Pacing method

• US 7,529,584 B2
• Filed: 02/19/2004
• Issued: 05/05/2009
• Est. Priority Date: 09/30/2002
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Laske, Timothy G., Iaizzo, Paul A.
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US10/782,420
• Publication Number:
  US 20060142814A1
• Time in Patent Office: 1,902 Days
• Field of Search: 607/28, 607/9, 607/27, 600/517
• US Class Current: 607/9
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook

Abstract

A method for delivering physiological pacing includes selecting an electrode implant site within an interventricular septal zone, which is in proximity to the bundle of His where pacing stimulation results in a rhythm breaking out at an intrinsic location, and wherein a ratio of sensed P-wave amplitude to sensed R-wave amplitude is less than approximately 0.5 and a pacing threshold is less than or equal to approximately 1.5 volts.

Claims

1. A method for delivering physiological pacing, the method comprising the steps of:

identifying a zone within an interventricular septum of a patient'"'"'s heart, which is in proximity to the bundle of His where pacing stimulation results in a rhythm breaking out at an intrinsic location;

mapping locations within the identified interventricular septal zone according to a ratio of measured P-wave amplitude to R-wave amplitude and a pacing threshold measurement;

selecting an electrode implant site from the mapped locations where a mapped location exhibits a ratio of P-wave amplitude to R-wave amplitude that is less than approximately 0.5 and exhibits a pacing threshold is less than or equal to approximately 1.5 volts; and

positioning an electrode at the selected implant site to deliver physiological pacing,

wherein the step of mapping locations comprises measuring a P-wave amplitude and an R-wave amplitude at each mapped location to determine the ratio and measuring a pacing threshold at each mapped location.

2. The method of claim 1, wherein the mapping step comprises:

positioning an electrode within the identified interventricular septal zone at different locations;

sensing a P-wave at each location and measuring the P-wave amplitude;

sensing an R-wave at each location and measuring the R-wave amplitude; and

pacing at each location and measuring a pacing threshold.

3. The method of claim 2, wherein the step of positioning an electrode comprises positioning a single electrode or pair of electrodes at the different locations by varying an insertion depth.

4. The method of claim 2, wherein the step of positioning an electrode comprises positioning a single electrode or pair of electrodes at the different locations by re-inserting the single electrode or pair of electrodes.

5. The method of claim 2, wherein the step of positioning an electrode comprises positioning an array of electrodes and selecting a single electrode or pair of electrodes from the array at each of the different locations.

6. The method of claim 2, wherein the step of positioning an electrode comprises inserting a single electrode or pair of electrodes by advancing the single electrode or pair of electrodes endocardially through a right atrium.

7. The method of claim 2, wherein the step of positioning an electrode comprises inserting a single electrode or pair of electrodes by advancing the single electrode or pair of electrodes endocardially through a right ventricle.

8. The method of claim 2, wherein the step of positioning an electrode comprises inserting a single electrode or pair of electrodes by advancing the single electrode or pair of electrodes epicardially.