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Methods and systems for analyzing valve related timing and monitoring heart failure

PACESETTER, INC.
2015
Online Patent

Titel:
Methods and systems for analyzing valve related timing and monitoring heart failure
Autor/in / Beteiligte Person: PACESETTER, INC.
Link:
Veröffentlichung: 2015
Medientyp: Patent
Sonstiges:
  • Nachgewiesen in: USPTO Patent Grants
  • Sprachen: English
  • Patent Number: 9,095,717
  • Publication Date: August 04, 2015
  • Appl. No: 14/010366
  • Application Filed: August 26, 2013
  • Assignees: PACESETTER, INC. (Sylmar, CA, US)
  • Claim: 1. A method for analyzing valve-related mechanical timing, the method comprising: collecting cardiac signals associated with an atrial chamber of interest using an implantable medical device; collecting dynamic impedance (DI) data along an atria-function focused (AFF) vector to form a DI data set, the DI data set including information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest; identifying, from the cardiac signals, an intra-atrial conduction timing (IACT) associated with the atrial chamber of interest; estimating an MF landmark at which the mechanical function of the valve occurs based on the DI data set; analyzing a timing delay between the MF landmark and the IACT; adjusting a therapy, based on the timing delay, to encourage atrial contribution to ventricular filling; and applying the adjusted therapy to one or more chambers of the heart using the implantable medical device.
  • Claim: 2. The method of claim 1 , wherein the identifying includes identifying a feature of interest (FOI) in a P-wave representing an end of the IACT, the analyzing operation further comprising determining, as the time delay, an interval between the FOI in the P-wave and the MF landmark.
  • Claim: 3. The method of claim 1 , wherein the estimating operation includes estimating the MF landmark by determining a timing of an impedance waveform peak associated with the DI data set.
  • Claim: 4. The method of claim 1 , wherein the first chamber represents the right atrium and the MF landmark represents an estimate for one of mitral valve closure (MVC) or mitral valve opening (MVO).
  • Claim: 5. The method of claim 1 , wherein the analyzing comprises analyzing at least one morphologic characteristic of the DI data set to estimate the MF landmark.
  • Claim: 6. The method of claim 1 , further comprising identifying a second timing delay between a peak of a QRS complex from the cardiac signals and the MF landmark, wherein the MF landmark represents opening of an aortic valve, and utilizing the timing delay to monitor progression of heart failure.
  • Claim: 7. The method of claim 1 , wherein the identifying includes determining, from a P-wave, a time between right atrial and left atrial activation, in a single cycle, the total duration constituting the IACT.
  • Claim: 8. The method of claim 1 , further comprising monitoring the timing delay for progression of heart failure.
  • Claim: 9. The method of claim 1 , wherein the collecting of DI data includes utilizing an IMD case electrode and at least one of an SVC electrode and an RA electrode to define the AFF vector and to collect the DI data.
  • Claim: 10. The method of claim 1 , wherein the estimating the MF landmark includes determining, as a morphologic characteristic, at least one of i) a peak, or ii) a maximum negative change per unit time (dZ/dt) of the DI data.
  • Claim: 11. A system for characterizing analyzing valve-related mechanical timing, comprising: inputs configured to collect cardiac signals associated with an atrial chamber of interest; and a processor configured to: collect dynamic impedance data along an atria-function focused (AFF) vector to form a DI data set, the DI data set including information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest; identify, from the cardiac signals, an intra-atrial conduction timing (IACT) associated with the atrial chamber of interest; estimate an MF landmark at which the mechanical function of the valve occurs based on the DI data set; analyze a timing delay between the MF landmark and the IACT; and adjust a therapy, based on the timing delay, to encourage atrial contribution to ventricular filling.
  • Claim: 12. The system of claim 11 , wherein the processor is further configured to identify a feature of interest (FOI) in a P-wave representing an end of the IACT, and to determine, as the time delay, an interval between the FOI in the P-wave and the MF landmark.
  • Claim: 13. The system of claim 11 , wherein the processor is further configured to estimate the MF landmark by determining a timing of an impedance waveform peak associated with the DI data set.
  • Claim: 14. The system of claim 11 , wherein the processor is further configured to estimate for one of mitral valve closure (MVC) or mitral valve opening (MVO) in the right atrium.
  • Claim: 15. The system of claim 11 , wherein the processor is further configured to analyze at least one morphologic characteristic of the DI data set to estimate the MF landmark.
  • Claim: 16. The system of claim 11 , wherein the processor is further configured to identify a second timing delay between a peak of a QRS complex from the cardiac signals and the MF landmark, wherein the MF landmark represents opening of an aortic valve, and utilizing the timing delay to monitor progression of heart failure.
  • Claim: 17. The system of claim 11 , wherein the processor is further configured to determine, from a P-wave, a time between right atrial and left atrial activation, in a single cycle, the total duration constituting the IACT.
  • Claim: 18. The system of claim 11 , wherein the processor is further configured to monitor the timing delay for progression of heart failure.
  • Claim: 19. The system of claim 11 , wherein the inputs are configured to collect DI data includes utilizing an IMD case electrode and at least one of an SVC electrode and an RA electrode to define the AFF vector and to collect the DI data.
  • Claim: 20. The system of claim 11 , wherein the processor is further configured to determine, as a morphologic characteristic, at least one of i) a peak, or ii) a maximum negative change per unit time (dZ/dt) of the DI data.
  • Patent References Cited: 7689283 March 2010 Schecter ; 2003/0181952 September 2003 Jverud et al. ; 2010/0121398 May 2010 Bjorling et al. ; 2010/0152795 June 2010 Schecter ; 2010/0152802 June 2010 Min ; 2011/0237968 September 2011 Blomqvist et al. ; 2013/0079839 March 2013 Lian et al. ; 2014/0276125 September 2014 Hou et al.
  • Primary Examiner: Porter, Jr., Allen

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