Integrated multi-device cardiac resynchronization therapy using P-wave to pace timing
First Claim
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1. A method of providing cardiac pacing therapy to a patient comprising:
- delivering pacing pulses using a Pace to Pace interval, the pacing pulses delivered by a first device which stores the Pace to Pace interval and is configured to deliver at least one of the pacing pulses upon expiration of the Pace to Pace interval after a preceding pacing pulse delivery by the first device;
monitoring cardiac activity in a second device; and
adjusting the Pace to Pace interval as stored by the first device in response to communication from the second device to the first device.
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Abstract
Methods, systems and devices for providing cardiac resynchronization therapy (CRT) to a patient using a leadless cardiac pacemaker (LCP) and an extracardiac device (ED). The LCP is configured to deliver pacing therapy at a pacing interval. Illustratively, the ED may be configured to analyze the cardiac cycle including a portion preceding the pacing therapy delivery for one or several cardiac cycles, and determine whether an interval from the P-wave to the pace therapy in the cardiac cycle(s) is in a desired range. In an example, if the P-wave to pace interval is outside the desired range, the ED communicates to the LCP to adjust the pacing interval.
1209 Citations
20 Claims
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1. A method of providing cardiac pacing therapy to a patient comprising:
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delivering pacing pulses using a Pace to Pace interval, the pacing pulses delivered by a first device which stores the Pace to Pace interval and is configured to deliver at least one of the pacing pulses upon expiration of the Pace to Pace interval after a preceding pacing pulse delivery by the first device; monitoring cardiac activity in a second device; and adjusting the Pace to Pace interval as stored by the first device in response to communication from the second device to the first device. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. An implantable medical device (IMD) configured for use as part of a cardiac therapy system comprising a leadless cardiac pacemaker (LCP) and the IMD, the IMD comprising:
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a plurality of electrodes for sensing cardiac activity; and operational circuitry configured to receive sensed cardiac signals from the plurality of electrodes and analyze cardiac activity as follows; determine when pace therapy is delivered by the LCP; analyze a segment of the sensed cardiac signals from the plurality of electrodes including a time period prior to pace therapy delivery by the LCP and calculate a P-wave to Pace interval; determine whether the P-wave to Pace interval is in a desired range, and, if the P-wave to Pace interval is not in the desired range, modifying a Pace to Pace interval that determines timing of the LCP pacing therapy. - View Dependent Claims (12, 13, 14, 15, 16)
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17. An implantable leadless cardiac pacemaker (LCP) configured to operate in coordination with an extracardiac device (ED), comprising a plurality of electrodes for delivering pacing therapy;
- communication circuitry configured to send and receive messages with the ED;
and operational circuitry configured to; deliver a pacing pulse using a Pace to Pace interval relative to a previously delivered pacing pulse; receive a message from the ED indicating a time at which a P-wave occurred in relation to a paced cardiac event; calculate a P-wave to Pace interval for the paced cardiac event; analyze the P-wave to Pace interval relative to a desired range; and
;if the P-wave to pace interval is longer than a first threshold defining the range, shorten the Pace to Pace interval;
orif the P-wave to pace interval is shorter than a second threshold defining the range, extend the Pace to Pace interval. - View Dependent Claims (18, 19, 20)
- communication circuitry configured to send and receive messages with the ED;
Specification