System and method for left atrial pacing in patients with diastolic heart failure

• US 8,583,234 B1
• Filed: 08/09/2012
• Issued: 11/12/2013
• Est. Priority Date: 08/09/2012
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Muller, David
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US13/571,235
• Time in Patent Office: 460 Days
• Field of Search: 607/25, 607/3, 607/9
• US Class Current: 607/25
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

Techniques are provided for use with an implantable medical device for delivering left atrial (LA) pacing to address Diastolic Heart Failure, also referred to as Heart Failure with Preserved Ejection Fraction. In one example, pulse delivery times are selected for delivery of LA pacing pulses sufficient so that activation of the LA occurs when LA pressure (LAP) is lower than would occur in the absence of LA pacing. The pulse delivery times and also set so that subsequent activation of the right ventricle (RV) occurs when LAP is lower than would occur in the absence of LA pacing. LA pacing then is delivered by the implanted device at the selected pulse delivery times to mitigate Diastolic Heart Failure or to address other conditions.

Claims

1. A method for use with an implantable medical device having a stimulation electrode positioned for delivering left atrial pacing stimulation, the method comprising:

sensing electrical cardiac signals;

determining pulse delivery times for delivery of left atrial pacing pulses sufficient so that subsequent activation of the right ventricle of the heart of the patient occurs when left atrial pressure is lower than would occur in the absence of left atrial pacing; and

delivering left atrial pacing using the stimulation electrode at the determined pulse delivery times.

2. The method of claim 1 wherein the pulse delivery times are also sufficient so that activation of the left atrium occurs when left atrial pressure (LAP) is lower than would occur in the absence of left atrial (LA) pacing.

3. The method of claim 1 wherein determining the pulse delivery times for delivery of LA pacing pulses times includes:

identifying at least one cardiac cycle within the electrical cardiac signals; and

identifying a time during the cardiac cycle prior to an intrinsic depolarization of the atria for delivery of a LA pacing pulse.

4. The method of claim 3 for use with a diastolic heart failure (DHF) patient wherein identifying the time for delivery of the LA pacing pulse is performed to identify a pulse delivery time sufficient to mitigate the DHF.

5. The method of claim 3 further including a preliminary step of detecting an indication of DHF within the patient and activating the delivery of LA pacing in response to the indication of DHF.

6. The method of claim 1 further including detecting atrial fibrillation (AF) and wherein delivery of LA pacing is inhibited in the presence of atrial fibrillation.

7. The method of claim 1 wherein all of the steps are performed by the implantable medical device.

8. The method of claim 1 wherein at least some steps are performed by an external system in communication with the implantable medical device.