Autonomic balance monitoring to control intermittent therapy

摘要

Various system embodiments comprise a myocardial stimulator, at least one sensor adapted for use in detecting heart rate to determine heart rate turbulence (HRT), and a controller connected to the myocardial stimulator and the at least one sensor. The myocardial stimulator is adapted to deliver pacing pulses through at least one electrode to provide cardiac pacing. The controller is adapted to intermittently deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The controller is further adapted to determine HRT from the detected heart rate to assess cardiac stress to the stress-inducing pacing pulses, and adjust at least one parameter of the stress-inducing pacing pulses to adjust cardiac stress if the cardiac stress to the stress-inducing pacing pulses is undesirable.

主权项

1. A system, comprising:
a myocardial stimulator adapted to deliver pacing pulses through at least one electrode to provide cardiac pacing; at least one sensor adapted for use in detecting heart rate to determine heart rate turbulence (HRT); a controller connected to the myocardial stimulator and the at least one sensor, wherein the controller is configured deliver a close-loop cardiac protective pacing therapy (CPPT) that intermittently stresses a heart to improve health through modulation of autonomic tone, wherein in delivering the close-loop CPPT the controller is configured to:
intermittently deliver, using the myocardial stimulator, stress-inducing pacing pulses to the heart, wherein the intermittently delivered stress-inducing pacing pulses include sequences of stress-inducing pacing pulses to the heart to intentionally stress the heart to increase sympathetic tone during each of the sequences of stress-inducing pacing pulses, wherein the sequences are separated by time without stress-inducing pacing pulses;monitor cardiac stress by determining, using the detected heart rate from the at least one sensor, HRT to assess the cardiac stress to the stress-inducing pacing pulses; andadjust at least one parameter of the stress-inducing pacing pulses delivered for the CPPT to adjust the cardiac stress if the cardiac stress due to the stress-inducing pacing pulses is undesirable.