Rate smoothing control

• US 8,512,220 B2
• Filed: 06/07/2007
• Issued: 08/20/2013
• Est. Priority Date: 05/26/2000
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Lovett, Eric G., Schwartz, Mark
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US11/759,394
• Publication Number:
  US 20070233201A1
• Time in Patent Office: 2,266 Days
• Field of Search: 607/9, 607 17- 19
• US Class Current: 600/17
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

A rate smoothing function used in implantable pulse generators uses detected triggering events, which cause the rate smoothing function to be activated or deactivated, and detected parameter adjusting events, which cause parameter(s) of the rate smoothing function to be changed. In one example, the activation/deactivation and/or change to the parameters of the rate smoothing function are temporary, and the pre-event state of the rate smoothing function is set to a post-adjusting state, such as after a first time interval. Rate smoothing may be selected, activated or deactivated, or adjusted based on a cardiac signal state, or based on an activity or other physiological sensor signal. The adjusted rate smoothing parameters may include an up-smoothing percentage to limit a speed of pacing rate increase and a down-smoothing percentage to limit a speed of pacing rate drop.

Claims

1. A cardiac pacing system, comprising:

a sensor configured to monitor a physiologic parameter other than intrinsic electrical cardiac depolarizations, the physiologic parameter including a physical activity;

a processing circuit coupled to the sensor, the processing circuit configured to translate the physical activity into an activity level;

a state detector coupled to the processing circuit, the state detector configured to detect a predetermined state of the physiologic parameter and including an activity level detector configured to determine whether the activity level matches the predetermined state of the physiologic parameter by comparing the activity level to one or more predetermined activity levels; and

a controller circuit configured to determine and control a pacing rate, the controller circuit including a rate smoothing module configured to perform rate smoothing that limits a rate of change in the pacing rate, the rate smoothing module coupled to the state detector and configured to receive the physiologic parameter and activate the rate smoothing, deactivate the rate smoothing, or adjust one or more rate smoothing parameters of the rate smoothing in response to a detection of the predetermined state of the physiologic parameter.

2. The system of claim 1, wherein the sensor is configured to provide an indication of a metabolic need for a heart rate.

3. The system of claim 2, wherein the sensor comprises an accelerometer.

4. The system of claim 2, wherein the sensor comprises a respiration sensor.

5. The system of claim 1, wherein the sensor is configured to monitor a cardiac function.

6. The system of claim 5, wherein the sensor comprises a pressure sensor.

7. The system of claim 5, wherein the sensor comprises a cardiac contractility sensor.

8. The system of claim 1, wherein the rate smoothing module is configured to limit a speed of pacing rate increase using a first rate smoothing percentage.

9. The system of claim 8, wherein the rate smoothing module is configured to limit a speed of pacing rate drop using a second rate smoothing percentage.

10. The system of claim 9, wherein the controller circuit further comprises a parameter adjusting event detector configured to detect a parameter adjusting event from the physiologic parameter, and the rate smoothing module is configured to adjust the first rate smoothing percentage and the second rate smoothing percentage in response to a detection of the parameter adjusting event.

11. The system of claim 10, wherein the rate smoothing module is configured to calculate the first rate smoothing percentage and the second rate smoothing percentage using the physiologic parameter.

12. The system of claim 11, wherein the controller circuit further comprises a trigger event detector configured to detect a trigger event from the physiologic parameter, and the rate smoothing module is configured to activate or deactivate the rate smoothing in response to a detection of the trigger event.

13. The system of claim 1, wherein the controller circuit further comprises a trigger event detector configured to detect a trigger event from the physiologic parameter, and the rate smoothing module is configured to activate or deactivate the rate smoothing in response to a detection of the trigger event.

14. The system of claim 1, wherein the rate smoothing module is configured to select a stored rate smoothing algorithm in response to the detection of the predetermined state of the physiologic parameter.

15. The system of claim 1, wherein the rate smoothing module is configured to select a first rate smoothing percentage and a second rate smoothing percentage of the rate smoothing in response to the detection of the predetermined state of the physiologic parameter, the first rate smoothing percentage limiting a degree of pacing rate increase, the second rate smoothing percentage limiting a degree of pacing rate drop.

16. The system of claim 15, wherein the first rate smoothing percentage and the second rate smoothing percentage comprise different percentages.

17. The system of claim 15, wherein the rate smoothing module is configured to select the first rate smoothing percentage and the second rate smoothing percentage based on the activity level.

18. The system of claim 17, wherein the rate smoothing module is configured to set the first rate smoothing percentage and the second rate smoothing percentage to the same value in response to the activity level being below a predetermined activity level of the one or more predetermined activity levels.

19. The system of claim 17, wherein the rate smoothing module is configured to set the first rate smoothing percentage to a relatively large value and the second rate smoothing percentage to a relatively small value in response to the activity level exceeding a predetermined activity level of the one or more predetermined activity levels.

20. The system of claim 17, wherein the activity level detector is configured to determine the activity level falls within predetermined range of activity levels of the one or more predetermined activity levels.

21. The system of claim 1, wherein the rate smoothing module is configured to activate the rate smoothing or adjust the one or more rate smoothing parameters for a programmable time interval.