Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. The device incorporates a program microcontroller which is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A method of optimizing inter-site delay is disclosed for a cardiac rhythm management device that includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. A microcontroller is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker, especially designed for treating congestive heart failure. The device incorporates a program microcontroller which is operative to adjust the pacing site, AV delay and interventricular delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the site, AV delay and interventricular delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Paced transient beats following periods of baseline beats are synchronized to the patient's respiratory cycle to minimize effects of respiratory noise on atrial cycle length measurements.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. The device incorporates a program microcontroller which is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker, especially designed for treating congestive heart failure. The device incorporates a program microcontroller which is operative to adjust the pacing site, AV delay and interventricular delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the site, AV delay and interventricular delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Paced transient beats following periods of baseline beats are synchronized to the patient's respiratory cycle to minimize effects of respiratory noise on atrial cycle length measurements.

Abstract: A method and apparatus for determining the baroreflex sensitivity in a chronic heart failure patient and a method for chronic heart therapy evaluation. The method including providing a series of pacing stimuli to the heart of a chronic heart failure patient and measuring the change in pulse pressure and the change in cycle length incident to each pacing series. The changes being plotted to produce a line indicative of baroreflex sensitivity. The apparatus including a pacemaker having sensors for monitoring both cycle length and pulse pressure wherein the sensors may be integral or separate from the pacemaker. The method for evaluating chronic heart failure therapies including administering a series of therapies and evaluating each therapy based on the resultant increase of the patient's baroreflex sensitivity.

Abstract: A method and apparatus for determining the baroreflex sensitivity in a chronic heart failure patient and a method for chronic heart therapy evaluation. The method including providing a series of pacing stimuli to the heart of a chronic heart failure patient and measuring the change in pulse pressure and the change in cycle length incident to each pacing series. The changes being plotted to produce a line indicative of baroreflex sensitivity. The apparatus including a pacemaker having sensors for monitoring both cycle length and pulse pressure wherein the sensors may be integral or separate from the pacemaker. The method for evaluating chronic heart failure therapies including administering a series of therapies and evaluating each therapy based on the resultant increase of the patient's baroreflex sensitivity.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker, especially designed for treating congestive heart failure by pacing a plurality of sites. The device incorporates a program microcontroller which is operative to adjust the pacing mode and inter-site delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode inter-site delay are signal processed and a determination can then be made as to which particular configuration yields the optimum performance. Performance is optimized when the patient is at rest and when the patient exercises so that a rate-adapted dynamic value of the optimum performance can be applied.

Abstract: A cardiac stimulating apparatus and method which optimizes cardiac performance by determining, from a filtered waveform transmitted from an accelerometer contained within the cardiac pacer, an optimum timing interval between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart. Digitized data of the accelerometer signal, corresponding with identified R--R intervals, are stored for a plurality of preselected timing intervals for analysis and comparison. The accelerometer signal is filtered to isolate features of the waveform associated with specific cardiac events including for example, the first heart sound, the second heart sound or an amplitude in the frequency domain thereof. Characteristic values of these features of the accelerometer signal are calculated over a plurality of complete R--R intervals for each of the preselected timing intervals. The characteristic values are analyzed and compared to determine which timing interval optimizes cardiac performance.

Abstract: A cardiac rhythm management device includes a dual chamber pacemaker especially designed for treating congestive heart failure. The device incorporates a programmed microcontroller which is operative to adjust the pacing mode-AV delay of the pacemaker so as to achieve optimum hemodynamic performance. Atrial cycle lengths measured during transient (immediate) time intervals following a change in the mode-AV delay are signal processed and a determination can then be made as to which particular configuration yields optimum performance.

Abstract: A cardiac discrimination method in which feature values of a heart related signal (e.g., cardiac biopotentials) determined to be non-baseline are compared with feature values of a heart related signal determined to be normal baseline. The feature values are extracted on an event-basis (a periodically), for obtaining feature values of a complex. For each complex, the feature values form a sequence with the value having the largest absolute value for the sequence given special identity as a fiducial point. The normal baseline complexes' characteristic sequence and a non-baseline complex's sequence are aligned according to the fiducial points, and unoccupied positions on the ends of the sequences resulting from the alignment are filled with zeros to create normal baseline and non-baseline vectors. The similarity value and dissimilarity value of the normalized non-baseline vector with respect to the normalized normal baseline vector are determined.