METHOD AND APPARATUS FOR ADJUSTABLE AVD PROGRAMMING USING A TABLE

• US 20070135854A1
• Filed: 02/14/2007
• Published: 06/14/2007
• Est. Priority Date: 12/12/2003
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Yu, Yinghong, Ding, Jiang, Spinelli, Julio, Kramer, Andrew
• Application Number:
  US11/674,773
• Publication Number:
  US 20070135854A1
• Time in Patent Office: Days
• US Class Current: 607/30
• 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 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

A pacing system provides for optimal hemodynamic cardiac function for parameters such as ventricular synchrony or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal. A look-up table relating the timing of such electrical or mechanical events to atrio-ventricular delay time intervals is provided for programming the pacing system.

Claims

1. An apparatus for programming a cardiac pacemaker, the apparatus comprising:

a look-up table including values of a first cardiac parameter, values of a second cardiac parameter, and values of a programmable pacing parameter arranged to allow mapping of a measured value of the first cardiac parameter and a measured value of the second cardiac parameters to one of the values of the programmable pacing parameter.

2. The apparatus of claim 1, wherein the programmable pacing parameter comprises an atrio-ventricular delay (AVD).

3. The apparatus of claim 2, wherein the first cardiac parameter comprises a time interval between two cardiac electrical events each detected from an intracardiac electrogram.

4. The apparatus of claim 2, wherein the first cardiac parameter comprises a time interval between a cardiac electrical event detected from an intracardiac electrogram and a pressure event detected from a blood pressure signal.

5. The apparatus of claim 2, wherein the second cardiac parameter comprises a QRS duration.

6. The apparatus of claim 2, wherein each of the values of the AVD is calculated using a mathematical relationship between the AVD and the first cardiac parameter.

7. The apparatus of claim 6, wherein the each of the values of the AVD is calculated using an equation relating the AVD to the first cardiac parameter and constants, the constants each selected using the second cardiac parameter.

8. An apparatus for programming a cardiac pacemaker, the apparatus comprising:

a look-up table for determining an atrio-ventricular delay (AVD) using a measured atrio-ventricular interval (AV) and a measured QRS duration, the look-up table including;

an AV list including a plurality of AV value ranges;

a QRS duration list including a plurality of QRS duration ranges; and

a plurality of atrio-ventricular delay (AVD) lists each corresponding to one of the QRS duration ranges and including a plurality of AVD values each corresponding to one of the AV value ranges, wherein each AVD value of the plurality of AVD lists is calculated using an equation relating the AVD to the AV and constants each selected using the QRS duration.

9. The apparatus of claim 8, wherein the look-up table is presented in a visually readable form comprising:

a first column including the plurality of AV value ranges;

a first row including the plurality of QRS duration ranges; and

second columns each including a list of the AVD values each corresponding to one of the QRS duration ranges in the first row and including a plurality of AVD values each corresponding to one of the AV value ranges in the first column.

10. The apparatus of claim 9, comprising a card to present the look-up table.

11. The apparatus of claim 9, comprising a screen to display the look-up table upon request.

12. The apparatus of claim 8, wherein the look-up table is in a microprocessor-readable form, and furthering comprising a microprocessor-based device to electronically store the look-up table.

13. The apparatus of claim 12, wherein the microprocessor-based device comprises:

a user input device adapted to receive the measured AV value and the measured QRS duration value; and

an output device adapted to produce a value for the AVD mapped to the measured AV value and the measured QRS duration value using the electronically stored look-up table.

14. A method for producing a look-up table for a cardiac pacing device, the method comprising:

generating a plurality of first value ranges for a first cardiac parameter;

generating a plurality of second value ranges for a second cardiac parameter;

determining values for a programmable pacing parameter each corresponding to one value range of the plurality of first value ranges and one value range of the plurality of second value ranges; and

producing a look-up table including the plurality of first value ranges, the plurality of second value ranges, and the values for the programmable pacing parameter arranged to allow mapping of a measured value of the first cardiac parameter and a measured value of the second cardiac parameter to one of the values for the programmable pacing parameter.

15. The method of claim 14, comprising presenting the look-up table in a visual form.

16. The method of claim 14, comprising storing the look-up table in a microprocessor-readable form.

17. The method of claim 14, wherein:

generating the plurality of first value ranges comprises generating a plurality of value ranges for an atrio-ventricular interval (AV);

generating the plurality of second value ranges comprises generating a plurality of value ranges for a QRS duration; and

determining values for the programmable pacing parameter comprises determining values for an atrio-ventricular delay (AVD).

18. The method of claim 17, wherein determining each of the values of the AVD comprises determining an AV value representative of each value range of the plurality of value ranges for the AV.

19. The method of claim 18, wherein determining the each of the values of the AVD comprises calculating the each of the values of the AVD using an equation:

AVD=N1·

AV−

N2, where AVD is the each of the values of the AVD, AV is the AV value representative of the each value range of the plurality of value ranges for the AV, and N1 and N2 are predetermined constants each selected using the QRS duration.

20. The method of claim 19, wherein determining the each of the values of the AVD comprises:

setting the each of the values of the AVD to a predetermined minimum value if the each of the values of the AVD as calculated using the equation is below the predetermined minimum value; and

setting the each of the values of the AVD to a predetermined maximum value if the each of the values of the AVD as calculated using the equation is above the predetermined maximum value.