System and Method for Evaluating Mechanical Cardiac Dyssynchrony Based on Multiple Impedance Vectors Using an Implantable Medical Device
First Claim
1. A method for use with an implantable medical device for implant within a patient, the method comprising:
- detecting a plurality of cardiogenic impedance signals along different sensing vectors within the patient;
detecting a measure of mechanical dyssynchrony in the heart of the patient based on a comparison of the cardiogenic impedance signals, including detecting abnormally contracting segments, if any, within the heart of the patient; and
controlling at least one device function based on the measure of mechanical dyssynchrony.
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Abstract
Techniques are provided for evaluating mechanical dyssynchrony within the heart of patient in which a pacemaker, implantable cardioverter-defibrillator (ICD) or other medical device is implanted. In one example, a set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart.
66 Citations
30 Claims
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1. A method for use with an implantable medical device for implant within a patient, the method comprising:
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detecting a plurality of cardiogenic impedance signals along different sensing vectors within the patient; detecting a measure of mechanical dyssynchrony in the heart of the patient based on a comparison of the cardiogenic impedance signals, including detecting abnormally contracting segments, if any, within the heart of the patient; and controlling at least one device function based on the measure of mechanical dyssynchrony. - 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)
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26. A system for use with an implantable medical device for implant within a patient, the system comprising:
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a multiple cardiogenic impedance signal detector operative to detect a plurality of cardiogenic impedance signals along different sensing vectors within the patient; and a mechanical dyssynchrony evaluation system operative to detect a measure of mechanical dyssynchrony in the heart of the patient based on a comparison of the cardiogenic impedance signals, including detecting abnormally contracting segments, if any, within the heart of the patient. - View Dependent Claims (27, 28, 29)
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30. A method for use with an implantable medical device for implant within a patient, the method comprising:
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detecting a plurality of cardiogenic impedance signals along different sensing vectors within the patient; detecting a measure of mechanical dyssynchrony in the heart of the patient based on a comparison of the cardiogenic impedance signals, including detecting differences in one or more of peak magnitude delay times of the cardiogenic impedance signals, peak velocity delay times of the cardiogenic impedance signals, peak magnitudes of the cardiogenic impedance signals, and integrals of the cardiogenic impedance signals; and controlling at least one device function based on the measure of mechanical dyssynchrony.
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Specification