Microperfusive electrical stimulation
A method of treating a patient in cardiac arrest (e.g., in fibrillation, electrochemical dissociation, or asystole), the method comprising delivering an agent for enhancement of cardiac function to the coronary arteries of the patient; and microperfusing the patient's cardiac tissue by electromagnetically stimulating the cardiac tissue at an energy level below a threshold sufficient to defibrillate the heart.
1. A method of treating a patient in cardiac arrest (including in fibrillation, electrochemical dissociation, or asystole), the method comprising:
delivering an agent for enhancement of cardiac function to the patient's coronary arteries, wherein delivering the agent comprises intravenous infusion of the agent and a circulatory enhancement method for delivery of the agent to the coronary arteries; and
microperfusing the patient's cardiac tissue by electromagnetically stimulating the cardiac tissue with a plurality of microperfusing pulses, applied via electrodes external to the patient, wherein the microperfusing pulses are
at an energy below a threshold sufficient to defibrillate the patient's heart and below a threshold sufficient to pace the patient's heart with hemodynamic output,
but of a frequency, duration, and energy level to produce sufficient myocardial cell contraction for pumping of Calcium ions into the cell interior without causing electroporation of the myocardial cells.
2. The method of claim 1 wherein the circulatory enhancement method comprises manual chest compressions.
3. The method of claim 1 wherein the circulatory enhancement method comprises assistance by a cardiac mechanical pump.
4. The method of claim 1 further comprising delivering a defibrillation pulse to the patient's cardiac tissue following the delivering and microperfusing steps.
5. The method of claim 1 wherein the order in which the steps are performed is delivering the agent, followed by circulatory enhancement of the agent, followed by microperfusing.
6. The method of claim 1 further comprising delivering calcium.
7. The method of claim 1 wherein the electromagnetic stimulating comprises applying an electrical current.
8. The method of claim 1 wherein the electromagnetic stimulating comprises applying a magnetic field.
9. The method of claim 1 wherein the delivering step comprises cardiac compression performed by chest compression.
10. The method of claim 1 , wherein the metabolic agent comprises a metabolite selected from the group consisting of aspartate, oxidized form of nicotinamide adenine dinucleotide (NAD+), proglycogen, and 2-oxoglutarate.