Monitoring short term fluctuations in PR intervals following premature ventricular contractions

• US 8,145,309 B2
• Filed: 02/26/2010
• Issued: 03/27/2012
• Est. Priority Date: 02/17/2005
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Farazi, Taraneh Ghaffari, Park, Euljoon
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): SARCIONE, JESSICA LYNN
• Application Number:
  US12/714,244
• Publication Number:
  US 20100160805A1
• Time in Patent Office: 760 Days
• Field of Search: 607/9, 607 17- 18, 607 25- 26
• US Class Current: 607/25
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Implantable systems, and methods for use therein, perform at least one of a cardiac assessment and an autonomic assessment. Short-term fluctuations in PR intervals, that follow the premature contractions in the ventricles, are monitored. At least one of a cardiac assessment and an autonomic assessment is performed based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles. This can include assessing a patient'"'"'s risk of sudden cardiac death (SCD), assessing a patient'"'"'s autonomic tone and/or detecting myocardial ischemic events based on the monitored fluctuations in PR intervals that follow the premature contractions in the ventricles.

Claims

1. For use with an implantable system, a method of performing at least one of a cardiac assessment and an autonomic assessment, comprising:

(a) monitoring morphology of a signal that is indicative of PR intervals that follow premature ventricular contractions; and

(b) performing, using a processor of the implantable system, at least one of a cardiac assessment and an autonomic assessment, based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

2. The method of claim 1, wherein step (b) comprises assessing a patient'"'"'s risk of sudden cardiac death (SCD) based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

3. The method of claim 1, wherein step (b) comprises assessing a patient'"'"'s autonomic tone based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

4. The method of claim 1, wherein step (b) comprises detecting a myocardial ischemic event based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

5. The method of claim 4, wherein step (b) includes comparing the monitored morphology to a baseline morphology, and detecting a myocardial ischemic event when the monitored morphology differs from the baseline morphology by more than a specified degree.

6. An implantable system for performing at least one of a cardiac assessment and an autonomic assessment, comprising:

means for monitoring morphology of a signal that is indicative of PR intervals that follow premature ventricular contractions; and

means for performing at least one of a cardiac assessment and an autonomic assessment, based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

7. The system of claim 6, wherein the means for performing assesses a patient'"'"'s risk of sudden cardiac death (SCD) based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

8. The system of claim 6 wherein the means for performing assesses a patient'"'"'s autonomic tone based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

9. The system of claim 6, wherein the means for performing detects a myocardial ischemic event based on the monitored morphology of the signal that is indicative of PR intervals that follow premature ventricular contractions.

10. The system of claim 9, wherein the means for performing compares the monitored morphology to a baseline morphology, and detects a myocardial ischemic event when the monitored morphology differs from the baseline morphology by more than a specified degree.