Method and apparatus for optimizing cardiac resynchronization therapy

• US 7,769,451 B2
• Filed: 04/28/2005
• Issued: 08/03/2010
• Est. Priority Date: 04/28/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hjelle, Mark A., Yang, Zhongping, Hine, Douglas S.
• Primary Examiner(s): Layno; Carl H.
• Assistant Examiner(s): MORALES, JON ERIC C
• Application Number:
  US11/116,547
• Publication Number:
  US 20060247692A1
• Time in Patent Office: 1,923 Days
• Field of Search: 607/18, 607/22, 607/23
• US Class Current: 607/17
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• 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 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

In some embodiments, a method for optimizing cardiac resynchronization therapy (CRT) may include one or more of the following steps: (a) conducting a baseline measurement of a physical parameter of a patient before initiating CRT, (b) performing an implantation process including implanting a pacing device and pacing leads in the patient, the pacing device and pacing leads for providing the CRT, (c) initiating CRT on the patient, (d) measuring the physical parameter of the patient after initiation of the CRT, (e) comparing the measured physical parameter after initiation of the CRT to the baseline measure of the physical parameter to analyze the patient'"'"'s response to the CRT, (f) adjusting the CRT during the implantation process to try and improve the patient'"'"'s response to the CRT, and (g) repositioning at least one of the patient leads during the implantation process to try and improve the patient'"'"'s response to the CRT.

Claims

1. A method for optimizing cardiac resynchronization therapy (CRT), the method comprising:

conducting a baseline measurement of a physical parameter of a patient before initiating CRT;

performing an implantation process including implanting a pacing device and pacing leads in the patient, the pacing device and pacing leads for providing the CRT;

initiating CRT on the patient;

measuring the physical parameter of the patient after initiation of the CRT;

comparing the measured physical parameter after initiation of the CRT to the baseline measure of the physical parameter to analyze the patient'"'"'s response to the CRT; and

based upon the comparison of the measured physical parameter to the baseline measure of the physical parameter, adjusting the CRT during the implantation process to improve the patient'"'"'s analyzed response to the CRT, and

wherein the physical parameter comprises the concentration of a blood biochemical; and

wherein the blood biochemical is B-type Neurouretic Peptide (BNP).

2. The method of claim 1, wherein the BNP concentration level is measured from blood taken directly from the patient'"'"'s heart.

3. The method of claim 1, further including repositioning at least one of the patient leads during the implantation process to try and improve the patient'"'"'s response to the CRT.

4. The method of claim 3, wherein the at least one of the patient leads is a lead that stimulates a left ventricle of the patient'"'"'s heart.

5. The method of claim 1, wherein the adjusting the CRT during the implantation process includes adjusting at least one of an AV time interval and a VV time interval.

6. A method for optimizing cardiac resynchronization therapy (CRT), the method comprising:

conducting a baseline measurement of a physical parameter of a patient before initiating CRT;

performing an implantation process including implanting a pacing device and pacing leads in the patient, the pacing device and pacing leads for providing the CRT;

initiating CRT on the patient;

measuring the physical parameter of the patient after initiation of the CRT;

comparing the measured physical parameter after initiation of the CRT to the baseline measure of the physical parameter to analyze the patient'"'"'s response to the CRT; and

based upon the comparison of the measured physical parameter to the baseline measure of the physical parameter, adjusting the CRT during the implantation process to improve the patient'"'"'s analyzed response to the CRT,

wherein the physical parameter comprises the concentration of B-type Neurouretic Peptide (BNP),

wherein the BNP concentration level is measured from blood taken directly from the patient'"'"'s heart, and

wherein measuring the physical parameter of the patient is performed with an elongated lead delivery catheter and said elongated lead delivery catheter includes a means for measuring the patient'"'"'s BNP concentration level coupled to a portion of said elongated lead delivery catheter.

7. The method of claim 6 wherein adjusting the CRT comprises repositioning a said pacing lead.

8. The method of claim 6, wherein the at least one of the pacing leads is located to stimulate the patient'"'"'s left ventricle.

9. The method of claim 6, wherein adjusting the CRT comprises adjusting at least one of an AV time interval and a VV time interval.

10. A method for optimizing cardiac resynchronization therapy (CRT), the method comprising:

conducting a baseline measurement of a physical parameter of a patient before initiating CRT;

performing an implantation process including implanting a pacing device and pacing leads in the patient, the pacing device and pacing leads for providing the CRT;

initiating CRT on the patient;

measuring the physical parameter of the patient after initiation of the CRT;

repositioning at least one of the patient leads during the implantation process;

measuring the physical parameter of the patient after repositioning at least one of the patient leads;

comparing the physical parameter measured after initiation of the CRT and after repositioning at least one of the patient leads to the baseline measurement to determine the preferred location of the last one of the patient leads based upon the comparison of the measured physical parameter to the baseline measure of the physical parameter,

wherein the physical parameter comprises the concentration of a blood biochemical.

11. The method of claim 10, wherein the at least one of the patient leads is a lead that stimulates a left ventricle of the patient'"'"'s heart.

12. The method of claim 10, wherein the blood biochemical is B-type Neurouretic Peptide (BNP).

13. A method for optimizing cardiac resynchronization therapy (CRT), comprising:

conducting a baseline measurement of a physical parameter comprising concentration of a blood chemical of a patient before initiating CRT;

performing an implantation process including locating the pacing leads in the patient, including locating a said pacing lead using a lead delivery catheter having means for measuring said physical parameter;

initiating CRT on the patient using the pacing leads;

using the lead delivery catheter to measure the physical parameter of the patient after initiation of the CRT;

comparing the measured physical parameter after initiation of the CRT to the baseline measure of the physical parameter to analyze the patient'"'"'s response to the CRT; and

based upon the comparison of the measured physical parameter to the baseline measure of the physical parameter, adjusting the CRT during the implantation process to improve the patient'"'"'s analyzed response to the CRT.

14. The method of claim 13, wherein the chemical in the patient'"'"'s blood comprises B-type Neurouretic Peptide (BNP).

15. The method of claim 13 wherein adjusting the CRT comprises repositioning a said pacing lead.

16. The method of claim 13, wherein the at least one of the pacing leads is located to stimulate the patient'"'"'s left ventricle.

17. The method of claim 13, wherein adjusting the CRT comprises adjusting at least one of an AV time interval and a VV time interval.