Multi-site active implantable medical device including a mode of resynchronization of the ventricles

• US 20050131471A1
• Filed: 12/14/2004
• Published: 06/16/2005
• Est. Priority Date: 12/15/2003
• Status: Active Grant

• Current Assignee: Ela Medical S.A. (LivaNova Plc)
• Original Assignee: Ela Medical S.A. (LivaNova Plc)
• Inventors: Henry, Christine, Limousin, Marcel
• Granted Patent: US 7,400,922 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• 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 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

An active implantable medical device comprising circuits for right ventricular, left ventricular, right atrial and eventually left atrial detection, as well as circuits for right and left ventricular stimulation. The device can operate in mode of resynchronization of the ventricular contractions, with an adjustable delay of inter-ventricular stimulation. It includes moreover: circuits for atrial stimulation; circuits able to operate the device in AAI mode with right atrial stimulation and right ventricular detection; circuits for detection of ventricular capture, to determine the detection or the loss of capture after a right ventricular stimulation and a left ventricular stimulation; and of the circuits for mode switching, able to control a switching of mode, from the mode of resynchronization towards AAI mode, in response to the detection of a loss of capture after a right ventricular stimulation or a left ventricular stimulation.

Claims

1. An active implantable medical device comprising:

means for right and left ventricular detection, able to detect a potential of spontaneous depolarization in the right ventricle and the left ventricle;

means for right atrial detection and eventually left atrial detection, able to detect a potential of spontaneous depolarization in the right atrium and eventually in the left atrium;

means for right and left ventricular stimulation, able to deliver to the right ventricle and to the left ventricle impulses of stimulation; and

means able to operate the device in a mode of resynchronization of the ventricular contractions, comprising means to establish an adjustable inter-ventricular delay between the moments of application of the impulses respectively delivered to the right ventricle and to the left ventricle during the same cardiac cycle;

said device characterized in that it further comprises;

means for atrial stimulation, able to deliver impulses of stimulation to the right atrium,

means able to operate the device in AAI mode with right atrial stimulation and right ventricular detection;

means for detection of ventricular capture, to determine the detection or the loss of capture after a right ventricular stimulation and a left ventricular stimulation; and

means for mode switching, able to control a mode switching from a mode of resynchronization towards AAI mode in response to the detection of a loss of capture after a right ventricular stimulation or a left ventricular stimulation.

2. The device of claim 1 further comprising:

means for analyzing the heartbeat rate, said means being able to detect occurrence of an atrio-ventricular block;

means able to operate the device in double-chamber stimulation DDD mode with atrio-ventricular association, and in which;

the means for mode switching are also able to control the mode switching from AAI towards DDD mode in the event of detection of an atrio-ventricular block.

3. The device of claim 1, in which the means for mode switching are also able to control the opposite switching from AAI mode towards the mode of resynchronization in response to detection of a re-establishment of the right and left ventricular capture.

4. The device of claim 3, in which the means for mode switching further comprise means to apply a predetermined delay before the aforementioned opposite switching from AAI mode towards the mode of resynchronization, after the aforementioned detection of a re-establishment of the right and left ventricular capture.

5. The device of claim 3, in which the means for mode switching further comprise means for, after opposite switching from the AAI mode towards the mode of resynchronization, inhibiting all new later switching from the mode of resynchronization towards the AAI mode for a predetermined length of time.