Post-MI pacing with autocapture function

摘要

A method and apparatus is described for preventing or reducing the ventricular remodeling that normally occurs after a myocardial infarction using pacing therapy. By pacing sites in proximity to the infarct with appropriately timed pacing pulses, the infarct region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the stimulus for remodeling. If capture by the pacing pulses is not being achieved, the device may be configured to change the pacing pulse energy and/or pacing site as appropriate.

主权项

1. A method for minimizing post-infarct ventricular remodeling, comprising:
identifying an infarct region in a ventricle; delivering pacing pulses to one or more sites in proximity to the infarct region; wherein the pacing pulses are delivered in a manner that pre-excites the site or sites in proximity to the infarct region relative to other areas of the ventricle; verifying whether or not the pacing pulses delivered to the one or more sites have achieved capture; adjusting the energy of the pacing pulses if capture is not being achieved; and, changing the pacing site if capture is not being achieved and if the pacing pulse energy cannot be increased sufficiently to achieve capture, wherein the pacing site is changed in accordance with an ordered list of available electrodes that lists the electrodes in an order of preferred use reflecting their proximity to the infarct region.