Method and apparatus for selective his bundle pacing
AssigneeCardiac Pacemakers, Inc.
InventorsAllan C. Shuros, Jiang Ding, Barun Maskara, Rodney W. Salo
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Abstract
A cardiac rhythm management system provides for cardiac pacing that is delivered to a target portion of conductive tissue in a heart, such as the His bundle. In various embodiments, the system is configured to verify capture of the target portion and provide for selective pacing of the target portion. In various embodiments, the system is configured to detect responses of the target portion and adjacent myocardial tissue to delivery of pacing pulses and use an outcome of the detection to verify selective capture of the target portion (i.e., without directly exciting the adjacent myocardial tissue.
Claims20
A system for pacing a heart having conduction tissue including a His bundle and myocardial tissue, comprising:
- a pacing output circuit configured to deliver cardiac pacing pulses to a target portion of the conductive tissue;
- a sensing circuit configured to sense one or more signals indicative of one or more responses of the heart to the delivery of each pulse of the cardiac pacing pulses;
- and
- a control circuit coupled to the pacing output circuit and the sensing circuit, the control circuit configured to control the delivery of the cardiac pacing pulses using pacing parameters and including:
- a capture verification circuit configured to perform a selective capture verification including detection of conductive tissue responses and myocardial responses using the sensed one or more signals, the conductive tissue responses each representative of excitation of the target portion of the conductive tissue directly resulting from the delivery of the each pulse, the myocardial responses each representative of excitation of portions of the myocardial tissue directly resulting from the delivery of the each pulse;
- and
- a parameter adjuster configured to adjust at least one parameter of the pacing parameters using an outcome of the selective capture verification such that the conductive tissue responses are detected and the myocardial responses are not detected.
A method for operating an implantable cardiac pacemaker configured to stimulate a heart having conductive tissue including a His bundle and myocardial tissue, comprising:
- delivering cardiac pacing pulses to a target portion of the conductive tissue from the implantable cardiac pacemaker;
- controlling the delivery of the cardiac pacing pulses using pacing parameters;
- sensing one or more signals indicative of one or more responses of the heart to the delivery of each pulse of the cardiac pacing pulses;
- performing a selective capture verification including:
- detecting conductive tissue responses using a first signal of the sensed one or more signals, the conductive tissue responses each representative of excitation of the target portion of the conductive tissue directly resulting from the delivery of the each pulse;
- and
- detecting myocardial responses using a second signal of the sensed one or more signals, the myocardial responses each representative of excitation of portions of the myocardial tissue directly resulting from the delivery of the each pulse;
- and
- adjusting at least one parameter of the pacing parameters using an outcome of the selective capture verification such that the conductive tissue responses are detected and the myocardial responses are not detected.
Dependencies are inferred from the claim text.