摘要:
A system and method for identifying patients with asynchronous ventricular contractions due to abnormal electro-mechanical coupling and computing optimal pacing parameters for restoring synchronous contractions is disclosed. Such patients may have normal intra-ventricular and inter-ventricular conduction and cannot be identified from intrinsic conduction data alone such as QRS width. Techniques for computing optimal resynchronization pacing in order to compensate for abnormal electro-mechanical coupling are also described.
摘要:
Systems and methods for detecting and measuring cardiac contractile function of a heart using an acceleration sensor unit inserted within the heart, such as within a vein of the cardiac wall are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart by inserting and positioning an implantable lead having an electrode near a cardiac wall as well as detecting mechanical events within the patient's heart by then inserting and positioning a cardiac motion sensor unit through the inner lumen of the implantable lead. Furthermore, the systems and methods do not require dedicated leads and may be used with preexisting implantable leads.
摘要:
A method or system for computing and/or setting optimal cardiac resynchronization pacing parameters as derived from intrinsic conduction data is presented. The intrinsic conduction data includes intrinsic atrio-ventricular and interventricular delay intervals which may be collected via the sensing channels of an implantable cardiac device. Among the parameters which may be optimized in this manner are an atrio-ventricular delay interval and a biventricular offset interval. In one of its aspects, the invention provides for computing optimum pacing parameters for patients having some degree of AV block or with atrial conduction deficits. Another aspect of the invention relates to a pacing mode and configuration for providing cardiac resynchronization therapy to patients with a right ventricular conduction disorder.
摘要:
A method and apparatus for predicting acute response to cardiac resynchronization therapy is disclosed. The method can comprise measuring a first interval during an intrinsic systolic cycle and measuring a second interval during a stimulated systolic cycle. The acute response can be predicted by comparing the percent change in duration between the first interval and the second interval against a pre-determined threshold value. The first and second time intervals can be measured using, for example, a surface ECG or, alternatively, an intracardiac electrogram. In one embodiment, the first interval can be the duration of an intrinsic QRS complex measured during a non-stimulated systolic cycle. Similarly, the second interval can be the duration of a stimulated QRS complex measured during a stimulated systolic cycle.
摘要:
A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.
摘要:
A method and apparatus for determining whether a patient with congestive heart failure (CHF) will benefit from pacing therapy through the use of an implantable cardiac rhythm management device. A patient's right ventricular and left ventricular pressures are measured, and the patient's PP_Area is calculated for each normal heartbeat that occurs during the testing period. Depending upon the value of the patient's mean PP_Area, it can be determined whether the patient will or will not respond well acutely to pacing therapy. A mean PP_Area value of greater than or equal to a predetermined threshold, which is about 0.3, indicates that the patient is a responder to pacing therapy, while a value of less than the predetermined threshold of about 0.3 indicates that the patient is a non-responder.
摘要:
Systems and methods for determining the coronary sinus vein branch location of a left ventricle electrode are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart including sensing one or more of the electrical events with the electrode and then analyzing the electrical events to determine the electrode's position. The determination of electrode position may be used to automatically adjust operating parameters of a VRT device. Furthermore, the determination of electrode position may be made in real-time during installation of the electrode and a visual indication of the electrode position may be provided on a display screen.
摘要:
A method and apparatus is described for detecting and localizing areas of myocardial infarction or ischemia. By pacing sites in proximity to the infarcted or ischemic region with appropriately timed pacing pulses, the region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the metabolic demand of the region and the stimulus for remodeling.
摘要:
Systems and methods for determining the coronary sinus vein branch location of a left ventricle electrode are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart including sensing one or more of the electrical events with the electrode and then analyzing the electrical events to determine the electrode's position. The determination of electrode position may be used to automatically adjust operating parameters of a VRT device. Furthermore, the determination of electrode position may be made in real-time during installation of the electrode and a visual indication of the electrode position may be provided on a display screen.
摘要:
A method and apparatus is described for detecting and localizing areas of myocardial infarction or ischemia. By pacing sites in proximity to the infarcted or ischemic region with appropriately timed pacing pulses, the region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the metabolic demand of the region and the stimulus for remodeling.