US3835845A - Cardiac synchronization system and method - Google Patents
Cardiac synchronization system and method Download PDFInfo
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- US3835845A US3835845A US00300290A US30029072A US3835845A US 3835845 A US3835845 A US 3835845A US 00300290 A US00300290 A US 00300290A US 30029072 A US30029072 A US 30029072A US 3835845 A US3835845 A US 3835845A
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H9/00—Pneumatic or hydraulic massage
- A61H9/005—Pneumatic massage
- A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0285—Measuring or recording phase velocity of blood waves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
Definitions
- the control means consists of a marker 128/2 O6 i 5 means, such as a pip on an oscilloscope, which is adjustable by variable-delay circuitry throughout a range [56] References Cited equal to the time difference between the sensing of a selected cardiac event at an earliest-reacting monitor- UNITED STATES PATENTS ing site and the sensing of a selected cardiac event at Becker R a later reacting monitoring site 3,734,087 5/1973 Sauer et al 128/64 8 Claims, 4 Drawing Figures TO 9O l WATER EMPTY /62 64 68 FROM"2 EMPTY PUMP PRESSURE SENSOR CONTROL DELAY I j DURATION CONTROL CONTROL 89 84 I96 w I PRESSURE V Q QQE DELAY DURATION 2g???
- This invention relates to a novel apparatus for assisting blood flow in the circulatory system by synchronizing the pulsing of an external-assist means with the heartbeat and particularly relates to a novel synchronization-control system for use with the aforesaid appara- H15.
- synchronous external pressure assist processes are distinguishable and advantageous over pre-existing counter-pulsation processes because the latter kind of procedure involves the cannulation of a major artery, use of an extra-corporeal blood handling device, the use of stringently sterile techniques and the necessity of administering anticoagulants to the patient.
- the blood trauma or hemolysis produced by extra-corporeal pumping devices limits permissible duration of the assist procedure and compromises the condition of the patient.
- these trauma-requiring procedures are not only time consuming, they can present a very significant hazard to many patients, and they increase the risk factor in treating all patients.
- the external counterpulsation method is the only controlled method of assist which requires no surgical intervention or sterile procedures, no use of anticoagulants or anesthesia, and produces no significant trauma. These factors are most important because they usually allow a much earlier use of the apparatus on a patient in, say, a state of circulatory shock than could be justified if another type of assist apparatus had to be used.
- the selective application of positive and negative pressures to the portion of the vascular bed in the legs serves to control directly the volume of blood within that portion of the vascular bed and, hence, the pressures within the arterial system, particularly the pressures of the aorta. It is these controlled changes in aortic pressure that lead directly to a reduction in cardiac work, to increased perfusion of the systemic circulation, and to preferential perfusion of the myocardium.
- the control system of the aforesaid improved apparatus comprises a built-in 80-second delay factor adapting it for use on the pre-selected wrist sensing site.
- the beginning of diastole is indicated in the arterial wave by the so-called dicrotic notch in good approximation by the end of the so-called T-wave which is known to be positive indication of the relaxation of the left ventricle and the end of systole.
- the leg pressurization signal was used to intensify the ECG and arterial trace on the oscilloscope after this pressurization signal has been delayed for 80 and 170 ms respectively.
- the duration of intensification is the duration of each positive pressurization cycle of the leg.
- Another object of the invention is to provide an external circulatory assist device having a synchronizationcontrol means of greater versatility.
- Another object of the invention is to provide an apparatus easily synchronized by personnel of moderate skill and training.
- a further object of the invention is to provide an improved control means and method which allows the operator of the apparatus to accurately synchronize the apparatus without (1) the necessity of precise prediction of the time delay between the heart action and its effect on the arterial wave sensing site and (2) without predicting the sensing site to be selected.
- the above objects have been substantially achieved by controlling the synchronization of the external circulatory assist apparatus with a control means whereby the optimum time period between a certain cardiac event (typically the R wave of an ECG curve) and the triggering of the circulatory assist pressure is precisely achieved by a visual and movable indicator means which can be moved during the setting of a time variable, throughout a time range which allows compensation for the time differences between the cardiac event and its manifestation at any arterial-wave sensing site which may be selected at the time of treatment.
