Systems and methods for using pulmonary artery pressure from an implantable sensor to detect mitral regurgitation and optimize pacing delays
First Claim
1. A method for use with an implantable pulmonary artery pressure sensor and an implantable cardiac rhythm management device (CRMD) for implant within a patient, the method comprising:
- sensing a pulmonary artery pressure (PAP) signal representative of variations in PAP occurring during individual cardiac cycles within the patient;
detecting a rate of change of the PAP signal with time (dPAP/dt);
detecting a maximum in the dPAP/dt signal (dPAP/dt|max) and a minimum in the dPAP/dt signal (dPAP/dt|min) within a portion of the PAP signal corresponding to an individual cardiac cycle; and
examining the dPAP/dt signal within a window between dPAP/dt|max and dPAP/dt|min to detect regurgitation peaks, if present, within the PAP signal;
detecting mitral regurgitation (MR) based on the presence of a regurgitation peak in the PAP signal;
detecting a pulmonary artery systole (PAS) peak within the PAP signal corresponding to a cardiac cycle;
detecting a delay interval between the PAS peak and the regurgitation peak; and
adjusting a cardiac pacing parameter based, at least in part, on the delay interval.
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Accused Products
Abstract
Techniques are provided for use with a pulmonary artery pressure (PAP) monitor having an implantable PAP sensor. In one example, a PAP signal is sensed that is representative of beat-by-beat variations in PAP occurring during individual cardiac cycles of the patient. The PAP monitor detects peaks within the PAP signal corresponding to valvular regurgitation within the heart, then detects mitral regurgitation (MR) based on the peaks. In other examples, the PAP monitor optimizes pacing parameters based on the PAP signal and corresponding electrical cardiac signals. Examples are provided where the PAP monitor is an external system and other examples are provided where the PAP monitor is a component of an implantable cardiac rhythm management device.
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Citations
22 Claims
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1. A method for use with an implantable pulmonary artery pressure sensor and an implantable cardiac rhythm management device (CRMD) for implant within a patient, the method comprising:
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sensing a pulmonary artery pressure (PAP) signal representative of variations in PAP occurring during individual cardiac cycles within the patient; detecting a rate of change of the PAP signal with time (dPAP/dt); detecting a maximum in the dPAP/dt signal (dPAP/dt|max) and a minimum in the dPAP/dt signal (dPAP/dt|min) within a portion of the PAP signal corresponding to an individual cardiac cycle; and examining the dPAP/dt signal within a window between dPAP/dt|max and dPAP/dt|min to detect regurgitation peaks, if present, within the PAP signal; detecting mitral regurgitation (MR) based on the presence of a regurgitation peak in the PAP signal; detecting a pulmonary artery systole (PAS) peak within the PAP signal corresponding to a cardiac cycle; detecting a delay interval between the PAS peak and the regurgitation peak; and adjusting a cardiac pacing parameter based, at least in part, on the delay interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method for use with an implantable pulmonary artery pressure sensor and an implantable cardiac rhythm management device (CRMD) for implant within a patient, the method comprising:
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sensing a pulmonary artery pressure (PAP) signal representative of variations in PAP occurring during individual cardiac cycles within the patient; detecting closure of AV valves within a portion of the PAP signal corresponding to a cardiac cycle; detecting a ventricular depolarization event (R-wave) within an electrical cardiac signal corresponding to the same cardiac cycle subsequent to the detected closure of the AV valves; detecting a delay interval (DeltaTime1) between the closure of AV valves and the R-wave detected subsequent to the detected closure of the AV valve; and adjusting an AV delay based on the delay interval (DeltaTime1). - View Dependent Claims (18, 19)
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20. A method for use with an implantable pulmonary artery pressure sensor and an implantable cardiac rhythm management device (CRMD) for implant within a patient, the method comprising:
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sensing a pulmonary artery pressure (PAP) signal representative of variations in PAP occurring during individual cardiac cycles within the patient; detecting a pulmonary artery systole (PAS) peak within the PAP signal corresponding to a cardiac cycle; detecting an MR peak within the PAP signal corresponding to the same cardiac cycle; detecting a second delay interval (DeltaTime2) between the PAS peak and the MR peak; and adjusting an interventricular (VV) pacing delay based on the second delay interval (DeltaTime2). - View Dependent Claims (21)
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22. A system for use with an implantable pulmonary artery pressure sensor for implant within a patient, the system comprising:
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means for sensing a pulmonary artery pressure (PAP) signal representative of variations in PAP occurring during cardiac cycles of the patient; means for detecting a rate of change of the PAP signal with time (dPAP/dt), detecting a maximum in the dPAP/dt signal (dPAP/dt|max) and a minimum in the dPAP/dt signal (dPAP/dt|min) within a portion of the PAP signal corresponding to an individual cardiac cycle and examining the dPAP/dt signal within a window between dPAP/dt|max and dPAP/dt|min to detect; means for detecting a regurgitation peak, if present, within the PAP signal; means for detecting mitral regurgitation (MR) in the patient based on the MR peaks in the PAP signal; means for detecting a pulmonary artery systole (PAS) peak within the PAP signal corresponding to a cardiac cycle; means for detecting a delay interval between the PAS peak and the regurgitation peak; and means for adjusting a cardiac pacing parameter based, at least in part, on the delay interval.
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Specification