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Determining onsets and offsets of cardiac depolarization and repolarization waves

  • US 10,449,365 B2
  • Filed: 12/02/2016
  • Issued: 10/22/2019
  • Est. Priority Date: 07/26/2013
  • Status: Active Grant
First Claim
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1. A method of selecting an implant site for an implantable pacing electrode, the method comprising:

  • sensing an intrinsic heart rhythm signal using a plurality of body-surface electrodes, wherein the intrinsic heart rhythm signal includes an atrial marker and a ventricular marker;

    sensing a cardiac contraction signal comprising heart mechanical contraction information, wherein the heart mechanical contraction information comprises times of local cardiac contraction;

    determining a global electromechanical delay for each of a plurality of candidate cardiac pacing sites, wherein determining each global electromechanical delay comprises;

    defining a window between the atrial marker and the ventricular marker of the intrinsic heart rhythm signal sensed using the plurality of body-surface electrodes,determining a point of onset of a depolarization complex in the intrinsic heart rhythm signal within the defined window,sensing a time of local cardiac contraction within a window of the cardiac contraction signal corresponding to the defined window; and

    determining the global electromechanical delay for the candidate cardiac pacing site between the determined point of onset of the depolarization complex within the defined window and the time of local cardiac contraction within the corresponding window;

    selecting two or more of the plurality of candidate cardiac pacing sites as potential implant sites for an implantable pacing electrode for delivering cardiac pacing based upon the determined global electromechanical delays;

    sensing a local intrinsic heart rhythm signal using one or more electrodes at localized heart tissue, wherein the local intrinsic heart rhythm signal includes a local atrial marker and a local ventricular marker;

    sensing a local cardiac contraction signal comprising heart mechanical contraction information, wherein the heart mechanical contraction information comprises times of local cardiac contraction;

    determining a local electromechanical delay for each of the selected two or more of the plurality of candidate cardiac pacing sites, wherein determining each local electromechanical delay comprises;

    defining a local window between the local atrial marker and the local ventricular marker of the local intrinsic heart rhythm signal sensed using the one or more electrodes at localized heart tissue,determining a point of onset of a local depolarization complex in the local intrinsic heart rhythm signal,sensing a time of local cardiac contraction within a window of the local cardiac contraction signal corresponding to the defined local window; and

    determining the local electromechanical delay for the selected candidate cardiac pacing site between the determined point of onset of the local depolarization complex within the defined local window and the time of local cardiac contraction within the corresponding window; and

    identifying a subset of the selected two or more of the plurality of candidate cardiac pacing sites as potential pacing sites to be paced by an implantable electrode based on the local electromechanical delays.

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