SELECTING PACING SITE OR SITES BASED ON CARDIO-PULMONARY INFORMATION

• US 20100042174A1
• Filed: 08/12/2008
• Published: 02/18/2010
• Est. Priority Date: 08/12/2008
• Status: Abandoned Application

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Koh, Steve, Yang, Michael, Ryu, Kyungmoo
• Application Number:
  US12/190,545
• Publication Number:
  US 20100042174A1
• Time in Patent Office: Days
• US Class Current: 607/19
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/3688 configured for switching the pacing mode, e.g. from AAI to DDD
• CPC Class Codes: A61N 1/3708 for power depletion

Abstract

An exemplary method for multi-tier pacing includes delivering single site, left ventricular pacing, sensing patient activity; comparing the sensed patient activity to a patient activity threshold and, if the sensed patient activity exceeds the patient activity threshold, then delivering multi-site, left ventricular pacing for a predetermined period of time and, after the predetermined period of time, delivering single, site left ventricular pacing. In such a method, the period of time may be determined based on cardio-pulmonary demand. Other exemplary technologies are also disclosed.

Claims

1. A method for multi-tier pacing comprising:

delivering single site, left ventricular pacing;

sensing patient activity;

comparing the sensed patient activity to a patient activity threshold;

if the sensed patient activity exceeds the patient activity threshold, then delivering multi-site, left ventricular pacing for a predetermined period of time; and

after the predetermined period of time, delivering single site, left ventricular pacing.

2. The method of claim 1 wherein the predetermined period of time comprises a period of time based at least in part on cardio-pulmonary demand.

3. The method of claim 1 wherein the predetermined period of time comprises a period of time based at least in part on a battery level.

4. The method of claim 1 wherein the predetermined period of time comprises a period of time based at least in part on the sensed patient activity.

5. The method of claim 1 further comprising sensing intrathoracic impedance.

6. The method of claim 5 further comprising sensing intrathoracic impedance during the delivering multi-site, left ventricular pacing.

7. The method of claim 5 further comprising determining tidal volume based on the sensed intrathoracic impedance.

8. The method of claim 7 further comprising comparing the tidal volume to a tidal volume threshold and if the tidal volume exceeds the tidal volume threshold, then delivering multi-site, left ventricular pacing and right ventricular pacing.

9. The method of claim 7 further comprising comparing the tidal volume to a tidal volume threshold and if the tidal volume exceeds the tidal volume threshold, then delivering multi-site, left ventricular pacing and multi-site, right ventricular pacing.

10. The method of claim 9 further comprising delivering the multi-site, left ventricular pacing and multi-site right ventricular pacing for a predetermined period of time.

11. A method for multi-tier pacing, the method comprising:

providing a first pacing tier that comprises left ventricular pacing only wherein the pacing paces the left ventricle at at least one left ventricular pacing site;

providing a second pacing tier that comprises bi-ventricular pacing;

providing a third pacing tier that comprises left ventricular pacing wherein the pacing paces the left ventricle at a greater number of left ventricular pacing sites than the first pacing tier;

sensing patient activity; and

selecting the first, second or third pacing tier for delivery of pacing therapy based at least in part on the sensed patient activity.

12. A method for multi-tier pacing, the method comprising:

providing a first pacing tier that comprises single-site ventricular pacing;

providing a second pacing tier that comprises multi-site ventricular pacing;

providing a decision tree to decide whether to select the first pacing tier or the second pacing tier based on cardio-pulmonary demand; and

calling for delivery of pacing therapy according to the first pacing tier or the second pacing tier based on a decision of the decision tree.

13. The method of claim 12 wherein the decision tree comprises a decision based at least in part on patient activity.

14. The method of claim 12 wherein the decision tree comprises a decision based at least in part on heart rate.

15. The method of claim 12 wherein the decision tree comprises a decision based at least in part on respiration.

16. The method of claim 12 wherein the decision tree comprises at least one of a decision based at least in part on patient activity, a decision based at least in part on heart rate, and a decision based at least in part on respiration.

17. A method for multi-tier pacing, the method comprising:

providing a first pacing tier that comprises single-site ventricular pacing;

providing a second pacing tier that comprises bi-ventricular pacing;

providing a third pacing tier that comprises multi-site ventricular pacing of both ventricles;

providing a decision tree to decide whether to select the first pacing tier, the second pacing tier or the third pacing tier based on cardio-pulmonary demand; and

calling for delivery of pacing therapy according to the first pacing tier, the second pacing tier or the third pacing tier based on a decision of the decision tree.