WO2002007814B1 - An estimate of efficiency using acceleration - heart rate ratio - Google Patents

An estimate of efficiency using acceleration - heart rate ratio

Info

Publication number
WO2002007814B1
WO2002007814B1 PCT/US2001/021833 US0121833W WO0207814B1 WO 2002007814 B1 WO2002007814 B1 WO 2002007814B1 US 0121833 W US0121833 W US 0121833W WO 0207814 B1 WO0207814 B1 WO 0207814B1
Authority
WO
WIPO (PCT)
Prior art keywords
heart rate
acceleration
patient
time period
values
Prior art date
Application number
PCT/US2001/021833
Other languages
French (fr)
Other versions
WO2002007814A1 (en
Inventor
Veerichetty A Kadhiresan
Original Assignee
Cardiac Pacemakers Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiac Pacemakers Inc filed Critical Cardiac Pacemakers Inc
Priority to AU2001273358A priority Critical patent/AU2001273358A1/en
Priority to EP01952625A priority patent/EP1301240A1/en
Publication of WO2002007814A1 publication Critical patent/WO2002007814A1/en
Publication of WO2002007814B1 publication Critical patent/WO2002007814B1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/37—Monitoring; Protecting
    • A61N1/3702—Physiological parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
    • A61N1/36542—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by body motion, e.g. acceleration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method for estimating the efficiency of a patient's body, and specifically for estimating the efficiency of a patient's body while undergoing different cardiac therapies. Acceleration and heart rates of the patient are measured while undergoing various therapies. The acceleration - heart rate ratio for each therapy is calculated. The ratios for each therapy are compared and the therapy that has the highest acceleration - heart rate ratio is determined to be the most efficient. The most efficient therapy allows the patient to have the most acceleration with the lowest corresponding heart rate.

