Method and apparatus for closed-loop intermittent cardiac stress augmentation pacing
First Claim
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1. A cardiac rhythm management (CRM) system, comprising:
- one or more sensors to sense one or more physiological signals;
a pacing circuit to deliver cardiac pacing pulses;
a signal analyzer coupled to the one or more sensors, the signal analyzer adapted to produce one or more physiological parameters indicative of progression of heart failure and a level of acute cardiac stress created by delivery of the cardiac pacing pulses during a cardiac stress augmentation pacing sequence using the one or more physiological signals, the one or more physiological parameters including an asynchrony parameter indicative of a degree of cardiac asynchrony;
a pacing controller coupled to the signal analyzer and the pacing circuit, the pacing controller adapted to control the delivery of the cardiac pacing pulses and increase the degree of cardiac asynchrony by adjusting one or more pacing parameters using feedback control using the one or more physiological parameters, the pacing controller including;
a stress augmentation pacing initiator adapted to initiate the cardiac stress augmentation pacing sequence having the one or more pacing parameters and a sequence duration and including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of the cardiac pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which none of the cardiac pacing pulses is delivered;
a stress augmentation pacing timer adapted to time the cardiac stress augmentation pacing sequence; and
a pacing parameter adjuster adapted to adjust the one or more pacing parameters using the one or more physiological parameters.
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Abstract
A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.
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Citations
31 Claims
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1. A cardiac rhythm management (CRM) system, comprising:
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one or more sensors to sense one or more physiological signals; a pacing circuit to deliver cardiac pacing pulses; a signal analyzer coupled to the one or more sensors, the signal analyzer adapted to produce one or more physiological parameters indicative of progression of heart failure and a level of acute cardiac stress created by delivery of the cardiac pacing pulses during a cardiac stress augmentation pacing sequence using the one or more physiological signals, the one or more physiological parameters including an asynchrony parameter indicative of a degree of cardiac asynchrony; a pacing controller coupled to the signal analyzer and the pacing circuit, the pacing controller adapted to control the delivery of the cardiac pacing pulses and increase the degree of cardiac asynchrony by adjusting one or more pacing parameters using feedback control using the one or more physiological parameters, the pacing controller including; a stress augmentation pacing initiator adapted to initiate the cardiac stress augmentation pacing sequence having the one or more pacing parameters and a sequence duration and including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of the cardiac pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which none of the cardiac pacing pulses is delivered; a stress augmentation pacing timer adapted to time the cardiac stress augmentation pacing sequence; and a pacing parameter adjuster adapted to adjust the one or more pacing parameters using the one or more physiological parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A method for operating a cardiac rhythm management (CRM) system, the method comprising:
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sensing one or more physiological signals; producing one or more physiological parameters indicative of progression of heart failure and a level of acute cardiac stress created by delivery of cardiac pacing pulses during a cardiac stress augmentation pacing sequence using the one or more physiological signals, the one or more physiological parameters including an asynchrony parameter indicative of a degree of cardiac asynchrony; delivering the cardiac pacing pulses according to the cardiac stress augmentation pacing sequence having one or more pacing parameters and a sequence duration and including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of the cardiac pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which none of the cardiac pacing pulses is delivered; and increasing the degree of cardiac asynchrony by adjusting the one or more pacing parameters using feedback control using the one or more physiological parameters. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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Specification