentially reduce epileptic activity.
  • An electrode- wielding catheter could be inserted into the very high internal jugular vein to stimulate the hypoglossal nerve and/or into the very low internal jugular vein or superior vena cava to stimulate the phrenic nerve for respiratory control.
  • catheters of the present invention could be inserted into the azygos or accessory hemizygous veins to stimulate the sympathetic nerves for increasing heart rate or altering DFT efficacy for antiarrhythrnic and hemodynamic benefits.
  • Other transvenous routes to nerve stimulation for functional purposes may also be applicable.
  • the electro-stimulation device may also have specificity for direction of neural stimulation in regards to the location of the vessel and the nerve bundle that is to be stimulated.
  • the phrenic nerve could be elicited on and off by a mere rotation of the transvenous catheter, depending on the location of the electrodes on the catheter and the resulting electric current density generated.
  • a series of degree markings may be located on an outer circumference of the catheter at a position readily observable by the surgeon.
  • the catheter may be associated with a rotary encoder to obtain a digital read-out of the amount of catheter rotation.
  • the electrodes of the intravenous catheters according to the present invention could also be used to manipulate the heart rate or hemodynamics in response to device sensors.
  • the device in response to precursors of an arrhythmic event, the device may stimulate either the sympathetic or the parasympathetic individually or in combination to attempt to delay or prevent the event.
  • current may be applied to different pairs of electrodes as discussed above.
  • this new device in its preferred embodiment eliminates the potential for direct nerve damage and reduces the invasiveness of the placement of the electrodes for direct neural stimulation
  • the present invention provides numerous advantages over the prior art. First, by using electrical means to stimulate and destimulate the heart, the requirement to cool the heart and perfuse the heart with a potassium-containing solution is eliminated. This greatly simplifies the procedure for preparing the heart for surgery. In addition, it minimizes the incisions into the heart tissue, typically required during a perfusion process.
  • a second advantage is that, in some cases, it eliminates the need for utilizing a heart-lung bypass machine. Because the heart can be started and stopped almost instantaneously, blood flow can be maintained through the body by utilizing the heart, rather than by artificial means such as a machine. Therefore, the amount of heparin required to be injected into the blood stream is reduced, thereby speeding the healing process.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Radiology & Medical Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Biophysics (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L'invention concerne un dispositif d'électro-stimulation comportant une paire d'électrodes se raccordant à au moins un emplacement du corps conditionnant ou régulant les pulsations cardiaques. Ce dispositif d'électro-stimulation arrête et stimule électriquement les pulsations cardiaques. La paire d'électrodes peut être connectée à un cathéter intraveineux en vue d'une stimulation transveineuse du nerf approprié. Un premier commutateur est relié entre une alimentation électrique et les électrodes pour permettre une amenée sélective de courant depuis l'alimentation électrique jusqu'aux électrodes en vue d'augmenter tout stimuli naturel à destination du coeur et ainsi faire cesser ses battements. Un deuxième commutateur est relié entre l'alimentation électrique et les électrodes en vue de permettre une amenée sélective de courant depuis l'alimentation électrique jusqu'aux électrodes pour délivrer un stimulus artificiel pour déclencher les pulsations cardiaques. Dans un autre aspect, l'invention concerne une méthode pour arrêter le battement d'un coeur dans un organisme vivant, consistant à relier la paire d'électrodes à au moins un emplacement du corps conditionnant ou régulant les pulsations cardiaques et à délivrer à ses électrodes un courant électrique d'amplitude et de durée suffisantes pour arrêter les battements cardiaques. Ce dispositif peut également servir à immobiliser les poumons par raccordement à un respirateur ou par stimulation du nerf phrénique lors d'interventions chirurgicales.
PCT/US1997/001907 1996-04-30 1997-02-05 Procede et dispositif pour la regulation electronique des battements d'un coeur WO1997040885A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU21183/97A AU2118397A (en) 1996-04-30 1997-02-05 Method and device for electronically controlling the beating of a heart

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US64001396A 1996-04-30 1996-04-30
US08/640,013 1996-04-30

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WO1997040885A1 true WO1997040885A1 (fr) 1997-11-06

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Cited By (23)

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US6043273A (en) * 1997-08-08 2000-03-28 Duke University Compositions, apparatus and methods for facilitating surgical procedures
EP0940155A3 (fr) * 1998-02-04 2000-05-17 Medtronic, Inc. Appareil pour le traitement de l'apnée pendant le sommeil
US6449507B1 (en) 1996-04-30 2002-09-10 Medtronic, Inc. Method and system for nerve stimulation prior to and during a medical procedure
US6487446B1 (en) 2000-09-26 2002-11-26 Medtronic, Inc. Method and system for spinal cord stimulation prior to and during a medical procedure
US6532388B1 (en) 1996-04-30 2003-03-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
US6628987B1 (en) 2000-09-26 2003-09-30 Medtronic, Inc. Method and system for sensing cardiac contractions during vagal stimulation-induced cardiopalegia
US6711436B1 (en) 1997-08-08 2004-03-23 Duke University Compositions, apparatus and methods for facilitating surgical procedures
US6735471B2 (en) 1996-04-30 2004-05-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
US7072720B2 (en) 1999-06-25 2006-07-04 Emory University Devices and methods for vagus nerve stimulation
US7142910B2 (en) 1997-08-26 2006-11-28 Emory University Methods of indirectly stimulating the vagus nerve with an electrical field
US7225019B2 (en) 1996-04-30 2007-05-29 Medtronic, Inc. Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure
US7555341B2 (en) 2005-04-05 2009-06-30 Cardiac Pacemakers, Inc. System to treat AV-conducted ventricular tachyarrhythmia
US8036741B2 (en) 1996-04-30 2011-10-11 Medtronic, Inc. Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure
US8406868B2 (en) 2010-04-29 2013-03-26 Medtronic, Inc. Therapy using perturbation and effect of physiological systems
US8620425B2 (en) 2010-04-29 2013-12-31 Medtronic, Inc. Nerve signal differentiation in cardiac therapy
US8639327B2 (en) 2010-04-29 2014-01-28 Medtronic, Inc. Nerve signal differentiation in cardiac therapy
US8706223B2 (en) 2011-01-19 2014-04-22 Medtronic, Inc. Preventative vagal stimulation
US8718763B2 (en) 2011-01-19 2014-05-06 Medtronic, Inc. Vagal stimulation
US8725259B2 (en) 2011-01-19 2014-05-13 Medtronic, Inc. Vagal stimulation
US8781582B2 (en) 2011-01-19 2014-07-15 Medtronic, Inc. Vagal stimulation
US8781583B2 (en) 2011-01-19 2014-07-15 Medtronic, Inc. Vagal stimulation
US8929990B2 (en) 2005-04-11 2015-01-06 Cardiac Pacemakers, Inc. Transvascular neural stimulation device and method for treating hypertension
CN105167842A (zh) * 2014-09-23 2015-12-23 邵志辉 射频调控监测套管针

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DE2811325A1 (de) * 1978-03-16 1979-09-27 Messerschmitt Boelkow Blohm Fibrillator fuer herzchirurgie
WO1992011064A1 (fr) * 1990-12-20 1992-07-09 Medtronic, Inc. Dispositif d'induction automatique de fibrillation
EP0589252A2 (fr) * 1992-09-25 1994-03-30 Cardiac Pacemakers, Inc. Méthode d'induction de fibrillation dans des dispositifs implantables

Patent Citations (3)

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Publication number Priority date Publication date Assignee Title
DE2811325A1 (de) * 1978-03-16 1979-09-27 Messerschmitt Boelkow Blohm Fibrillator fuer herzchirurgie
WO1992011064A1 (fr) * 1990-12-20 1992-07-09 Medtronic, Inc. Dispositif d'induction automatique de fibrillation
EP0589252A2 (fr) * 1992-09-25 1994-03-30 Cardiac Pacemakers, Inc. Méthode d'induction de fibrillation dans des dispositifs implantables

Cited By (42)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7184829B2 (en) 1996-04-30 2007-02-27 Medtronic, Inc. Method and system for nerve stimulation prior to and during a medical procedure
US6735471B2 (en) 1996-04-30 2004-05-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
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