Implantable hemodynamic monitor and methods for use therewith
First Claim
1. For use in an implantable system including an implantable photoplethysmography (PPG) sensor, a method for monitoring mean arterial pressure (MAP) of a patient, comprising:
- (a) determining, with a controller, a metric of a terminal portion (Tmetric) of an arterial photoplethysmography (PPG) waveform measured using the implantable PPG sensor, wherein the terminal portion is from a maximum of the arterial PPG waveform to a following minimum of the PPG waveform, wherein the Tmetric is a total relaxation time (TRT), which is a time from a maximum to the following minimum of the arterial PPG waveform;
(b) determining, with the controller, a metric of an initial portion (Imetric) of the arterial PPG waveform measured using the implantable PPG sensor, wherein the initial portion is from a minimum of the arterial PPG waveform to the following maximum of the PPG waveform, wherein the Imetric is an initial acceleration time (IAT), which is a time from a minimum to the following maximum of the arterial PPG signal;
(c) determining, with the controller, a surrogate of MAP based on the metric of the terminal portion and the metric of the initial portion; and
(d) adjusting, with the controller, an electrical therapy delivered to a heart of the patient as a function of the surrogate MAP.
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Abstract
Provided herein are implantable systems that include an implantable photoplethysmography (PPG) sensor, which can be used to obtain an arterial PPG waveform. In an embodiment, a metric of a terminal portion of an arterial PPG waveform is determined, and a metric of an initial portion of the arterial PPG waveform is determined, and a surrogate of mean arterial pressure is determined based on the metric of the terminal portion and the metric of the initial portion. In another embodiment, a surrogate of diastolic pressure is determined based on a metric of a terminal portion of an arterial PPG waveform. In a further embodiment, a surrogate of cardiac afterload is determined based on a metric of a terminal portion of an arterial PPG waveform.
54 Citations
5 Claims
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1. For use in an implantable system including an implantable photoplethysmography (PPG) sensor, a method for monitoring mean arterial pressure (MAP) of a patient, comprising:
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(a) determining, with a controller, a metric of a terminal portion (Tmetric) of an arterial photoplethysmography (PPG) waveform measured using the implantable PPG sensor, wherein the terminal portion is from a maximum of the arterial PPG waveform to a following minimum of the PPG waveform, wherein the Tmetric is a total relaxation time (TRT), which is a time from a maximum to the following minimum of the arterial PPG waveform; (b) determining, with the controller, a metric of an initial portion (Imetric) of the arterial PPG waveform measured using the implantable PPG sensor, wherein the initial portion is from a minimum of the arterial PPG waveform to the following maximum of the PPG waveform, wherein the Imetric is an initial acceleration time (IAT), which is a time from a minimum to the following maximum of the arterial PPG signal; (c) determining, with the controller, a surrogate of MAP based on the metric of the terminal portion and the metric of the initial portion; and (d) adjusting, with the controller, an electrical therapy delivered to a heart of the patient as a function of the surrogate MAP. - View Dependent Claims (2, 3)
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4. For use in an implantable system including an implantable photoplethysmography (PPG) sensor, a method for monitoring mean arterial pressure (MAP) of a patient, comprising:
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(a) determining, with a controller, a metric of a terminal portion (Tmetric) of an arterial photoplethysmography (PPG) waveform measured using the implantable PPG sensor, wherein the terminal portion is from a maximum of the arterial PPG waveform to a following minimum of the PPG waveform, wherein the Tmetric is a terminal deceleration slope (TDS) or the beginning terminal deceleration slope (BTDS), where the TDS is a downward slope from a maximum to the following minimum of the arterial PPG waveform, and the BTDS is a downward slope from a maximum to the following dicrotic notch of the arterial PPG waveform; (b) determining, with the controller, a metric of an initial portion (Imetric) of the arterial PPG waveform measured using the implantable PPG sensor, wherein the initial portion is from a minimum of the arterial PPG waveform to the following maximum of the PPG waveform and wherein the Imetric is an initial acceleration slope (IAS), which is an upward slope from a minimum to the following maximum of the arterial PPG waveform; (c) determining, with the controller, a surrogate of MAP based on the metric of the terminal portion and the metric of the initial portion; and (d) adjusting, with the controller, an electrical therapy delivered to a heart of the patient as a function of the surrogate MAP.
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5. For use in an implantable system including an implantable photoplethysmography (PPG) sensor, a method for monitoring mean arterial pressure (MAP) of a patient, comprising:
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(a) determining, with a controller, a metric of a terminal portion (Tmetric) of an arterial photoplethysmography (PPG) waveform measured using the implantable PPG sensor, wherein the terminal portion is from a maximum of the arterial PPG waveform to a following minimum of the PPG waveform, wherein the Tmetric is a terminal deceleration time (TeDT), which is a time from a dicrotic notch to the following minimum of the arterial PPG waveform; (b) determining, with the controller, a metric of an initial portion (Imetric) of the arterial PPG waveform measured using the implantable PPG sensor, wherein the initial portion is from a minimum of the arterial PPG waveform to the following maximum of the PPG waveform, wherein the Imetric is an initial acceleration time (IAT), which is a time from a minimum to the following maximum of the arterial PPG waveform; (c) determining, with the controller, a surrogate of MAP based on the metric of the terminal portion and the metric of the initial portion; and (d) adjusting, with the controller, an electrical therapy delivered to a heart of the patient as a function of the surrogate MAP.
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Specification