Method and apparatus for delivering defibrillation shock therapy while reducing electrical dispersion due to ventricular conduction disorder
AssigneeCardiac Pacemakers, Inc.
InventorsJeffrey E. Stahmann, Jesse W. Hartley, Steven D. Girouard
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Abstract
A method and device for delivering defibrillation shock therapy in patients having an inter-ventricular conduction disorder is presented. Ventricular resynchronization therapy is employed to reduce the dispersion of ventricular depolarization which takes place due to the conduction disorder and reduces the safety margin of shocks delivered synchronously with ventricular beats. The method may be employed in the treatment of atrial or ventricular tachyarrhythmias.
Claims20
A method for delivering ventricular cardioversion therapy to a patient, comprising:
- identifying the patient as having a ventricular conduction deficit by measuring the patient's ventricular conduction delay;
- and,
- configuring an implantable cardiac rhythm management device implanted in the patient to detect the presence of a ventricular tachyarrhythmia and, in response thereto, to:
- initiate delivery of ventricular pacing in a selected pacing mode which reduces QRS dispersion from that exhibited by an intrinsic beat in the patient;
- and,
- deliver a cardioversion shock after a predetermined time interval following a ventricular pace.
A method for delivering ventricular cardioversion therapy, comprising:
- detecting the presence of a ventricular tachyarrhythmia;
- delivering a first type of ventricular pacing while no ventricular tachyarrhythmia is detected;
- delivering a second type of ventricular pacing while a ventricular tachyarrhythmia is detected;
- wherein the QRS dispersion resulting from the first type of ventricular pacing is greater than the QRS dispersion resulting from the second type of ventricular pacing;
- and,
- delivering a cardioversion shock pulse within a predetermined time after a pacing pulse of the second type of ventricular pacing.
A device for delivering ventricular cardioversion therapy, comprising:
- a sensing channel for detecting the presence of a ventricular tachyarrhythmia;
- sensing/pacing channels for delivering biventricular pacing therapy and sensing ventricular depolarizations (R waves);
- a controller for controlling the operation of the device, wherein the controller is programmed to:
- initiate ventricular pacing in a mode which includes pacing of the left ventricle after detection of a tachyarrhythmia;
- sense an R wave after a ventricular pace and measure an R-R interval;
- and,
- deliver a cardioversion shock pulse synchronously with the sensed R wave if the R-R interval is longer than a specified minimum limit value.
A device for delivering ventricular cardioversion therapy, comprising:
- means for detecting the presence of a ventricular tachyarrhythmia;
- means for delivering a first type of ventricular pacing while no ventricular tachyarrhythmia is detected;
- means for delivering a second type of ventricular pacing while a ventricular tachyarrhythmia is detected;
- wherein the QRS dispersion resulting from the first type of ventricular pacing is greater than the QRS dispersion resulting from the second type of ventricular pacing;
- and,
- means for delivering a cardioversion shock pulse within a predetermined time after a pacing pulse of the second type of ventricular pacing.
Dependencies are inferred from the claim text.