Methods and apparatuses for cardiac resynchronization therapy mode selection based on intrinsic conduction
First Claim
1. A method of selecting a cardiac resynchronization therapy (CRT) mode, the method comprising:
- sensing electrocardiogram (ECG) data for a patient;
identifying a PR interval from the sensed ECG data;
comparing the PR interval to a predetermined time threshold; and
selecting a CRT mode by selecting between a synchrony optimization mode and a preload optimization mode, the selection based on the comparison of the PR interval to the predetermined time threshold, wherein;
the synchrony optimization mode is selected if the PR interval is less than the predetermined time threshold, optimizes CRT for fusion between a left ventricular pulse and an intrinsic atrial activity wavefront, and comprises either a LV only CRT that stimulates only the left ventricle or a biventricular simultaneous CRT that stimulates the left ventricle and the right ventricle simultaneously; and
the preload optimization mode is selected if the PR interval is greater than the predetermined time threshold, comprises a biventricular sequential CRT that stimulates the left ventricle and the right ventricle where timing between stimulation of the left ventricular and the right ventricle is optimized for fusion between respective wavefronts of the left ventricular pulse and a right ventricular pulse, and timing between atrial activity and the left ventricular pulse is optimized for blood preloading of the left ventricle.
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Abstract
Systems and methods for selecting a cardiac resynchronization therapy (CRT) mode involve sensing electrocardiogram (ECG) data for a patient, identifying a PR interval from the sensed ECG data, comparing the PR interval to a threshold, and selecting a CRT mode by selecting between a synchrony optimization mode and a preload optimization mode, the selection based on the comparison of the PR interval to the threshold. A synchrony optimization mode may be selected if the parameter is less than the threshold, and may optimize CRT for fusion between a left ventricular pulse and an intrinsic wavefront. The preload optimization mode may be selected if the parameter is greater than the threshold, and may optimize CRT for fusion between respective wavefronts of the left ventricular pace and a right ventricular pace.
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Citations
22 Claims
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1. A method of selecting a cardiac resynchronization therapy (CRT) mode, the method comprising:
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sensing electrocardiogram (ECG) data for a patient; identifying a PR interval from the sensed ECG data; comparing the PR interval to a predetermined time threshold; and selecting a CRT mode by selecting between a synchrony optimization mode and a preload optimization mode, the selection based on the comparison of the PR interval to the predetermined time threshold, wherein; the synchrony optimization mode is selected if the PR interval is less than the predetermined time threshold, optimizes CRT for fusion between a left ventricular pulse and an intrinsic atrial activity wavefront, and comprises either a LV only CRT that stimulates only the left ventricle or a biventricular simultaneous CRT that stimulates the left ventricle and the right ventricle simultaneously; and the preload optimization mode is selected if the PR interval is greater than the predetermined time threshold, comprises a biventricular sequential CRT that stimulates the left ventricle and the right ventricle where timing between stimulation of the left ventricular and the right ventricle is optimized for fusion between respective wavefronts of the left ventricular pulse and a right ventricular pulse, and timing between atrial activity and the left ventricular pulse is optimized for blood preloading of the left ventricle. - View Dependent Claims (2, 3, 4)
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5. A method of selecting a cardiac resynchronization therapy (CRT) mode, the method comprising:
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sensing an electrophysiologic signal containing cardiac data from a patient; identifying a cardiac parameter from the sensed electrophysiologic data; comparing the parameter to a predetermined time threshold; and selecting a CRT mode by selecting between a synchrony optimization mode and a preload optimization mode, the selection based on the comparison of the parameter to the predetermined time threshold, wherein the synchrony optimization mode optimizes CRT for fusion between a left ventricular pulse and an intrinsic atrial activity wavefront; and the preload optimization mode optimizes CRT for fusion between respective wavefronts of the left ventricular pulse and a right ventricular pulse. - View Dependent Claims (6, 7, 8, 9, 10, 11)
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12. A cardiac resynchronization therapy (CRT) system, the system comprising:
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memory; an implantable housing configured to be implanted in a patient; a plurality of electrodes coupled to the housing; sensing circuitry configured to sense a least one electrocardiac signal using at least some of the plurality of electrodes; stimulation circuitry configured to deliver a CRT using at least some of the plurality of electrodes in a synchrony optimization mode with pulse timing for fusion between a left ventricular pulse and an intrinsic atrial activity wavefront, and a preload optimization mode with pulse timing for fusion between respective wavefronts of the left ventricular pulse and a right ventricular pulse; and a controller configured to execute program instructions stored in the memory to cause the system to identify at least one parameter of the at least one electrocardiac signal, compare the parameter to a parameter predetermined time threshold, and select between the synchrony optimization mode and the preload optimization mode for therapy delivery using the stimulation circuitry based on the comparison of the parameter to the parameter predetermined time threshold. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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19. A system of selecting a cardiac resynchronization therapy (CRT) mode, the system comprising:
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means for sensing an electrophysiologic signal containing cardiac information from a patient; means for identifying a cardiac parameter from the sensed electrophysiologic signal; means for comparing the parameter to a predetermined time threshold; and means for selecting a CRT mode by selecting between a synchrony optimization mode and a preload optimization mode, the selection based on the comparison of the parameter to the predetermined time threshold, wherein the synchrony optimization mode optimizes CRT for fusion between a left ventricular pulse and an intrinsic atrial activity wavefront; and the preload optimization mode optimizes CRT for fusion between respective wavefronts of the left ventricular pace and a right ventricular pace. - View Dependent Claims (20, 21, 22)
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Specification