Circuit-based devices and methods for pulse control of endocardial pacing in cardiac rhythm management
First Claim
1. A method for treating an asynchronous condition of a heart of a patient, the method comprising:
- generating an electrostimulation profile that includes pulse waveforms for delivery via respective electrodes, the pulse waveforms including opposing polarities that are at least partially overlapping in time; and
delivering the electrostimulation profile via the respective electrodes, the electrodes located in a right ventricle of the heart, at or near the septum of the heart and distal from an apex of the right ventricle;
wherein the delivering the electrostimulation profile includes capturing the myocardium so as to improve synchronization of the right and left ventricles as compared to delivering pacing at the apex of the right ventricle; and
wherein the generating the electrostimulation profile includes;
in a first stage of a switching circuit, selecting one of a bi-ventricular switch configuration and a single-ventricle switch configuration to provide the pulse waveforms to a second stage of the switching circuit;
in the second stage of the switching circuit, selecting an initial pulse polarity for providing the pulse waveforms to the respective electrodes; and
recurrently alternating the pulse polarity using the second stage of the switching circuit.
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Accused Products
Abstract
Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart.
240 Citations
20 Claims
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1. A method for treating an asynchronous condition of a heart of a patient, the method comprising:
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generating an electrostimulation profile that includes pulse waveforms for delivery via respective electrodes, the pulse waveforms including opposing polarities that are at least partially overlapping in time; and delivering the electrostimulation profile via the respective electrodes, the electrodes located in a right ventricle of the heart, at or near the septum of the heart and distal from an apex of the right ventricle; wherein the delivering the electrostimulation profile includes capturing the myocardium so as to improve synchronization of the right and left ventricles as compared to delivering pacing at the apex of the right ventricle; and wherein the generating the electrostimulation profile includes; in a first stage of a switching circuit, selecting one of a bi-ventricular switch configuration and a single-ventricle switch configuration to provide the pulse waveforms to a second stage of the switching circuit; in the second stage of the switching circuit, selecting an initial pulse polarity for providing the pulse waveforms to the respective electrodes; and recurrently alternating the pulse polarity using the second stage of the switching circuit. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A machine-readable medium that stores instructions which when performed by a machine, causes the machine to perform the operations comprising:
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generating an electrostimulation profile that includes pulse waveforms for delivery via respective electrodes, the pulse waveforms including opposing polarities that are at least partially overlapping in time; and delivering the electrostimulation profile via the respective electrodes, the electrodes located in a right ventricle of the heart, at or near the septum of the heart and distal from an apex of the right ventricle; wherein the delivering the electrostimulation profile includes capturing the myocardium so as to improve synchronization of the right and left ventricles as compared to delivering pacing at the apex of the right ventricle; and wherein the generating the electrostimulation profile includes; in a first stage of a switching circuit, selecting one of a bi-ventricular switch configuration and a single-ventricle switch configuration to provide the pulse waveforms to a second stage of the switching circuit; in the second stage of the switching circuit, selecting an initial pulse polarity for providing the pulse waveforms to the respective electrodes; and recurrently alternating the pulse polarity using the second stage of the switching circuit. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification