Cardiac rhythm management system selecting between multiple same-chamber electrodes for delivering cardiac therapy
First Claim
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1. A system, comprising:
- a sensing circuit including a sense amplifier to sense, at two or more candidate stimulation sites associated with a first heart chamber, physiologic signals indicative of cardiac activation;
an activation timer circuit coupled to the sensing circuit, the activation timer circuit configured to detect from the sensed physiologic signals activation timings at each of the two or more candidate stimulation sites;
a stimulation site selector circuit coupled to the activation timer circuit, the stimulation site selector circuit configured to identify, from the two or more candidate stimulation sites, a late-responsive stimulation site having the latest activation timing; and
an output circuit configured to generate an indication for delivering electrostimulation, among the two or more candidate stimulation sites, only at the identified late-responsive stimulation site having the latest activation timing.
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Abstract
A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode.
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Citations
20 Claims
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1. A system, comprising:
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a sensing circuit including a sense amplifier to sense, at two or more candidate stimulation sites associated with a first heart chamber, physiologic signals indicative of cardiac activation; an activation timer circuit coupled to the sensing circuit, the activation timer circuit configured to detect from the sensed physiologic signals activation timings at each of the two or more candidate stimulation sites; a stimulation site selector circuit coupled to the activation timer circuit, the stimulation site selector circuit configured to identify, from the two or more candidate stimulation sites, a late-responsive stimulation site having the latest activation timing; and an output circuit configured to generate an indication for delivering electrostimulation, among the two or more candidate stimulation sites, only at the identified late-responsive stimulation site having the latest activation timing. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method, comprising:
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sensing, at two or more candidate stimulation sites associated with a first heart chamber, physiologic signals indicative of cardiac activation; detecting from the sensed physiologic signals activation timings at each of the two or more candidate stimulation sites; identifying, from the two or more candidate stimulation sites, a late-responsive stimulation site having the latest activation timing; and generating an indication for delivering electrostimulation, among the two or more candidate stimulation sites, only at the identified late-responsive stimulation site having the latest activation timing. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification