KR20120067555A - Ventricular assist device having cardioverter defibrillator - Google Patents

Abstract

PURPOSE: A ventricular assisting device having a cardioverter defibrillator is provided to enhance the survival rate of patients. CONSTITUTION: A ventricular assisting device having a cardioverter defibrillator comprises a pair of conduits, a detecting device, a cardioverter defibrillator(6), and a control device(4). A pair of the conduits comprises a cut unit, a connection pipe, and an electrode(20). The detecting device senses the abnormality of heartbeat. The cardioverter defibrillator applies electric stimulation to heart. The control device controls a blood pump and the cardioverter defibrillator.

Description

Ventricular assist device with defibrillation device {Ventricular assist device having cardioverter defibrillator}

The present invention relates to a ventricular assist device, and more particularly to a ventricular assist device having a defibrillation device.

Ventricular Assist Device (VAD) is generally used in patients with heart failure who have no medical effect or are difficult to treat with surgical open heart surgery. It is used to replace the function of the ventricles until the heart is transplanted, or to reduce the load on the heart and induce recovery.

Ventricular assist devices are classified into implantable type ventricular assist devices and extracoporeal type ventricular assist devices according to the implanted area, and LVAD and right ventricular assist devices (RVAD) depending on the assisting heart site. ) And biventricular assist device (BiVAD). Many left ventricular assists are used. In addition, it can be classified into pneumatic type (electric type) and electric (electric type) according to the difference in the way of supplying the power source by another classification method. The electric type is subdivided into electrohydraulic type and electromechanical type. In addition, according to the driving method can be classified into pulsatile type (non-pulsatile type) according to the presence of pulsation (pulsation) when the blood is ejected. The implantable biventricular assist device can be viewed as an artificial heart, but is distinct from a fully transplantable artificial heart in which the natural heart is removed and blood circulation is achieved only by the artificial heart.

The defibrillator detects when the ventricle causes tachycardia or an abnormal rhythm such as ventricular fibrillation due to deep vein, coronary artery disease, or myocardial infarction. It is a device that returns to the state. In general, the implantable defibrillator is implanted into the patient's chest through surgery, two electrodes are inserted through the vein into the atria and ventricles, and the patient's ECG is continuously monitored to detect the abnormal heart rhythm. There is a program installed to apply a direct electric shock.

When myocardial injuries due to myocardial infarction can cause various side effects such as arrhythmia and ventricular fibrillation in addition to the pump function of the heart, it is difficult to expect to greatly improve the survival rate of patients by simply using ventricular assist devices. However, the use of a separate external defibrillator may result in malfunction and damage of the ventricular assist device. In addition, there is a problem that additional procedures and the body volume of the patient is required to install the implantable defibrillator. The present invention is to improve the above-described problems, while the ventricular assist device and the defibrillator while operating at the same time to develop a fusion-type device to minimize the effects on each other to increase the survival rate of the patient, minimizing the cause of malfunction and damage of the device It aims to do it.

According to the present invention, a ventricular assist device having a blood pump for pumping blood, comprising: a connecting tube connecting the incision portion of the biological tissue and the blood pump so that blood can flow, and the connecting tube and the living body At least one pair of conduits including electrodes in contact with the incisions of the tissues to transmit electrical signals to the biological tissues; Sensing device for detecting whether the heart beat abnormality; A defibrillation device for applying an electric shock to the heart by applying a defibrillation pulse to the electrode; And a control device that receives a signal from the sensing device and controls the blood pump and the defibrillation device. The ventricular assist device having the defibrillation device is provided.

In addition, the electrode is provided with a ventricular assist device provided with a defibrillator, characterized in that the conductive sheet attached to the surface of the connector.

In addition, the electrode is provided with a ventricular assist device having a defibrillation device, characterized in that the hollow is formed in the inner tube is inserted into the connector, the outer surface is in close contact with the incision of the biological tissue. do. It is preferable that a receiving groove is formed around the outer surface of the hollow electrode to accommodate the incision of the biological tissue.

In addition, the electrode, a hollow through which blood can flow is formed inside, the outer surface is in close contact with the incision of the biological tissue, the body portion is inserted into the interior of the biological tissue, extending from the body portion, the connection Provided is a ventricular assist device having a defibrillation device, characterized in that it is a connector-type electrode comprising a fixed portion inserted into and fixed to the tube.

