SYSTEMS, DEVICES AND METHODS RELATING TO ENDOCARDIAL PACING FOR RESYNCHRONIZATION

• US 20110319956A1
• Filed: 09/01/2011
• Published: 12/29/2011
• Est. Priority Date: 12/20/2004
• Status: Active Grant

• Current Assignee: Newstim, Inc.
• Original Assignee: Daniel Felipe Ortega, Qingsheng Zhu
• Inventors: Zhu, Qingsheng, Ortega, Daniel Felipe
• Granted Patent: US 8,825,155 B2
• Time in Patent Office: Days
• US Class Current: 607/25
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0565 Electrode heads
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• 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

Abstract

Disclosed are certain methods, apparatus, and processor-readable mediums that may be used to treat a conduction abnormality of the heart. In one example, the apparatus includes an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including a first pulse for delivery via a first electrode; and a second pulse for delivery via a second electrode; and wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other.

Claims

1. An apparatus, comprising:

an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including;

a first pulse for delivery via a first electrode; and

a second pulse for delivery via a second electrode; and

wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other.

2. The apparatus of claim 1, wherein the implantable pacing profile generator is configured to monitor one or more of:

a QRS width, an electrogram fractionation, a late LV activation timing, a mechanical synchronicity of a free wall and a septal wall, or an effective throughput.

3. The apparatus of claim 2, wherein the pacing profile generator includes a wireless interface configured to allow an external device to obtain monitored information indicative of one or more of:

the QRS width, the electrogram fractionation, the late LV activation timing, the mechanical synchronicity of the free wall and the septal wall, or the effective throughput.

4. The apparatus of claim 1, wherein the first and second pulses are substantially identical in time and duration.

5. The apparatus of claim 1, further comprising an implantable lead assembly including the first electrode and the second electrode.

6. The apparatus of claim 1, wherein the pacing profile generator includes a wireless interface configured to receive a command to adjust one or more parameters of the pacing profile from an external device in response to monitored information indicative of one or more of:

a QRS width, an electrogram fractionation, a late LV activation timing, a mechanical synchronicity of a free wall and a septal wall, or an effective throughput.

7. The apparatus of claim 6, wherein the one or more adjustable parameters include one or more of a pulse width, a pulse amplitude, or a timing offset between initiation or termination of respective pulses.

8. A method, comprising:

generating a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including;

a first pulse for delivery via a first electrode; and

a second pulse for delivery via a second electrode; and

wherein the first and second pulses at least partially concurrent in time and opposite in polarity to each other.

9. The method of claim 8, comprising monitoring one or more of:

a QRS width, an electrogram fractionation, a late LV activation timing, a mechanical synchronicity of a free wall and a septal wall, or an effective throughput.

10. The method of claim 9, comprising wirelessly communicating to an external device monitored information indicative of one or more of:

the QRS width, the electrogram fractionation, the late LV activation timing, the mechanical synchronicity of the free wall and the septal wall, or the effective throughput.

11. The method of claim 8, wherein the first and second pulses are substantially identical in time and duration.

12. The method of claim 8, comprising receiving, at an implantable medical device, a command to adjust one or more parameters of the pacing profile, the command provided from an external device using a wireless interface.

13. The method of claim 12, wherein the one or more adjustable parameters include one or more of a pulse width, a pulse amplitude, or a timing offset between initiation or termination of respective pulses.

14. The method of claim 8, comprising adjusting one or more of the adjustable parameters to improve at least one of:

a QRS width, an electrogram fractionation, a late LV activation timing, a mechanical synchronicity of a free wall and a septal wall, or an effective throughput.

15. A processor-readable medium comprising instructions, which when executed by a processor included as a portion of an implantable medical device cause the implantable medical device to:

generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including;

a first pulse for delivery via a first electrode; and

a second pulse for delivery via a second electrode; and

wherein the first and second pulses at least partially concurrent in time and opposite in polarity to each other.

16. The processor-readable medium of claim 15, wherein the instructions include instructions that cause the implantable medical device to monitor one or more of:

a QRS width, an electrogram fractionation, a late LV activation timing, a mechanical synchronicity of a free wall and a septal wall, or an effective throughput.

17. The processor-readable medium of claim 16, wherein the instructions include instructions that cause the implantable medical device to wirelessly communicate monitored information indicative of one or more of:

the QRS width, the electrogram fractionation, the late LV activation timing, the mechanical synchronicity of the free wall and the septal wall, or the effective throughput.

18. The processor-readable medium of claim 17, wherein the first and second pulses are substantially identical in time and duration.

19. The processor-readable medium of claim 18, wherein the instructions include instructions that cause the implantable medical device to receive a command to adjust one or more parameters of the pacing profile, the command provided from an external device using a wireless interface.

20. The processor-readable medium of claim 19, wherein the one or more adjustable parameters include one or more of a pulse width, a pulse amplitude, or a timing offset between initiation or termination of respective pulses.