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Optimization of pacemaker settings with R-wave detection

  • US 9,220,903 B2
  • Filed: 12/16/2014
  • Issued: 12/29/2015
  • Est. Priority Date: 12/16/2013
  • Status: Active Grant
First Claim
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1. A method of optimizing one or more programmer settings of a cardiac pacemaker comprising the steps of:

  • attending to a patient with a cardiac pacemaker having one or more programmable settings;

    measuring the electrical activity of a heart of the patient in the form of an electrocardiogram which plots a sensed voltage difference between electrodes placed noninvasively in the patient'"'"'s skin as a function of time, for each pulse of the heart, the electrocardiogram being characterized in part by a QRS complex having an R-wave;

    simultaneously using a sensor to measure a peripheral pulse waveform of the patient as a function of time;

    for each respective pulse, determining from the electrocardiogram the R-wave of the QRS complex and defining a time corresponding to the R-wave as an R-wave impulse time (TR) for a contracting ventricle;

    for each respective pulse, determining the realization of systolic onset in the detected peripheral pulse waveform and defining the corresponding time as a peripherally measured systolic onset time (T2) for the pulse;

    using TR and T2 to calculate an R-wave surrogate pre-ejection time interval SPET for the pulse;

    presenting information related to the calculated R-wave surrogate pre-ejection interval (SPET); and

    adjusting one or more of the programmable settings for the cardiac pacemaker in an effort to optimize the value of the calculated surrogate pre-ejection time interval SPET for the patient.

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