| Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection -> Monitor Keywords |
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Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detectionRelated Patent Categories: Surgery: Light, Thermal, And Electrical Application, Light, Thermal, And Electrical Application, Electrical Therapeutic Systems, Heart Rate Regulating (e.g., Pacing), Parameter Control In Response To Sensed Physiological Load On HeartCardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20070118180, Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection. Brief Patent Description - Full Patent Description - Patent Application Claims
FIELD OF THE INVENTION [0001] The present invention relates generally to implantable medical devices and, more particularly, to cardiac sensing and/or stimulation devices with disordered breathing detection. BACKGROUND OF THE INVENTION [0002] The healthy heart produces regular, synchronized contractions. Rhythmic contractions of the heart are normally initiated by the sinoatrial (SA) node, which is a group of specialized cells located in the upper right atrium. The SA node is the normal pacemaker of the heart, typically initiating 60-100 heartbeats per minute. When the SA node is pacing the heart normally, the heart is said to be in normal sinus rhythm. [0003] If the heart's electrical activity becomes uncoordinated or irregular, the heart is denoted to be arrhythmic. Cardiac arrhythmia impairs cardiac efficiency and may be a potential life-threatening event. Cardiac arrhythmias have a number of etiological sources, including tissue damage due to myocardial infarction, infection, or degradation of the heart's ability to generate or synchronize the electrical impulses that coordinate contractions. [0004] Bradycardia occurs when the heart rhythm is too slow. This condition may be caused, for example, by impaired function of the SA node, denoted sick sinus syndrome, or by delayed propagation or blockage of the electrical impulse between the atria and ventricles. Bradycardia produces a heart rate that is too slow to maintain adequate circulation. [0005] When the heart rate is too rapid, the condition is denoted tachycardia. Tachycardia may have its origin in either the atria or the ventricles. Tachycardias occurring in the atria of the heart, for example, include atrial fibrillation and atrial flutter. Both conditions are characterized by rapid contractions of the atria. Besides being hemodynamically inefficient, the rapid contractions of the atria may also adversely affect the ventricular rate. [0006] Ventricular tachycardia occurs, for example, when electrical activity arises in the ventricular myocardium at a rate more rapid than the normal sinus rhythm. Ventricular tachycardia may quickly degenerate into ventricular fibrillation. Ventricular fibrillation is a condition denoted by extremely rapid, uncoordinated electrical activity within the ventricular tissue. The rapid and erratic excitation of the ventricular tissue prevents synchronized contractions and impairs the heart's ability to effectively pump blood to the body, which is a fatal condition unless the heart is returned to sinus rhythm within a few minutes. [0007] Implantable cardiac rhythm management systems have been used as an effective treatment for patients with serious arrhythmias, as well as for patients with conditions such as heart failure. These systems typically include one or more leads and circuitry to sense signals from one or more interior and/or exterior surfaces of the heart. Such systems also include circuitry for generating electrical pulses that are applied to cardiac tissue at one or more interior and/or exterior surfaces of the heart. For example, leads extending into the patient's heart are connected to electrodes that contact the myocardium for sensing the heart's electrical signals and for delivering pulses to the heart in accordance with various therapies for treating arrhythmias. [0008] People with severe cardiopulmonary deficiencies, such as those associated with chronic heart failure and other cardiopulmonary maladies, are particularly susceptible to morbidities associated with disordered breathing conditions such as sleep apnea. Disordered breathing may be caused by a wide spectrum of respiratory conditions involving the disruption of the normal respiratory cycle. Although disordered breathing often occurs during sleep, the condition may also occur while the patient is awake. Respiratory disruption can be particularly serious for patients concurrently suffering from cardiovascular deficiencies, such as congestive heart failure. Unfortunately, disordered breathing is often undiagnosed. If left untreated, the effects of disordered breathing may result in serious health consequences for the patient. [0009] Various types of disordered respiration have been identified, including, for example, apnea, hypopnea, dyspnea, hyperpnea, tachypnea, orthopnea, paroxysmal nocturnal dyspnea, and periodic breathing, including Cheyne-Stokes respiration (CSR). Apnea is a fairly common disorder characterized by periods of interrupted breathing. Apnea is typically classified based on its etiology. One type of apnea, denoted obstructive apnea, occurs when the patient's airway is obstructed by the collapse of soft tissue in the rear of the throat. Central apnea is caused by a derangement of the central nervous system control of respiration. The patient ceases to breathe when control signals from the brain to the respiratory muscles are absent or interrupted. Mixed apnea is a combination of the central and obstructive apnea types. Regardless of the type of apnea, people experiencing an apnea event stop breathing for a period of time. The cessation of breathing may occur repeatedly during sleep, sometimes hundreds of times a night and sometimes for a minute or longer. SUMMARY OF THE INVENTION [0010] The present invention is directed to methods and devices that detect the presence of disordered breathing and a cardiac condition indicative of a patient's cardiac status. Methods and devices of the present invention are further directed to identifying a patient as suitable for a cardiac resynchronization therapy based on the presence of disordered breathing and a cardiac condition indicative of a patient's cardiac status. [0011] According to embodiments of the present invention, the presence of disordered breathing is detected using an implantable medical device. A cardiac condition