Method and system for improved estimation of time of left ventricular pacing with respect to intrinsic right ventricular activation in cardiac resynchronization therapy
First Claim
1. A computer-implemented method of cardiac pacing comprising:
- determining a baseline rhythm, the baseline rhythm includes a baseline atrial event and a baseline right ventricular (RV) event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of cardiac electrical activation times determined from a plurality of body-surface electrodes;
determining whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times;
applying a correction factor to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the time interval measured from the atrial event to the RV event is disparate from the time interval measured from the atrial event to the earliest RV activation time; and
configuring the processor to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before the RV sensing time.
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Abstract
A method and system of cardiac pacing is disclosed. A baseline rhythm is determined. The baseline rhythm includes a baseline atrial event and a baseline right ventricular RV event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes. A determination is made as to whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times. A correction factor is applied to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the RV event is disparate from the earliest RV activation time. The processor is configured to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before RV sensing time.
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Citations
34 Claims
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1. A computer-implemented method of cardiac pacing comprising:
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determining a baseline rhythm, the baseline rhythm includes a baseline atrial event and a baseline right ventricular (RV) event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of cardiac electrical activation times determined from a plurality of body-surface electrodes; determining whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times; applying a correction factor to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the time interval measured from the atrial event to the RV event is disparate from the time interval measured from the atrial event to the earliest RV activation time; and configuring the processor to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before the RV sensing time. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A system of cardiac pacing comprising:
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processing means for determining a baseline rhythm, the baseline rhythm includes a baseline atrial event and a baseline right ventricular (RV) event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes; processing means for determining whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times; processing means for applying a correction factor to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the time interval measured from the atrial event to the RV event is disparate from the time interval measured from the atrial event to the earliest RV activation time; and processing means for configuring the processor to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before the RV sensing time. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A system of cardiac pacing comprising:
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processing means for determining a baseline rhythm, the baseline rhythm includes a baseline atrial event and a baseline right ventricular (RV) event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes; processing means for determining whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times; processing means for applying a correction factor to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the time interval measured from an atrial event to the RV event is disparate from the time interval measured from the atrial event to the earliest RV activation time; and processing means for configuring the processor to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before the RV sensing time, wherein disparate is defined as the earliest RV activation time which is about 40-300 ms ahead of the earliest sensed RV event.
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34. A system of cardiac pacing comprising:
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processing means for determining a baseline rhythm, the baseline rhythm includes a baseline atrial event and a baseline right ventricular (RV) event from an implanted cardiac lead or a leadless device, a pre-excitation interval determined from the baseline atrial event and the baseline RV event, and a plurality of activation times determined from a plurality of body-surface electrodes; processing means for determining whether a time interval measured from an atrial event to a RV event is disparate from another time interval measured from the atrial event to an earliest RV activation time of the plurality of activation times; processing means for applying a correction factor to the pre-excitation interval to obtain a corrected pre-excitation interval in response to determining the time interval measured from an atrial event to the RV event is disparate from the time interval measured from the atrial event to the earliest RV activation time; and processing means for configuring the processor to signal the pulse generator to deliver electrical stimuli to a left ventricle (LV) using the corrected pre-excitation interval before the RV sensing time, wherein disparate is defined as the earliest RV activation time which is about 40-300 ms ahead of the earliest sensed RV event, wherein each of the plurality of activation times are determined by a timing of a steepest negative slope on the unipolar ECG signal from each of a plurality of surface electrodes and a common fiducial point, wherein the common fiducial point is the onset of depolarization (Q-point) measured from a surface ECG electrode or timing of an atrial event as sensed by an implantable medical device.
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Specification