Method and system for delivering cardiac resynchronization therapy with variable atrio-ventricular delay
First Claim
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1. A cardiac rhythm management system, comprising:
- a plurality of sense amplifiers configured to sense cardiac electrical activity;
a plurality of pulse generators configured to deliver pacing pulses; and
a controller for controlling delivery of the pacing pulses, the controller programmed to;
control delivery of ventricular pacing using a programmable atrio-ventricular delay (AVD) interval in accordance with an atrial tracking or AV sequential pacing mode;
determine a present atrial rate;
vary the AVD interval by setting the AVD interval to an optimum value stored in a table, the optimal value associated with the present atrial rate;
measure an intrinsic conduction parameter;
compute an optimal value for the AVD interval as a linear function of the measured intrinsic conduction parameter; and
initialize or update the table by storing the computed optimal value and an associated atrial rate in the table, the associated atrial rate corresponding to the present atrial rate.
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Abstract
A pacing system computes optimal cardiac resynchronization pacing parameters using intrinsic conduction intervals. In various embodiments, values for atrio-ventricular delay intervals are each computed as a function of an intrinsic atrio-ventricular interval and a parameter reflective of an interventricular conduction delay. Examples of the parameter reflective of the interventricular conduction delay include QRS width and interval between right and left ventricular senses.
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Citations
20 Claims
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1. A cardiac rhythm management system, comprising:
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a plurality of sense amplifiers configured to sense cardiac electrical activity; a plurality of pulse generators configured to deliver pacing pulses; and a controller for controlling delivery of the pacing pulses, the controller programmed to; control delivery of ventricular pacing using a programmable atrio-ventricular delay (AVD) interval in accordance with an atrial tracking or AV sequential pacing mode; determine a present atrial rate; vary the AVD interval by setting the AVD interval to an optimum value stored in a table, the optimal value associated with the present atrial rate; measure an intrinsic conduction parameter; compute an optimal value for the AVD interval as a linear function of the measured intrinsic conduction parameter; and initialize or update the table by storing the computed optimal value and an associated atrial rate in the table, the associated atrial rate corresponding to the present atrial rate. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method for operating an implantable cardiac rhythm management device, comprising:
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sensing cardiac electrical activity using the implantable cardiac rhythm management device; delivering pacing pulses from the implantable cardiac rhythm management device; controlling the delivering pacing pulses using a programmable atrio-ventricular delay (AVD) interval in accordance with an atrial tracking or AV sequential pacing mode; determining a present atrial rate using the sensed cardiac electrical activity; setting the AVD interval to an optimum value stored in a table, the optimal value associated with the present atrial rate; measuring at least one intrinsic conduction parameter using the sensed cardiac electrical activity; computing an optimal value for the AVD interval as a linear function of the measured at least one intrinsic conduction parameter; and initialize or update the table by storing the computed optimal value and an associated atrial rate in the table, the associated atrial rate corresponding to the present atrial rate. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20)
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Specification