Cardiac treatment system and method for sensing and responding to heart failure
First Claim
1. An implantable system for pacing a patient'"'"'s heart and for determining a condition of heart failure, comprising:
- stimulus means for generating and delivering stimulus pulses to said patient'"'"'s heart;
heart signal means for monitoring patient heart signals and collecting heart signal data relating to said heart signals;
process means for processing said heart signal data to find changes in predetermined features of said heart signals;
indication means for providing an indication of heart failure as a function of said heart signal changes; and
response means for automatically responding to said heart failure indication by providing a treatment for said heart failure,wherein said response means comprises pacing control means for controlling said stimulus means to deliver pacing pulses in accordance with a predetermined routine adapted to said heart failure condition and, wherein said stimulus means comprises bi-ventricular means for delivering pacing pulses to at least said patient'"'"'s left and right ventricles, and wherein said control means comprises means for timing delivery of pacing pulses to said patient left and right ventricles so as to improve cardiac output.
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Accused Products
Abstract
A pacing system and method for determining a heart failure condition such as left ventricular dysfunction in a patient are provided, based upon obtaining information from cardiac signals, which information is processed and examined for an indication of the onset or progression of LVD. Since LVD is generally characterized by conduction disorders and other body responses calling for different heart rates during exercise, an examination of sensed cardiac signals is utilized to obtain data reflective of an LVD condition. In one embodiment, a QT rate responsive pacemaker is utilized, wherein variations in QT interval corresponding to heart rate are detected and stored, and then periodically analyzed to detect changes of sufficient magnitude to indicate onset of LVD. In another embodiment, changes in lower natural rate at nighttime or rest are monitored and analyzed for detection for a trend indicating LVD. Other cardiac signal parameters, such as T-wave amplitude changes during exercise, and QRS duration changes, can also be processed to obtain information from which LVD can be determined. When an LVD indication is made, the system responds automatically so as to take initial steps to treat the condition. Thus, in one embodiment, the control of pacing rate is altered so as to be better responsive to patient exercise. In another embodiment, 3- or 4-chamber pacing is initiated. In yet another embodiment, drug therapy is automatically administered.
131 Citations
17 Claims
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1. An implantable system for pacing a patient'"'"'s heart and for determining a condition of heart failure, comprising:
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stimulus means for generating and delivering stimulus pulses to said patient'"'"'s heart; heart signal means for monitoring patient heart signals and collecting heart signal data relating to said heart signals; process means for processing said heart signal data to find changes in predetermined features of said heart signals; indication means for providing an indication of heart failure as a function of said heart signal changes; and response means for automatically responding to said heart failure indication by providing a treatment for said heart failure, wherein said response means comprises pacing control means for controlling said stimulus means to deliver pacing pulses in accordance with a predetermined routine adapted to said heart failure condition and, wherein said stimulus means comprises bi-ventricular means for delivering pacing pulses to at least said patient'"'"'s left and right ventricles, and wherein said control means comprises means for timing delivery of pacing pulses to said patient left and right ventricles so as to improve cardiac output. - View Dependent Claims (2, 3)
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4. An implantable system for pacing a patient'"'"'s heart and for determining a condition of heart failure, comprising:
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stimulus means for generating and delivering stimulus pulses to said patient'"'"'s heart; heart signal means for monitoring patient heart signals and collecting heart signal data relating to said heart signals; process means for processing said heart signal data to find changes in predetermined features of said heart signals; indication means for providing an indication of heart failure as a function of said heart signal changes; and response means for automatically responding to said heart failure indication by providing a treatment for said heart failure, wherein said monitoring means comprises means for determining the QT interval corresponding to patient heartbeats, said process means comprises means for determining variations of said QT interval with patient heart rate, and said indication means comprises means for indicating an LVD condition as a function of said variations of QT interval with heart rate.
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5. An implantable system for pacing a patient'"'"'s heart and for determining a condition of heart failure, comprising:
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stimulus means for generating and delivering stimulus pulses to said patient'"'"'s heart; heart signal means for monitoring patient heart signals and collecting heart signal data relating to said heart signals; process means for processing said heart signal data to find changes in predetermined features of said heart signals; indication means for providing an indication of heart failure as a function of said heart signal changes; and response means for automatically responding to said heart failure indication by providing a treatment for said heart failure, wherein said process means comprises means for finding changes in morphology of a portion of a patient heart signals, and said indication means comprises means for determining when said changes indicate a progression of heart failure.
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6. An implantable pacing system for pacing a patient'"'"'s heart and for diagnosing heart conditions representative of a form of left ventricular dysfunction (LVD), having a pacemaker, and lead means for sensing cardiac signals from said patient'"'"'s heart and for delivering said sensed signals to said pacemaker and for delivering pacing pulses from said pacemaker to said heart, said pacemaker comprising:
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pace pulse means for generating pacing pulses; signal means for processing said sensed cardiac signals to obtain information representative of predetermined portions of said signals for use in diagnosing whether said patient has a form of LVD; and diagnosing means for diagnosing when said patient has a form of LVD as a function of said obtained information. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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Specification