System and method for automated adjustment of cardiac resynchronization therapy control parameters

摘要

A system and method for cardiac resynchronization therapy in which pacing control parameters are automatically adjusted by comparison of local electrograms acquired by a cardiac implantable electrical device with a model of cardiac electrical activity derived from surface-lead electrocardiograph measurements under baseline and paced conditions is provided. The adjusted pacing control parameters guarantee substantially maximum evidence of ventricular activation wavefront fusion while reducing the risk of compromising diastolic function. Atrioventricular intervals (AVIs] are measured and utilized to constrain the adjustment of pacing control parameters such that diastolic dysfunctions are not induced in the patient's heart.

主权项

1. A cardiac implantable electrical device for delivering cardiac resynchronization therapy to a patient's heart, the cardiac implantable electrical device comprising:
an input for receiving signals indicative of cardiac electrical activity in the heart; an impulse delivery system for delivering electrical impulses to the heart in order to provide cardiac resynchronization therapy thereto; a memory for storing pacing control parameters and a model of global cardiac electrical activity derived from surface electrocardiograph signals; a processor in communication with the memory, the processor being configured to:
receive the received signals;compare the received signals with the stored model of global cardiac electrical activity that is derived from surface-lead electrocardiogram (ECG) measurements, wherein the comparison is made using a morphological framework that characterizes the received signals as surrogates for ECG measures of global cardiac electrical activity by deconstructing the ECG measures into waveform elements that are combinable into morphological patterns that are compared with the received signals;adjust the stored pacing control parameters based on the comparison of the received signals with the stored model of global cardiac electrical activity; andcommunicate with the impulse delivery system to provide cardiac resynchronization therapy to the heart in accordance with the received at least one of the stored pacing control parameters and adjusted pacing control parameters.