SYSTEMS AND METHODS FOR OPTIMIZING VENTRICULAR PACING DELAYS DURING ATRIAL FIBRILLATION
First Claim
1. A method for controlling the delivery of cardiac pacing therapy by an implantable cardiac rhythm management device for use with patients subject to atrial fibrillation, the method comprising:
- detecting atrial fibrillation (AF) within the patient, and in response to detecting AF performing the following;
determining a first degree of variation within intervals between ventricular events sensed by the device on a first channel and preceding ventricular events sensed on a second channel;
determining a second degree of variation within intervals between ventricular events sensed by the device on the first channel and subsequent ventricular events sensed on the second channel; and
controlling ventricular pacing based, at least in part, on a comparison of the first and second degrees of variation.
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Abstract
Techniques are provided for use by implantable medical devices for controlling ventricular pacing, particularly during atrial fibrillation. In one example, during a V sense test for use in optimizing ventricular pacing, the implantable device determines relative degrees of variation within antecedent and succedent intervals detected between ventricular events sensed on left ventricular (LV) and right ventricular (RV) sensing channels. Preferred or optimal ventricular pacing delays are then determined, in part, based on a comparison of the relative degrees of variation obtained during the V sense test. In another example, during RV and LV pace tests, the device distinguishes QRS complexes arising due to interventricular conduction from QRS complexes arising due to atrioventricular conduction from the atria, so as to permit the determination of correct paced interventricular conduction delays for the patient. The paced interventricular conduction delays are also used to optimize ventricular pacing. Biventricular and monoventricular pacing regimes are provided.
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Citations
15 Claims
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1. A method for controlling the delivery of cardiac pacing therapy by an implantable cardiac rhythm management device for use with patients subject to atrial fibrillation, the method comprising:
detecting atrial fibrillation (AF) within the patient, and in response to detecting AF performing the following; determining a first degree of variation within intervals between ventricular events sensed by the device on a first channel and preceding ventricular events sensed on a second channel; determining a second degree of variation within intervals between ventricular events sensed by the device on the first channel and subsequent ventricular events sensed on the second channel; and controlling ventricular pacing based, at least in part, on a comparison of the first and second degrees of variation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A system for controlling the delivery of cardiac pacing therapy by an implantable cardiac rhythm management device for use with patients subject to atrial fibrillation (AF), the system comprising:
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an AF detection unit operative to detect an episode of AF; an interval variation determination unit operative in response to the detection of AF to determine a first degree of variation within intervals between ventricular events sensed on a first channel and preceding ventricular events sensed on a second channel; the interval variation determination unit further operative to determine a second degree of variation between ventricular events sensed on the first channel and subsequent ventricular events sensed on the second channel; and a ventricular pacing controller operative to control ventricular pacing based, at least in part, on a comparison of the first and second degrees of variation.
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15. A system for controlling the delivery of cardiac pacing therapy by an implantable cardiac rhythm management device for use with patients subject to atrial fibrillation (AF), the system comprising:
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means for detecting AF means, responsive to a detection of AF, for determining a first degree of variation within intervals between ventricular events sensed by the device on a first channel and preceding ventricular events sensed on a second channel; means for determining a second degree of variation within intervals between ventricular events sensed by the device on the first channel and subsequent ventricular events sensed on the second channel; and means for controlling ventricular pacing based, at least in part, on a comparison of the first and second degrees of variation.
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Specification