Pace counter isolation for cardiac resynchronization pacing

• US 8,718,768 B2
• Filed: 01/21/2013
• Issued: 05/06/2014
• Est. Priority Date: 12/26/2000
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Wentkowski, Rene H., Kramer, Andrew P., Kalgren, James
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US13/746,098
• Publication Number:
  US 20130138172A1
• Time in Patent Office: 470 Days
• Field of Search: None
• US Class Current: 607/27
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

A system and method for recording sensing and pacing events in a cardiac rhythm management device. The method may be particularly useful in assessment of pacing parameters for ventricular resynchronization therapy.

Claims

1. A method for operating a cardiac rhythm management device, comprising:

sensing depolarizations and delivering paces to multiple sites of a heart chamber through a plurality of sensing/pacing channels, wherein the heart chamber is paced in accordance with a pacing mode in which a pace is delivered upon expiration of an escape interval or as a result of a triggering event; and

for at least some of the plurality of sensing/pacing channels, separately counting the number of senses received, the number of paces delivered by reason of expiration of an escape interval, and the number of paces triggered by a triggering event.

2. The method of claim 1, wherein the heart chamber is a ventricle.

3. The method of claim 2, wherein the ventricle is a left ventricle.

4. The method of claim 2, further comprising:

sensing atrial depolarizations through at least one atrial sensing channel and generating atrial sense signals in accordance therewith, wherein the pacing mode further includes pacing the ventricle upon expiration of an atrio-ventricular interval triggered by an atrial sense; and

separately counting the number of ventricular paces delivered by reason of expiration of the atrio-ventricular interval.

5. The method of claim 2, wherein the pacing mode is a biventricular resynchronization pacing mode.

6. The method of claim 2, wherein the pacing mode is a ventricular synchronized chamber-only pacing mode.

7. The method of claim 2, wherein the pacing mode further includes ventricular rate regularization.

8. The method of claim 1, wherein the escape interval corresponds to a programmed lower rate limit, and the triggering event is a ventricular sense.

9. The method of claim 1, wherein the at least some of the plurality of sensing/pacing channels comprises each of the plurality of sensing/pacing channels.

10. A cardiac rhythm management system comprising:

a plurality of sensing/pacing channels for sensing depolarizations and delivering paces to multiple sites of a heart chamber; and

a controller configured to;

control the delivery of paces to the heart chamber in accordance with a pacing mode in which a pace is delivered upon expiration of an escape interval or as a result of a triggering event; and

separately count the number of senses received, the number of paces delivered by reason of expiration of an escape interval, and the number of paces triggered by a triggering event for at least some of the plurality of sensing/pacing channels.

11. The system of claim 10, wherein at least one of the sensing/pacing channels is configured to be coupled to the heart chamber that is a ventricle.

12. The system of claim 11, wherein at least one of the sensing/pacing channels is configured to be coupled to the ventricle that is a left ventricle.

13. The system of claim 11, wherein the controller is further configured to:

control sensing of atrial depolarizations through at least one atrial sensing channel and generate atrial sense signals in accordance therewith, wherein the pacing mode further includes pacing the ventricle upon expiration of an atrio-ventricular interval triggered by an atrial sense; and

separately count the number of ventricular paces delivered by reason of expiration of the atrio-ventricular interval.

14. The system of claim 11, wherein the pacing mode is a biventricular resynchronization pacing mode.

15. The system of claim 11, wherein the pacing mode is a ventricular synchronized chamber-only pacing mode.

16. The system of claim 11, wherein the pacing mode further includes ventricular rate regularization.

17. The system of claim 10, wherein the escape interval corresponds to a programmed lower rate limit, and the triggering event is a ventricular sense.

18. The system of claim 10, wherein the at least some of the plurality of sensing/pacing channels comprises each of the plurality of sensing/pacing channels.

19. The system of claim 10, further comprising:

an external programmer with an associated display and a telemetry interface for receiving the counts, wherein the external programmer is configured to display separate counts for each sensing/pacing channel as a percentage of total cardiac cycles.