Methods, systems and devices for optimizing cardiac pacing parameters

• US 7,096,066 B1
• Filed: 08/05/2004
• Issued: 08/22/2006
• Est. Priority Date: 01/12/2001
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: O'Hara, Casey, Turcott, Robert
• Primary Examiner(s): Pezzuto, Robert E.
• Assistant Examiner(s): Gedeon, Brian T.
• Application Number:
  US10/913,170
• Time in Patent Office: 747 Days
• Field of Search: 607/9, 607 27- 29
• 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 device 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 device comprising:

a sensing circuit that determines cardiac performance associated the current set of N pacing parameters and cardiac performance associated with sets of test pacing parameters; and

a processor that for i=one to N increments 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, and

updates the i^th increment value based on the cardiac performance associated with the i^th set of test pacing parameters as determined by the sensing circuit,

wherein the processor updates the current set of N pacing parameters based on the updated increment values.

2. The device of claim 1, wherein the processor repeatedly updates the current set of N pacing parameters.

3. The device of claim 1, wherein the processor repeatedly updates the current set of N pacing parameters until each of the updated increment values is less than a predetermined threshold value.

4. The device of claim 1, wherein the processor employs the equation:

δ

_i←

k·

δ

_i·

(P_t−

P₀) to update i^th increment value, where

δ

_i is the i^th increment value,

k is a predetermined constant scale factor,

P_t is a measure of the cardiac performance associated with i^th set of test pacing parameters as determined by the sensing circuit,

P₀ is a measure of the cardiac performance associated with the current set of N pacing parameters as determined by the sensing circuit, and

←

denotes replacement.

5. The device of claim 1, wherein the processor employs one of the following equations to update the i^th increment value:

δ

_i←

δ

_i if P_t>

P₀, otherwise δ

_i←

−

δ

_i, and 

 

(1)

δ

_i←

δ

_i if P_t≧

P₀, otherwise δ

_i←

−

δ

_i, 

 

(2)

where,

δ

_i is the i^th increment value,

P_t is a measure of the cardiac performance associated with i^th set of test pacing parameters as determined by the sensing circuit,

P₀ is a measure of the cardiac performance associated with the current set of N pacing parameters as determined by the sensing cirucuit, and

←

denotes replacement.

6. A device 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 device comprising:

a sensing circuit that determines cardiac performance associated the current set of N pacing parameters and cardiac performance associated with sets of test pacing parameters; and

a processor that for i=one to N

increments 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,

updates the i^th increment value based on the cardiac performance associated with the i^th set of test pacing parameters as determined by the sensing circuit, and

updates the current set of N pacing parameters based on the updated i^th increment value.

7. The device of claim 6, wherein the processor repeatedly updates the current set of N pacing parameters.

8. The device of claim 6, wherein the processor repeatedly updates the current set of N pacing parameters until each of the updated increment values is less than a predetermined threshold value.

9. The device of claim 6, wherein the processor employs the equation:

δ

_i←

k·

δ

_i·

(P_t−

P₀)

to update i^th increment value, where

δ

_i is the i^th increment value,

k is a predetermined constant scale factor,

P_t is a measure of the cardiac performance associated with i^th set of test pacing parameters as determined by the sensing circuit,

P₀ is a measure of the cardiac performance associated with the current set of N pacing parameters as determined by the sensing circuit, and

←

denotes replacement.

10. The device of claim 6, wherein the processor employs one of the following equations to update the i^th increment value:

δ

_i←

δ

_i if P_t>

P₀, otherwise δ

_i←

−

δ

_i, and 

 

(1)

δ

_i←

δ

_i if P_t≧

P₀, otherwise δ

_i←

−

δ

_i, 

 

(2)

where,

δ

_i is the i^th increment value,

P_t is a measure of the cardiac performance associated with i^th set of test pacing parameters as determined by the sensing circuit,

P₀ is a measure of the cardiac performance associated with the current set of N pacing parameters as determined by the sensing cirucuit, and

←

denotes replacement.

11. A device 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 device comprising:

a sensing circuit that determines cardiac performance associated the current set of N pacing parameters and cardiac performance associated with random sets of test pacing parameters;

a random value generator that generates random test sets of N pacing parameters; and

a processor that replaces the current set of N pacing parameters with a random test set of N pacing parameters if the cardiac performance associated with the random test set of N pacing parameters is greater than the cardiac performance associated with the current set of N pacing parameters.

12. The device of claim 11, wherein the random value generator selects N values from a plurality of predefined values, the selected N values comprising the random test set of N pacing parameters.

13. The device of claim 11, wherein the processor repeatedly updates the current set of N pacing parameters until, 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.