System for achieving double-ventricle re-synchronization via single left ventricle hop-by-hop tracking biological atrioventricular delay

Abstract

The invention provides a system for achieving double-ventricle re-synchronization by tracking biological atrioventricular delay (AVD) via single left ventricle hop-by-hop. The system comprises a three-chamber pacemaker system and a single left ventricle hop-by-hop tracking biological AVD working procedure. Before the procedure is started, when ultrasonic cardiogram optimization has not been performed, an optional empirical value of a period (V-R period) where the left ventricle should be prior to the right ventricle is 10ms-40ms. If the V-R period should be obtained via the ultrasonic cardiogram optimization, the system will firstly finish the ultrasonic cardiogram optimization to obtain the V-R period before working. According to the invention, the system can approximately track the biological atrioventricular delay and achieve double-ventricle re-synchronization just via the left ventricle pace-making, and is quite physiological with no need for extending the AVD acquisition AS-VS period; limitations on atrioventricular synchronization by other systems are overcome; the left ventricle electrode is free from power consumption pace-making, so service lifetime of a cell is extended; 50% of cost of heart re-synchronization treatment is reduced; and the system has important significance and application value on limited medical treatment resources.

Description

technical field [0001] The invention belongs to the field of biomedical signal processing, in particular to a single left ventricle pacing beat-by-beat real-time tracking physiological atrioventricular delay (AVD) system to realize double ventricle resynchronization. Background technique [0002] The current standard three-chamber pacemaker cardiac resynchronization therapy (CRT) sets a short and fixed atrioventricular delay (AVD) (100-120ms) to ensure biventricular capture, abandoning the physiological conduction of the atrioventricular node, which is not in line with physiological , usually in heart failure patients with complete left bundle branch block, the conduction of the right His-Purkinson system is normal, and the right ventricle does not need pacing. Therefore, CRT can be achieved as long as the single left ventricular pacing tracks the physiological atrioventricular delay. [0003] In recent years, various pacemaker companies have also developed algorithms for si...

AI Technical Summary

Problems solved by technology

[0004] First, prolong the AVD every minute, so that the self-excitement is transmitted from the right bundle branch to the right ventricle, which is equivalent to the state of complete left bundle branch block before CRT, the right ventricle is excited first, and the left ventricle is delayed. If the heart rate is 60 beats / min, there will be 24 minutes a day or 6 days a year that the left ventricle will not be able to give priority to inter-ventricular synchronization. If the battery life of each three-chamber pacemaker is calculated as 5 years, there will be a total of one month The CRT is underutilized;

[0005] Secondly, in each minute, the AVD of the pacemaker programmed according to the algorithm is fixed. When the patient’s heart rate changes significantly within this minute, the physiological atrioventricular delay will change accordingly, which will inevitably lead to The change of the fusion wave formed by the excitation generated by left ventricular pacing and the physiological excitation from the right His-Pu system is manifested by the change of QRS wave shape and timing, which can affect the synchronization between the left and right ventricles, and even fail to achieve left Room priority, the above limitations can partially offset the benefits of CRT

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