Dynamic device therapy control for treating post myocardial infarction patients
First Claim
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1. An implantable pacemaker comprising:
- a sensing circuit to sense at least one electrogram;
a pacing circuit to deliver pacing pulses;
an activity sensor to sense an activity level; and
a pacing controller coupled to the sensing circuit, the pacing circuit, and the activity sensor, the pacing controller including;
a dynamic pacing parameter controller adapted to receive an activation signal and adapted to control one or more pacing parameters based on at least the activity level after the activation signal is received;
a myocardial infarction detector to detect a signal indicative of a myocardial infarction event; and
a pacing algorithm selector adapted to generate the activation signal after the signal indicative of the myocardial infarction event is detected.
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Abstract
A cardiac rhythm management system includes an implantable device executing a dynamic pacing algorithm after an myocardial infarction (MI) event. The dynamic pacing algorithm dynamically adjusts one or more pacing parameters based on a person'"'"'s gross physical activity level. Examples of the one or more pacing parameters include atrioventricular pacing delays and pacing channels/sites. The dynamic pacing algorithm provides for improved hemodynamic performance when a person'"'"'s metabolic need is high, and post MI remodeling control when the person'"'"'s metabolic need is low.
221 Citations
71 Claims
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1. An implantable pacemaker comprising:
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a sensing circuit to sense at least one electrogram;
a pacing circuit to deliver pacing pulses;
an activity sensor to sense an activity level; and
a pacing controller coupled to the sensing circuit, the pacing circuit, and the activity sensor, the pacing controller including;
a dynamic pacing parameter controller adapted to receive an activation signal and adapted to control one or more pacing parameters based on at least the activity level after the activation signal is received;
a myocardial infarction detector to detect a signal indicative of a myocardial infarction event; and
a pacing algorithm selector adapted to generate the activation signal after the signal indicative of the myocardial infarction event is detected. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. A cardiac rhythm management system, comprising:
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an implantable medical device including;
a sensing circuit to sense at least one electrogram;
a pacing circuit to deliver pacing pulses;
an activity sensor to sense an activity level; and
a pacing controller coupled to the sensing circuit, the pacing circuit, and the activity sensor, the pacing controller including;
a dynamic pacing parameter controller adapted to receive an activation signal and adapted to control one or more pacing parameters based on at least the activity level after the activation signal is received;
a myocardial infarction detector to detect a signal indicative of a myocardial infarction event; and
a pacing algorithm selector adapted to generate the activation signal after the signal indicative of the myocardial infarction event is detected; and
an external system communicatively coupled to the implantable medical device via telemetry, the external system including a user input to receive commands controlling operations of the implanted medical device. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. A method for operating an implantable pacemaker, comprising:
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detecting a signal indicative of a myocardial infarction event; and
executing a dynamic pacing algorithm after the signal indicative of the myocardial infarction event is detected, the executing including;
sensing an activity level;
dynamically adjusting one or more pacing parameters based on at least the activity level;
sensing at least one electrogram; and
delivering pacing pulses. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61)
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62. A cardiac pacing method, comprising:
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sensing an activity level;
comparing the activity level to a predetermined threshold;
executing a cardiac resynchronization therapy (CRT) pacing algorithm if the activity level exceeds the predetermined threshold; and
executing a remodeling control therapy (RCT) pacing algorithm if the activity level does not exceed the predetermined threshold. - View Dependent Claims (63, 64, 65, 66, 67, 68, 69, 70, 71)
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Specification