US 11,446,505 B2 · His-bundle pacing for atrioventricular block

Abstract

Systems and methods for dynamically controlling His-bundle pacing (HBP) according to an indication of a rate-related or intermittent atrioventricular (AV) block in a subject are disclosed. An exemplary medical system includes an AV conduction monitor to detect an indication of either a presence or an absence of intermittent or rate-related AV conduction disturbance using physiologic information of the subject. In the event that an intermittent or rate-related AV conduction disturbance is present, a control circuit provides a control signal to an electrostimulation circuit to deliver HBP pulses. If there is no indication of intermittent or rate-related AV conduction disturbance, or a previously detected intermittent or rate-related AV conduction disturbance has been terminated, the control circuit withholds or discontinues delivery of the HBP pulses to promote intrinsic ventricular conduction and activation.

Claims20

Dependent claims

A system, comprising:

an atrioventricular (AV) conduction monitor configured to:
receive physiologic information of a subject, the received physiologic information including a heart rate (HR);
determine for the subject, using the received physiologic information of the subject, a personalized HR threshold at and above which an intermittent or rate-related AV conduction disturbance occurs;
and
detect an indication of either a presence or an absence of the intermittent or rate-related AV conduction disturbance in a heart of the subject using the received HR and the personalized HR threshold;
and
a pacing control circuit configured to control an electrostimulation circuit to generate His-bundle pacing (HBP) pulses, and to provide a control signal to:
deliver HBP pulses to stimulate a physiologic conduction pathway of the heart in response to a detected indication of a presence of intermittent or rate-related AV conduction disturbance;
and
withhold or discontinue delivery of the HBP pulses in response to a detected indication of an absence of intermittent or rate-related AV conduction disturbance.

7 more elements

A method for pacing a physiologic conduction pathway including a His bundle or a bundle branch of a heart of a subject, the method comprising:

receiving physiologic information of the subject using an atrioventricular (AV) conduction monitor, the received physiologic information including a heart rate (HR);
determining for the subject, using the received physiologic information of the subject, a personalized HR threshold at and above which an intermittent or rate-related AV conduction disturbance occurs using the AV conduction monitor;
detecting, using the AV conduction monitor, an indication of either a presence or an absence of an intermittent or rate-related AV conduction disturbance in the heart of the subject using the received HR and the personalized HR threshold;
and
controlling, using a pacing control circuit, generation of His-bundle pacing (HBP) pulses of an electrostimulation circuit, comprising:
in response to an indication of a presence of intermittent or rate-related AV conduction disturbance, delivering HBP pulses to stimulate a physiologic conduction pathway;
and
in response to an indication of an absence of intermittent or rate-related AV conduction disturbance, withholding or discontinuing delivery of the HBP pulses.

5 more elements

Dependencies are inferred from the claim text.

His-bundle pacing for atrioventricular block

Life of this patent

His-bundle pacing for atrioventricular block

Life of this patent

Abstract

Claims20