Method and system for sensing cardiac contractions during a medical procedure

Abstract

A system of performing a medical procedure, such as surgery, is provided. The system comprises a sensor to sense a state of cardiac tissue, such as an impending contraction and an indicator to indicate the state of the cardiac tissue. Methods and devices for performing the medical procedure are also provided.

We claim:  
     
         1 . A system for performing a medical procedure, comprising: 
 a sensor to sense a state of a cardiac tissue; and    an indicator to indicate the state of the cardiac tissue.    
     
     
         2 . The system of  claim 1  further comprising: 
 a cardiac stimulator in communication with the sensor to stimulate beating of a heart when the state indicated by the indicator is a contracting state.  
 
     
     
         3 . The system of  claim 1  further comprising: 
 a nerve stimulator in communication with the sensor to inhibit beating of a heart when the state indicated by the indicator is a non-contracting state.  
 
     
     
         4 . The system of  claim 1  further comprising: 
 drug delivery means for delivering at least one drug during the medical procedure.  
 
     
     
         5 . The system of  claim 4  wherein the drug delivery means is selected from the group consisting of: 
 a spray, a cream, an ointment, a medicament, a pill, a patch, a catheter, a cannula, a needle and syringe, a pump, and an iontophoretic drug delivery device.  
 
     
     
         6 . The system of  claim 4  wherein the drug is selected from the group consisting of: 
 a beta-blocker, a cholinergic agent, a cholinesterase inhibitor, a calcium channel blocker, a sodium channel blocker, a potassium channel agent, adenosine, an adenosine receptor agonist, an adenosine deaminase inhibitor, dipyridamole, a monoamine oxidase inhibitor, digoxin, digitalis, lignocaine, a bradykinin agent, a serotoninergic agonist, an antiarrythmic agent, a cardiac glycoside, a local anesthetic, atropine, a calcium solution, an agent that promotes heart rate, an agent that promotes heart contractions, dopamine, a catecholamine, an inotrope glucagon, a hormone, forskolin, epinephrine, norepinephrine, thyroid hormone, a phosphodiesterase inhibitor, prostacyclin, prostaglandin and a methylxanthine.  
 
     
     
         7 . The system of  claim 4  wherein the drug is naturally occurring.  
     
     
         8 . The system of  claim 4  wherein the drug is chemically synthesized.  
     
     
         9 . The system of  claim 3  wherein the nerve stimulator stimulates a nerve selected from the group consisting of: 
 a vagal nerve, a carotid sinus nerve, a fat pad.  
 
     
     
         10 . The system of  claim 3  wherein the nerve stimulator stops stimulation automatically when the state indicated by the indicator is a contracting state.  
     
     
         11 . The system of  claim 1  wherein the sensor is selected from the group consisting of: 
 an electrical sensor, a chemical sensor, an electromagnetic interference sensor, an electrochemical sensor, a pressure sensor, a sound wave sensor, a magnetic sensor, an ultraviolet sensor, a visible light sensor, an infrared sensor, a radiation sensor, a flow sensor, a temperature sensor, a gas sensor, an optical sensor, a pH sensor, a potentiometric sensor, a fluorescence sensor, a depolarization sensor and a biosensor.  
 
     
     
         12 . The system of  claim 1  wherein the sensor comprises at least one electrode.  
     
     
         13 . The system of  claim 12  wherein the electrode is selected from the group consisting of: 
 cardiac stimulation electrodes, clip electrodes, needle electrodes, probe electrodes, pacing electrodes, epicardial electrodes, patch electrodes, intravascular electrodes, balloon-type electrodes, basket-type electrodes, tape-type electrodes, umbrella-type electrodes, suction-type electrodes, endotracheal electrodes, endoesophageal electrodes, transcutaneous electrodes, intracutaneous electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes and cuff electrodes.  
 
     
     
         14 . The system of  claim 2  wherein the cardiac stimulator comprises at least one electrode.  
     
     
         15 . The system of  claim 14  wherein the electrode is selected from the group consisting of: 
 cardiac stimulation electrodes, clip electrodes, needle electrodes, probe electrodes, pacing electrodes, epicardial electrodes, patch electrodes, intravascular electrodes, balloon-type electrodes, basket-type electrodes, tape-ype electrodes, umbrella-type electrodes, suction-type electrodes, endotracheal electrodes, endoesophageal electrodes, transcutaneous electrodes, intracutaneous electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes and cuff electrodes.  
 
     
     
         16 . The system of  claim 2  wherein the sensor and the cardiac stimulator are the same.  
     
     
         17 . The system of  claim 3  wherein the nerve stimulator comprises at least one electrode.  
     
     
         18 . The system of  claim 17  wherein the electrode is selected from the group consisting of: 
 nerve stimulation electrodes, endotracheal electrodes, endoesophageal electrodes, intravascular electrodes, transcutaneous electrodes, intracutaneous electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, tape-type electrodes, suction-type electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes, patch electrodes, cuff electrodes, clip electrodes, needle electrodes and probe electrodes.  
 
     
     
         19 . The system of  claim 1  further comprising a breathing regulator.  
     
     
         20 . The system of  claim 19  wherein the breathing regulator stimulates a phrenic nerve.  
     
     
         21 . The system of  claim 19  wherein the breathing regulator controls a respirator.  
     
     
         22 . The system of  claim 19  wherein the breathing regulator comprises at least one electrode.  
     
