Method and apparatus for biventricular stimulation and capture monitoring
First Claim
1. A method of providing synchronous cardiac biventricular stimulation by stimulating a left ventricle with a left ventricular lead that includes a left ventricular electrode, and by stimulating a right ventricle with a right ventricular lead that includes a right ventricular electrode, the method comprising the steps of:
- generating biventricular stimulation pulses;
selectively delivering the biventricular stimulation pulses on demand with a cross-chamber configuration between the left ventricular electrode and the right ventricular electrode, for synchronously stimulating the left and right ventricles; and
verifying capture of the left ventricle and the right ventricles.
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Abstract
A multi-chamber stimulation device and associated method reliably and automatically verify capture during cardiac stimulation. The stimulation device achieves efficient synchronous biventricular stimulation by using cross-chamber electrode configurations to minimize pacing energy requirements, and further achieves reliable capture detection by using cross-chamber sensing electrode configurations to minimize the effect of lead polarization. During cross-chamber stimulation, a biphasic pulse, a balanced monophasic pulse, or a biventricular pacing pulse may be delivered. By delivering a biventricular pacing pulse, a larger potential difference is established across the ventricles, improving the recruitment of Purkinje fibers and other conductive elements of the cardiac tissue, thus enhancing conduction of the stimulating pulses through the cardiac tissue.
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Citations
30 Claims
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1. A method of providing synchronous cardiac biventricular stimulation by stimulating a left ventricle with a left ventricular lead that includes a left ventricular electrode, and by stimulating a right ventricle with a right ventricular lead that includes a right ventricular electrode, the method comprising the steps of:
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generating biventricular stimulation pulses;
selectively delivering the biventricular stimulation pulses on demand with a cross-chamber configuration between the left ventricular electrode and the right ventricular electrode, for synchronously stimulating the left and right ventricles; and
verifying capture of the left ventricle and the right ventricles. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A cardiac simulation system for providing synchronous biventricular stimulation, comprising:
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a left ventricular lead including a left ventricular electrode that delivers stimulation pulses to a left ventricle;
a right ventricular lead including a right ventricular electrode that delivers stimulation pulses to a right ventricle;
a pulse generator connected to the left ventricular lead and the right ventricular lead, and adapted to perform biventricular stimulation with a cross-chamber configuration between the left ventricular electrode and the right ventricular electrode, to synchronously capture the left and right ventricles; and
an automatic capture detector coupled to the pulse generator to verify capture of the left ventricle and the right ventricles. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26)
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27. A cardiac simulation system for providing synchronous biventricular stimulation, comprising:
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means for generating stimulation pulses;
means for selectively delivering the stimulation pulses to a left ventricle;
means for selectively delivering the stimulation pulses to a right ventricle;
means for synchronously capturing the left and right ventricles by performing biventricular stimulation with a cross-chamber configuration between the left ventricular electrode and the right ventricular electrode; and
means for verifying capture of the left ventricle and the right ventricles. - View Dependent Claims (28, 29, 30)
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Specification