MORPHOLOGY-BASED OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY
First Claim
1. A method for operating a cardiac rhythm management device in a patient, comprising:
- delivering paces to both right and left ventricles in accordance with a programmed biventricular pacing mode, such that the biventricular paces are delivered at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event;
recording evoked response test electrograms during the biventricular pacing;
comparing the test electrograms to evoked response template electrograms representing biventricular capture, left ventricle-only capture, and right ventricle-only capture to determine the type of pacing event that has occurred during a paced cardiac cycle; and
, maintaining a count of the number of instances of each type of pacing event.
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Abstract
A method and apparatus for delivering cardiac resynchronization therapy (CRT) in which an evoked response electrogram is recorded during one or more cardiac cycles and used to aid in the selection of resynchronization pacing parameters and/or to monitor the effectiveness of resynchronization therapy. The morphology of an evoked response electrogram may be recorded and analyzed to determine if and when intrinsic activation of one ventricle is occurring in order to optimally adjust the programmed atrio-ventricular (AV) delay interval for ventricular resynchronization pacing of a patient with intact AV node conduction.
111 Citations
20 Claims
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1. A method for operating a cardiac rhythm management device in a patient, comprising:
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delivering paces to both right and left ventricles in accordance with a programmed biventricular pacing mode, such that the biventricular paces are delivered at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event;
recording evoked response test electrograms during the biventricular pacing;
comparing the test electrograms to evoked response template electrograms representing biventricular capture, left ventricle-only capture, and right ventricle-only capture to determine the type of pacing event that has occurred during a paced cardiac cycle; and
,maintaining a count of the number of instances of each type of pacing event. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac rhythm management device, comprising:
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pacing channels through which paces may be delivered to both right and left ventricles;
one or more sensing channels;
a controller programmed to deliver the paces in accordance with a programmed biventricular pacing mode at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event;
wherein the controller is programmed to;
record evoked response test electrograms during the biventricular pacing;
compare the test electrograms to evoked response template electrograms representing biventricular capture, left ventricle-only capture, and right ventricle-only capture to determine the type of pacing event that has occurred during a paced cardiac cycle; and
,maintain a count of the number of instances of each type of pacing event. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification