Optimization of pacemaker settings
First Claim
1. A method of optimizing one or more programmer settings of a cardiac pacemaker comprising the steps of:
- attending to a patient with a cardiac pacemaker having one or more programmable settings;
measuring the electrical activity of a heart of the patient in the form of an electrocardiogram which plots a sensed voltage difference between electrodes placed noninvasively on the patient'"'"'s skin as a function of time, for each pulse of the heart, the electrocardiogram being characterized in part by a Q-wave;
simultaneously using a sensor to measure a peripheral pressure waveform of the patient as a function of time;
for each respective pulse, determining from the electrocardiogram a Q-wave and defining a corresponding time as an initial impulse time (T0) for a contracting ventricle;
for each respective pulse, determining the realization of systolic onset in the detected peripheral pressure waveform and defining the corresponding time as a peripherally measured systolic onset time (T2) for the pulse;
using T0 and T2 to calculate a surrogate pre-ejection time interval SPET for the pulse;
presenting information related to the calculated surrogate pre-ejection interval SPET; and
adjusting one or more of the programmable settings for the cardiac pacemaker in an effort to optimize the value of the calculated surrogate pre-ejection time interval SPET for the patient.
1 Assignment
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Accused Products
Abstract
The system provides information to facilitate efficient optimization of programmer settings for cardiac pacemakers. It uses simultaneous measurement of a patient'"'"'s electrocardiogram and peripheral blood pressure waveform in order to calculate, in real-time, a value correlated to the patient'"'"'s pre-ejection time (PET) and, optionally, ejection duration (ED) for the patient'"'"'s left ventricle. The peripheral blood pressure waveform is preferably monitored with a wrist mounted tonometer. Data including the electrocardiogram and peripheral blood pressure trace, as well as the surrogate pre-ejection time interval (SPET) for each heart beat and trending is displayed on a computer monitor, thereby allowing a physician or nurse to quickly optimize PET for the patient and adjusting programmer settings for an implanted pacemaker.
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Citations
22 Claims
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1. A method of optimizing one or more programmer settings of a cardiac pacemaker comprising the steps of:
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attending to a patient with a cardiac pacemaker having one or more programmable settings; measuring the electrical activity of a heart of the patient in the form of an electrocardiogram which plots a sensed voltage difference between electrodes placed noninvasively on the patient'"'"'s skin as a function of time, for each pulse of the heart, the electrocardiogram being characterized in part by a Q-wave; simultaneously using a sensor to measure a peripheral pressure waveform of the patient as a function of time; for each respective pulse, determining from the electrocardiogram a Q-wave and defining a corresponding time as an initial impulse time (T0) for a contracting ventricle; for each respective pulse, determining the realization of systolic onset in the detected peripheral pressure waveform and defining the corresponding time as a peripherally measured systolic onset time (T2) for the pulse; using T0 and T2 to calculate a surrogate pre-ejection time interval SPET for the pulse; presenting information related to the calculated surrogate pre-ejection interval SPET; and adjusting one or more of the programmable settings for the cardiac pacemaker in an effort to optimize the value of the calculated surrogate pre-ejection time interval SPET for the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A system to facilitate optimization of programmable cardiac pacemaker settings during cardiac resynchronization therapy, the system comprising:
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a blood pressure sensor adapted to detect a peripheral pressure waveform of a cardiac pacemaker patient; an electrocardiogram unit having electrodes that are placed on the patient, the ECG unit measuring the electrical activity of the patient'"'"'s heart in the form of an electrocardiogram which is, for each pulse of the heart, characterized in part by a Q-wave; a screen display; and a computer processor programmed with software to implement the following steps; for each respective pulse, determining from the electrocardiogram Q-wave and defining the corresponding time as an initial impulse time (T0) for a contracting ventricle; for each respective pulse, determining systolic onset of the detected peripheral pressure wave and defining the corresponding time as a peripherally measured systolic onset time (T2) for the pulse; and using (T0) and (T2) to calculate a surrogate pre-ejection time interval SPET; and displaying information on the screen relating to the calculated surrogate pre-ejection time interval SPET. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22)
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Specification