System and method for automated adjustment of cardiac resynchronization therapy control parameters
First Claim
1. A method for delivering cardiac resynchronization therapy to a patient'"'"'s heart with a cardiac rhythm management (CRM) device, the steps of the method comprising:
- a) receiving intracardiac signals indicative of cardiac electrical activity in the patient'"'"'s heart, using electrodes in electrical communication with one of the CRM device and an external programmer, after delivery of electrical impulses to the heart;
b)comparing the received cardiac electrical activity signals with a baseline cardiac electrical activity to characterize ventricular activation patterns using a QRS hieroglyphic framework, the baseline cardiac electrical activity acquired, using electrocardiograph surface leads, before the delivery of electrical impulses to the heart;
c) determining an activation fusion response phenotype based on the comparison in step b), the activation fusion response phenotype corresponding with odds of increased ventricular activation wavefront fusion associated with improved ventricular pump function, the activation fusion response phenotype being differentiated into distinct mutually exclusive phenotypes, including a cancellation fusion response phenotype, an oblique fusion response phenotype, and a summation fusion response phenotype;
d) setting one or more pacing control parameters based on the activation fusion response phenotype determined in step c) and the comparison in step (b); and
e) delivering cardiac resynchronization therapy to the patient'"'"'s heart using the one or more pacing control parameters.
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Accused Products
Abstract
A system and method for cardiac resynchronization therapy (“CRT”) in which a model of baseline cardiac electrical activity, such as a model of global baseline cardiac electrical activity derived from various surface electrocardiograph (“ECG”) signals, is utilized to automatically adjust pacing control parameters of a cardiac implantable electrical device (“CIED”) are provided. The baseline model is compared to CRT response patterns using modified pacing control parameters in an iterative fashion, based on a patient-specific response pattern phenotype determination, until ventricular electrical asynchrony is minimized. The pacing control parameters resulting in the minimum ventricular electrical asynchrony are used to generate final control parameters for CRT.
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Citations
18 Claims
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1. A method for delivering cardiac resynchronization therapy to a patient'"'"'s heart with a cardiac rhythm management (CRM) device, the steps of the method comprising:
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a) receiving intracardiac signals indicative of cardiac electrical activity in the patient'"'"'s heart, using electrodes in electrical communication with one of the CRM device and an external programmer, after delivery of electrical impulses to the heart; b)comparing the received cardiac electrical activity signals with a baseline cardiac electrical activity to characterize ventricular activation patterns using a QRS hieroglyphic framework, the baseline cardiac electrical activity acquired, using electrocardiograph surface leads, before the delivery of electrical impulses to the heart; c) determining an activation fusion response phenotype based on the comparison in step b), the activation fusion response phenotype corresponding with odds of increased ventricular activation wavefront fusion associated with improved ventricular pump function, the activation fusion response phenotype being differentiated into distinct mutually exclusive phenotypes, including a cancellation fusion response phenotype, an oblique fusion response phenotype, and a summation fusion response phenotype; d) setting one or more pacing control parameters based on the activation fusion response phenotype determined in step c) and the comparison in step (b); and e) delivering cardiac resynchronization therapy to the patient'"'"'s heart using the one or more pacing control parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac implantable electrical device for delivering cardiac resynchronization therapy to a patient'"'"'s heart, the cardiac implantable electrical device comprising:
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an input for receiving intracardiac signals indicative of cardiac electrical activity in the heart; an impulse delivery system for delivering electrical impulses to the heart to provide cardiac resynchronization therapy thereto; a memory for storing; pacing control parameters for the impulse delivery system, and a baseline electrocardiograph electrical activity acquired, using electrocardiograph surface leads, before delivery of electrical impulses delivered to the heart by the impulse delivery system; and a processor in communication with the memory, the processor being configured to; receive intracardiac signals after the delivery of electrical impulses; compare the received intracardiac signals to the baseline electrocardiograph electrical activity to characterize ventricular activation patterns using a QRS hieroglyphic framework; determine an activation fusion response phenotype based on the comparison, the activation fusion response phenotype corresponding with odds of increased ventricular activation wavefront fusion associated with improved ventricular pump function, the activation fusion response phenotype being differentiated into distinct mutually exclusive phenotypes, including a cancellation fusion response phenotype, an oblique fusion response phenotype, and a summation fusion response phenotype; generate adjusted pacing control parameters based on the activation fusion response phenotype and the comparison of the received signals with the baseline electrocardiograph electrical activity; and provide cardiac resynchronization therapy to the heart in accordance with the adjusted pacing control parameters. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A system for delivering cardiac resynchronization therapy to a patient'"'"'s heart with a cardiac rhythm management (CRM) device, the system comprising:
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an input configured to be coupled to electrodes in electrical communication with the CRM device to receive intracardiac signals representing cardiac electrical activity in the patient'"'"'s heart; an output configured to communicate operational control parameters to the CRM device; and a processor configured to; receive the intracardiac signals representing cardiac electrical activity after delivery of electrical impulses to the patient'"'"'s heart; access baseline cardiac electrical activity information, the baseline cardiac electrical activity information acquired, using electrocardiograph surface leads, before the delivery of electrical impulses to the patient'"'"'s heart; compare the intracardiac signals representing cardiac electrical activity with the baseline cardiac electrical activity to characterize ventricular activation patterns using a QRS hieroglyphic framework; determine a patient-specific activation fusion response phenotype based on the comparison of the signals representing cardiac electrical activity with the baseline cardiac electrical activity, the activation fusion response phenotype corresponding with odds of increased ventricular activation wavefront fusion associated with improved ventricular pump function, the activation fusion response phenotype being differentiated into distinct mutually exclusive phenotypes, including a cancellation fusion response phenotype, an oblique fusion response phenotype, and a summation fusion response phenotype; determine at least one adjusted operational control parameter for controlling pacing using the activation fusion response phenotype and the comparison; and communicate the at least one adjusted operational control parameter to the CRM device to perform cardiac resynchronization therapy using the at least one adjusted operational control parameter.
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Specification