Detection of diastolic heart failure
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Abstract
An implantable medical apparatus for detecting diastolic heart failure, DHF, has a DHF determining device for determining at least one blood pressure parameter for detecting a DHF state of the heart of a patient. The DHF determining device has a pressure measuring unit for measuring the absolute value of left atrial pressure during the diastasis phase just before atrial contraction, or the absolute value of the pressure in the pulmonary vein when the pulmonary valve is closed, for a predetermined workload situation and a rest situation of the patient. A comparator compares the difference between left atrial pressure or pulmonary vein pressure, in the workload and rest situations, with a predetermined pressure difference reference value. A pacemaker includes such an apparatus and a control unit that optimizes pacing therapy depending on the result of the comparisons with the reference values. in a corresponding method of detecting diastolic heart failure, DHF at least one blood pressure parameter for detecting a DHF state of the heart of a patient is determined. The absolute value of left atrial pressure is measured during the diastasis phase just before atrial contraction, or the absolute value of the pressure in the pulmonary vein when the pulmonary valve is closed, for a predetermined workload situation and a rest situation of the patient. The difference between left atrial pressure or pulmonary vein pressure in said workload and rest situations is compared with a predetermined pressure difference reference value.
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Citations
49 Claims
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1-26. -26. (canceled)
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27. An implantable medical apparatus for detecting diastolic heart failure (DHF), comprising:
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a pressure measuring unit adapted to interact with a living subject to measure an absolute pressure value at a location and time selected from the group consisting of the left atrium during the diastasis phase immediately preceding an atrial contraction, and the pulmonary vein when the pulmonary valve is closed, both for a predetermined workload situation of the subject and a rest situation of the subject for a predetermined workload situation of the subject and for a rest situation of the subject; and
a calculation unit supplied with said absolute pressure value for said predetermined workload situation and said pressure value for said rest situation, said calculation unit forming a difference, Δ
P, between said absolute pressure value for said predetermined workload situation and said absolute pressure value for said rest situation, and comparing said difference Δ
P to a predetermined pressure difference reference value to obtain a comparison result indicative of a DHF state of the heart of the subject. - View Dependent Claims (28, 30, 31, 32, 33, 34, 35)
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36. An implantable cardiac pacemaker comprising:
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a diastolic heart failure (DHF) determining device comprising a pressure measuring unit adapted to interact with a living subject to measure an absolute pressure value at a location and time selected from the group consisting of the left atrium during the diastasis phase immediately preceding an atrial contraction, and the pulmonary vein when the pulmonary valve is closed, both for a predetermined workload situation of the subject and a rest situation of the subject for a predetermined workload situation of the subject and for a rest situation of the subject, and a calculation unit supplied with said absolute pressure value for said predetermined workload situation and said pressure value for said rest situation, said calculation unit forming a difference, Δ
P, between said absolute pressure value for said predetermined workload situation and said absolute pressure value for said rest situation, and comparing said difference Δ
P to a predetermined pressure difference reference value to obtain a comparison result indicative of a DHF state of the heart of the subject; and
a therapy administration unit adapted to interact with the heart of the subject to administer electrical cardiac therapy thereto, said therapy administration unit being connected to said DHF determining device, and being supplied with said comparison result, and administering said electrical cardiac therapy dependent on said comparison result. - View Dependent Claims (37, 38, 39)
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40. A method for detecting diastolic heart failure (DHF), comprising the steps of:
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measuring an absolute pressure value in vivo in a subject at a location and time selected from the group consisting of the left atrium during the diastasis phase immediately preceding an atrial contraction, and the pulmonary vein when the pulmonary valve is closed, both for a predetermined workload situation of the subject and a rest situation of the subject for a predetermined workload situation of the subject and for a rest situation of the subject; and
electronically forming a difference, Δ
P, between said absolute pressure value for said predetermined workload situation and said absolute pressure value for said rest situation, and electronically comparing said difference Δ
P to a predetermined pressure difference reference value to obtain a comparison result indicative of a DHF state of the heart of the subject. - View Dependent Claims (41, 42, 43, 44, 45, 46, 47, 48, 49)
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Specification