Method and apparatus for improving ventricular status using the force interval relationship
First Claim
1. A method of improving a ventricular contractile status of a patient with an implantable medical device, the method comprising the steps of:
- observing a cardiac perturbation of a patient during a first cardiac cycle, wherein said cardiac perturbation comprises one of an extra-systole and a premature contraction of a cardiac chamber;
measuring heart beat potentiation of the cardiac perturbation for at least one subsequent cardiac cycle;
quantifying the measured heart beat potentiation to determine the ventricular contractile status of the patient; and
providing a response from the implantable medical device to the patient as a function of the quantified ventricular contractile status.
1 Assignment
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Accused Products
Abstract
Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device.
21 Citations
37 Claims
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1. A method of improving a ventricular contractile status of a patient with an implantable medical device, the method comprising the steps of:
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observing a cardiac perturbation of a patient during a first cardiac cycle, wherein said cardiac perturbation comprises one of an extra-systole and a premature contraction of a cardiac chamber; measuring heart beat potentiation of the cardiac perturbation for at least one subsequent cardiac cycle; quantifying the measured heart beat potentiation to determine the ventricular contractile status of the patient; and providing a response from the implantable medical device to the patient as a function of the quantified ventricular contractile status. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A method of improving a ventricular contractile status of a patient with an implantable medical device, the method comprising the steps of:
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producing an extra-systolic beat from an implantable medical device during a first cardiac cycle; measuring potentiation in a ventricular force interval resulting from the extra-systolic beat during at east one subsequent cardiac cycle; quantifying the potentiation in the ventricular force interval to determine the ventricular contractile status of the patient; and adjusting a parameter of a stimulus provided by the implantable medical device to the patient as a function of the determined ventricular contractile status.
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19. A medical device configured to be implanted in a patient, the device comprising:
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a data collection module configured to identify contractile potentiation in the patient following a cardiac perturbation for a first cardiac cycle; a data processing module in communication with the data collection module, wherein the data processing module is configured to correlate the contractile potentiation to a hemodynamic status of the patient for at least one subsequent cardiac cycle; and a response module in communication with the data processing module, wherein the response module is configured to provide a response based upon the correlated hemodynamic status. - View Dependent Claims (20, 21, 22, 23, 24, 25)
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26. A medical device implanted in a patient, the method comprising the steps of:
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means for observing a cardiac perturbation of a patient for a first cardiac cycle; means for measuring potentiation in ventricular force resulting from the cardiac perturbation during at least one subsequent cardiac cycle; means for quantifying the potentiation to determine a hemodynamic status of the patient; and means for providing a response to the patient as a function of the hemodynamic status of the patient. - View Dependent Claims (27)
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28. A method of calibrating a parameter using an implantable medical device, the method comprising the steps of:
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providing a cardiac perturbation to a patient from an implantable medical device using an initial value of the parameter during a first cardiac cycle; observing contractile potentiation in the patient as a result of the cardiac perturbation for at east one subsequent cardiac cycle; adjusting a value of the parameter in response to the observed contractile potentiation; and repeating the adjusting and observing steps until a maximum amount of contractile potentiation is observed in the patient. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35, 36, 37)
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Specification