- a control means whereby the optimum time period between a certain cardiac event (typically the R wave of an ECG curve) and the triggering of the circulatory assist pressure is precisely achieved by a visual and movable indicator means which can be moved during the setting of a time variable, throughout a time range which allows compensation for the time differences between the cardiac event and its manifestation at any arterial-wave sensing site which may be selected at the time of treatment.
- the visual marker is advantageously electronic and moved along a channel of an oscilloscope as a trace intensification of a finger plethysmograph, or some like manifestation of a cardiac event, until the marker is positioned at an easily-recognized point on the curve (e.g., at a point indicative of the start of systole).
- FIGS. 1 and 2 taken together, are a schematic diagram of an external circulatory assist apparatus, including the control means which forms the particular improvement of this invention.
- FIG. 3 is a graph illustrating, in real time, the relationship of an electrocardiographic curve and external circulatory assist pressurization.
- FIG. 4 is a graph showing curves similar to those which would appear on a two-channel oscilloscope, displaying (I) an electrocardiographic curve and (2) any of several alternative curves manifesting the heartbeat as it is manifested by pressure at the central aorta, a radial artery or a finger.
- a transducer-type pressure sensor 34 including a sensing bladder 35 is utilized to sense hydraulic pressure in bladder 22. If the pressure so sensed is less than 20 millimeters of mercury (mm of Hg), then a pressure-level amplifier 46 will provide an output to the and-type gate 48. If during this low-pressure signal situation, the operator closes a water fill switch 50, he will cause the and gate 48 to transmit a signal which will activate a fill pump 52 through pump control circuit 54 and simultaneously cause a multiposition, solenoid valve 56 to shift to its fill position, i.e., the position allowing water to flow from conduit 58 to conduit 60.
- a fill pump 52 through pump control circuit 54 and simultaneously cause a multiposition, solenoid valve 56 to shift to its fill position, i.e., the position allowing water to flow from conduit 58 to conduit 60.
- Water is emptied from bladder 22 by using an analogous system whereby pressure is sensed by sensor 62.
- a signal is sent to and-gate" 64. If empty switch 66 is closed, the gate 64 will allow a signal command to actuate pump control 68 and empty pump 69 and cause solenoid valve 56 to shift to its empty position, i.e., the position allowing water to flow from conduit 60 to conduit 70 and thence back to water reservoir 72 through 74.
- the pump 69 will empty until a pressure of less than the illustrative minus 15 mm Hg is sensed. At that time the and-gate" 64 will no longer sense the required signal from sensor 62, and the pump 69 will be turned off and valve 56 will return to its off position.
- the pressure within bladder 34 is maintained at its desired level by adding or removing water from the bladder system as follows:
- a displacement sensing type transducer 76 is" mounted on hydraulically-actuated rod .78. Transducer 76 is adapted to provide an electrical signal output pro-.
- a normalized value of the position of rod 78 is provided by feeding the signal from transducer 76 intoa by numeral 415 in FIGS. 3 and 4.)
- a manually controlled delay 86 is to convert the original signal from first trigger generator 84 to a second time-delayed signal corresponding in real time with the beginning of cardiac diastole. This second signal enters a duration signal generator 88.
- Generator 88 is so selected that the signal therefrom continues for the length of time that leg pressurization (as caused by pressure in bladder 34) is desired.
- This signal from generator 88 is fed to level comparator 82 through a level strobe signal generator 89.
- the signal from generator 88 is also fed to a waveform generator 90 which produces a wave whose amplitude and shape is analogous to that desired for the leg pressurization sequence.
- a typical such wave will be trapazoidal-like in shape with a rise of 60 ms, a plateau of 250 ms, and a fall of 60 ms.
- This wave from generator 90 is fed to a wave form comparator 92 wherein it is continually compared to a signal derived from the actual bladder pressure wave as experienced by sensor 34.
- the output of comparator 92 is a so-called error signal, i.e., a signal which is indicative of the quality and strength of the difference between the desired wave signal from generator 90 and the actual wave signal from sensor 34.
- a typical generated wave will normally have a total positive pressure period of from about 250 to about 300 milliseconds.
- the rise and fall in pressure will take about 60 ms each and rise will start about 80 ms before diastole.
- the error signal is used to control servo valve 94 through a servo-amplifier 93 and thereby controls the supply of fluid to, and consequently the movement of, hydraulic cylinder 78.
- level comparator 82 receives two signals: one, a periodic signal from a duration signal generator 88, via strobe signal generator 89 and the other from displacement level sensor 80.
