Circuit-based devices and methods for pulse control of endocardial pacing in cardiac rhythm management
First Claim
1. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
- an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region so as to increase synchronization of the right and left ventricles relative to pacing at the apex of the right ventricle.
3 Assignments
0 Petitions
Accused Products
Abstract
Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart.
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Citations
43 Claims
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1. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region so as to increase synchronization of the right and left ventricles relative to pacing at the apex of the right ventricle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
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an electrode control module, included in an implantable pulse generator (IPG), configured for providing one or more control signals for generating an electrical pacing signal that includes separately and individually addressable and controlled pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for a single myocardium capture at or near the target region so as to activate one or more conduction fibers in at least one of the Left Bundle Branch (LBB) of His, Right Bundle Branch (RBB) of His, or Purkinje fibers so as to increase synchronization of the right and left ventricles relative to pacing at the apex of the right ventricle; a monitor configured to monitor at least one of a QRS width of the patient, a fractionation of the patient, and a timing of electrical stimulation of a late activation site of the left ventricle relative to the QRS, and wherein the control module is configured to adjust, using information from the monitor, the one or more control signals for generating the electrical pacing signal; wherein the control module is configured for providing one or more control signals for generating the electrical pacing signal that includes pulse waveforms of opposing polarities that are alternating in time and are capable of at least partially overlapping in time by an adjustable overlap duration (OD) using information from the monitor. - View Dependent Claims (26, 27, 28, 29, 30, 31)
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32. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region wherein the control module is configured for providing one or more control signals for generating the electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time by an adjustable overlap duration (OD). - View Dependent Claims (33, 34)
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35. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
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an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region, wherein the control module is configured for providing one or more control signals for generating the electrical pacing signal that includes pulse waveforms of opposing polarities that are alternating in polarity with each other over time by an amount of alternating that is capable of reducing anodal blocking at the target region in the right ventricle at or near the septum of the heart and distal from the apex of the right ventricle. - View Dependent Claims (36, 37)
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38. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
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an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region, wherein the control module is configured for selecting one or more individual electrodes, from a plurality of electrodes located along the septum of the right ventricle away from the apex of the right ventricle, for providing the electrical pacing signal that includes pulse waveforms of opposing polarities. - View Dependent Claims (39, 40)
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41. For use in a myocardium capture by delivering electrical pacing signals via electrodes to a target region in the right ventricle, at or near the septum of a heart and distal from an apex of the right ventricle, a circuit arrangement comprising:
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an electrode control module configured for providing one or more control signals for generating an electrical pacing signal that includes pulse waveforms of opposing polarities that are capable of at least partially overlapping in time to drive the electrodes such that the two pulse waveforms occur sufficiently proximate one another in time for the myocardium capture at or near the target region, wherein the control module is configured for providing one or more control signals for generating the electrical pacing signal for a particular set of at least two electrodes so as to be capable of being switched between (1) at least partially overlapping in time; and
(2) one of unipolar pacing or bipolar pacing. - View Dependent Claims (42, 43)
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Specification