US4798211A
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Diagnostic methods and apparatus employing monitoring of myocardial ischemia
Assignee: Itamar Medical Ltd
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Filing: 1986-04-25
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Granted: 1989-01-17
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Expires: 2006-04-25
Abstract
Abstract A method and apparatus monitor myocardial ischemic events in various medical applications for providing continuous and contemporaneous information regarding, for example, modifying the amount of medication for a patient, determining response during (PTCA) balloon angioplasty, monitoring the onset of myocardial ischemic events during induction of anesthesia, determining painless myocardial ischemia in a resting patient, and monitoring the onset of myocardial ischemic during stress conditions in a patient. The method and apparatus also provide a calibration method for determining from a Resistive Index and using the resulting transformation for calculating, on a continuing basis, both systemic vascular resistance and cardiac output.
Inventors
- 👤 Daniel Goor
- 👤 Raphael Mohr
- 👤 Ihsan A. Haddad
- 👤 William R. Oliver
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-28 13:59
CPC Classifications
A; A61; A61B; A61B5/00; A61B5/02; A61B5/021; A61B5/0215; A61B5/02108; A61B5/72; A61B5/7235; A61B5/7239
Claims Analysis
Total Claims: 19
Claim 1
Independent Claim
62 words
A method for monitoring the onset of a myocardial ischemic event during the induction of anesthesia in a subject comprising the steps of monitoring values of a parameter corresponding to systemic vascular resistance of the subject, and detecting the onset of myocardial ischemic events during the induction of anesthesia when said monitored parameter value changes in accordance with a selected numerical amount.
Claim 2
Independent Claim
62 words
A method for monitoring the onset of a myocardial ischemic event during the induction of anesthesia in a subject comprising the steps of monitoring values of a parameter corresponding to systemic vascular resistance of the subject, and detecting the onset of myocardial ischemic events during the induction of anesthesia when said monitored parameter value changes in accordance with a selected numerical amount.
Claim 3
Dependent Claim
131 words
The method according to claim 1 wherein said parameter monitoring step comprises the steps of: A. detecting the arterial pressure, P, of the subject and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak DP/dt; and dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter corresponding to the systemic vascular resistance of said subject's cardiovascular system.
Claim 4
Independent Claim
59 words
A method for quantifying the extent of myocardial ischemic response during (PTCA) balloon angioplasty of a subject comprising the steps of monitoring values of a parameter corresponding to systemic vascular resistance of the subject, and detecting when said parameter value changes by a selected numerical value for indicating the degree of myocardial ischemia developed during said (PTCA) balloon angioplasty.
Claim 5
Independent Claim
59 words
A method for quantifying the extent of myocardial ischemic response during (PTCA) balloon angioplasty of a subject comprising the steps of monitoring values of a parameter corresponding to systemic vascular resistance of the subject, and detecting when said parameter value changes by a selected numerical value for indicating the degree of myocardial ischemia developed during said (PTCA) balloon angioplasty.
Claim 6
Dependent Claim
131 words
The method of claim 3 wherein the parameter monitoring step comprises the steps of: A. detecting the arterial pressure, P, of the subject and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak dP/dt; and E. dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter corresponding to the systemic vascular resistance of said subject's cardiovascular system.
Claim 7
Independent Claim
58 words
A method for monitoring the onset of painless myocardial ischemia in a resting patient comprising the steps of monitoring a parameter corresponding to systemic vascular resistance of the patient, and detecting when the parameter being monitored changes above or below a predetermined base line value as an indication that a myocardial ischemic change in the patient has occurred.
Claim 8
Independent Claim
58 words
A method for monitoring the onset of painless myocardial ischemia in a resting patient comprising the steps of monitoring a parameter corresponding to systemic vascular resistance of the patient, and detecting when the parameter being monitored changes above or below a predetermined base line value as an indication that a myocardial ischemic change in the patient has occurred.
Claim 9
Dependent Claim
131 words
The method of claim 5 wherein the parameter monitoring step comprises the steps of: A. detecting the arterial pressure, P, of the patient and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak dP/dt; and E. dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter corresponding to the systemic vascular resistance of said patient's cardiovascular system.
