Method and apparatus for assessing cardiac functional status
First Claim
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1. A method for operating a cardiac management device, comprising:
- measuring a moving average over a specified averaging period of exertion levels attained by a patient during daily activities;
extracting daily maximal exertion levels from the measured moving average exertion levels for a specified number of days;
classifying the patient'"'"'s cardiac functional status based upon the daily maximum daily exertion levels; and
, performing a testing sequence in which different pacing schemes are tried for predetermined periods and a patient'"'"'s functional status is assessed for each scheme tried.
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Abstract
A method for assessing cardiac function suitable for incorporation into an implantable cardiac rhythm management device. By measuring daily exertion levels in accordance with the invention, an assessment of cardiac function can be made that has been found to correlate well with conventional clinical classifications. The invention also provides for assessing cardiac function in conjunction with different pacing schemes designed to treat heart failure and using the assessment to select the best such scheme for the patient.
46 Citations
20 Claims
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1. A method for operating a cardiac management device, comprising:
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measuring a moving average over a specified averaging period of exertion levels attained by a patient during daily activities;
extracting daily maximal exertion levels from the measured moving average exertion levels for a specified number of days;
classifying the patient'"'"'s cardiac functional status based upon the daily maximum daily exertion levels; and
,performing a testing sequence in which different pacing schemes are tried for predetermined periods and a patient'"'"'s functional status is assessed for each scheme tried. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
performing a test sequence in which different therapies capable of being delivered by the device are tried while maximal exertion levels associated with the therapy are measured; and
,automatically reconfiguring device parameter settings to select the optimum therapy for delivery by the device in accordance with the measured exertion levels.
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12. The method of claim 11 wherein the device is a cardiac pacemaker and the different therapies are pacing schemes.
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13. The method of claim 1 further comprising computing and storing averages of daily maximal exertion levels over a specified period of time.
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14. The method of claim 1 further comprising automatically adjusting a pacing scheme of the device based upon the extracted maximal exertion levels.
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15. A cardiac rhythm management device, comprising:
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sensing channels for sensing atrial and ventricular depolarization signals, each channel including an electrode and a sense amplifier;
a pulse generator for delivering pacing pulses to the atrium and/or ventricle;
an exertion level sensor; and
,a processor for controlling the delivery of pacing pulses in response to elapsed time intervals and detected depolarization signals in accordance with a programmed mode, wherein the processor is programmed to;
measure a moving average over a specified averaging period of exertion levels attained by the patient during daily activities;
extract daily maximal exertion levels from the measured moving average exertion levels for a specified number of days;
classify the patient'"'"'s cardiac functional status based upon the daily maximum daily exertion levels;
perform a testing sequence in which different pacing schemes are tried for predetermined periods and a patient'"'"'s functional status is assessed for each scheme tried. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification