Monitoring of his bundle pacing capture during ventricular pacing therapy

A cardiac pacing and pacing technology, used in therapy, electrotherapy, cardiac stimulator, etc., to solve problems affecting ventricular capture, pacing lead migration or displacement, etc.

Pending Publication Date: 2020-11-03
MEDTRONIC INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Sense atrioventricular delay (SAV), paced atrioventricular delay (PAV), RV pre-excitation can also affect whether the ventricle is effectively captured In addition, pacing leads may migrate after the medical device has been implanted or shift

Method used

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  • Monitoring of his bundle pacing capture during ventricular pacing therapy
  • Monitoring of his bundle pacing capture during ventricular pacing therapy
  • Monitoring of his bundle pacing capture during ventricular pacing therapy

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0076] Embodiment 1: A method for delivering cardiac pacing therapy to a patient comprising:

[0077] sensing a cardiac signal of the patient;

[0078] determining the occurrence of one of an intrinsic atrial depolarization event and a paced atrial depolarization event for the current cardiac cycle in response to the sensed cardiac signal;

[0079] delivering a first pacing therapy during the current cardiac cycle in response to the determined occurrence of the depolarizing event;

[0080] comparing the amplitude of the cardiac signal after the delivered first pacing therapy during the current cardiac cycle to a predetermined amplitude threshold; and

[0081] Responsive to the comparison, it is determined whether to deliver a second pacing therapy within the current cardiac cycle and subsequent to the delivered first pacing therapy.

Embodiment 2

[0082] Embodiment 2: The method of Embodiment 1, wherein the first pacing therapy comprises His bundle pacing and the second pacing therapy comprises ventricular pacing therapy.

Embodiment 3

[0083] Embodiment 3: The method of any one of Embodiments 1-2, further comprising determining whether intrinsic AV conduction is absent, wherein the first pacing therapy comprises His bundle pacing and the second pacing therapy Ventricular pacing therapy is included wherein His bundle pacing is delivered with an AV delay of between about 60 ms and 150 ms in response to the absence of intrinsic atrioventricular conduction.

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Abstract

A method and system for delivering a cardiac pacing therapy that includes a cardiac signal being sensed via electrodes of an atrial lead, and an occurrence of one of an intrinsic and a paced atrial depolarization event of a current cardiac cycle being determined in response to the sensed cardiac signal. A first pacing therapy is delivered during the current cardiac cycle in response to the determined occurrence of the depolarization event, and an amplitude of the cardiac signal within the current cardiac cycle subsequent to the delivered first pacing therapy is compared to a predetermined amplitude threshold. A second pacing therapy is delivered, via a left ventricular lead, within the same cardiac cycle and subsequent to the delivered first pacing therapy in response to the amplitude notbeing more negative than the predetermined amplitude threshold and is not delivered in response to the amplitude being more negative than the predetermined amplitude threshold.

Description

[0001] This application claims the benefit of US Patent Application Serial No. 15 / 928,753, filed March 22, 2018, which is hereby incorporated by reference in its entirety. technical field [0002] The present disclosure relates to cardiac pacing methods and systems, and more particularly to methods and apparatus for delivering continuous ventricular pacing therapy in implantable medical devices. Background technique [0003] Cardiac resynchronization therapy devices operate by delivering pacing stimuli to both ventricles or to one ventricle, achieving the desired result of more or less simultaneous mechanical contraction and ejection of blood from the ventricle. Ideally, each pacing pulse stimulus delivered to the ventricle elicits a response from the ventricle. The delivery of electrical stimulation that causes the ventricle to respond is commonly referred to as capturing the ventricle. [0004] For various reasons, the cardiac pacing system may not be effectively capturin...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): A61N1/365A61N1/372
CPCA61N1/3627A61N1/36507A61N1/36585A61N1/3714A61N1/37282A61N1/3756A61N1/37235A61N1/025A61N1/3684
Inventor S·戈什
Owner MEDTRONIC INC
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