SYSTEM AND METHOD FOR EVALUATING AND OPTIMIZING THE CONTRIBUTION OF PARTICULAR HEART CHAMBERS TO THE OVERALL EFFICACY OF CARDIAC PACING THERAPY

• US 20100042173A1
• Filed: 10/22/2009
• Published: 02/18/2010
• Est. Priority Date: 01/11/2006
• Status: Abandoned Application

• Current Assignee: Euljoon Park, Taraneh Ghaffari Farazi
• Original Assignee: Euljoon Park, Taraneh Ghaffari Farazi
• Inventors: Farazi, Taraneh Ghaffari, Park, Euljoon
• Application Number:
  US12/603,829
• Publication Number:
  US 20100042173A1
• Time in Patent Office: Days
• US Class Current: 607/18
• 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 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/3688 configured for switching the pacing mode, e.g. from AAI to DDD

Abstract

Techniques are provided for evaluating and optimizing the contribution of particular heart chambers to pacing efficacy. Briefly, a pacemaker temporarily alters the mode with which pacing therapy is delivered so as to selectively alter the heart chambers that are paced. The pacemaker detects any transient changes in pacing efficacy following the alteration in pacing mode. The pacemaker then assesses the contribution of particular heart chambers to pacing efficacy based on the alteration in the pacing mode and on any transient changes in the pacing efficacy. Additionally, techniques are provided herein for automatically adjusting pacing parameters to optimize the contribution of particular chambers to pacing efficacy.

Claims

1. A system for use with an implantable cardiac stimulation device equipped to deliver pacing therapy to the heart of a patient in which the device is implanted, the system comprising:

a pacing controller operative to control the delivery of pacing therapy; and

a heart chamber contribution evaluation unit operative to evaluate the contribution of a particular heart chamber to the overall efficacy of pacing therapy based on a temporary alteration in pacing mode and based on any transient changes in the efficacy of the pacing therapy following the alteration in pacing mode.

2. The system of claim 1 wherein the heart chamber contribution evaluation unit includes:

a pacing mode temporary adjustment unit operative to temporarily alter the pacing mode with which pacing therapy is delivered, the pacing mode specifying which chambers are paced;

a pacing efficacy detector operative to detect transient changes in the efficacy of pacing therapy following the alteration in pacing mode; and

a heart chamber contribution determination unit operative to determine the contribution of the particular heart chamber to the overall efficacy of pacing therapy based on the alteration in pacing mode and based on the transient changes in the effectiveness of the pacing therapy.

3. The system of claim 1 wherein pacing therapy is controlled by the pacing controller subject to one or more pacing parameters that affect the efficacy of pacing therapy and wherein the system further includes a heart chamber contribution optimization unit operative to adjust the pacing parameters based on the contribution of the particular heart chamber to pacing efficacy.

4. The system of claim 1 further comprising a diagnostic controller operative to record diagnostic information indicative of the contribution of the particular heart chamber to the overall efficacy of pacing therapy.

5. The system of claim 1 further comprising a tracking unit operative to track changes over time in the contribution of the particular heart chamber to the overall efficacy of pacing therapy.

6. The system of claim 1 further comprising an internal warning device operative to generate warning signals if the contribution of the particular heart chamber to the overall efficacy of pacing therapy falls below a predetermined minimum acceptable amount.

7. The system of claim 2 wherein the pacing mode temporary adjustment unit is operative to temporarily alter the pacing mode by switching between a biventricular pacing mode and a monoventricular pacing mode.

8. The system of claim 2 wherein the pacing mode temporary adjustment unit is operative to temporarily alter the pacing mode by switching between a dual-chambered pacing mode, wherein pacing is performed in both the atria and ventricles, and a non-dual-chambered pacing mode, wherein pacing is exclusively performed in either the atria or the ventricles.

9. The system of claim 2 wherein the pacing mode temporary adjustment unit is operative to temporarily alter the pacing mode by switching among any of:

AAI;

VVI;

DDD;

DDI;

VDD; and

VOO pacing modes.

10. The system of claim 2 wherein the pacing mode temporary adjustment unit is operative to temporarily alter the pacing mode for a duration in the range of two to sixty seconds.

11. The system of claim 2 wherein the pacing efficacy detector is operative to detect signals representative of one or more of:

morphological features of an intracardiac electrogram (IEGM);

blood oxygen saturation;

blood pressure;

contractility;

stroke volume;

cardiac output; and

a heart output pulse waveform.

12. The system of claim 11 wherein the pacing efficacy detector is operative to detect transient changes in the peak amplitude of the signals.

13. The system of claim 3 wherein the pacing parameters include one or more of:

an atrioventricular (A-V) delay;

an inter-ventricular (V-V) delay; and

an inter-atrial (A-A) delay.

14. The system of claim 3 wherein the heart chamber contribution optimization system is operative to adjust the pacing parameters to increase the contribution of the particular heart chamber to the overall efficacy of pacing therapy.

15. The system of claim 14 wherein the heart chamber contribution optimization unit is operative to adjust the pacing parameters to maximize the contribution of the particular heart chamber.

16. The system of claim 3 wherein the heart chamber contribution optimization unit is operative to adjust the pacing parameters to decrease the contribution of the particular heart chamber to the overall efficacy of pacing therapy.

19. The system of claim 1 further comprising means for recording diagnostic information indicative of the contribution of the particular heart chamber to the overall efficacy of pacing therapy.

20. The system of claim 1 further comprising means for generating warning signals if the contribution of the particular heart chamber to the overall efficacy of pacing therapy falls below a predetermined minimum acceptable amount.

17. A system for adjusting pacing parameters used in delivering cardiac pacing therapy to the heart of a patient in which an implantable cardiac stimulation device is implanted, the system comprising:

means for temporarily altering a pacing mode with which pacing therapy is delivered, the pacing mode specifying which chambers are paced;

means for detecting any transient changes in the efficacy of pacing therapy following the temporary alteration in pacing mode; and

means for evaluating the contribution of a particular heart chamber to the overall efficacy of pacing therapy based on any transient changes in the efficacy of the pacing therapy following an alteration in pacing mode.

18. The system of claim 17 further comprising:

means for controlling pacing therapy by using one or more pacing parameters that affect the efficacy of pacing therapy; and

means for adjusting the pacing parameters based on the contribution of the particular heart chamber to pacing efficacy.