Cardiac rhythm management system for edema
First Claim
Patent Images
1. A method including:
- sensing, in a subject, a condition correlative to edema; and
initiating/adjusting, in response to the sensing, at least one of a cardiac resynchronization therapy that coordinates a spatial nature of a depolarization associated with a heart contraction in at least one heart chamber and a cardiac contractility modulation therapy that includes delivering electrical energy to a portion of a heart during a refractory time period of the portion of the heart.
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Abstract
A cardiac rhythm management system detects edema. In response to an episode of detected edema, it initiates or adjusts a cardiac resynchronization therapy and/or a cardiac contractility modulation (CCM) therapy.
246 Citations
49 Claims
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1. A method including:
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sensing, in a subject, a condition correlative to edema; and initiating/adjusting, in response to the sensing, at least one of a cardiac resynchronization therapy that coordinates a spatial nature of a depolarization associated with a heart contraction in at least one heart chamber and a cardiac contractility modulation therapy that includes delivering electrical energy to a portion of a heart during a refractory time period of the portion of the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A cardiac rhythm management system including:
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an edema detection circuit to sense a condition correlative to edema in a subject; an electrical energy delivery circuit to deliver electrical energy to the subject; and a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller including a cardiac resynchronization therapy parameter and a cardiac contractility modulation therapy mode, and in which the controller is configured to initiate/adjust, in response to the detected edema indicator, at least one of the cardiac resynchronization therapy that coordinates a spatial nature of a depolarization associated with a heart contraction in at least one heart chamber and the cardiac contractility modulation therapy that includes delivering electrical energy to a portion of a heart during a refractory time period of the portion of the heart. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. A method including:
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sensing, in a subject, a condition correlative to edema, the sensing including detecting a decrease in the baseline thoracic impedance associated with fluid buildup in the portion of the thorax of the subject, in which the baseline portion of the thoracic impedance is less than or equal to a cutoff frequency value that is between 0.01 Hz and 0.5 Hz inclusive; and initiating/adjusting, in response to the sensing, at least one of a cardiac resynchronization therapy and a cardiac contractility modulation therapy. - View Dependent Claims (31)
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32. A method including:
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sensing, in a subject, a condition correlative to edema, the sensing including detecting a change in a baseline thoracic impedance associated with fluid buildup in a portion of a thorax of the subject, and in which the sensing also includes detecting an increase in a rate of breathing of the subject from a portion of the thoracic impedance that is approximately between 0.05 Hz and 2.0 Hz inclusive; and initiating/adjusting, in response to the sensing, at least one of a cardiac resynchronization therapy and a cardiac contractility modulation therapy.
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33. A method including:
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sensing, in a subject, a condition correlative to edema; and initiating/adjusting, in response to the sensing, a cardiac resynchronization therapy that includes selecting an interelectrode delay value, for subsequent delivery of contraction-evoking stimulations occurring during a single cardiac cycle, wherein the interelectrode delay is selected from a set of delays including interventricular delays and intraventricular delays.
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34. A method including:
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sensing, in a subject, a condition correlative to edema; and initiating/adjusting, in response to the sensing, a cardiac resynchronization therapy that includes selecting at least one particular electrode, from a plurality of electrodes differently located in association with a heart of the subject, for subsequent delivery of a contraction-evoking stimulation. - View Dependent Claims (35, 36, 37)
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38. A method including:
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sensing, in a subject, a condition correlative to edema; and initiating/adjusting, in response to the sensing, a cardiac contractility modulation therapy that includes providing a non-contraction-evoking stimulus to a location of a heart of the subject during a refractory period of the heart location. - View Dependent Claims (39)
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40. A cardiac rhythm management system including:
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an edema detection circuit to sense a condition correlative to edema in a subject, the edema detection circuit including a thoracic impedance detection circuit configured to be coupled to first and second electrodes configured for association with a portion of the subject'"'"'s thorax, the thoracic impedance detection circuit including an averager/lowpass filter to obtain a baseline portion of the thoracic impedance signal associated with the condition correlative to edema, the averager/lowpass filter including an effective cutoff frequency that is between 0.01 Hz and 0.5 Hz; an electrical energy delivery circuit to deliver electrical energy to the subject; and a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller including a cardiac resynchronization therapy parameter and a cardiac contractility modulation therapy mode, and in which the controller is configured to initiate/adjust, in response to the detected edema indicator, at least one of the cardiac resynchronization therapy and the cardiac contractility modulation therapy. - View Dependent Claims (41, 42, 43)
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44. A cardiac rhythm management system including:
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an edema detection circuit to sense a condition correlative to edema in a subject; an electrical energy delivery circuit to deliver electrical energy to the subject; and a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller including a cardiac resynchronization therapy parameter and a stored interelectrode delay, the stored interelectrode delay selected from a set of delays including stored interventricular delays and intraventricular delays, and in which the controller is configured to initiate/adjust, in response to the detected edema indicator, the cardiac resynchronization therapy by adjusting a value of the interelectrode delay.
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45. A cardiac rhythm management system including:
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an edema detection circuit to sense a condition correlative to edema in a subject; an electrical energy delivery circuit to deliver electrical energy to the subject; and a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller including a cardiac resynchronization therapy parameter, and in which the controller is configured to initiate/adjust, in response to the detected edema indicator, the cardiac resynchronization therapy by selecting at least one particular electrode, from a plurality of electrodes differently located in association with a heart of the subject, for subsequent delivery of a contraction-evoking stimulation. - View Dependent Claims (46, 47)
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48. A cardiac rhythm management system including:
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an edema detection circuit to sense a condition correlative to edema in a subject; an electrical energy delivery circuit to deliver electrical energy to the subject; and a controller circuit, coupled to the edema detection circuit to receive a detected edema indicator, and coupled to the energy delivery circuit to provide a control signal for timing delivery of the electrical energy to the subject, the controller including a cardiac contractility modulation therapy mode, and in which the controller is configured to initiate/adjust, in response to the detected edema indicator, the cardiac contractility modulation therapy by providing a non-contraction-evoking stimulus to a location of a heart of the subject during a refractory period of the heart location. - View Dependent Claims (49)
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Specification