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Apparatus and methods of optimizing atrioventricular pacing delay intervals

a technology of atrioventricular pacing and delay interval, which is applied in the field of apparatus and methods of optimizing atrioventricular pacing delay interval, can solve the problem that the algorithm is not exclusive, and achieve the effect of optimizing pacing delivery and simple and effectiv

Inactive Publication Date: 2015-10-08
MEDTRONIC INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

The invention provides a way to optimize the timing of stimulating the heart based on signals from inside or outside of the heart. This can be done using simple equipment and methods. In some cases, it can also be done using complex echocardiographic imaging. This technology is useful for ensuring that pacing is delivered optimally.

Problems solved by technology

Of course, the algorithm is not the exclusive manner of determining PWend and PWd, however, as other methods could be utilized such as by determining changes to the slope of the P-wave signal, threshold crossings, changing polarity of the signal, and the like.

Method used

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  • Apparatus and methods of optimizing atrioventricular pacing delay intervals
  • Apparatus and methods of optimizing atrioventricular pacing delay intervals
  • Apparatus and methods of optimizing atrioventricular pacing delay intervals

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Embodiment Construction

[0027]A Methods and apparatus are provided to optimize timing intervals for and / or monitor a subject receiving pacing therapy, including cardiac resynchronization therapy (CRT) to improve the hemodynamics of the subject to closely mimic a normal depolarization-repolarization cardiac cycle sequence.

[0028]FIG. 1 is a pair of illustrations of a cardiac depolarization and repolarization waveforms with the PQRST complex indicated by a corresponding letter and the P-wave duration (herein PWd) indicated at reference numeral 1, PR interval 2, QRS duration (QRSd) 3 and QT interval 4 of a normal intrinsic electrical activation sequence.

[0029]FIG. 2 is a schematic representation of an implanted, triple-chamber cardiac pacemaker comprising a pacemaker IPG 14 and associated leads 16, 32 and 52. The pacemaker IPG 14 is implanted subcutaneously in a patient's body between the skin and the ribs. The three endocardial leads 16,32,52 operatively couple the IPG 14 with the RA, the RV and the LV, respe...

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Abstract

Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.

Description

RELATED APPLICATION[0001]This application is a continuation of U.S. patent application Ser. No. 13 / 084,244, filed Apr. 11, 2011 entitled “APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS”, which is a divisional of U.S. patent application Ser. No. 12 / 047,876, filed Mar. 13, 2008 entitled “APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS”, now U.S. Pat. No. 7,941,218, herein incorporated by reference in its entirety.FIELD[0002]This invention relates to cardiac pacing systems, and more particularly to apparatus and methods for improving cardiac function by optimizing atrioventricular (AV) timing intervals for a cardiac pacing system, such as a dual-chamber or a triple-chamber cardiac resynchronization therapy (CRT) delivery system.BACKGROUND[0003]Cardiac resynchronization therapy (CRT) is a promising and accepted device therapy for patients with systolic heart failure classified in New York Heart Association (NYHA) class III and IV....

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61N1/365A61N1/368
CPCA61N1/3684A61N1/36585A61N1/3627A61N1/3682A61N1/36843A61N1/3752A61N1/3756
Inventor SAMBELASHVILI, ALEKSANDRE T.MULLEN, THOMAS J.
Owner MEDTRONIC INC
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