Therapy optimization in heart failure patients based on minute ventilation patterns
First Claim
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1. A method for adjusting the responsiveness of a rate-adaptive pacemaker operating in a patient, wherein measured minute ventilation values in the patient are mapped to a pacing rate by a dual-slope rate response curve, comprising:
- measuring minute ventilation values and determining that an average of those minute ventilation values are increasing, signifying that the patient'"'"'s exertion level is increasing;
determining an amplitude of an oscillatory component in the measured minute ventilation values to be above a specified threshold value; and
, if the amplitude of the oscillatory component falls below the specified threshold value as the average minute ventilation continues to increase, setting the breakpoint of the rate response curve equal to the presently measured minute ventilation value.
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Abstract
A method and system for operating a rate-adaptive pacemaker utilizing minute ventilation to measure exertion level. The method is applicable to heart failure patients who exhibit an oscillatory minute ventilation pattern.
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Citations
20 Claims
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1. A method for adjusting the responsiveness of a rate-adaptive pacemaker operating in a patient, wherein measured minute ventilation values in the patient are mapped to a pacing rate by a dual-slope rate response curve, comprising:
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measuring minute ventilation values and determining that an average of those minute ventilation values are increasing, signifying that the patient'"'"'s exertion level is increasing;
determining an amplitude of an oscillatory component in the measured minute ventilation values to be above a specified threshold value; and
,if the amplitude of the oscillatory component falls below the specified threshold value as the average minute ventilation continues to increase, setting the breakpoint of the rate response curve equal to the presently measured minute ventilation value. - View Dependent Claims (2, 3)
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4. A method for operating a pacemaker in a patient, comprising:
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sensing ventricular depolarizations and resetting a ventricular escape interval upon each ventricular sense;
delivering paces to a ventricle such that a ventricular pace is delivered upon expiration of the ventricular escape interval, the reciprocal of the ventricular escape interval being the lower rate limit of the pacemaker;
measuring minute ventilation values corresponding to the exertion level of the patient;
determining if an amplitude of an oscillatory component in the measured minute ventilation values is above a specified threshold value;
if the amplitude of the oscillatory component is below the specified threshold value, adjusting the lower rate limit in accordance with the measured minute ventilation value; and
,if the amplitude of the oscillatory component is above the specified threshold, cross-checking the measured minute ventilation value with a measured activity level before adjusting the lower rate limit.
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5. A method for operating a pacemaker in a patient, comprising:
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sensing depolarizations from both ventricles;
pacing both ventricles in accordance with a ventricular resynchronization pacing mode;
measuring minute ventilation values corresponding to the exertion level of the patient; and
,determining if an amplitude of an oscillatory component in the measured minute ventilation values is above a specified threshold value. - View Dependent Claims (6, 7, 8, 9)
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10. A rate-adaptive pacemaker, comprising;
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sensing and pacing channels for sensing cardiac depolarizations and delivering paces to a selected chamber;
a minute ventilation sensor, a controller for controlling the delivery of paces in accordance with a pacing mode at a programmed pacing rate, wherein measured minute ventilation values in the patient are mapped to a pacing rate by a dual-slope rate response curve;
wherein the controller is configured to determine if an amplitude of an oscillatory component in the measured minute ventilation values is above a specified threshold value and, if the amplitude of the oscillatory component falls below the specified threshold value as the average minute ventilation continues to increase, to set the breakpoint of the rate response curve equal to the presently measured minute ventilation value. - View Dependent Claims (11, 12, 15, 16, 17, 18, 19, 20)
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13. A rate-adaptive pacemaker, comprising:
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sensing and pacing channels for sensing cardiac depolarizations and delivering paces to a selected chamber;
a minute ventilation sensor, a controller for controlling the delivery of paces in accordance with a pacing mode at a programmed pacing rate, wherein measured minute ventilation values in the patient are mapped to a pacing rate by a rate response curve;
wherein the controller is programmed to determine if an amplitude of an oscillatory component in the measured minute ventilation values is above a specified threshold value and, if the amplitude of the oscillatory component is below the specified threshold value, to adjust the lower rate limit in accordance with the measured minute ventilation value and, if the amplitude of the oscillatory component is above the specified threshold, to cross-check the measured minute ventilation value with a measured activity level before adjusting the lower rate limit.
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14. A pacemaker, comprising:
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sensing channels for sensing depolarizations from both ventricles;
pacing channels for delivering paces to both ventricles;
a minute ventilation sensor;
a controller for pacing the ventricles in accordance with a ventricular resynchronization pacing mode; and
,wherein the controller is configured to measure minute ventilation values corresponding to the exertion level of the patient and to determine if an amplitude of an oscillatory component in the measured minute ventilation values is above a specified threshold value.
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Specification