- lever comparator 82 compares these two signals, one indicative of the actual position of hydraulic cylinder 78 at a given time. It is the periodic, or strobe signal from duration signal generator 88, as modified by a level strobe signal generator 89, which determines when this comparison is to be made. The comparison is most usefully made at the time platen 30 is in the upper-most portion of its stroke and pressing firmly against bladder 22.
- level comparator 82 senses that the uppermost position of platen 30 is too high, output signal is provided to a one shot (monostable multivibrator) 96.
- This one shot 96 will then turn on fill pump 52 and also position solenoid valve 56 for a 0.5-second fill period.
- the 0.5-second fill periods will continue during each cardiac period, (i.e., each heartbeat) until the water volume in bladder 22 is sufficient so that the uppermost position of platen 30 is within an acceptable displacement range at the top of its stroke.
- the level comparator 82 receives a signal that the uppermost position of platen 30 is too low in its stroke, the uppermost position of empty pump is turned on for one-half second on each cardiac cycle by activation of the one shot device 98 and the empty pump 69. Water is then pumped out of the bladder until the platen achieves a desired rise during its stroke.
- a signal from any given arterial pressure-sensing device 99 is fed into a dual trace oscilloscope 101 along with a signal from ECG device 102. These signals appear only as width intensifications 103 of ECG trace 104 and the arterial trace 106.
- FIG. 3 shows the relative real timing of the cardiac cycle as represented by electrocardiogram 402, radial arterial pressure waveform 407, and the curve 404, representing the leg pressure rise 405 exerted by the external circulatory assist device on legs of a patient.
- the electrocardiograph is characterized by R wave 415, sometimes called a QRS complex, and a T wave 420 see FIG. 4.
- the beginning of systole is manifested at 399 or about 40 ms after the R wave peak 415.
- a radial arterial sensing of this heart action will provide a waveform representative of the heart cycle; however, the precise time at which the arterial waveform is sensed, as shown in FIG. 4, will be out of phase with the ECG signal itself by a time dependent on the particular site at which the arterial waveform is sensed.
- a modified waveform, and not the arterial waveform itself will be sensed at the radial arterial sites.
- These modified arterial waveforms are characterized by a so-called dicrotic notch 409 which is a manifestation of the beginning of diastole in the cardiac cycle.
- the external assist pressurization for example at the legs, was to occur at a time (D,) after the triggering signal; milliseconds later the pressure wave reached the heart and after more milliseconds it was sensed at the wrist, the pre-selected sensing site.
- D time
- the external pressure wave became effective at the heart at the start of diastole as desired.
- This time corresponds, with reference to an arterial waveform, to the appearance of dicrotic notch 409 on the arterial waveform at the wrist and the apparatus was designed to initiate the pressure pulse at the legs at a time equal to seconds before the manifestation of diastole at the wrist.
- a signal from an arterial pressure-sensing device 99 was fed into a dual trace oscilloscope 101 along with a signal from ECG device 102.
- the duration of an intensification of these signals was the duration of a pressure command signal as receiyed from druation signal gen: erator 88 and appeared as intensifications of ECG trace 104 and arterial trace 106.
- D i.e., variable delay 86 was used to bring the intensification signal into register with the diastolic period as viewed on either the ECG or arterial traces, thereby simultaneously phasing the pressurization wave to the cardiac cycle.
- the operator of the apparatus also has variable control means for changing the characteristics of the duration signal generator 88 to provide the intensified signal duration which is required for a particular patient. On the oscilloscope 100, this duration showed up as intensifications 103 of the oscilloscope traces.
- This prior control system depended for optimum operation on the pre-selection of a particular arterialsensing site, such as the wrist, which would typically be about 90 milliseconds out of phase with the ECG cycle.
- a signal from an ECG device 102 is fed through a trigger generator 84, delay 86, and duration signal generator 88, into an 80 ms delay device 110 as before.
- the output from device 110 a pulse equal in duration to D is delayed from the R wave by a time D (imparted by delay 86) plus 80 milliseconds. This pulse is used to provide the ECG (Channel 1) intensification.
- variable delay device 112 from which-a signal is obtained which is delayed from the R wave by a time equalling D plus 80 milliseconds plus D wherein D is the variable delay imparted by adjustable delay device 112.
- the trigger signal from trigger generator 84 is being fed to a 40-millisecond delay device 114, and thence to a variable delay device 116.