     
         23 . The system of  claim 22  wherein the electrode is selected from the group consisting of: 
 nerve stimulation electrodes, endotracheal electrodes, endoesophageal electrodes, intravascular electrodes, transcutaneous electrodes, intracutaneous electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, suction-type electrodes, screw-type electrodes, tape-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes, patch electrodes, cuff electrodes, clip electrodes, needle electrodes and probe electrodes.  
 
     
     
         24 . The system of  claim 1  wherein the medical procedure is selected from the group consisting of: 
 a surgical procedure, a non-surgical procedure, a fluoroscopic procedure, a cardiac procedure, a vascular procedure, a neurosurgical procedure, an electrophysiology procedure, a diagnostic procedure, a therapeutic procedure, an ablation procedure, an endovascular procedure, a liver procedure, a spleen procedure, a pulmonary procedure, an aneurysm repair, an imaging procedure, a CAT scan procedure, a MRI procedure, a pharmacological therapy, a drug delivery procedure, a biological delivery procedure, a genetic therapy, a cellular therapy, a cancer therapy, a radiation therapy, a transplantation procedure, a coronary angioplasty procedure, a stent delivery procedure, an atherectomy procedure, a procedure that requires precise control of cardiac motion, a procedure that requires precise control of bleeding, a non-invasive procedure, a minimally invasive procedure, an invasive procedure, a port-access procedure, an endoscopic procedure, a sternotomy procedure, a thoracotomy procedure and a robotic procedure.  
 
     
     
         25 . A method for performing a medical procedure, comprising: 
 inhibiting beating of a heart;    performing the medical procedure; and    sensing a state of cardiac tissue while beating of the heart is inhibited.    
     
     
         26 . The method of  claim 25 , further comprising: 
 inhibiting beating of the heart automatically when the state of cardiac tissue is a non-contracting state.    
     
     
         27 . The method of  claim 25  further comprising: 
 stimulating a nerve to inhibit beating of the heart when the state of cardiac tissue is a non-contracting state.  
 
     
     
         28 . The method of  claim 27  further comprising: 
 stopping stimulation of the nerve when the state of cardiac contraction is a contracting state.  
 
     
     
         29 . The method of  claim 25 , further comprising: 
 allowing beating of the heart to occur when the state of cardiac tissue is a contracting state.    
     
     
         30 . The method of  claim 25 , further comprising: 
 stimulating beating of the heart automatically when the state of cardiac tissue is a contracting state.    
     
     
         31 . The method of  claim 25  further comprising: 
 delivering at least one drug during the medical procedure.  
 
     
     
         32 . The method of  claim 25  further comprising: 
 stopping breathing when the state of cardiac tissue is a non-contracting state.  
 
     
     
         33 . A device for performing a medical procedure, comprising: 
 a processor;    a sensor to sense a state of cardiac tissue, the sensor operatively connected to the processor; and    at least one nerve stimulation electrode, the nerve stimulation electrode operatively connected to the processor wherein the processor receives a signal from the sensor and adjusts output from the nerve stimulation electrode in response to the signal.    
     
     
         34 . The device of  claim 33  wherein the sensor is selected from the group consisting of: 
 an electrical sensor, a chemical sensor, an electromagnetic interference sensor, an electrochemical sensor, a pressure sensor, a sound wave sensor, a magnetic sensor, an ultraviolet sensor, a visible light sensor, an infrared sensor, a radiation sensor, a flow sensor, a temperature sensor, a gas sensor, an optical sensor, a pH sensor, a potentiometric sensor, a fluorescence sensor, a depolarization sensor and a biosensor.  
 
     
     
         35 . The device of  claim 33  wherein the nerve stimulation electrode selected from the group consisting of: 
 endotracheal electrodes, endoesophageal electrodes, intravascular electrodes, transcutaneous electrodes, intracutaneous electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, tape-type electrodes, suction-type electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes, patch electrodes, cuff electrodes, clip electrodes, needle electrodes and probe electrodes.  
 
     
     
         36 . The device of  claim 33  further comprising: 
 at least one cardiac stimulation electrode to stimulate beating of the heart, the cardiac stimulator operatively connected to the processor wherein the processor receives a signal from the sensor and adjusts output from the cardiac stimulation electrode in response to the signal.  
 
     
     
         37 . The device of  claim 36  wherein the cardiac stimulation electrode is selected from the group consisting of: 
 clip electrodes, needle electrodes, probe electrodes, pacing electrodes, epicardial electrodes, patch electrodes, intravascular electrodes, balloon-type electrodes, basket-type electrodes, tape-type electrodes, umbrella-type electrodes, suction-type electrodes, endotracheal electrodes, endoesophageal electrodes, transcutaneous electrodes, intracutaneous electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes and cuff electrodes.  
 
     
     
         38 . The device of  claim 36  wherein the cardiac stimulation electrode and the sensor are the same.  
     
     
         38 . The device of  claim 33  further comprising: 
 at least one breathing regulation electrode for controlling breathing, the breathing regulation electrode operatively connected to the processor wherein the processor adjusts the output from the breathing regulation electrode in response to the signal.  
 
     
     
         39 . The device of  claim 38  wherein the breathing regulation electrode is selected from the group consisting of: 
 nerve stimulation electrodes, endotracheal electrodes, endoesophageal electrodes, intravascular electrodes, transcutaneous electrodes, intracutaneous electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, suction-type electrodes, screw-type electrodes, tape-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes, patch electrodes, cuff electrodes, clip electrodes, needle electrodes and probe electrodes.  
 
     
     
         40 . The device of  claim 33  further comprising: 
 a drug pump for delivering at least one drug, the drug pump operatively connected to the processor wherein the processor adjusts the output of the drug.