Systems and methods for selectively limiting multi-site ventricular pacing delays during optimization of cardiac resynchronization therapy parameters
First Claim
1. A method for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead in combination with an RV lead, the method comprising:
- detecting intraventricular and interventricular conduction delays for paced cardiac events;
determining maximum pacing time delays for use with MSLV pacing, wherein the maximum pacing time delays are set, based on the conduction delays, to values sufficient to avoid capture problems due to wavefront propagation;
setting MSLV pacing time delays to values no greater than the maximum pacing delays; and
controlling the delivery of ventricular pacing to deliver a set of pulses using the MSLV pacing delays;
wherein the device accommodates two programmable MSLV delays (IED#1 and IED#2);
wherein the device is programmed to apply a first MSLV pacing sequence (Seq#1) wherein an RV pulse is followed by an LV1 pacing pulse and then by an LV2 pacing pulse, wherein LV1 represents a first LV pacing site, LV2 represents a second LV pacing site, and a first pacing delay (IED#1) is applied between the RV and LV1 pulses and a second pacing delay (IED#2) is applied between the LV1 and LV2 pulses.
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Accused Products
Abstract
Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.
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Citations
14 Claims
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1. A method for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead in combination with an RV lead, the method comprising:
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detecting intraventricular and interventricular conduction delays for paced cardiac events; determining maximum pacing time delays for use with MSLV pacing, wherein the maximum pacing time delays are set, based on the conduction delays, to values sufficient to avoid capture problems due to wavefront propagation; setting MSLV pacing time delays to values no greater than the maximum pacing delays; and controlling the delivery of ventricular pacing to deliver a set of pulses using the MSLV pacing delays; wherein the device accommodates two programmable MSLV delays (IED#1 and IED#2); wherein the device is programmed to apply a first MSLV pacing sequence (Seq#1) wherein an RV pulse is followed by an LV1 pacing pulse and then by an LV2 pacing pulse, wherein LV1 represents a first LV pacing site, LV2 represents a second LV pacing site, and a first pacing delay (IED#1) is applied between the RV and LV1 pulses and a second pacing delay (IED#2) is applied between the LV1 and LV2 pulses. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A system for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead in combination with an RV lead, the system comprising:
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an intraventricular/interventricular activation time detector configured to detect intraventricular and interventricular conduction delays for paced cardiac events; a maximum MSLV pacing time delay determination system configured to determine maximum pacing time delays for use with MSLV pacing, wherein the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation; an MSLV pacing delay specification system configured to set MSLV pacing delays to values no greater than the maximum pacing time delays; and an MSLV controller configured to control delivery of ventricular pacing to deliver a set of pulses using the MSLV pacing delays; wherein the MSLV pacing delay specification system accommodates two programmable MSLV delays (IED#1 and IED#2); wherein the MSLV controller is programmed to apply a MSLV pacing sequence including an RV pacing pulse, an LV1 pacing pulse, and an LV2 pacing pulse, wherein LV1 represents a first LV pacing site and LV2 represents a second LV pacing site, and a first pacing delay (IED#1) is applied between a first pair of pulses in the MSLV pacing sequence and a second pacing delay (IED#2) is applied between a second pair of pulses in the MSLV pacing sequence.
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14. A system for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead in combination with an RV lead, the system comprising:
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means for detecting intraventricular and interventricular activation times for paced cardiac events; means for determining maximum pacing time delays for use with MSLV pacing, wherein the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation; means for setting MSLV pacing delays to values no greater than the maximum pacing time delays; and means for controlling delivery of ventricular pacing to deliver a set of pulses using the MSLV pacing delays; wherein the means for setting MSLV pacing delays accommodates two programmable MSLV delays (IED#1 and IED#2); wherein the means for controlling delivery is programmed to apply a MSLV pacing sequence including an RV pacing pulse, an LV1 pacing pulse, and an LV2 pacing pulse, wherein LV1 represents a first LV pacing site and LV2 represents a second LV pacing site, and a first pacing delay (IED#1) is applied between a first pair of pulses in the MSLV pacing sequence and a second pacing delay (IED#2) is applied between a second pair of pulses in the MSLV pacing sequence.
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Specification