Systems and methods for determining ventricular pacing sites for use with multi-pole leads

摘要

Techniques are provided for use by implantable medical devices for controlling multi-site left ventricular (MSLV) pacing using a multi-pole left ventricular (LV) lead. In various examples, a reduced number of “V sense”, “RV pace”, and “LV pace” tests are performed to determine preferred or optimal interventricular pacing delays (VV) for use with MSLV pacing. Additionally, techniques are described for sorting the order by which LV sites are to be paced during MSLV pacing. Furthermore, techniques are described for detecting and addressing circumstances where AV/PV delays are longer than corresponding AR/PR delays during MSLV.

主权项

1. A method for controlling multi-site ventricular pacing for use by an implantable cardiac rhythm management device equipped with a multi-pole ventricular lead having a plurality of electrodes, the method comprising:
determining an interventricular conduction time delay value (Δ) for each of the plurality of electrodes of the multi-pole lead; determining preliminary multi-site interventricular pacing delays (VVT) for the plurality of electrodes of the multi-pole lead based, at least in part, on the multi-site interventricular conduction time delay values (Δ) determined for the electrodes; determining multi-site interelectrode pacing delays (IVV) for the plurality of electrodes of the multi-pole lead based on the preliminary interventricular pacing delays (VVT); determining an order by which the electrodes of the multi-pole lead are to be used to deliver a set of multi-site pacing pulses, with the order determined based on the interelectrode pacing time delays (IVV); and delivering multi-site ventricular pacing by delivering a set of pulses using the electrodes of the multi-pole lead in the determined order.