Therapy control based on the rate of change of intracardiac impedance
First Claim
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1. A system comprising a medical device including:
- an impedance measurement circuit adapted to be communicatively coupled to implantable electrodes to provide an intracardiac impedance signal between electrodes;
a therapy circuit configured to deliver pacing therapy to a right ventricle and a left ventricle of a subject; and
a controller circuit communicatively coupled to the impedance measurement circuit and the therapy circuit, wherein the controller circuit is configured to determine a time rate of change of the intracardiac impedance signal, and to adjust a time delay between pacing of the right ventricle and pacing of the left ventricle in order to controllably increase or maximize a magnitude of the time rate of change in a closed feedback loop manner.
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Abstract
A system comprising a medical device that includes an impedance measurement circuit adapted to be coupled to implantable electrodes to obtain an intracardiac impedance signal between electrodes, a therapy circuit operable to deliver a therapy to a subject, and a controller circuit coupled to the impedance measurement circuit and the therapy circuit. The controller circuit determines a time rate of change of the intracardiac impedance signal and adjusts at least one parameter related to therapy in a manner that alters the rate of change.
9 Citations
20 Claims
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1. A system comprising a medical device including:
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an impedance measurement circuit adapted to be communicatively coupled to implantable electrodes to provide an intracardiac impedance signal between electrodes; a therapy circuit configured to deliver pacing therapy to a right ventricle and a left ventricle of a subject; and a controller circuit communicatively coupled to the impedance measurement circuit and the therapy circuit, wherein the controller circuit is configured to determine a time rate of change of the intracardiac impedance signal, and to adjust a time delay between pacing of the right ventricle and pacing of the left ventricle in order to controllably increase or maximize a magnitude of the time rate of change in a closed feedback loop manner. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A system comprising a medical device including:
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an impedance measurement circuit adapted to be coupled to implantable electrodes to obtain an intracardiac impedance signal between electrodes; a therapy circuit configured to deliver pacing therapy to a subject; and a controller circuit communicatively coupled to the impedance measurement circuit and the therapy circuit, wherein the controller circuit is configured to; determine a time rate of change of the intracardiac impedance signal; derive a time duration from a cardiac event to a time of peak wall thickness for a ventricle free wall using the time rate of change of the intracardiac impedance signal; and adjust a therapy parameter provided to the patient to controllably adjust the time duration in a closed feedback loop manner. - View Dependent Claims (10, 11, 12, 13, 14)
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15. A system comprising a medical device including:
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an impedance measurement circuit adapted to be communicatively coupled to a first set of electrodes adapted for placement to correspond to a first impedance vector at a first site of a heart of a subject, and a second set of electrodes adapted for placement to correspond to a different second impedance vector at a second site of the heart, wherein the impedance circuit is configured to provide a first intracardiac impedance signal from the first set of electrodes and a second intracardiac impedance signal from the second set of electrodes; a therapy circuit configured to deliver pacing therapy to a right ventricle and a left ventricle of a subject; and a controller circuit communicatively coupled to the impedance measurement circuit and the therapy circuit, wherein the controller circuit is configured to; derive a time to a peak value of the rate of change of the first intracardiac impedance signal and a time to a peak value of the rate of change of the second intracardiac impedance signal, and adjust a time delay between pacing of the right and left ventricles in a closed loop feedback arrangement to controllably decrease or minimize a difference in the time to peak values. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification