Systems and methods for improving heart rate kinetics in heart failure patients
First Claim
1. An implantable device, comprising:
- electrodes for electrically coupling to a patient'"'"'s heart;
an activity sensor configured to detect activity of the patient;
a physiologic sensor configured to measure physiologic demand of the patient;
memory configured to store patient profile data, the patient profile data comprising heart rate response data relative to varying workloads established for the patient; and
a processor coupled to the electrodes, activity sensor, physiologic sensor, and memory, the processor configured to determine onset of sustained patient activity and that a heart rate parameter of the patient has reached a steady-state in response to the sustained patient activity, the processor configured to determine a timing relationship between the onset of sustained patient activity and the heart rate parameter reaching the steady-state, and to one or both of initiate and change a pacing therapy based on a comparison of the timing relationship to a stored patient profile of the patient'"'"'s heart rate response to varying workloads indicating slow heart rate response to the sustained patient activity.
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Accused Products
Abstract
Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient'"'"'s heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient'"'"'s heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient'"'"'s intrinsic heart rate based on a profile of the patient'"'"'s heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.
70 Citations
20 Claims
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1. An implantable device, comprising:
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electrodes for electrically coupling to a patient'"'"'s heart; an activity sensor configured to detect activity of the patient; a physiologic sensor configured to measure physiologic demand of the patient; memory configured to store patient profile data, the patient profile data comprising heart rate response data relative to varying workloads established for the patient; and a processor coupled to the electrodes, activity sensor, physiologic sensor, and memory, the processor configured to determine onset of sustained patient activity and that a heart rate parameter of the patient has reached a steady-state in response to the sustained patient activity, the processor configured to determine a timing relationship between the onset of sustained patient activity and the heart rate parameter reaching the steady-state, and to one or both of initiate and change a pacing therapy based on a comparison of the timing relationship to a stored patient profile of the patient'"'"'s heart rate response to varying workloads indicating slow heart rate response to the sustained patient activity. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. An implantable device, comprising:
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electrodes for electrically coupling to a patient'"'"'s heart; an activity sensor configured to detect activity of the patient; a physiologic sensor configured to measure physiologic demand of the patient; memory configured to store patient profile data, the patient profile data comprising heart rate response data relative to varying workloads established for the patient; and a processor coupled to the electrodes, activity sensor, physiologic sensor, and memory, the processor configured to determine onset of sustained patient activity and whether the patient'"'"'s intrinsic heart rate response is slow during a kinetic phase of the onset of the sustained activity based on a timing relationship between the onset of sustained patient activity and a heart rate parameter reaching the steady-state in response to the sustained patient activity, the processor configured to initiate or change a pacing therapy to deliver pacing pulses at a rate above the patient'"'"'s intrinsic heart rate based at least in part on the patient profile data if the patient'"'"'s intrinsic heart rate response during the kinetic phase is determined by the processor to be slow. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19)
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20. An implantable device, comprising:
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means for determining onset of sustained patient activity; means for determining that a heart rate parameter of the patient has reached a steady-state in response to the sustained patient activity; means for determining a timing relationship between the onset of sustained patient activity and the heart rate parameter reaching the steady-state; and means for one or both of initiating and changing a pacing therapy based on a comparison of the timing relationship to a profile of the patient'"'"'s heart rate response to varying workloads indicating slow heart rate response to the sustained patient activity.
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Specification