Cardiac rhythm management system using time-domain heart rate variability indicia
First Claim
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33. A method including:
- detecting ventricular heart contractions over a time period;
detecting atrial heart contractions over the time period;
if any ventricular heart contraction is not preceded by a corresponding atrial contraction, then deeming that ventricular heart contraction a premature ventricular contraction (PVC);
replacing the PVC with a substitute R-wave at that time which the R-wave would have occurred had the PVC not occurred;
obtaining a time-domain first signal representing time intervals between the detected ventricular heart contractions, wherein the detected ventricular heart contractions include any substitute R-waves generated as a result of a PVC;
filtering the first signal to obtain a time-domain second signal including frequency components substantially in a first frequency band, wherein the second signal is influenced by both sympathetic and parasympathetic components of an autonomic nervous system;
filtering the first signal to obtain a time-domain third signal including frequency components substantially in a second frequency band, wherein the third signal is influenced by the parasympathetic component of the autonomic nervous system and not substantially influenced by the sympathetic component of the autonomic nervous system;
obtaining a time domain variance of each of the second and third signals; and
providing an indication associated with a balance between the sympathetic and parasympathetic components of the autonomic nervous system based on a ratio between the time-domain variances of the second and third signals.
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Abstract
A cardiac rhythm management system that provides an indication of patient well-being based on the autonomic balance between the sympathetic and parasympathetic/vagal components of the autonomic nervous system, using time-domain processing of frequency components of a heart rate interval signal.
69 Citations
54 Claims
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33. A method including:
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detecting ventricular heart contractions over a time period;
detecting atrial heart contractions over the time period;
if any ventricular heart contraction is not preceded by a corresponding atrial contraction, then deeming that ventricular heart contraction a premature ventricular contraction (PVC);
replacing the PVC with a substitute R-wave at that time which the R-wave would have occurred had the PVC not occurred;
obtaining a time-domain first signal representing time intervals between the detected ventricular heart contractions, wherein the detected ventricular heart contractions include any substitute R-waves generated as a result of a PVC;
filtering the first signal to obtain a time-domain second signal including frequency components substantially in a first frequency band, wherein the second signal is influenced by both sympathetic and parasympathetic components of an autonomic nervous system;
filtering the first signal to obtain a time-domain third signal including frequency components substantially in a second frequency band, wherein the third signal is influenced by the parasympathetic component of the autonomic nervous system and not substantially influenced by the sympathetic component of the autonomic nervous system;
obtaining a time domain variance of each of the second and third signals; and
providing an indication associated with a balance between the sympathetic and parasympathetic components of the autonomic nervous system based on a ratio between the time-domain variances of the second and third signals. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40, 41, 42)
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43. A method including:
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detecting heart contractions over a time period;
obtaining a time-domain first signal representing time intervals between the detected heart contractions;
filtering the first signal to obtain a time-domain second signal including frequency components substantially in a first frequency band, wherein the second signal is influenced by both sympathetic and parasympathetic components of an autonomic nervous system;
filtering the first signal to obtain a time-domain third signal including frequency components substantially in a second frequency band, wherein the third signal is influenced by the parasympathetic component of the autonomic nervous system and not substantially influenced by the sympathetic component of the autonomic nervous system;
obtaining a time domain variance of each of the second and third signals;
providing a balance indication associated with a balance between the sympathetic and parasympathetic components of the autonomic nervous system based on a ratio between the time-domain variances of the second and third signals; and
automatically adjusting a therapy at least in part by using the balance indication to control the adjusting. - View Dependent Claims (44, 45, 46, 47, 48, 49)
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50. A method including:
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detecting heart contractions over a time period;
obtaining a time-domain first signal representing time intervals between the detected heart contractions;
filtering the first signal to obtain a time-domain second signal including frequency components substantially in a first frequency band, wherein the second signal is influenced by both sympathetic and parasympathetic components of an autonomic nervous system;
filtering the first signal to obtain a time-domain third signal including frequency components substantially in a second frequency band, wherein the third signal is influenced by the parasympathetic component of the autonomic nervous system and not substantially influenced by the sympathetic component of the autonomic nervous system;
obtaining a time domain variance of each of the second and third signals; and
providing an indication associated with a balance between the sympathetic and parasympathetic components of the autonomic nervous system based on a ratio between the time-domain variances of the second and third signals during a period of time that is deemed to correspond to a resting state. - View Dependent Claims (51, 52, 53, 54)
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Specification