SYSTEM AND METHOD FOR DECOMPENSATION DETECTION AND TREATMENT BASED ON PATIENT HEMODYNAMICS
First Claim
1. A method of operating an implanted cardiac rhythm management system in a patient, the method comprising:
- applying an electrical stimulus to the patient'"'"'s heart at a first set of pacing parameters including a lower rate limit (LRL) setting;
acquiring a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient;
calculating an average coronary venous end diastolic pressure (CV-EDP) value from the CVP signal;
monitoring the average CV-EDP value over a predetermined interval; and
dynamically adjusting the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.
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Abstract
A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient'"'"'s heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.
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Citations
20 Claims
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1. A method of operating an implanted cardiac rhythm management system in a patient, the method comprising:
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applying an electrical stimulus to the patient'"'"'s heart at a first set of pacing parameters including a lower rate limit (LRL) setting; acquiring a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient; calculating an average coronary venous end diastolic pressure (CV-EDP) value from the CVP signal; monitoring the average CV-EDP value over a predetermined interval; and dynamically adjusting the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value. - View Dependent Claims (2, 6, 7, 8)
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- 3. The method of claim 3 wherein the first predetermined event is an increase in the average CV-EDP value indicative of an onset of early decompensation symptoms.
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9. A method of operating an implanted cardiac rhythm management system in a patient, the method comprising:
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applying an electrical stimulus to the patient'"'"'s heart at a first set of pacing parameters including an LRL setting; acquiring a CVP signal from a pressure sensor implanted in a coronary vein of the patient; calculating a baseline CV-EDP value from the CVP signal corresponding to a first interval; monitoring average CV-EDP values over a predetermined time interval subsequent to the first interval; comparing each of average CV-EDP values to the baseline CV-EDP value; automatically increasing the LRL setting in response to a difference (Δ
CV-EDP) between at least one of the average CV-EDP values and the baseline average CV-EDP value exceeding a predetermined threshold; andsubsequently automatically reducing the LRL setting upon detecting a predetermined event. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An implantable rate adaptive cardiac rhythm management system configured for applying pacing stimuli to a patient'"'"'s heart, the pacing stimuli defined by pacing parameters including a pacing rate and an LRL setting, the system comprising:
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a plurality of implantable medical electrical leads configured to sense cardiac electrical activity and to deliver the pacing stimuli, at least one of the leads being configured for chronic implantation within a coronary vein of the patient'"'"'s heart and including a pressure sensor configured to generate a coronary venous pressure (CVP) signal indicative of fluid pressure within the coronary vein; an implantable pulse generator operatively coupled to the leads configured to generate the pacing stimuli, the pulse generator including a control system configured to; acquire the CVP signal from the pressure sensor; calculate an average coronary venous end diastolic pressure (CV-EDP) value from the CVP signal; monitor the calculated average CV-EDP value over a predetermined interval; dynamically adjust the LRL setting responsive to the detection of a first or a second predetermined event based on the calculated average CV-EDP value. - View Dependent Claims (20)
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Specification