Cardiac rhythm management system selecting A-V delay based on interval between atrial depolarization and mitral valve closure
First Claim
Patent Images
1. A method including:
- providing ventricular stimulations, separated from corresponding preceding atrial depolarizations, occurring during the same cardiac cycle, by different atrioventricular (A-V) delays;
detecting mitral valve closures associated with each ventricular stimulation;
measuring time intervals between the atrial depolarizations and the mitral valve closures; and
selecting, based on the time intervals, an A-V delay for subsequent delivery of ventricular stimulations.
0 Assignments
0 Petitions
Accused Products
Abstract
A cardiac rhythm management system selects an atrioventricular (A-V) delay based on a time-interval between an atrial depolarization and mitral valve closure (MVC). For several different A-V delays, the system measures time intervals between atrial depolarizations (i.e., sensed or paced P-waves) and accelerometer-detected MVCs. Based on this information, the system selects a particular A-V delay for improving cardiac output during subsequent delivery of cardiac rhythm management therapy.
82 Citations
21 Claims
-
1. A method including:
-
providing ventricular stimulations, separated from corresponding preceding atrial depolarizations, occurring during the same cardiac cycle, by different atrioventricular (A-V) delays;
detecting mitral valve closures associated with each ventricular stimulation;
measuring time intervals between the atrial depolarizations and the mitral valve closures; and
selecting, based on the time intervals, an A-V delay for subsequent delivery of ventricular stimulations. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
-
-
16. A method including:
-
providing ventricular stimulations separated from corresponding preceding atrial depolarizations by different atrioventricular (A-V) delays;
detecting an acceleration signal associated with the heart;
differentiating the acceleration signal to form a first derivative acceleration signal;
detecting, for each ventricular stimulation, a corresponding mitral valve closure, occurring during the same cardiac cycle as the ventricular stimulation and the preceding atrial depolarization, by detecting a peak of the first derivative acceleration signal, wherein the peak occurs after an R-wave associated with the ventricular stimulation and before a P-wave associated with a next atrial depolarization;
measuring P-MVC time intervals between the atrial depolarizations and the corresponding mitral valve closures;
calculating slopes of the P-MVC time intervals against the different A-V delays; and
selecting, based on the slopes, an A-V delay for subsequent delivery of ventricular stimulations. - View Dependent Claims (17)
-
-
18. A method including:
-
providing ventricular stimulations, separated from preceding atrial depolarizations by different atrioventricular (A-V) delays;
detecting a mitral valve closure associated with each ventricular stimulation;
measuring P-MVC time intervals between the atrial depolarizations and the mitral valve closures;
calculating slopes of the P-MVC time intervals against the different A-V delays; and
selecting, for subsequent delivery of ventricular stimulations, the shortest of the A-V delays with which an adjacent shorter one of the A-V delays provides a larger slope than an adjacent longer one of the A-V delays. - View Dependent Claims (19)
-
-
20. A method including:
-
providing ventricular stimulations, separated from preceding atrial depolarizations by different atrioventricular (A-V) delays;
detecting a mitral valve closure associated with each ventricular stimulation;
measuring P-MVC time intervals between the atrial depolarizations and the mitral valve closures;
storing the P-MVC time intervals and the corresponding different A-V delays;
forming a first linear approximation of the P-MVC time intervals at small A-V delays;
forming a second linear approximation of P-MVC time intervals at large A-V delays, relative to the small A-V delays. finding an intersection between the first and second linear approximations; and
selecting an A-V delay associated with the intersection for subsequent delivery of ventricular stimulations. - View Dependent Claims (21)
-
Specification