Demand-based cardiac function therapy
First Claim
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1. A implantable cardiac pacing device, comprising:
- one or more pulse generators for incorporation into a plurality of pacing channels;
one or more cardiac sensing amplifiers for incorporation into sensing channels for detecting cardiac activity;
a controller for controlling the delivery of paces in accordance with a programmed pacing mode;
wherein the controller is programmed to deliver cardiac function therapy for effecting reversal of ventricular remodeling by delivering pacing pulses to one or more stressed or hypertrophied ventricular regions in a manner that pre-excites those region(s) relative to other ventricular regions;
a thoracic impedance sensor configured to measure cardiac output of a patient;
a sensor for measuring an exertion level of the patient;
wherein the controller is programmed to assess the patient'"'"'s cardiac function by comparing the measured cardiac output with the measured exertion level and computing a cardiac function parameter indicative as to whether the patient'"'"'s cardiac output is adequate for the measured exertion level; and
,wherein the controller is programmed to temporarily suspend delivery of cardiac function therapy, assess the patient'"'"'s cardiac function while no cardiac function therapy is being delivered by comparing the cardiac function parameter to a threshold value, continue delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to be inadequate, and cease delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to have improved to a specified extent.
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Abstract
A method and device for delivering cardiac function therapy on a demand basis. An implantable device for delivering cardiac function therapy is programmed to suspend such therapy at periodic intervals or upon command from an external programmer. Measurements related to hemodynamic performance are then taken using one or more sensing modalities incorporated into the device. Based upon these measurements, the device uses a decision algorithm to determine whether further delivery of the cardiac function therapy is warranted.
209 Citations
20 Claims
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1. A implantable cardiac pacing device, comprising:
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one or more pulse generators for incorporation into a plurality of pacing channels; one or more cardiac sensing amplifiers for incorporation into sensing channels for detecting cardiac activity; a controller for controlling the delivery of paces in accordance with a programmed pacing mode; wherein the controller is programmed to deliver cardiac function therapy for effecting reversal of ventricular remodeling by delivering pacing pulses to one or more stressed or hypertrophied ventricular regions in a manner that pre-excites those region(s) relative to other ventricular regions; a thoracic impedance sensor configured to measure cardiac output of a patient; a sensor for measuring an exertion level of the patient; wherein the controller is programmed to assess the patient'"'"'s cardiac function by comparing the measured cardiac output with the measured exertion level and computing a cardiac function parameter indicative as to whether the patient'"'"'s cardiac output is adequate for the measured exertion level; and
,wherein the controller is programmed to temporarily suspend delivery of cardiac function therapy, assess the patient'"'"'s cardiac function while no cardiac function therapy is being delivered by comparing the cardiac function parameter to a threshold value, continue delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to be inadequate, and cease delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to have improved to a specified extent. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A device, comprising:
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means for delivering cardiac function therapy for effecting reversal of ventricular remodeling by delivering pacing pulses to one or more stressed or hypertrophied ventricular regions in a manner that pre-excites those region(s) relative to other ventricular regions; means for measuring cardiac output of a patient; means for measuring an exertion level of the patient; means for assessing the patient'"'"'s cardiac function by comparing the measured cardiac output with the measured exertion level and computing a cardiac function parameter indicative as to whether the patient'"'"'s cardiac output is adequate for the measured exertion level; and
,means for temporarily suspending delivery of cardiac function therapy, assessing the patient'"'"'s cardiac function while no cardiac function therapy is being delivered by comparing the cardiac function parameter to a threshold value, continuing delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to be inadequate, and ceasing delivery of cardiac function therapy if the patient'"'"'s cardiac function is determined to have improved to a specified extent. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification