Method and apparatus for optimization of cardiac resynchronization therapy using heart sounds
First Claim
1. A system for analyzing a heart having a first cardiac valve and a second cardiac valve, the system comprising:
- a heart sound input to receive one or more signals each indicative of heart sounds;
a heart sound detector, coupled to the heart sound input, to detect heart sounds of at least one predetermined type from the one or more signals; and
a computer-based heart sound morphology analyzer, coupled to the heart sound detector, to produce at least one dyssynchrony parameter indicative of a degree of cardiac mechanical dyssynchrony, the heart sound morphology analyzer including a heart sound measurement module to measure one or more parameters each based on at least one morphological feature of the heart sounds of the at least one predetermined type, the at least one morphological feature indicative of a time interval between closures of the first cardiac valve and the second cardiac valve in one cardiac cycle.
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Accused Products
Abstract
A cardiac rhythm management system provides for assessment of cardiac mechanical dyssynchrony based on heart sound morphology and optimization of pacing parameters based on the effect of pacing on the cardiac mechanical dyssynchrony assessment. A degree of cardiac mechanical dyssynchrony is measured by the time delay between tricuspid valve closure and mitral valve closure and/or the time delay between pulmonary valve closure and aortic valve closure. A cardiac resynchronization therapy is optimized by determining therapy parameters to provide an approximately minimum degree of cardiac mechanical dyssynchrony by cardiac pacing.
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Citations
72 Claims
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1. A system for analyzing a heart having a first cardiac valve and a second cardiac valve, the system comprising:
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a heart sound input to receive one or more signals each indicative of heart sounds; a heart sound detector, coupled to the heart sound input, to detect heart sounds of at least one predetermined type from the one or more signals; and a computer-based heart sound morphology analyzer, coupled to the heart sound detector, to produce at least one dyssynchrony parameter indicative of a degree of cardiac mechanical dyssynchrony, the heart sound morphology analyzer including a heart sound measurement module to measure one or more parameters each based on at least one morphological feature of the heart sounds of the at least one predetermined type, the at least one morphological feature indicative of a time interval between closures of the first cardiac valve and the second cardiac valve in one cardiac cycle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. A system for analyzing a heart having a first cardiac valve and a second cardiac valve, the system comprising:
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an implantable system including; one or more implantable heart sound sensors to sense one or more heart sound signals each indicative of heart sounds of at least one predetermined type; and an implantable medical device including; an implant controller, coupled to the one or more implantable heart sound sensors, to process the one or more heart sound signals; and an implant telemetry module, coupled to the implantable controller, to transmit the one or more heart sound signals; an external system communicatively coupled to the implantable medical device, the external system including; an external telemetry module to receive the one or more heart sound signals; and an external controller coupled to the external telemetry module, the external controller including a heart sound morphology analyzer to produce at least one dyssynchrony parameter indicative of a degree of cardiac mechanical dyssynchrony, the heart sound morphology analyzer including a heart sound measurement module to measure one or more parameters each based on at least one morphological feature of the heart sounds of the at least one predetermined type, the at least one morphological feature indicative of a time interval between closures of the first cardiac valve and the second cardiac valve in one cardiac cycle. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43)
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44. A method for operating a cardiac pacemaker, comprising:
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receiving one or more heart sound signals indicative of heart sounds of at least one predetermined type; detecting the heart sounds of the at least one predetermined type; producing one or more dyssynchrony parameters each indicative of a degree of cardiac mechanical dyssynchrony based on at least one morphological feature of the detected heart sounds of the at least one predetermined type by executing an automated cardiac mechanical dyssynchrony algorithm; and determining one or more pacing parameters for minimizing the degree of cardiac mechanical dyssynchrony based on the one or more dyssynchrony parameters. - View Dependent Claims (45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72)
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Specification