Phonocardiographic image-based atrioventricular delay optimization
First Claim
1. A system for applying pacing pulses to a heart, the system comprising:
- a sensing circuit to sense a cardiac signal;
a therapy circuit to deliver the pacing pulses;
an acoustic sensor to produce an acoustic sensor signal indicative of heart sounds;
a controller coupled to the therapy circuit, the controller including;
a therapy protocol synthesizer adapted to generate a sequence of pacing parameters; and
an automatic therapy protocol execution module adapted to time pacing pulse deliveries each associated with one parameter of the sequence of pacing parameters; and
a processor coupled to the sensing circuit, the acoustic sensor, and the controller, the processor including an image formation module adapted to produce a phonocardiographic image based on the cardiac signal and the acoustic sensor signal, the phonocardiographic image including a stack of segments of the acoustic sensor signal aligned by a selected type of the cardiac events and grouped by at least parameters of the sequence of pacing parameters.
1 Assignment
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Accused Products
Abstract
A cardiac rhythm management system provides a phonocardiographic image indicative of a heart'"'"'s mechanical events related to hemodynamic performance to allow, among other things, diagnosis of cardiac conditions and evaluation of therapies treating the cardiac conditions. The phonocardiographic image includes a stack of acoustic sensor signal segments representing multiple cardiac cycles. Each acoustic sensor signal segment includes heart sounds indicative of the heart'"'"'s mechanical events and representations of the heart'"'"'s electrical events. The diagnosis and/or therapy evaluation are performed by observing or detecting at least an occurrence of a particular heart sound related to a cardiac time interval or a trend of a particular time interval between an electrical event and a mechanical event over the cardiac time interval.
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Citations
45 Claims
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1. A system for applying pacing pulses to a heart, the system comprising:
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a sensing circuit to sense a cardiac signal;
a therapy circuit to deliver the pacing pulses;
an acoustic sensor to produce an acoustic sensor signal indicative of heart sounds;
a controller coupled to the therapy circuit, the controller including;
a therapy protocol synthesizer adapted to generate a sequence of pacing parameters; and
an automatic therapy protocol execution module adapted to time pacing pulse deliveries each associated with one parameter of the sequence of pacing parameters; and
a processor coupled to the sensing circuit, the acoustic sensor, and the controller, the processor including an image formation module adapted to produce a phonocardiographic image based on the cardiac signal and the acoustic sensor signal, the phonocardiographic image including a stack of segments of the acoustic sensor signal aligned by a selected type of the cardiac events and grouped by at least parameters of the sequence of pacing parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac rhythm management system, comprising:
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an implantable device including;
a sensing circuit to sense a cardiac signal; and
a therapy circuit to deliver pacing pulses;
an acoustic sensor to produce an acoustic sensor signal indicative of heart sounds; and
an external programmer communicatively coupled to the implantable device and the acoustic sensor, the external programmer including;
a controller communicatively coupled to the therapy circuit, the controller including;
a therapy protocol synthesizer adapted to generate a sequence of pacing parameters; and
an automatic therapy protocol execution module adapted to time pacing pulse deliveries each associated with one parameter of the sequence of pacing parameters; and
a processor communicatively coupled to the sensing circuit, the acoustic sensor, and the controller, the processor including an image formation module adapted to produce a phonocardiographic image based on the cardiac signal and the acoustic sensor signal, the phonocardiographic image including a stack of segments of the acoustic sensor signal aligned by a selected type of the cardiac events and grouped by at least parameters of the sequence of pacing parameters. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method for apply pacing pulses to a heart, the method comprising:
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generating a first sequence of atrioventricular delays (AVDs);
delivering a first sequence of pacing pulses each associated with one AVD of the first sequence of AVDs;
receiving a cardiac signal indicative of cardiac events during the delivering the first sequence of pacing pulses;
receiving an acoustic sensor signal indicative of heart sounds during the delivering the first sequence of pacing pulses; and
forming a phonocardiographic image based on the cardiac signal and the acoustic sensor signal, the phonocardiographic image including a stack of segments of the acoustic sensor signal aligned by a selected type of the cardiac events and grouped by at least the first sequence of AVDs; and
presenting the phonocardiographic image. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. A method comprising;
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receiving an acoustic sensor signal indicative of an intrinsic heart sound associated with an intrinsic ventricular contraction adjacently subsequent to a first atrial contraction and a paced heart sound associated with a paced ventricular contraction adjacently subsequent to a second atrial contraction;
receiving a cardiac signal temporally associated with the acoustic sensor signal, the cardiac signal indicative of the first and second atrial contractions;
measuring a first time interval between the first atrial contraction and the intrinsic heart sound;
measuring a second time interval between the second atrial contraction and the paced heart sound; and
determining an approximately optimal pacing therapy based on the first and second time intervals. - View Dependent Claims (38, 39, 40, 41)
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42. A system for applying pacing pulses to a heart, the system comprising:
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means for producing an acoustic sensor signal indicative of heart sounds;
means for delivering pacing pulses associated with a predetermined sequence of pacing parameters; and
means for producing a phonocardiographic image based on selected type cardiac events and the acoustic sensor signal, the phonocardiographic image including a stack of segments of the acoustic sensor signal aligned by the selected type cardiac events and grouped by at least parameters of the predetermined sequence of pacing parameters. - View Dependent Claims (43, 44, 45)
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Specification