Active Implantable Medical Device For Cardiac Resynchronization With Automatic Optimization Of Atrioventricular And Interventricular Delays
First Claim
1. An active implantable medical device for cardiac resynchronization therapy, comprising:
- means for detecting spontaneous and stimulated atrial events and spontaneous and stimulated ventricular events;
means for stimulating a patient'"'"'s left and right ventricles;
means for calculating of an atrioventricular delay (AVD) having a duration counted from a detection of one of a spontaneous and stimulated atrial event;
means for delivering a ventricle stimulation pulse in the right ventricle in the absence of detected spontaneous ventricular event during the calculated AVD;
means for calculating an inter-ventricular delay (VVD) between delivery of stimulation pulses in the patient'"'"'s left and right ventricles; and
means for collecting of an endocardial acceleration (EA) signal representative of movements produced by cyclical contractions of the patient'"'"'s atrial and ventricular cavities;
wherein the means for calculating the AVD and the means for calculating the VVD further comprise;
means for identifying and isolating in the collected EA signal a component EA4 that corresponds to the fourth peak of the EA signal associated with the atrial activity, and a first measure of a temporal parameter related to the time interval between the atrial event detection (P/A) and a marker related to the EA4 component that immediately follows the atrial event detection;
means for identifying and isolating in the EA signal a component EA1 that corresponds to the first peak of endocardial acceleration associated with the ventricular isovolumetric contraction, and a second measure of one of a non-temporal parameter related to the peak amplitude or a signal energy of the EA1 component;
means for determining an optimal AVD (AVDO) as a function of said first measure, said AVDO being calculated for each of a plurality of different values of VVD, so as to obtain a plurality of pairs of values {AVDO, VVD} andmeans for selecting, among said plurality of pairs of values {AVDO, VVD}, one of said pairs of values based on said non-temporal parameter related to the EA1 component.
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Abstract
An active implantable medical device for cardiac resynchronization with automatic optimization of atrioventricular and interventricular delays is disclosed. The device collects an endocardial acceleration signal EA and calculates the atrioventricular delay AVD and the interventricular delay VVD. The device isolate in the EA signal a component EA4 corresponding to the fourth EA peak and measure a temporal parameter related to a time interval between the detection of an atrial event (P/A) and the occurrence of the EA4 component. The device isolates an EA1 component corresponding to the first EA peak and measures a non-temporal parameter (APEA1) related to the peak amplitude or a signal energy of the EA1 component. The optimal AVD (AVDO) is determined by the temporal parameter related to the EA4 component, and is calculated for a plurality of different values of VVD to obtain a plurality of pairs of optimal values {AVDO, VVD}. The device selects one of these pairs of values based on the non-temporal parameter related to the EA1 component.
21 Citations
8 Claims
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1. An active implantable medical device for cardiac resynchronization therapy, comprising:
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means for detecting spontaneous and stimulated atrial events and spontaneous and stimulated ventricular events; means for stimulating a patient'"'"'s left and right ventricles; means for calculating of an atrioventricular delay (AVD) having a duration counted from a detection of one of a spontaneous and stimulated atrial event; means for delivering a ventricle stimulation pulse in the right ventricle in the absence of detected spontaneous ventricular event during the calculated AVD; means for calculating an inter-ventricular delay (VVD) between delivery of stimulation pulses in the patient'"'"'s left and right ventricles; and means for collecting of an endocardial acceleration (EA) signal representative of movements produced by cyclical contractions of the patient'"'"'s atrial and ventricular cavities; wherein the means for calculating the AVD and the means for calculating the VVD further comprise; means for identifying and isolating in the collected EA signal a component EA4 that corresponds to the fourth peak of the EA signal associated with the atrial activity, and a first measure of a temporal parameter related to the time interval between the atrial event detection (P/A) and a marker related to the EA4 component that immediately follows the atrial event detection; means for identifying and isolating in the EA signal a component EA1 that corresponds to the first peak of endocardial acceleration associated with the ventricular isovolumetric contraction, and a second measure of one of a non-temporal parameter related to the peak amplitude or a signal energy of the EA1 component; means for determining an optimal AVD (AVDO) as a function of said first measure, said AVDO being calculated for each of a plurality of different values of VVD, so as to obtain a plurality of pairs of values {AVDO, VVD} and means for selecting, among said plurality of pairs of values {AVDO, VVD}, one of said pairs of values based on said non-temporal parameter related to the EA1 component. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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Specification