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US 6,665,564 B2Granted
Cardiac rhythm management system selecting A-V delay based on interval between atrial depolarization and mitral valve closure
AssigneeCardiac Pacemakers, Inc.
InventorsWilliam C. Lincoln, Gerrard M. Carlson
Life of this patent
Estimating the term…
Abstract
A cardiac rhythm management system selects an atrioventricular (A-V) delay based on a time-interval between an atrial depolarization and mitral valve closure (MVC). For several different A-V delays, the system measures time intervals between atrial depolarizations (i.e., sensed or paced P-waves) and accelerometer-detected MVCs. Based on this information, the system selects a particular A-V delay for improving cardiac output during subsequent delivery of cardiac rhythm management therapy.
Claims12
A system, including:
- an atrial module selected from the group consisting essentially of an atrial stimulation module and an atrial sensing module, the atrial module providing times associated with atrial depolarizations;
- a ventricular stimulation module;
- a mitral valve closure detector providing times associated with mitral valve closures;
- and
- an atrioventricular (A-V) timing module, coupled to the atrial module and the ventricular stimulation module, for controlling the delivery of ventricular stimulations at different A-V delays, the A-V timing module including:
- a timer, coupled to the mitral valve closure detector for receiving the times associated with mitral valve closures corresponding to the ventricular stimulations at the different A-V delays, and coupled to the atrial module for receiving the times associated with the atrial depolarizations, the timer calculating, for each of the ventricular stimulations at the different A-V delays, a time interval between the preceding atrial depolarization and a next mitral valve closure following that ventricular stimulation;
- a slope calculation module, coupled to the timer and calculating the slopes of the time intervals against the different A-V delays;
- and
- an A-V delay selection module, coupled to the timer and selecting one of the different A-V delays based on the time intervals obtained corresponding to the ventricular stimulations at the different A-V delays, and in which the A-V delay selection module is coupled to the slope calculation module to select an A-V delay based on the slopes of the time intervals.
6 more elements
A system, including:
- an atrial electrode, configured to be associated with an atrium of a heart;
- an atrial module, selected from the group consisting of an atrial stimulation module and an atrial sensing module, the atrial module coupled to the atrial electrode, the atrial module providing times associated with atrial depolarizations;
- a ventricular electrode, configured to be associated with a ventricle of the heart;
- a ventricular stimulation circuit, coupled to the ventricular electrode for delivering ventricular stimulations;
- an accelerometer, configured to be associated with the heart for detecting and providing a heart acceleration signal;
- an accelerometer interface module, including an input coupled to the accelerometer for receiving the heart acceleration signal, and including an output providing fiducial point times associated with mitral valve closures obtained from the heart acceleration signal;
- and
- an atrioventricular (A-V) timing module, coupling the ventricular stimulation circuit to the ventricular electrode for delivering ventricular stimulations separated from corresponding preceding atrial depolarizations by different A-V delays, the A-V timing module including:
- a timer, coupled to the accelerometer interface module for receiving the fiducial point times, and coupled to the A-V timing module for receiving the times associated with the atrial depolarizations, the timer calculating, for each ventricular stimulation associated with the different A-V delays, a P-MVC time interval between the atrial depolarization time and the fiducial point time following that ventricular stimulation;
- a slope calculation module, calculating the slopes of the P-MVC time intervals against the different A-V delays;
- and
- an A-V delay selection module, selecting one of the different A-V delays based on the slopes of the P-MVC time intervals.
9 more elements
A system, including:
- an atrial module, selected from the group consisting of an atrial stimulation module and an atrial sensing module, the atrial module configured to be coupled to an atrial electrode, the atrial module providing times associated with atrial depolarizations;
- a ventricular stimulation circuit, configured to be coupled to the ventricular electrode for delivering ventricular stimulations;
- an accelerometer, configured to be associated with the heart for detecting and providing a heart acceleration signal;
- an accelerometer interface module, including an input coupled to the accelerometer for receiving the heart acceleration signal, and including an output providing fiducial point times associated with mitral valve closures obtained from the heart acceleration signal;
- and
- an atrioventricular (A-V) timing module, coupled to the ventricular stimulation circuit to control delivery of ventricular stimulations separated from corresponding preceding atrial depolarizations by different A-V delays, the A-V timing module including:
- a timer, coupled to the accelerometer interface module for receiving the fiducial point times, and coupled to the A-V timing module for receiving the times associated with the atrial depolarizations, the timer calculating, for each ventricular stimulation associated with the different A-V delays, a P-MVC time interval between the atrial depolarization time and the fiducial point time following that ventricular stimulation;
- a slope calculation module, calculating the slopes of the P-MVC time intervals against the different A-V delays;
- and
- an A-V delay selection module, selecting one of the different A-V delays based on the slopes of the P-MVC time intervals.
7 more elements
Dependencies are inferred from the claim text.