US 7,254,442 B2 · Apparatus and method for “LEPARS” interval-based fusion pacing

Abstract

Efficient provision of hemodynamic benefits and therapy for patients suffering from intraventricular conduction delays or conduction blockage. By effectively measuring conduction delay or block (e.g., left bundle branch block or “LBBB”) and enhancing delivery of a novel form of left ventricle-only cardiac resynchronization therapy. Accordingly, a single LV fusion pacing stimulus is triggered from an atrial event (e.g., intrinsic or evoked depolarization). The triggering event can emanate from the right atrium (RA) or the left atrium (LA). The single LV fusion pacing stimulus is delivered prior to the intrinsic depolarization of the RV—upon expiration of a “LEPARS interval”—thus efficiently providing intraventricular electromechanical synchrony by fusion. During variations in heart rate the operating AV interval (herein A-LVp interval) is varied while the LEPARS interval is substantially essentially constant, thereby preserving the enhanced hemodynamics resulting from the fusion depolarization.

Claims36

Dependent claims

A method of LV-only fusion pacing therapy delivery to a non-synchronous pair of ventricles, comprising:

a) measuring an intrinsic P-R cardiac interval for a right ventricular (RV) chamber for at least one prior cardiac cycle;
b) decrementing the P-R interval to derive a nominal A-LVp interval;
c) delivering an LV-only pacing therapy using the nominal A-LVp interval and
d) determining whether ventricular fusion resulted, and in the event that adequate ventricular fusion resulted, then:
i) measuring a left ventricular pacing, right ventricular sensing (LEPARS) interval by the amount of time elapsed between the delivery of the LV-only pacing therapy and a subsequent sensed depolarization of the RV;
and
ii) delivering during a subsequent cardiac cycle at least one LV-only pacing therapy pulse to a left ventricular (LV) chamber, wherein said at least one LV-only pacing therapy pulse is delivered at the expiration of an A-LVp interval that preserves heart rate response requirements and substantially preserves the LEPARS interval;
and
in the event that ventricular fusion failed to result, then:
modifying the A-LVp interval and repeating step c) through step d) above wherein the modified A-LVp interval is implemented in lieu of the nominal A-LVp interval.

7 more elements

Dependencies are inferred from the claim text.

Apparatus and method for “LEPARS” interval-based fusion pacing

Life of this patent

Apparatus and method for “LEPARS” interval-based fusion pacing

Life of this patent

Abstract

Claims36