Method and apparatus for monitoring and optimizing atrial function

• US 7,869,876 B2
• Filed: 10/07/2005
• Issued: 01/11/2011
• Est. Priority Date: 10/07/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Prakash, Rajan, Chinchoy, Edward, Mullen, Thomas J.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Oropeza; Frances P
• Application Number:
  US11/245,623
• Publication Number:
  US 20070083243A1
• Time in Patent Office: 1,922 Days
• Field of Search: 600/373, 600/374, 600/393, 600/509, 600/513, 607/4, 607/5, 607/6, 607/7, 607/9, 607/17, 607/119, 607/122
• US Class Current: 607/17
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• 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 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

A method for use in an implantable medical device, comprising: sensing a signal corresponding to ventricular wall acceleration; and determining a metric of atrial function using the ventricular wall acceleration signal. The method includes sensing the ventricular wall acceleration signal during at least during a sensing window corresponding to a ventricular filling phase.

Claims

1. A method for use in an implantable medical device, comprising:

sensing a signal corresponding to ventricular wall acceleration during a ventricular filling phase; and

determining a metric of atrial function using the ventricular wall acceleration signal sensed during the ventricular filling phase, wherein sensing the ventricular wall acceleration signal includes sensing a signal corresponding to left ventricular wall acceleration.

2. A method according to claim 1 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering pacing pulses on expirations of pacing intervals; and

adjusting durations of the pacing intervals responsive to the determined metric of atrial function.

3. A method according to claim 1 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering ventricular pacing pulses on expirations of AV intervals; and

adjusting durations of the AV intervals responsive to the determined metric of atrial function.

4. A method for use in an implantable medical device, comprising:

sensing a signal corresponding to ventricular wall acceleration during a ventricular filling phase; and

determining a metric of atrial function using the ventricular wall acceleration signal sensed during the ventricular filling phase, wherein determining a metric of atrial function includes detecting a first ventricular filling phase peak during the ventricular filling phase and detecting if a second ventricular filling phase peak during the ventricular filling phase follows the first ventricular filling phase peak.

5. A method according to claim 4 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering pacing pulses on expirations of pacing intervals; and

adjusting durations of the pacing intervals responsive to the detection of a second ventricular filling phase peak.

6. A method according to claim 4 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering ventricular pacing pulses on expirations of AV intervals; and

adjusting durations of the AV intervals responsive to the detection of a second ventricular filling phase peak.

7. A method for use in an implantable medical device, comprising:

sensing a signal corresponding to ventricular wall acceleration during a ventricular filling phase; and

determining a metric of atrial function using the ventricular wall acceleration signal sensed during the ventricular filling phase, wherein determining a metric of atrial function includes determining a time interval between a first ventricular filling phase peak and a second ventricular filling phase peak during the ventricular filling phase.

8. A method according to claim 7 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering pacing pulses on expirations of pacing intervals; and

adjusting durations of the pacing intervals responsive to the determined time interval.

9. A method according to claim 7 wherein the medical device comprises a cardiac pacemaker, and further comprising:

delivering ventricular pacing pulses on expirations of AV intervals; and

adjusting durations of the AV intervals responsive to the determined time interval.

10. An implantable medical device comprising:

means for generating a signal corresponding to ventricular wall acceleration during a ventricular filling phase;

means for receiving the signal from the generating means;

means for deriving a metric of atrial function using the acceleration signal sensed during the ventricular filling phase; and

means for storing the atrial function metric, wherein the means for deriving the atrial function metric includes means for detecting a first ventricular filling phase peak during the ventricular filling phase and means for detecting if a second ventricular filling phase peak during the ventricular filling phase follows the first ventricular filling phase peak.

11. A device according to claim 10, further comprising:

means for delivering pacing pulses on expirations of pacing intervals; and

means for adjusting durations of the pacing intervals responsive to the detection of a second ventricular filling phase peak.

12. A device according to claim 10, further comprising:

means for delivering ventricular pacing pulses on expirations of AV intervals; and

means for adjusting durations of the AV intervals responsive to the detection of a second ventricular filling phase peak.

13. An implantable medical device comprising:

means for generating a signal corresponding to ventricular wall acceleration during a ventricular filling phase;

means for receiving the signal from the generating means;

means for deriving a metric of atrial function using the acceleration signal sensed during the ventricular filling phase; and

means for storing the atrial function metric, wherein the means for deriving the atrial function metric includes means for determining a time interval between a first ventricular filling phase peak during the ventricular filling phase and a second ventricular filling phase peak during the ventricular filling phase.

14. A non-transitory computer readable medium storing a set of instructions which when implemented in an implantable medical device system cause the system to:

sense a signal corresponding to ventricular wall acceleration during a ventricular filling phase;

determine a metric of atrial function using the ventricular wall acceleration signal sensed during the ventricular filling phase, wherein the instructions for determining a metric of atrial function include;

instructions for detecting a first ventricular filling phase peak during the ventricular filling phase; and

instructions for detecting if a second ventricular filling phase peak during the ventricular filling phase follows the first ventricular filling phase peak.

15. A medium according to claim 14, further storing instructions which when implemented in an implantable medical device system cause the system to:

deliver pacing pulses on expirations of pacing intervals; and

adjust durations of the pacing intervals responsive to the determined time interval.

16. A medium according to claim 14, further storing instructions which when implemented in an implantable medical device system cause the system to:

deliver ventricular pacing pulses on expirations of AV intervals; and

adjust durations of the AV intervals responsive to the determined time interval.

17. A non-transitory computer readable medium storing a set of instructions which when implemented in an implantable medical device system cause the system to:

sense a signal corresponding to ventricular wall acceleration during a ventricular filling phase; and

determine a metric of atrial function using the ventricular wall acceleration signal sensed during the ventricular filling phase, wherein the instructions for determining a metric of atrial function include instructions for determining a time interval between a first ventricular filling phase peak during the ventricular filling phase and a second ventricular filling phase peak during the ventricular filling phase.

18. A medium according to claim 17, further storing instructions which when implemented in an implantable medical device system cause the system to:

deliver pacing pulses on expirations of pacing intervals; and

adjust durations of the pacing intervals responsive to the detection of a second ventricular filling phase peak.

19. A medium according to claim 17, further storing instructions which when implemented in an implantable medical device system cause the system to:

deliver ventricular pacing pulses on expirations of AV intervals; and

adjust durations of the AV intervals responsive to the detection of a second ventricular filling phase peak.