Apparatus and methods of energy efficient, atrial-based Bi-ventricular fusion-pacing
First Claim
1. A method of bi-ventricular, fusion-pacing therapy delivery to a non-synchronous pair of ventricles, including delivery of a single ventricular pre-excitation pacing pulse to a relatively late activated ventricular chamber to promote mechanical synchrony between the late activated ventricular chamber and a relatively more rapid, intrinsically conducting ventricular chamber, comprising:
- measuring an intrinsic atrio-ventricular delay interval for a first-to-depolarize ventricular (V1) chamber for at least two prior cardiac cycles; and
delivering during a subsequent cardiac cycle at least one ventricular pre-excitation pacing pulse to a second-to-depolarize ventricular (V2) chamber,wherein said at least one ventricular pre-excitation pacing pulse is delivered at the expiration of a V2 pacing interval, wherein the V2 pacing interval is temporally shorter than an A-V1 delay interval derived from the measured intrinsic atrio-ventricular delay intervals of the V1 chamber.
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Accused Products
Abstract
The bi-ventricular implantable pulse generator described and depicted herein enables hemodynamic efficiencies for patients suffering from intraventricular conduction delays or conduction blockage. The pulse generator effectively overcomes such conduction delay or block (e.g., left bundle branch block, “LBBB,” or right bundle branch block, “RBBB”) by delivering a novel form of cardiac resynchronization therapy (CRT). Specifically, a single ventricular pre-excitation pacing stimulus is triggered from an atrial event (e.g., intrinsic or evoked depolarization). The triggering event may emanate from the right atrium (RA) or the left atrium (LA). A single ventricular pre-excitation pacing stimulus is delivered prior to the intrinsic depolarization of the other ventricle and thus promotes intraventricular electromechanical synchrony during CRT delivery.
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Citations
51 Claims
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1. A method of bi-ventricular, fusion-pacing therapy delivery to a non-synchronous pair of ventricles, including delivery of a single ventricular pre-excitation pacing pulse to a relatively late activated ventricular chamber to promote mechanical synchrony between the late activated ventricular chamber and a relatively more rapid, intrinsically conducting ventricular chamber, comprising:
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measuring an intrinsic atrio-ventricular delay interval for a first-to-depolarize ventricular (V1) chamber for at least two prior cardiac cycles; and delivering during a subsequent cardiac cycle at least one ventricular pre-excitation pacing pulse to a second-to-depolarize ventricular (V2) chamber, wherein said at least one ventricular pre-excitation pacing pulse is delivered at the expiration of a V2 pacing interval, wherein the V2 pacing interval is temporally shorter than an A-V1 delay interval derived from the measured intrinsic atrio-ventricular delay intervals of the V1 chamber. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An apparatus for delivering bi-ventricular, fusion-pacing therapy to one of a non-synchronous pair of ventricles, to promote mechanical synchrony between an intrinsically first-to-depolarize ventricular chamber and an intrinsically second-to-depolarize, ventricular chamber, comprising:
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means for measuring an intrinsic atrio-ventricular delay interval for a first-to-depolarize ventricular (V1) chamber for at least two prior cardiac cycles; and means for delivering during a subsequent cardiac cycle at least one ventricular pre-excitation pacing pulse to a second-to-depolarize ventricular (V2) chamber, wherein said at least one ventricular pre-excitation pacing pulse is delivered at the expiration of a V2 pacing interval, wherein the V2 pacing interval is temporally shorter than an A-V1 delay interval derived from the measured intrinsic atrio-ventricular delay intervals of the V1 chamber. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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37. A computer readable medium for storing instructions for delivering bi-ventricular, fusion-pacing therapy to one of a non-synchronous pair of ventricles, to promote mechanical synchrony between an intrinsically first-to-depolarize ventricular chamber and an intrinsically second-to-depolarize, ventricular chamber, comprising:
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instructions for measuring an intrinsic atrio-ventricular delay interval for a first-to-depolarize ventricular (V1) chamber for at least two prior cardiac cycles; and instructions for delivering during a subsequent cardiac cycle at least one ventricular pre-excitation pacing pulse to a second-to-depolarize ventricular (V2) chamber, wherein said at least one ventricular pre-excitation pacing pulse is delivered at the expiration of a V2 pacing interval, wherein the V2 pacing interval is temporally shorter than an A-V1 delay interval derived from the measured intrinsic atrio-ventricular delay intervals of the V1 chamber. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51)
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Specification