System and method for tracking progression of left ventricular dysfunction using implantable cardiac stimulation device
First Claim
1. In an implantable cardiac stimulation device having a control unit, a sinus rate detector and a profound rest detector, a method for monitoring left ventricular dysfunction (LVD) within a patient, the method comprising:
- detecting when the patient is in a state of profound rest using the profound rest detector;
measuring the sinus rate of the patient while the patient is in a state of profound rest using the sinus rate detector;
tracking changes in LVD, if any, within the patient using the control unit based on changes in the sinus rate measured while at profound rest; and
adjusting V—
V timing of bi-ventricular pacing in response to changes in LVD.
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Accused Products
Abstract
The progression or regression of left ventricular dysfunction (LVD) is automatically evaluated by a pacemaker or other implantable cardiac stimulation device by tracking changes in the resting sinus rate of the patient in which the device is implanted. The resting sinus rate is detected by first determining whether the patient is in a state of profound rest, such as sleep, then measuring the actual sinus rate during profound rest. Profound rest may be detected by using an activity variance sensor. An increase in the profound rest sinus rate over a period of several months indicates progression of LVD; whereas a decrease indicates regression. Appropriate LVD diagnostic information is recorded for subsequent review by a physician. Based on the progression or regression of LVD, the physician may then modify LVD drug therapy administered to the patient or may adjust control parameters of the pacemaker, such as overdrive pacing control parameters or control parameters affecting heart contractility via post-extrasystolic potentiation. If a drug pump is implanted within the patient for automatically delivering LVD drug therapy, the pacemaker controls the drug pump in view of any detected progression or regression of LVD. The technique may also be used to verify the efficacy of LVD drug therapy administered to the patient, whether delivered via an implanted drug pump or otherwise. Processing may be primarily performed within the implanted device itself or with an external programmer in communication with the implanted device. Activity state-based LVD tracking techniques are also set forth.
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Citations
24 Claims
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1. In an implantable cardiac stimulation device having a control unit, a sinus rate detector and a profound rest detector, a method for monitoring left ventricular dysfunction (LVD) within a patient, the method comprising:
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detecting when the patient is in a state of profound rest using the profound rest detector;
measuring the sinus rate of the patient while the patient is in a state of profound rest using the sinus rate detector;
tracking changes in LVD, if any, within the patient using the control unit based on changes in the sinus rate measured while at profound rest; and
adjusting V—
V timing of bi-ventricular pacing in response to changes in LVD. - View Dependent Claims (2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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4. In an implantable cardiac stimulation device having a control unit, a sinus rate detector and a profound rest detector, a method for monitoring left ventricular dysfunction (LVD) within a patient, the method comprising:
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detecting when the patient is in a state of profound rest using the profound rest detector;
measuring the sinus rate of the patient while the patient is in a state of profound rest using the sinus rate detector;
tracking changes in LVD, if any, within the patient using the control unit based on changes in the sinus rate measured while at profound rest;
recording a baseline sinus rate detected while in an initial state of profound rest;
comparing the baseline rate with a subsequent sinus rate detected while in a subsequent state of profound rest; and
determining whether the subsequent sinus rate exceeds the baseline rate by a predetermined margin and, if so, generating a signal indicative of progression of LVD within the patient.
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15. In an implantable cardiac stimulation device, a system for monitoring left ventricular dysfunction (LVD) within a patient comprising:
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a profound rest detector operative to determine when the patient is in a state of profound rest;
a sinus rate detector operative to measure the sinus rate of the patient while the patient is in a state of profound rest;
an LVD tracking unit operative to track changes in LVD, if any, within the patient based on changes in the sinus rate measured while at profound rest; and
a controller adapted to adjust V—
V timing of bi-ventricular pacing in response to changes in LVD. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A system for monitoring left ventricular dysfunction (LVD) within a patient, the system comprising:
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means for measuring the sinus rate of the patient while in a state of profound rest;
means for tracking changes in LVD, if any, within the patient based on changes in the sinus rate measured while at profound rest; and
means for adjusting V—
V timing of bi-ventricular pacing in response to chances in LVD.
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23. A method for monitoring left ventricular dysfunction (LVD) within a patient, an implantable cardiac stimulation device performing a method comprising:
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detecting when the patient is in a predetermined activity state;
measuring the sinus rate of the patient while the patient in the predetermined activity state; and
tracking changes in LVD, if any, within the patient based on changes in the sinus rate measured while in the predetermined activity state.
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24. In an implantable cardiac stimulation device, a system for monitoring left ventricular dysfunction (LVD) within a patient comprising:
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an activity detector operative to determine when the patient is in a predetermined activity state;
a sinus rate detector operative to measure the sinus rate of the patient while the patient is in the predetermined activity state; and
an LVD tracking unit operative to track changes in LVD, if any, within the patient based on changes in the sinus rate measured while in the predetermined activity state.
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Specification