Methods and systems for identifying and using heart rate variability and heart rate variation

摘要

A heart rate variability or heart rate variation can be identified using sensed and/or paced heart beats. One or more patient metrics, such as a variability index or a variation index, can correspond to the identified heart rate variability or heart rate variation. The patient metrics can be used to identify a need for a particular therapy, such as a rate-responsive pacing therapy. The patient metrics can be used to identify patients at an elevated risk of death. Methods and systems to identify therapy indications or at-risk patients are provided. In an example, a patient risk profile can be adjusted, such as in response to an identified patient heart rate variability or heart rate variation. In an example, a rate-responsive pacing mode can be used to adjust the patient risk profile.

主权项

1. An apparatus for determining whether to provide a rate-responsive pacing therapy or a non-rate-responsive pacing therapy to a patient, the apparatus comprising:
a data input circuit configured to receive a cardiac activity signal of a patient, the cardiac activity signal including information about intrinsic and non-intrinsic cardiac activity; a memory circuit configured to store information about the received cardiac activity signal; and a processor circuit, coupled to the memory circuit, the processor circuit configured to:
determine a heart rate variability using the stored information about the cardiac activity signal including information about intrinsic and non-intrinsic cardiac activity;determine a suitability indication configured to indicate whether to provide a rate-responsive pacing therapy to the patient instead of a non-rate-responsive pacing therapy, the suitability indication based on a characteristic of the determined heart rate variability; andat least one of: update, via a telemetry circuit, a therapy mode in a therapy delivery circuit to deliver either the rate-responsive or non-rate-responsive pacing therapy to the patient based on the suitability indication; and communicate, via the telemetry circuit, a recommendation to a caregiver using an external programmer that is communicatively coupled to the apparatus, the recommendation for delivering either the rate-responsive or non-rate-responsive pacing therapy to the patient based on the suitability indication.