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System for identification and adjustment of loss of effective cardiac resynchronization therapy

A heart resynchronization, implantable medical technology, applied in the direction of treatment, cardiac stimulator, application, etc., can solve the problems of pacing lead wire migration or displacement, affecting ventricular capture, etc.

Pending Publication Date: 2021-03-26
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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  • System for identification and adjustment of loss of effective cardiac resynchronization therapy
  • System for identification and adjustment of loss of effective cardiac resynchronization therapy
  • System for identification and adjustment of loss of effective cardiac resynchronization therapy

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0122] Embodiment 1: An implantable medical device system for delivering cardiac resynchronization therapy (CRT) pacing, comprising: an implantable medical device housing; at least one lead having a lead body and capable of being electrically coupled to the housing; a plurality of electrodes positioned along one or both of the device housing and the lead body of the at least one lead to sense cardiac signals of the patient and deliver CRT pacing and a processor positioned within the housing and configured to: in response to the delivered CRT pacing, determine that capture associated with the delivered CRT pacing is invalid; determine that the capture is invalid and adjusting one of the safety margin and the capture threshold in response to the determined cause of ineffective capture being a loss of capture; and in response to the determined cause of ineffective capture being a delayed left ventricle (LV) depolarization while adjusting LV pre-excitation.

Embodiment 2

[0123] Embodiment 2: The system of Embodiment 1, wherein the processor is configured to: determine whether a left ventricular capture management (LVCM) feature is enabled, generate an alarm in response to the LVCM not being enabled, and generate an alarm in response to the LVCM feature being enabled Adjust one of the safety margin and capture threshold.

Embodiment 3

[0124] Embodiment 3: The system of any one of Embodiments 1 and 2, wherein the processor is configured to: respond to an adjustment in performing the adjustment of one of the safety margin and the capture threshold and the adjustment of the LV pre-excitation one after which CRT pacing is delivered, while determining whether a change in effective CRT has occurred; in response to determining that a change in effective CRT has occurred, determining that invalid capture has been resolved; and in response to determining that no change in effective CRT has occurred, determining that invalid capture was not resolved.

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PUM

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Abstract

An implantable medical device system and method for delivering cardiac resynchronization therapy (CRT) pacing that includes determining capture associated with the delivered CRT pacing is ineffectivein response to the delivered CRT pacing. A reason for capture being ineffective is determined and a safety margin is adjusted if the determined reason for capture being ineffective is loss of captureand a left ventricle (LV) pre-excitation is adjusted if the determined reason for capture being ineffective is delayed LV depolarization. Monitoring for a change in effective cardiac resynchronizationtherapy is used to confirm that the adjustment of the CRT pacing was effective in resolving the ineffective capture.

Description

[0001] The disclosure herein relates to systems and methods for the delivery of cardiac pacing therapy, and more particularly, to the delivery of cardiac resynchronization therapy. Background technique [0002] During normal sinus rhythm (NSR), the heartbeat is regulated by electrical signals generated by the sinoatrial (SA) node located in the wall of the right atrium. Each atrial depolarization signal generated by the SA node spreads across the atria (causing depolarization and contraction of the atria) and reaches the atrioventricular (A-V) node. The A-V node responds by propagating ventricular depolarizing signals through the His bundle of the ventricular septum and subsequently to the bundle branches and Purkinje myofibers of the right and left ventricles. [0003] Cardiac resynchronization pacing devices operate by delivering pacing stimuli to both ventricles or to one ventricle, with the desired result of more or less simultaneous mechanical contraction and ejection of ...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): A61N1/368A61N1/37A61N1/372
CPCA61N1/3712A61N1/368A61N1/37247A61N1/37252A61B5/721A61N1/36542A61N1/36585
Inventor R·W·斯塔德勒R·N·克莱弗S·戈什Y·格林伯格
Owner MEDTRONIC INC
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