Pacemaker with vagal surge monitoring and response
First Claim
1. A system for pacing a heart, comprising:
- a monitoring circuit including;
a monitoring timer configured to initiate and time a monitoring interval including an anticipated duration of vagal surge resulting from a delivery of a first therapy;
a sensing circuit configured to sense one or more physiological signals each indicative of a level of the vagal surge, the one or more physiological signals including at least a cardiac signal; and
a detection circuit configured to detect one or more parameters each indicative of the level of the vagal surge using the sensed one or more physiological signals, the one or more parameters including at least an intrinsic heart rate;
a pacing output circuit configured to deliver a second therapy including delivering pacing pulses, the second therapy different from the first therapy; and
a pacing control circuit coupled to the monitoring circuit and the pacing output circuit, the pacing control circuit configured to control the delivery of the second therapy using pacing parameters and including;
a response timer configured to initiate and time a response interval following the delivery of the first therapy, the response interval including the anticipated duration of the vagal surge; and
a parameter adjustment module configured to adjust one or more pacing parameters of the pacing parameters to allow the heart to beat at the intrinsic heart rate during the response interval.
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Accused Products
Abstract
A pacemaker initiates and times a monitoring interval in response to an event such as a therapy delivery to a patient. The monitoring interval is specified to include a duration of an anticipated acute response to the event, such as vagal surge. One or more physiological parameters indicative of the acute response are detected during the monitoring interval for analyzing therapeutic effect of the event. In various embodiments, one or more pacing parameters are adjusted for a response interval specified to include the duration of the anticipated acute response to allow for the analysis and maximization of the therapeutic effect. In various embodiments, the event includes a session of pacing therapy delivered according to an intermittent cardiac stress augmentation pacing protocol, and the therapeutic effect is analyzed to adjust that protocol.
178 Citations
40 Claims
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1. A system for pacing a heart, comprising:
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a monitoring circuit including; a monitoring timer configured to initiate and time a monitoring interval including an anticipated duration of vagal surge resulting from a delivery of a first therapy; a sensing circuit configured to sense one or more physiological signals each indicative of a level of the vagal surge, the one or more physiological signals including at least a cardiac signal; and a detection circuit configured to detect one or more parameters each indicative of the level of the vagal surge using the sensed one or more physiological signals, the one or more parameters including at least an intrinsic heart rate; a pacing output circuit configured to deliver a second therapy including delivering pacing pulses, the second therapy different from the first therapy; and a pacing control circuit coupled to the monitoring circuit and the pacing output circuit, the pacing control circuit configured to control the delivery of the second therapy using pacing parameters and including; a response timer configured to initiate and time a response interval following the delivery of the first therapy, the response interval including the anticipated duration of the vagal surge; and a parameter adjustment module configured to adjust one or more pacing parameters of the pacing parameters to allow the heart to beat at the intrinsic heart rate during the response interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A method for operating a system for pacing a heart, comprising:
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delivering a first therapy; sensing a cardiac signal from the heart; delivering a second therapy including delivery of pacing pulses to the heart, the second therapy different from the first therapy; controlling the delivery of the second therapy using pacing parameters; initiating a monitoring interval in response to the delivery of the first therapy, the monitoring interval including an anticipated duration of vagal surge resulting from the delivery of the first therapy; detecting an intrinsic heart rate from the cardiac signal during the monitoring interval; initiating a response interval in response to the delivery of the first therapy, the response interval including the anticipated duration of the vagal surge; and adjusting one or more pacing parameters of the pacing parameters to allow the heart to beat at the intrinsic heart rate during the response interval. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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Specification