Measurement of coronary sinus parameters to optimize left ventricular performance

• US 20060247702A1
• Filed: 04/28/2005
• Published: 11/02/2006
• Est. Priority Date: 04/28/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Receveur, Rogier, Stegemann, Berthold
• Granted Patent: US 7,904,158 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• 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 1/3655 controlled by body or blood temperature
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

In some embodiments, an implantable medical device (IMD) system may include one or more of the following elements: (a) an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient'"'"'s heart, (b) an oxygen signal generated by the oxygen sensor, (c) an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal, and (d) an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient'"'"'s heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal, wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.

Claims

1. An implantable medical device (IMD) system, comprising:

an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient'"'"'s heart;

an oxygen signal generated by the oxygen sensor;

an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal; and

an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient'"'"'s heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal;

wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal and wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.

2. An IMD according to claim 1, further comprising a blood pressure sensor for detecting a signal proportional to the left heart chamber blood pressure, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and the blood pressure signal.

3. An IMD according to claim 1, further comprising a blood flow sensor for measuring coronary blood flow producing a blood flow signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and the blood flow signal.

4. An IMD according to claim 1, further comprising a glucose sensor for sensing a rate of extraction of glucose through the coronary sinus and producing a glucose signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and glucose signal.

5. An IMD according to claim 1, further comprising a blood temperature sensor for sensing the temperature of the blood in the coronary sinus and producing a temperature signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and temperature signal.

6. An IMD according to claim 1, wherein the pacing pulses are adjusted as the heart changes during the life of a patient as a function of the oxygen signal.

7. An IMD according to claim 1, wherein a left ventricular performance index is created within the implantable medical device as a function of the oxygen signal.

8. A method for pacing a patient'"'"'s heart using an implanted medical device comprising:

sensing a rate extraction of glucose through a coronary sinus of a patient'"'"'s heart;

generating a pacing pulse as a function of the sensed rate;

adjusting a pacing parameter of the pacing pulse as a function of a glucose signal; and

adjusting the pacing parameter to optimize left ventricular performance.

9. A method according to claim 8, further comprising the step of adjusting the pacing parameter of the pacing pulse as a function of the glucose signal and a blood pressure signal produced by a blood pressure sensor for detecting a signal proportional to the left heart chamber blood pressure.

10. A method according to claim 8, further comprising the step of adjusting the pacing parameter of the pacing pulse as a function of the glucose signal and a blood flow signal produced by a blood flow sensor for measuring coronary blood flow.

11. A method according to claim 8, further comprising the step of adjusting the pacing parameter of the pacing pulse as a function of the glucose signal and an oxygen signal produced by an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient'"'"'s heart.

12. A method according to claim 8, further comprising the step of adjusting the pacing parameter of the pacing pulse as a function of a glucose signal and a blood temperature signal produced by a blood temperature sensor for sensing the temperature of the blood in the coronary sinus.

13. A method according to claim 8, further comprising the step of adjusting the pacing parameter during implantation of the implantable medical device to optimize the delivery of the pacing pulses.

14. A method according to claim 8, further comprising the step of adjusting the pacing parameter as the heart changes during the life of a patient.

15. An implantable multi-chamber pacing system comprising:

atrial sense means for sensing signals from an atrium of a patient'"'"'s heart;

ventricular sense means for sending ventricular signals from a patient'"'"'s right ventricle;

coronary sense means for sensing ventricular signals from the patient'"'"'s left ventricle and for sensing a signal representing blood temperature through the patient'"'"'s coronary sinus; and

pace control means for generating and delivering pacing pulses to a plurality of chambers within the patient'"'"'s heart, wherein the pace control means includes means for setting and timing cardiac resynchronization therapy as a function of the sensed temperature signal.

16. An implantable multi-chamber pacing system according to claim 15, wherein the coronary sense means further detects a signal proportional to the left heart chamber blood pressure, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the blood pressure signal.

17. An implantable multi-chamber pacing system according to claim 15, wherein the coronary sense means further detects a signal proportional to blood flow, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the blood flow signal.

18. An implantable multi-chamber pacing system according to claim 15, wherein the coronary sense means further detects a signal proportional to a rate of glucose in the coronary sinus, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the glucose signal.

19. An implantable multi-chamber pacing system according to claim 15, wherein the coronary sense means further detects a signal proportional to oxygen in the blood flowing through a coronary sinus of a patient'"'"'s heart, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the oxygen signal.

20. An implantable multi-chamber pacing system according to claim 15, wherein the coronary sense means is coupled to a delivery catheter and placed in a coronary sinus where it remains during implantation of the multi-chamber pacing system to take measurements to optimize the delivery of pacing pulses.