- the output from device 116 is fed to a marker generator 118, which generates a marker pulse delayed from the R wave by D plus 40 milliseconds wherein D is the variable delay imparted by adjustable delay device 116.
- the signals from marker generator 118 and delay device 112 are fed into pulse mixer 120 and the resulting signal is fed to the channel 2 trace of the oscilloscope, i.e., that channel showing the arterial waveform.
- a marker pip from generator 118 is moved along arterial trace 106 to a position which is at the start of systole, e.g., as shown at 414. This position is characterized by the start of a fast rise 403 in the arterial trace.
- the marker pip can be moved by use of marker position control 122 throughout a range equivalent to the D variable time delay simultaneously achievable with delay devices 112 and 116. As the marker pip is so moved, the intensified trace provided by duration generator 86 and representative of the external assist pressure stroke follows the marker pip but is delayed by an amount D less 40 milliseconds from the marker pip.
- variable delay device 86 i.e., D will be set by adjusting delay control 124 to bring the intensification signal into register with the dicrotic notch, thereby adjusting the time between notch and the intensification signal to a time represented in FIG. 4 by D
- duration generator 88 is set by adjusting duration control 126 to give the proper pulse length, i.e., as shown by numerals 410, 411, 412 and 413 for ECG,
- an external circulatory assist apparatus comprising means to pressurize a portion of a patients body, means to synchronize actuation of said pressurization means on a portion of the body with the heart cycle of a patient being treated, means for creating an arterial waveforms signal representative of said heart cycle, and display means for monitoring a said waveform signal exhibiting a dicrotic notch portion representative of said heart cycle in the form of visible traces on said display means the improvement wherein said synchronizing means includes:
- C. means to, concurrently with the adjustment of said first marker pip, move a second intensified pip along said waveform at a constant distance from said first marker
- said means to provide said second said intensified marker pip comprises means to form an ECG-derived signal, a signal generator, means for triggering said signal generator by said ECG-derived signal, a variable delay means, a marker pip generator, and a pulse mixer for integrating said second marker pip signal with a signal representative of a pressure wave exerted by said external assist apparatus on said patient.
- variable delay means provides a delay variable over a time difference at least equal to the time elapsing from diastole in a patients heart cycle to the time such diastole is registered in said patients digital extremities.
- position adjusting means provide means to adjust said marker pip over a portion of the waveform equivalent in length to time elapsing from diastole in a patients heart cycle to the time such diastole is registered in said patients digital extremities.
- apparatus for applying external pressure assist action to the limbs of a patient in cyclic synchronization with the heartbeat of said patient wherein said assist is achieved with means for transmitting pressure to said limbs through a fluid-filled bladder pressurizing means surrounding said limbs, means for creating an arterial waveform signal representative of said heartbeat and display means for monitoring a said waveform signal representative of said hearbeat in the form of visible traces on said display means, wherein the apparatus also includes a visual cycle-phasing monitor comprising:
- A. means to provide a first marker pip on display apparatus displaying a marker trace representative of a radial arterial waveform derived from a patient
- D. means to move, concurrently with said adjusting, an intensified trace along said waveform at a constant distance from said first marker
- E. means to bring said intensified trace into register with the dicrotic notch of said waveform, thereby adjusting the synchronization for activating said pressure command signal.
- apparatus for applying external pressure assist action to the limbs of a patient in cyclic synchronization with the heartbeat of said patient
- said apparatus comprises means for producing a pressure command signal, means for transmitting pressure through a hydraulic cylinder to said limbs through a fluid-filled bladder pressurizing means surrounding said limbs in response to means for activating said pressure command signal, and means for creating an arterial waveform signal representative of said heartbeat and display means for monitoring a said waveform signal representative of said heartbeat in the form of visible traces on said display means
- the apparatus includes A. an ideal pressure waveform generator means,
- said display means forming means for continually comparing said ideal and actual waveforms
- variable valve means responsible to a signal from said comparing means, to modify fluid flow to said hydraulic cylinder and thereby to transmit pressure to said limbs through said fluid-filled bladder more nearly achieve said ideal-pressure waveform at said limbs the improvement wherein said apparatus comprises:
- A. means to provide a first marker pip on display apparatus displaying a marker trace representative of said arterial waveform derived from a patient
- D. means to move, concurrently with said adjusting, an intensified trace along said waveform at a constant distance from said first marker
- E. means to bring said intensified trace into register with the dicrotic notch of said waveform, thereby adjusting the synchronization for activating said pressure command signal.
- Apparatus as defined in claim 6 comprising: A. a multi-channel oscillosopce adapted to display 1. an ECG trace, and
Abstract
Description
Claims (12)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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US00300290A US3835845A (en) | 1972-10-24 | 1972-10-24 | Cardiac synchronization system and method |
JP48044268A JPS586502B2 (en) | 1972-10-24 | 1973-04-20 | Gaiatsujiyunkanenjiyosouchi |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US00300290A US3835845A (en) | 1972-10-24 | 1972-10-24 | Cardiac synchronization system and method |
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US3835845A true US3835845A (en) | 1974-09-17 |
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US00300290A Expired - Lifetime US3835845A (en) | 1972-10-24 | 1972-10-24 | Cardiac synchronization system and method |
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JP (1) | JPS586502B2 (en) |
Cited By (48)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4016871A (en) * | 1975-03-06 | 1977-04-12 | Peter Schiff | Electronic synchronizer-monitor system for controlling the timing of mechanical assistance and pacing of the heart |
US4077402A (en) * | 1976-06-25 | 1978-03-07 | Benjamin Jr J Malvern | Apparatus for promoting blood circulation |
US4094310A (en) * | 1976-10-04 | 1978-06-13 | American Optical Corporation | Apparatus for enhanced display of physiological waveforms and for defibrillation |
US4204524A (en) * | 1977-11-07 | 1980-05-27 | Dov Jaron | Method and apparatus for controlling cardiac assist device |
EP0081051A1 (en) * | 1981-11-25 | 1983-06-15 | Dornier Gmbh | Releasing device for shock waves for therapeutic purposes |
US4388919A (en) * | 1980-11-17 | 1983-06-21 | Intermedics Cardiassist Corporation | Rapid stabilization of external cardiac pulsation |
US4506658A (en) * | 1982-01-11 | 1985-03-26 | Casile Jean P | Pericardiac circulatory assistance device |
WO1989009041A1 (en) * | 1988-03-31 | 1989-10-05 | Cardiopulmonary Corporation | Circulatory assist method and apparatus |
US5000164A (en) * | 1989-06-26 | 1991-03-19 | The United States Of America As Represented By The Secretary Of The Navy | Circulation enhancing apparatus |
EP0514204A1 (en) * | 1991-05-15 | 1992-11-19 | Lcr Holding Company, Inc. | Apparatus fo cyclically applying pressure to a body part |
US5279283A (en) * | 1992-08-11 | 1994-01-18 | Dillon Richard S | Method for promoting circulation of blood |
US5377671A (en) * | 1991-04-26 | 1995-01-03 | Cardiopulmonary Corporation | Cardiac synchronous ventilation |
US5443440A (en) * | 1993-06-11 | 1995-08-22 | Ndm Acquisition Corp. | Medical pumping apparatus |
US5514079A (en) * | 1992-08-11 | 1996-05-07 | Dillon; Richard S. | Method for promoting circulation of blood |
US5554103A (en) * | 1992-05-07 | 1996-09-10 | Vasomedical, Inc. | High efficiency external counterpulsation apparatus and method for controlling same |
US5769801A (en) * | 1993-06-11 | 1998-06-23 | Ndm Acquisition Corp. | Medical pumping apparatus |
US5840049A (en) * | 1995-09-07 | 1998-11-24 | Kinetic Concepts, Inc. | Medical pumping apparatus |
WO1999036028A1 (en) | 1998-01-14 | 1999-07-22 | Cardiologic Systems, Inc. | Cardiac assist method using an inflatable vest |
US5931160A (en) * | 1995-12-08 | 1999-08-03 | Cardiopulmonary Corporation | Ventilator control system and method |
US6119043A (en) * | 1995-12-28 | 2000-09-12 | Cardiac Pacemakers, Inc. | Atrial and ventricular cardiac lead having a mechanical bias |
US6152954A (en) * | 1998-07-22 | 2000-11-28 | Cardiac Pacemakers, Inc. | Single pass lead having retractable, actively attached electrode for pacing and sensing |
US6158432A (en) * | 1995-12-08 | 2000-12-12 | Cardiopulmonary Corporation | Ventilator control system and method |
US6195759B1 (en) * | 1997-10-20 | 2001-02-27 | Intel Corporation | Method and apparatus for operating a synchronous strobe bus |
