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US 2002/0177879 A1Published application
Cardiac rhythm management system selecting between multiple same-chamber electrodes for delivering cardiac therapy
AssigneeCardiac Pacemakers, Inc.
InventorsJiang Ding, Julio C. Spinelli, Andrew P. Kramer
Life of this patent
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Abstract
A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode.
Claims86
A method including:
- detecting a first fiducial point, associated with a first heart depolarization, at a first electrode associated with a first heart chamber;
- detecting the first fiducial point, associated with the first heart depolarization, at a second electrode associated with the first heart chamber;
- determining a timing between the detecting the first fiducial point at the first electrode and the detecting the first fiducial point associated with the second electrode;
- selecting the first electrode if the first fiducial point is detected at the second electrode before the first fiducial point is detected at the first electrode, and selecting the second electrode if the first fiducial point is detected at the first electrode before the first fiducial point is detected at the second electrode;
- and
- delivering from a selected electrode a subsequent stimulation for evoking a contraction of the first heart chamber.
3 more elements
A method including:
- detecting, from a first electrode associated with a first heart chamber, a first fiducial point associated with a first depolarization of the first heart chamber;
- detecting, from a second electrode associated with a second heart chamber, a second fiducial point associated with a second depolarization of the second heart chamber;
- detecting, from a third electrode associated with the second heart chamber, a third fiducial point associated with the second depolarization of the second heart chamber, in which the second and third fiducial points are substantially similarly located on the second depolarization;
- measuring a first time difference between the first and second fiducial points;
- measuring a second time difference between the first and third fiducial points;
- selecting the second electrode if the first time difference is longer than the second time difference, and selecting the third electrode if the second time difference is longer than the first time difference;
- and
- delivering from a selected electrode a subsequent stimulation for evoking a contraction of the second heart chamber.
5 more elements
A method including:
- detecting, from a first electrode associated with a first heart chamber, a first fiducial point associated with a first depolarization of the first heart chamber during a first cardiac cycle;
- detecting, from a second electrode associated with a second heart chamber, a second fiducial point associated with a second depolarization of the second heart chamber during the first cardiac cycle;
- detecting, from the first electrode associated with the first heart chamber, a third fiducial point associated with a third depolarization of the first heart chamber during a second cardiac cycle, and in which the first and third fiducial points are substantially similarly located on the respective first and third depolarizations;
- detecting, from a third electrode associated with the second heart chamber, a fourth fiducial point associated with a fourth depolarization of the second heart chamber during the second cardiac cycle, in which the second and fourth fiducial points are substantially similarly located on the respective second and fourth depolarizations
- measuring a first time difference between the first and second fiducial points;
- measuring a second time difference between the third and fourth fiducial points;
- selecting the second electrode if the first time difference is longer than the second time difference, and selecting the third electrode if the second time difference is longer than the first time difference;
- and
- delivering from a selected electrode a subsequent stimulation for evoking a contraction of the second heart chamber.
6 more elements
A system including:
- first and second electrodes, both configured to be associated with a first heart chamber;
- a sensing circuit, coupled to the first and second electrodes, the sensing circuit detecting heart depolarizations associated with the first heart chamber, including detecting a first depolarization time at which a first depolarization of the first heart chamber is received at the first electrode, and detecting a second depolarization time at which the first depolarization of the first heart chamber is received at the second electrode;
- a therapy circuit delivering stimulations for evoking heart contractions from at least one of the first and second electrodes;
- and
- a controller, coupled to the sensing circuit, the controller selecting the second electrode if the first depolarization time occurs before the second depolarization time, and selecting the first electrode if the second depolarization time occurs before the first depolarization time, the controller coupling the therapy circuit to the selected one of the first and second electrodes for delivering the stimulations.
2 more elements
A system including:
- a first electrode configured to be associated with a first heart chamber;
- second and third electrodes, both configured to be associated with a second heart chamber;
- a sensing circuit, coupled to the first, second, and third electrodes, the sensing circuit detecting heart depolarizations from the first and second chambers;
- a timer, coupled to the sensing circuit, the timer measuring a first time interval between a first depolarization received at the first electrode and a subsequent second depolarization received at the second electrode during the same cardiac cycle, and measuring a second time interval between the first depolarization received at the first electrode and the subsequent second depolarization received at the third electrode during the same cardiac cycle;
- a therapy circuit delivering stimulations for evoking heart contractions from one of the second and third electrodes;
- and
- a controller, coupled to the timer, the controller selecting the second electrode if the first time interval is longer than the second time interval, and selecting the third electrode if the second time interval is longer than the first time interval, the controller coupling the therapy circuit to the selected one of the second and third electrodes for delivering the stimulations.
