Cardiac resynchronization therapy optimization using cardiac activation sequence information
First Claim
1. A system, comprising:
- a plurality of electrodes configured for at least sensing cardiac electrical activity and energy delivery;
a signal processor coupled to the electrodes and configured to produce a cardiac signal vector on a polar plot that originates at an atrioventricular (AV) node of a subject'"'"'s heart, the cardiac signal vector associated with all or a portion of one or more cardiac activation sequences; and
a controller coupled to the electrodes and the signal processor, the controller configured to;
adjust a pacing parameter to elicit a cardiac signal vector indicative of one of pacing-dominant cardiac activation and intrinsic-dominant cardiac activation,continue to adjust the pacing parameter to elicit a cardiac signal vector indicative of the other of the pacing-dominant cardiac activation and the intrinsic-dominant cardiac activation,detect a change in an axis angle or a magnitude of the cardiac signal vector in response to the adjustment of the pacing parameter,define the change in the axis angle or the magnitude of the cardiac signal vector as a transition between the pacing-dominant cardiac activation and intrinsic-dominant cardiac activation; and
store the adjusted pacing parameters to define a transition region.
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Accused Products
Abstract
Systems and methods provide for pacing a heart to improve pumping efficiency of the heart, such as by producing a cardiac fusion response for patient'"'"'s subject to cardiac resynchronization therapy. A pacing parameter, such as an A-V delay, V-V delay, lead/electrode configuration or vector, is adjusted and a cardiac signal vector representative of all or a portion of one or more cardiac activation sequences is monitored during pacing parameter adjustment. A change in a characteristic of the cardiac signal vector is detected in response to an adjusted pacing parameter, the change indicative of a cardiac fusion response. A pacing therapy may be delivered to produce the cardiac fusion response using the adjusted pacing parameter.
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Citations
21 Claims
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1. A system, comprising:
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a plurality of electrodes configured for at least sensing cardiac electrical activity and energy delivery; a signal processor coupled to the electrodes and configured to produce a cardiac signal vector on a polar plot that originates at an atrioventricular (AV) node of a subject'"'"'s heart, the cardiac signal vector associated with all or a portion of one or more cardiac activation sequences; and a controller coupled to the electrodes and the signal processor, the controller configured to; adjust a pacing parameter to elicit a cardiac signal vector indicative of one of pacing-dominant cardiac activation and intrinsic-dominant cardiac activation, continue to adjust the pacing parameter to elicit a cardiac signal vector indicative of the other of the pacing-dominant cardiac activation and the intrinsic-dominant cardiac activation, detect a change in an axis angle or a magnitude of the cardiac signal vector in response to the adjustment of the pacing parameter, define the change in the axis angle or the magnitude of the cardiac signal vector as a transition between the pacing-dominant cardiac activation and intrinsic-dominant cardiac activation; and store the adjusted pacing parameters to define a transition region. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A system, comprising:
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a plurality of electrodes configured for at least sensing cardiac electrical activity and energy delivery; a signal processor coupled to the electrodes and configured to produce a cardiac signal vector on a polar plot that originates at an atrioventricular (AV) node of a subject'"'"'s heart, the cardiac signal vector associated with all or a portion of one or more cardiac activation sequences; and a controller coupled to memory, the electrodes, and the signal processor, the controller configured to; adjust a pacing parameter to elicit a cardiac signal vector indicative of one of pacing-dominant cardiac activation and intrinsic-dominant cardiac activation, continue to adjust the pacing parameter settings to elicit a cardiac signal vector indicative of the other of the pacing-dominant cardiac activation and the intrinsic-dominant cardiac activation pacing responses, detect a change in an axis angle or a magnitude of the cardiac signal vector in response to the adjustment of the pacing parameter; define a change above a predetermined threshold value in the axis angle or the magnitude of the cardiac signal vector as a transition between the pacing-dominant cardiac activation and the intrinsic-dominant cardiac activation, store at least one adjusted pacing parameter setting in the memory to record the transition between the pacing-dominant cardiac activation and the intrinsic-dominant cardiac activation responses, and deliver a pacing therapy that uses the stored pacing parameter setting. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification