Automated programmable stimulating device to optimize pacing parameters and method
First Claim
1. A cardiac stimulator system comprising:
- (a) a cardiac stimulator for normally applying cardiac stimulating pulses having programmable pacing cycle parameters to a heart during a first predetermined time interval sufficiently long to establish a baseline condition for a cardiac performance parameter;
(b) means for measuring and storing values of said cardiac performance parameter;
(c) means for periodically changing one of said programmable pacing cycle parameters during a second predetermined time interval that is only a small fraction of said first predetermined time interval;
(d) means including said means for measuring and storing values of said cardiac performance parameter for measuring and storing values of said cardiac performance parameters during successive ones of said first and second predetermined time intervals; and
(e) means for determining whether an improvement in said cardiac performance parameter over the baseline condition occurs during ones of said second predetermined time intervals.
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Abstract
A method and apparatus for automatically optimizing a cardiac performance parameter of the heart, such as its cardiac output mean arterial pressure pO2 or pCO2. The performance parameter is optimized by periodically pacing the heart for a short period of time with stimulating pulses having a modified pacing parameter value. The intrinsic operation of the heart is monitored a majority of the time and establishes a baseline value for the cardiac performance parameter. The heart is then paced with the modified pacing parameter value during an interval that is approximately a 1:4 ratio with respect to the baseline monitoring interval. The method of the present invention can be achieved using a totally implanted pacemaker, an implanted pulse generator in combination with external equipment communicating with the pacemaker via telemetry, or by using equipment located external the patient.
266 Citations
18 Claims
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1. A cardiac stimulator system comprising:
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(a) a cardiac stimulator for normally applying cardiac stimulating pulses having programmable pacing cycle parameters to a heart during a first predetermined time interval sufficiently long to establish a baseline condition for a cardiac performance parameter; (b) means for measuring and storing values of said cardiac performance parameter; (c) means for periodically changing one of said programmable pacing cycle parameters during a second predetermined time interval that is only a small fraction of said first predetermined time interval; (d) means including said means for measuring and storing values of said cardiac performance parameter for measuring and storing values of said cardiac performance parameters during successive ones of said first and second predetermined time intervals; and (e) means for determining whether an improvement in said cardiac performance parameter over the baseline condition occurs during ones of said second predetermined time intervals. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method of optimizing a cardiac performance parameter of a heart, comprising the steps of:
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monitoring an intrinsic baseline cardiac pacing cycle parameter of a cardiac stimulator device for a first time period; modifying said cardiac pacing cycle parameter by applying stimulating pulses to the heart for a second time period, said second time period being substantially shorter than said first time period; comparing a cardiac performance parameter of the heart during both said first time period and said second time period, and generating an output indicative of said comparison; and adjusting said baseline cardiac pacing cycle parameter as a function of said output. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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Specification