Extraction of hemodynamic pulse pressure from fluid and myocardial accelerations
First Claim
1. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
- a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, a linear prediction means for predicting values associated with the waveform, and means for determining an amount indicative of pulse pressure from said waveform.
0 Assignments
0 Petitions
Accused Products
Abstract
A cardiac stimulating apparatus and method is described that non-intrusively determines an amount indicative of hemodynamic pulse pressure from an accelerometer signal. The amount indicative of pulse pressure is determined over several cardiac cycles and is used to optimize cardiac performance by evaluating the amount indicative of pulse pressure over varying timing intervals. The timing intervals are measured between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart and a maximum pulse pressure indicates the optimum timing interval under manipulation. The cardiac stimulating apparatus and method may be used in any of several pacing modes including A-V pacing, V-V pacing, or A-A pacing.
133 Citations
28 Claims
-
1. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, a linear prediction means for predicting values associated with the waveform, and means for determining an amount indicative of pulse pressure from said waveform. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
-
-
11. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means for determining an amount indicative of pulse pressure from said waveform, said amount indicative of pulse pressure being analyzed and compared by said controller over a preselected number of cardiac cycles for a plurality of preselected timing intervals, said timing intervals being a time between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart, to thereby determine an optimum timing interval.
-
-
12. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means for determining an amount indicative of pulse pressure from said waveform, said means for determining including means for auto-regressive analysis of said waveform using algorithms selected from the group consisting of Levinson and Yule Walker.
-
-
13. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, means responsive to the signal transmitted by the accelerometer for identifying a time of physical inactivity and means for determining an amount indicative of pulse pressure from said waveform.
-
-
14. A cardiac stimulating apparatus functioning in a preset mode selected from the group consisting of A-V pacing, V-V pacing and A-A pacing and having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means for determining an amount indicative of pulse pressure from said waveform. - View Dependent Claims (15)
-
-
16. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, bandwidth determining means for determining a bandwidth from preselected values of the waveform and means for determining an amount indicative of pulse pressure from said waveform. - View Dependent Claims (17, 18)
-
-
19. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and analyzing means for analyzing the amounts indicative of pulse pressure over corresponding cardiac cycles.
-
-
20. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means for determining an amount indicative of pulse pressure from said waveform, the determined amount indicative of pulse pressure being analyzed and compared by said controller over a preselected number of cardiac cycles for a plurality of preselected timing intervals, said timing intervals being a time between at least one of intrinsic and paced stimulations of preselected chambers of the heart, to thereby determine an optimum timing interval.
-
-
21. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, means for auto-regressive analysis of said waveform using algorithms selected from the group consisting of Levinson and Yule-Walker and means for determining an amount indicative of pulse pressure from said waveform.
-
-
22. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means responsive to the signal transmitted by the accelerometer for identifying a time of physical inactivity, and means for determining an amount indicative of pulse pressure from said waveform.
-
-
23. A cardiac stimulating apparatus functioning in a preset pacing mode, said mode selected from the group consisting of A-V pacing, V-V pacing and A-A pacing and having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart and means for determining an amount indicative of pulse pressure from said waveform. - View Dependent Claims (24)
-
-
25. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, bandwidth determining means for determining a bandwidth from predicted values of the waveform and means for determining an amount indicative of pulse pressure from said waveform. - View Dependent Claims (26, 27)
-
-
28. A cardiac stimulating apparatus functioning in a preset pacing mode having preset pacing rates and timing intervals, and programmed to optimize cardiac performance of a patient'"'"'s heart, said cardiac stimulating apparatus comprising:
-
a) a pulse generator;
b) an accelerometer enclosed in a casing of the cardiac stimulating apparatus and electrically coupled to a controller of the cardiac stimulating apparatus, said accelerometer transmitting a signal associated with fluid and myocardial accelerations of the patient'"'"'s heart;
c) filtering means coupled to the accelerometer for filtering and conditioning the signal transmitted by the accelerometer to produce a waveform related to a pulse pressure within the patient'"'"'s heart; and
d) said controller including a timing means for identifying cardiac cycles of the patient'"'"'s heart, means for determining an amount indicative of pulse pressure from said waveform and analyzing means for analyzing the amounts indicative of pulse pressure over corresponding cardiac cycles.
-
Specification