Method and apparatus for delivering chronic and post-ischemia cardiac therapies
First Claim
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1. A system for treating a heart with an ischemic region, the system comprising:
- a sensing circuit to sense one or more physiological signals including one or more ischemia-indicating signals and one or more therapy-monitoring signals;
an ischemia detector, coupled to the sensing circuit, to detect an ischemic state indicative of an occurrence of an ischemic event from the one or more ischemia-indicating signals;
a therapy delivery device to deliver a post-ischemia therapy and a chronic therapy;
a therapy monitor, coupled to the sensing circuit, to produce one or more therapy-monitoring parameters from the one or more therapy-monitoring signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the post-ischemia therapy and the chronic therapy; and
a controller coupled to the ischemia detector, the therapy delivery device, and the therapy monitor, the controller including;
a post-ischemia therapy controller adapted to initiate a delivery of the post-ischemia therapy and to adjust the delivery of the post-ischemia therapy based on the detected ischemic state and at least one post-ischemia therapy-monitoring parameter of the one or more therapy-monitoring parameters; and
a chronic therapy controller adapted to adjust a delivery of the chronic therapy based on the detected ischemic state and at least one chronic therapy-monitoring parameter of the one or more therapy-monitoring parameters.
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Abstract
An implantable cardiac rhythm management (CRM) device delivers a chronic therapy while detecting an ischemic state. When the ischemic state indicates the occurrence of an ischemic event, the implantable CRM device delivers a post-ischemia therapy. The post-ischemia therapy and the chronic therapy are adjusted using feedback control with the ischemic state and parameters indicative of the effectiveness of the post-ischemic therapy and the effectiveness of the chronic therapy as inputs.
209 Citations
25 Claims
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1. A system for treating a heart with an ischemic region, the system comprising:
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a sensing circuit to sense one or more physiological signals including one or more ischemia-indicating signals and one or more therapy-monitoring signals;
an ischemia detector, coupled to the sensing circuit, to detect an ischemic state indicative of an occurrence of an ischemic event from the one or more ischemia-indicating signals;
a therapy delivery device to deliver a post-ischemia therapy and a chronic therapy;
a therapy monitor, coupled to the sensing circuit, to produce one or more therapy-monitoring parameters from the one or more therapy-monitoring signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the post-ischemia therapy and the chronic therapy; and
a controller coupled to the ischemia detector, the therapy delivery device, and the therapy monitor, the controller including;
a post-ischemia therapy controller adapted to initiate a delivery of the post-ischemia therapy and to adjust the delivery of the post-ischemia therapy based on the detected ischemic state and at least one post-ischemia therapy-monitoring parameter of the one or more therapy-monitoring parameters; and
a chronic therapy controller adapted to adjust a delivery of the chronic therapy based on the detected ischemic state and at least one chronic therapy-monitoring parameter of the one or more therapy-monitoring parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method for treating a heart with an ischemic region, the method comprising:
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delivering a chronic therapy;
sensing one or more physiological signals;
detecting an ischemic state indicative of an occurrence of an ischemic event from one or more ischemia-indicating signals of the one or more physiological signals;
initiating a delivery of a post-ischemia therapy in response to the occurrence of the ischemic event as indicated by the detected ischemic state;
producing one or more therapy-monitoring parameters from one or more therapy-monitoring signals of the one or more physiological signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the chronic therapy and the post-ischemia therapy; and
adjusting the delivery of the chronic therapy and the delivery of the post-ischemia therapy based on the detected ischemic state and the one or more therapy-monitoring parameters. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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Specification