4 more elements
A system including:
- a first electrode configured to be associated with a first heart chamber;
- second and third electrodes, both configured to be associated with a second heart chamber;
- a sensing circuit, coupled to the first, second, and third electrodes, the sensing circuit detecting heart depolarizations from the first and second chambers;
- a timer, coupled to the sensing circuit, the timer measuring a first time interval between a first depolarization received at the first electrode during a first cardiac cycle and a subsequent second depolarization received at the second electrode during the first cardiac cycle, and measuring a second time interval between a third depolarization received at the first electrode during a second cardiac cycle and a subsequent fourth depolarization received at the third electrode during the second cardiac cycle;
- a therapy circuit delivering stimulations for evoking heart contractions from one of the second and third electrodes;
- and
- a controller, coupled to the timer, the controller selecting the second electrode if the first time interval is longer than the second time interval, and selecting the third electrode if the second time interval is longer than the first time interval, the controller coupling the therapy circuit to the selected one of the second and third electrodes for delivering the stimulations.
4 more elements
A method including:
- detecting, from one of first and second electrodes, each associated with a first heart chamber, a first fiducial point associated with a first depolarization of the first heart chamber;
- detecting, from the first electrode, a second fiducial point associated with the first depolarization;
- detecting, from one of the first and second electrodes, a third fiducial point associated with a second depolarization of the first heart chamber;
- detecting, from the second electrode, a fourth fiducial point associated with the second depolarization;
- measuring a first time interval between the first and second fiducial points;
- measuring a second time interval between the third and fourth fiducial points;
- selecting the first electrode if the first time interval is longer than the second time interval, and selecting the second electrode if the second time interval is longer than the first time interval;
- and
- delivering from the selected electrode a subsequent stimulation for evoking a contraction of the first heart chamber.
6 more elements
A system including:
- first and second electrodes configured to be associated with a first heart chamber;
- a sensing circuit, coupled to the first and second electrodes, the sensing circuit detecting from one of the first and second electrodes a first fiducial point associated with a first heart depolarization of the first heart chamber, the sensing circuit detecting from the first electrode a second fiducial point associated with the first heart depolarization, the sensing circuit detecting from one of the first and second electrodes a third fiducial point associated with a second heart depolarization of the first heart chamber, the sensing circuit detecting from the second electrode a fourth fiducial point associated with the second heart depolarization;
- a timer, coupled to the sensing circuit, the timer measuring a first time interval between the first and second fiducial points, and measuring a second time interval between the third and fourth fiducial points;
- a therapy circuit delivering stimulations for evoking heart contractions from one of the first and second electrodes;
- and
- a controller, coupled to the timer, the controller selecting the first electrode if the first time interval exceeds the second time interval, the controller selecting the second electrode if the second time interval exceeds the first time interval, the controller coupling the therapy circuit to the selected one of the first and second electrodes for delivering the stimulations.
3 more elements
A method including:
- detecting, from one of first and second electrodes, each associated with a first heart chamber, a first fiducial point associated with a first depolarization of the first heart chamber;
- detecting, from the first electrode, a second fiducial point associated with the first depolarization;
- detecting, from the second electrode, a third fiducial point associated with the first depolarization;
- measuring a first time interval between the first and second fiducial points;
- measuring a second time interval between the first and third fiducial points;
- selecting the first electrode if the first time interval is longer than the second time interval, and selecting the second electrode if the second time interval is longer than the first time interval;
- and
- delivering from the selected electrode a subsequent stimulation for evoking a contraction of the first heart chamber.
5 more elements
A system including:
- first and second electrodes configured to be associated with a first heart chamber;
- a sensing circuit, coupled to the first and second electrodes, the sensing circuit detecting from one of the first and second electrodes a first fiducial point associated with a first heart depolarization of the first heart chamber, the sensing circuit detecting from the first electrode a second fiducial point associated with the first heart depolarization, the sensing circuit detecting from the second electrode a third fiducial point associated with the first heart depolarization;
- a timer, coupled to the sensing circuit, the timer measuring a first time interval between the first and second fiducial points, and measuring a second time interval between the first and third fiducial points;
- a therapy circuit delivering stimulations for evoking heart contractions from one of the first and second electrodes;
- and
- a controller, coupled to the timer, the controller selecting the first electrode if the first time interval exceeds the second time interval, the controller selecting the second electrode if the second time interval exceeds the first time interval, the controller coupling the therapy circuit to the selected one of the first and second electrodes for delivering the stimulations.
3 more elements
Dependencies are inferred from the claim text.