System and method for respiration-modulated pacing

Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems

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607 18, A61N 1365

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active

061415901

ABSTRACT:
A system and method of providing for cardiac pacing which incorporates modulation of the pacing rate in order to minimize variations in ventricular power output, e.g., variation related to patient respiratory phases. In a preferred embodiment, pacing rate is increased during inspiration relative to expiration, to restore a measure of the normal rate modulation which occurs in a normal person. Patient respiration is monitored and a respiration signal is processed to determine the timing of rate modulation. Parameters representative of respiratory changes, such as right ventricular volume and right ventricular blood pressure are also monitored and, together with respiration amplitudes changes, are used to determine an incremental rate signal for controlling the extent of rate variation. Heart rate and patient activity are also sensed, to provide further control of rate modulation, with maximum modulation being provided when the patient is sleeping, and minimal or no modulation being provided when the patient is active. The system of this invention is applicable in combination with conventional pacing systems, or can be adapted to special clinical applications.

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Paul Grossman et al. "Respiratory Sinus Arrhythmia as an Index of Parasympathetic Cardiac Control During Active Coping", Psychophysiology, vol. 24, No. 2, Mar. 1987, pp. 228-235.

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