Implantable medical device (IMD) system configurable to subject a patient to a stress test and to detect myocardial ischemia within the patient
First Claim
1. An implantable medical device (IMD) for implantation in a patient to detect symptomatic and asymptomatic myocardial ischemia, comprising:
- pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate for delivery to muscle tissue of a heart of the patient, wherein the pacing circuitry is configurable to subject the patient to a variety of stress tests, and wherein the variety of stress tests further comprise;
(i) a first stress test protocol wherein the programmable pacing rate is slowly increased at from between about five paces per minute (ppm) to about ten ppm from a start rate to a stop rate, wherein the stop rate is greater than the start rate, and the patient'"'"'s response to the first stress test protocol is acquired and stored in a memory structure as a part of a stress test data set;
(ii) a second stress test protocol wherein the IMD is configurable to store timing information specifying a time the IMD is to subject the patient to the first stress test protocol, and to subject the patient to the first stress test protocol at the time, day and/or date specified by the timing information, and the patient'"'"'s response to the second stress test protocol is acquired and stored in the memory structure as a part of the stress test data set; and
(iii) a third stress test protocol wherein the protocol comprises recreating the physiologic conditions of a previously stored episode of paced or intrinsic symptomatic myocardial ischemia that were stored in the memory structure after the patient triggers an episode storage event, and the patient'"'"'s response to the third stress test protocol is acquired and stored in the memory structure as a part of the stress test data set.
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Abstract
Various implantable medical devices (IMDs) are disclosed for implantation in a patient. The IMD includes pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate. In one embodiment, the IMD is configurable to subject a patient to a stress test. The IMD may be configurable to subject the patient to the stress test at the time specified by stored timing information, or in response to a signal (e.g., from a patient activator). Another embodiment of the implantable medical device (IMD) includes sensor circuitry, a memory for storing data, and a control unit. The sensor circuitry produces sensor data relating to cardiac condition. The control unit is configurable to store the sensor data in the memory until a trigger signal is received. Methods are described for performing a stress test in a patient with an IMD, and for subsequently reproducing cardiac operational states.
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Citations
41 Claims
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1. An implantable medical device (IMD) for implantation in a patient to detect symptomatic and asymptomatic myocardial ischemia, comprising:
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pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate for delivery to muscle tissue of a heart of the patient, wherein the pacing circuitry is configurable to subject the patient to a variety of stress tests, and wherein the variety of stress tests further comprise;
(i) a first stress test protocol wherein the programmable pacing rate is slowly increased at from between about five paces per minute (ppm) to about ten ppm from a start rate to a stop rate, wherein the stop rate is greater than the start rate, and the patient'"'"'s response to the first stress test protocol is acquired and stored in a memory structure as a part of a stress test data set;
(ii) a second stress test protocol wherein the IMD is configurable to store timing information specifying a time the IMD is to subject the patient to the first stress test protocol, and to subject the patient to the first stress test protocol at the time, day and/or date specified by the timing information, and the patient'"'"'s response to the second stress test protocol is acquired and stored in the memory structure as a part of the stress test data set; and
(iii) a third stress test protocol wherein the protocol comprises recreating the physiologic conditions of a previously stored episode of paced or intrinsic symptomatic myocardial ischemia that were stored in the memory structure after the patient triggers an episode storage event, and the patient'"'"'s response to the third stress test protocol is acquired and stored in the memory structure as a part of the stress test data set. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. An implantable medical device for implantation in a patient, comprising;
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pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate for delivery to muscle tissue of a heart of the patient;
a memory for storing data, including a stress test data set; and
a control unit coupled to the pacing circuitry and the memory, wherein the control unit is configurable to subject the patient to a variety of stress test protocols, and wherein;
during a first the stress test protocol the control unit programs the pacing rate such that the pacing rate is increased incrementally at about between five paces per minute and ten ppm from a start rate to a stop rate, wherein the stop rate is greater than the start while acquiring and storing the stress test data set in the memory; and
during a second stress test protocol the control unit recreates the physiologic conditions of a previously stored episode of paced or intrinsic symptomatic myocardial ischemia that were stored in the memory after the patient triggers an episode storage event, and the patient'"'"'s response to the third stress test protocol is acquired and stored in the memory as a part of the stress test data set, wherein the device further comprises;
a clock circuit coupled to the control unit and configured to keep track of time; and
a telemetry unit coupled to the control unit and configured to send and receive signals and data; and
wherein the control unit is configurable to receive timing data or a trigger signal via the telemetry unit, wherein the timing data specifies a time the IMD is to subject the patient to the stress test so that the clock circuit or the trigger signal to subject the patient to one of the first stress test protocol and the second stress test protocol at the time specified by the timing data or upon receipt of the trigger signal, respectively. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. A medium for producing control signals for executing an instruction set in an implantable medical device (IMD) to perform a method of detecting a symptomatic or asymptomatic episode of myocardial ischemia, said medium comprising:
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(i) instructions for performing a first stress test protocol wherein a programmable pacing rate is slowly increased at from between about five paces per minute (ppm) to about ten ppm from a start rate to a stop rate, wherein the stop rate is greater than the start rate, and including instructions for acquiring and storing a patient'"'"'s response to the first stress test protocol in a memory structure as a part of a stress test data set;
(ii) instructions for performing a second stress test protocol according to stored timing information specifying a time the IMD is to subject the patient to the first stress test protocol, and including instructions to subject the patient to the first stress test protocol at the time, day and/or date specified by the timing information, and including instructions for acquiring and storing the patient'"'"'s response to the second stress test protocol in the memory structure as a part of the stress test data set; and
(iii) instructions for performing a third stress test protocol wherein the protocol comprises recreating the physiologic conditions of a previously stored episode of paced or intrinsic symptomatic myocardial ischemia that were stored in the memory structure after the patient triggers an episode storage event, and including acquiring and storing the patient'"'"'s response to the third stress test protocol in the memory structure as a part of the stress test data set.
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Specification