Method and apparatus for setting pacing parameters in cardiac resynchronization therapy
First Claim
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1. A cardiac rhythm management device, comprising:
- an atrial sensing channel for generating electrogram signals corresponding to electrical activity in an atrium;
right and left ventricular sensing channels for generating electrogram signals corresponding to electrical activity in the right and left ventricles, respectively;
right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively;
a controller for controlling the output of pacing pulses and interpreting electrogram signals, wherein the controller is programmed to pace at least one ventricle within a programmable atrio-ventricular delay (AVD) interval after an atrial sense in an atrial-tracking mode;
wherein the controller is programmed to include instructions to perform;
measure at least one intrinsic atrio-ventricular delay interval and a duration of ventricular depolarization from electrogram signals during an intrinsic beat; and
set the AVD interval according to a formula which includes a linear combination of the measured intrinsic atrio-ventricular delay and the measured duration of ventricular depolarization defined by specified coefficients.
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Abstract
A method and apparatus is disclosed for automatically setting the pacing parameters utilized by an implantable cardiac device in delivering cardiac resynchronization therapy. The selection of the pacing parameters is based at least in part upon measurements of intrinsic cardiac conduction parameters. Among the pacing parameters which may be selected in this way is the atrio-ventricular delay interval used in atrial-tracking and AV sequential pacing modes.
149 Citations
31 Claims
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1. A cardiac rhythm management device, comprising:
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an atrial sensing channel for generating electrogram signals corresponding to electrical activity in an atrium;
right and left ventricular sensing channels for generating electrogram signals corresponding to electrical activity in the right and left ventricles, respectively;
right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively;
a controller for controlling the output of pacing pulses and interpreting electrogram signals, wherein the controller is programmed to pace at least one ventricle within a programmable atrio-ventricular delay (AVD) interval after an atrial sense in an atrial-tracking mode;
wherein the controller is programmed to include instructions to perform;
measure at least one intrinsic atrio-ventricular delay interval and a duration of ventricular depolarization from electrogram signals during an intrinsic beat; and
set the AVD interval according to a formula which includes a linear combination of the measured intrinsic atrio-ventricular delay and the measured duration of ventricular depolarization defined by specified coefficients. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method for operating a cardiac rhythm management device, comprising:
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generating electrogram signals corresponding to electrical activity in an atrium and the right and left ventricles;
pacing at least one ventricle within a programmable atrio-ventricular delay (AVD) interval after an atrial sense in an atrial-tracking mode;
measuring an intrinsic atrio-ventricular delay interval and a duration of ventricular depolarization from electrogram signals during an intrinsic beat; and
setting the AVD interval according to a formula which includes a linear combination of the measured intrinsic atrio-ventricular delay and the measured duration of ventricular depolarization defined by specified coefficients. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A cardiac rhythm management device, comprising:
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an atrial sensing channel for generating electrogram signals corresponding to electrical activity in an atrium;
right and left ventricular sensing channels for generating electrogram signals corresponding to electrical activity in the right and left ventricles, respectively;
right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively;
a controller for controlling the output of pacing pulses and interpreting electrogram signals, wherein the controller is programmed to pace at least one ventricle in a manner defined by at least one pre-excitation timing parameter;
wherein the controller is programmed to include instructions to perform;
measure a plurality of intrinsic conduction parameters during an intrinsic beat from electrogram signals generated in the sensing channels, including an intrinsic atrio-ventricular delay interval in each ventricular sensing channel and a duration of ventricular depolarization;
select between a biventricular, right ventricular-only, or left ventricular-only pacing mode based upon the measured intrinsic conduction parameters;
set the value of the pre-excitation timing parameter according to a formula which includes a linear combination of the measured intrinsic conduction parameters as defined by specified coefficients. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31)
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Specification