is detected that is indicative of the patient's cardiac status. Based on the presence of disordered breathing and the cardiac condition, the patient is identified as suitable for a cardiac resynchronization therapy. [0012] Such methods may further involve delivering at least one of a cardiac pacing therapy other than a cardiac resynchronization therapy, a cardiac shock therapy, and a cardiac neurostimulation therapy. Detecting the presence of disordered breathing may involve detecting at least one of obstructive sleep apnea, central sleep apnea, hypopnea, orthopnea, paroxysmal nocturnal dyspnea, and Cheyne-Stokes respiration. [0013] The implantable medical device may be enabled to perform the cardiac resynchronization therapy based on identifying the patient as suitable for the cardiac resynchronization therapy. For example, a pulse generator may be provided in the implantable medical device and coupled to electrodes, and the pulse generator and electrodes may be configured for cardiac resynchronization therapy delivery. One or more of initiating, terminating, adjusting, or optimizing the cardiac resynchronization therapy may be effected in response to detecting the presence of disordered breathing and the cardiac condition. [0014] Detecting the cardiac condition may involve detecting a ventricular dysynchrony in the patient's heart via an implantable or patient-external sensing arrangement. Detecting the cardiac condition may also involve detecting left ventricular systolic dysfunction via an implantable or patient-external sensing arrangement. Detecting the cardiac condition may further involve detecting a left ventricular systolic dysfunction comprising a left ventricular ejection fraction value less than a predetermined limit. Detecting the cardiac condition may involve determining that a QRS complex pulse width of a cardiac cycle exceeds a predetermined limit. Detecting the cardiac condition may also involve detecting a ventricular wall motion asynchrony that exceeds a predetermined limit. [0015] Detecting the presence of disordered breathing may be used to trigger an alert using a patient-external device or a transfer of data from the implantable medical device to the patient-external device. Detecting the presence of disordered breathing may involve detecting an apnea/hypopnea index greater than a predetermined limit. According to one approach, the implantable medical device may be enabled to perform a first cardiac resynchronization therapy in response to detecting obstructive sleep apnea, and enabled to perform a second cardiac resynchronization therapy after detecting central sleep apnea. [0016] In embodiments that incorporate a pulse generator, methods of the present invention provide for adjusting an atrioventricular delay based on the detected disordered breathing. The cardiac resynchronization therapy, in such embodiments, may involve selecting a cardiac stimulation vector based on the detected disordered breathing. [0017] In accordance with other embodiments, an implantable medical device included a housing configured for implantation in a patient. A lead system comprises an electrode arrangement and is coupled to the housing. A processor is provided in the housing and coupled to the lead system. The processor is configured to detect presence of disordered breathing, detect a cardiac condition indicative of the patient's cardiac status, and identify the patient as suitable for a cardiac resynchronization therapy based on the presence of disordered breathing and the cardiac condition. [0018] The implantable medical device may include a pulse generator coupled to the processor and configured to deliver at least one of a cardiac pacing therapy other than a cardiac resynchronization therapy, a cardiac shock therapy, and a cardiac neurostimulation therapy. The processor may be configured to enable the pulse generator to perform the cardiac resynchronization therapy based on identifying the patient as suitable for the cardiac resynchronization therapy. The processor may be configured to adjust an atrioventricular delay based on the detected disordered breathing. The processor may be configured to detect at least one of obstructive sleep apnea, central sleep apnea, hypopnea, orthopnea, paroxysmal nocturnal dyspnea, and Cheyne-Stokes respiration. [0019] In other embodiments, one or both of an implantable sensor arrangement and a patient-external sensor arrangement may be coupled to the implantable medical device. The processor may be configured to detect a ventricular dysynchrony in the patient's heart via one or both of the implantable or patient-external sensing arrangement. The processor may be coupled to communication circuitry configured to facilitate wireless communication between the processor and a patient-external device or system. The patient-external device or system may be configured to generate a clinician alert to initiate, terminate, adjust, or optimize the cardiac resynchronization therapy. The implantable medical device may include a transthoracic impedance measuring circuitry coupled to the processor and configured to detect patient breathing. [0020] The above summary of the present invention is not intended to describe each embodiment or every implementation of the present invention. Advantages and attainments, together with a more complete understanding of the invention, will become apparent and appreciated by referring to the following detailed description and claims taken in conjunction with the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS Continue reading about Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection... Full patent description for Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. Start now! - Receive info on patent apps like Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection or other areas of interest. ### Previous Patent Application: Heart treatment apparatus and heart treatment method Next Patent Application: Selection of cardiac capture verification modes Industry Class: Surgery: light, thermal, and electrical application ### FreshPatents.com Support Thank you for viewing the Cardiac resynchronization therapy for improved hemodynamics based on disordered breathing detection patent info. IP-related news and info Results in 1.19906 seconds Other interesting Feshpatents.com categories: Software: Finance , AI , Databases , Development , Document , Navigation , Error 174 |
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