IMPLANTABLE MEDICAL DEVICE WITH OPTIMIZATION PROCEDURE
First Claim
1. An implantable medical devicea pulse generator that emits cardiac stimulating pacing pulses at least one lead comprising electrodes for delivering said pulses to cardiac tissue in at least one ventricle of a heart of a patient;
- an acoustic sensor that detects acoustic energy in the patient and that emits a sensed signal corresponding thereto;
a signal processing circuit configured to extract a signal corresponding to a second heart sound (S2) from the sensed signal, said signal being received from said acoustic sensor, and to produce signals indicative of second heart sounds of the heart of said patient over predetermined periods of a cardiac cycle during successive cardiac cycles, and to determine a duration of successive second heart sound signals; and
a controller configured to perform an optimization procedure that controls delivery of said pacing pulses based on the determined durations of successive second heart sound signals to identify a combination of stimulation intervals including at least one of a AV interval and a VV interval that causes a substantially synchronized closure of the aortic and pulmonary valves.
1 Assignment
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Accused Products
Abstract
In an implantable medical device and a method for the operation thereof, acoustic energy is sensed in a subject in whom the device is implanted, and signals indicative of heart sounds of the heart of the patient are produced over predetermined periods of a cardiac cycle, during successive cardiac cycles. A signal corresponding to the second heart sound (S2) is extracted from the sensed signal, and the respective durations of successive second heart sound signals are determined. An optimization procedure is implemented that includes controlling delivery of pacing pulses based on the determined durations of successive second heart sounds, to determined a combination of stimulation intervals, including at least the AV interval and the VV interval, that causes a substantially synchronized closure of the aortic and pulmonary valves.
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Citations
69 Claims
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1. An implantable medical device
a pulse generator that emits cardiac stimulating pacing pulses at least one lead comprising electrodes for delivering said pulses to cardiac tissue in at least one ventricle of a heart of a patient; -
an acoustic sensor that detects acoustic energy in the patient and that emits a sensed signal corresponding thereto; a signal processing circuit configured to extract a signal corresponding to a second heart sound (S2) from the sensed signal, said signal being received from said acoustic sensor, and to produce signals indicative of second heart sounds of the heart of said patient over predetermined periods of a cardiac cycle during successive cardiac cycles, and to determine a duration of successive second heart sound signals; and a controller configured to perform an optimization procedure that controls delivery of said pacing pulses based on the determined durations of successive second heart sound signals to identify a combination of stimulation intervals including at least one of a AV interval and a VV interval that causes a substantially synchronized closure of the aortic and pulmonary valves. - 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, 25, 26, 27, 28, 29, 30, 31, 32, 33)
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34. A method for operating an implantable medical device, said device including a pulse generator adapted to produce cardiac stimulating pacing pulses and being connectable to at least one lead comprising electrodes for delivering said pulses to cardiac tissue, comprising the steps of:
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sensing an acoustic energy; producing signals indicative of heart sounds of the heart of said patient over predetermined periods of a cardiac cycle during successive cardiac cycles; extracting a signal corresponding to a second heart sound (S2) from a sensed signal; determining durations of successive second heart sound signals; and performing an optimization procedure, said optimization procedure comprising the step of controlling said pacing pulses based on said determined durations of successive second heart sounds to determine a combination of stimulation intervals including at least one of an AV interval and a VV interval that causes a substantially synchronized closure of the aortic and pulmonary valves. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66)
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67-68. -68. (canceled)
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69. A computer-readable medium encoded with programming instructions for use in an implantable medical device, said device including a pulse generator that emits cardiac stimulating pacing pulses and at least one lead connected to the pulse generator comprising electrodes for delivering said pulses to cardiac tissue, and an acoustic energy sensor, said programming instructions causing said implantable medical device to:
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sense acoustic energy with said acoustic energy sensor; produce signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; extract a signal corresponding to a second heart sound (S2) from the sensed signal from said acoustic energy sensor; determine durations of successive second heart sound signals; and perform an optimization procedure including controlling delivery of said pacing pulses dependent on the determined durations of successive second heart sounds to determine a combination of stimulation intervals, including at least one of an AV interval and VV interval, that causes a substantially synchronized closure of the aortic and pulmonary valves.
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Specification