Method and apparatus for adjustment of sequential biventricular pacing parameters
First Claim
1. An implantable cardiac rhythm management device, comprising:
- sensing amplifiers for incorporating into atrial, right ventricular, and left ventricular sensing channels;
one or more pulse generators for incorporating into right and left ventricular pacing channels;
a controller for controlling the output of pacing pulses and receiving signals from the sensing amplifiers, wherein the controller is programmed to deliver a left ventricular pace and a right ventricular pace separated by a programmed biventricular offset interval in accordance with a demand pacing mode;
wherein the controller is programmed to generate signals from which the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, may be measured; and
,wherein the controller is programmed to compute an optimum biventricular offset interval in accordance with a formula which expresses the optimum biventricular offset interval as a function of the measured Δ
RL interval.
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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. An implantable cardiac rhythm management device, comprising:
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sensing amplifiers for incorporating into atrial, right ventricular, and left ventricular sensing channels; one or more pulse generators for incorporating into right and left ventricular pacing channels; a controller for controlling the output of pacing pulses and receiving signals from the sensing amplifiers, wherein the controller is programmed to deliver a left ventricular pace and a right ventricular pace separated by a programmed biventricular offset interval in accordance with a demand pacing mode; wherein the controller is programmed to generate signals from which the delay between right ventricular and left ventricular activation during an intrinsic beat, referred to as the Δ
RL interval, may be measured; and
,wherein the controller is programmed to compute an optimum biventricular offset interval in accordance with a formula which expresses the optimum biventricular offset interval as a function of the measured Δ
RL interval. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. An implantable cardiac rhythm management device, comprising:
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sensing amplifiers for incorporating into atrial, right ventricular, and left ventricular sensing channels; one or more pulse generators for incorporating into right and left ventricular pacing channels; a controller for controlling the output of pacing pulses and receiving electrogram signals from the sensing amplifiers, wherein the controller is programmed to deliver right and left ventricular pacing in accordance with a programmed pacing mode; 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 (19, 20)
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Specification