Method for assessing cardiac functional status
First Claim
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1. A cardiac rhythm management device, comprising:
- 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 perform a method comprising;
measuring a moving average over a specified averaging period of exertion levels attained by the patient during daily activities;
extracting daily maximal exertion levels from the measured moving average exertion levels for a specified number of days; and
classifying the patient'"'"'s cardiac functional status based upon the daily maximum daily exertion levels.
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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.
31 Citations
26 Claims
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1. 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 perform a method comprising;
measuring a moving average over a specified averaging period of exertion levels attained by the patient during daily activities;
extracting daily maximal exertion levels from the measured moving average exertion levels for a specified number of days; and
classifying the patient'"'"'s cardiac functional status based upon the daily maximum daily exertion levels. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A system for assessing a patent'"'"'s cardiac functional status, comprising:
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a sensor adapted to measure an exertion level; and
a processor, coupled to the sensor, the processor adapted to;
calculate a moving averaged exertion level from the measured exertion level over a specified averaging period;
extract a maximal exertion level from the moving averaged exertion levels calculated over a first duration, the first duration including a plurality of the specified averaging periods; and
classify the patient'"'"'s cardiac functional status based on the maximal exertion durations extracted over a second duration, the second duration including a plurality of the first durations. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A cardiac rhythm management device, comprising:
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a first sensing channel adapted to sense a first cardiac signal;
a first pacing channel adapted to deliver pacing pulses to a first cardiac site;
a second sensing channel adapted to sense a second cardiac signal;
a second pacing channel adapted to deliver pacing pulses to a second cardiac site;
a first sensor adapted to measure a first exertion level;
a processor, coupled to the first and second sensing channels, the first and second pacing channels, and the first sensor, the processor adapted to;
calculate a moving average exertion level from the measured exertion level over a specified averaging period;
extract a maximal exertion level from the moving average exertion levels calculated over a first duration, the first duration including a plurality of the specified averaging periods;
classify the patient'"'"'s cardiac functional status based on the maximal exertion durations extracted over a second duration, the second duration including a plurality of first durations; and
control the delivery of the pacing pulses based on at least the first and second cardiac signals and a programmed pacing mode. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26)
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Specification