US 8,571,652 B2 · Adaptive determination of patient specific optimal AV delay during elevated heart rates based on cardiac output measurements

Abstract

Adaptively creating a table of optimal, patient-specific atrioventricular (AV) delays for a an implantable medical device (IMD) begins as the IMD detects the patient entering a target heart rates within a defined range of elevated heart rates. On detection, the device begins testing AV delays by pacing the heart at a number of different AV delays. The IMD selects the optimal AV delay based on a comparison of measurements of cardiac output obtained during each delay's test pacing period. The optimal AV delay corresponds to the one which resulted in the highest cardiac output. The device selects this optimal AV delay and stores it in an AV delay table on the device. The process continues as the device detects the patient entering the other target heart rates in order to complete the table.

Claims20

Dependent claims

A method for optimizing atrioventricular (AV) delay in elevated heart rates, said method comprising:

measuring a heart rate from an implantable medical device (IMD);
responsive to said heart rate falling within a target range of elevated heart rates, pacing a heart by said IMD using a plurality of AV delays, wherein each of said plurality of AV delays is different than another of said plurality of AV delays;
measuring a cardiac output of said heart during said pacing at each of said plurality of AV delays wherein measuring the cardiac output comprises determining aortic arch blood flow;
selecting an optimal AV delay of said plurality of AV delays, wherein said optimal AV delay corresponds to one of said plurality of AV delays producing a highest cardiac output;
and
storing said optimal AV delay and said heart rate in an optimal AV delay table on said IMD.

3 more elements

An implantable medical device (IMD) comprising:

a heart rate sensor;
at least one cardiac pacing lead;
at least one cardiac output sensor;
a programmable microcontroller coupled to said heart rate sensor, to said at least one cardiac pacing lead, and to said at least one cardiac output sensor, wherein said programmable microcontroller controls operation of said IMD;
a memory coupled to said programmable microcontroller;
an atrioventricular (AV) delay optimization feature module stored on said memory, wherein, when executed by said programmable microcontroller, said AV delay optimization feature module configures said IMD:
to measure a heart rate of a heart associated with said IMD;
to operate, responsive to said heart rate falling within a target range of elevated heart rates stored in an optimal AV table on said memory, said at least one cardiac pacing lead to pace said heart using a plurality of AV delays, wherein each of said AV delays is different than another of said plurality of AV delays;
to operate said at least one cardiac output sensor to measure a cardiac output of said heart during said pacing at each of said plurality of AV delays by determining aortic arch blood flow values at each of the plurality of AV delays;
to select an optimal AV delay of said plurality of AV delays, wherein said optimal AV delay corresponds to one of said plurality of AV delays producing a highest cardiac output;
and
to store said optimal AV delay in said optimal AV table associated with said heart rate.

9 more elements

A system that optimizes atrioventricular (AV) delay in elevated heart rates, said system comprising:

means for measuring a heart rate from an implantable medical device (IMD);
means, executable responsive to said heart rate falling within a target range of elevated heart rates, for pacing a heart by said IMD using a plurality of AV delays, wherein each of said plurality of AV delays is different from another of said plurality of AV delays;
means for measuring a cardiac output of said heart during said pacing at each of said plurality of AV delays comprising means for determining aortic arch blood flow;
means for selecting an optimal AV delay of said plurality of AV delays, wherein said optimal AV delay corresponds to one of said plurality of AV delays producing a highest cardiac output;
and
means for storing said optimal AV delay and said heart rate in an optimal AV delay table on said IMD.

3 more elements

Dependencies are inferred from the claim text.

Adaptive determination of patient specific optimal AV delay during elevated heart rates based on cardiac output measurements

Life of this patent

Adaptive determination of patient specific optimal AV delay during elevated heart rates based on cardiac output measurements

Life of this patent

Abstract

Claims20