Method and apparatus for initiating and delivering cardiac protection pacing

• US 8,396,552 B2
• Filed: 02/02/2011
• Issued: 03/12/2013
• Est. Priority Date: 05/13/2005
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Baynham, Tamara Colette, Spinelli, Julio C., Prinzen, Frits W., Cornelussen, Richard N., Vanagt, Ward Y. R.
• Primary Examiner(s): Layno, Carl H.
• Assistant Examiner(s): MORALES, JON ERIC C
• Application Number:
  US13/019,888
• Publication Number:
  US 20110137363A1
• Time in Patent Office: 769 Days
• Field of Search: 607/2, 607/9
• US Class Current: 607/9
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A pacing system delivers cardiac protection pacing to protect the heart from injuries associated with ischemic events. The pacing system detects an ischemic event and, in response, initiates one or more cardiac protection pacing sequences each including alternative pacing and non-pacing periods. In one embodiment, the pacing system initiates a cardiac protection pacing sequence in response to the detection of the onset of an ischemic event, such that a pacing concurrent conditioning therapy is applied during the detected ischemic event.

Claims

1. A method for delivering pacing pulses, the method comprising:

sensing one or more signals indicative of an ischemic event;

detecting an onset of the ischemic event from the one or more signals;

starting an ischemia time interval when the onset of the ischemic event is detected;

initiating one or more cardiac protection pacing sequences in response to the detection of the onset of the ischemic event, the one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which no pacing pulse is delivered; and

delivering the plurality of pacing pulses during each of the pacing periods,

wherein the one or more cardiac protection pacing sequences include at least one concurrent conditioning sequence, and initiating the one or more cardiac protection pacing sequences includes initiating the at least one concurrent conditioning pacing sequence when the ischemia time interval expires.

2. The method of claim 1, further comprising switching a pacing mode from a chronic pacing mode to a temporary pacing mode when one of the one or more cardiac protection pacing sequence is initiated and switching the pacing mode from the temporary pacing mode to the chronic pacing mode when the one of the one or more cardiac protection pacing sequence is completed, the temporary pacing mode substantially different from the chronic pacing mode.

3. The method of claim 1, further comprising programming the ischemia time interval to a time interval between approximately 15 minutes and 6 hours.

4. The method of claim 1, further comprising:

detecting an arrhythmia; and

suspending the one or more cardiac protection pacing sequences when the arrhythmia is detected.

5. The method of claim 1, comprising delivering the plurality of pacing pulses from an implantable medical device.

6. The method of claim 5, comprising detecting the onset of the ischemic event using the implantable medical device.

7. The method of claim 6, further comprising:

producing an ischemia alert signal using the implantable medical device in response to the detection of the onset of the ischemic event; and

transmitting the ischemia alert signal to an external system communicatively coupled to the implantable medical device.

8. The method of claim 7, further comprising:

receiving one or more commands from a user using the external system; and

initiating the one or more cardiac protection pacing sequences in response to the one or more commands.

9. The method of claim 1, comprising timing the pacing duration in a range of approximately 5 seconds to 10 minutes and the non-pacing duration in a range of approximately 5 seconds to 10 minutes for the at least one concurrent conditioning sequence.

10. A method for delivering pacing pulses, the method comprising:

sensing one or more signals indicative of an ischemic event;

detecting an onset of the ischemic event from the one or more signals;

initiating one or more cardiac protection pacing sequences including at least one concurrent conditioning sequence in response to the detection of the onset of the ischemic event, the one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which no pacing pulse is delivered; and

delivering the plurality of pacing pulses during each of the pacing periods,

wherein initiating the one or more cardiac protection pacing sequences includes initiating the at least one concurrent conditioning sequence when a concurrent conditioning command is received.

11. A method for delivering pacing pulses, the method comprising:

sensing one or more signals indicative of an ischemic event;

detecting an onset of the ischemic event from the one or more signals;

initiating one or more cardiac protection pacing sequences including at least one concurrent conditioning sequence and a plurality of prophylactic preconditioning sequences in response to the detection of the onset of the ischemic event, the one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which no pacing pulse is delivered; and

delivering the plurality of pacing pulses during each of the pacing periods,

wherein initiating the one or more cardiac protection pacing sequences comprises;

initiating the at least one concurrent conditioning sequence; and

initiating the prophylactic preconditioning sequences after the concurrent conditioning sequence is completed.

12. The method of claim 11, wherein initiating the prophylactic preconditioning sequences comprises initiating the prophylactic preconditioning pacing sequences on a periodic basis.

13. The method of claim 12, comprising initiating the prophylactic preconditioning pacing sequences on the periodic basis using a predetermined period in a range of approximately 24 hours to 72 hours.

14. The method of claim 11, wherein initiating the prophylactic preconditioning sequences comprises initiating the prophylactic preconditioning pacing sequences in response to one or more preconditioning commands.

15. The method of claim 11, comprising timing the pacing duration in a range of approximately 1 minute to 30 minutes and the non-pacing duration in a range of approximately 1 minute to 30 minutes for each prophylactic preconditioning sequence of the plurality of prophylactic preconditioning sequences.

16. A method for delivering pacing pulses, the method comprising:

sensing one or more signals indicative of an ischemic event;

detecting an onset of the ischemic event from the one or more signals;

initiating one or more cardiac protection pacing sequences in response to the detection of the onset of the ischemic event, the one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which no pacing pulse is delivered;

switching a pacing mode from a chronic pacing mode to a temporary pacing mode when one of the one or more cardiac protection pacing sequence is initiated, the temporary pacing mode substantially different from the chronic pacing mode, the chronic pacing mode including a pacing mode used in a bradycardia pacing therapy, a cardiac resynchronization therapy, or a remodeling control therapy;

delivering the plurality of pacing pulses during each of the pacing periods; and

switching the pacing mode from the temporary pacing mode to the chronic pacing mode when the one of the one or more cardiac protection pacing sequence is completed.

17. The method of claim 16, wherein the one or more cardiac protection pacing sequences comprises at least one concurrent conditioning sequence, and further comprising initiating the at least one concurrent conditioning pacing sequence when an ischemia time interval expires.

18. The method of claim 17, further comprising starting the ischemia time interval when the onset of the ischemic event is detected.

19. The method of claim 16, wherein the chronic pacing mode comprises the pacing mode used in the bradycardia pacing therapy.

20. The method of claim 16, wherein the chronic pacing mode comprises the pacing mode used in the cardiac resynchronization therapy.

21. The method of claim 16, wherein the chronic pacing mode comprises the pacing mode used in the remodeling control therapy.