Claim 10
Independent Claim
56 words
A method for monitoring the onset of myocardial ischemia during a stress condition in a patient comprising the steps of monitoring a parameter value corresponding to the systemic vascular resistance of the subject, and detecting when said parameter value increases a selected amount of determining the onset of the myocardial ischemic event during said stress condition.
Claim 11
Independent Claim
56 words
A method for monitoring the onset of myocardial ischemia during a stress condition in a patient comprising the steps of monitoring a parameter value corresponding to the systemic vascular resistance of the subject, and detecting when said parameter value increases a selected amount of determining the onset of the myocardial ischemic event during said stress condition.
Claim 12
Dependent Claim
131 words
The method of claim 7 wherein said monitoring step comprises the steps of: A. detecting the arterial pressure, P, of the subject and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak dP/dt; and E. dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter value corresponding to the systemic vascular resistance of said subject's cardiovascular system.
Claim 13
Independent Claim
67 words
A method for determining the drug dose level for inhibiting myocardial ischemic events in a subject comprising the steps of: monitoring a parameter value corresponding to the systemic vascular resistance of the subject, recognizing the time of myocardial ischemic event by a selected increase in value of said monitored parameter, and increasing the subject drug level in response to said selected increase in the monitored parameter value.
Claim 14
Independent Claim
67 words
A method for determining the drug dose level for inhibiting myocardial ischemic events in a subject comprising the steps of: monitoring a parameter value corresponding to the systemic vascular resistance of the subject, recognizing the time of myocardial ischemic event by a selected increase in value of said monitored parameter, and increasing the subject drug level in response to said selected increase in the monitored parameter value.
Claim 15
Dependent Claim
131 words
The method of claim 9 wherein the monitoring step comprises the steps of: A. detecting the arterial pressure, P, of the subject and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak dP/dt; and E. dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter value corresponding to the systemic vascular resistance of said subject's cardiovascular system.
Claim 16
Independent Claim
83 words
A method for continuously determining systemic vascular resistance and cardiac output of a patient comprising the steps of A. generating values of a parameter corresponding to systemic vascular resistance of the patient by a first method; B. determining the systemic vascular resistance of the patient at two operating conditions using a method other than that of step A above; and C. calibrating said determining method of step A for providing a one-to-one reading of the thus calibrated parameter and said systemic vascular resistance.
Claim 17
Independent Claim
83 words
A method for continuously determining systemic vascular resistance and cardiac output of a patient comprising the steps of A. generating values of a parameter corresponding to systemic vascular resistance of the patient by a first method; B. determining the systemic vascular resistance of the patient at two operating conditions using a method other than that of step A above; and C. calibrating said determining method of step A for providing a one-to-one reading of the thus calibrated parameter and said systemic vascular resistance.
Claim 18
Dependent Claim
131 words
The method of claim 11 wherein the generating step comprises the steps of: A. detecting the arterial pressure, P, of the patient and generating in response thereto a blood pressure signal having a waveform in accordance with the detected arterial pressure; B. differentiating said blood pressure signal to produce a dP/dt signal having a waveform varying in accordance with the rate at which the blood pressure signal varies; C. detecting the peak of said dP/dt signal to determine the peak dP/dt; D. determining a value which is substantially equal to the arterial pressure at the time of said peak dP/dt; and E. dividing said latter value by said peak dP/dt signal, which thereby produces a measurement of the parameter value corresponding to the systemic vascular resistance of said patient's cardiovascular system.
Claim 19
Dependent Claim
21 words
The method of claim 12 further comprising the step of determining cardiac output from said measurement corresponding to systemic vascular resistance.
References Cited (Backward Citations)
US4429701A
Cited
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| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
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| 3.5 Years (Year 4) | 1992-01-17 | 1992-07-18 | 1993-01-17 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1996-01-17 | 1996-07-18 | 1997-01-17 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2000-01-17 | 2000-07-18 | 2001-01-17 | $7700.00 | Window Closed / Lapsed |