Method and apparatus for adjustment of sequential biventricular pacing parameters
First Claim
1. A system for setting one of more pacing parameters used by an implantable cardiac rhythm management device in delivering cardiac resynchronization therapy, comprising:
- an implantable cardiac rhythm management device that includes;
sensing channels for generating electrogram signals corresponding to electrical activity in an atrium, the right ventricle, and the left ventricle;
right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively;
a controller for interpreting electrogram signals and controlling the output of pacing pulses in a programmed pacing mode; and
a telemetry interface;
an external programmer in communication with the implantable device via the telemetry interface;
wherein the system is programmed to measure at least one intrinsic atrio-ventricular delay (AVD) interval from electrogram signals during an intrinsic beat and compute an optimum AVD interval for delivering ventricular pacing in an atrial tracking or AV sequential pacing mode in accordance with a formula which expresses the optimum AVD interval as a function of the measured intrinsic AVD interval;
wherein the system is programmed to measure the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, and compute an optimum biventricular offset (BVO) interval in accordance with a formula which expresses the optimum BVO interval as a function of the measured Δ
RL interval;
and,wherein the system is programmed to select between a left ventricle-only pacing mode, a right ventricle-only pacing mode, and a biventricular pacing mode based upon the computed optimum BVO and AVD intervals.
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Abstract
A method and system are disclosed for setting the pacing parameters utilized by an implantable cardiac device in delivering cardiac resynchronization therapy. The system may, in different embodiments, be implemented in programming of the implantable device and an external programmer in communication therewith or in the programming of the implantable device by itself. The selection of the pacing parameters is based at least in part upon measurements of intrinsic cardiac conduction parameters. Among the pacing parameters which may be selected in this way are the atrio-ventricular delay interval used in atrial-tracking and AV sequential pacing modes and the biventricular offset interval.
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Citations
20 Claims
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1. A system for setting one of more pacing parameters used by an implantable cardiac rhythm management device in delivering cardiac resynchronization therapy, comprising:
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an implantable cardiac rhythm management device that includes;
sensing channels for generating electrogram signals corresponding to electrical activity in an atrium, the right ventricle, and the left ventricle;
right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively;
a controller for interpreting electrogram signals and controlling the output of pacing pulses in a programmed pacing mode; and
a telemetry interface;an external programmer in communication with the implantable device via the telemetry interface; wherein the system is programmed to measure at least one intrinsic atrio-ventricular delay (AVD) interval from electrogram signals during an intrinsic beat and compute an optimum AVD interval for delivering ventricular pacing in an atrial tracking or AV sequential pacing mode in accordance with a formula which expresses the optimum AVD interval as a function of the measured intrinsic AVD interval; wherein the system is programmed to measure the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, and compute an optimum biventricular offset (BVO) interval in accordance with a formula which expresses the optimum BVO interval as a function of the measured Δ
RL interval;and, wherein the system is programmed to select between a left ventricle-only pacing mode, a right ventricle-only pacing mode, and a biventricular pacing mode based upon the computed optimum BVO and AVD intervals. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An implantable cardiac rhythm management device for delivering cardiac resynchronization therapy, comprising:
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sensing channels for generating electrogram signals corresponding to electrical activity in an atrium, the right ventricle, and the left ventricle; right and left ventricular pacing channels for delivering pacing pulses to the right and left ventricles, respectively; a controller for interpreting electrogram signals and controlling the output of pacing pulses in a programmed pacing mode; and
a telemetry interface;wherein the controller is programmed to measure at least one intrinsic atrio-ventricular delay (AVD) interval from electrogram signals during an intrinsic beat and compute an optimum AVD interval for delivering ventricular pacing in an atrial tracking or AV sequential pacing mode in accordance with a formula which expresses the optimum AVD interval as a function of the measured intrinsic AVD interval; wherein the controller is programmed to measure the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, and compute an optimum biventricular offset (BVO) interval in accordance with a formula which expresses the optimum BVO interval as a function of the measured Δ
RL interval;and, wherein the controller is programmed to select between a left ventricle-only pacing mode, a right ventricle-only pacing mode, and a biventricular pacing mode based upon the computed optimum BVO and AVD intervals. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A method for configuring an implantable cardiac rhythm management device for delivering cardiac resynchronization therapy, comprising:
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generating electrogram signals corresponding to electrical activity in an atrium, the right ventricle, and the left ventricle; measuring at least one intrinsic atrio-ventricular delay (AVD) interval from electrogram signals during an intrinsic beat and compute an optimum AVD interval for delivering ventricular pacing in an atrial tracking or AV sequential pacing mode in accordance with a formula which expresses the optimum AVD interval as a function of the measured intrinsic AVD interval; measuring the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, and compute an optimum biventricular offset (BVO) interval in accordance with a formula which expresses the optimum BVO interval as a function of the measured Δ
RL interval;and, selecting between a left ventricle-only pacing mode, a right ventricle-only pacing mode, and a biventricular pacing mode based upon the computed optimum BVO and AVD intervals. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification