Importance

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Abstract

An implantable monitor/stimulator is disclosed that monitors and assesses indices of cardiac function, including the strength and timing of cardiac contraction, then automatically executes a physician-selected mode of therapy. It accomplishes this by assessing impedance, electrocardiogram, and/or pressure measurements, then calculating various cardiac parameters. The results of these calculations may be stored within the device, telemetered to an external monitor or display and/or may be used by the physician to determine the mode of therapy to be chosen. If indicated, therapy is administered by the device itself or by telemetering control signals to various peripheral devices for the purpose of enhancing either contraction or relaxation of the heart. The cardiac parameters that are calculated all provide an assessment of level of cardiac function by monitoring changes in ventricular filling and ejection or by calculating isovolumic phase indices of heart contraction. Examples of such parameters are ejection fraction, cardiac output, stroke work, and/or various pressure-volume relationships. These parameters determine the mode of therapy that will be selected by a physician. Choices of therapy include several forms of pacing of cardiac or skeletal muscle, and telemetry to implanted or external units for drug infusion or for monitoring by a central data system.

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First Claim