Electromechanical delay (EMD) monitoring devices, systems and methods
First Claim
1. For use with an implantable system, a method for monitoring a patient'"'"'s electromechanical delay (EMD) and arterial blood pressure, the method comprising:
- (a) causing paced cardiac events by delivering sufficient pacing stimulation to cause capture to the patient'"'"'s heart;
(b) using one or more electrodes implanted within and/or on the patient'"'"'s heart to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity while the patient'"'"'s heart is being paced at step (a);
(c) using an implanted sensor or implanted electrodes, remote from the patient'"'"'s heart, to obtain a plethysmography signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart while the patient'"'"'s heart is being paced at step (a);
(d) detecting one or more predetermined features of the CI signal obtained at step (b);
(e) detecting one or more predetermined features of the plethysmography signal obtained at step (c);
(f) determining a value indicative of the patient'"'"'s electromechanical delay (EMD) by determining a time between a pacing stimulation delivered at step (a) and at least one of the one or more predetermined features of the CI signal detected at step (d);
(g) determining a metric indicative of pulse arrival time (PAT) by determining a time between a pacing stimulation delivered at step (a) and at least one of the one or more predetermined features of the plethysmography signal detected at step (e), minus the determined value indicative of EMD; and
(h) estimating the patient'"'"'s arterial blood pressure based on the metric indicative of PAT determined at step (g);
wherein at least one of steps (f), (g) and (h) is/are performed using at least one processor.
1 Assignment
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Accused Products
Abstract
Implantable systems, and methods for use therewith, enable the monitoring of a patient'"'"'s electromechanical delay (EMD) and arterial blood pressure. Paced cardiac events are caused by delivering sufficient pacing stimulation to cause capture. A cardiogenic impedance (CI) signal, indicative of cardiac contractile activity in response to the pacing stimulation being delivered, is obtained. One or more predetermined features of the CI signal are detected, and a value indicative of the patient'"'"'s EMD is determined by determining a time between a delivered pacing stimulation and at least one of the detected one or more features of the CI signal. The value indicative of EMD can be used to more accurately determine metrics indicative of pulse arrival time (PAT), which can be used to estimate arterial blood pressure.
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Citations
10 Claims
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1. For use with an implantable system, a method for monitoring a patient'"'"'s electromechanical delay (EMD) and arterial blood pressure, the method comprising:
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(a) causing paced cardiac events by delivering sufficient pacing stimulation to cause capture to the patient'"'"'s heart; (b) using one or more electrodes implanted within and/or on the patient'"'"'s heart to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity while the patient'"'"'s heart is being paced at step (a); (c) using an implanted sensor or implanted electrodes, remote from the patient'"'"'s heart, to obtain a plethysmography signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart while the patient'"'"'s heart is being paced at step (a); (d) detecting one or more predetermined features of the CI signal obtained at step (b); (e) detecting one or more predetermined features of the plethysmography signal obtained at step (c); (f) determining a value indicative of the patient'"'"'s electromechanical delay (EMD) by determining a time between a pacing stimulation delivered at step (a) and at least one of the one or more predetermined features of the CI signal detected at step (d); (g) determining a metric indicative of pulse arrival time (PAT) by determining a time between a pacing stimulation delivered at step (a) and at least one of the one or more predetermined features of the plethysmography signal detected at step (e), minus the determined value indicative of EMD; and (h) estimating the patient'"'"'s arterial blood pressure based on the metric indicative of PAT determined at step (g); wherein at least one of steps (f), (g) and (h) is/are performed using at least one processor. - View Dependent Claims (2, 3, 4, 5)
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6. An implantable system, comprising:
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a pulse generator configured to generate pacing stimulation sufficient to cause capture, which can be delivered to a patient'"'"'s heart using at least one electrode implanted within or on the patient'"'"'s heart; a cardiogenic impedance measurement circuit configured to obtain a cardiogenic impedance (CI) signal indicative of cardiac contractile activity; an implantable sensor or electrodes configured to obtain a plethysmography signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart while the patient'"'"'s heart is being paced using the pulse generator; an electromechanical delay (EMD) monitor configured to detect one or more predetermined features of a CI signal obtained using the CI measuring circuit while the patient'"'"'s heart is being paced using the pulse generator; and determine a value indicative of the patient'"'"'s electromechanical delay (EMD) by determining a time between a pacing stimulation delivered to the patient'"'"'s heart and at least one of the one or more predetermined features of the CI signal; an arterial pressure monitor configured to detect one or more predetermined features of the plethysmography signal obtained by the implantable sensor or electrodes while the patient'"'"'s heart is being paced using the pulse generator; determine a metric indicative of pulse arrival time (PAT) by determining a time between a pacing stimulation delivered to the patient'"'"'s heart and at least one of the one or more predetermined features of the plethysmography signal, minus the determined value indicative of EMD; and estimate the patient'"'"'s arterial blood pressure based on the metric indicative of PAT. - View Dependent Claims (7, 8, 9, 10)
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Specification