Morphology-based optimization of cardiac resynchronization therapy
First Claim
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1. A method for operating a cardiac rhythm management device in a patient, comprising:
- delivering paces to both right and left ventricles in accordance with a programmed biventricular pacing mode, such that the paces are delivered at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event;
switching to a single ventricle pacing mode and recording an evoked response test electrogram during a single ventricle pace with the programmed AV delay interval;
comparing the test electrogram to an evoked response template electrogram previously recorded during single ventricle pacing when the programmed AV delay interval was known to be matched to the patient'"'"'s then existing intrinsic AV interval;
adjusting the programmed AV delay interval to match the patient'"'"'s current intrinsic AV interval based upon the comparison of the test and template electrograms;
returning to the biventricular pacing mode with the adjusted AV delay interval.
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Abstract
A method and apparatus for delivering cardiac resynchronization therapy (CRT) in which an evoked response electrogram is recorded during one or more cardiac cycles and used to aid in the selection of resynchronization pacing parameters and/or to monitor the effectiveness of resynchronization therapy. The morphology of an evoked response electrogram may be recorded and analyzed to determine if and when intrinsic activation of one ventricle is occurring in order to optimally adjust the programmed atrio-ventricular (AV) delay interval for ventricular resynchronization pacing of a patient with intact AV node conduction.
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Citations
8 Claims
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1. A method for operating a cardiac rhythm management device in a patient, comprising:
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delivering paces to both right and left ventricles in accordance with a programmed biventricular pacing mode, such that the paces are delivered at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event; switching to a single ventricle pacing mode and recording an evoked response test electrogram during a single ventricle pace with the programmed AV delay interval; comparing the test electrogram to an evoked response template electrogram previously recorded during single ventricle pacing when the programmed AV delay interval was known to be matched to the patient'"'"'s then existing intrinsic AV interval; adjusting the programmed AV delay interval to match the patient'"'"'s current intrinsic AV interval based upon the comparison of the test and template electrograms; returning to the biventricular pacing mode with the adjusted AV delay interval. - View Dependent Claims (2, 3, 4)
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5. A cardiac rhythm management device, comprising:
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pacing channels through which paces may be delivered to both right and left ventricles; one or more sensing channels; a controller programmed to deliver the paces in accordance with a programmed biventricular pacing mode at a programmed biventricular offset interval and after a programmed AV delay interval with respect to an atrial event; wherein the controller is programmed to; switch to a single ventricle pacing mode and recording an evoked response test electrogram during a single ventricle pace with the programmed AV delay interval; compare the test electrogram to an evoked response template electrogram previously recorded during single ventricle pacing when the programmed AV delay interval was known to be matched to the patient'"'"'s then existing intrinsic AV interval; adjust the programmed AV delay interval to match the patient'"'"'s current intrinsic AV interval based upon the comparison of the test and template electrograms; return to the biventricular pacing mode with the adjusted AV delay interval. - View Dependent Claims (6, 7, 8)
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Specification