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:
- sensing circuitry for sensing cardiac electrical activity;
- pulse generation circuitry for generating pacing pulses and shock pulses;
- a controller for controlling the operation of the device;
- a switching network operable by the controller for connecting the pulse generation circuitry and sensing circuitry to selected electrodes in order to configure selected sensing and pacing channels
- wherein the controller is programmed to:
- configure a sensing channel for detecting the presence of a ventricular tachyarrhythmia and configure sensing/pacing channels for delivering biventricular pacing therapy and sensing ventricular depolarizations (R waves);
- 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:
- sensing circuitry for sensing cardiac electrical activity;
- pulse generation circuitry for generating pacing pulses and shock pulses;
- a controller for controlling the operation of the device;
- a switching network operable by the controller for connecting the pulse generation circuitry and sensing circuitry to selected electrodes in order to configure selected sensing and pacing channels
- wherein the controller is programmed to:
- configure a sensing channel for detecting the presence of a ventricular tachyarrhythmia and configure sensing/pacing channels for delivering a first and a second type of ventricular pacing, wherein QRS dispersion resulting from the first type of ventricular pacing is greater than QRS dispersion resulting from the second type of ventricular pacing;
- deliver a first type of ventricular pacing while no ventricular tachyarrhythmia is detected;
- deliver a second type of ventricular pacing while a ventricular tachyarrhythmia is detected;
- and,
- deliver 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.