In addition, the electrode, the hollow is formed to the blood flow inside, the outer surface includes a body portion in close contact with the incision of the biological tissue and fixing portions extending from the body portion to the upstream and downstream, respectively, The connection tube, one end is connected to the fixing portion and the other end is inserted into the inside of the biological tissue and the first end is connected to the fixing portion and the other end is connected to the blood pump includes a second connection tube A ventricular assist device having a defibrillation device is provided.

In addition, the sensing device is provided with a ventricular assist device with a defibrillator, characterized in that it comprises a pressure sensor for measuring the inlet pressure of the conduit.

In addition, the sensing device is provided with a ventricular assist device with a defibrillator, characterized in that it comprises an impedance measuring device for measuring the impedance between the electrodes.

In addition, the control device, the defibrillation device is provided with a defibrillation device, characterized in that when the charging of the defibrillation energy for applying the defibrillation pulse is completed, operating a protection mode for blocking the power supply and input and output signals of the ventricular assist device. One ventricular assist device is provided. Preferably, the control device includes an external alarm device that sounds an alarm when ventricular fibrillation or cardiac arrest is detected through the detection device.

The ventricular assist device according to the present invention can provide an efficient defibrillation method for restoring cardiac function in preparation for lethal arrhythmias that may occur during use of the ventricular assist device. In addition, it is possible to minimize the possibility of malfunction and damage of the ventricular assist device that may occur due to the operation of a separate defibrillation device. In addition, since direct electrical stimulation can be applied to the perkinase fibers of the heart muscle, fast and efficient defibrillation is possible even with a small electric stimulation compared to the general defibrillation method.

1 is a conceptual diagram of a ventricular assist device having a defibrillation device according to an embodiment of the present invention.
FIG. 2 is a block diagram of the ventricular assist device shown in FIG. 1.
3 is a side view showing a conduit of the ventricular assist device shown in FIG.
4 is a flow chart showing the operation steps of the ventricular assist device shown in FIG.
5 through 7 illustrate conduits of a ventricular assist device with a defibrillation device in accordance with other embodiments of the present invention.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is a conceptual diagram of a ventricular assist device having a defibrillation device according to an embodiment of the present invention, Figure 2 is a block diagram of the ventricular assist device shown in FIG.

1 and 2, the ventricular assist device equipped with a defibrillator according to an embodiment of the present invention, like the general ventricular assist device, is connected to the ventricle 1, the inlet conduit in which blood in the ventricle 1 flows in (10a, 20), the blood pump (3) connected to the inlet conduits (10a, 20) to pump blood, the blood pump (3) and the artery (2) by connecting the blood ejected from the blood pump (3) artery And outlet conduits 10b and 20 for delivery to (2).

3 is a side view showing a conduit of the ventricular assist device shown in FIG. Referring to Figure 3, the inlet and outlet conduits are long tubes that are empty inside to allow blood to flow. The inlet and outlet conduits comprise a connector 10 and a conductive sheet 20 attached to the surface of the connector 10. The connector 10 may be made of a flexible material, but has elasticity capable of contraction expansion to function as an bypass conduit (AAC) that reduces the load on the heart when not used as a ventricular assist device. More preferably, it is made of a material. In addition, the connection tube 10 is preferably made of a biopolymer material having excellent blood compatibility and excellent durability, for example, medical polyurethane.

The conductive sheet 20 is attached to the surface of the connection pipe 10 and is connected to the defibrillation device 6 through the conductive wire 30. The conductive sheet 20 is made of Ag / AgCl, Pt (platinum), Au (gold) or other electrode material. The conductive sheet 20 may contact the end face of the incision when the connecting tube 10 is inserted into the ventricle 1 or the artery 2 through an incision of a living tissue such as the ventricle 1 or the artery 2. Attached to the location. Therefore, the electrical signal transmitted through the conductive sheet 20 can be directly transmitted to the muscle cells or conductive fibers (purkinje fiber) of the heart, it is an advantage that can effectively apply electrical stimulation to the entire heart through a small electrical energy have.

The blood pump 3 can be classified into a pneumatic type and an electric type. The electric type is subdivided into electrohydraulic type and electromechanical type. The blood pump 3 stores the blood flowing in from the inlet connecting pipe 10a, and expands and compresses the blood bag and the blood bag flowing out of the outlet connecting pipe 10b, thereby allowing blood to flow, Electrical devices. Since the blood pump 3 may use a well-known apparatus, detailed description is abbreviate | omitted.

1 to 2, a ventricular assist device having a defibrillator according to an embodiment of the present invention applies a defibrillation pulse to a sensing device 8 and an electrode 20 of a conduit for detecting a heartbeat abnormality. And a control device 4 for controlling the blood pump 3 and the defibrillation device 6 by receiving a signal from the defibrillation device 6 and the sensing device 8 that apply electrical stimulation to the heart.

