Atrial interval based heart rate variability diagnostic for cardiac rhythm management system

• US 20030199937A1
• Filed: 05/21/2003
• Published: 10/23/2003
• Est. Priority Date: 03/08/2001
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Carlson, Gerrard M., Stahmann, Jeffrey E., Baker, Kenneth L.
• Application Number:
  US10/443,338
• Publication Number:
  US 20030199937A1
• Time in Patent Office: Days
• US Class Current: 607/25
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data

Abstract

A cardiac rhythm management system acquires atrial heart rate variability data. The system provides a graphic or other indication of patient well-being based on the atrial heart rate variability data. Such atrial heart rate variability information provides an indication of the autonomic balance between the sympathetic and parasympathetic/vagal components of the autonomic nervous system. One example of the system also provides time-domain processing of frequency components of the atrial heart rate interval signal to obtain the indication of patient well-being.

Claims

1. A method including:

detecting, over a time period, intrinsic atrial heart contractions;

measuring P-P intervals between the intrinsic atrial heart contractions;

calculating beat-to-beat P-P time differences between a pair of successive P-P intervals;

categorizing the P-P time differences based on at least one of;

(1) a magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) an amount of the P-P time difference;

storing, over the time period, a categorized count of the P-P time differences; and

providing a diagnostic based on the stored categorized count of the P-P time differences.

2. The method of claim 1, in which providing the diagnostic includes displaying the P-P time differences as a function of at least one of:

(1) the magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) the amount of the P-P time difference.

3. The method of claim 1, in which categorizing the P-P time differences includes categorizing the P-P time differences as a function of both of:

(1) the magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) the amount of the P-P time difference.

4. The method of claim 1, further including adjusting a cardiac rhythm management therapy based on at least one P-P time difference.

5. The method of claim 1, further including disposing an atrial electrode in an atrium of a heart.

6. A system including:

an atrial electrode configured for being associated with an atrium of a heart;

an atrial sense amplifier, including an atrial sense amplifier input coupled to the atrial electrode for receiving, over a time period, intrinsic atrial electrical depolarizations therefrom, and including an atrial sense amplifier output;

a P-P interval timer, including a P-P timer input coupled to the atrial sense amplifier output for receiving intrinsic atrial electrical depolarizations, and including a P-P timer output providing a P-P interval between successive atrial heart contractions;

a difference circuit, including a difference circuit input coupled to the P-P interval timer, and a difference circuit output providing a P-P time difference between a successive pair of P-P intervals; and

a controller, coupled to the P-P timer output for receiving the P-P intervals and also coupled to the difference circuit output for receiving the P-P time differences, the controller categorizing the P-P time differences based on at least one of;

(1) a magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) an amount of the P-P time difference.

7. The system of claim 6, further including a memory device, coupled to the controller, the memory device storing, over the time period, a categorized count of the P-P time differences.

8. The system of claim 7, further including a display, communicatively coupled to the memory device, the display providing information associated with the P-P time differences.

9. The system of claim 8, in which the display provides information associated with the categorized count of the P-P time differences displayed as a function of at least one of:

(1) the magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) the amount of the P-P time difference.

10. The system of claim 9, in which the display provides information associated with the categorized count of the P-P time differences displayed as a function of both of:

(1) the magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) the amount of the P-P time difference.

11. The system of claim 7, in which the controller categorizes the P-P time differences based on both of:

(1) the magnitude of at least one P-P interval in the pair of successive P-P intervals; and

(2) the amount of the P-P time difference.

12. The system of claim 7, further including a therapy module providing therapy to the heart based on a comparison of an attribute of at least one P-P time difference to a predetermined criterion.