Methods, systems and devices for optimizing cardiac pacing parameters

• US 6,792,310 B1
• Filed: 01/12/2001
• Issued: 09/14/2004
• Est. Priority Date: 01/12/2001
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Turcott, Robert, OʼHara, Casey
• Primary Examiner(s): ROBINSON, DANIEL LEON
• Application Number:
  US09/759,395
• Time in Patent Office: 1,341 Days
• Field of Search: 607/9, 607/27, 607/28, 607/29, 607/23, 607/19, 607/20, 607/14, 128/419
• US Class Current: 607/27
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371

Abstract

Cardiac performance associated with a current set of N pacing parameters is improved by adjusting the cardiac pacing parameters until optimal or substantially optimal cardiac performance is achieved. The cardiac performance associated with the current set of N pacing parameters is determined. An incrementing step, a determining step, and a increment updating step, are repeated for i=1 to N, where i represents which of the N pacing parameter is being adjusted. The incrementing step includes incrementing an i^th pacing parameter in the current set of N pacing parameters based on a corresponding i^th increment value, to thereby produce an i^th set of test pacing parameters. The determining step includes determining a cardiac performance associated with the i^th set of test pacing parameters. The increment updating step includes updating the i^th increment value based on the cardiac performance associated with the i^th set of test pacing parameters. Finally, after all of the N increment values have been updated, the current set of N pacing parameters is updated based on the updated increment values. The updated current set of N pacing parameters should provide superior cardiac performance than the previous current set of N pacing parameters.

Claims

1. A method for improving cardiac performance associated with a current set of N pacing parameters by adjusting the N cardiac pacing parameters, where N is an integer greater than one, the method comprising the steps of:

(a) determining cardiac performance associated with the current set of N pacing parameters;

(b) repeating steps (c) through (e) for i=one to N, where i represents which of the N pacing parameter is being adjusted;

(c) in renting an i^th pacing parameter in the current set of N pacing parameters based on a corresponding i^th increment value to thereby produce an i^th set of test pacing parameters;

(d) determining a cardiac performance associated with the i^th set of test pacing parameters;

(e) updating the i^th increment value based on the cardiac performance associated with the i^th set of test pacing parameters; and

(f) updating the current set of N pacing parameters based on the updated increment values determined in step (e).

2. The method of claim 1, wherein step (e) comprises the step of updating the i^th increment value based on the difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters.

3. The method of claim 1, wherein step (e) comprises the step of updating the i^th increment value based on:

the i^th increment value used in stop (c), and

the difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters.

4. The method of claim 3, wherein step (e) comprises the step of updating the i^th increment value based on the equation:

5. The method of claim 1, wherein step (e) comprises the step of updating the i^th increment value based on one of the following equations:

6. The method of claim 1, further comprising the step of:

(g) repeating steps (a) through (f).

7. The method of claim 1, further comprising the step of:

(g) repeating steps (a) through (f) until each of the updated increment values determined in step (e) is less than a predetermined threshold value.

8. The method of claim 1, further comprising the step of:

(g) repeating steps (a) through (f) until a difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters is less than a predetermined threshold value for all i between 1 and N inclusive.

9. A method for improving cardiac performance associated with a current set of N pacing parameters by adjusting the N cardiac pacing parameters, where N is an integer greater than 1, the method comprising the steps of:

(a) determining cardiac performance associated with the current set of N pacing parameters;

(b) incrementing the i^th pacing parameter in the current set of N pacing parameters based on an i^th increment value, to thereby produce an i^th set of test pacing parameters, wherein i is an integer between 1 and N inclusive;

(c) determining cardiac performance associated with the i^th set of test paving parameters;

(d) updating the i^th increment value;

(a) updating the current set of N pacing parameters based on the updated i^th increment value determined in step (d); and

(f) repeating steps (a) through (e) for all N pacing parameters.

10. The method of claim 9, wherein step (d) comprises the step of updating the i^th increment value bay on the difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters.

11. The method of claim 9, wherein step (d) comprises the step of updating the i^th increment value based on:

the i^th increment value used in step (c), and

the difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters.

12. The method of claim 11, wherein step (d) comprises the step of updating the i^th increment value bused on the equation:

13. The method of claim 9, wherein step (d) comprises the step of updating the i^th increment value based on one of the following equations:

14. The method of claim 9, further comprising the step of:

(g) repeating steps (a) through (f).

15. The method of claim 9, further comprising the step of:

(g) repeating steps (a) through (f) until each of the updated increment values determined in step (d) is less than a predetermined threshold value.

16. The method of claim 9, further comprising die step of:

(g) repeating steps (a) through (f) until a difference between the cardiac performance associated with the current set of N pacing parameters and the cardiac performance associated with the i^th set of test pacing parameters is less than a predetermined threshold value for all i between 1 and N inclusive.

17. A method for improving cardiac performance associated with a current set of N pacing parameters by adjusting the N cardiac pacing parameters, where N is an integer, the method comprising the steps of:

(a) determining cardiac performance associated with the current set of N pacing parameters;

(b) determining a random test set of N pacing parameters;

(c) determining cardiac performance associated with the test set of N pacing parameters; and

(d) replacing the current set of N pacing parameters with the test set of N pacing parameters if the cardiac performance associated with the test set of N pacing parameters is greater than the cardiac performance associated with the current set of N pacing parameters.

18. The method of claim 17, wherein step (b) comprises selecting N values from a plurality of predefined values, the selected N values comprising the random test set of N pacing parameters.

19. The method of claim 17, further comprising the step of:

(f) repeating steps (a) through (e).

20. The method of claim 17, further comprising the step of:

(f) repeating steps (a) through (e) until, for a predetermined number of consecutive times, the cardiac performance associated with the test set of N pacing parameters is not greater than the cardiac performance associated with the current set of N pacing parameters.

21. The method of claim 17, wherein step (b) comprises the steps of:

i. determining a set of N random increment values; and

ii. incrementing the pacing parameters in the current set of N pacing parameters using the set of N random increment values, to thereby produce the random test set of N pacing parameters.

22. The method of claim 21, wherein step (b)i. comprises selecting N values from a plurality of predefined values, the selected N values comprising the set of N random increment values.

23. The method of claim 21, further comprising the step of:

(f) repeating steps (a) through (c).

24. The method of claim 21, further comprising the step of:

(f) repeating steps (a) through (e) until, for a predetermined number of consecutive times, the cardiac performance associated with the test set of N pacing parameters is not greater than the cardiac performance associated with the current set of N pacing parameters

ii. incrementing the pacing parameters in the current set of N pacing parameters using the set of N random increment values, to thereby produce the random test set of N pacing parameters.