Diastolic mechanical algorithm for optimization of AV timing using a plurality of sensors

• US 7,689,283 B1
• Filed: 02/26/2007
• Issued: 03/30/2010
• Est. Priority Date: 11/15/2004
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Schecter, Stuart O.
• Primary Examiner(s): Bockelman; Mark W
• Assistant Examiner(s): Dinga; Roland
• Application Number:
  US11/679,030
• Time in Patent Office: 1,128 Days
• Field of Search: 607 17- 18, 600/528
• US Class Current: 607/18
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

Systems and methods are provided for adjusting atrioventricular timing of a cardiac resynchronization therapy device, based upon multi-modal sensory data. In one particular embodiment, one or more acoustic signals are processed and categorized into certain cardiac-related mechanical events. Impedance waveforms are obtained from implanted electrodes and analyzed to identify certain valvular events. The acoustic and impedance data is analyzed to optimize AV timing and improve cardiac performance.

Claims

1. A method for adjusting the timing of a cardiac treatment device, comprising:

providing an implantable device comprising a first programmable timing, a first implanted sensor system having a first sensory modality comprising intracardiac dynamic impedance, and a second implanted sensor system having a second sensory modality, different from the first sensory modality;

detecting a first valve mechanical event time from the first implanted sensor system;

detecting a second valve mechanical event time from the second implanted sensor system;

generating a comparison value based upon the first valve mechanical event time and the second valve mechanical event time;

comparing the comparison value to a target value; and

adjusting the first programmable timing based upon the difference between the comparison value and the target value.

2. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the second sensory modality is cardiac acoustics.

3. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the second sensory modality is vascular pressure.

4. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the first valve mechanical event time is aortic valve opening.

5. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the second valve mechanical event time is mitral valve closure.

6. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein generating the comparison value comprises calculating a difference between the first valve mechanical event time and the second valve mechanical event time.

7. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein generating the comparison value comprises calculating a ratio of the first valve mechanical event time and the second valve mechanical event time.

8. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the first programmable timing is an AV timing interval.

9. The method for adjusting the timing of a cardiac treatment device as in claim 1, wherein the target value is determined using echocardiography.

10. A method for adjusting the timing of a cardiac treatment device, comprising:

providing an implantable device with a programmable timing setting;

detecting a first valve mechanical event time using an acoustic sensor;

detecting a second valve mechanical event time using an impedance sensor;

generating a comparison value based upon the first valve mechanical event time and the second valve mechanical event time;

comparing the comparison value to a target value; and

adjusting the programmable timing of the implantable device based upon the difference between the comparison value and the target value.