Blood pump for ischemia detection and treatment
A blood pump incorporating a rotary pump such as a rotary impeller pump implantable in fluid communication with a ventricle and an artery to assist blood flow from the ventricle to the artery. The device may include a pump drive circuit supplying power to the pump, one or more sensors for sensing one or more electrophysiological signals such as subcutaneous, pre-cordial ECG signals and a signal processing circuit connected to the sensors and to the pump drive circuit. The signal processing circuit is operative to detect the sensor signals and control power supplied to the pump from the pump drive circuit so that the pump may run in a normal sinus rhythm mode, with a varying speed synchronized with the cardiac cycle. When an ischemic or myocardial infarction condition is detected, the pump drive circuit may also run the pump in an ischemia or myocardial infarction mode different from the normal sinus rhythm mode.
1. A blood pump, comprising:
a rotary pump configured to be implantable in a subject and in fluid communication with a ventricle and an artery of the subject to assist blood flow from the ventricle to the artery;
at least one pump drive circuit for applying power to the pump, controlling the speed of the pump or both;
at least one sensor for sensing one or more electrogram (ECG) signals in the subject; and
a signal processing circuit in communication with the sensors and the at least one pump drive circuit, the signal processing circuit being operative to:
(i) receive subcutaneous ECG signals,
(ii) determine the presence of cardiac ischemia or a myocardial infarction condition based on subcutaneous pre-cordial electrode signals, and
(iii) control the power supplied to the pump from the at least one pump drive circuit so as to control the speed of the pump and operate the pump in a normal sinus rhythm mode in the absence of an ischemic condition or myocardial infarction condition,
(iv) to operate the pump in at least one modified mode of operation based on the presence of an ischemic condition or myocardial infarction condition, the at least one modified mode of operation includes at least one ischemia mode different from the normal sinus rhythm mode, the at least one ischemia mode includes a pulsatile mode different from the normal sinus rhythm mode.
2. The blood pump of claim 1 , wherein the pump is a rotary impeller pump.
3. The blood pump of claim 1 , wherein the signal processing circuit is operative to adjust the pump speed responsive to a condition of the subject.
4. The blood pump of claim 3 , wherein the signal processing circuit adjusts the varying speed in accordance with electrophysiological signals that it receives from the at least one sensor.
5. The blood pump of claim 4 , wherein the electrophysiological signals include subcutaneous ECG waveforms.
6. The blood pump of claim 5 , wherein the subcutaneous ECG waveforms include at least one unipolar signal.
7. The blood pump of claim 5 , wherein the subcutaneous ECG waveforms include at least one bipolar signal from a pair of electrodes.
8. The blood pump of claim 1 , in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the P-wave of the subject's cardiac cycle.
9. The blood pump of claim 1 , in which the signal processing circuit is operative to control power supplied to the pump so that the varying speed has a substantially fixed phase relationship with the R-wave of the subject's cardiac cycle.
10. The blood pump of claim 9 , wherein the substantially fixed phase relationship of the varying speed with the R-wave of the subject's cardiac cycle is relative to a moving average cycle time over a number of cardiac cycles.
11. The blood pump of claim 1 , wherein the at least one ischemia mode includes a non-pulsatile mode such that the pump runs in a non-pulsatile manner.
12. The blood pump of claim 1 , wherein the at least one pulsatile mode includes an increase in pump speed for increased cardiac output.
13. The blood pump of claim 1 , wherein the at least one ischemia mode includes a pulsatile mode wherein the pump runs in a pulsatile manner unsynchronized with the cardiac cycle of the subject.
14. The blood pump of claim 1 , wherein the circuit is operable to detect a myocardial infarction condition and the at least one modified mode of operation includes at least one myocardial infarction mode different from the normal sinus rhythm mode.
15. The blood pump of claim 14 , wherein the at least one myocardial infarction mode includes a non-pulsatile mode wherein the pump runs in a non-pulsatile manner.
16. The blood pump of claim 14 , wherein the at least one myocardial infarction mode includes a pulsatile mode different from the normal sinus rhythm mode.
17. The blood pump of claim 14 , wherein the at least one myocardial infarction mode includes a pulsatile mode wherein the pump runs in a pulsatile mode unsynchronized with a cardiac cycle of the subject.
18. The blood pump of claim 17 , wherein the at least one pulsatile mode includes an increase in pump speed for increased cardiac output.
19. The blood pump of claim 1 , wherein the at least one modified mode includes a non-pulsatile mode and wherein the signal processing circuit is operative via the motor drive to control power supplied to the pump so as to vary the speed of the pump in the non-pulsatile mode based on a condition of the subject.
20. The blood pump of claim 1 , wherein at least one modified mode includes a ventricular tachy-arrhythmia mode in response to a detected tachy-arrhythmia condition.