Systems and Methods for Controlling Ventricular Pacing in Patients with Long Inter-Atrial Conduction Delays
First Claim
1. A method for controlling the delivering cardiac pacing therapy using an implantable cardiac stimulation device, the method comprising:
- determining an atrio-ventricular pacing delay (AV/PV) and an interventricular pacing delay (VV) for use in pacing the heart of the patient based, in part, on a measured inter-atrial conduction time delay (IACT);
comparing the atrio-ventricular pacing delay (AV/PV) with a measured atrio-ventricular conduction delay (AR/PR);
if the atrio-ventricular pacing delay (AV/PV) is less than the measured atrio-ventricular conduction delay (AR/PR), delivering biventricular pacing using the atrio-ventricular pacing delay (AV/PV) and the interventricular pacing delay (VV); and
if the atrio-ventricular pacing delay (AV/PV) is not less than the corresponding atrio-ventricular conduction delay (AR/PR), selectively enabling an alternative pacing regime.
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Accused Products
Abstract
Techniques are provided for use by implantable medical devices for controlling ventricular pacing. In one example, optimal atrio-ventricular and interventricular pacing delay values are determined for pacing the heart of the patient based, in part, on a measured inter-atrial conduction delay. Atrio-ventricular conduction delays are then measured within the patient. The atrio-ventricular pacing delays are compared with the measured atrio-ventricular conduction delays. If the atrio-ventricular pacing delays are less than the measured atrio-ventricular conduction delays, biventricular pacing is delivered using the atrio-ventricular pacing delay and the interventricular pacing delay. However, if the atrio-ventricular pacing delays are not less than the corresponding atrio-ventricular conduction delays, as can occur if the inter-atrial conduction delay is large, then alternative pacing regimes are selectively enabled, such as monoventricular pacing in the chamber having the longer conduction delay value, biventricular pacing with negative hysteresis, or biventricular pacing with pacing delays reduced using predetermined offset values.
143 Citations
19 Claims
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1. A method for controlling the delivering cardiac pacing therapy using an implantable cardiac stimulation device, the method comprising:
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determining an atrio-ventricular pacing delay (AV/PV) and an interventricular pacing delay (VV) for use in pacing the heart of the patient based, in part, on a measured inter-atrial conduction time delay (IACT); comparing the atrio-ventricular pacing delay (AV/PV) with a measured atrio-ventricular conduction delay (AR/PR); if the atrio-ventricular pacing delay (AV/PV) is less than the measured atrio-ventricular conduction delay (AR/PR), delivering biventricular pacing using the atrio-ventricular pacing delay (AV/PV) and the interventricular pacing delay (VV); and if the atrio-ventricular pacing delay (AV/PV) is not less than the corresponding atrio-ventricular conduction delay (AR/PR), selectively enabling an alternative pacing regime. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A system for controlling cardiac pacing therapy to the heart of a patient in which an implantable cardiac stimulation device is implanted, the system comprising:
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a pacing delay determination unit operative to determine an atrio-ventricular pacing delay (AV/PV) and an inter-ventricular pacing delay for use in pacing the heart of the patient based, in part, on a measured inter-atrial conduction time delay (IACT); an atrio-ventricular conduction delay measurement unit operative to measure atrio-ventricular conduction delays (AR/PR) in the patient; and a ventricular pacing controller operative to selectively enable a ventricular pacing regime based on a comparison of, at least, the atrio-ventricular pacing delay (AV/PV) and the measured atrio-ventricular conduction delay (AR/PR). - View Dependent Claims (17, 18)
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19. A system for controlling cardiac pacing therapy to the heart of a patient in which an implantable cardiac stimulation device is implanted, the system comprising:
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means for determining an atrio-ventricular pacing delay (AV/PV) and an interventricular pacing delay (VV) for use in pacing the heart of the patient based, in part, on a measured inter-atrial conduction time delay (IACT); means for comparing the atrio-ventricular pacing delay (AV/PV) with a measured atrio-ventricular conduction delay (AR/PR); means, operative if the atrio-ventricular pacing delay (AV/PV) is less than the measured atrio-ventricular conduction delay (AR/PR), for delivering biventricular pacing using the atrio-ventricular pacing delay (AV/PV) and the interventricular pacing delay (VV); and means, operative if the atrio-ventricular pacing delay (AV/PV) is not less than the corresponding atrio-ventricular conduction delay (AR/PR), for selectively enabling an alternative pacing regime.
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Specification