Method and apparatus for delivering chronic and post-ischemia cardiac therapies
First Claim
Patent Images
1. A system for treating a heart with an ischemic region, the system comprising:
- a sensing circuit to sense one or more physiological signals including one or more ischemia-indicating signals and one or more therapy-monitoring signals;
an ischemia detector, coupled to the sensing circuit, to detect an ischemic state indicative of an occurrence of an ischemic event from the one or more ischemia-indicating signals, the ischemic detector including an ischemia locator adapted to locate the ischemic region;
a therapy delivery device including a pacing output circuit to deliver a post-ischemia therapy and a chronic pacing therapy each including delivering of pacing pulses;
a therapy monitor, coupled to the sensing circuit, to produce one or more therapy-monitoring parameters from the one or more therapy-monitoring signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the post-ischemia therapy and the chronic pacing therapy; and
a controller coupled to the ischemia detector, the therapy delivery device, and the therapy monitor, the controller including;
a post-ischemia therapy controller adapted to initiate a delivery of the post-ischemia therapy in response to the occurrence of the ischemic event as indicated by the detected ischemic state and to adjust the delivery of the post-ischemia therapy based on the detected ischemic state, the location of the ischemic region, and at least one post-ischemia therapy-monitoring parameter of the one or more therapy-monitoring parameters, the post-ischemic therapy controller including a post-ischemic pacing controller programmed to adjust one or more regional pacing parameters to provide pre-excitation of the ischemic region to reduce stress and workload of the ischemic region in response to the occurrence of the ischemic event; and
a chronic therapy controller adapted to adjust a delivery of the chronic pacing therapy based on the detected ischemic state and at least one chronic therapy-monitoring parameter of the one or more therapy-monitoring parameters, the chronic therapy controller including a chronic pacing controller programmed to adjust one or more global pacing parameters to reduce overall workload on the heart in response to the occurrence of the ischemic event.
1 Assignment
0 Petitions
Accused Products
Abstract
An implantable cardiac rhythm management (CRM) device delivers a chronic therapy while detecting an ischemic state. When the ischemic state indicates the occurrence of an ischemic event, the implantable CRM device delivers a post-ischemia therapy. The post-ischemia therapy and the chronic therapy are adjusted using feedback control with the ischemic state and parameters indicative of the effectiveness of the post-ischemic therapy and the effectiveness of the chronic therapy as inputs.
-
Citations
25 Claims
-
1. A system for treating a heart with an ischemic region, the system comprising:
-
a sensing circuit to sense one or more physiological signals including one or more ischemia-indicating signals and one or more therapy-monitoring signals; an ischemia detector, coupled to the sensing circuit, to detect an ischemic state indicative of an occurrence of an ischemic event from the one or more ischemia-indicating signals, the ischemic detector including an ischemia locator adapted to locate the ischemic region; a therapy delivery device including a pacing output circuit to deliver a post-ischemia therapy and a chronic pacing therapy each including delivering of pacing pulses; a therapy monitor, coupled to the sensing circuit, to produce one or more therapy-monitoring parameters from the one or more therapy-monitoring signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the post-ischemia therapy and the chronic pacing therapy; and a controller coupled to the ischemia detector, the therapy delivery device, and the therapy monitor, the controller including; a post-ischemia therapy controller adapted to initiate a delivery of the post-ischemia therapy in response to the occurrence of the ischemic event as indicated by the detected ischemic state and to adjust the delivery of the post-ischemia therapy based on the detected ischemic state, the location of the ischemic region, and at least one post-ischemia therapy-monitoring parameter of the one or more therapy-monitoring parameters, the post-ischemic therapy controller including a post-ischemic pacing controller programmed to adjust one or more regional pacing parameters to provide pre-excitation of the ischemic region to reduce stress and workload of the ischemic region in response to the occurrence of the ischemic event; and a chronic therapy controller adapted to adjust a delivery of the chronic pacing therapy based on the detected ischemic state and at least one chronic therapy-monitoring parameter of the one or more therapy-monitoring parameters, the chronic therapy controller including a chronic pacing controller programmed to adjust one or more global pacing parameters to reduce overall workload on the heart in response to the occurrence of the ischemic event. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
-
-
15. A method for treating a heart with an ischemic region, the method comprising:
-
delivering a chronic pacing therapy; sensing one or more physiological signals; detecting an ischemic state indicative of an occurrence of an ischemic event from one or more ischemia-indicating signals of the one or more physiological signals; locating the ischemic region; initiating a delivery of a post-ischemia therapy including a post-ischemia pacing therapy during which pacing pulses are delivered to the ischemic region in response to the occurrence of the ischemic event as indicated by the detected ischemic state; producing one or more therapy-monitoring parameters from one or more therapy-monitoring signals of the one or more physiological signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the chronic pacing therapy and the post-ischemia therapy; and adjusting the delivery of the chronic pacing therapy and the delivery of the post-ischemia therapy based on the detected ischemic state, the location of the ischemic region, and the one or more therapy-monitoring parameters, the adjusting including adjusting one or more global pacing parameters of the chronic pacing therapy to reduce overall workload on the heart in response to the occurrence of the ischemic event and adjusting one or more regional pacing parameters of the post-ischemia pacing therapy to provide pre-excitation of the ischemic region to reduce stress and workload of the ischemic region in response to the occurrence of the ischemic event. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
-
Specification