Secure and efficacious therapy delivery for an extra-systolic stimulation pacing engine
First Claim
1. A method for managing an extra-systolic stimulation cardiac pacing therapy on a beat-by-beat basis, comprising:
- sensing electrical activity of a heart on a beat-by-beat basis to provide output signals related to at least one of;
a sensed atrial depolarization, a first atrial pacing event, a second atrial pacing event, a sensed right ventricular depolarization, a first right ventricular pacing event, a second right ventricular pacing event, a sensed left ventricular depolarization, a first left ventricular pacing event, a second left ventricular pacing event;
determining if the output signals indicate an occurrence of at least one unscheduled depolarization in a single cardiac chamber; and
if at least one unscheduled depolarization occurred, then deciding between a mode of ceasing delivery and delivering an extra-systolic stimulation therapy to at least one chamber of the heart,wherein the ceasing step further comprises one of;
withholding delivery and not initiating delivery of the extra-systolic stimulation therapy in the event that the unscheduled cardiac activity begins an accumulating tachycardia evidence counter of an on-going tachycardia episode or until such time as either the evidence counter reaches a preset threshold and a tachycardia episode is declared or the evidence counter is reset to a nominal or null value.
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Abstract
An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
49 Citations
17 Claims
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1. A method for managing an extra-systolic stimulation cardiac pacing therapy on a beat-by-beat basis, comprising:
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sensing electrical activity of a heart on a beat-by-beat basis to provide output signals related to at least one of;
a sensed atrial depolarization, a first atrial pacing event, a second atrial pacing event, a sensed right ventricular depolarization, a first right ventricular pacing event, a second right ventricular pacing event, a sensed left ventricular depolarization, a first left ventricular pacing event, a second left ventricular pacing event;determining if the output signals indicate an occurrence of at least one unscheduled depolarization in a single cardiac chamber; and if at least one unscheduled depolarization occurred, then deciding between a mode of ceasing delivery and delivering an extra-systolic stimulation therapy to at least one chamber of the heart, wherein the ceasing step further comprises one of; withholding delivery and not initiating delivery of the extra-systolic stimulation therapy in the event that the unscheduled cardiac activity begins an accumulating tachycardia evidence counter of an on-going tachycardia episode or until such time as either the evidence counter reaches a preset threshold and a tachycardia episode is declared or the evidence counter is reset to a nominal or null value. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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Specification