Systems and methods for evaluating ventricular dyssynchrony using atrial and ventricular pressure measurements obtained by an implantable medical device

• US 9,414,754 B1
• Filed: 08/10/2011
• Issued: 08/16/2016
• Est. Priority Date: 11/08/2006
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Shelchuk, Anne M.
• Primary Examiner(s): Berhanu, Etsub
• Assistant Examiner(s): TOTH, KAREN E
• Application Number:
  US13/207,302
• Time in Patent Office: 1,833 Days
• Field of Search: 600481-508
• US Class Current: 1/1
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/02158 provided with two or more sensor elements
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation

Abstract

Techniques are provided for exploiting left atrial pressure (LAP) measurements to determine various ventricular mechanical and electromechanical contraction intervals and for evaluating ventricular dyssynchrony based on those intervals. In one example, LAP measurements are combined with right ventricular pressure (RVP) measurements to determine the interventricular mechanical delay, which is the primary parameter representative of ventricular dyssynchrony. Other intervals determined based, in part, on LAP measurements include the electromechanical delay for the left ventricle (LV), as well as the LV systolic and diastolic intervals. Techniques are also described herein for detecting various RV intervals including the electromechanical delay for the RV, as well as the RV systolic and diastolic intervals.

Claims

1. A system for use with an implantable medical device for determining ventricular contraction intervals, the system comprising:

means for detecting a left atrial pressure (LAP) signal;

means for identifying a c-wave and a v-wave in the LAP signal;

means for determining a left ventricular (LV) systolic interval based in part on a time interval between the c-wave and the v-wave of the LAP signal; and

means for modifying therapy delivered by the implantable medical device based on the LV systolic interval.

2. A system for use with an implantable medical device for determining ventricular contraction intervals, the system comprising:

means for detecting a left atrial pressure (LAP) signal;

means for detecting a left ventricular (LV) electrical cardiac signal using at least one LV electrode;

means for determining a left ventricular diastolic interval based on a comparison of the LAP signals and the LV electrical cardiac signal; and

means for modifying therapy delivered by the device based on the LV diastolic interval.

3. The system of claim 2 wherein the means for detecting the LV electrical cardiac signal comprises means for identifying an R_L-R_L interval therein and wherein the means for detecting the LAP signal includes means for identifying both a c-wave and a v-wave therein and for determining a c-v time interval therebetween and wherein the means for determining the LV diastolic interval comprises means for determining the LV diastolic interval based on a difference between the R_L-R_L interval of the LV electrical signal and the c-v time interval of the LAP.

4. A method for use with an implantable media device for determining ventricular contraction intervals, the method comprising

detecting a left atrial pressure (LAP) signal;

identifying a c-wave and a v-wave in the LAP signal;

determining a left ventricular (LV) systolic interval based at least in part on a time interval between the c-wave and the v-wave of the LAP signal;

modifying therapy delivered by the implantable medical device based on the LV systolic interval.

5. A method for use with an implantable medical device for determining ventricular contraction intervals, the method comprising

detecting a left atrial pressure (LAP) signal;

detecting a left ventricular (LV) electrical cardiac signal using at least one LV electrode;

determining a left ventricular diastolic interval based on a comparison of the LAP signals and the LV electrical cardiac signal; and

modifying therapy delivered by the implantable medical device based on the left ventricular diastolic interval.

6. The method of claim 5 wherein detecting the LV electrical cardiac signal comprises identifying an R_L-R_L interval therein and wherein detecting the LAP signal includes identifying both a c-wave and a v-wave therein and determining a c-v time interval therebetween and wherein determining the LV diastolic interval comprises determining the LV diastolic interval based on a difference between the R_L-R_L interval of the LV electrical signal and the c-v time interval of the LAP.