Optimization of impedance signals for closed loop programming of cardiac resynchronization therapy devices
First Claim
1. A method of programming a cardiac resynchronization therapy (CRT) device comprising:
- determining a control parameter associated with dynamic intracardiac impedance data of a patient;
determining if said control parameter is acceptable; and
setting an operational parameter of said CRT based on said control parameter;
wherein said control parameter is determined by measuring the impedances along several vectors and determining said control parameter from these vectors.
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Accused Products
Abstract
What are described herein are implantable cardiac devices such as pacemakers and defibrillators that deliver cardiac resynchronization therapy (CRT), and to a method of optimizing acquisition of impedance signals between electrodes present on implanted lead systems. This system then automatically determines which electrodes or electrode combinations acquire impedance waveforms that have the best signal to noise ratio (highest fidelity) and characterize data most representative of dysynchronous electro-mechanical events. Using closed loop algorithms which provide electrograms and a variety of impedance data reflective of the patient'"'"'s clinical status, the system autonomously modifies interval timing within the CRT device.
190 Citations
15 Claims
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1. A method of programming a cardiac resynchronization therapy (CRT) device comprising:
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determining a control parameter associated with dynamic intracardiac impedance data of a patient; determining if said control parameter is acceptable; and setting an operational parameter of said CRT based on said control parameter; wherein said control parameter is determined by measuring the impedances along several vectors and determining said control parameter from these vectors. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A programming system comprising:
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a cardiac resynchronization therapy (CRT) device applying therapy to a patient based on a plurality of operational parameters; a parameter detector that detects a control parameter related to the dynamic intrathoracic impedance of the patient; a parameter evaluator that determines if said control parameter is acceptable; a controller that uses said control parameter to set said operational parameters based on said control parameter, if said control parameter is found acceptable; a programmer, said parameter detector and said parameter evaluator being disposed in said programmer; and wherein said parameter detector and said parameter evaluator are disposed in said CRT.
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8. An implantable cardiac resynchronization therapy (CRT) device comprising:
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a sensor that senses intrinsic cardiac events and generates corresponding sensing signals; an excitation generator generating excitation signals for different locations of the heart in response to commands; a controller generating said commands in accordance with a plurality of operational parameters dependent on said sensing signals; a parameter generator generating a control parameter dependent on a thoracic impedance of the patient; and a parameter evaluator that determines if said control parameter is acceptable based on a set of preset criteria; wherein said control parameter is used by the controller to reduce dysynchrony between or within the cardiac chambers; and wherein said control parameter is used by the controller to optimize cardiac performance by maximizing cardiac output. - View Dependent Claims (9, 10, 11)
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12. A method of stimulating a patient'"'"'s heart comprising:
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generating stimulation signals to the heart; measuring a thoracic impedance of the heart by performing measurements between several implanted electrode pairs and combining said measurements to determine said impedance; detecting a dysynchrony between a right and a left chamber from said impedance; and adjusting the timing of said stimulation signals to reduce said dysynchrony. - View Dependent Claims (13)
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14. A method of programming a cardiac resynchronization therapy (CRT) device comprising:
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determining a control parameter associated with dynamic intracardiac impedance data of a patient; determining if said control parameter is acceptable; and setting an operational parameter of said CRT device based on said control parameter; wherein acceptable control parameters are determined using multivariate statistical analysis techniques.
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15. An implantable cardiac resynchronization therapy (CRT) device comprising:
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a sensor that senses intrinsic cardiac events and generates corresponding sensing signals; an excitation generator generating excitation signals for different locations of the heart in response to commands; a controller generating said commands in accordance with a plurality of operational parameters dependent on said sensing signals; a parameter generator generating a control parameter dependent on a thoracic impedance of the patient; and a parameter evaluator that determines if said control parameter is acceptable based on a set of preset criteria; wherein said control parameter is used by the controller to optimize cardiac performance by maximizing cardiac output.
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Specification