264 results about "Ventricular pacing" patented technology

The present invention relates to monitoring septal wall motion of the atrial and / or ventricular chambers of a heart for optimizing cardiac pacing intervals based on signals derived from the monitored wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e.g., suitably filter, rectify and / or integrate) motion signals to determine acceleration, velocity and / or displacement. During pacing interval optimization the wall motion is measured for those pacing intervals and the pacing interval setting(s) that produce minimal wall motion for chronic therapy delivery. In addition, methods for periodically determining whether to cease or resume delivery of a bi-ventricular pacing therapy to a patient that may have experienced beneficial reverse remodeling of the heart.

The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI / R, VVI / R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).

A method for quantifying cardiac desynchrony of the right and left ventricles includes obtaining cardiac acquisition data from a medical imaging system, and determining a movement profile from the cardiac acquisition data. The movement profile is directed toward identifying at least one of a time-based contraction parameter for a region of the left ventricle (LV), and a displacement-based contraction parameter for a region of the LV. The determined movement profile is visually displayed by generating a 3D model therefrom.

A method of treating hemodynamic disfunction by simultaneously pacing both ventricles of a heart. At least one ECG amplifier is arranged to separately detect contraction of each ventricle and a stimulator is then activated for issuing stimulating pulses to both ventricles in a manner to assure simultaneous contraction of both ventricles, thereby to assure hemodynamic efficiency. A first ventricle is stimulated simultaneously with contraction of a second ventricle when the first fails to properly contract. Further, both ventricles are stimulated after lapse of a predetermined A-V escape interval. One of a pair of electrodes, connected in series, is placed through the superior vena cava into the right ventricle and a second is placed in the coronary sinus about the left ventricle. Each electrode performs both pacing and sensing functions. The pacer is particularly suitable for treating bundle branch blocks or slow conduction in a portion of the ventricles.

A pacing system provides for optimal hemodynamic cardiac function for parameters such as ventricular synchrony or contractility (peak left ventricle pressure change during systole or LV+dp / dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal. A look-up table relating the timing of such electrical or mechanical events to atrio-ventricular delay time intervals is provided for programming the pacing system.

Bi-ventricular cardiac pacing systems and systems for improving cardiac function for heart failure patients that pace and sense in right and left ventricles of the heart and particularly pace in one of the right and left ventricles after an AV delay timed from a preceding atrial event and after a spontaneous depolarization in the other of the right and left ventricles to achieve fusion pacing. An A-RVp delay and an A-LVp delay are each determined from an intrinsic sensed A-RVs delay and an intrinsic A-LVs delay. If the derived A-LVp delay becomes substantially equal to or shorter than the intrinsic A-RVs delay, then the A-RVp delay is decremented to be shorter than the A-LVp delay. Bi-ventricular pacing of the RV and LV is then established closely timed to the intrinsic RV and LV depolarizations.

A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp / dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

The present invention relates to a method and apparatus for pacing the ventricle of a patient's heart through the pericardial space, including an epicardial lead and a method for placement of the lead.

A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of a refractory period stimulation (RPS) therapy to determine if the desired non-capture (i.e., lack of ventricular mechanical capture due to refractory period stimulation) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and / or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture due to pacing stimulus delivery, non-capture due to RPS therapy delivery, and / or contractile status based on the qualities of evoked response to pacing stimulation.

Techniques are provided for use by implantable medical devices for controlling ventricular pacing. In one example, optimal atrio-ventricular and interventricular pacing delay values are determined for pacing the heart of the patient based, in part, on a measured inter-atrial conduction delay. Atrio-ventricular conduction delays are then measured within the patient. The atrio-ventricular pacing delays are compared with the measured atrio-ventricular conduction delays. If the atrio-ventricular pacing delays are less than the measured atrio-ventricular conduction delays, biventricular pacing is delivered using the atrio-ventricular pacing delay and the interventricular pacing delay. However, if the atrio-ventricular pacing delays are not less than the corresponding atrio-ventricular conduction delays, as can occur if the inter-atrial conduction delay is large, then alternative pacing regimes are selectively enabled, such as monoventricular pacing in the chamber having the longer conduction delay value, biventricular pacing with negative hysteresis, or biventricular pacing with pacing delays reduced using predetermined offset values.

An medical electrical lead in embodiments of the teachings may include one or more of the following features: (a) a lead body having a proximal end and a distal end, (b) a conductor traversing from the proximal end to the distal end, (c) an electrode disposed at the distal end of the lead body and electrically coupled to the conductor adapted to electrically stimulate a heart, (d) occlusion fabric disposed at the distal end of the lead body and supported by the electrode in a shape adapted to cover holes in the heart, and (f) a second electrode adapted to provide bipolar electrical stimulation of the heart.

A method for planning biventricular pacing lead placement for a patient includes obtaining acquisition data from a medical imaging system and generating a 3D model of the left ventricle and thoracic wall of the patient. One or more left ventricle anatomical landmarks are identified on the 3D model, and saved views of the 3D model are registered on an interventional system. One or more of the registered saved views are visualized with the interventional system, and at least one suitable region on the left ventricle wall is identified for epicardial lead placement.

A system and method which employs atrial discrimination algorithms to distinguish between different atrial arrhythmias occurring in a patient for selecting an optimal pacing therapy corresponding to the type of arrhythmia identified. The invention may be implemented in a bradycardia pacemaker or other implantable cardiac device. In response to the detection of an atrial rate above the atrial tracking rate, discrimination criteria are applied to a detected atrial activity signal to distinguish between different types of supraventricular tachycardia, such as fast atrial flutter and other atrial flutter at a relatively slower rate, which may be occurring in the patient. The discrimination criteria may be, for example, rate-based or morphology based. The pacer is controlled to provide pacing therapy to a heart in a manner corresponding to the type of supraventricular tachycardia identified. For example, antitachycardia pacing may be provided to the heart in response to the detection of a relatively lower rate supraventricular tachycardia / other atrial flutter, whereas another pacing control, e.g., ventricular pacing, such as ventricular rate regulation or Rate Smoothing, may be applied if a more rapid rate supraventricular tachycardia / fast atrial flutter is identified. The output of an atrial discrimination algorithm may be tracked and the trend thereof used to improve therapy timing.

A catheter system suitable for implanting pacemaker leads. A guide catheter is provided with steering capability, and the necessary steering components are modified to permit the catheter to be sliced during withdrawal, so that the proximal forced applied to the pacemaker lead is minimized and the lead is less likely to be dislodged.