Atrioventricular delay adjustment
First Claim
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1. An implantable medical device system comprising:
- a pacemaker that paces a ventricle of a heart at an atrioventricular delay following an atrial event;
a pressure monitor that monitors the onset of isovolumetric contraction of the heart; and
a processor that;
selects a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
measures a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
computes a difference between the first interval and the second interval; and
adjusts the atrioventricular delay as a function of the computed difference.
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Abstract
In a system that includes a ventricular pacemaker, the system adjusts an atrioventricular delay to synchronize the onset of isovolumetric contraction with the completion of ventricular filling. The system adjusts the atrioventricular delay as a function of electrical and pressure data from the heart. The system further adjusts the atrioventricular delay as a function of measurements of the time interval between a cardiac occurrence such as a ventricular pace and the completion of ventricular filling. The system may also adjust the atrioventricular delay as a function of the heart rate.
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Citations
71 Claims
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1. An implantable medical device system comprising:
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a pacemaker that paces a ventricle of a heart at an atrioventricular delay following an atrial event;
a pressure monitor that monitors the onset of isovolumetric contraction of the heart; and
a processor that;
selects a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
measures a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
computes a difference between the first interval and the second interval; and
adjusts the atrioventricular delay as a function of the computed difference. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 40)
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17. A method comprising:
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selecting a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
measuring a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
computing a difference between the first interval and the second interval; and
adjusting the atrioventricular delay as a function of the computed difference. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25)
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26. A computer-readable medium comprising instructions that cause a processor to:
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select a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
measure a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
compute a difference between the first interval and the second interval; and
adjust the atrioventricular delay as a function of the computed difference. - View Dependent Claims (27, 28, 29, 30, 31, 32)
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33. A method comprising:
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measuring a first time interval between a first ventricular pace and a first atrioventricular valve closure at a first heart rate;
measuring a second time interval between a second ventricular pace and a second atrioventricular valve closure at a second heart rate;
recording the first time interval as function of the first heart rate; and
recording the second time interval as a function of the second heart rate. - View Dependent Claims (34, 35, 36, 37)
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38. A computer-readable medium comprising instructions that cause a processor to:
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measure a first time interval between a first ventricular pace and a first atrioventricular valve closure at a first heart rate;
measure a second time interval between a second ventricular pace and a second atrioventricular valve closure at a second heart rate;
record the first time interval as function of the first heart rate; and
record the second time interval as a function of the second heart rate . - View Dependent Claims (39, 41, 42)
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43. An implantable medical device system, comprising:
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a pacemaker that paces a ventricle of a heart at an atrioventricular delay following an atrial event;
a pressure monitor that monitors the onset of isovolumetric contraction of the heart; and
a processor that;
selects a value of a first interval representing a time between a ventricular pace and an atrioventricular valve closure;
measures a second interval as a function of a time between a second ventricular pace and an onset of isovolumetric contraction;
computes a difference between the first interval and the second interval; and
adjusts the atrioventricular delay as a function of the difference. - View Dependent Claims (44, 45, 46, 47)
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48. A method comprising:
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selecting a value of a first interval representing a time between a first ventricular pace and an atrioventricular valve closure;
measuring a second interval as a function of a time between a second ventricular pace and an onset of isovolumetric contraction;
computing a difference between the first interval and the second interval; and
adjusting an atrioventricular delay as a function of the difference. - View Dependent Claims (49, 50)
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51. A computer-readable medium comprising instructions that cause a processor to:
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select a value of a first interval representing a time between a first ventricular pace and an atrioventricular valve closure;
measure a second interval as a function of a time between a second ventricular pace and an onset of isovolumetric contraction;
compute a difference between the first interval and the second interval; and
adjust an atrioventricular delay as a function of the difference. - View Dependent Claims (52, 53)
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54. An implantable medical device system comprising:
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means for pacing a ventricle of a heart at an atrioventricular delay following an atrial event;
means for monitoring the onset of isovolumetric contraction of the heart; and
means for selecting a value of a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
means for measuring a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
means for computing a difference between the first interval and the second interval; and
means for adjusting the atrioventricular delay as a function of the difference. - View Dependent Claims (55, 56, 57, 58, 59, 60)
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61. An implantable medical device comprising:
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a pulse generator that applies paces to a ventricle of a heart;
a controller that controls the pulse generator to deliver each of the paces at an atrioventricular delay following an atrial event, wherein the atrioventricular delay is a function of a difference between a first value representing a time between a first ventricular pace and an atrioventricular valve closure, and a second value as a function of a time between a second ventricular pace and an onset of isovolumetric contraction. - View Dependent Claims (62, 63, 64, 65, 66)
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67. A method comprising:
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measuring a first interval representing a time between a first cardiac occurrence and an atrioventricular valve closure, wherein the cardiac occurrence is one of an atrial sense, an atrial pace and a ventricular pace;
measuring a second interval as a function of a time between a second cardiac occurrence and an onset of isovolumetric contraction;
adjusting an atrioventricular delay to cause the first interval to equal the second interval. - View Dependent Claims (68, 69, 70, 71)
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Specification