Measurement of coronary sinus parameters to optimize left ventricular performance

Abstract

In some embodiments, an implantable medical device (IMD) system may include one or more of the following elements: (a) an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient's heart, (b) an oxygen signal generated by the oxygen sensor, (c) an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal, and (d) an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient's heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal, wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.

1 . An implantable medical device (IMD) system, comprising:
 an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient's heart;   an oxygen signal generated by the oxygen sensor;   an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal; and   an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient's heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal;   wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal and wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.   
     
     
         2 . An IMD according to  claim 1 , further comprising a blood pressure sensor for detecting a signal proportional to the left heart chamber blood pressure, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and the blood pressure signal. 
     
     
         3 . An IMD according to  claim 1 , further comprising a blood flow sensor for measuring coronary blood flow producing a blood flow signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and the blood flow signal. 
     
     
         4 . An IMD according to  claim 1 , further comprising a glucose sensor for sensing a rate of extraction of glucose through the coronary sinus and producing a glucose signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and glucose signal. 
     
     
         5 . An IMD according to  claim 1 , further comprising a blood temperature sensor for sensing the temperature of the blood in the coronary sinus and producing a temperature signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen and temperature signal. 
     
     
         6 . An IMD according to  claim 1 , wherein the pacing pulses are adjusted as the heart changes during the life of a patient as a function of the oxygen signal. 
     
     
         7 . An IMD according to  claim 1 , wherein a left ventricular performance index is created within the implantable medical device as a function of the oxygen signal. 
     
     
         8 . An implantable multi-chamber pacing system comprising:
 atrial sense means for sensing signals from an atrium of a patient's heart;   ventricular sense means for sending ventricular signals from a patient's right ventricle;   coronary sense means for sensing ventricular signals from the patient's left ventricle and for sensing a signal representing blood temperature through the patient's coronary sinus; and   pace control means for generating and delivering pacing pulses to a plurality of chambers within the patient's heart, wherein the pace control means includes means for setting and timing cardiac resynchronization therapy as a function of the sensed temperature signal.   
     
     
         9 . An implantable multi-chamber pacing system according to  claim 8 , wherein the coronary sense means further detects a signal proportional to the left heart chamber blood pressure, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the blood pressure signal. 
     
     
         10 . An implantable multi-chamber pacing system according to  claim 8 , wherein the coronary sense means further detects a signal proportional to blood flow, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the blood flow signal. 
     
     
         11 . An implantable multi-chamber pacing system according to  claim 8 , wherein the coronary sense means further detects a signal proportional to a rate of glucose in the coronary sinus, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the glucose signal. 
     
     
         12 . An implantable multi-chamber pacing system according to  claim 8 , wherein the coronary sense means further detects a signal proportional to oxygen in the blood flowing through a coronary sinus of a patient's heart, wherein the means for setting and timing cardiac resynchronization therapy does it as a function of the sensed temperature signal and the oxygen signal. 
     
     
         13 . An implantable multi-chamber pacing system according to  claim 8 , wherein the coronary sense means is coupled to a delivery catheter and placed in a coronary sinus where it remains during implantation of the multi-chamber pacing system to take measurements to optimize the delivery of pacing pulses.