System and method for providing hemodynamically optimal pacing
First Claim
1. A cardiac pacemaker for providing optimal pacing therapy to a patient, the pacemaker having a plurality of pacing modes, the pacemaker comprising:
- first sensing means for providing a signal indicative of cardiac performance;
pulse generating means for generating stimulation pulses to a patient'"'"'s heart;
exercise detecting means for detecting the exercise state of a patient;
means for determining when the cardiac performance is maximized based on the first sensing means;
processing means for controlling the pulse generating means to operate in the plurality of pacing modes and for determining an optimal pacing mode when the determining means indicates that the cardiac performance is maximized for a current exercise state of the patient; and
means for automatically switching from a current pacing mode to the optimal pacing mode.
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Abstract
A system and method for a pacemaker are provided, for monitoring cardiac performance and adjusting a pacing regime to ensure hemodynamically optimal pacing therapy. The pacemaker includes a sensor for measuring a physiological parameter as an indicator of cardiac performance. A processing system dithers various programmable pacing parameters and notes the resulting changes in cardiac performance. The processor analyzes the changes in cardiac performance corresponding to changes in the pacing parameters and selects those parameters resulting in maximum cardiac performance. An activity sensor may be provided to allow the processing system to consider the activity level of a patient when determining a hemodynamically optimal pacing regime.
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Citations
24 Claims
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1. A cardiac pacemaker for providing optimal pacing therapy to a patient, the pacemaker having a plurality of pacing modes, the pacemaker comprising:
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first sensing means for providing a signal indicative of cardiac performance; pulse generating means for generating stimulation pulses to a patient'"'"'s heart; exercise detecting means for detecting the exercise state of a patient; means for determining when the cardiac performance is maximized based on the first sensing means; processing means for controlling the pulse generating means to operate in the plurality of pacing modes and for determining an optimal pacing mode when the determining means indicates that the cardiac performance is maximized for a current exercise state of the patient; and means for automatically switching from a current pacing mode to the optimal pacing mode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method of providing hemodynamically optimum pacing therapy in an implantable stimulation device having a plurality of pacing modes, comprising the steps of:
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sensing a signal indicative of cardiac performance; detecting the exercise state of a patient; generating stimulation pulses with a pulse generator to a patient'"'"'s heart; controlling the pulse generator to operate in the plurality of pacing modes; determining an optimal pacing mode when the cardiac performance is maximized while the patient is in a current exercise state; and automatically switching from a current pacing mode to the optimal pacing mode when cardiac performance is improved by a prescribed amount. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16)
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17. A dual-chamber implantable stimulation device, comprising:
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atrial sensing means for sensing P-waves; ventricular sensing means for sensing R-waves; timing means for controlling an atrial escape interval and an A-V time interval; pulse generator means for generating an atrial stimulation pulse (A-pulse) in the absence of a sensed P-wave within the atrial escape interval, and a ventricular stimulation pulse (V-pulse) in the absence of an R-wave within the A-V time interval; sensing means for sensing a signal representative of hemodynamic performance; exercise detection means for detecting a patient'"'"'s level of exercise corresponding to at least one of a rest state, a wake state, or an exercise state; means for determining an optimal sequential mode of operation corresponding to maximum hemodynamic performance based on the patient'"'"'s level of exercise; and means for adjusting the pulse generator means to generate stimulation pulses in the optimal sequential mode of operation. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24)
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Specification