Criteria for optimal electrical resynchronization during fusion pacing

摘要

Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate.

主权项

1. A method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:
a) pacing a left ventricular electrode using a first A-V delay; b) measuring activation times at other ones of the left ventricular electrodes and at one or more right ventricular electrodes in response to pacing the left ventricular electrode; c) determining a weighted fusion index associated with the first A-V delay; d) pacing the left ventricular electrode using a second A-V delay; e) measuring activation times at other ones of the left ventricular electrodes and at the one or more right ventricular electrodes; f) determining a weighted fusion index for the second A-V delay; g) comparing weighted fusion indices for the first and the second A-V delays; and h) selecting an optimal A-V delay in response to comparing weighted fusion indices for the first and the second A-V delays, wherein the weighted fusion indices are determined using: FI(j,A)=ΣI=1nwLv(i,j)|LVAT(i,A)|+ΣI=1mwRV(i,j)|RVAT(i,A)|, wherein “n” is a total number of left ventricular electrodes, m is the total number of right ventricular electrodes, LVAT is left ventricular activation times, RVAT is right ventricular activation times, “i” is a nonpacing electrode and j represents the pacing electrode.