Implantable devices, and methods for use therewith, for monitoring sympathetic and parasympathetic influences on the heart
First Claim
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1. For use with an implantable device, a method for independently monitoring levels of parasympathetic and sympathetic tone of a patient, comprising:
- (a) sensing a cardiac electrogram (EGM) signal using implanted electrodes;
(b) measuring cardiac intervals within a portion of the sensed EGM signal; and
(c) independently assessing levels of parasympathetic tone and sympathetic tone based on the measured cardiac intervals, wherein step (c) comprises;
(c.1) assessing the level of parasympathetic tone in one of the following manners;
(c.1.i) determining the patient'"'"'s diurnal variation of cardiac intervals based on the measured cardiac intervals, wherein diurnal variation of cardiac intervals is a measurement of change in cardiac intervals over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of cardiac intervals;
(c.1.ii) determining the patient'"'"'s diurnal variation of heart rate based on the measured cardiac intervals, wherein diurnal variation of heart rate is a measurement of change in heart rate over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of heart rate; and
(c.1.iii) identifying each said cardiac interval that is longer than the immediately preceding cardiac interval as being indicative of cardiac deceleration, and assessing the level of parasympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac deceleration; and
(c.2) assessing the patient'"'"'s level of sympathetic tone in one of the following manners(c.2.i) determining the patient'"'"'s average cardiac interval based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average cardiac interval;
(c.2.ii) determining the patient'"'"'s average heart rate based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average heart rate; and
(c.2.iii) identifying each said cardiac interval that is shorter than the immediately preceding cardiac interval as being indicative of cardiac acceleration, and assessing the level of sympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac acceleration.
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Abstract
Provided herein are implantable devices, and methods for use therewith, that independently monitor levels of parasympathetic and sympathetic tone of a patient. In accordance with an embodiment, a cardiac electrogram (EGM) signal is sensed using implanted electrodes, cardiac intervals are measured within a portion of the sensed EGM signal, and levels of parasympathetic tone and sympathetic tone are independently assessed based on the measured cardiac intervals. This abstract is not intended to describe all of the various embodiments of the present invention.
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Citations
20 Claims
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1. For use with an implantable device, a method for independently monitoring levels of parasympathetic and sympathetic tone of a patient, comprising:
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(a) sensing a cardiac electrogram (EGM) signal using implanted electrodes; (b) measuring cardiac intervals within a portion of the sensed EGM signal; and (c) independently assessing levels of parasympathetic tone and sympathetic tone based on the measured cardiac intervals, wherein step (c) comprises; (c.1) assessing the level of parasympathetic tone in one of the following manners; (c.1.i) determining the patient'"'"'s diurnal variation of cardiac intervals based on the measured cardiac intervals, wherein diurnal variation of cardiac intervals is a measurement of change in cardiac intervals over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of cardiac intervals; (c.1.ii) determining the patient'"'"'s diurnal variation of heart rate based on the measured cardiac intervals, wherein diurnal variation of heart rate is a measurement of change in heart rate over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of heart rate; and (c.1.iii) identifying each said cardiac interval that is longer than the immediately preceding cardiac interval as being indicative of cardiac deceleration, and assessing the level of parasympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac deceleration; and (c.2) assessing the patient'"'"'s level of sympathetic tone in one of the following manners (c.2.i) determining the patient'"'"'s average cardiac interval based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average cardiac interval; (c.2.ii) determining the patient'"'"'s average heart rate based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average heart rate; and (c.2.iii) identifying each said cardiac interval that is shorter than the immediately preceding cardiac interval as being indicative of cardiac acceleration, and assessing the level of sympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac acceleration. - View Dependent Claims (14, 15, 16, 17, 18)
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2. For use with an implantable device, a method for independently monitoring levels of parasympathetic and sympathetic tone of a patient, comprising:
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(a) sensing a cardiac electrogram (EGM) signal using implanted electrodes; (b) measuring cardiac intervals within a portion of the sensed EGM signal; and (c) independently assessing levels of parasympathetic tone and sympathetic tone based on the measured cardiac intervals, wherein step (c) includes; (c.1) identifying each said cardiac interval that is longer than the immediately preceding cardiac interval as being indicative of cardiac deceleration; and (c.2) assessing the level of parasympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac deceleration. - View Dependent Claims (3)
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4. For use with an implantable device, a method for independently monitoring levels of parasympathetic and sympathetic tone of a patient, comprising:
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(a) sensing a cardiac electrogram (EGM) signal using implanted electrodes; (b) measuring cardiac intervals within a portion of the sensed EGM signal; and (c) independently assessing levels of parasympathetic tone and sympathetic tone based on the measured cardiac intervals, wherein step (c) includes; (c.1) identifying each said cardiac interval that is longer than the immediately preceding cardiac interval as a positive anchor point; (c.2) defining for each identified positive anchor point a segment of at least three consecutive said cardiac intervals that is generally centered about the positive anchor point; (c.3) averaging the segments defined for the positive anchor points to produce an average deceleration segment; and (c.4) assessing a level of parasympathetic tone based on the average deceleration segment. - View Dependent Claims (5, 6, 7, 8, 9, 10, 11, 12, 13)
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19. An implantable device for assessing levels of parasympathetic and sympathetic tone of a patient, comprising:
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implantable electrodes for sensing a cardiac electrogram (EGM) signal; means for measuring cardiac intervals within a portion of the sensed EGM signal; means for independently assessing levels of parasympathetic tone and sympathetic tone based on the measured cardiac intervals, wherein the means for independently assessing levels of parasympathetic tone and sympathetic tone comprises one or more processor, and wherein the one or more processor assesses the level of parasympathetic tone in one of the following manners; determining the patient'"'"'s diurnal variation of cardiac intervals based on the measured cardiac intervals, wherein diurnal variation of cardiac intervals is a measurement of change in cardiac intervals over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of cardiac intervals; determining the patient'"'"'s diurnal variation of heart rate based on the measured cardiac intervals, wherein diurnal variation of heart rate is a measurement of change in heart rate over the course of a day, and assessing the level of parasympathetic tone based on the diurnal variation of heart rate; and identifying each said cardiac interval that is longer than the immediately preceding cardiac interval as being indicative of cardiac deceleration, and assessing the level of parasympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac deceleration; and wherein the one or more processor assesses the level of sympathetic tone in one of the following manners determining the patient'"'"'s average cardiac interval based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average cardiac interval; determining the patient'"'"'s average heart rate based on the measured cardiac intervals, and assessing the level of sympathetic tone based on the determined average heart rate; and identifying each said cardiac interval that is shorter than the immediately preceding cardiac interval as being indicative of cardiac acceleration, and assessing the level of sympathetic tone based on the cardiac intervals that are identified as being indicative of cardiac acceleration. - View Dependent Claims (20)
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Specification