Real-time optimization of right to left ventricular timing sequence in bi-ventricular pacing of heart failure patients
First Claim
1. A cardiac monitoring method, comprising:
- deploying at least two cardiac wall motion sensors into operative communication with spaced-apart portions of myocardial tissue;
receiving a signal from each of the at least two cardiac wall motion sensors;
obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors;
filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors;
locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors;
comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and
generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors,wherein deploying one of the at least two cardiac wall motion sensors comprises deploying an accelerometer sensor.
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Accused Products
Abstract
A system and automated method for assessing ventricular synchrony in ambulatory patients is provided including at least one mechanical sensor (e.g., accelerometer, tensiometric sensor, force transducer, and the like) operatively coupled to a first myocardial location in order to measure a wall motion signal of a first chamber, and a second mechanical sensor operatively coupled to a second myocardial location in order to measure a wall motion signal of a second chamber. The wall motion signals are processed in order to identify the time at which a fiducial (e.g., an inflection point, a threshold crossing, a maximum amplitude, etc.) occurs for each respective signal. The temporal separation between the fiducial points on each respective signal is measured as a metric of ventricular synchrony and can be optionally utilized to adjust pacing therapy timing to improve synchrony.
66 Citations
42 Claims
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1. A cardiac monitoring method, comprising:
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deploying at least two cardiac wall motion sensors into operative communication with spaced-apart portions of myocardial tissue; receiving a signal from each of the at least two cardiac wall motion sensors; obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors; filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein deploying one of the at least two cardiac wall motion sensors comprises deploying an accelerometer sensor. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac monitoring method, comprising:
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deploying at least two cerdiac wall motion sensors into operative communication with spaced-apart portions of myocardial tissue; receiving a signal from each of the at least two cardiac wall motion sensors; obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cadiac wall motion sensors; filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein deploying one of the at least two cardiac wall motion sensors comprises deploying a tensiometric sensor.
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10. A cardiac monitoring method, comprising:
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deploying at least two cardiac wall motion sensors into operative communication with spaced-apart portions of myocardial tissue; receiving a signal from each of the at least two cardiac wall motion sensors; obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors; filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors; wherein the step of obtaining a sensor signal segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors, further comprises; initiating the predetermined sensing window upon one of the beginning or the expiration of a pacing therapy timing interval. - View Dependent Claims (11)
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12. A cardiac monitoring method, comprising:
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deploying at least two cardiac wall motion sensors into operative communication with Spaced-apart portions of myocardial tissue; receiving a signal from each of the at least two cardiac wall motion sensors; obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors; filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein the step of obtaining the sensor signal output segment for the predetermined sensing window for each of the at least two cardiac wall motion sensors comprises; obtaining the sensor signal output segment over at least two cardiac cycles. - View Dependent Claims (13, 14)
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15. A cardiac monitoring apparatus, comprising:
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means for deploying at least two cardiac wall motion sensors into operative communication with spaced-apart portions of myocardial tissue; means for receiving a signal from each of the at least two cardiac wall motion sensors; means for obtaining a sensor signal output for a predetermined sensing window for each of the at least two cardiac wall motion sensors; means for filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; means for locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; means for comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and means for generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein one of the at least two cardiac wall motion sensors comprises an accelerometer sensor. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. A computer readable mediums for performing a method of monitoring cardiac synchrony, comprising:
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instructions for receiving a signal from each of the at least two cardiac wall motion sensors; instructions for obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors; instructions for filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; instructions for locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wail motion sensors; instructions for comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and instructions for generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein the instructions for receiving the signal from one of the at least two cardiac wall motion sensors comprises instructions for receiving the signal from an accelerometer sensor. - View Dependent Claims (31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41)
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42. A computer readable medium for performing a method of monitoring cardiac synchrony, comprising:
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instructions for receiving a signal from each of the at least two cardiac wall motion sensors; instructions for obtaining a sensor signal output segment for a predetermined sensing window for each of the at least two cardiac wall motion sensors; instructions for filtering the sensor signal output segment of each of the at least two cardiac wall motion sensors; instructions for locating an fiducial point for the filtered sensor signal output segments of each of the at least two cardiac wall motion sensors; instructions for comparing the relative temporal location of the initial fiducial points of the filtered sensor signals of each of the at least two cardiac wall motion sensors; and instructions for generating a metric of ventricular synchrony using the time difference between the relative temporal location of the initial fiducial points for each of the filtered sensor signal of the at least two cardiac wall motion sensors, wherein the instructions for receiving the signal from one of the at least two cardiac wall motion sensors comprises instructions for receiving the signal from a tensiometric sensor.
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Specification