Adaptive timing interval control method for treating congestive heart failure
First Claim
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1. A method of treating a heart with an implantable cardiac stimulation device, the heart exhibiting initial steady state hemodynamic parameters, the method comprising:
- pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value;
disturbing the steady state hemodynamic parameters by altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for the at least one cardiac cycle; and
adjusting the cardiac pacing timing interval by selecting a desired steady state value within a range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the desired steady state value is different from the initial steady state value and the temporary value.
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Abstract
A method of treating a heart with an implantable cardiac stimulation device involves transiently disturbing the steady state hemodynamic parameters by altering a cardiac cycle timing interval sufficient to reduce end diastolic volume for that cycle. The cardiac cycle timing interval is then adaptively controlled for successive cardiac cycles to achieve a second set of hemodynamic parameters.
65 Citations
18 Claims
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1. A method of treating a heart with an implantable cardiac stimulation device, the heart exhibiting initial steady state hemodynamic parameters, the method comprising:
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pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; disturbing the steady state hemodynamic parameters by altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for the at least one cardiac cycle; and adjusting the cardiac pacing timing interval by selecting a desired steady state value within a range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the desired steady state value is different from the initial steady state value and the temporary value. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of treating a heart with an implantable cardiac stimulation device, the heart exhibiting initial steady state hemodynamic parameters, the method comprising:
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pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; disturbing the steady state hemodynamic parameters by altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for the at least one cardiac cycle; adjusting the cardiac pacing timing interval by selecting a desired steady state value within a range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value; adaptively controlling the cardiac pacing timing interval for successive cardiac cycles to achieve a second set of hemodynamic parameters; and maintaining the second set of hemodynamic parameters as a second set of steady state hemodynamic parameters.
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11. A method of treating a heart with an implantable cardiac stimulation device, the heart exhibiting initial steady state hemodynamic parameters, the method comprising:
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pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; disturbing the steady state hemodynamic parameters by altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for the at least one cardiac cycle; and adjusting the cardiac pacing timing interval by selecting a desired steady state value within a range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the cardiac pacing timing interval is changed from the temporary value to the desired steady state value in a series of steps over a predefined period.
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12. An implantable cardiac stimulation device for treating a heart suffering from congestive heart failure, the device comprising:
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means for pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; means for disturbing steady state hemodynamic parameters of the heart comprising means for altering the cardiac pacing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for that cycle; and means for adjusting the cardiac pacing interval by selecting a desired steady state value within the range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the desired steady state value is different from the initial steady state value and the temporary value. - View Dependent Claims (13)
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14. An implantable cardiac stimulation device for treating a heart suffering from congestive heart failure, the device comprising:
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means for pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; means for disturbing steady state hemodynamic parameters of the heart comprising means for altering the cardiac pacing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for that cycle; and means for adjusting the cardiac pacing interval by selecting a desired steady state value within the range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value; wherein the means for disturbing comprises means for selecting the temporary timing interval value, and means for incrementally adjusting the cardiac pacing interval value from the steady state value to the temporary value.
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15. A method of pacing a heart comprising:
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pacing the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value; altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle, wherein the altering is sufficient to reduce end diastolic volume for the at least one cardiac cycle; and adjusting the cardiac pacing timing interval by selecting a desired steady state value within the range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the desired steady state value is different from the initial steady state value and the temporary value.
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16. An implantable cardiac stimulation system comprising:
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at least one lead adapted for implant within a patient and comprising at least one electrode connected to the lead for electrical contact with the patient'"'"'s heart; an implantable cardiac stimulation device connected to the at least one lead and comprising a controller and a pulse generator, wherein the controller is operative to control the pulse generator to pace the heart using a first set of pacing parameters comprising at least one cardiac pacing timing interval having an initial steady state value, to disturb the steady state hemodynamic parameters by altering the cardiac pacing timing interval from the initial steady state value to a temporary value for at least one cardiac cycle sufficient to reduce end diastolic volume for the at least one cardiac cycle, and to adjust the cardiac pacing timing interval by selecting a desired steady state value within the range defined by the initial steady state value and the temporary value, and changing the cardiac pacing timing interval from the temporary value to the desired steady state value, wherein the desired steady state value is different from the initial steady state value and the temporary value. - View Dependent Claims (17, 18)
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Specification