Systems and methods for ranking and selection of pacing vectors
First Claim
1. A medical system, comprising:
- a plurality of cardiac electrodes configured to be electrically coupled to a heart;
a hemodynamic function circuit configured to measure a parameter value indicative of hemodynamic function for a selected plurality of cardiac electrodes as potential Left Ventricular (LV) pacing vectors;
a pacing viability circuit configured to eliminate one or more of the selected plurality of cardiac electrodes from a set of viable cardiac electrodes according to the parameter indicating hemodynamic function;
a threshold test circuit configured to measure one or both of a cardiac capture threshold and a phrenic nerve activation threshold for the set of viable cardiac electrodes;
a ranking circuit configured to rank at least some of the potential LV pacing vectors based on the value of the hemodynamic function parameter and the one or both of the measured capture threshold and the phrenic nerve activation threshold.
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Abstract
Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds.
48 Citations
20 Claims
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1. A medical system, comprising:
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a plurality of cardiac electrodes configured to be electrically coupled to a heart; a hemodynamic function circuit configured to measure a parameter value indicative of hemodynamic function for a selected plurality of cardiac electrodes as potential Left Ventricular (LV) pacing vectors; a pacing viability circuit configured to eliminate one or more of the selected plurality of cardiac electrodes from a set of viable cardiac electrodes according to the parameter indicating hemodynamic function; a threshold test circuit configured to measure one or both of a cardiac capture threshold and a phrenic nerve activation threshold for the set of viable cardiac electrodes; a ranking circuit configured to rank at least some of the potential LV pacing vectors based on the value of the hemodynamic function parameter and the one or both of the measured capture threshold and the phrenic nerve activation threshold. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A cardiac system for ranking potential Left Ventricular (LV) pacing vectors, comprising:
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an input circuit configured to receive input utilized at least in part for one or both of a selection of a plurality of cardiac electrodes for testing as potential LV pacing vectors and selection from a plurality of measurable parameter values and threshold measurements for priority in ranking the potential LV pacing vectors; a hemodynamic function circuit configured to measure a parameter value indicative of hemodynamic function for the selected plurality of cardiac electrodes; a pacing viability circuit configured to eliminate one or more of the selected plurality of cardiac electrodes from a set of viable cardiac electrodes according to the parameter indicating hemodynamic function; a threshold test circuit configured to measure one or both of a cardiac capture threshold and a phrenic nerve activation threshold for the set of viable cardiac electrodes; a ranking circuit configured to rank at least some of the potential LV pacing vectors based at least in part on each of the values of the hemodynamic function parameter, the one or both of the measured capture threshold and the phrenic nerve activation threshold, and the priority input; and the ranking circuit further configured to provide an output based on the ranking. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17)
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18. A medical system, comprising:
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means for receiving input utilized for, at least in part, a selection of a plurality of cardiac electrodes for testing as potential Left Ventricular (LV) pacing vectors; means for measuring a value of a parameter indicating hemodynamic function of pacing for the selected plurality of cardiac electrodes; means for eliminating one or more cardiac electrodes from a set of viable cardiac electrodes according to the parameter indicating hemodynamic function, wherein further testing is performed only on the set of viable cardiac electrodes; means for measuring one or both of a cardiac capture threshold and a phrenic nerve activation threshold for the set of viable cardiac electrodes; and means for ranking at least some of the potential LV pacing vectors based on the value of the hemodynamic function parameter and the one or both of the measured capture threshold and the phrenic nerve activation threshold. - View Dependent Claims (19, 20)
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Specification