Measurement of coronary sinus parameters to optimize left ventricular performance
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. A method for pacing a patient's heart using an implanted medical device comprising:
sensing a rate extraction of glucose through a coronary sinus of a patient's heart;
generating pacing pulses as a function of the sensed rate;
adjusting a pacing parameter of the pacing pulses as a function of a glucose signal; and
adjusting the pacing parameter to optimize left ventricular performance wherein adjusting the pacing parameter comprises adjusting the pacing parameter to minimize the rate of extraction of glucose.
2. A method according to claim 1 wherein generating the pacing pulses comprises generating ventricular pacing pulses after expirations of AV intervals and wherein adjusting the pacing parameter comprises adjusting the AV intervals.
3. A method according to claim 1 wherein generating the pacing pulses comprises generating left and right ventricular pacing pulses separated by inter-ventricular VV intervals and wherein adjusting the pacing parameter comprises adjusting the inter-ventricular VV intervals.
4. A method according to claim 1 wherein adjusting the pacing parameter comprises setting a curve relating the pacing parameter to the rate of extraction of glucose.
5. A method according to claim 4 wherein adjusting the pacing parameter further comprises defining a region associated with the curve.
6. A method according to claim 5 further comprising resetting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.
7. A method for pacing a patient's heart using an implanted medical device comprising:
sensing a rate extraction of glucose through a coronary sinus of a patient's heart;
generating pacing pulses as a function of the sensed rate;
adjusting a pacing parameter of the pacing pulses as a function of a glucose signal; and
adjusting the pacing parameter to optimize left ventricular performance wherein adjusting the pacing parameter comprises setting a curve relating the pacing parameter to the rate of extraction of glucose.
8. A method according to claim 7 wherein adjusting the pacing parameter further comprises defining a region associated with the curve.
9. A method according to claim 8 further comprising resetting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.
10. A method according to claim 8 further comprising shifting the curve responsive to the relationship of the pacing parameter and the sensed rate of extraction of glucose to the region.