Systems, devices and methods for monitoring efficiency of pacing
First Claim
1. An apparatus comprising:
- a monitoring circuit configured to monitor a left ventricular contraction elicited at least partially in response to an electrostimulation delivered from a location in a right ventricle of the heart at or near a His bundle, the electrostimulation comprising two at least partially overlapping opposite polarity waveforms; and
a processor circuit configured to;
determine an efficacy of the delivered electrostimulation using information provided by the monitoring circuit obtained during the left ventricular contraction about at least one of;
a QRS width, an electrogram fractionation, a pressure generated by the heart, or a timing activation of a late activation site of the left ventricle; and
adjust an electrostimulation parameter for subsequent electrostimulation using information about the efficacy.
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Accused Products
Abstract
Various systems, methods, devices and arrangements are implemented for use in pacing of the heart. One implementation is directed to methods and systems for determining a pacing location in the right ventricle of a heart and near the His bundle. A pacing signal is delivered to the location in the right ventricle. The pacing signal produces a capture of a left ventricle. Properties of the capture are monitored. Results of the monitored capture are used to assess the effectiveness of the delivered pacing signal as a function of heart function. The heart function can be, for example, at least one of a QRS width, fractionation and a timing of electrical stimulation of a late activation site of a left ventricle relative to the QRS.
386 Citations
22 Claims
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1. An apparatus comprising:
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a monitoring circuit configured to monitor a left ventricular contraction elicited at least partially in response to an electrostimulation delivered from a location in a right ventricle of the heart at or near a His bundle, the electrostimulation comprising two at least partially overlapping opposite polarity waveforms; and a processor circuit configured to; determine an efficacy of the delivered electrostimulation using information provided by the monitoring circuit obtained during the left ventricular contraction about at least one of;
a QRS width, an electrogram fractionation, a pressure generated by the heart, or a timing activation of a late activation site of the left ventricle; andadjust an electrostimulation parameter for subsequent electrostimulation using information about the efficacy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A processor-readable medium including instructions that, when performed by a processor, cause the processor to:
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monitor a left ventricular contraction elicited at least partially in response to an electrostimulation delivered from a location in a right ventricle of the heart at or near a His bundle, the electrostimulation comprising two at least partially overlapping opposite polarity waveforms; determine an efficacy of the delivered electrostimulation using information provided by the monitoring operation about at least one of;
a QRS width, an electrogram fractionation, a pressure generated by the heart, or a timing of activation of a late activation site of the left ventricle; andadjust an electrostimulation parameter for subsequent electrostimulation using information about the efficacy. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method comprising:
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monitoring a left ventricular contraction elicited at least partially in response to an electrostimulation delivered from a location in a right ventricle of the heart at or near a His bundle, the electrostimulation comprising two at least partially overlapping opposite polarity waveforms; determining an efficacy of the delivered electrostimulation using information provided by the monitoring operation about at least one of;
a QRS width, an electrogram fractionation, a pressure generated by the heart, or a timing of activation of a late activation site of the left ventricle; andadjusting an electrostimulation parameter for subsequent electrostimulation using information about the efficacy.
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Specification