Anodal stimulation detection and avoidance
First Claim
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1. A cardiac resynchronization therapy system, comprising:
- an implantable lead system comprising left and right ventricular electrodes configurable in at least an extended bipolar configuration and at least an alternative bipolar or unipolar configuration differing from the extended bipolar configuration, at least one left ventricular electrode defining a cathode of the extended bipolar configuration and a right ventricular electrode defining an anode of the extended bipolar configuration;
energy delivery circuitry coupled to the lead system;
sensing circuitry coupled to the lead system;
a controller coupled to the sensing circuitry and the energy delivery circuitry, the controller configured to execute program instructions for sensing cardiac electrical activity and delivering cardiac resynchronization therapy (CRT) to the heart in accordance with programmed pacing parameters including a non-zero intraventricular delay (IVD), the controller configured to deliver a pace pulse to the at least one left ventricular electrode defining the cathode of the extended bipolar configuration;
a detector coupled to the sensing circuitry and the controller, the detector configured to sense for a response to the pace pulse and detect anodal stimulation of the right ventricle based on the sensed response; and
the controller is configured to selectably switch from a current extended bipolar pace vector to an alternative bipolar or unipolar pace vector without ganging an additional anode electrode with the right ventricular electrode to mitigate or eliminate detected anodal stimulation of the right ventricle.
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Abstract
Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.
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Citations
28 Claims
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1. A cardiac resynchronization therapy system, comprising:
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an implantable lead system comprising left and right ventricular electrodes configurable in at least an extended bipolar configuration and at least an alternative bipolar or unipolar configuration differing from the extended bipolar configuration, at least one left ventricular electrode defining a cathode of the extended bipolar configuration and a right ventricular electrode defining an anode of the extended bipolar configuration; energy delivery circuitry coupled to the lead system; sensing circuitry coupled to the lead system; a controller coupled to the sensing circuitry and the energy delivery circuitry, the controller configured to execute program instructions for sensing cardiac electrical activity and delivering cardiac resynchronization therapy (CRT) to the heart in accordance with programmed pacing parameters including a non-zero intraventricular delay (IVD), the controller configured to deliver a pace pulse to the at least one left ventricular electrode defining the cathode of the extended bipolar configuration; a detector coupled to the sensing circuitry and the controller, the detector configured to sense for a response to the pace pulse and detect anodal stimulation of the right ventricle based on the sensed response; and the controller is configured to selectably switch from a current extended bipolar pace vector to an alternative bipolar or unipolar pace vector without ganging an additional anode electrode with the right ventricular electrode to mitigate or eliminate detected anodal stimulation of the right ventricle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A method of delivering cardiac resynchronization therapy, comprising:
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selectably delivering cardiac resynchronization therapy (CRT) to a heart using at least an extended bipolar electrode configuration and at least an alternative bipolar or unipolar electrode configuration differing from the extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay (IVD), the extended bipolar electrode configuration comprising at least a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a single right ventricular electrode defining an anode of the extended bipolar electrode configuration; delivering a pace pulse to the left ventricular electrode; sensing for a response to the pace pulse; detecting anodal stimulation of the right ventricle based on the sensed response; and switching from a current extended bipolar pace vector to an alternative bipolar or unipolar pace vector without ganging an additional anode electrode with the single right ventricular electrode to mitigate or eliminate detected anodal stimulation of the right ventricle. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A system for delivering cardiac resynchronization therapy, comprising:
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means for selectably delivering cardiac resynchronization therapy (CRT) to a heart using at least an extended bipolar electrode configuration and at least an alternative bipolar or unipolar electrode configuration differing from the extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay (IVD), the extended bipolar electrode configuration comprising at least a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a single right ventricular electrode defining an anode of the extended bipolar electrode configuration; energy delivery circuitry configured to deliver a pace pulse to the left ventricular electrode; sensing circuitry configured to sense for a response to the pace pulse; means for detecting anodal stimulation of the right ventricle based on the sensed response; and means for switching from a current extended bipolar pace vector to an alternative bipolar or unipolar pace vector without ganging an additional anode electrode with the right ventricular electrode to mitigate or eliminate detected anodal stimulation of the right ventricle.
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Specification