Method of optimizing cardiac resynchronization therapy using...

A - Human Necessities – 61 – N

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A61N 1/365 (2006.01) A61B 5/02 (2006.01)

Patent

CA 2533762

The present invention relates to monitoring septal wall motion of the atrial and/or ventricular chambers of a heart for optomizing cardiac pacing intervals based on signals derived from said wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e,g., suitably filter, rectify and/or integrate) motion signals to determine acceleration, velocity or displacement. During facing interval optimization the wall motion is measured for many facing intervals and the facing interval setting(s) that produve minimal wall motion are implemented for theraphy delivery. In addition, the present invention provides methods for periodically determining whether to cease or to resume delivery of a bi-ventricular pacing theraphy to a patient that may have experienced beneficial reverse remodeling of the heart.

L'invention concerne le contrôle du mouvement de paroi septale, interauriculaire et/ou interventriculaire, pour l'optimisation des intervalles du rythme cardiaque sur la base de signaux relatifs à ce mouvement. Au moins un dispositif de guidage médical est équipé d'un capteur de mouvement pouvant être couplé au tissu septal. Le dispositif reçoit et peut post-traiter (par exemple, filtrage approprié, rectification et/ou intégration) les signaux de mouvement pour déterminer l'accélération, la vitesse ou le déplacement. Durant l'optimisation des intervalles de rythme, on mesure le mouvement de paroi septale pour plusieurs intervalles de rythme, et la ou les valeurs d'intervalle induisant un mouvement de paroi minimum sont retenues pour la thérapie. Par ailleurs, l'invention concerne des procédés de détermination périodique, indiquant s'il faut cesser ou reprendre la thérapie de resynchronisation bi-ventriculaire sur un patient ayant éventuellement subi un remodelage cardiaque inverse bénéfique.

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