The sensing device 8 comprises an electrocardiogram measuring device 8. Electrocardiogram is a curve recording the active current according to the contraction of the heart, abbreviated as ECG or EKG. Myocardial excitation occurs in the venous sinus and travels to the atrial and ventricular directions, so when the excitation is directed to the electrocardiogram at any of two points, the heart's active current is depicted graphically. Thus obtained is an electrocardiogram. The ECG can be used to check for abnormalities in the heart. The sensing device 8 transmits the measured data to the control device 4.

The defibrillation apparatus 6 includes a high voltage generating unit for applying an electric shock and a high voltage switching unit for discharging a current generated in the high voltage generating unit to the human body. The defibrillator 6 is implanted into the chest without being visible from the outside, or contained within the control device 4 and implanted together. Since the defibrillation apparatus 6 may use a well-known apparatus, detailed description is abbreviate | omitted.

The control device 4 includes a microcontroller unit for processing the signal measured by the sensing device 8 and determining whether the electric shock and the electric shock amount. The microcontroller unit controls the high voltage generator of the defibrillator 6. The microcontroller unit also controls the blood pump 3. In addition, the control device 4 further includes an external alarm device (not shown) that sounds an alarm when ventricular fibrillation is confirmed.

4 is a flow chart showing the operation steps of the ventricular assist device shown in FIG. Referring to Figure 4, the operation of the ventricular assist device with a defibrillator according to the present invention begins with measuring the state of the heart through the sensing device. If there is no abnormality by processing the signal measured by the controller, a driving signal is sent to the blood pump to drive the blood pump. When ventricular fibrillation is detected, an external alarm is sounded, the amount of electric shock is determined and the defibrillation energy is set. When the defibrillation energy is charged and the preparation of the defibrillation pulse is completed, the operation of the blood pump is cut off, and the protection mode for blocking the input / output signal is entered to prevent damage to the blood pump due to the defibrillation pulse. If defibrillation is confirmed by defibrillation, the protection mode is released, the blood pump is restarted, and if the defibrillation fails, the defibrillation alarm is issued.

5 through 7 illustrate conduits of a ventricular assist device with a defibrillation device in accordance with other embodiments of the present invention.

Referring to FIG. 5, the conduit according to the present embodiment includes a connector 10 and a hollow electrode 40. Since the connection pipe 10 is the same as the embodiment of FIG. 3, description thereof will be omitted and only the hollow electrode 40 will be described. The hollow electrode 40 has a cylindrical shape in which a hollow 41 into which the inner connection pipe 10 can be inserted is formed. The periphery of the hollow electrode 40 is formed with a receiving groove 42 that can accommodate the incision of the biological tissue. When the hollow electrode 40 is inserted through the incision of the biological tissue, the incision of the biological tissue is inserted into the receiving groove 42. The connector 10 is inserted into the biological tissue through the hollow 41 of the hollow electrode 40. Inside the receiving groove 42 of the hollow electrode, a conductive layer 43 made of an electrode material such as Ag / AgCl, Pt (platinum), Au (gold) is formed, and the conductive layer 43 is formed of a conductive wire ( 30 is connected to the defibrillation device (6). The entire hollow electrode may be made of an electrode material without forming a separate conductive layer 43.

Referring to FIG. 6, the conduit of the ventricular assist device provided with the defibrillation device according to the present embodiment includes an electrode 50 having a connection pipe 11, a body part 51, and a fixing part 54. The body portion 51 is formed with a hollow (not shown) through which blood can flow, and similarly to the second embodiment, a receiving groove 52 is formed in the circumference to accommodate the incision of the biological tissue. In the drawing, a through hole 53 through which blood can pass is formed at one end of the body 51, and a fixing part 54 extending from the body 51 is formed at one end of the body 51. The fixing part 54 is inserted into the connecting pipe 11 and serves to connect the electrode 50 and the connecting pipe 11, and a protrusion 55 is formed to prevent the connecting part from being easily separated.

 Referring to FIG. 7, the conduit of the ventricular assist device provided with the defibrillation device according to the present embodiment includes a connection pipe and a body portion 61 divided into a first connection pipe 12 and a second connection pipe 13. An electrode 60 with government portions 64. The body portion 61 is formed with a hollow (not shown) through which blood can flow, and the outer surface is in close contact with the incision of the biological tissue. The fixing portions 64 extend from the body portion 61 to the left side and the right side, respectively, and protrusions 65 are formed to prevent separation from the connection pipes 12 and 13. One end of the first connecting tube 12 is connected to the left fixing part 64, the other end is inserted into the inside of the biological tissue, and the second connecting tube 13 is connected to the right fixing part 64 at one end thereof. The other end is connected to a ventricular assist device (not shown).

