Pacemaker with av interval optimization

Details Pacemaker with av interval optimization Pacemaker with av interval optimization

A - Human Necessities

61

N

A61N 1/368 (2006.01) A61N 1/362 (2006.01)

Patent

CA 2514259

A system and method for use in an implanted cardiac pacing device, whereby an optimal AV delay is determined at or near lower rate (pacing) limit (LRL) by determining measuring the variance, or instability, of the QT interval for a set of intervals. In one embodiment, asynchronous "LRL pacing" with a first programmed AV delay determines a measure of QT variance. The difference between the maximum QT and the minimum QT is expressed as QTdifference (QTD). For each programmed AV delay the QT variance is again measured and the optimal AV delay produces minimum QTD. In another embodiment, AV delay is modulated around base values for a time. The difference between QT for the modulated AV and for the base AV (dQT) is measured at each base value, and the optimal AV delay corresponds to the smallest dQT.

L'invention concerne un système et un procédé utilisés dans un dispositif de stimulation cardiaque implanté, un retard optimal AV étant déterminé au niveau ou à proximité d'une limite de cadence de stimulation (LRL) par mesure de l'écart ou de l'instabilité de l'intervalle QT pour un ensemble d'intervalles. Dans un mode de réalisation, la stimulation asynchrone LRL au moyen d'un premier retard AV programmé permet de déterminer une mesure d'écart QT. La différence entre QT maximum et QT minimum est exprimée comme une différence QT (QTD). Pour chaque retard AV programmé, on mesure à nouveau l'écart QT, et le retard AV optimal produit un QTD minimum. Dans un autre mode de réalisation, un retard AV est modulé autour de valeurs de base pour une durée. La différence QT entre AV modulé et AV de base (dQT) est mesurée à chaque valeur de base et le retard AV optimal correspond à la plus petite valeur dQT.

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