Implantable heart stimulator and method for trending analysis of ventricular activation time

摘要

Exemplary versions of the invention include methods and apparatuses for assessing ventricular activation time by determining a point in time t1 of an initial positive deflection on a far-field electrogram and a point in time t2 of a first peak of the negative deflection on a near-field electrogram of a same heart cycle. They also determine a time difference between points in time t1 and t2 said time difference representing the ventricular activation time. A progression of ventricular conduction disorders such as the left bundle branch block (LBBB) and the right bundle branch block (RBBB) can be monitored. Trending analysis of the ventricular activation time provides a means for monitoring the progression of ventricular conduction diseases.

主权项

1. An implantable heart stimulator including a housing, electronic circuitry, and a ventricular activation time trend analyzing unit, wherein:
a. the housing encloses the electronic circuitry and has an at least partially electrically conducting outer surface; b. the electronic circuitry is connected or can be connected to at least one electrode lead, the at least one electrode lead carrying at least two electrodes; and c. the electronic circuitry includes:
i. a far-field electrogram recording unit that is electrically connected or can be connected to the at least partially electrically conducting outer surface and to a first one of the at least two electrodes;ii. a near-field electrogram recording unit that is electrically connected or can be connected to at least two electrodes carried by the electrode lead; andiii. a ventricular activation time assessing unit that is operatively connected to the far-field electrogram recording unit and the near-field electrogram recording unit, the ventricular activation time assessing unit being configured to:
1) determine a point in time t1 of an initial positive deflection on a far-field electrogram and a point in time t2 of a first peak of the negative deflection on a near-field electrogram of a same heart cycle; and2) determine a time difference between points in time t1 and t2, the time difference representing a ventricular activation time; d. the ventricular activation time trend analyzing unit is:
i. at least indirectly connected to the ventricular activation time assessing unit, andii. configured to:
1) analyze a trend in ventricular activation time by comparing most recently measured ventricular activation time values with a moving average of the previously measured ventricular activation time values; and2) trigger a warning signal when an increase in ventricular activation time values is detected that exceeds a predefined threshold.