APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS
First Claim
1. A method of adjusting an operating atrio-ventricular (AV) interval in a cardiac pacing therapy delivery device, comprising:
- measuring the following temporal cardiac parameters of a subject'"'"'s heart;
a P-wave duration (PWd) value, a sensed intrinsic atrioventrical (PR) interval, a sensed or paced QRS duration (QRSd) value, a heart rate (HR) for at least one cardiac cycle;
calculating an optimized AV interval (AVopt) as a linear function of the sensed PWd value, the sensed PR interval value, the sensed or paced QRSd value, and the HR value; and
storing the calculated AV interval as an operating AV interval in a memory structure of a pacing therapy delivery device.
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Abstract
Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
123 Citations
22 Claims
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1. A method of adjusting an operating atrio-ventricular (AV) interval in a cardiac pacing therapy delivery device, comprising:
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measuring the following temporal cardiac parameters of a subject'"'"'s heart;
a P-wave duration (PWd) value, a sensed intrinsic atrioventrical (PR) interval, a sensed or paced QRS duration (QRSd) value, a heart rate (HR) for at least one cardiac cycle;calculating an optimized AV interval (AVopt) as a linear function of the sensed PWd value, the sensed PR interval value, the sensed or paced QRSd value, and the HR value; and storing the calculated AV interval as an operating AV interval in a memory structure of a pacing therapy delivery device. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. An apparatus for adjusting an operating atrio-ventricular (AV) interval in a cardiac pacing therapy delivery device, comprising:
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means for measuring the following temporal cardiac parameters of a subject'"'"'s heart;
a P-wave duration (PWd) value, a sensed intrinsic atrioventrical (PR) interval, a sensed or paced QRS duration (QRSd) value, a heart rate (HR) for at least one cardiac cycle;means for calculating an optimized AV interval (AVopt) as a linear function of the sensed PWd value, the sensed PR interval value, the sensed or paced QRSd value, and the HR value; and means for storing the calculated AV interval as an operating AV interval in a memory structure of a pacing therapy delivery device for diverse values of the measured parameters. - View Dependent Claims (19)
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20. A computer medium for storing executable instructions operable under computer processor control to adjust an operating atrio-ventricular (AV) interval in a cardiac pacing therapy delivery device, comprising:
- instructions;
instructions for measuring the following temporal cardiac parameters of a subject'"'"'s heart;
a P-wave duration (PWd) value, a sensed intrinsic atrioventrical (PR) interval, a sensed or paced QRS duration (QRSd) value, a heart rate (HR) for at least one cardiac cycle;instructions for calculating an optimized AV interval (AVopt) as a linear function of the sensed PWd value, the sensed PR interval value, the sensed or paced QRSd value, and the HR value; and instructions for storing the calculated AV interval as an operating AV interval in a memory structure of a pacing therapy delivery device. - View Dependent Claims (21)
- instructions;
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22. An apparatus for adjusting an operating atrio-ventricular (AV) interval in a pacing therapy delivery device, comprising:
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at least a pair of electrodes adapted to sense a PQRST complex, including a P-wave, a sensed intrinsic atrioventrical event (PR), a QRS complex, a heart rate (HR, based on successive R-waves); a processor coupled to the at least a pair of electrodes and adapted to determine a P-wave duration (PWd) value beginning from a sensed atrial event, an intrinsic atrioventrical (PR) interval based upon, a sensed or paced QRS duration (QRSd) value, and a heart rate (HR) for at least one cardiac cycle; means for calculating an optimized AV interval (AVopt) as a linear function of the sensed PWd value, the sensed PR interval value, the sensed or paced QRSd value, and the HR value; and a memory structure adapted to receive the AVopt from the means for calculating as an operating AV interval in a pacing therapy delivery device for diverse values of the measured parameters.
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Specification