Claims

16
AMENDED CLAIMS
[received by the International Bureau on 22 January 2002 (22.01.02); original claims 1-20 replaced by amended claims 1-10 (4 pages)]
1 A method of pperating a cardiac rhythm management device, said method comprising the steps of:
(a) providing a programmable microprocessor with a program defining a monitoring protocol including.
(i) types of cardiac pacing modes that are to be evaluated;
(ii) a total time period during which an optimum mode for a given patient will be determined; (iii) a plurality of first time periods within said total time period in which the pacing modes are to be tested on the patient; (iv) a plurality of wash-out periods between said first time periods in which no pacing takes place, (v) a plurality of second time periods within said first time periods in which values of acceleration and heart rate are measured,
(b) measuring and storing average acceleration and heart rate values for each second time period within the first time period of a given pacing therapy;
(c) calculating and storing an acceleration - heart rate ratio and resting heart rate value for each second time period during said given pacing mode;
(d) repeating steps (b) and (c) for said given pacing mode until said first time period hasielapsed;
(e) calculating and storing average acceleration - heart rate ratio and average resting heart rate for said given pacing mode;
(f) running the wash-out period after said given pacing mode is tested,
(g) repeating steps (b), (c), (d), (e) and (f) for each pacing mode that is to be tested;
(h) comparing the average acceleration - heart rate ratios and resting heart rate values from the pacing modes that were tested; and 17
(i) determining the best pacing as the one exhibiting the highest average acceleration - heart rate ratio.
2. The method as defined in claim 1 wherein said implantable cardiac rhythm management device includes a closed loop switch that is enabled after the acceleration - heart rate ratios have been compared and said closed loop switch chooses and automatically programs the microprocessor with the mode yielding the highest acceleration - heart ratio.
3. A method of determining a heart rate that a chronotropically incompetent patient should have to correspond to a certain acceleration, comprising the steps of:
(a) measuring the patient's acceleration and heart rate;
(b) increasing heart rate of the patient during exercise activity up to a point that the heart rate no longer increases;
(c) extrapolating the acceleration values and heart rate values of the patient to determine the heart rate that is necessary for any acceleration.
4. An implantable cardiac rhythm management device capable of operating in a plurality of modes, comprising:
(a) means in the device for measuring acceleration of a patient in whom the device is implanted and producing an electrical signal proportional thereto;
(b) means for measuring heart rate of the patient and producing an electrical signal proportional thereto;
(c) means for storing values corresponding to the acceleration and heart rate measurements;
(d) means for calculating average values of acceleration and heart rate and ratios of acceleration to heart rate;
(e) means in the device for comparing the values and the ratios obtained from different ones of said operating modes and determining which mode is the best for the patient; and
(f) means for displaying the average values and the ratios. 18
5. The apparatus as defined in claim 4 wherein the means for measuring heart rate is electrodes on a pacing lead of said implantable cardiac rhythm management device.
6. The apparatus defined in claim 4 wherein the means for measuring acceleration is an accelerometer contained within a housing of said implantable device
7 The apparatus as defined in claim 4 wherein the means for displaying values is a monitor.
8 The apparatus as defined in claim 4 wherein the means for storing, computing and comparing is a microprocessor.
9. The apparatus as defined in claim 8 and further comprising a pulse generator in said implantable cardiac rhythm management device that is controlled by the microprocessor to generate pulses at a determined rate
10. A method of optimizing an operating mode of an implantable cardiac stimulating device of a type having a means for sensing a patient's heart rate and physical activity, a microprocessor-based controller having a memory operatively coupled thereto, said microprocessor-based controller being programmed to control a source of cardiac stimulating pulses to deliver stimulating pulses to the patient's heart at selected ones of a plurality of sites and at predetermined time intervals, comprising the steps of
(a) programming the microprocessor-based controller to cause the source of cardiac stimulating pulses to apply stimulating pulses to a first selected one of the plurality of sites at first predetermined time intervals over a first defined time period,
(b) sensing the patient's heart rate and physical activity and creating an efficiency index as a ratio of physical activity to heart rate at times within the first defined time period;
(c) storing the efficiency index in the memory at said time within the first defined time period;
(d) repeating steps (a) - (c) following a predetermined second time period during which no cardiac stimulating pulses are applied to the patient's heart, but with one of the sites and predetermined time intervals being changed;
(e) repeating step (d) a predetermined number of times; and 19
(f) comparing the average of efficiency indices stored in the memory for each of the first defined time periods resulting when step (d) is repeated to determined the particular site and predetermined time interval resulting in the largest average efficiency index.
20
STATEMENT UNDER ARTICLE 19(1)
The replacement pages 12-15 containing claims 1- 10 are intended to replace the originally submitted pages 12-15 containing claims 1-20 Claims 1-9 contain modifications intended to clarify and more concisely describe the invention, including differences from references cited These claims are consistent with the claims of the application to which this application claims priority.
The newly presented amended claims are believed to be within the scope of the invention described in the specification and, in addition to capturing the inventive concept more concisely, the amended claims enhance the definition over the reference cited in category "X" in the
PCT/US2001/021833 2000-07-21 2001-07-11 An estimate of efficiency using acceleration - heart rate ratio WO2002007814A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2001273358A AU2001273358A1 (en) 2000-07-21 2001-07-11 An estimate of efficiency using acceleration - heart rate ratio
EP01952625A EP1301240A1 (en) 2000-07-21 2001-07-11 An estimate of efficiency using acceleration - heart rate ratio

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/621,389 US6459934B1 (en) 2000-07-21 2000-07-21 Estimate of efficiency using acceleration-heart rate ratio
US09/621,389 2000-07-21

Publications (2)

Publication Number Publication Date
WO2002007814A1 WO2002007814A1 (en) 2002-01-31
WO2002007814B1 true WO2002007814B1 (en) 2002-04-04

Family

ID=24489960

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2001/021833 WO2002007814A1 (en) 2000-07-21 2001-07-11 An estimate of efficiency using acceleration - heart rate ratio

Country Status (4)

Country Link
US (1) US6459934B1 (en)
EP (1) EP1301240A1 (en)
AU (1) AU2001273358A1 (en)
WO (1) WO2002007814A1 (en)

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Also Published As

Publication number Publication date
US6459934B1 (en) 2002-10-01
AU2001273358A1 (en) 2002-02-05
EP1301240A1 (en) 2003-04-16
WO2002007814A1 (en) 2002-01-31

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