Method and apparatus for treating diastolic heart failure

• US 7,792,581 B2
• Filed: 02/28/2006
• Issued: 09/07/2010
• Est. Priority Date: 02/28/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hettrick, Douglas A., Mulligan, Lawrence J., Euler, David E.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US11/363,729
• Publication Number:
  US 20070203522A1
• Time in Patent Office: 1,652 Days
• Field of Search: 607/9, 607 17- 19
• US Class Current: 607/19
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Methods and systems for treating patients with diastolic heart failure (DHF) are disclosed which include slowing a patient'"'"'s heart rate below its intrinsic rate, and controlling the rate using cardiac pacing therapy to improve LV filling and cardiac output. In certain embodiments, a pacing treatment rate may be determined by adjusting an adaptive rate by an amount determined by evaluating one or more patient parameters.

Claims

1. A method of treating a patient responsive to a diagnosis of diastolic heart failure (DHF), the method comprising:

causing the patient'"'"'s heart rate to decrease below the patient'"'"'s intrinsic heart rate;

sensing the patient'"'"'s level of exercise and level of left ventricular afterload;

determining an adaptive heart rate R₀ as a function of the patients level of exercise;

determining a rate adjustment R_A as a function of the patient'"'"'s level of ventricular afterload;

adjusting the adaptive rate, R₀, by the rate adjustment, R_A, to provide exercise responsive pacing at a treatment rate, R_T, corresponding to a desired level of left ventricular afterload;

and delivering cardiac pacing therapy to the patient at the treatment rate.

2. The method of claim 1 wherein determining the rate adjustment, R_A, comprises determining the rate adjustment as a function of aortic impedance.

3. The method of claim 1 wherein determining the adaptive rate, R₀, comprises deriving the adaptive rate from an activity sensor.

4. The method of claim 1 wherein determining the adaptive rate, R₀, comprises deriving the adaptive rate from a physiologic sensor.

5. The method of claim 1 wherein R_A is a function of R₀.

6. The method of claim 1 comprising triggering application of the rate adjustment, R_A, when the patient'"'"'s level of left ventricular afterload crosses a predetermined threshold.

7. The method of claim 1 wherein determining R_T comprises subtracting R_A from R₀.