Cardiac pacing using adjustable atrio-ventricular delays
First Claim
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1. An apparatus, comprising:
- a programmable pulse generator; and
at least one sensor, coupled to the programmable pulse generator, to sense a plurality of cardiac events, wherein the programmable pulse generator is adapted to;
measure a first time interval between a first cardiac event and a second cardiac event that has an approximately constant timing relationship with respect to the first cardiac event and a predictable timing relationship to a delivery of pacing timed for maximizing aortic pulse pressure;
determine a delay time interval referenced to the first cardiac event using a predetermined mapping relationship of the first time interval to an approximately optimal delay time interval for maximizing aortic pulse pressure; and
transmit pacing pulses using the delay time interval.
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Abstract
A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.
152 Citations
19 Claims
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1. An apparatus, comprising:
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a programmable pulse generator; and
at least one sensor, coupled to the programmable pulse generator, to sense a plurality of cardiac events, wherein the programmable pulse generator is adapted to;
measure a first time interval between a first cardiac event and a second cardiac event that has an approximately constant timing relationship with respect to the first cardiac event and a predictable timing relationship to a delivery of pacing timed for maximizing aortic pulse pressure;
determine a delay time interval referenced to the first cardiac event using a predetermined mapping relationship of the first time interval to an approximately optimal delay time interval for maximizing aortic pulse pressure; and
transmit pacing pulses using the delay time interval. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method, comprising:
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measuring an interval during a systolic cycle between a first event and a second event, the first event related to a paced atrial contraction which is in a first predictable time-dependent relationship and the second event which is in a second predictable time-dependent relationship to a ventricular pacing signal optimally timed for maximum pulse pressure during systole;
generating an atrio-ventricular delay (AVDs) calculated from a predetermined mapping of a relationship of the interval to an optimal atrio-ventricular delay for maximum pulse pressure during systole; and
delivering a pacing pulse to a ventricle with the generated atrio-ventricular delay (AVDs), wherein AVDs provides an approximation of the optimal atrio-ventricular delay for pacing the ventricle to provide maximum pulse pressure during systole. - View Dependent Claims (9, 10, 11, 12, 13)
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14. An apparatus, comprising:
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a programmable pulse generator transmitting ventricular pacing pulses with an atrio-ventricular delay (AVDs) calculated from an interval measured during a systolic cycle by the programmable pulse generator between a first event and a second event, the first event related to a paced atrial contraction which is in a first predictable time-dependent relationship and the second event which is in a second predictable time-dependent relationship to a ventricular pacing signal optimally timed for maximum pulse pressure during systole, wherein the AVDs is calculated by the programmable pulse generator from a predetermined mapping of a relationship of the interval to an optimal atrio-ventricular delay for maximum pulse pressure during systole, and wherein AVDs provides an approximation of the optimal atrio-ventricular delay for pacing the ventricle to provide maximum pulse pressure. - View Dependent Claims (15, 16, 17, 18, 19)
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Specification