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US 2022/0032062 A1Published application
Cardiac conduction system pacing
AssigneeMedtronic, Inc.
InventorSubham Ghosh
Life of this patent
Estimating the term…
Abstract
The present disclosure relates generally to pacing of the cardiac conduction system of a patient, and more particularly, to providing adaptive cardiac conducting system pacing therapy and to determining selective or non-selective capture of the cardiac conduction system by cardiac conduction system pacing therapy. The adaptive cardiac conduction system pacing therapy may adjust AV delay and VV delay based on various signals and metrics and may switch between cardiac conduction system pacing therapy exclusively and cardiac conduction system pacing therapy in combination with traditional left ventricular pacing therapy.
Claims54
An implantable medical device comprising:
- a plurality of implantable electrodes to sense and pace a patient's heart, wherein the plurality of electrodes comprise:
- a left ventricular electrode positionable proximate the patient's left ventricle;
- and
- a cardiac conduction system electrode positionable proximate a portion of the patient's cardiac conduction system;
- and
- a computing apparatus comprising processing circuitry, the computing apparatus operably coupled to the plurality of implantable electrodes, wherein the computing apparatus is configured to:
- initiate delivery of cardiac conduction system pacing therapy to the patient's cardiac conduction system using the cardiac conduction system electrode;
- monitor local electrical activity of the patient using the left ventricular electrode during the delivery of cardiac conduction system pacing therapy using the cardiac conduction system electrode;
- and
- switch to delivery of both cardiac conduction system pacing therapy to the patient's cardiac conduction system using the cardiac conduction system electrode and left ventricular pacing therapy to the patient's left ventricle using the left ventricular electrode in response to the monitored local electrical activity.
7 more elements
A method comprising:
- delivering cardiac conduction system pacing therapy to a patient's cardiac conduction system using a cardiac conduction system electrode implanted proximate a portion of the patient's cardiac conduction system;
- monitoring local electrical activity of the patient using a left ventricular electrode implanted proximate the patient's left ventricle during the delivery of cardiac conduction system pacing therapy using the cardiac conduction system electrode;
- and
- switching to delivery of both cardiac conduction system pacing therapy to the patient's cardiac conduction system using the cardiac conduction system electrode and left ventricular pacing therapy to the patient's left ventricle using the left ventricular electrode in response to the monitored local electrical activity.
1 more element
An implantable medical device comprising:
- a plurality of implantable electrodes to sense and pace a patient's heart, wherein the plurality of electrodes comprise:
- a left ventricular electrode positionable proximate the patient's left ventricle;
- and
- a cardiac conduction system electrode positionable proximate a portion of the patient's cardiac conduction system;
- and
- a computing apparatus comprising processing circuitry, the computing apparatus operably coupled to the plurality of implantable electrodes, wherein the computing apparatus is configured to:
- determine a paced AV delay for use in delivery of cardiac conduction system pacing therapy using the cardiac conduction system electrode, wherein the paced AV delay is a time period between an atrial event and delivery of cardiac conduction system pacing therapy;
- determine a paced VV delay for use in delivery of cardiac conduction system pacing therapy using the cardiac conduction system electrode and delivery of left ventricular pacing therapy using the left ventricular electrode, wherein the paced VV delay is a time period between the delivery of the left ventricular pacing therapy and the delivery of the cardiac conduction system pacing therapy;
- and
- deliver either cardiac conduction system pacing therapy using the paced AV delay or cardiac conduction system pacing therapy and left ventricular pacing therapy using the paced AV delay and the paced VV delay.
7 more elements
A method comprising:
- determining a paced AV delay for use in delivery of cardiac conduction system pacing therapy using a cardiac conduction system electrode implanted proximate a portion of the patient's cardiac conduction system, wherein the paced AV delay is a time period between an atrial event and delivery of cardiac conduction system pacing therapy;
- determining a paced VV delay for use in delivery of cardiac conduction system pacing therapy using the cardiac conduction system electrode and delivery of left ventricular pacing therapy using a left ventricular electrode implanted proximate the patient's left ventricle, wherein the paced VV delay is a time period between the delivery of the left ventricular pacing therapy and the delivery of the cardiac conduction system pacing therapy;
- and
- delivering either cardiac conduction system pacing therapy using the paced AV delay or cardiac conduction system pacing therapy and left ventricular pacing therapy using the paced AV delay and the paced VV delay.
1 more element
An implantable medical device comprising:
- a plurality of implantable electrodes to sense and pace a patient's heart;
- and
- a computing apparatus comprising processing circuitry, the computing apparatus operably coupled to the plurality of implantable electrodes and configured to:
- initiate a delivery of pacing therapy to the patient's heart;
- monitor a near-field signal over a sensing time period proximate the left bundle branch using the plurality of implantable electrodes following the delivery of pacing therapy;
- generate a derivative signal based on the near-field signal;
- and
- determine whether the pacing therapy has selective or non-selective capture of the cardiac conduction system based on the derivative signal.
5 more elements
A method comprising:
- delivering pacing therapy to the patient's heart using one or more of a plurality of implantable electrodes;
- monitoring a near-field signal over a sensing time period proximate the left bundle branch using the plurality of implantable electrodes following the delivery of pacing therapy;
- generating a derivative signal based on the near-field signal;
- and
- determining whether the pacing therapy has selective or non-selective capture of the cardiac conduction system based on the derivative signal.
2 more elements
Dependencies are inferred from the claim text.