Active implantable medical device such as a pacemaker with anodal stimulation detection by vector cardiogram analysis

摘要

#CMT# #/CMT# The device has a stimulation circuit delivering electrical stimulation pulses using electrodes to be implanted in a heart chamber of a patient, and a circuit intended to collect electrogram (EGM) signals. The circuit detects anodal stimulation by collecting two distinct EGM signals to derive distinct temporal components (Vbip, Vuni), combining the temporal components to create a non-temporal two-dimensional (2D) vectogram representative of a cardiac cycle, and determining the presence or absence of anodal stimulation by analyzing the non-temporal 2D vectogram. #CMT#USE : #/CMT# Active implantable medical device i.e. pacemaker for cardiac resynchronization therapy in a patient. #CMT#ADVANTAGE : #/CMT# The device allows two EGM signals from the same cavity to be collected and combined to reduce the risk of erroneous diagnosis of presence/absence of anodal stimulation due to degraded EGM quality while enabling to correct EGM quality on one channel to compensate for degraded quality in another channel. The device allows simple and effective identification of cycles with anodal stimulation, without implementing complex technical morphological analysis of vectogram characteristic, or comparison of the characteristic to previously collected reference models requiring a regular update. #CMT#DESCRIPTION OF DRAWINGS : #/CMT# The drawing shows a schematic view of a bipolar lead implanted at the apex of the right ventricle of a heart. Vbip, Vuni : Temporal components 10 : Pulse generator 12 : Lead 14 : Right ventricle 30, 32 : Electrodes 34 : Left ventricle.