Method, apparatus, and system to optimize cardiac preload based on measured pulmonary artery pressure
First Claim
1. A medical system, comprising:
- one or more electrodes for delivering pacing pulses to a patient'"'"'s heart;
an energy delivery and sensing unit coupled to the one or more electrodes;
a pulmonary artery pressure sensor capable of making pulmonary artery pressure measurements;
a memory configured to store at least the pulmonary artery pressure measurements; and
a controller coupled to the memory, the pulmonary artery pressure sensor, and the energy delivery and sensing unit, the controller configured to,vary, for each repetition of an acute burst protocol, a parameter of pacing applied to the patient'"'"'s heart via the energy delivery and sensing unit during the acute burst protocol;
store the pulmonary artery pressure measurements made during the repetitions of the acute burst protocol; and
provide pacing therapy using a value of the parameter that is selected based on an optimum ventricular preload that is determined via the stored pulmonary artery pressure measurements;
wherein a length of the repetitions is chosen so that the patient'"'"'s baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol.
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Abstract
Optimizing cardiac preload based on measured pulmonary artery pressure involves varying, for each repetition of an acute burst protocol, a parameter of pacing applied to a patient'"'"'s heart during the acute burst protocol. Pulmonary artery pressure is measured during the repetitions of the acute burst protocol. The length of the repetitions is chosen so that the patient'"'"'s baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol. An optimum ventricular preload is determined based on the measured pulmonary artery pressure. Pacing therapy is provided using a value of the parameter that is selected based on the determination of optimum ventricular preload.
51 Citations
15 Claims
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1. A medical system, comprising:
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one or more electrodes for delivering pacing pulses to a patient'"'"'s heart; an energy delivery and sensing unit coupled to the one or more electrodes; a pulmonary artery pressure sensor capable of making pulmonary artery pressure measurements; a memory configured to store at least the pulmonary artery pressure measurements; and a controller coupled to the memory, the pulmonary artery pressure sensor, and the energy delivery and sensing unit, the controller configured to, vary, for each repetition of an acute burst protocol, a parameter of pacing applied to the patient'"'"'s heart via the energy delivery and sensing unit during the acute burst protocol; store the pulmonary artery pressure measurements made during the repetitions of the acute burst protocol; and provide pacing therapy using a value of the parameter that is selected based on an optimum ventricular preload that is determined via the stored pulmonary artery pressure measurements; wherein a length of the repetitions is chosen so that the patient'"'"'s baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A medical system, comprising:
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means for applying pacing to a patient'"'"'s heart for multiple repetitions of an acute burst protocol, wherein a parameter of the pacing is varied for each repetition of the acute burst protocol, and wherein a length of the repetitions is chosen so that the patient'"'"'s baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol; means for measuring pulmonary artery pressure during the repetitions of the acute burst protocol; means for determining an optimum ventricular preload based on the measured pulmonary artery pressure; and means for providing pacing therapy using a value of the parameter of pacing that is selected based on the determination of optimum ventricular preload. - View Dependent Claims (11, 12, 13, 14, 15)
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Specification