Metrics of electrical dyssynchrony and electrical activation patterns from surface ECG electrodes
First Claim
1. A method of cardiac pacing comprising:
- (a) determining a baseline rhythm using a plurality of body-surface electrodes;
(b) determining a set of baseline functional electrical metrics in response to determining the baseline rhythm;
(c) delivering resynchronization pacing using a right ventricular electrode and a left ventricular electrode or delivering the resynchronization pacing using only a left ventricular electrode;
(d) determining a set of functional electrical metrics relating to cardiac depolarization and repolarization in response to resynchronization pacing;
(e) determining whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics in step d exceeds X % of its corresponding value from the set of baseline functional electrical metrics in step (b);
(f) determining whether an absolute value of at least one electrical metric from the set of the functional electrical metrics in step (d) is less than Y ms; and
(g) determining that a site is responsive to cardiac resynchronization therapy (CRT) in response to determining whether steps (e) or (f) are met.
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Abstract
A method and system of cardiac pacing is disclosed. A baseline rhythm is determined using a plurality of body-surface electrodes. A set of baseline functional electrical metrics is determined in response to determining the baseline rhythm. Resynchronization pacing is delivered using a right ventricular electrode and a pacing left ventricular electrode or only with a left ventricular electrode. A set of functional electrical metrics relating to cardiac depolarization and repolarization is determined in response to resynchronization pacing. A determination is made as to whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics exceeds X % of its corresponding value from the set of baseline functional electrical metrics. A determination is made as to whether an absolute value of at least one electrical metric from the set of the functional electrical metrics is less than Y ms. A determination is made as to whether a site is responsive to cardiac resynchronization therapy (CRT).
313 Citations
40 Claims
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1. A method of cardiac pacing comprising:
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(a) determining a baseline rhythm using a plurality of body-surface electrodes; (b) determining a set of baseline functional electrical metrics in response to determining the baseline rhythm; (c) delivering resynchronization pacing using a right ventricular electrode and a left ventricular electrode or delivering the resynchronization pacing using only a left ventricular electrode; (d) determining a set of functional electrical metrics relating to cardiac depolarization and repolarization in response to resynchronization pacing; (e) determining whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics in step d exceeds X % of its corresponding value from the set of baseline functional electrical metrics in step (b); (f) determining whether an absolute value of at least one electrical metric from the set of the functional electrical metrics in step (d) is less than Y ms; and (g) determining that a site is responsive to cardiac resynchronization therapy (CRT) in response to determining whether steps (e) or (f) are met. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A method of cardiac pacing comprising:
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(a) determining a baseline rhythm using a plurality of body-surface electrodes; (b) determining a set of baseline functional electrical metrics in response to determining the baseline rhythm; (c) delivering resynchronization pacing using a right ventricular electrode and a pacing left ventricular electrode or delivering resynchronization pacing using only a left ventricular electrode; (d) determining a set of functional electrical metrics relating to cardiac depolarization and repolarization in response to resynchronization pacing; (e) determining whether relative reduction of a first functional electrical metric from the set of functional electrical metrics in step (d) exceeds X % of a first electrical functional metric from the set of baseline functional electrical metrics in step (b); (f) determining whether an absolute value of a second functional electrical metric from the set of the functional electrical metrics is less than Y ms; and (g) determining that a site is responsive to CRT in response to determining whether steps (e) and (f) are met. - View Dependent Claims (28, 29)
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30. A system of cardiac pacing comprising:
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a plurality of body-surface electrodes; means for determining a baseline rhythm using the plurality of body-surface electrodes; means for determining a set of baseline functional electrical metrics in response to determining the baseline rhythm; at least one of a right ventricular electrode and a pacing left ventricular electrode; delivering means for delivering resynchronization pacing using the right ventricular electrode and the pacing left ventricular electrode or delivering means for delivering resynchronization pacing using only the left ventricular electrode; means for determining a set of functional electrical metrics relating to cardiac depolarization and repolarization in response to resynchronization pacing; means for determining whether relative reduction of a first functional electrical metric from the set of functional electrical metrics exceeds X % of a first electrical functional metric from the set of baseline functional electrical metrics; means for determining whether an absolute value of a second functional electrical metric from the set of the functional electrical metrics is less than Y ms; and means for determining that a site is responsive to CRT in response to determining whether the relative reduction of the first functional electrical metric from the set of functional electrical metrics exceeds X % of the first electrical functional metric from the set of baseline functional electrical metrics and whether the absolute value of the second functional electrical metric from the set of the functional electrical metrics is less than Y ms. - View Dependent Claims (31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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Specification