Pressure regulated atrio-ventricular delay for multi-site pacing

• US 20040215266A1
• Filed: 04/24/2003
• Published: 10/28/2004
• Est. Priority Date: 04/24/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Grandjean, Pierre A., Struble, Chester L.
• Granted Patent: US 7,069,079 B2
• Time in Patent Office: Days
• US Class Current: 607/17
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

The hemodynamic operation of certain heart disease patient can be improved using pressure regulated atrio-ventricular delay. The pressure regulated atrio-ventricular delay involves recording atrial activation and ventricle activation, identifying a maximum diastolic pressure, identifying a declination pressure, calculating a percent decrease, and adjusting atrio-ventricular delay. The declination pressure occurs at the beginning of an isovolumetric contraction. The percent decrease is calculated between the maximum diastolic pressure and the declination pressure. The atrio-ventricular delay is adjusted according to the percent decrease between the maximum diastolic pressure and the declination pressure.

Claims

1. A cardiac pacemaker for pressure regulated atrio-ventricular delay for multi-site pacing, comprising:

a housing having a power supply carried in the housing and a feedthrough;

a controller carried in the housing coupled to the power supply;

memory coupled to the controller;

pacing electronics coupled to the controller and the feedthrough;

sensing electronics coupled to the controller and the feedthrough;

a first electrical lead coupled to the feedthrough and configured for positioning in an atrium;

a second electrical lead coupled to the feedthrough and configured for positioning in a ventricle

a pressure sensor carried on the second electrical lead;

a second electrical lead coupled to the feedthrough and configured for positioning in the left ventricle; and

,

software stored in memory containing instructions including,

a first sequence of instructions when executed by the controller, causes the controller to record atrial activation and ventricle activation,

a second sequence of instructions when executed by the controller, causes the controller to identify a maximum diastolic pressure,

a third sequence of instructions when executed by the controller, causes the controller to identify a declination pressure occurring at an isovolumetric contraction beginning,

a forth sequence of instructions when executed by the controller, causes the controller to calculate the percent decrease between the maximum diastolic pressure and the declination pressure, and,

a fifth sequence of instructions when executed by the controller, causes the controller to adjust atrio-ventricular delay according to the percent decrease between the maximum diastolic pressure and the declination pressure.

2. A method for pressure regulated atrio-ventricular delay in multi-site pacing, comprising:

recording atrial activation and ventricle activation,

identifying a maximum diastolic pressure,

identifying a declination pressure occurring at an isovolumetric contraction beginning,

calculating a percent decrease between the maximum diastolic pressure and the declination pressure, and,

adjusting atrio-ventricular delay according to the percent decrease between the maximum diastolic pressure and the declination pressure.