Cardiac pacing using adjustable atrio-ventricular delays
AssigneeCardiac Pacemakers, Inc.
InventorsJiang Ding, Yinghong Yu, Andrew P. Kramer, Julio Spinelli
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Abstract
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.
Claims54
A method, comprising:
- measuring an interval during a nonpaced systolic cycle between a first event and a second event, the first event related to an atrial contraction which is in a first predictable time-dependent relationship and the second event which is in a second predictable time-dependent relationship to a ventricular pacing signal optimally timed for maximum peak positive LV pressure change during systole, (LV+dp/dt);
- generating an atrio-ventricular delay (AVD.sub.c) calculated from a predetermined mapping of a relationship of the interval to an optimal atrio-ventricular delay for maximum peak positive LV pressure change during systole, (LV+dp/dt);
- and
- delivering a pacing pulse to a ventricle with the generated atrio-ventricular delay (AVD.sub.c);
- wherein AVD.sub.c provides an approximation of the optimal atrio-ventricular delay for pacing the ventricle to provide maximum peak positive LV pressure change during systole, (LVA+dp/dt).
An apparatus, comprising:
- a programmable pulse generator transmitting ventricular pacing pulses with an atrio-ventricular delay (AVD.sub.c) calculated from an interval measured during a nonpaced systolic cycle by the programmable pulse generator between a first event and a second event, the first event related to an atrial contraction which is in a first predictable time-dependent relationship and the second event which is in a second predictable time-dependent relationship to a ventricular pacing signal optimally timed for maximum peak positive LV pressure change during systole, (LV+dp/dt)
- wherein the AVD.sub.c is calculated by the programmable pulse generator from a predetermined mapping of a relationship of the interval to an optimal atrio-ventricular delay for maximum peak positive LV pressure change during systole, (LV+dp/dt) and
- wherein AVD.sub.c provides an approximation of the optimal atrio-ventricular delay for pacing the ventricle to provide maximum LV+dp/dt.
Dependencies are inferred from the claim text.