Cardiac pacing using sensed coronary vein blood temperature and left ventricular flow rate

• US 20070112388A1
• Filed: 01/09/2007
• Published: 05/17/2007
• Est. Priority Date: 12/31/2001
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Salo, Rodney
• Granted Patent: US 7,738,967 B2
• Time in Patent Office: Days
• US Class Current: 607/21
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• 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 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

Methods of cardiac pacing involve sensing left ventricular electrical rhythms, sensing left ventricular blood flow rate, and sensing a coronary vein blood temperature. The methods further involve modifying delivery of synchronized electrical signals to the patient'"'"'s heart based at least in part on the sensed coronary vein blood temperature and sensed left ventricular flow rate.

Claims

1. A body implantable system, comprising:

a lead system comprising;

an elongated body suitable for passage into the coronary sinus;

a thermal sensor located proximal to the distal end of the elongated body, the thermal sensor configured for sensing a coronary sinus blood temperature at a location distal to the coronary sinus ostium when the elongated body is positioned in the coronary sinus; and

a programmable circuit coupled to the lead system, the programmable circuit configured to determine a hemodynamic state using the sensed coronary sinus blood temperature.

2. The system of claim 1, wherein the thermal sensor comprises a thermistor.

3. The system of claim 1, wherein the thermal sensor comprises a MEMS temperature sensor.

4. The system of claim 1, wherein the thermal sensor comprises a thermocouple.

5. The system of claim 1, wherein the thermal sensor comprises a fiber optic temperature probe.

6. The system of claim 1, further comprising an energy delivery system coupled to the programmable circuit, and wherein the energy delivery system modifies the delivery of electrical signals based on the sensed blood temperature.

7. The system of claim 1, further comprising a flow sensor for sensing a cardiac output, and wherein the programmable circuit further senses a left ventricular flow rate from the flow sensor.

8. The system of claim 7, wherein the flow sensor comprises a ventricular impedance sensor.

9. The system of claim 7, wherein the programmable circuit determines a hemodynamic efficiency of the heart using the sensed left ventricular flow rate and the sensed blood temperature.

10. The system of claim 7, further comprising an energy delivery system coupled to the programmable circuit, and wherein the energy delivery system modifies the delivery of electrical signals based on the sensed left ventricular flow rate and the sensed blood temperature.

11. The system of claim 1, further comprising a ventricular thermal sensor for sensing a blood temperature entering the left ventricle, the ventricular thermal sensor coupled to the programmable circuit, and wherein the programmable circuit further senses a temperature difference between the ventricular thermal sensor and the thermal sensor.

12. The system of claim 11, wherein the programmable circuit determines a hemodynamic efficiency of the heart using the sensed temperature difference.

13. The system of claim 11, further comprising an energy delivery system coupled to the programmable circuit, and wherein the energy delivery system modifies the delivery of electrical signals based on the sensed temperature difference.

14. The system of claim 1, further comprising an activity sensor coupled to the programmable circuit.

15. The system of claim 14, wherein the activity sensor comprises an accelerometer.

16. The system of claim 14, wherein the activity sensor comprises a minute ventilation sensor.

17. The system of claim 14, wherein the programmable circuit updates a long term average blood temperature measurement from the at least one thermal sensor, the long term average blood temperature updated at a state of rest as sensed by the activity sensor.

18. The system of claim 1, wherein the lead system comprises at least one electrode at a distal end of the elongated body.

19. A body implantable system, comprising:

a lead system comprising;

an elongated body configured for passage into the coronary sinus;

a thermal sensor located proximal to the distal end of the elongated body, the thermal sensor configured for sensing a coronary sinus blood temperature at a location distal to the coronary sinus ostium when the elongated body is positioned within the coronary sinus; and

a programmable circuit coupled to the lead system, the programmable circuit configured to determine a myocardial temperature using the sensed coronary sinus blood temperature.

20. The system of claim 19, wherein the lead comprises at least one electrode at a distal end of the elongated body.

21. The system of claim 19, further comprising a flow sensor for sensing a cardiac output, and wherein the programmable circuit further senses a left ventricular flow rate from the flow sensor.

22. The system of claim 19, further comprising a ventricular thermal sensor for sensing a blood temperature entering the left ventricle, the ventricular thermal sensor coupled to the programmable circuit, and wherein the programmable circuit is further configured to sense a temperature difference between the ventricular thermal sensor and the thermal sensor.

23. The system of claim 22, wherein the programmable circuit is configured to determine a hemodynamic efficiency of the heart using the sensed temperature difference.