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US 8,301,253 B2Granted
Cardiac rhythm management system selecting between multiple same-chamber electrodes for delivering cardiac therapy
AssigneeCardiac Pacemakers, Inc.
InventorsJiang Ding, Julio C. Spinelli, Andrew P. Kramer
Life of this patent
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Abstract
A cardiac rhythm management system selects one of multiple electrodes associated with a particular heart chamber based on a relative timing between detection of a depolarization fiducial point at the multiple electrodes, or based on a delay between detection of a depolarization fiducial point at the multiple electrodes and detection of a reference depolarization fiducial point at another electrode associated with the same or a different heart chamber. Subsequent contraction-evoking stimulation therapy is delivered from the selected electrode.
Claims16
A method including:
- detecting, from one of first and second electrodes, each associated with a first heart chamber, a first fiducial point associated with a first heart depolarization of the first heart chamber;
- detecting, from the first electrode, a second fiducial point associated with the first heart depolarization;
- detecting, from the second electrode, a third fiducial point associated with the first heart depolarization;
- measuring a first time interval between the first and second fiducial points;
- measuring a second time interval between the first and third fiducial points;
- selecting the first electrode if the first time interval is longer than the second time interval, and selecting the second electrode if the second time interval is longer than the first time interval;
- and
- delivering from the selected electrode a subsequent stimulation for evoking a contraction of the first heart chamber.
5 more elements
A system including:
- a sensing circuit, configured to be coupled to first and second electrodes that are each associated with a first heart chamber, the sensing circuit configured to detect from one of the first and second electrodes a first fiducial point associated with a first heart depolarization of the first heart chamber, the sensing circuit configured to detect from the first electrode a second fiducial point associated with the first heart depolarization, the sensing circuit configured to detect from the second electrode a third fiducial point associated with the first heart depolarization of the first heart chamber;
- a timer, coupled to the sensing circuit, the timer configured to measure a first time interval between the first and second fiducial points, and configured to measure a second time interval between the first and third fiducial points;
- a therapy circuit, configured to deliver stimulations for evoking heart contractions from one of the first and second electrodes;
- and
- a controller, coupled to the timer, the controller configured to determine a selected electrode based on values of the first time interval and the second time interval and a selection of one of the first and second electrodes, the selection of one of the first and second electrodes including selecting the first electrode if the first time interval exceeds the second time interval and selecting the second electrode if the second time interval exceeds the first time interval, the controller configured to couple the therapy circuit to the selected electrode for delivering the stimulations.
2 more elements
A system including:
- a sensing circuit, configured to be coupled to first and second electrodes that are each associated with a first heart chamber selected from a group consisting of a left ventricle and a right ventricle, the sensing circuit configured to detect from one of the first and second electrodes a first fiducial point associated with a first heart depolarization of the first heart chamber, the sensing circuit configured to detect from the first electrode a second fiducial point associated with the first heart depolarization, the sensing circuit configured to detect from the second electrode a third fiducial point associated with the first heart depolarization of the first heart chamber;
- a timer, coupled to the sensing circuit, the timer configured to measure a first time interval between the first and second fiducial points, and the timer configured to measure a second time interval between the first and third fiducial points;
- a therapy circuit, configured to deliver stimulations for evoking heart contractions from one of the first and second electrodes;
- and
- a controller, coupled to the timer, the controller configured to select the first electrode if the first time interval exceeds the second time interval, the controller configured to select the second electrode if the second time interval exceeds the first time interval, the controller configured to select one of the first and second electrodes based on values of the first time interval and the second time interval, wherein the selection of one of the first and second electrodes includes the controller selecting the one of the first and second electrodes that is located closer to a heart apex if the first and second time intervals are substantially equal
- wherein the timer is configured to provide, over a plurality of cardiac cycles, a plurality of first and second time intervals, and the controller is configured to compute a first statistic associated with the plurality of first time intervals and a second statistic associated with the plurality of second time intervals, wherein the selection of one of the first and second electrodes includes the controller selecting the one of the first and second electrodes based on a difference between the first and second statistics if the first and second time intervals are not substantially equal, wherein the controller is configured to select the first electrode if the first time interval is statistically longer than the second time interval, and to select the second electrode if the second time interval is statistically longer than the first time interval;
- and
- wherein the controller is configured to couple the therapy circuit to the selected one of the first and second electrodes for delivering the stimulations.
5 more elements
Dependencies are inferred from the claim text.