IMPLANTABLE CARDIAC RESYNCHRONIZER WITH BIVENTRICULAR PACING AND DETECTION OF LOSS OF CAPTURE AND ANODAL STIMULATION
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Abstract
A medical device for stimulating the heart using biventricular stimulation. The device includes a sensor for detecting an endocardial acceleration parameter and a processing circuit configured to receive the endocardial acceleration parameter. The device further includes stimulation electronics coupled to the processing circuit. The processing circuit is configured to use the EA parameter to evaluate the biventricular stimulation. The evaluation includes comparing the value of the EA parameter in biventricular mode to the value of the EA parameter in left only mode or right only mode, and using the comparison and an assessment of the variability of the EA parameter as a function of the AVD in the left or right mode to distinguish between cases comprising: (a) normal operation, (b) a loss of RV or LV capture, (c) possible anodal stimulation. The processing circuit is further configured to conduct at least one update to operational parameters of the device based on the determined case.
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Citations
40 Claims
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1-20. -20. (canceled)
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21. An active implantable medical device that provides cardiac resynchronization by biventricular pacing, comprising:
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a memory storing a plurality of executable instructions; and a processor configured to execute the instructions to; selectively operate the stimulation in a first mode and a second mode, the first mode comprising a right only mode wherein a right ventricle is stimulated and a left ventricle is not stimulated or a left only mode wherein the left ventricle is stimulated and the right ventricle is not stimulated, the second mode comprising a biventricular mode in which both the left ventricle and the right ventricle are stimulated; receive, from an endocardial acceleration sensor, an endocardial acceleration (EA) signal in each of the first mode and the second mode; extract, from the EA signal, an EA parameter in each of the first mode and the second mode; use the extracted EA parameters to evaluate the stimulation in the second mode, the evaluation comprising comparing values of the EA parameter in the second mode to the values of the EA parameter in the first mode to distinguish between;
(a) normal operation, (b) a loss of a right ventricular capture or a left ventricular capture, and (c) possible anodal stimulation. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A method for an active implantable medical device that provides cardiac resynchronization by biventricular pacing, comprising:
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receiving, from an endocardial acceleration sensor, an endocardial acceleration (EA) signal in a first mode, wherein only one of the left ventricle and the right ventricle are stimulated and a second mode, wherein both of a left ventricle and a right ventricle are stimulated, extracting, from the EA signal, an EA parameter in each of the first mode and the second mode; and comparing values of the EA parameter of the first mode to the values of the EA parameter of the second mode to distinguish between a plurality of operating conditions of the active implantable medical device; and updating an operational parameter of the device based on the comparison of the values of the EA parameter in the first mode to the values of the EA parameter in the second mode. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36)
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37. An active implantable medical device that provides cardiac resynchronization by biventricular pacing, comprising:
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a sensor configured to generate an endocardial acceleration (EA) signal in a first mode, wherein only one of the left ventricle and the right ventricle are stimulated, and a second mode, wherein both of a left ventricle and a right ventricle are stimulated; and processing electronics configured to; receive the EA signal; extract, from the EA signal, an EA parameter in each of the first mode and the second mode; and compare values of the EA parameter of the first mode to the values of the EA parameter of the second mode to distinguish between a plurality of operating conditions of the active implantable medical device; and update an operational parameter of the device based on the comparison of the values of the EA parameter in the first mode to the values of the EA parameter in the second mode. - View Dependent Claims (38, 39, 40)
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Specification