Implantable systems and methods for use therewith for monitoring and modifying arterial blood pressure without requiring an intravascular pressure transducer
First Claim
1. For use with an implantable system, a method for monitoring and modifying a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer, the method comprising:
- (a) for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced,(a.1) obtaining a signal indicative of electrical activity of the patient'"'"'s heart, and a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart;
(a.2) detecting one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart, and one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart;
(a.3) determining one or more metrics indicative of pulse arrival time (PAT), each metric indicative of PAT determined by determining a time from one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and
(a.4) estimating the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT;
(b) monitoring changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure wherein the monitoring comprises monitoring a circadian variability of the patient'"'"'s arterial blood pressure; and
(c) modifying the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure, wherein the modifying comprises adjusting at least one pacing parameter and/or pacing configuration to increase the circadian variability if the circadian variability is below a first threshold, and adjusting at least one pacing parameter and/or pacing configuration to decrease the circadian variability if the circadian variability is above a second threshold.
1 Assignment
0 Petitions
Accused Products
Abstract
Embodiments of the present invention are directed to implantable systems, and methods for use therewith, that monitor and modify a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer. In accordance with an embodiment, for each of a plurality of periods of time, there is a determination one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes for the left ventricle to generate a pressure pulsation that travels from the patient'"'"'s aorta to a location remote from the patient'"'"'s aorta. Based on the one or more metrics indicative of PAT, the patient'"'"'s arterial blood pressure is estimated. Changes in the arterial blood pressure are monitored over time. Additionally, the patient'"'"'s arterial blood pressure can be modified by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient'"'"'s arterial blood pressure and/or monitored changes therein.
-
Citations
18 Claims
-
1. For use with an implantable system, a method for monitoring and modifying a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer, the method comprising:
-
(a) for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced, (a.1) obtaining a signal indicative of electrical activity of the patient'"'"'s heart, and a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.2) detecting one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart, and one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.3) determining one or more metrics indicative of pulse arrival time (PAT), each metric indicative of PAT determined by determining a time from one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and (a.4) estimating the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; (b) monitoring changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure wherein the monitoring comprises monitoring a circadian variability of the patient'"'"'s arterial blood pressure; and (c) modifying the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure, wherein the modifying comprises adjusting at least one pacing parameter and/or pacing configuration to increase the circadian variability if the circadian variability is below a first threshold, and adjusting at least one pacing parameter and/or pacing configuration to decrease the circadian variability if the circadian variability is above a second threshold. - View Dependent Claims (2, 3, 4)
-
-
5. For use with an implantable system, a method for monitoring and modifying a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer, the method comprising:
-
(a) for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced, (a.1) obtaining a signal indicative of electrical activity of the patient'"'"'s heart, and a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.2) detecting one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart, and one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.3) determining one or more metrics indicative of pulse arrival time (PAT), each metric indicative of PAT determined by determining a time from one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and (a.4) estimating the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; (b) monitoring changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure; and (c) modifying the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure; wherein; step (b) includes monitoring a circadian variability pattern of the patient'"'"'s arterial blood pressure; and step (c) includes adjusting at least one pacing parameter and/or pacing configuration to cause the circadian variability pattern of the patient'"'"'s arterial blood pressure to track a predetermined circadian variability pattern.
-
-
6. For use with an implantable system, a method for monitoring and modifying a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer, the method comprising:
-
(a) for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced, (a.1) obtaining a signal indicative of electrical activity of the patient'"'"'s heart, and a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.2) detecting one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart, and one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.3) determining one or more metrics indicative of pulse arrival time IPAT), each metric indicative of PAT determined by determining a time from one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and (a.4) estimating the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; (b) monitoring changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure; and (c) modifying the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure; wherein; step (a) also includes monitoring changes in the patient'"'"'s activity level; and step (c) includes adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure and based on the monitored changes in the patient'"'"'s activity level. - View Dependent Claims (7)
-
-
8. For use with an implantable system, a method for monitoring and modifying a patient'"'"'s arterial blood pressure without requiring an intravascular pressure transducer, the method comprising:
-
(a) for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced, (a.1) obtaining a signal indicative of electrical activity of the patient'"'"'s heart, and a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.2) detecting one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart, and one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; (a.3) determining one or more metrics indicative of pulse arrival time (PAT), each metric indicative of PAT determined by determining a time from one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and (a.4) estimating the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; (b) monitoring changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure; and (c) modifying the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure; wherein; step (a) also includes monitoring changes in the patient'"'"'s body position; and step (c) includes adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure and based on the monitored changes in the patient'"'"'s body position. - View Dependent Claims (9, 10)
-
-
11. An implantable system configured to monitor and modify a patient'"'"'s arterial blood pressure without an intravascular pressure transducer, the system comprising:
-
one or more pulse generator configured to pace the patient'"'"'s heart; one or more sensing circuit configured to obtaining a signal indicative of electrical activity of the patient'"'"'s heart; a plethysmography sensor configured to obtain a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; a monitor configured to, for each of a plurality of periods of time per day during which the patient'"'"'s heart is being paced, detect one or more predetermined features of the signal indicative of electrical activity of the patient'"'"'s heart; detect one or more predetermined features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; determine one or more metrics indicative of pulse arrival time (PAT) by determining a time from at least one of the detected features of the signal indicative of electrical activity of the patient'"'"'s heart to at least one of the detected features of the signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; and estimate the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; wherein the monitor is also configured to monitor changes in the patient'"'"'s arterial blood pressure based on the estimates of the patient'"'"'s arterial blood pressure; and a controller configured to modify the patient'"'"'s arterial blood pressure by adjusting at least one pacing parameter and/or pacing configuration based on the monitored changes in the patient'"'"'s arterial blood pressure. - View Dependent Claims (12, 13, 14, 15, 16, 17)
-
-
18. An implantable system configured to monitor and modify a patient'"'"'s arterial blood pressure without an intravascular pressure transducer, the system comprising:
-
one or more sensing circuit configured to obtaining a signal indicative of electrical activity of the patient'"'"'s heart; a plethysmography sensor configured to obtain a signal indicative of changes in arterial blood volume remote from the patient'"'"'s heart; a monitor configured to, for each of a plurality of periods of time, determine one or more metrics indicative of pulse arrival time (PAT), each of which are indicative of how long it takes a pulse wave to travel from the patient'"'"'s aorta to a location remote from the patient'"'"'s aorta; and estimate the patient'"'"'s arterial blood pressure based on at least one of the one or more metrics indicative of PAT; a controller configured to modify the patient'"'"'s arterial blood pressure by initiating and/or adjusting pacing and/or other therapy based on the estimates of the patient'"'"'s arterial blood pressure and/or changes therein.
-
Specification