CARDIAC DEVICE INTERFACE TO REDUCE VENTRICULAR PACING
First Claim
1. A method of programming an implantable cardiac rhythm management device to avoid unnecessary ventricular pacing, the method comprising:
- measuring an intrinsic conducted AV interval at a first heart rate or interval, wherein the intrinsic conducted AV interval is initiated by either a sensed or paced atrial contraction and is concluded by a sensed ventricular contraction;
measuring the first heart rate or interval;
automatically measuring or automatically extrapolating intrinsic conducted AV intervals at heart rates or intervals that are different from the first heart rate or interval to determine a measured or predicted intrinsic conducted AV interval as a function of different heart rates or intervals, wherein the automatically extrapolating includes using the measured intrinsic conducted AV interval at the measured first heart rate or interval and the measured first heart rate or interval for performing the extrapolating; and
automatically suggesting or automatically programming a dynamic AV delay interval, based upon the measured or predicted intrinsic conducted AV interval as a function of the different heart rates or intervals, such that the dynamic AV delay interval is longer than the measured or predicted intrinsic conducted AV interval at each of the different heart rates or intervals.
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Abstract
A cardiac interface device helps program an implantable cardiac rhythm or function management device, such as to reduce unnecessary ventricular pacing to avoid contributing to the advancement of heart failure disease progression. An intrinsic conducted AV interval is measured for at least one heart rate, and is predicted or measured for other heart rates. One or more of an age-predicted upper rate limit, a measured sensed AV offset, a PVARP based on measured retrograde conduction time can be used to determine an AV search hysteresis control parameter, and a resulting ventricular interval is graphically displayed relative to the intrinsic conducted AV interval at various heart rates. Confidence intervals or percentage ventricular pacing can also be displayed. Separate graphs for sense and pace initiated AV intervals can be provided.
38 Citations
33 Claims
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1. A method of programming an implantable cardiac rhythm management device to avoid unnecessary ventricular pacing, the method comprising:
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measuring an intrinsic conducted AV interval at a first heart rate or interval, wherein the intrinsic conducted AV interval is initiated by either a sensed or paced atrial contraction and is concluded by a sensed ventricular contraction; measuring the first heart rate or interval; automatically measuring or automatically extrapolating intrinsic conducted AV intervals at heart rates or intervals that are different from the first heart rate or interval to determine a measured or predicted intrinsic conducted AV interval as a function of different heart rates or intervals, wherein the automatically extrapolating includes using the measured intrinsic conducted AV interval at the measured first heart rate or interval and the measured first heart rate or interval for performing the extrapolating; and automatically suggesting or automatically programming a dynamic AV delay interval, based upon the measured or predicted intrinsic conducted AV interval as a function of the different heart rates or intervals, such that the dynamic AV delay interval is longer than the measured or predicted intrinsic conducted AV interval at each of the different heart rates or intervals. - 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. An apparatus for programming an implantable cardiac rhythm management device to avoid unnecessary ventricular pacing, the apparatus comprising:
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means for measuring an intrinsic conducted AV interval at a first heart rate or interval, wherein the intrinsic conducted AV interval is initiated by either a sensed or paced atrial contraction and is concluded by a sensed ventricular contraction; means for measuring the first heart rate or interval; means for automatically measuring or automatically extrapolating intrinsic conducted AV intervals at heart rates or intervals that are different from the first heart rate or interval to determine a measured or predicted intrinsic conducted AV interval as a function of different heart rates or intervals, wherein the automatically extrapolating includes using the measured intrinsic conducted AV interval at the measured first heart rate or interval and the measured first heart rate or interval for performing the extrapolating; and means for automatically suggesting or automatically programming a dynamic AV delay interval, based upon the measured or predicted intrinsic conducted AV interval as a function of the different heart rates or intervals, such that the dynamic AV delay interval is longer than the measured or predicted intrinsic conducted AV interval at each of the different heart rates or intervals.
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22. An apparatus for programming an implantable cardiac rhythm management device to avoid unnecessary ventricular pacing, the apparatus comprising:
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an atrial sensing circuit; an atrial therapy circuit; a ventricular sensing circuit; a ventricular therapy circuit a controller circuit, coupled to the atrial sensing and therapy circuits and the ventricular sensing and therapy circuits, the controller circuit configured to; measure an intrinsic conducted AV interval at a first heart rate or interval, wherein the intrinsic conducted AV interval is initiated by either a sensed or paced atrial contraction and is concluded by a sensed ventricular contraction; measure the first heart rate or interval; measure or extrapolate intrinsic conducted AV intervals at heart rates or intervals that are different from the first heart rate or interval to determine a measured or predicted intrinsic conducted AV interval as a function of different heart rates or intervals, wherein the extrapolating includes using the measured intrinsic conducted AV interval at the measured first heart rate or interval and the measured first heart rate or interval for performing the extrapolating; and to automatically suggest or automatically program a dynamic AV delay interval, based upon the measured or predicted intrinsic conducted AV interval as a function of the different heart rates or intervals, such that the dynamic AV delay interval is longer than the measured or predicted intrinsic conducted AV interval at each of the different heart rates or intervals. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method comprising:
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displaying to a user a graphical indication of AV interval vs. heart rate or interval; displaying to the user at least one of; first data of predicted or measured intrinsic conducted AV interval as a function of heart rate or interval; second data of a time intervals, as a function of heart rate or interval, between a sensed atrial contraction and a sensed ventricular contraction occurring during the same cardiac cycle; and third data of time intervals, as a function of heart rate or interval, between a paced atrial contraction and a sensed ventricular contraction occurring during the same cardiac cycle; and displaying to the user an indication of an expected or actual amount of ventricular pacing for at least one heart rate for at least one of the first data, the second data, and the third data.
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33. An apparatus comprising:
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a user interface including a display configured to display to a user a graphical indication of AV interval vs. heart rate or interval and at least one of; first data of predicted or measured intrinsic conducted AV interval as a function of heart rate or interval; second data of a time intervals, as a function of heart rate or interval, between a sensed atrial contraction and a sensed ventricular contraction occurring during the same cardiac cycle; and third data of time intervals, as a function of heart rate or interval, between a paced atrial contraction and a sensed ventricular contraction occurring during the same cardiac cycle; and wherein the user interface is also configured to display to the user an indication of an expected or actual amount of ventricular pacing for at least one heart rate for at least one of the first data, the second data, and the third data.
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Specification