Cardiac resynchronization system and method

• US 9,861,823 B2
• Filed: 05/04/2015
• Issued: 01/09/2018
• Est. Priority Date: 05/05/2014
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Nabutovsky, Yelena, Razavi, Hoda
• Primary Examiner(s): PATTON, AMANDA K
• Application Number:
  US14/703,757
• Publication Number:
  US 20150313495A1
• Time in Patent Office: 981 Days
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/283 Invasive
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Embodiments of the present disclosure provide a method of determining an inter-chamber delay within a heart of an individual that may include determining a position of a first sensor in a first chamber of the heart, determining a position of a second sensor in a second chamber of the heart, automatically computing a distance between the first and second sensors, and automatically determining the inter-chamber delay based on the automatically computing operation.

Claims

1. A method of determining an inter-chamber delay within a heart of an individual, the method comprising:

under control of one or more processors configured to execute program instruction;

determining a position of a first sensor in a first chamber of the heart;

determining a position of a second sensor in a second chamber of the heart;

repeating the determining operations for multiple inter-chamber delays;

automatically computing distance changes between the first and second sensors in connection with the corresponding inter-chamber delays; and

automatically determining a select inter-chamber delay from the inter-chamber delays based on the distance changes computed in the automatically computing operation.

2. The method of claim 1, wherein the inter-chamber delay is an atrial-ventricular (AV) delay, wherein the first chamber is a right ventricle of the heart, and wherein the second chamber is a right atrium of the heart.

3. The method of claim 1, wherein the inter-chamber delay is a ventricular-ventricular (VV) delay, wherein the first chamber is a left ventricle of the heart, and wherein the second chamber is a right ventricle of the heart.

4. The method of claim 1, wherein the distance change, associated with at least one of the inter-chamber delays, represents a distance change index calculated based on changes in location of the first sensor for first and second points in a cardiac cycle and based on changes in location of the second sensor for the first and second points in the cardiac cycle.

5. The method of claim 4, wherein the first and second points in the cardiac cycle correspond to end of systole (ESD) and end of diastole (EDD), respectively, and wherein the distance change index (DCI) is based on DCI=(EDD−

ESD)/EDD.

6. The method of claim 1, further comprising communicating programming settings between a surgical navigation sub-system and an implanted device.

7. The method of claim 1, wherein the automatically computing a distance operation comprises determining a sum of volumes of the first and second chambers of the heart, wherein the distance increases as the sum increases.

8. The method of claim 1, further comprising:

mapping coronary sinus branches; and

determining a site of latest mechanical activation through the mapping operation.

9. The method of claim 1, wherein the automatically computing a distance operation comprises calculating a distance change index.

10. The method of claim 9, wherein the calculating a distance change index comprises:

subtracting an end of systole from an end of diastole;

determining a difference from the subtracting operation; and

dividing the difference by the end of diastole.

11. A system for determining an inter-chamber delay within a heart of an individual, the system comprising:

a first sensor configured to be positioned within a first chamber of the heart;

a second sensor configured to be positioned within a second chamber of the heart, wherein the first chamber differs from the second chamber;

a surgical navigation sub-system configured to;

determine a position of the first sensor in the first chamber of the heart,

determine a position of the second sensor in the second chamber of the heart, and

repeat the determining operations for multiple inter-chamber delays; and

at least one processor configured to automatically compute distance changes between the first and second sensors in connection with the corresponding inter-chamber delays, and automatically determine a select inter-chamber delay from the inter-chamber delays based on the distance changes between the first and second sensors.

12. The system of claim 11, wherein the inter-chamber delay is an atrial-ventricular (AV) delay, wherein the first chamber is a right ventricle of the heart, and wherein the second chamber is a right atrium of the heart.

13. The system of claim 11, wherein the inter-chamber delay is a ventricular-ventricular (VV) delay, wherein the first chamber is a left ventricle of the heart, and wherein the second chamber is a right ventricle of the heart.

14. The system of claim 11, wherein the at least one processor is further configured to automatically determine electrode settings using motion mapping at electrode sites.

15. The system of claim 11, wherein the at least one processor is configured to use motion mapping at electrode sites to automatically determine the inter-chamber delay.

16. The system of claim 11, wherein the surgical navigation sub-system and an implanted device are configured to communicate programming settings.

17. The system of claim 11, wherein the at least one processor is configured to automatically compute the distance by determining a sum of volumes of the first and second chambers of the heart, wherein the distance increases as the sum increases.

18. The system of claim 11, wherein one or both of the surgical navigation sub-system or the at least one processor is configured to map coronary sinus branches, and determine a site of latest mechanical activation through the map.

19. The system of claim 11, wherein the at least one processor is configured to automatically compute a distance operation by calculating a distance change index.

20. The system of claim 19 wherein the at least one process is configured to calculate the distance change index by subtracting an end of systole from an end of diastole, determine a difference from the subtracting operation, and divide the difference by the end of diastole.