Multi-Pole LV Lead Capture Threshold Determination
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Solution Overview
Problem
Existing automatic threshold determining techniques for left ventricular pacing vectors in cardiac pacemakers require an extended period of time, which is inefficient compared to conventional bipolar leads.
Innovation Solution
A method and system that use a multi-pole left ventricular lead to automatically determine capture thresholds by measuring base and secondary capture thresholds using varied stimulation pulses over defined test ranges, with the secondary test range being narrower and correlated to the base threshold, allowing for quicker identification of available LV pacing vectors.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If existing automatic threshold determining techniques are used for left ventricular pacing vectors, then capture thresholds can be determined, but the process requires an extended period of time
Solution Approach 1:
The patent segments the test range into multiple discrete levels (e.g., first test range with higher amplitude pulses, second test range with lower amplitude pulses). This segmentation allows the system to efficiently narrow down the capture threshold by testing at progressively refined ranges, reducing the total time required while maintaining measurement accuracy.
Solution Approach 2:
The patent performs preliminary testing at a first test range with higher amplitude stimulation pulses before proceeding to a second test range with lower amplitude pulses. This preliminary action establishes an initial capture threshold estimate that guides subsequent more precise measurements, thereby reducing overall determination time while preserving accuracy.
2Reliability
If multiple LV pacing vectors are tested to identify capture thresholds, then accurate pacing vector selection is achieved, but the process becomes time-consuming
Solution Approach 1:
The patent dynamically adjusts the test parameters based on results from previous test ranges. After identifying capture thresholds at a first test range, the system modifies the second test range parameters (lower amplitude, refined levels) based on the preliminary findings. This dynamic adaptation allows efficient testing of multiple LV pacing vectors while maintaining reliable threshold identification.
Solution Approach 2:
The patent changes stimulation parameters between test ranges - using higher amplitude pulses in the first test range followed by lower amplitude pulses in the second test range. This parameter change strategy enables the system to efficiently screen multiple LV pacing vectors for capture thresholds while reducing the time required for each subsequent measurement, thereby improving overall productivity without sacrificing reliability.
Data Source
AI summary
Computer implemented methods and systems are provided for automatically determining capture thresholds for an implantable medical device equipped for cardiac stimulus pacing using a multi-pole left ventricular (LV) lead. The methods and systems measures a base capture threshold for a base pacing vector utilizing stimulation pulses varied over at least a portion of an outer test range. The base pacing vector is defined by a first LV electrode provided on the LV lead and a second electrode located remote from an LV chamber. The methods and systems designate a secondary pacing vector that includes the first LV electrode and a neighbor LV electrode provided on the LV lead. The methods and systems further define an inner test range having secondary limits based on the base capture threshold, wherein at least one of the limits for the inner test range differs from a corresponding limit for the outer test range. The methods and systems measure a secondary capture threshold associated with the secondary pacing vector utilizing stimulation pulses varied over at least a portion of the inner test range.