IMPLANTABLE CARDIAC RESYNCHRONIZER WITH BIVENTRICULAR PACING AND DETECTION OF LOSS OF CAPTURE AND ANODAL STIMULATION

摘要

A medical device for stimulating the heart using biventricular stimulation. The device includes a sensor for detecting an endocardial acceleration parameter and a processing circuit configured to receive the endocardial acceleration parameter. The device further includes stimulation electronics coupled to the processing circuit. The processing circuit is configured to use the EA parameter to evaluate the biventricular stimulation. The evaluation includes comparing the value of the EA parameter in biventricular mode to the value of the EA parameter in left only mode or right only mode, and using the comparison and an assessment of the variability of the EA parameter as a function of the AVD in the left or right mode to distinguish between cases comprising: (a) normal operation, (b) a loss of RV or LV capture, (c) possible anodal stimulation. The processing circuit is further configured to conduct at least one update to operational parameters of the device based on the determined case.

主权项

1. An method for an active implantable medical device that provides cardiac resynchronization by biventricular pacing, comprising:
detecting atrial and ventricular events; stimulating a right ventricle and a left ventricle; selectively operating the stimulation in either a right only mode wherein only the right ventricle is paced, a left only mode wherein only the left ventricle is stimulated, or in a biventricular mode wherein both ventricles are stimulated together; using a sensor coupled to processing circuitry to provide an endocardial acceleration (EA) signal; extracting, from the EA signal, at least one predetermined EA parameter; using the EA parameter to evaluate the biventricular mode stimulation, the evaluation comprising comparin1 values of the EA parameter in the biventricular mode to the values of the EA parameter in at least one of the left only mode or the right only mode to distinguish between: (a) normal operation, (b) a loss of a right ventricular capture or a left ventricular capture, and (c) possible anodal stimulation; and conducting at least one update to operational parameters of the device based on the determined case.