Implantable electric heart defibrillator with attenuation of the pain resulting from the electric shock

Abstract

An implantable electrical heart defibrillation system for both ventricle and atrium is proposed and is characterized in that it acts in a manner such as: to diagnose the type of arrhythmia within a maximum time of 2 seconds from the onset of the arrhythmia; to deliver the therapeutic shock by electrodes implanted in the region to be defibrillated no more than 4-5 seconds after the recognition of the arrhythmia, if it is ventricular fibrillation, so that the patient does not loose consciousness; immediately after the onset of the arrhythmia and before the defibrillation shock is delivered, to prevent the conduction of neural pain signals coming from the region in which the electric shock acts, by means of nerve stimulation by a catheter inserted in the spinal column, utilizing the gate effect, or by the perfusion of a drug with immediate analgesic effect by means of an infusion pump and a catheter positioned in the region affected by the pain signals. This system enables defibrillation or conversion to be carried out with the patient conscious and within a sufficiently short time to be able to use low shock energy, and with prevention of the consequent painful shock. This considerably improves the quality of life of the patient who is no longer subject to loss of consciousness during ventricular fibrillation and does not feel the pain during the electric shock.

What is claimed is:  
     
         1 . A method of electrically defibrillating a heart, comprising: 
 (a) sensing a heart arrhythmia;    (b) stimulating the spinal column to produce an analgesic effect; and    (c) delivering an electrical shock to defibrillate the heart.    
     
     
         2 . A method of electrically defibrillating a heart as in  claim 1 , wherein the step of stimulating the spinal column comprises saturating the pathways of the pain caused by the shock by the gate control method.  
     
     
         3 . A method of electrically defibrillating a heart as in  claim 1 , wherein the step of delivering the electrical shock is synchronized with the patient's QRS.  
     
     
         4 . A method of electrically defibrillating a heart as in  claim 1 , wherein a blanking circuit is provided, the blanking circuit generating a signal which can protect the other circuits from the electrical shock, the blanking circuit being activated prior to the delivery of the shock and terminating after delivery of the shock.  
     
     
         5 . A method of electrically defibrillating a heart as in  claim 1 , wherein the arrhythmia is a ventricular fibrillation.  
     
     
         6 . A method of electrically defibrillating a heart as in  claim 5 , wherein the step of sensing the ventricular fibrillation comprises sensing within 2 seconds from the start of the ventricular fibrillation an electrical signal from the heart having an average frequency of greater than 280-300 beats per minute with irregularities in period and amplitude and sensing a stoppage of pumping of the heart.  
     
     
         7 . A method of electrically defibrillating a heart as in  claim 5 , wherein the step of delivering the electrical shock comprises delivering the electrical shock no longer than three seconds after sensing the ventricular fibrillation.  
     
     
         8 . A method of electrically defibrillating a heart as in  claim 5 , wherein the step of stimulating the spinal column to produce an analgesic effect comprises infusing an analgesic drug immediately upon sensing the ventricular fibrillation.  
     
     
         9 . A method of electrically defibrillating a heart as in  claim 5 , wherein the step of stimulating the spinal column to produce an analgesic effect comprises electrically stimulating a nerve immediately upon sensing the ventricular fibrillation.  
     
     
         10 . A method of electrically defibrillating a heart as in  claim 5 , wherein the step of stimulating the spinal column comprises saturating the pathways of the pain caused by the shock by the gate control method.  
     
     
         11 . A method of electrically defibrillating a heart as in  claim 5 , wherein a blanking circuit is provided, the blanking circuit generating a signal which can protect the other circuits from the electrical shock, the blanking circuit being activated prior to the delivery of the shock and terminating after delivery of the shock.  
     
     
         12 . A method of electrically defibrillating a heart as in  claim 1 , wherein the arrhythmia is an atrial arrhythmia.  
     
     
         13 . A method of electrically defibrillating a heart as in  claim 12 , wherein the step of sensing the arrhythmia allows sufficient time to verify the stability of the arrhythmia.  
     
     
         14 . A method of electrically defibrillating a heart as in  claim 12 , wherein the step of delivering the electrical shock may take up to one minute from sensing the arrhythmia, and the electrical shock is between 1 and 10 Joules.  
     
     
         15 . A method of electrically defibrillating a heart as in  claim 12 , wherein the step of stimulating the spinal column occurs at least two seconds before the electrical shock.  
     
     
         16 . A method of electrically defibrillating a heart as in  claim 12 , wherein the step of delivering the electrical shock is synchronized with the patient's QRS.  
     
     
         17 . A method of electrically defibrillating a heart as in  claim 12 , wherein the step of stimulating the spinal column comprises saturating the pathways of the pain caused by the shock by the gate control method.  
     
     
         18 . A method of electrically defibrillating a heart as in  claim 12 , wherein a blanking circuit is provided, the blanking circuit generating a signal which can protect the other circuits from the electrical shock, the blanking circuit being activated prior to the delivery of the shock and terminating after delivery of the shock.  
     
     
         19 . A method of electrically defibrillating a heart as in  claim 1 , wherein the arrhythmia is ventricular tachycardia.  
     
     
         20 . A method of electrically defibrillating a heart as in  claim 19 , wherein the step of sensing the ventricular tachycardia comprises sensing an electrical signal from the heart beating up to 300 beats per minutes, wherein the beats have substantially constant frequency and amplitude, and further sensing an attenuated and/or irregular blood flow without stoppage of the heart.  
     
     
         21 . A method of electrically defibrillating a heart as in  claim 19 , further comprising the step of applying a pacing electrical stimulus as a first treatment and, if this is unsuccessful after a programmed number of attempts, delivering a low energy cardioversion shock.  
     
     
         22 . A method of electrically defibrillating a heart as in  claim 19 , wherein the step of stimulating the spinal column comprises saturating the pathways of the pain caused by the shock by the gate control method.  
     
     
         23 . A method of electrically defibrillating a heart as in  claim 19 , wherein a blanking circuit is provided, the blanking circuit generating a signal which can protect the other circuits from the electrical shock, the blanking circuit being activated prior to the delivery of the delivery of the shock and terminating after delivery of the shock.  
     
     
         24 . A method of electrically defibrillating a heart as in  claim 1 , wherein the step of stimulating the spinal column comprises infusing an analgesic drug with immediate effect.  
     
     
         25 . A method of electrically defibrillating a heart as in  claim 1 , wherein the step of sensing the arrhythmia comprises sensing the arrhythmia through electrical, mechanical, or electromechanical impulses.