Contractility modulation based on impedance signal
First Claim
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1. An implantable medical device, comprising:
- edema detection circuitry configured to sense a condition correlative to edema associated with cardiac dysfunction in a subject; and
therapy delivery circuitry configured to deliver a cardiac therapy in response to said detection, wherein said therapy delivery circuitry provides non-excitatory electrical energy to the heart during a refractory period for the purpose of cardiac contractility modulation.
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Abstract
A cardiac rhythm management system detects edema. In response to an episode of detected edema, it initiates or adjusts a cardiac resynchronization therapy and/or a cardiac contractility modulation (CCM) therapy.
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Citations
26 Claims
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1. An implantable medical device, comprising:
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edema detection circuitry configured to sense a condition correlative to edema associated with cardiac dysfunction in a subject; and therapy delivery circuitry configured to deliver a cardiac therapy in response to said detection, wherein said therapy delivery circuitry provides non-excitatory electrical energy to the heart during a refractory period for the purpose of cardiac contractility modulation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A device adapted to be implanted in a patient, comprising:
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an implantable cardiac rhythm management apparatus including a circuit housing and a plurality of electrodes; a cardiac pacing circuit disposed in the housing and coupled to at least some of the electrodes to deliver pacing therapy to the patient'"'"'s heart; an impedance measurement circuit disposed in the housing, coupled to at least some of the electrodes, and configured to measure a transthoracic impedance of the patient, the impedance measurement circuit including (a) an exciter circuit configured to apply a high frequency test stimulus to the patient'"'"'s thorax, the test stimulus being of a type that does not stimulate tissue or muscle contractions in the thorax, (b) a preamplifier configured to receive a transthoracic response signal associated with the high frequency test stimulus, and configured to provide a preamplifier output as a function thereof, and (c) a demodulator configured to demodulate the preamplifier output; a processor disposed in the housing and being configured to (a) receive the measured transthoracic impedance from the impedance measurement circuit, (b) generate first and second transthoracic impedance signals by averaging the measured transthoracic impedance, the first transthoracic impedance signal being long-term relative to the second transthoracic impedance signal, (c) compare the first and second thoracic impedance signals, and (d) provide an indicator based on the comparison, the indicator relating to fluid buildup in the patient'"'"'s thorax and taking into account a cardiac stroke of said heart; and therapy delivery circuitry configured to modify one or more of a timing parameter, a pulse width parameter and a magnitude parameter of the delivery of cardiac therapy based on the indicator, wherein said cardiac therapy includes the therapeutic delivery of non-excitatory electrical energy to the heart during a refractory period for the purpose of cardiac contractility modulation. - View Dependent Claims (15, 16, 17, 18)
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19. A method of monitoring fluid buildup and providing corrective therapy to a patient, comprising:
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measuring a transthoracic impedance of the patient; determining edema associated with a cardiac dysfunction based on the measured transthoracic impedance; and delivering a corrective cardiac therapy signal based on the determination, wherein said cardiac therapy includes the therapeutic delivery of non-excitatory electrical energy to the heart during a refractory period for the purpose of cardiac contractility modulation. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26)
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Specification