In the above, the present invention has been described in detail with reference to preferred embodiments, but the present invention is not limited to the above embodiments, and various modifications can be made by those skilled in the art within the technical idea of the present invention. Is obvious.

For example, although the sensing device 8 is described as being a commonly used electrocardiogram measuring device 8, a pressure sensor installed at the inlet of the inlet conduit 10a may be used. When ventricular fibrillation occurs, each part of the ventricles is irregularly contracted irregularly, the flow of blood flowing through the inlet of the inlet conduit (10a) is also irregular, so if you measure this through a pressure sensor, to determine whether the ventricular fibrillation Can be. In addition, when cardiac arrest occurs, the blood flowing into the inlet conduit (10a) is reduced, so that the pressure drop can determine whether or not cardiac arrest. In addition, as a method for measuring impedance between the electrodes 20 of the inlet and outlet conduits, a sensing device for measuring heart abnormalities such as ventricular fibrillation and cardiac arrest may be used. Since the impedance between the electrodes 20 of the inlet and outlet conduits varies depending on the flow of blood between the ventricle and the aorta, measuring this can detect whether there is a heart abnormality.

1: ventricle 2: aorta
3: blood pump 4: controller
6: defibrillator 8: ECG measuring device
10: connector 20, 40, 50, 60: electrode
30: lead wire

Claims (12)

In the ventricular assist device provided with a blood pump for pumping blood,
And a connector for connecting the incision of the biological tissue and the blood pump so that blood flows, and an electrode coupled with the connecting tube and in contact with the incision of the biological tissue to transmit an electrical signal to the biological tissue. At least a pair of conduits;
Sensing device for detecting whether the heart beat abnormality;
A defibrillation device for applying an electric shock to the heart by applying a defibrillation pulse to the electrode; And
A ventricular assist device with a defibrillator comprising a; control device for receiving a signal from the sensing device to control the blood pump and the defibrillator. The method of claim 1,
The electrode
Ventricular assist device provided with a defibrillator, characterized in that the conductive sheet attached to the surface of the connecting tube. The method of claim 1,
The electrode
A hollow is formed inside the hollow tube into which the connector can be inserted, and the outer surface is a ventricular assist device having a defibrillator, characterized in that the hollow electrode in close contact with the incision of the biological tissue. The method of claim 3,
Ventricular assist device provided with a defibrillator, characterized in that the receiving groove is formed around the outer surface of the hollow electrode to accommodate the incision of the biological tissue. The method of claim 1,
The electrode
The hollow is formed inside the blood flow, the outer surface is in close contact with the incision of the biological tissue, the body portion is inserted into the interior of the biological tissue, extending from the body portion, is inserted into and fixed to the connecting tube A ventricular assist device with a defibrillator, characterized in that the connector-type electrode comprising a fixed portion. The method of claim 5,
Ventricular assist device with a defibrillator, characterized in that the receiving groove is formed around the outer surface of the body portion for receiving the incision of the biological tissue. The method of claim 1,
The electrode
The hollow is formed inside the blood flow, the outer surface includes a body portion in close contact with the incision of the biological tissue and fixing portions extending from the body portion upstream and downstream, respectively,
The connector,
Defibrillation, characterized in that it comprises a first connecting pipe is connected to the fixing portion and the other end is inserted into the inside of the biological tissue and one end is connected to the fixing portion and the other end is connected to the blood pump Ventricular assist device with device. The method of claim 7, wherein
Ventricular assist device with a defibrillator, characterized in that the receiving groove is formed around the outer surface of the body portion for receiving the incision of the biological tissue. The method of claim 1,
The sensing device,
Ventricular assist device with a defibrillator, characterized in that it comprises a pressure sensor for measuring the inlet pressure of the conduit. The method of claim 1,
The sensing device,
Ventricular assist device with a defibrillator, characterized in that it comprises an impedance measuring device for measuring the impedance between the electrodes. The method of claim 1,
The control device includes:
And a defibrillation device, when the defibrillation device is charged with the defibrillation energy for applying a defibrillation pulse, operating a protection mode to block power and input / output signals of the ventricular assist device. The method of claim 1,
The control device includes:
Ventricular assist device with a defibrillation device comprising a ventricular fibrillation, an external alarm device that sounds an alarm when a cardiac arrest is detected through the sensing device.

Images