US20020107461A1 (en) * | 2000-11-10 | 2002-08-08 | Hui John C.K. | High efficiency external counterpulsation apparatus and method for controlling same |
US6463930B2 (en) | 1995-12-08 | 2002-10-15 | James W. Biondi | System for automatically weaning a patient from a ventilator, and method thereof |
US6620116B2 (en) | 2000-12-08 | 2003-09-16 | Michael P. Lewis | External counterpulsation unit |
US20030233118A1 (en) * | 2002-06-13 | 2003-12-18 | Hui John C. K. | Method for treating congestive heart failure using external counterpulsation |
EP1435892A2 (en) * | 2001-09-20 | 2004-07-14 | Living Data Technology Apparatus | External counter pulsation apparatus |
US20050070755A1 (en) * | 1993-05-06 | 2005-03-31 | Zhensheng Zheng | High efficiency external counterpulsation method |
US20050075531A1 (en) * | 2003-10-07 | 2005-04-07 | Loeb Marvin P. | Devices and methods for non-invasively improving blood circulation |
US6915169B2 (en) | 1998-07-22 | 2005-07-05 | Cardiac Pacemakers, Inc. | Extendable and retractable lead having a snap-fit terminal connector |
US6983185B2 (en) | 1998-07-22 | 2006-01-03 | Cardiac Pacemakers, Inc. | Lead with terminal connector assembly |
US20060058716A1 (en) * | 2004-09-14 | 2006-03-16 | Hui John C K | Unitary external counterpulsation device |
US7048702B2 (en) | 2002-06-13 | 2006-05-23 | Vasomedical, Inc. | External counterpulsation and method for minimizing end diastolic pressure |
US20070016115A1 (en) * | 2005-07-04 | 2007-01-18 | Gerhard Buchholtz | Shockwave system controlled dependent on patient's blood pressure |
US20070272250A1 (en) * | 2006-05-24 | 2007-11-29 | Michael Paul Lewis | External pulsation treatment apparatus |
US20080015478A1 (en) * | 2006-07-17 | 2008-01-17 | Arani Bose | Counter pulsation system and method for stroke recovery treatment |
US20080202525A1 (en) * | 2007-02-23 | 2008-08-28 | General Electric Company | Setting mandatory mechanical ventilation parameters based on patient physiology |
US20080202518A1 (en) * | 2007-02-23 | 2008-08-28 | General Electric Company | Setting mandatory mechanical ventilation parameters based on patient physiology |
US20080202519A1 (en) * | 2007-02-23 | 2008-08-28 | General Electric Company | Setting mandatory mechanical ventilation parameters based on patient physiology |
US20080202517A1 (en) * | 2007-02-23 | 2008-08-28 | General Electric Company | Setting madatory mechanical ventilation parameters based on patient physiology |
US20080202520A1 (en) * | 2007-02-23 | 2008-08-28 | General Electric Company | Setting mandatory mechanical ventilation parameters based on patient physiology |
US20080230064A1 (en) * | 2007-03-23 | 2008-09-25 | General Electric Company | Setting inspiratory time in mandatory mechanical ventilation based on patient physiology, such as when forced inhalation flow ceases |
US20080230063A1 (en) * | 2007-03-23 | 2008-09-25 | General Electric Company | Setting inspiratory time in mandatory mechanical ventilation based on patient physiology, such as forced inhalation time |
US20080230060A1 (en) * | 2007-03-23 | 2008-09-25 | General Electric Company | Setting inspiratory time in mandatory mechanical ventilation based on patient physiology, such as when tidal volume is inspired |
US20080230061A1 (en) * | 2007-03-23 | 2008-09-25 | General Electric Company | Setting expiratory time in mandatory mechanical ventilation based on a deviation from a stable condition of end tidal gas concentrations |
US20080319248A1 (en) * | 2007-06-20 | 2008-12-25 | Michael Paul Lewis | Hydraulically Actuated External Pulsation Treatment Apparatus |
US9265693B2 (en) * | 2010-07-06 | 2016-02-23 | Aleksey Monesovich Sudarev | Method and devices providing impact on cardiovascular system |
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Also Published As
Publication number | Publication date |
---|---|
JPS4973878A (en) | 1974-07-17 |
JPS586502B2 (en) | 1983-02-04 |
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