System and method for determining optimal pacing sites based on myocardial activation times
First Claim
1. A method for determining a preferred location for delivering cardiac pacing pulses to the myocardium of a heart chamber of a patient, the method comprising:
- collecting information pertaining to myocardial activation times within the myocardium of a selected heart chamber of the patient;
determining the preferred location for pacing for the selected chamber based on the information pertaining to myocardial activation times by identifying the last activated site within the myocardium of the selected chamber; and
positioning one or more electrodes at a location selected based on the preferred location.
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Accused Products
Abstract
The optimal location for delivering pacing pulses to a given cardiac chamber (such as the left ventricle) is determined by identifying the last electrically or mechanically activated site within the chamber. For example, the last site within the left ventricular myocardium to depolarize during an intrinsic ventricular contraction triggered by an initial atrial depolarization is identified as being the optimal pacing location for the left ventricle. A pacing electrode is then implanted as close as possible to that location. The technique is particularly effective for use in identifying optimal epicardial pacing locations for mounting satellite pacing devices for use in delivering cardiac resynchronization therapy. However, the techniques may also be applied to identify locations for mounting endocardial electrodes as well. Capture thresholds may also be taken into account in determining the optimal location. Examples are described for both master/satellite pacing systems as well as biventricular single device systems.
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Citations
25 Claims
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1. A method for determining a preferred location for delivering cardiac pacing pulses to the myocardium of a heart chamber of a patient, the method comprising:
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collecting information pertaining to myocardial activation times within the myocardium of a selected heart chamber of the patient;
determining the preferred location for pacing for the selected chamber based on the information pertaining to myocardial activation times by identifying the last activated site within the myocardium of the selected chamber; and
positioning one or more electrodes at a location selected based on the preferred location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A system for determining a preferred location for cardiac pacing for a patient, the system comprising:
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means for collecting information pertaining to myocardial activation times within a selected heart chamber of the patient; and
means for determining the preferred location for pacing within the selected chamber by identifying the last activated site within the myocardium of the selected chamber.
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22. A system for determining a preferred location for delivering cardiac pacing pulses to the myocardium of a heart chamber of a patient, the system comprising:
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circuitry operative to collect information for the patient pertaining to myocardial activation times within a selected heart chamber of the patient; and
an optimal pacing location determination system operative to determine a preferred location for pacing within the selected chamber based on the information pertaining to myocardial activation times by identifying the last activated site within the myocardium of the selected chamber. - View Dependent Claims (23, 24, 25)
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Specification