Measurement of coronary sinus parameters to optimize left ventricular performance

• US 7,904,158 B2
• Filed: 04/28/2005
• Issued: 03/08/2011
• Est. Priority Date: 04/28/2005
• Status: Expired due to Fees

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Stegemann, Berthold, Receveur, Rogier
• Primary Examiner(s): Patel; Niketa I
• Assistant Examiner(s): HOLMES, REX R
• Application Number:
  US11/116,876
• Publication Number:
  US 20060247702A1
• Time in Patent Office: 2,140 Days
• Field of Search: 600/513, 600/364, 607 17- 18, 607/22
• US Class Current: 607/18
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• 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 1/3655 controlled by body or blood temperature
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters

Abstract

In some embodiments, an implantable medical device (IMD) system may include one or more of the following elements: (a) an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient'"'"'s heart, (b) an oxygen signal generated by the oxygen sensor, (c) an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal, and (d) an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient'"'"'s heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal, wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.

Claims

1. A method for pacing a patient'"'"'s heart using an implanted medical device comprising:

sensing a rate extraction of glucose through a coronary sinus of a patient'"'"'s heart;

generating pacing pulses as a function of the sensed rate;

adjusting a pacing parameter of the pacing pulses as a function of a glucose signal; and

adjusting the pacing parameter to optimize left ventricular performance wherein adjusting the pacing parameter comprises adjusting the pacing parameter to minimize the rate of extraction of glucose.

2. A method according to claim 1 wherein generating the pacing pulses comprises generating ventricular pacing pulses after expirations of AV intervals and wherein adjusting the pacing parameter comprises adjusting the AV intervals.

3. A method according to claim 1 wherein generating the pacing pulses comprises generating left and right ventricular pacing pulses separated by inter-ventricular VV intervals and wherein adjusting the pacing parameter comprises adjusting the inter-ventricular VV intervals.

4. A method according to claim 1 wherein adjusting the pacing parameter comprises setting a curve relating the pacing parameter to the rate of extraction of glucose.

5. A method according to claim 4 wherein adjusting the pacing parameter further comprises defining a region associated with the curve.

6. A method according to claim 5 further comprising resetting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.

7. A method for pacing a patient'"'"'s heart using an implanted medical device comprising:

sensing a rate extraction of glucose through a coronary sinus of a patient'"'"'s heart;

generating pacing pulses as a function of the sensed rate;

adjusting a pacing parameter of the pacing pulses as a function of a glucose signal; and

adjusting the pacing parameter to optimize left ventricular performance wherein adjusting the pacing parameter comprises setting a curve relating the pacing parameter to the rate of extraction of glucose.

8. A method according to claim 7 wherein adjusting the pacing parameter further comprises defining a region associated with the curve.

9. A method according to claim 8 further comprising resetting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.

10. A method according to claim 8 further comprising shifting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.